<a id="pl.1.3"></a><var>1.3</var>personal care assistance services;amending Minnesota Statutes 2008, sections <br/>
<a id="pl.1.4"></a><var>1.4</var>43A.318, subdivision 2; 144A.071, subdivision 4b; 144A.161, subdivision <br/>
<a id="pl.1.5"></a><var>1.5</var>1a; 245A.03, by adding a subdivision; 256B.0911, subdivision 4d; 256B.092, <br/>
<a id="pl.1.6"></a><var>1.6</var>subdivision 4d; 326B.43, subdivision 2; 626.557, subdivision 9a; Minnesota <br/>
<a id="pl.1.7"></a><var>1.7</var>Statutes 2009 Supplement, sections 144.0724, subdivision 11; 245A.03, <br/>
<a id="pl.1.8"></a><var>1.8</var>subdivision 7; 245A.11, subdivision 7b; 256B.0625, subdivision 19c; 256B.0651, <br/>
<a id="pl.1.9"></a><var>1.9</var>by adding a subdivision; 256B.0652, subdivision 6; 256B.0653, subdivision <br/>
<a id="pl.1.10"></a><var>1.10</var>3; 256B.0659, subdivisions 1, 3, 4, 10, 11, 13, 14, 18, 19, 20, 21, 24, 27, 30, <br/>
<a id="pl.1.11"></a><var>1.11</var>by adding a subdivision; 256B.0911, subdivisions 1a, 2b, 3a, 3b; 256D.44, <br/>
<a id="pl.1.12"></a><var>1.12</var>subdivision 5; Laws 2009, chapter 79, article 8, section 81; repealing Minnesota <br/>
<a id="pl.1.13"></a><var>1.13</var>Statutes 2008, section 256B.0919, subdivision 4.<br/>
<a id="pl.1.14"></a><var>1.14</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.1.0.0"></a>

<a id="bill.1.1.0"></a><a id="pl.1.17"></a><var>1.17</var>    Section 1. Minnesota Statutes 2008, section 43A.318, subdivision 2, is amended to <br/>
<a id="pl.1.18"></a><var>1.18</var>read:<br/>
<a id="pl.1.19"></a><var>1.19</var>    Subd. 2. <b>Program creation; general provisions.</b> (a) The commissioner may <br/>
<a id="pl.1.20"></a><var>1.20</var>administer a program to make long-term care coverage available to eligible persons. The <br/>
<a id="pl.1.21"></a><var>1.21</var>commissioner may determine the program's funding arrangements, request bids from <br/>
<a id="pl.1.22"></a><var>1.22</var>qualified vendors, and negotiate and enter into contracts with qualified vendors. Contracts <br/>
<a id="pl.1.23"></a><var>1.23</var>are not subject to the requirements of section 
         <statute_ref>16C.16</statute_ref> or 
         <statute_ref>16C.19</statute_ref>. Contracts must be for a <br/>
<a id="pl.1.24"></a><var>1.24</var>uniform term of at least one year, but may be made automatically renewable from term <br/>
<a id="pl.1.25"></a><var>1.25</var>to term in the absence of notice of termination by either party. The program may not be <br/>
<a id="pl.1.26"></a><var>1.26</var>self-insured until the commissioner has completed an actuarial study of the program and <br/>
<a id="pl.2.1"></a><var>2.1</var>reported the results of the study to the legislature and self-insurance has been specifically <br/>
<a id="pl.2.2"></a><var>2.2</var>authorized by law. <br/>
<a id="pl.2.3"></a><var>2.3</var>(b) The program may provide coverage for home, community, and institutional <br/>
<a id="pl.2.4"></a><var>2.4</var>long-term care and any other benefits as determined by the commissioner. Coverage is <br/>
<a id="pl.2.5"></a><var>2.5</var>optional. The enrolled eligible person must pay the full cost of the coverage.<br/>
<a id="pl.2.6"></a><var>2.6</var>(c) The commissioner shall promote activities that attempt to raise awareness of <br/>
<a id="pl.2.7"></a><var>2.7</var>the need for long-term care insurance among residents of the state and encourage the <br/>
<a id="pl.2.8"></a><var>2.8</var>increased prevalence of long-term care coverage. These activities must include the sharing <br/>
<a id="pl.2.9"></a><var>2.9</var>of knowledge gained in the development of the program.<br/>
<a id="pl.2.10"></a><var>2.10</var>(d) The commissioner may employ and contract with persons and other entities to <br/>
<a id="pl.2.11"></a><var>2.11</var>perform the duties under this section and may determine their duties and compensation <br/>
<a id="pl.2.12"></a><var>2.12</var>consistent with this chapter.<br/>
<a id="pl.2.13"></a><var>2.13</var>(e) The benefits provided under this section are not terms and conditions of <br/>
<a id="pl.2.14"></a><var>2.14</var>employment as defined under section 
         <statute_ref>179A.03, subdivision 19</statute_ref>, and are not subject to <br/>
<a id="pl.2.15"></a><var>2.15</var>collective bargaining. <br/>
<a id="pl.2.16"></a><var>2.16</var>(f) The commissioner shall establish underwriting criteria for entry of all eligible <br/>
<a id="pl.2.17"></a><var>2.17</var>persons into the program. Eligible persons who would be immediately eligible for benefits <br/>
<a id="pl.2.18"></a><var>2.18</var>may not enroll.<br/>
<a id="pl.2.19"></a><var>2.19</var>(g) Eligible persons who meet underwriting criteria may enroll in the program upon <br/>
<a id="pl.2.20"></a><var>2.20</var>hiring and at other times established by the commissioner.<br/>
<a id="pl.2.21"></a><var>2.21</var>(h) An eligible person enrolled in the program may continue to participate in the <br/>
<a id="pl.2.22"></a><var>2.22</var>program even if an event, such as termination of employment, changes the person's <br/>
<a id="pl.2.23"></a><var>2.23</var>employment status.<br/>
<a id="pl.2.24"></a><var>2.24</var>(i) Participating public employee pension plans and public employers may provide <br/>
<a id="pl.2.25"></a><var>2.25</var>automatic pension or payroll deduction for payment of long-term care insurance premiums <br/>
<a id="pl.2.26"></a><var>2.26</var>to qualified vendors contracted with under this section.<br/>
<a id="pl.2.27"></a><var>2.27</var>(j) The premium charged to program enrollees must include an administrative fee to <br/>
<a id="pl.2.28"></a><var>2.28</var>cover all program expenses incurred in addition to the cost of coverage. All fees collected <br/>
<a id="pl.2.29"></a><var>2.29</var>are appropriated to the commissioner for the purpose of administrating the program.<br/>
<a id="pl.2.30"></a><var>2.30</var>(k) Public employees of local units of government including but not limited to <br/>
<a id="pl.2.31"></a><var>2.31</var>townships, municipalities, cities, and counties may buy into the long-term care insurance <br/>
<a id="pl.2.32"></a><var>2.32</var>under this section.<br/>
<br/>
<a id="bill.1.2.0"></a><a id="pl.2.33"></a><var>2.33</var>    Sec. 2. Minnesota Statutes 2009 Supplement, section 144.0724, subdivision 11, <br/>
<a id="pl.2.34"></a><var>2.34</var>is amended to read:<br/>
<a id="pl.3.1"></a><var>3.1</var>    Subd. 11. <b>Nursing facility level of care.</b> (a) For purposes of medical assistance <br/>
<a id="pl.3.2"></a><var>3.2</var>payment of long-term care services, a recipient must be determined, using assessments <br/>
<a id="pl.3.3"></a><var>3.3</var>defined in subdivision 4, to meet one of the following nursing facility level of care criteria:<br/>
<a id="pl.3.4"></a><var>3.4</var>    (1) the person requires formal clinical monitoring at least once per day;<br/>
<a id="pl.3.5"></a><var>3.5</var>    (1) (2) the person needs the assistance of another person or constant supervision to <br/>
<a id="pl.3.6"></a><var>3.6</var>begin and complete at least four of the following activities of living: bathing, bed mobility, <br/>
<a id="pl.3.7"></a><var>3.7</var>dressing, eating, grooming, toileting, transferring, and walking; <br/>
<a id="pl.3.8"></a><var>3.8</var>    (2) (3) the person needs the assistance of another person or constant supervision <br/>
<a id="pl.3.9"></a><var>3.9</var>to begin and complete toileting, transferring, or positioning and the assistance cannot <br/>
<a id="pl.3.10"></a><var>3.10</var>be scheduled;<br/>
<a id="pl.3.11"></a><var>3.11</var>    (3) (4) the person has significant difficulty with memory, using information, daily <br/>
<a id="pl.3.12"></a><var>3.12</var>decision making, or behavioral needs that require intervention;<br/>
<a id="pl.3.13"></a><var>3.13</var>    (4) (5) the person has had a qualifying nursing facility stay of at least 90 days;<br/>
<a id="pl.3.14"></a><var>3.14</var>    (6) the person meets the nursing facility level of care criteria determined 90 days <br/>
<a id="pl.3.15"></a><var>3.15</var>after admission or on the first quarterly assessment after admission, whichever is later; or<br/>
<a id="pl.3.16"></a><var>3.16</var>    (5) (7) the person is determined to be at risk for nursing facility admission or <br/>
<a id="pl.3.17"></a><var>3.17</var>readmission through a face-to-face long-term care consultation assessment as specified <br/>
<a id="pl.3.18"></a><var>3.18</var>in section 
         <statute_ref>256B.0911, subdivision 3a</statute_ref>, 3b, or 4d, by a county, tribe, or managed care <br/>
<a id="pl.3.19"></a><var>3.19</var>organization under contract with the Department of Human Services. The person is <br/>
<a id="pl.3.20"></a><var>3.20</var>considered at risk under this clause if the person currently lives alone or will live alone <br/>
<a id="pl.3.21"></a><var>3.21</var>upon discharge and also meets one of the following criteria:<br/>
<a id="pl.3.22"></a><var>3.22</var>    (i) the person has experienced a fall resulting in a fracture;<br/>
<a id="pl.3.23"></a><var>3.23</var>    (ii) the person has been determined to be at risk of maltreatment or neglect, <br/>
<a id="pl.3.24"></a><var>3.24</var>including self-neglect; or<br/>
<a id="pl.3.25"></a><var>3.25</var>    (iii) the person has a sensory impairment that substantially impacts functional ability <br/>
<a id="pl.3.26"></a><var>3.26</var>and maintenance of a community residence.<br/>
<a id="pl.3.27"></a><var>3.27</var>    (b) The assessment used to establish medical assistance payment for nursing facility <br/>
<a id="pl.3.28"></a><var>3.28</var>services must be the most recent assessment performed under subdivision 4, paragraph <br/>
<a id="pl.3.29"></a><var>3.29</var>(b), that occurred no more than 90 calendar days before the effective date of medical <br/>
<a id="pl.3.30"></a><var>3.30</var>assistance eligibility for payment of long-term care services. In no case shall medical <br/>
<a id="pl.3.31"></a><var>3.31</var>assistance payment for long-term care services occur prior to the date of the determination <br/>
<a id="pl.3.32"></a><var>3.32</var>of nursing facility level of care.<br/>
<a id="pl.3.33"></a><var>3.33</var>    (c) The assessment used to establish medical assistance payment for long-term care <br/>
<a id="pl.3.34"></a><var>3.34</var>services provided under sections 
         <statute_ref>256B.0915</statute_ref> and 
         <statute_ref>256B.49</statute_ref> and alternative care payment <br/>
<a id="pl.3.35"></a><var>3.35</var>for services provided under section 
         <statute_ref>256B.0913</statute_ref> must be the most recent face-to-face <br/>
<a id="pl.3.36"></a><var>3.36</var>assessment performed under section 
         <statute_ref>256B.0911, subdivision 3a</statute_ref>, 3b, or 4d, that occurred <br/>
<a id="pl.4.1"></a><var>4.1</var>no more than 60 calendar days before the effective date of medical assistance eligibility <br/>
<a id="pl.4.2"></a><var>4.2</var>for payment of long-term care services.<br/>
<br/>
<a id="bill.1.3.0"></a><a id="pl.4.3"></a><var>4.3</var>    Sec. 3. Minnesota Statutes 2008, section 144A.071, subdivision 4b, is amended to read:<br/>
<a id="pl.4.4"></a><var>4.4</var>    Subd. 4b. <b>Licensed beds on layaway status.</b> A licensed and certified nursing <br/>
<a id="pl.4.5"></a><var>4.5</var>facility may lay away, upon prior written notice to the commissioner of health, up to 50 <br/>
<a id="pl.4.6"></a><var>4.6</var>percent of its licensed and certified beds. A nursing facility may not discharge a resident <br/>
<a id="pl.4.7"></a><var>4.7</var>in order to lay away a bed. Notice to the commissioner shall be given 60 days prior <br/>
<a id="pl.4.8"></a><var>4.8</var>to the effective date of the layaway. Beds on layaway shall have the same status as <br/>
<a id="pl.4.9"></a><var>4.9</var>voluntarily delicensed and decertified beds and shall not be subject to license fees and <br/>
<a id="pl.4.10"></a><var>4.10</var>license surcharge fees. In addition, beds on layaway may be removed from layaway at any <br/>
<a id="pl.4.11"></a><var>4.11</var>time on or after one year after the effective date of layaway in the facility of origin, with a <br/>
<a id="pl.4.12"></a><var>4.12</var>60-day notice to the commissioner. A nursing facility that removes beds from layaway <br/>
<a id="pl.4.13"></a><var>4.13</var>may not place beds on layaway status for one year after the effective date of the removal <br/>
<a id="pl.4.14"></a><var>4.14</var>from layaway. The commissioner may approve the immediate removal of beds from <br/>
<a id="pl.4.15"></a><var>4.15</var>layaway if necessary to provide access to those nursing home beds to residents relocated <br/>
<a id="pl.4.16"></a><var>4.16</var>from other nursing homes due to emergency situations or closure. In the event approval <br/>
<a id="pl.4.17"></a><var>4.17</var>is granted, the one-year restriction on placing beds on layaway after a removal of beds <br/>
<a id="pl.4.18"></a><var>4.18</var>from layaway shall not apply. Beds may remain on layaway for up to five ten years. The <br/>
<a id="pl.4.19"></a><var>4.19</var>commissioner may approve placing and removing beds on layaway at any time during <br/>
<a id="pl.4.20"></a><var>4.20</var>renovation or construction related to a moratorium project approved under this section <br/>
<a id="pl.4.21"></a><var>4.21</var>or section 
         <statute_ref>144A.073</statute_ref>. Nursing facilities are not required to comply with any licensure or <br/>
<a id="pl.4.22"></a><var>4.22</var>certification requirements for beds on layaway status.<br/>
<br/>
<a id="bill.1.4.0"></a><a id="pl.4.23"></a><var>4.23</var>    Sec. 4. Minnesota Statutes 2008, section 144A.161, subdivision 1a, is amended to read:<br/>
<a id="pl.4.24"></a><var>4.24</var>    Subd. 1a. <b>Scope.</b> Where a facility is undertaking closure, curtailment, reduction, or <br/>
<a id="pl.4.25"></a><var>4.25</var>change in operations, or where a housing with services unit registered under chapter 144D <br/>
<a id="pl.4.26"></a><var>4.26</var>is closed because the space that it occupies is being replaced by a nursing facility bed that <br/>
<a id="pl.4.27"></a><var>4.27</var>is being reactivated from layaway status, the facility and the county social services agency <br/>
<a id="pl.4.28"></a><var>4.28</var>must comply with the requirements of this section.<br/>
<br/>
<a id="bill.1.5.0"></a><a id="pl.4.29"></a><var>4.29</var>    Sec. 5. Minnesota Statutes 2009 Supplement, section 245A.03, subdivision 7, is <br/>
<a id="pl.4.30"></a><var>4.30</var>amended to read:<br/>
<a id="pl.4.31"></a><var>4.31</var>    Subd. 7. <b>Licensing moratorium.</b> (a) The commissioner shall not issue an <br/>
<a id="pl.4.32"></a><var>4.32</var>initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to <br/>
<a id="pl.4.33"></a><var>4.33</var>2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to <br/>
<a id="pl.5.1"></a><var>5.1</var>9555.6265, under this chapter for a physical location that will not be the primary residence <br/>
<a id="pl.5.2"></a><var>5.2</var>of the license holder for the entire period of licensure. If a license is issued during this <br/>
<a id="pl.5.3"></a><var>5.3</var>moratorium, and the license holder changes the license holder's primary residence away <br/>
<a id="pl.5.4"></a><var>5.4</var>from the physical location of the foster care license, the commissioner shall revoke the <br/>
<a id="pl.5.5"></a><var>5.5</var>license according to section 
         <statute_ref>245A.07</statute_ref>. Exceptions to the moratorium include:<br/>
<a id="pl.5.6"></a><var>5.6</var>(1) foster care settings that are required to be registered under chapter 144D;<br/>
<a id="pl.5.7"></a><var>5.7</var>(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, <br/>
<a id="pl.5.8"></a><var>5.8</var>and determined to be needed by the commissioner under paragraph (b);<br/>
<a id="pl.5.9"></a><var>5.9</var>(3) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.5.10"></a><var>5.10</var>paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;<br/>
<a id="pl.5.11"></a><var>5.11</var>(4) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.5.12"></a><var>5.12</var>paragraph (b) for persons requiring hospital level care; or<br/>
<a id="pl.5.13"></a><var>5.13</var>(5) new foster care licenses determined to be needed by the commissioner for the <br/>
<a id="pl.5.14"></a><var>5.14</var>transition of people from personal care assistance to the home and community-based <br/>
<a id="pl.5.15"></a><var>5.15</var>services. <br/>
<a id="pl.5.16"></a><var>5.16</var>(b) The commissioner shall determine the need for newly licensed foster care homes <br/>
<a id="pl.5.17"></a><var>5.17</var>as defined under this subdivision. As part of the determination, the commissioner shall <br/>
<a id="pl.5.18"></a><var>5.18</var>consider the availability of foster care capacity in the area in which the licensee seeks to <br/>
<a id="pl.5.19"></a><var>5.19</var>operate, and the recommendation of the local county board. The determination by the <br/>
<a id="pl.5.20"></a><var>5.20</var>commissioner must be final. A determination of need is not required for a change in <br/>
<a id="pl.5.21"></a><var>5.21</var>ownership at the same address.<br/>
<a id="pl.5.22"></a><var>5.22</var>    (c) Residential settings that would otherwise be subject to the moratorium established <br/>
<a id="pl.5.23"></a><var>5.23</var>in paragraph (a), that are in the process of receiving an adult or child foster care license as <br/>
<a id="pl.5.24"></a><var>5.24</var>of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult <br/>
<a id="pl.5.25"></a><var>5.25</var>or child foster care license. For this paragraph, all of the following conditions must be met <br/>
<a id="pl.5.26"></a><var>5.26</var>to be considered in the process of receiving an adult or child foster care license:<br/>
<a id="pl.5.27"></a><var>5.27</var>    (1) participants have made decisions to move into the residential setting, including <br/>
<a id="pl.5.28"></a><var>5.28</var>documentation in each participant's care plan;<br/>
<a id="pl.5.29"></a><var>5.29</var>    (2) the provider has purchased housing or has made a financial investment in the <br/>
<a id="pl.5.30"></a><var>5.30</var>property;<br/>
<a id="pl.5.31"></a><var>5.31</var>    (3) the lead agency has approved the plans, including costs for the residential setting <br/>
<a id="pl.5.32"></a><var>5.32</var>for each individual;<br/>
<a id="pl.5.33"></a><var>5.33</var>    (4) the completion of the licensing process, including all necessary inspections, is <br/>
<a id="pl.5.34"></a><var>5.34</var>the only remaining component prior to being able to provide services; and<br/>
<a id="pl.5.35"></a><var>5.35</var>    (5) the needs of the individuals cannot be met within the existing capacity in that <br/>
<a id="pl.5.36"></a><var>5.36</var>county.<br/>
<a id="pl.6.1"></a><var>6.1</var>To qualify for the process under this paragraph, the lead agency must submit <br/>
<a id="pl.6.2"></a><var>6.2</var>documentation to the commissioner by August 1, 2009, that all of the above criteria are <br/>
<a id="pl.6.3"></a><var>6.3</var>met.<br/>
<a id="pl.6.4"></a><var>6.4</var>(d) The commissioner shall study the effects of the license moratorium under this <br/>
<a id="pl.6.5"></a><var>6.5</var>subdivision and shall report back to the legislature by January 15, 2011. This study shall <br/>
<a id="pl.6.6"></a><var>6.6</var>include, but is not limited to the following:<br/>
<a id="pl.6.7"></a><var>6.7</var>(1) the overall capacity and utilization of foster care beds where the physical location <br/>
<a id="pl.6.8"></a><var>6.8</var>is not the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.6.9"></a><var>6.9</var>of the moratorium;<br/>
<a id="pl.6.10"></a><var>6.10</var>(2) the overall capacity and utilization of foster care beds where the physical <br/>
<a id="pl.6.11"></a><var>6.11</var>location is the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.6.12"></a><var>6.12</var>of the moratorium; and<br/>
<a id="pl.6.13"></a><var>6.13</var>(3) the number of licensed and occupied ICF/MR beds prior to and after <br/>
<a id="pl.6.14"></a><var>6.14</var>implementation of the moratorium.<br/>
<br/>
<a id="bill.1.6.0"></a><a id="pl.6.15"></a><var>6.15</var>    Sec. 6. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision <br/>
<a id="pl.6.16"></a><var>6.16</var>to read:<br/>
<a id="pl.6.17"></a><var>6.17</var>    Subd. 9. <b>Permitted services by an individual who is related.</b> Notwithstanding <br/>
<a id="pl.6.18"></a><var>6.18</var>subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a <br/>
<a id="pl.6.19"></a><var>6.19</var>person receiving supported living services may provide licensed services to that person if:<br/>
<a id="pl.6.20"></a><var>6.20</var>    (1) the person who receives supported living services received these services in a <br/>
<a id="pl.6.21"></a><var>6.21</var>residential site on July 1, 2005;<br/>
<a id="pl.6.22"></a><var>6.22</var>    (2) the services under clause (1) were provided in a corporate foster care setting for <br/>
<a id="pl.6.23"></a><var>6.23</var>adults and were funded by the developmental disabilities home and community-based <br/>
<a id="pl.6.24"></a><var>6.24</var>services waiver defined in section 256B.092;<br/>
<a id="pl.6.25"></a><var>6.25</var>    (3) the individual who is related obtains and maintains both a license under <br/>
<a id="pl.6.26"></a><var>6.26</var>chapter 245B and an adult foster care license under Minnesota Rules, parts 9555.5105 <br/>
<a id="pl.6.27"></a><var>6.27</var>to 9555.6265; and<br/>
<a id="pl.6.28"></a><var>6.28</var>    (4) the individual who is related is not the guardian of the person receiving supported <br/>
<a id="pl.6.29"></a><var>6.29</var>living services.<br/>
<a id="pl.6.30"></a><var>6.30</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.1.7.0"></a><a id="pl.6.31"></a><var>6.31</var>    Sec. 7. Minnesota Statutes 2009 Supplement, section 245A.11, subdivision 7b, is <br/>
<a id="pl.6.32"></a><var>6.32</var>amended to read:<br/>
<a id="pl.6.33"></a><var>6.33</var>    Subd. 7b. <b>Adult foster care data privacy and security.</b> (a) An adult foster <br/>
<a id="pl.6.34"></a><var>6.34</var>care license holder who creates, collects, records, maintains, stores, or discloses any <br/>
<a id="pl.7.1"></a><var>7.1</var>individually identifiable recipient data, whether in an electronic or any other format, <br/>
<a id="pl.7.2"></a><var>7.2</var>must comply with the privacy and security provisions of applicable privacy laws and <br/>
<a id="pl.7.3"></a><var>7.3</var>regulations, including:<br/>
<a id="pl.7.4"></a><var>7.4</var>(1) the federal Health Insurance Portability and Accountability Act of 1996 <br/>
<a id="pl.7.5"></a><var>7.5</var>(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, <br/>
<a id="pl.7.6"></a><var>7.6</var>title 45, part 160, and subparts A and E of part 164; and<br/>
<a id="pl.7.7"></a><var>7.7</var>(2) the Minnesota Government Data Practices Act as codified in chapter 13.<br/>
<a id="pl.7.8"></a><var>7.8</var>(b) For purposes of licensure, the license holder shall be monitored for compliance <br/>
<a id="pl.7.9"></a><var>7.9</var>with the following data privacy and security provisions:<br/>
<a id="pl.7.10"></a><var>7.10</var>(1) the license holder must control access to data on foster care recipients according <br/>
<a id="pl.7.11"></a><var>7.11</var>to the definitions of public and private data on individuals under section 
         <statute_ref>13.02</statute_ref>; <br/>
<a id="pl.7.12"></a><var>7.12</var>classification of the data on individuals as private under section 
         <statute_ref>13.46, subdivision 2</statute_ref>; <br/>
<a id="pl.7.13"></a><var>7.13</var>and control over the collection, storage, use, access, protection, and contracting related <br/>
<a id="pl.7.14"></a><var>7.14</var>to data according to section 
         <statute_ref>13.05</statute_ref>, in which the license holder is assigned the duties <br/>
<a id="pl.7.15"></a><var>7.15</var>of a government entity;<br/>
<a id="pl.7.16"></a><var>7.16</var>(2) the license holder must provide each foster care recipient with a notice that <br/>
<a id="pl.7.17"></a><var>7.17</var>meets the requirements under section 
         <statute_ref>13.04</statute_ref>, in which the license holder is assigned the <br/>
<a id="pl.7.18"></a><var>7.18</var>duties of the government entity, and that meets the requirements of Code of Federal <br/>
<a id="pl.7.19"></a><var>7.19</var>Regulations, title 45, part 
         <statute_ref>164.52</statute_ref>. The notice shall describe the purpose for collection of <br/>
<a id="pl.7.20"></a><var>7.20</var>the data, and to whom and why it may be disclosed pursuant to law. The notice must <br/>
<a id="pl.7.21"></a><var>7.21</var>inform the recipient that the license holder uses electronic monitoring and, if applicable, <br/>
<a id="pl.7.22"></a><var>7.22</var>that recording technology is used;<br/>
<a id="pl.7.23"></a><var>7.23</var>(3) the license holder must not install monitoring cameras in bathrooms;<br/>
<a id="pl.7.24"></a><var>7.24</var>(4) electronic monitoring cameras must not be concealed from the foster care <br/>
<a id="pl.7.25"></a><var>7.25</var>recipients; and<br/>
<a id="pl.7.26"></a><var>7.26</var>(5) electronic video and audio recordings of foster care recipients shall not be <br/>
<a id="pl.7.27"></a><var>7.27</var>stored by the license holder for more than five days unless: (i) a foster care recipient or <br/>
<a id="pl.7.28"></a><var>7.28</var>legal representative requests that the recording be held longer based on a specific report <br/>
<a id="pl.7.29"></a><var>7.29</var>of alleged maltreatment; or (ii) the recording captures an incident or event of alleged <br/>
<a id="pl.7.30"></a><var>7.30</var>maltreatment under section 626.556 or 626.557 or a crime under chapter 609. When <br/>
<a id="pl.7.31"></a><var>7.31</var>requested by a recipient or when a recording captures an incident or event of alleged <br/>
<a id="pl.7.32"></a><var>7.32</var>maltreatment or a crime, the license holder must maintain the recording in a secured area <br/>
<a id="pl.7.33"></a><var>7.33</var>for no longer than 30 days to give the investigating agency an opportunity to make a copy <br/>
<a id="pl.7.34"></a><var>7.34</var>of the recording. The investigating agency will maintain the electronic video or audio <br/>
<a id="pl.7.35"></a><var>7.35</var>recordings as required in section 626.557, subdivision 12b.<br/>
<a id="pl.8.1"></a><var>8.1</var>(c) The commissioner shall develop, and make available to license holders and <br/>
<a id="pl.8.2"></a><var>8.2</var>county licensing workers, a checklist of the data privacy provisions to be monitored <br/>
<a id="pl.8.3"></a><var>8.3</var>for purposes of licensure.<br/>
<br/>
<a id="bill.1.8.0"></a><a id="pl.8.4"></a><var>8.4</var>    Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 19c, <br/>
<a id="pl.8.5"></a><var>8.5</var>is amended to read:<br/>
<a id="pl.8.6"></a><var>8.6</var>    Subd. 19c. <b>Personal care.</b> Medical assistance covers personal care assistance <br/>
<a id="pl.8.7"></a><var>8.7</var>services provided by an individual who is qualified to provide the services according to <br/>
<a id="pl.8.8"></a><var>8.8</var>subdivision 19a and sections 
         <statute_ref>256B.0651</statute_ref> to 
         <statute_ref>256B.0656</statute_ref>, provided in accordance with a <br/>
<a id="pl.8.9"></a><var>8.9</var>plan, and supervised by a qualified professional.<br/>
<a id="pl.8.10"></a><var>8.10</var>"Qualified professional" means a mental health professional as defined in section 
         <statute_ref>245.462, <br/>
<a id="pl.8.11"></a><var>8.11</var>subdivision 18
         </statute_ref>, or 
         <statute_ref>245.4871, subdivision 27</statute_ref>; or a registered nurse as defined in sections <br/>
<statute_ref><a id="pl.8.12"></a><var>8.12</var>148.171
         </statute_ref> to 
         <statute_ref>148.285</statute_ref>, a licensed social worker as defined in section 
<statute_ref>148B.21</statute_ref> sections <br/>
<a id="pl.8.13"></a><var>8.13</var>148D.010 and 148D.055, or a qualified developmental disabilities specialist under section <br/>
<statute_ref><a id="pl.8.14"></a><var>8.14</var>245B.07, subdivision 4
         </statute_ref>. The qualified professional shall perform the duties required in <br/>
<a id="pl.8.15"></a><var>8.15</var>section 
         <statute_ref>256B.0659</statute_ref>.<br/>
<br/>
<a id="bill.1.9.0"></a><a id="pl.8.16"></a><var>8.16</var>    Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.0651, is amended by <br/>
<a id="pl.8.17"></a><var>8.17</var>adding a subdivision to read:<br/>
<a id="pl.8.18"></a><var>8.18</var>    Subd. 17. <b>Recipient protection.</b> (a) Providers of home care services must provide <br/>
<a id="pl.8.19"></a><var>8.19</var>each recipient with a copy of the home care bill of rights under section 144A.44 at <br/>
<a id="pl.8.20"></a><var>8.20</var>least 30 days prior to terminating services to a recipient, if the termination results from <br/>
<a id="pl.8.21"></a><var>8.21</var>provider sanctions under section 256B.064, such as a payment withhold, a suspension of <br/>
<a id="pl.8.22"></a><var>8.22</var>participation, or a termination of participation. If a home care provider determines it is <br/>
<a id="pl.8.23"></a><var>8.23</var>unable to continue providing services to a recipient, the provider must notify the recipient, <br/>
<a id="pl.8.24"></a><var>8.24</var>the recipient's responsible party, and the commissioner 30 days prior to terminating <br/>
<a id="pl.8.25"></a><var>8.25</var>services to the recipient because of an action under section 256B.064, and must assist the <br/>
<a id="pl.8.26"></a><var>8.26</var>commissioner and lead agency in supporting the recipient in transitioning to another <br/>
<a id="pl.8.27"></a><var>8.27</var>home care provider of the recipient's choice.<br/>
<a id="pl.8.28"></a><var>8.28</var>    (b) In the event of a payment withhold from a home care provider, a suspension of <br/>
<a id="pl.8.29"></a><var>8.29</var>participation, or a termination of participation of a home care provider under section <br/>
<a id="pl.8.30"></a><var>8.30</var>256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care <br/>
<a id="pl.8.31"></a><var>8.31</var>and the lead agencies for all recipients with active service agreements with the provider. <br/>
<a id="pl.8.32"></a><var>8.32</var>At the commissioner's request, the lead agencies must contact recipients to ensure that the <br/>
<a id="pl.8.33"></a><var>8.33</var>recipients are continuing to receive needed care, and that the recipients have been given <br/>
<a id="pl.8.34"></a><var>8.34</var>free choice of provider if they transfer to another home care provider. In addition, the <br/>
<a id="pl.9.1"></a><var>9.1</var>commissioner or the commissioner's delegate may directly notify recipients who receive <br/>
<a id="pl.9.2"></a><var>9.2</var>care from the provider that payments have been withheld or that the provider's participation <br/>
<a id="pl.9.3"></a><var>9.3</var>in medical assistance has been suspended or terminated, if the commissioner determines <br/>
<a id="pl.9.4"></a><var>9.4</var>that notification is necessary to protect the welfare of the recipients. For purposes of this <br/>
<a id="pl.9.5"></a><var>9.5</var>subdivision, "lead agencies" means counties, tribes, and managed care organizations.<br/>
<br/>
<a id="bill.1.10.0"></a><a id="pl.9.6"></a><var>9.6</var>    Sec. 10. Minnesota Statutes 2009 Supplement, section 256B.0652, subdivision 6, <br/>
<a id="pl.9.7"></a><var>9.7</var>is amended to read:<br/>
<a id="pl.9.8"></a><var>9.8</var>    Subd. 6. <b> Authorization; personal care assistance and qualified professional.</b><br/>
<a id="pl.9.9"></a><var>9.9</var>    (a) All personal care assistance services, supervision by a qualified professional, and <br/>
<a id="pl.9.10"></a><var>9.10</var>additional services beyond the limits established in 
         <statute_ref>subdivision 11</statute_ref>, must be authorized <br/>
<a id="pl.9.11"></a><var>9.11</var>by the commissioner or the commissioner's designee before services begin except for the <br/>
<a id="pl.9.12"></a><var>9.12</var>assessments established in 
         <statute_ref>subdivision 11 and section 256B.0911</statute_ref>. The authorization for <br/>
<a id="pl.9.13"></a><var>9.13</var>personal care assistance and qualified professional services under section 
         <statute_ref>256B.0659</statute_ref> must <br/>
<a id="pl.9.14"></a><var>9.14</var>be completed within 30 days after receiving a complete request.<br/>
<a id="pl.9.15"></a><var>9.15</var>    (b) The amount of personal care assistance services authorized must be based <br/>
<a id="pl.9.16"></a><var>9.16</var>on the recipient's home care rating. The home care rating shall be determined by the <br/>
<a id="pl.9.17"></a><var>9.17</var>commissioner or the commissioner's designee based on information submitted to the <br/>
<a id="pl.9.18"></a><var>9.18</var>commissioner identifying the following:<br/>
<a id="pl.9.19"></a><var>9.19</var>    (1) total number of dependencies of activities of daily living as defined in section <br/>
<statute_ref><a id="pl.9.20"></a><var>9.20</var>256B.0659
         </statute_ref>;<br/>
<a id="pl.9.21"></a><var>9.21</var>    (2) number presence of complex health-related needs as defined in section <br/>
<statute_ref><a id="pl.9.22"></a><var>9.22</var>256B.0659
         </statute_ref>; and<br/>
<a id="pl.9.23"></a><var>9.23</var>    (3) number presence of Level I behavior descriptions as defined in section <br/>
<statute_ref><a id="pl.9.24"></a><var>9.24</var>256B.0659
         </statute_ref>.<br/>
<a id="pl.9.25"></a><var>9.25</var>    (c) The methodology to determine total time for personal care assistance services for <br/>
<a id="pl.9.26"></a><var>9.26</var>each home care rating is based on the median paid units per day for each home care rating <br/>
<a id="pl.9.27"></a><var>9.27</var>from fiscal year 2007 data for the personal care assistance program. Each home care rating <br/>
<a id="pl.9.28"></a><var>9.28</var>has a base level of hours assigned. Additional time is added through the assessment and <br/>
<a id="pl.9.29"></a><var>9.29</var>identification of the following:<br/>
<a id="pl.9.30"></a><var>9.30</var>    (1) 30 additional minutes per day for a dependency in each critical activity of daily <br/>
<a id="pl.9.31"></a><var>9.31</var>living as defined in section 
         <statute_ref>256B.0659</statute_ref>;<br/>
<a id="pl.9.32"></a><var>9.32</var>    (2) 30 additional minutes per day for each complex health-related function as <br/>
<a id="pl.9.33"></a><var>9.33</var>defined in section 
         <statute_ref>256B.0659</statute_ref>; and<br/>
<a id="pl.9.34"></a><var>9.34</var>    (3) 30 additional minutes per day for each behavior issue as defined in section <br/>
<statute_ref><a id="pl.9.35"></a><var>9.35</var>256B.0659, subdivision 4, paragraph (d)
</statute_ref>.<br/>
<a id="pl.10.1"></a><var>10.1</var>    (d) A limit of 96 units of qualified professional supervision may be authorized for <br/>
<a id="pl.10.2"></a><var>10.2</var>each recipient receiving personal care assistance services. A request to the commissioner <br/>
<a id="pl.10.3"></a><var>10.3</var>to exceed this total in a calendar year must be requested by the personal care provider <br/>
<a id="pl.10.4"></a><var>10.4</var>agency on a form approved by the commissioner.<br/>
<br/>
<a id="bill.1.11.0"></a><a id="pl.10.5"></a><var>10.5</var>    Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 10, <br/>
<a id="pl.10.6"></a><var>10.6</var>is amended to read:<br/>
<a id="pl.10.7"></a><var>10.7</var>    Subd. 10. <b>Responsible party; duties; delegation.</b> (a) A responsible party shall <br/>
<a id="pl.10.8"></a><var>10.8</var>enter into a written agreement with a personal care assistance provider agency, on a form <br/>
<a id="pl.10.9"></a><var>10.9</var>determined by the commissioner, to perform the following duties:<br/>
<a id="pl.10.10"></a><var>10.10</var>    (1) be available while care is provided in a method agreed upon by the individual <br/>
<a id="pl.10.11"></a><var>10.11</var>or the individual's legal representative and documented in the recipient's personal care <br/>
<a id="pl.10.12"></a><var>10.12</var>assistance care plan;<br/>
<a id="pl.10.13"></a><var>10.13</var>    (2) monitor personal care assistance services to ensure the recipient's personal care <br/>
<a id="pl.10.14"></a><var>10.14</var>assistance care plan is being followed; and<br/>
<a id="pl.10.15"></a><var>10.15</var>    (3) review and sign personal care assistance time sheets after services are provided <br/>
<a id="pl.10.16"></a><var>10.16</var>to provide verification of the personal care assistance services.<br/>
<a id="pl.10.17"></a><var>10.17</var>Failure to provide the support required by the recipient must result in a referral to the <br/>
<a id="pl.10.18"></a><var>10.18</var>county common entry point.<br/>
<a id="pl.10.19"></a><var>10.19</var>    (b) Responsible parties who are parents of minors or guardians of minors or <br/>
<a id="pl.10.20"></a><var>10.20</var>incapacitated persons may delegate the responsibility to another adult who is not the <br/>
<a id="pl.10.21"></a><var>10.21</var>personal care assistant during a temporary absence of at least 24 hours but not more <br/>
<a id="pl.10.22"></a><var>10.22</var>than six months. The person delegated as a responsible party must be able to meet the <br/>
<a id="pl.10.23"></a><var>10.23</var>definition of the responsible party. The responsible party must ensure that the delegate <br/>
<a id="pl.10.24"></a><var>10.24</var>performs the functions of the responsible party, is identified at the time of the assessment, <br/>
<a id="pl.10.25"></a><var>10.25</var>and is listed on the personal care assistance care plan. The responsible party must <br/>
<a id="pl.10.26"></a><var>10.26</var>communicate to the personal care assistance provider agency about the need for a delegate <br/>
<a id="pl.10.27"></a><var>10.27</var>delegated responsible party, including the name of the delegated responsible party, dates <br/>
<a id="pl.10.28"></a><var>10.28</var>the delegated responsible party will be living with the recipient, and contact numbers.<br/>
<br/>
<a id="bill.1.12.0"></a><a id="pl.10.29"></a><var>10.29</var>    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, <br/>
<a id="pl.10.30"></a><var>10.30</var>is amended to read:<br/>
<a id="pl.10.31"></a><var>10.31</var>    Subd. 11. <b>Personal care assistant; requirements.</b> (a) A personal care assistant <br/>
<a id="pl.10.32"></a><var>10.32</var>must meet the following requirements:<br/>
<a id="pl.10.33"></a><var>10.33</var>    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years <br/>
<a id="pl.10.34"></a><var>10.34</var>of age with these additional requirements:<br/>
<a id="pl.11.1"></a><var>11.1</var>    (i) supervision by a qualified professional every 60 days; and<br/>
<a id="pl.11.2"></a><var>11.2</var>    (ii) employment by only one personal care assistance provider agency responsible <br/>
<a id="pl.11.3"></a><var>11.3</var>for compliance with current labor laws;<br/>
<a id="pl.11.4"></a><var>11.4</var>    (2) be employed by a personal care assistance provider agency;<br/>
<a id="pl.11.5"></a><var>11.5</var>    (3) enroll with the department as a personal care assistant after clearing a background <br/>
<a id="pl.11.6"></a><var>11.6</var>study. Except as provided in subdivision 11a, before a personal care assistant provides <br/>
<a id="pl.11.7"></a><var>11.7</var>services, the personal care assistance provider agency must initiate a background study on <br/>
<a id="pl.11.8"></a><var>11.8</var>the personal care assistant under chapter 245C, and the personal care assistance provider <br/>
<a id="pl.11.9"></a><var>11.9</var>agency must have received a notice from the commissioner that the personal care assistant <br/>
<a id="pl.11.10"></a><var>11.10</var>is:<br/>
<a id="pl.11.11"></a><var>11.11</var>    (i) not disqualified under section 
         <statute_ref>245C.14</statute_ref>; or<br/>
<a id="pl.11.12"></a><var>11.12</var>    (ii) is disqualified, but the personal care assistant has received a set aside of the <br/>
<a id="pl.11.13"></a><var>11.13</var>disqualification under section 
         <statute_ref>245C.22</statute_ref>;<br/>
<a id="pl.11.14"></a><var>11.14</var>    (4) be able to effectively communicate with the recipient and personal care <br/>
<a id="pl.11.15"></a><var>11.15</var>assistance provider agency;<br/>
<a id="pl.11.16"></a><var>11.16</var>    (5) be able to provide covered personal care assistance services according to the <br/>
<a id="pl.11.17"></a><var>11.17</var>recipient's personal care assistance care plan, respond appropriately to recipient needs, <br/>
<a id="pl.11.18"></a><var>11.18</var>and report changes in the recipient's condition to the supervising qualified professional <br/>
<a id="pl.11.19"></a><var>11.19</var>or physician;<br/>
<a id="pl.11.20"></a><var>11.20</var>    (6) not be a consumer of personal care assistance services;<br/>
<a id="pl.11.21"></a><var>11.21</var>    (7) maintain daily written records including, but not limited to, time sheets under <br/>
<a id="pl.11.22"></a><var>11.22</var>subdivision 12;<br/>
<a id="pl.11.23"></a><var>11.23</var>    (8) effective January 1, 2010, complete standardized training as determined by the <br/>
<a id="pl.11.24"></a><var>11.24</var>commissioner before completing enrollment. Personal care assistant training must include <br/>
<a id="pl.11.25"></a><var>11.25</var>successful completion of the following training components: basic first aid, vulnerable <br/>
<a id="pl.11.26"></a><var>11.26</var>adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of <br/>
<a id="pl.11.27"></a><var>11.27</var>personal care assistants including information about assistance with lifting and transfers <br/>
<a id="pl.11.28"></a><var>11.28</var>for recipients, emergency preparedness, orientation to positive behavioral practices, fraud <br/>
<a id="pl.11.29"></a><var>11.29</var>issues, and completion of time sheets. Upon completion of the training components, <br/>
<a id="pl.11.30"></a><var>11.30</var>the personal care assistant must demonstrate the competency to provide assistance to <br/>
<a id="pl.11.31"></a><var>11.31</var>recipients;<br/>
<a id="pl.11.32"></a><var>11.32</var>    (9) complete training and orientation on the needs of the recipient within the first <br/>
<a id="pl.11.33"></a><var>11.33</var>seven days after the services begin; and<br/>
<a id="pl.11.34"></a><var>11.34</var>    (10) be limited to providing and being paid for up to 310 hours per month of personal <br/>
<a id="pl.11.35"></a><var>11.35</var>care assistance services regardless of the number of recipients being served or the number <br/>
<a id="pl.11.36"></a><var>11.36</var>of personal care assistance provider agencies enrolled with.<br/>
<a id="pl.12.1"></a><var>12.1</var>    (b) A legal guardian may be a personal care assistant if the guardian is not being paid <br/>
<a id="pl.12.2"></a><var>12.2</var>for the guardian services and meets the criteria for personal care assistants in paragraph (a).<br/>
<a id="pl.12.3"></a><var>12.3</var>    (c) Effective January 1, 2010, persons who do not qualify as a personal care assistant <br/>
<a id="pl.12.4"></a><var>12.4</var>include parents and stepparents of minors, spouses, paid legal guardians, family foster <br/>
<a id="pl.12.5"></a><var>12.5</var>care providers, except as otherwise allowed in section 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>, or <br/>
<a id="pl.12.6"></a><var>12.6</var>staff of a residential setting.<br/>
<a id="pl.12.7"></a><var>12.7</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from July 1, 2009.<br/>
<br/>
<a id="bill.1.13.0"></a><a id="pl.12.8"></a><var>12.8</var>    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0659, is amended by <br/>
<a id="pl.12.9"></a><var>12.9</var>adding a subdivision to read:<br/>
<a id="pl.12.10"></a><var>12.10</var>    Subd. 11a. <b>Exception to personal care assistant; requirements.</b> The personal care <br/>
<a id="pl.12.11"></a><var>12.11</var>assistant for a recipient may be allowed to enroll with a different personal care assistant <br/>
<a id="pl.12.12"></a><var>12.12</var>provider agency upon initiation of a new background study according to chapter 245C, if <br/>
<a id="pl.12.13"></a><var>12.13</var>all of the following are met:<br/>
<a id="pl.12.14"></a><var>12.14</var>    (1) the commissioner determines that a change in enrollment or affiliation of the <br/>
<a id="pl.12.15"></a><var>12.15</var>personal care assistant is needed in order to ensure continuity of services and protect the <br/>
<a id="pl.12.16"></a><var>12.16</var>health and safety of the recipient;<br/>
<a id="pl.12.17"></a><var>12.17</var>    (2) the chosen agency has been continuously enrolled as a personal care assistance <br/>
<a id="pl.12.18"></a><var>12.18</var>provider agency for at least two years;<br/>
<a id="pl.12.19"></a><var>12.19</var>    (3) the recipient chooses to transfer to the personal care assistance provider agency;<br/>
<a id="pl.12.20"></a><var>12.20</var>    (4) the personal care assistant has been continuously enrolled with the former <br/>
<a id="pl.12.21"></a><var>12.21</var>personal care assistance provider agency since the last background study was completed; <br/>
<a id="pl.12.22"></a><var>12.22</var>and<br/>
<a id="pl.12.23"></a><var>12.23</var>    (5) the personal care assistant continues to meet requirements of subdivision 11, <br/>
<a id="pl.12.24"></a><var>12.24</var>excluding paragraph (a), clause (3).<br/>
<a id="pl.12.25"></a><var>12.25</var><b>EFFECTIVE DATE.</b>This section is effective retroactively from July 1, 2009.<br/>
<br/>
<a id="bill.1.14.0"></a><a id="pl.12.26"></a><var>12.26</var>    Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 13, <br/>
<a id="pl.12.27"></a><var>12.27</var>is amended to read:<br/>
<a id="pl.12.28"></a><var>12.28</var>    Subd. 13. <b>Qualified professional; qualifications.</b> (a) The qualified professional <br/>
<a id="pl.12.29"></a><var>12.29</var>must be employed by work for a personal care assistance provider agency and meet the <br/>
<a id="pl.12.30"></a><var>12.30</var>definition under section 
         <statute_ref>256B.0625, subdivision 19c</statute_ref>. Before a qualified professional <br/>
<a id="pl.12.31"></a><var>12.31</var>provides services, the personal care assistance provider agency must initiate a background <br/>
<a id="pl.12.32"></a><var>12.32</var>study on the qualified professional under chapter 245C, and the personal care assistance <br/>
<a id="pl.13.1"></a><var>13.1</var>provider agency must have received a notice from the commissioner that the qualified <br/>
<a id="pl.13.2"></a><var>13.2</var>professional:<br/>
<a id="pl.13.3"></a><var>13.3</var>    (1) is not disqualified under section 
         <statute_ref>245C.14</statute_ref>; or<br/>
<a id="pl.13.4"></a><var>13.4</var>    (2) is disqualified, but the qualified professional has received a set aside of the <br/>
<a id="pl.13.5"></a><var>13.5</var>disqualification under section 
         <statute_ref>245C.22</statute_ref>.<br/>
<a id="pl.13.6"></a><var>13.6</var>    (b) The qualified professional shall perform the duties of training, supervision, and <br/>
<a id="pl.13.7"></a><var>13.7</var>evaluation of the personal care assistance staff and evaluation of the effectiveness of <br/>
<a id="pl.13.8"></a><var>13.8</var>personal care assistance services. The qualified professional shall:<br/>
<a id="pl.13.9"></a><var>13.9</var>    (1) develop and monitor with the recipient a personal care assistance care plan based <br/>
<a id="pl.13.10"></a><var>13.10</var>on the service plan and individualized needs of the recipient;<br/>
<a id="pl.13.11"></a><var>13.11</var>    (2) develop and monitor with the recipient a monthly plan for the use of personal <br/>
<a id="pl.13.12"></a><var>13.12</var>care assistance services;<br/>
<a id="pl.13.13"></a><var>13.13</var>    (3) review documentation of personal care assistance services provided;<br/>
<a id="pl.13.14"></a><var>13.14</var>    (4) provide training and ensure competency for the personal care assistant in the <br/>
<a id="pl.13.15"></a><var>13.15</var>individual needs of the recipient; and<br/>
<a id="pl.13.16"></a><var>13.16</var>    (5) document all training, communication, evaluations, and needed actions to <br/>
<a id="pl.13.17"></a><var>13.17</var>improve performance of the personal care assistants.<br/>
<a id="pl.13.18"></a><var>13.18</var>    (c) Effective January 1, 2010, the qualified professional shall complete the provider <br/>
<a id="pl.13.19"></a><var>13.19</var>training with basic information about the personal care assistance program approved <br/>
<a id="pl.13.20"></a><var>13.20</var>by the commissioner within six months of the date hired by a personal care assistance <br/>
<a id="pl.13.21"></a><var>13.21</var>provider agency. Qualified professionals who have completed the required trainings <br/>
<a id="pl.13.22"></a><var>13.22</var>training as an employee with a worker from a personal care assistance provider agency do <br/>
<a id="pl.13.23"></a><var>13.23</var>not need to repeat the required trainings training if they are hired by another agency, if <br/>
<a id="pl.13.24"></a><var>13.24</var>they have completed the training within the last three years.<br/>
<br/>
<a id="bill.1.15.0"></a><a id="pl.13.25"></a><var>13.25</var>    Sec. 15. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 21, <br/>
<a id="pl.13.26"></a><var>13.26</var>is amended to read:<br/>
<a id="pl.13.27"></a><var>13.27</var>    Subd. 21. <b>Requirements for initial enrollment of personal care assistance </b><br/>
<a id="pl.13.28"></a><var>13.28</var><b>provider agencies.</b> (a) All personal care assistance provider agencies must provide, at the <br/>
<a id="pl.13.29"></a><var>13.29</var>time of enrollment as a personal care assistance provider agency in a format determined <br/>
<a id="pl.13.30"></a><var>13.30</var>by the commissioner, information and documentation that includes, but is not limited to, <br/>
<a id="pl.13.31"></a><var>13.31</var>the following:<br/>
<a id="pl.13.32"></a><var>13.32</var>    (1) the personal care assistance provider agency's current contact information <br/>
<a id="pl.13.33"></a><var>13.33</var>including address, telephone number, and e-mail address;<br/>
<a id="pl.13.34"></a><var>13.34</var>    (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the <br/>
<a id="pl.13.35"></a><var>13.35</var>provider's payments from Medicaid in the previous year, whichever is less;<br/>
<a id="pl.14.1"></a><var>14.1</var>    (3) proof of fidelity bond coverage in the amount of $20,000;<br/>
<a id="pl.14.2"></a><var>14.2</var>    (4) proof of workers' compensation insurance coverage;<br/>
<a id="pl.14.3"></a><var>14.3</var>    (5) proof of liability insurance;<br/>
<a id="pl.14.4"></a><var>14.4</var>    (5) (6) a description of the personal care assistance provider agency's organization <br/>
<a id="pl.14.5"></a><var>14.5</var>identifying the names of all owners, managing employees, staff, board of directors, and <br/>
<a id="pl.14.6"></a><var>14.6</var>the affiliations of the directors, owners, or staff to other service providers;<br/>
<a id="pl.14.7"></a><var>14.7</var>    (6) (7) a copy of the personal care assistance provider agency's written policies <br/>
<a id="pl.14.8"></a><var>14.8</var>and procedures including: hiring of employees; training requirements; service delivery; <br/>
<a id="pl.14.9"></a><var>14.9</var>and employee and consumer safety including process for notification and resolution <br/>
<a id="pl.14.10"></a><var>14.10</var>of consumer grievances, identification and prevention of communicable diseases, and <br/>
<a id="pl.14.11"></a><var>14.11</var>employee misconduct;<br/>
<a id="pl.14.12"></a><var>14.12</var>    (7) (8) copies of all other forms the personal care assistance provider agency uses in <br/>
<a id="pl.14.13"></a><var>14.13</var>the course of daily business including, but not limited to:<br/>
<a id="pl.14.14"></a><var>14.14</var>    (i) a copy of the personal care assistance provider agency's time sheet if the time <br/>
<a id="pl.14.15"></a><var>14.15</var>sheet varies from the standard time sheet for personal care assistance services approved <br/>
<a id="pl.14.16"></a><var>14.16</var>by the commissioner, and a letter requesting approval of the personal care assistance <br/>
<a id="pl.14.17"></a><var>14.17</var>provider agency's nonstandard time sheet;<br/>
<a id="pl.14.18"></a><var>14.18</var>    (ii) the personal care assistance provider agency's template for the personal care <br/>
<a id="pl.14.19"></a><var>14.19</var>assistance care plan; and<br/>
<a id="pl.14.20"></a><var>14.20</var>    (iii) the personal care assistance provider agency's template for the written <br/>
<a id="pl.14.21"></a><var>14.21</var>agreement in subdivision 20 for recipients using the personal care assistance choice <br/>
<a id="pl.14.22"></a><var>14.22</var>option, if applicable;<br/>
<a id="pl.14.23"></a><var>14.23</var>    (8) (9) a list of all trainings training and classes that the personal care assistance <br/>
<a id="pl.14.24"></a><var>14.24</var>provider agency requires of its staff providing personal care assistance services;<br/>
<a id="pl.14.25"></a><var>14.25</var>    (9) (10) documentation that the personal care assistance provider agency and staff <br/>
<a id="pl.14.26"></a><var>14.26</var>have successfully completed all the training required by this section;<br/>
<a id="pl.14.27"></a><var>14.27</var>    (10) (11) documentation of the agency's marketing practices;<br/>
<a id="pl.14.28"></a><var>14.28</var>    (11) (12) disclosure of ownership, leasing, or management of all residential <br/>
<a id="pl.14.29"></a><var>14.29</var>properties that is used or could be used for providing home care services; and<br/>
<a id="pl.14.30"></a><var>14.30</var>    (12) (13) documentation that the agency will use the following percentages of <br/>
<a id="pl.14.31"></a><var>14.31</var>revenue generated from the medical assistance rate paid for personal care assistance <br/>
<a id="pl.14.32"></a><var>14.32</var>services for employee personal care assistant wages and benefits: 72.5 percent of revenue <br/>
<a id="pl.14.33"></a><var>14.33</var>in the personal care assistance choice option and 72.5 percent of revenue from other <br/>
<a id="pl.14.34"></a><var>14.34</var>personal care assistance providers.<br/>
<a id="pl.14.35"></a><var>14.35</var>    (b) Personal care assistance provider agencies shall provide the information specified <br/>
<a id="pl.14.36"></a><var>14.36</var>in paragraph (a) to the commissioner at the time the personal care assistance provider <br/>
<a id="pl.15.1"></a><var>15.1</var>agency enrolls as a vendor or upon request from the commissioner. The commissioner <br/>
<a id="pl.15.2"></a><var>15.2</var>shall collect the information specified in paragraph (a) from all personal care assistance <br/>
<a id="pl.15.3"></a><var>15.3</var>providers beginning July 1, 2009.<br/>
<a id="pl.15.4"></a><var>15.4</var>    (c) All personal care assistance provider agencies shall complete mandatory training <br/>
<a id="pl.15.5"></a><var>15.5</var>as determined by the commissioner before enrollment as a provider. Personal care <br/>
<a id="pl.15.6"></a><var>15.6</var>assistance provider agencies are required to send all owners, qualified professionals <br/>
<a id="pl.15.7"></a><var>15.7</var>employed by the agency, and all other managing employees to the initial and subsequent <br/>
<a id="pl.15.8"></a><var>15.8</var>trainings training. Personal care assistance provider agency billing staff shall complete <br/>
<a id="pl.15.9"></a><var>15.9</var>training about personal care assistance program financial management. This training is <br/>
<a id="pl.15.10"></a><var>15.10</var>effective July 1, 2009. Any personal care assistance provider agency enrolled before that <br/>
<a id="pl.15.11"></a><var>15.11</var>date shall, if it has not already, complete the provider training within 18 months of July 1, <br/>
<a id="pl.15.12"></a><var>15.12</var>2009. Any new owners, new qualified professionals, and new managing employees are <br/>
<a id="pl.15.13"></a><var>15.13</var>required to complete mandatory training as a requisite of hiring.<br/>
<br/>
<a id="bill.1.16.0"></a><a id="pl.15.14"></a><var>15.14</var>    Sec. 16. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 30, <br/>
<a id="pl.15.15"></a><var>15.15</var>is amended to read:<br/>
<a id="pl.15.16"></a><var>15.16</var>    Subd. 30. <b>Notice of service changes to recipients.</b> The commissioner must provide:<br/>
<a id="pl.15.17"></a><var>15.17</var>    (1) by October 31, 2009, information to recipients likely to be affected that (i) <br/>
<a id="pl.15.18"></a><var>15.18</var>describes the changes to the personal care assistance program that may result in the <br/>
<a id="pl.15.19"></a><var>15.19</var>loss of access to personal care assistance services, and (ii) includes resources to obtain <br/>
<a id="pl.15.20"></a><var>15.20</var>further information; and<br/>
<a id="pl.15.21"></a><var>15.21</var>    (2) notice of changes in medical assistance home care personal care assistant services <br/>
<a id="pl.15.22"></a><var>15.22</var>to each affected recipient at least 30 days before the effective date of the change.<br/>
<a id="pl.15.23"></a><var>15.23</var>The notice shall include how to get further information on the changes, how to get help to <br/>
<a id="pl.15.24"></a><var>15.24</var>obtain other services, a list of community resources, and appeal rights. Notwithstanding <br/>
<a id="pl.15.25"></a><var>15.25</var>section 
         <statute_ref>256.045</statute_ref>, a recipient may request continued services pending appeal within the <br/>
<a id="pl.15.26"></a><var>15.26</var>time period allowed to request an appeal.<br/>
<br/>
<a id="bill.1.17.0"></a><a id="pl.15.27"></a><var>15.27</var>    Sec. 17. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a, <br/>
<a id="pl.15.28"></a><var>15.28</var>is amended to read:<br/>
<a id="pl.15.29"></a><var>15.29</var>    Subd. 1a. <b>Definitions.</b> For purposes of this section, the following definitions apply:<br/>
<a id="pl.15.30"></a><var>15.30</var>    (a) "Long-term care consultation services" means:<br/>
<a id="pl.15.31"></a><var>15.31</var>    (1) assistance in identifying services needed to maintain an individual in the most <br/>
<a id="pl.15.32"></a><var>15.32</var>inclusive environment;<br/>
<a id="pl.15.33"></a><var>15.33</var>    (2) providing recommendations on cost-effective community services that are <br/>
<a id="pl.15.34"></a><var>15.34</var>available to the individual;<br/>
<a id="pl.16.1"></a><var>16.1</var>    (3) development of an individual's person-centered community support plan;<br/>
<a id="pl.16.2"></a><var>16.2</var>    (4) providing information regarding eligibility for Minnesota health care programs;<br/>
<a id="pl.16.3"></a><var>16.3</var>    (5) face-to-face long-term care consultation assessments, which may be completed <br/>
<a id="pl.16.4"></a><var>16.4</var>in a hospital, nursing facility, intermediate care facility for persons with developmental <br/>
<a id="pl.16.5"></a><var>16.5</var>disabilities (ICF/DDs), regional treatment centers, or the person's current or planned <br/>
<a id="pl.16.6"></a><var>16.6</var>residence;<br/>
<a id="pl.16.7"></a><var>16.7</var>    (6) federally mandated screening to determine the need for a institutional level of <br/>
<a id="pl.16.8"></a><var>16.8</var>care under section 
         <statute_ref>256B.0911, subdivision 4</statute_ref>, paragraph (a);<br/>
<a id="pl.16.9"></a><var>16.9</var>    (7) determination of home and community-based waiver service eligibility including <br/>
<a id="pl.16.10"></a><var>16.10</var>level of care determination for individuals who need an institutional level of care as <br/>
<a id="pl.16.11"></a><var>16.11</var>defined under section 
         <statute_ref>144.0724, subdivision 11</statute_ref>, or 
         <statute_ref>256B.092</statute_ref>, service eligibility including <br/>
<a id="pl.16.12"></a><var>16.12</var>state plan home care services identified in section sections
<statute_ref>256B.0625, subdivisions 6</statute_ref>, <br/>
<a id="pl.16.13"></a><var>16.13</var>7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support plan <br/>
<a id="pl.16.14"></a><var>16.14</var>development with appropriate referrals, including the option for consumer-directed <br/>
<a id="pl.16.15"></a><var>16.15</var>community supports;<br/>
<a id="pl.16.16"></a><var>16.16</var>    (8) providing recommendations for nursing facility placement when there are no <br/>
<a id="pl.16.17"></a><var>16.17</var>cost-effective community services available; and<br/>
<a id="pl.16.18"></a><var>16.18</var>    (9) assistance to transition people back to community settings after facility <br/>
<a id="pl.16.19"></a><var>16.19</var>admission.<br/>
<a id="pl.16.20"></a><var>16.20</var>    (b) "Long-term care options counseling" means the services provided by the linkage <br/>
<a id="pl.16.21"></a><var>16.21</var>lines as mandated by sections 
         <statute_ref>256.01</statute_ref> and 
         <statute_ref>256.975, subdivision 7</statute_ref>, and also includes <br/>
<a id="pl.16.22"></a><var>16.22</var>telephone assistance and follow up once a long-term care consultation assessment has <br/>
<a id="pl.16.23"></a><var>16.23</var>been completed.<br/>
<a id="pl.16.24"></a><var>16.24</var>    (c) "Minnesota health care programs" means the medical assistance program under <br/>
<a id="pl.16.25"></a><var>16.25</var>chapter 256B and the alternative care program under section 
         <statute_ref>256B.0913</statute_ref>.<br/>
<a id="pl.16.26"></a><var>16.26</var>    (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health <br/>
<a id="pl.16.27"></a><var>16.27</var>plans administering long-term care consultation assessment and support planning services.<br/>
<br/>
<a id="bill.1.18.0"></a><a id="pl.16.28"></a><var>16.28</var>    Sec. 18. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 2b, <br/>
<a id="pl.16.29"></a><var>16.29</var>is amended to read:<br/>
<a id="pl.16.30"></a><var>16.30</var>    Subd. 2b. <b>Certified assessors.</b> (a) Beginning January 1, 2011, each lead agency <br/>
<a id="pl.16.31"></a><var>16.31</var>shall use certified assessors who have completed training and the certification processes <br/>
<a id="pl.16.32"></a><var>16.32</var>determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate <br/>
<a id="pl.16.33"></a><var>16.33</var>best practices in assessment and support planning including person-centered planning <br/>
<a id="pl.16.34"></a><var>16.34</var>principals and have a common set of skills that must ensure consistency and equitable <br/>
<a id="pl.16.35"></a><var>16.35</var>access to services statewide. Assessors must be part of a multidisciplinary team of <br/>
<a id="pl.17.1"></a><var>17.1</var>professionals that includes public health nurses, social workers, and other professionals <br/>
<a id="pl.17.2"></a><var>17.2</var>as defined in paragraph (b). For persons with complex health care needs, a public health <br/>
<a id="pl.17.3"></a><var>17.3</var>nurse or registered nurse from a multidisciplinary team must be consulted. A lead agency <br/>
<a id="pl.17.4"></a><var>17.4</var>may choose, according to departmental policies, to contract with a qualified, certified <br/>
<a id="pl.17.5"></a><var>17.5</var>assessor to conduct assessments and reassessments on behalf of the lead agency.<br/>
<a id="pl.17.6"></a><var>17.6</var>    (b) Certified assessors are persons with a minimum of a bachelor's degree in social <br/>
<a id="pl.17.7"></a><var>17.7</var>work, nursing with a public health nursing certificate, or other closely related field with at <br/>
<a id="pl.17.8"></a><var>17.8</var>least one year of home and community-based experience or a two-year registered nursing <br/>
<a id="pl.17.9"></a><var>17.9</var>degree with at least three years of home and community-based experience that have <br/>
<a id="pl.17.10"></a><var>17.10</var>received training and certification specific to assessment and consultation for long-term <br/>
<a id="pl.17.11"></a><var>17.11</var>care services in the state.<br/>
<br/>
<a id="bill.1.19.0"></a><a id="pl.17.12"></a><var>17.12</var>    Sec. 19. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3a, <br/>
<a id="pl.17.13"></a><var>17.13</var>is amended to read:<br/>
<a id="pl.17.14"></a><var>17.14</var>    Subd. 3a. <b>Assessment and support planning.</b> (a) Persons requesting assessment, <br/>
<a id="pl.17.15"></a><var>17.15</var>services planning, or other assistance intended to support community-based living, <br/>
<a id="pl.17.16"></a><var>17.16</var>including persons who need assessment in order to determine waiver or alternative care <br/>
<a id="pl.17.17"></a><var>17.17</var>program eligibility, must be visited by a long-term care consultation team within 15 <br/>
<a id="pl.17.18"></a><var>17.18</var>calendar days after the date on which an assessment was requested or recommended. After <br/>
<a id="pl.17.19"></a><var>17.19</var>January 1, 2011, these requirements also apply to personal care assistance services, private <br/>
<a id="pl.17.20"></a><var>17.20</var>duty nursing, and home health agency services, on timelines established in subdivision 5. <br/>
<a id="pl.17.21"></a><var>17.21</var>Face-to-face assessments must be conducted according to paragraphs (b) to (i).<br/>
<a id="pl.17.22"></a><var>17.22</var>    (b) The county may utilize a team of either the social worker or public health nurse, <br/>
<a id="pl.17.23"></a><var>17.23</var>or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the <br/>
<a id="pl.17.24"></a><var>17.24</var>assessment in a face-to-face interview. The consultation team members must confer <br/>
<a id="pl.17.25"></a><var>17.25</var>regarding the most appropriate care for each individual screened or assessed.<br/>
<a id="pl.17.26"></a><var>17.26</var>    (c) The assessment must be comprehensive and include a person-centered <br/>
<a id="pl.17.27"></a><var>17.27</var>assessment of the health, psychological, functional, environmental, and social needs of <br/>
<a id="pl.17.28"></a><var>17.28</var>referred individuals and provide information necessary to develop a support plan that <br/>
<a id="pl.17.29"></a><var>17.29</var>meets the consumers needs, using an assessment form provided by the commissioner.<br/>
<a id="pl.17.30"></a><var>17.30</var>    (d) The assessment must be conducted in a face-to-face interview with the person <br/>
<a id="pl.17.31"></a><var>17.31</var>being assessed and the person's legal representative, as required by legally executed <br/>
<a id="pl.17.32"></a><var>17.32</var>documents, and other individuals as requested by the person, who can provide information <br/>
<a id="pl.17.33"></a><var>17.33</var>on the needs, strengths, and preferences of the person necessary to develop a support plan <br/>
<a id="pl.17.34"></a><var>17.34</var>that ensures the person's health and safety, but who is not a provider of service or has any <br/>
<a id="pl.17.35"></a><var>17.35</var>financial interest in the provision of services.<br/>
<a id="pl.18.1"></a><var>18.1</var>    (e) The person, or the person's legal representative, must be provided with written <br/>
<a id="pl.18.2"></a><var>18.2</var>recommendations for community-based services, including consumer-directed options, <br/>
<a id="pl.18.3"></a><var>18.3</var>or institutional care that include documentation that the most cost-effective alternatives <br/>
<a id="pl.18.4"></a><var>18.4</var>available were offered to the individual. For purposes of this requirement, "cost-effective <br/>
<a id="pl.18.5"></a><var>18.5</var>alternatives" means community services and living arrangements that cost the same as or <br/>
<a id="pl.18.6"></a><var>18.6</var>less than institutional care.<br/>
<a id="pl.18.7"></a><var>18.7</var>    (f) If the person chooses to use community-based services, the person or the person's <br/>
<a id="pl.18.8"></a><var>18.8</var>legal representative must be provided with a written community support plan, regardless <br/>
<a id="pl.18.9"></a><var>18.9</var>of whether the individual is eligible for Minnesota health care programs. A person may <br/>
<a id="pl.18.10"></a><var>18.10</var>request assistance in identifying community supports without participating in a complete <br/>
<a id="pl.18.11"></a><var>18.11</var>assessment. Upon a request for assistance identifying community support, the person must <br/>
<a id="pl.18.12"></a><var>18.12</var>be transferred or referred to the services available under sections 
         <statute_ref>256.975, subdivision 7</statute_ref>, <br/>
<a id="pl.18.13"></a><var>18.13</var>and 
         <statute_ref>256.01</statute_ref>, subdivision 24, for telephone assistance and follow up.<br/>
<a id="pl.18.14"></a><var>18.14</var>    (g) The person has the right to make the final decision between institutional <br/>
<a id="pl.18.15"></a><var>18.15</var>placement and community placement after the recommendations have been provided, <br/>
<a id="pl.18.16"></a><var>18.16</var>except as provided in subdivision 4a, paragraph (c).<br/>
<a id="pl.18.17"></a><var>18.17</var>    (h) The team must give the person receiving assessment or support planning, or <br/>
<a id="pl.18.18"></a><var>18.18</var>the person's legal representative, materials, and forms supplied by the commissioner <br/>
<a id="pl.18.19"></a><var>18.19</var>containing the following information:<br/>
<a id="pl.18.20"></a><var>18.20</var>    (1) the need for and purpose of preadmission screening if the person selects nursing <br/>
<a id="pl.18.21"></a><var>18.21</var>facility placement;<br/>
<a id="pl.18.22"></a><var>18.22</var>    (2) the role of the long-term care consultation assessment and support planning in <br/>
<a id="pl.18.23"></a><var>18.23</var>waiver and alternative care program eligibility determination;<br/>
<a id="pl.18.24"></a><var>18.24</var>    (3) information about Minnesota health care programs;<br/>
<a id="pl.18.25"></a><var>18.25</var>    (4) the person's freedom to accept or reject the recommendations of the team;<br/>
<a id="pl.18.26"></a><var>18.26</var>    (5) the person's right to confidentiality under the Minnesota Government Data <br/>
<a id="pl.18.27"></a><var>18.27</var>Practices Act, chapter 13;<br/>
<a id="pl.18.28"></a><var>18.28</var>    (6) the long-term care consultant's decision regarding the person's need for <br/>
<a id="pl.18.29"></a><var>18.29</var>institutional level of care as determined under criteria established in section 
         <statute_ref>144.0724, <br/>
<a id="pl.18.30"></a><var>18.30</var>subdivision 11
         </statute_ref>, or 
         <statute_ref>256B.092</statute_ref>; and<br/>
<a id="pl.18.31"></a><var>18.31</var>    (7) the person's right to appeal the decision regarding the need for nursing facility <br/>
<a id="pl.18.32"></a><var>18.32</var>level of care or the county's final decisions regarding public programs eligibility according <br/>
<a id="pl.18.33"></a><var>18.33</var>to section 
         <statute_ref>256.045, subdivision 3</statute_ref>.<br/>
<a id="pl.18.34"></a><var>18.34</var>    (i) Face-to-face assessment completed as part of eligibility determination for <br/>
<a id="pl.18.35"></a><var>18.35</var>the alternative care, elderly waiver, community alternatives for disabled individuals, <br/>
<a id="pl.18.36"></a><var>18.36</var>community alternative care, and traumatic brain injury waiver programs under sections <br/>
<statute_ref><a id="pl.19.1"></a><var>19.1</var>256B.0915
         </statute_ref>, 
         <statute_ref>256B.0917</statute_ref>, and 
         <statute_ref>256B.49</statute_ref> is valid to establish service eligibility for no more <br/>
<a id="pl.19.2"></a><var>19.2</var>than 60 calendar days after the date of assessment. The effective eligibility start date <br/>
<a id="pl.19.3"></a><var>19.3</var>for these programs can never be prior to the date of assessment. If an assessment was <br/>
<a id="pl.19.4"></a><var>19.4</var>completed more than 60 days before the effective waiver or alternative care program <br/>
<a id="pl.19.5"></a><var>19.5</var>eligibility start date, assessment and support plan information must be updated in a <br/>
<a id="pl.19.6"></a><var>19.6</var>face-to-face visit and documented in the department's Medicaid Management Information <br/>
<a id="pl.19.7"></a><var>19.7</var>System (MMIS). The effective date of program eligibility in this case cannot be prior to <br/>
<a id="pl.19.8"></a><var>19.8</var>the date the updated assessment is completed.<br/>
<br/>
<a id="bill.1.20.0"></a><a id="pl.19.9"></a><var>19.9</var>    Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3b, <br/>
<a id="pl.19.10"></a><var>19.10</var>is amended to read:<br/>
<a id="pl.19.11"></a><var>19.11</var>    Subd. 3b. <b>Transition assistance.</b> (a) A long-term care consultation team shall <br/>
<a id="pl.19.12"></a><var>19.12</var>provide assistance to persons residing in a nursing facility, hospital, regional treatment <br/>
<a id="pl.19.13"></a><var>19.13</var>center, or intermediate care facility for persons with developmental disabilities who <br/>
<a id="pl.19.14"></a><var>19.14</var>request or are referred for assistance. Transition assistance must include assessment, <br/>
<a id="pl.19.15"></a><var>19.15</var>community support plan development, referrals to long-term care options counseling <br/>
<a id="pl.19.16"></a><var>19.16</var>under section 
         <statute_ref>256B.975, subdivision 10</statute_ref>, for community support plan implementation <br/>
<a id="pl.19.17"></a><var>19.17</var>and to Minnesota health care programs, including home and community-based waiver <br/>
<a id="pl.19.18"></a><var>19.18</var>services and consumer-directed options through the waivers, and referrals to programs <br/>
<a id="pl.19.19"></a><var>19.19</var>that provide assistance with housing. Transition assistance must also include information <br/>
<a id="pl.19.20"></a><var>19.20</var>about the Centers for Independent Living and the Senior LinkAge Line, and about other <br/>
<a id="pl.19.21"></a><var>19.21</var>organizations that can provide assistance with relocation efforts, and information about <br/>
<a id="pl.19.22"></a><var>19.22</var>contacting these organizations to obtain their assistance and support.<br/>
<a id="pl.19.23"></a><var>19.23</var>    (b) The county shall develop transition processes with institutional social workers <br/>
<a id="pl.19.24"></a><var>19.24</var>and discharge planners to ensure that:<br/>
<a id="pl.19.25"></a><var>19.25</var>    (1) persons admitted to facilities receive information about transition assistance <br/>
<a id="pl.19.26"></a><var>19.26</var>that is available;<br/>
<a id="pl.19.27"></a><var>19.27</var>    (2) the assessment is completed for persons within ten working days of the date of <br/>
<a id="pl.19.28"></a><var>19.28</var>request or recommendation for assessment; and<br/>
<a id="pl.19.29"></a><var>19.29</var>    (3) there is a plan for transition and follow-up for the individual's return to the <br/>
<a id="pl.19.30"></a><var>19.30</var>community. The plan must require notification of other local agencies when a person <br/>
<a id="pl.19.31"></a><var>19.31</var>who may require assistance is screened by one county for admission to a facility located <br/>
<a id="pl.19.32"></a><var>19.32</var>in another county.<br/>
<a id="pl.19.33"></a><var>19.33</var>    (c) If a person who is eligible for a Minnesota health care program is admitted to a <br/>
<a id="pl.19.34"></a><var>19.34</var>nursing facility, the nursing facility must include a consultation team member or the case <br/>
<a id="pl.19.35"></a><var>19.35</var>manager in the discharge planning process.<br/>
<br/>
<a id="bill.1.21.0"></a><a id="pl.20.1"></a><var>20.1</var>    Sec. 21. Minnesota Statutes 2008, section 256B.0911, subdivision 4d, is amended to <br/>
<a id="pl.20.2"></a><var>20.2</var>read:<br/>
<a id="pl.20.3"></a><var>20.3</var>    Subd. 4d. <b>Preadmission screening of individuals under 65 years of age.</b> (a) <br/>
<a id="pl.20.4"></a><var>20.4</var>It is the policy of the state of Minnesota to ensure that individuals with disabilities or <br/>
<a id="pl.20.5"></a><var>20.5</var>chronic illness are served in the most integrated setting appropriate to their needs and have <br/>
<a id="pl.20.6"></a><var>20.6</var>the necessary information to make informed choices about home and community-based <br/>
<a id="pl.20.7"></a><var>20.7</var>service options.<br/>
<a id="pl.20.8"></a><var>20.8</var>    (b) Individuals under 65 years of age who are admitted to a nursing facility from a <br/>
<a id="pl.20.9"></a><var>20.9</var>hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.<br/>
<a id="pl.20.10"></a><var>20.10</var>    (c) Individuals under 65 years of age who are admitted to nursing facilities with <br/>
<a id="pl.20.11"></a><var>20.11</var>only a telephone screening must receive a face-to-face assessment from the long-term <br/>
<a id="pl.20.12"></a><var>20.12</var>care consultation team member of the county in which the facility is located or from the <br/>
<a id="pl.20.13"></a><var>20.13</var>recipient's county case manager within 40 calendar days of admission.<br/>
<a id="pl.20.14"></a><var>20.14</var>    (d) Individuals under 65 years of age who are admitted to a nursing facility <br/>
<a id="pl.20.15"></a><var>20.15</var>without preadmission screening according to the exemption described in subdivision 4b, <br/>
<a id="pl.20.16"></a><var>20.16</var>paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive <br/>
<a id="pl.20.17"></a><var>20.17</var>a face-to-face assessment within 40 days of admission.<br/>
<a id="pl.20.18"></a><var>20.18</var>    (e) At the face-to-face assessment, the long-term care consultation team member or <br/>
<a id="pl.20.19"></a><var>20.19</var>county case manager must perform the activities required under subdivision 3b.<br/>
<a id="pl.20.20"></a><var>20.20</var>    (f) For individuals under 21 years of age, a screening interview which recommends <br/>
<a id="pl.20.21"></a><var>20.21</var>nursing facility admission must be face-to-face and approved by the commissioner before <br/>
<a id="pl.20.22"></a><var>20.22</var>the individual is admitted to the nursing facility.<br/>
<a id="pl.20.23"></a><var>20.23</var>    (g) In the event that an individual under 65 years of age is admitted to a nursing <br/>
<a id="pl.20.24"></a><var>20.24</var>facility on an emergency basis, the county must be notified of the admission on the <br/>
<a id="pl.20.25"></a><var>20.25</var>next working day, and a face-to-face assessment as described in paragraph (c) must be <br/>
<a id="pl.20.26"></a><var>20.26</var>conducted within 40 calendar days of admission.<br/>
<a id="pl.20.27"></a><var>20.27</var>    (h) At the face-to-face assessment, the long-term care consultation team member or <br/>
<a id="pl.20.28"></a><var>20.28</var>the case manager must present information about home and community-based options, <br/>
<a id="pl.20.29"></a><var>20.29</var>including consumer-directed options, so the individual can make informed choices. If the <br/>
<a id="pl.20.30"></a><var>20.30</var>individual chooses home and community-based services, the long-term care consultation <br/>
<a id="pl.20.31"></a><var>20.31</var>team member or case manager must complete a written relocation plan within 20 working <br/>
<a id="pl.20.32"></a><var>20.32</var>days of the visit. The plan shall describe the services needed to move out of the facility <br/>
<a id="pl.20.33"></a><var>20.33</var>and a time line for the move which is designed to ensure a smooth transition to the <br/>
<a id="pl.20.34"></a><var>20.34</var>individual's home and community.<br/>
<a id="pl.20.35"></a><var>20.35</var>    (i) An individual under 65 years of age residing in a nursing facility shall receive a <br/>
<a id="pl.20.36"></a><var>20.36</var>face-to-face assessment at least every 12 months to review the person's service choices <br/>
<a id="pl.21.1"></a><var>21.1</var>and available alternatives unless the individual indicates, in writing, that annual visits are <br/>
<a id="pl.21.2"></a><var>21.2</var>not desired. In this case, the individual must receive a face-to-face assessment at least <br/>
<a id="pl.21.3"></a><var>21.3</var>once every 36 months for the same purposes.<br/>
<a id="pl.21.4"></a><var>21.4</var>    (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay <br/>
<a id="pl.21.5"></a><var>21.5</var>county agencies directly for face-to-face assessments for individuals under 65 years of age <br/>
<a id="pl.21.6"></a><var>21.6</var>who are being considered for placement or residing in a nursing facility.<br/>
<br/>
<a id="bill.1.22.0"></a><a id="pl.21.7"></a><var>21.7</var>    Sec. 22. Minnesota Statutes 2009 Supplement, section 256D.44, subdivision 5, is <br/>
<a id="pl.21.8"></a><var>21.8</var>amended to read:<br/>
<a id="pl.21.9"></a><var>21.9</var>    Subd. 5. <b>Special needs.</b> In addition to the state standards of assistance established in <br/>
<a id="pl.21.10"></a><var>21.10</var>subdivisions 1 to 4, payments are allowed for the following special needs of recipients of <br/>
<a id="pl.21.11"></a><var>21.11</var>Minnesota supplemental aid who are not residents of a nursing home, a regional treatment <br/>
<a id="pl.21.12"></a><var>21.12</var>center, or a group residential housing facility.<br/>
<a id="pl.21.13"></a><var>21.13</var>    (a) The county agency shall pay a monthly allowance for medically prescribed <br/>
<a id="pl.21.14"></a><var>21.14</var>diets if the cost of those additional dietary needs cannot be met through some other <br/>
<a id="pl.21.15"></a><var>21.15</var>maintenance benefit. The need for special diets or dietary items must be prescribed by <br/>
<a id="pl.21.16"></a><var>21.16</var>a licensed physician. Costs for special diets shall be determined as percentages of the <br/>
<a id="pl.21.17"></a><var>21.17</var>allotment for a one-person household under the thrifty food plan as defined by the United <br/>
<a id="pl.21.18"></a><var>21.18</var>States Department of Agriculture. The types of diets and the percentages of the thrifty <br/>
<a id="pl.21.19"></a><var>21.19</var>food plan that are covered are as follows:<br/>
<a id="pl.21.20"></a><var>21.20</var>    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;<br/>
<a id="pl.21.21"></a><var>21.21</var>    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent <br/>
<a id="pl.21.22"></a><var>21.22</var>of thrifty food plan;<br/>
<a id="pl.21.23"></a><var>21.23</var>    (3) controlled protein diet, less than 40 grams and requires special products, 125 <br/>
<a id="pl.21.24"></a><var>21.24</var>percent of thrifty food plan;<br/>
<a id="pl.21.25"></a><var>21.25</var>    (4) low cholesterol diet, 25 percent of thrifty food plan;<br/>
<a id="pl.21.26"></a><var>21.26</var>    (5) high residue diet, 20 percent of thrifty food plan;<br/>
<a id="pl.21.27"></a><var>21.27</var>    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;<br/>
<a id="pl.21.28"></a><var>21.28</var>    (7) gluten-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.21.29"></a><var>21.29</var>    (8) lactose-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.21.30"></a><var>21.30</var>    (9) antidumping diet, 15 percent of thrifty food plan;<br/>
<a id="pl.21.31"></a><var>21.31</var>    (10) hypoglycemic diet, 15 percent of thrifty food plan; or<br/>
<a id="pl.21.32"></a><var>21.32</var>    (11) ketogenic diet, 25 percent of thrifty food plan.<br/>
<a id="pl.21.33"></a><var>21.33</var>    (b) Payment for nonrecurring special needs must be allowed for necessary home <br/>
<a id="pl.21.34"></a><var>21.34</var>repairs or necessary repairs or replacement of household furniture and appliances using <br/>
<a id="pl.22.1"></a><var>22.1</var>the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, <br/>
<a id="pl.22.2"></a><var>22.2</var>as long as other funding sources are not available.<br/>
<a id="pl.22.3"></a><var>22.3</var>    (c) A fee for guardian or conservator service is allowed at a reasonable rate <br/>
<a id="pl.22.4"></a><var>22.4</var>negotiated by the county or approved by the court. This rate shall not exceed five percent <br/>
<a id="pl.22.5"></a><var>22.5</var>of the assistance unit's gross monthly income up to a maximum of $100 per month. If the <br/>
<a id="pl.22.6"></a><var>22.6</var>guardian or conservator is a member of the county agency staff, no fee is allowed.<br/>
<a id="pl.22.7"></a><var>22.7</var>    (d) The county agency shall continue to pay a monthly allowance of $68 for <br/>
<a id="pl.22.8"></a><var>22.8</var>restaurant meals for a person who was receiving a restaurant meal allowance on June 1, <br/>
<a id="pl.22.9"></a><var>22.9</var>1990, and who eats two or more meals in a restaurant daily. The allowance must continue <br/>
<a id="pl.22.10"></a><var>22.10</var>until the person has not received Minnesota supplemental aid for one full calendar month <br/>
<a id="pl.22.11"></a><var>22.11</var>or until the person's living arrangement changes and the person no longer meets the criteria <br/>
<a id="pl.22.12"></a><var>22.12</var>for the restaurant meal allowance, whichever occurs first.<br/>
<a id="pl.22.13"></a><var>22.13</var>    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, <br/>
<a id="pl.22.14"></a><var>22.14</var>is allowed for representative payee services provided by an agency that meets the <br/>
<a id="pl.22.15"></a><var>22.15</var>requirements under SSI regulations to charge a fee for representative payee services. This <br/>
<a id="pl.22.16"></a><var>22.16</var>special need is available to all recipients of Minnesota supplemental aid regardless of <br/>
<a id="pl.22.17"></a><var>22.17</var>their living arrangement.<br/>
<a id="pl.22.18"></a><var>22.18</var>    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the <br/>
<a id="pl.22.19"></a><var>22.19</var>maximum allotment authorized by the federal Food Stamp Program for a single individual <br/>
<a id="pl.22.20"></a><var>22.20</var>which is in effect on the first day of July of each year will be added to the standards of <br/>
<a id="pl.22.21"></a><var>22.21</var>assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify <br/>
<a id="pl.22.22"></a><var>22.22</var>as shelter needy and are: (i) relocating from an institution, or an adult mental health <br/>
<a id="pl.22.23"></a><var>22.23</var>residential treatment program under section 
         <statute_ref>256B.0622</statute_ref>; (ii) eligible for the self-directed <br/>
<a id="pl.22.24"></a><var>22.24</var>supports option as defined under section 
         <statute_ref>256B.0657, subdivision 2</statute_ref>; or (iii) home and <br/>
<a id="pl.22.25"></a><var>22.25</var>community-based waiver recipients living in their own home or rented or leased apartment <br/>
<a id="pl.22.26"></a><var>22.26</var>which is not owned, operated, or controlled by a provider of service not related by blood <br/>
<a id="pl.22.27"></a><var>22.27</var>or marriage, unless allowed under paragraph (g).<br/>
<a id="pl.22.28"></a><var>22.28</var>    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the <br/>
<a id="pl.22.29"></a><var>22.29</var>shelter needy benefit under this paragraph is considered a household of one. An eligible <br/>
<a id="pl.22.30"></a><var>22.30</var>individual who receives this benefit prior to age 65 may continue to receive the benefit <br/>
<a id="pl.22.31"></a><var>22.31</var>after the age of 65.<br/>
<a id="pl.22.32"></a><var>22.32</var>    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that <br/>
<a id="pl.22.33"></a><var>22.33</var>exceed 40 percent of the assistance unit's gross income before the application of this <br/>
<a id="pl.22.34"></a><var>22.34</var>special needs standard. "Gross income" for the purposes of this section is the applicant's or <br/>
<a id="pl.22.35"></a><var>22.35</var>recipient's income as defined in section 
         <statute_ref>256D.35, subdivision 10</statute_ref>, or the standard specified <br/>
<a id="pl.22.36"></a><var>22.36</var>in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or <br/>
<a id="pl.23.1"></a><var>23.1</var>state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be <br/>
<a id="pl.23.2"></a><var>23.2</var>considered shelter needy for purposes of this paragraph.<br/>
<a id="pl.23.3"></a><var>23.3</var>(g) Notwithstanding this subdivision, to access housing and services as provided <br/>
<a id="pl.23.4"></a><var>23.4</var>in paragraph (f), the recipient may choose housing that may or may not be owned, <br/>
<a id="pl.23.5"></a><var>23.5</var>operated, or controlled by the recipient's service provider if the housing is located in a <br/>
<a id="pl.23.6"></a><var>23.6</var>multifamily building of six or more units.  In a multifamily building of four or more units, <br/>
<a id="pl.23.7"></a><var>23.7</var>the maximum number of units apartments that may be used by recipients of this program <br/>
<a id="pl.23.8"></a><var>23.8</var>shall be 50 percent of the units in a building. The department shall develop an exception <br/>
<a id="pl.23.9"></a><var>23.9</var>process to the 50 percent maximum. This paragraph expires on June 30, 2011 2012.<br/>
<br/>
<a id="bill.1.23.0"></a><a id="pl.23.10"></a><var>23.10</var>    Sec. 23. Minnesota Statutes 2008, section 326B.43, subdivision 2, is amended to read:<br/>
<a id="pl.23.11"></a><var>23.11</var>    Subd. 2.  <b>Agreement with municipality.</b> The commissioner may enter into an <br/>
<a id="pl.23.12"></a><var>23.12</var>agreement with a municipality, in which the municipality agrees to perform plan and <br/>
<a id="pl.23.13"></a><var>23.13</var>specification reviews required to be performed by the commissioner under Minnesota <br/>
<a id="pl.23.14"></a><var>23.14</var>Rules, part 4715.3130, if: <br/>
<a id="pl.23.15"></a><var>23.15</var>    (a) the municipality has adopted: <br/>
<a id="pl.23.16"></a><var>23.16</var>    (1) the plumbing code; <br/>
<a id="pl.23.17"></a><var>23.17</var>    (2) an ordinance that requires plumbing plans and specifications to be submitted to, <br/>
<a id="pl.23.18"></a><var>23.18</var>reviewed, and approved by the municipality, except as provided in paragraph (n); <br/>
<a id="pl.23.19"></a><var>23.19</var>    (3) an ordinance that authorizes the municipality to perform inspections required by <br/>
<a id="pl.23.20"></a><var>23.20</var>the plumbing code; and <br/>
<a id="pl.23.21"></a><var>23.21</var>    (4) an ordinance that authorizes the municipality to enforce the plumbing code in its <br/>
<a id="pl.23.22"></a><var>23.22</var>entirety, except as provided in paragraph (p); <br/>
<a id="pl.23.23"></a><var>23.23</var>    (b) the municipality agrees to review plumbing plans and specifications for all <br/>
<a id="pl.23.24"></a><var>23.24</var>construction for which the plumbing code requires the review of plumbing plans and <br/>
<a id="pl.23.25"></a><var>23.25</var>specifications, except as provided in paragraph (n); <br/>
<a id="pl.23.26"></a><var>23.26</var>    (c) the municipality agrees that, when it reviews plumbing plans and specifications <br/>
<a id="pl.23.27"></a><var>23.27</var>under paragraph (b), the review will: <br/>
<a id="pl.23.28"></a><var>23.28</var>    (1) reflect the degree to which the plans and specifications affect the public health <br/>
<a id="pl.23.29"></a><var>23.29</var>and conform to the provisions of the plumbing code; <br/>
<a id="pl.23.30"></a><var>23.30</var>    (2) ensure that there is no physical connection between water supply systems that <br/>
<a id="pl.23.31"></a><var>23.31</var>are safe for domestic use and those that are unsafe for domestic use; and <br/>
<a id="pl.23.32"></a><var>23.32</var>    (3) ensure that there is no apparatus through which unsafe water may be discharged <br/>
<a id="pl.23.33"></a><var>23.33</var>or drawn into a safe water supply system; <br/>
<a id="pl.24.1"></a><var>24.1</var>    (d) the municipality agrees to perform all inspections required by the plumbing <br/>
<a id="pl.24.2"></a><var>24.2</var>code in connection with projects for which the municipality reviews plumbing plans and <br/>
<a id="pl.24.3"></a><var>24.3</var>specifications under paragraph (b); <br/>
<a id="pl.24.4"></a><var>24.4</var>    (e) the commissioner determines that the individuals who will conduct the <br/>
<a id="pl.24.5"></a><var>24.5</var>inspections and the plumbing plan and specification reviews for the municipality do not <br/>
<a id="pl.24.6"></a><var>24.6</var>have any conflict of interest in conducting the inspections and the plan and specification <br/>
<a id="pl.24.7"></a><var>24.7</var>reviews; <br/>
<a id="pl.24.8"></a><var>24.8</var>    (f) individuals who will conduct the plumbing plan and specification reviews for <br/>
<a id="pl.24.9"></a><var>24.9</var>the municipality are: <br/>
<a id="pl.24.10"></a><var>24.10</var>    (1) licensed master plumbers; <br/>
<a id="pl.24.11"></a><var>24.11</var>    (2) licensed professional engineers; or <br/>
<a id="pl.24.12"></a><var>24.12</var>    (3) individuals who are working under the supervision of a licensed professional <br/>
<a id="pl.24.13"></a><var>24.13</var>engineer or licensed master plumber and who are licensed master or journeyman plumbers <br/>
<a id="pl.24.14"></a><var>24.14</var>or hold a postsecondary degree in engineering; <br/>
<a id="pl.24.15"></a><var>24.15</var>    (g) individuals who will conduct the plumbing plan and specification reviews for <br/>
<a id="pl.24.16"></a><var>24.16</var>the municipality have passed a competency assessment required by the commissioner to <br/>
<a id="pl.24.17"></a><var>24.17</var>assess the individual's competency at reviewing plumbing plans and specifications; <br/>
<a id="pl.24.18"></a><var>24.18</var>    (h) individuals who will conduct the plumbing inspections for the municipality <br/>
<a id="pl.24.19"></a><var>24.19</var>are licensed master or journeyman plumbers, or inspectors meeting the competency <br/>
<a id="pl.24.20"></a><var>24.20</var>requirements established in rules adopted under section 
         <statute_ref>326B.135</statute_ref>; <br/>
<a id="pl.24.21"></a><var>24.21</var>    (i) the municipality agrees to enforce in its entirety the plumbing code on all <br/>
<a id="pl.24.22"></a><var>24.22</var>projects, except as provided in paragraph (p); <br/>
<a id="pl.24.23"></a><var>24.23</var>    (j) the municipality agrees to keep official records of all documents received, <br/>
<a id="pl.24.24"></a><var>24.24</var>including plans, specifications, surveys, and plot plans, and of all plan reviews, permits <br/>
<a id="pl.24.25"></a><var>24.25</var>and certificates issued, reports of inspections, and notices issued in connection with <br/>
<a id="pl.24.26"></a><var>24.26</var>plumbing inspections and the review of plumbing plans and specifications; <br/>
<a id="pl.24.27"></a><var>24.27</var>    (k) the municipality agrees to maintain the records described in paragraph (j) in the <br/>
<a id="pl.24.28"></a><var>24.28</var>official records of the municipality for the period required for the retention of public <br/>
<a id="pl.24.29"></a><var>24.29</var>records under section 
         <statute_ref>138.17</statute_ref>, and shall make these records readily available for review at <br/>
<a id="pl.24.30"></a><var>24.30</var>the request of the commissioner; <br/>
<a id="pl.24.31"></a><var>24.31</var>    (l) the municipality and the commissioner agree that if at any time during the <br/>
<a id="pl.24.32"></a><var>24.32</var>agreement the municipality does not have in effect the plumbing code or any of ordinances <br/>
<a id="pl.24.33"></a><var>24.33</var>described in paragraph (a), or if the commissioner determines that the municipality is not <br/>
<a id="pl.24.34"></a><var>24.34</var>properly administering and enforcing the plumbing code or is otherwise not complying <br/>
<a id="pl.24.35"></a><var>24.35</var>with the agreement: <br/>
<a id="pl.25.1"></a><var>25.1</var>    (1) the commissioner may, effective 14 days after the municipality's receipt of <br/>
<a id="pl.25.2"></a><var>25.2</var>written notice, terminate the agreement; <br/>
<a id="pl.25.3"></a><var>25.3</var>    (2) the municipality may challenge the termination in a contested case before the <br/>
<a id="pl.25.4"></a><var>25.4</var>commissioner pursuant to the Administrative Procedure Act; and <br/>
<a id="pl.25.5"></a><var>25.5</var>    (3) while any challenge is pending under clause (2), the commissioner shall perform <br/>
<a id="pl.25.6"></a><var>25.6</var>plan and specification reviews within the municipality under Minnesota Rules, part <br/>
<a id="pl.25.7"></a><var>25.7</var>4715.3130; <br/>
<a id="pl.25.8"></a><var>25.8</var>    (m) the municipality and the commissioner agree that the municipality may terminate <br/>
<a id="pl.25.9"></a><var>25.9</var>the agreement with or without cause on 90 days' written notice to the commissioner; <br/>
<a id="pl.25.10"></a><var>25.10</var>    (n) the municipality and the commissioner agree that the municipality shall forward <br/>
<a id="pl.25.11"></a><var>25.11</var>to the state for review all plumbing plans and specifications for the following types of <br/>
<a id="pl.25.12"></a><var>25.12</var>projects within the municipality: <br/>
<a id="pl.25.13"></a><var>25.13</var>    (1) hospitals, nursing homes, supervised living facilities licensed for eight or <br/>
<a id="pl.25.14"></a><var>25.14</var>more individuals, and similar health-care-related facilities regulated by the Minnesota <br/>
<a id="pl.25.15"></a><var>25.15</var>Department of Health; <br/>
<a id="pl.25.16"></a><var>25.16</var>    (2) buildings owned by the federal or state government; and <br/>
<a id="pl.25.17"></a><var>25.17</var>    (3) projects of a special nature for which department review is requested by either <br/>
<a id="pl.25.18"></a><var>25.18</var>the municipality or the state; <br/>
<a id="pl.25.19"></a><var>25.19</var>    (o) where the municipality forwards to the state for review plumbing plans and <br/>
<a id="pl.25.20"></a><var>25.20</var>specifications, as provided in paragraph (n), the municipality shall not collect any fee for <br/>
<a id="pl.25.21"></a><var>25.21</var>plan review, and the commissioner shall collect all applicable fees for plan review; and <br/>
<a id="pl.25.22"></a><var>25.22</var>    (p) no municipality shall revoke, suspend, or place restrictions on any plumbing <br/>
<a id="pl.25.23"></a><var>25.23</var>license issued by the state. <br/>
<br/>
<a id="bill.1.24.0"></a><a id="pl.25.24"></a><var>25.24</var>    Sec. 24. Minnesota Statutes 2008, section 626.557, subdivision 9a, is amended to read:<br/>
<a id="pl.25.25"></a><var>25.25</var>    Subd. 9a. <b>Evaluation and referral of reports made to common entry point unit.</b><br/>
<a id="pl.25.26"></a><var>25.26</var>    The common entry point must screen the reports of alleged or suspected maltreatment for <br/>
<a id="pl.25.27"></a><var>25.27</var>immediate risk and make all necessary referrals as follows:<br/>
<a id="pl.25.28"></a><var>25.28</var>    (1) if the common entry point determines that there is an immediate need for <br/>
<a id="pl.25.29"></a><var>25.29</var>adult protective services, the common entry point agency shall immediately notify the <br/>
<a id="pl.25.30"></a><var>25.30</var>appropriate county agency;<br/>
<a id="pl.25.31"></a><var>25.31</var>    (2) if the report contains suspected criminal activity against a vulnerable adult, the <br/>
<a id="pl.25.32"></a><var>25.32</var>common entry point shall immediately notify the appropriate law enforcement agency;<br/>
<a id="pl.25.33"></a><var>25.33</var>    (3) if the report references alleged or suspected maltreatment and there is no <br/>
<a id="pl.25.34"></a><var>25.34</var>immediate need for adult protective services, the common entry point shall notify refer all <br/>
<a id="pl.26.1"></a><var>26.1</var>reports of alleged or suspected maltreatment to the appropriate lead agency as soon as <br/>
<a id="pl.26.2"></a><var>26.2</var>possible, but in any event no longer than two working days; and<br/>
<a id="pl.26.3"></a><var>26.3</var>    (4) if the report does not reference alleged or suspected maltreatment, the common <br/>
<a id="pl.26.4"></a><var>26.4</var>entry point may determine whether the information will be referred; and<br/>
<a id="pl.26.5"></a><var>26.5</var>    (5) (4) if the report contains information about a suspicious death, the common entry <br/>
<a id="pl.26.6"></a><var>26.6</var>point shall immediately notify the appropriate law enforcement agencies, the local medical <br/>
<a id="pl.26.7"></a><var>26.7</var>examiner, and the ombudsman established under section 
         <statute_ref>245.92</statute_ref>. Law enforcement <br/>
<a id="pl.26.8"></a><var>26.8</var>agencies shall coordinate with the local medical examiner and the ombudsman as provided <br/>
<a id="pl.26.9"></a><var>26.9</var>by law.<br/>
<br/>
<a id="bill.1.25.0"></a><a id="pl.26.10"></a><var>26.10</var>    Sec. 25. Laws 2009, chapter 79, article 8, section 81, is amended to read:<br/>
<a id="pl.26.11"></a><var>26.11</var>    Sec. 81. <b>ESTABLISHING A SINGLE SET OF STANDARDS.</b><br/>
<a id="pl.26.12"></a><var>26.12</var>(a) The commissioner of human services shall consult with disability service <br/>
<a id="pl.26.13"></a><var>26.13</var>providers, advocates, counties, and consumer families to develop a single set of standards, <br/>
<a id="pl.26.14"></a><var>26.14</var>to be referred to as "quality outcome standards," governing services for people with <br/>
<a id="pl.26.15"></a><var>26.15</var>disabilities receiving services under the home and community-based waiver services <br/>
<a id="pl.26.16"></a><var>26.16</var>program to replace all or portions of existing laws and rules including, but not limited <br/>
<a id="pl.26.17"></a><var>26.17</var>to, data practices, licensure of facilities and providers, background studies, reporting <br/>
<a id="pl.26.18"></a><var>26.18</var>of maltreatment of minors, reporting of maltreatment of vulnerable adults, and the <br/>
<a id="pl.26.19"></a><var>26.19</var>psychotropic medication checklist. The standards must:<br/>
<a id="pl.26.20"></a><var>26.20</var>(1) enable optimum consumer choice;<br/>
<a id="pl.26.21"></a><var>26.21</var>(2) be consumer driven;<br/>
<a id="pl.26.22"></a><var>26.22</var>(3) link services to individual needs and life goals;<br/>
<a id="pl.26.23"></a><var>26.23</var>(4) be based on quality assurance and individual outcomes; <br/>
<a id="pl.26.24"></a><var>26.24</var>(5) utilize the people closest to the recipient, who may include family, friends, and <br/>
<a id="pl.26.25"></a><var>26.25</var>health and service providers, in conjunction with the recipient's risk management plan to <br/>
<a id="pl.26.26"></a><var>26.26</var>assist the recipient or the recipient's guardian in making decisions that meet the recipient's <br/>
<a id="pl.26.27"></a><var>26.27</var>needs in a cost-effective manner and assure the recipient's health and safety;<br/>
<a id="pl.26.28"></a><var>26.28</var>(6) utilize person-centered planning; and<br/>
<a id="pl.26.29"></a><var>26.29</var>(7) maximize federal financial participation.<br/>
<a id="pl.26.30"></a><var>26.30</var>(b) The commissioner may consult with existing stakeholder groups convened under <br/>
<a id="pl.26.31"></a><var>26.31</var>the commissioner's authority, including the home and community-based expert services <br/>
<a id="pl.26.32"></a><var>26.32</var>panel established by the commissioner in 2008, to meet all or some of the requirements <br/>
<a id="pl.26.33"></a><var>26.33</var>of this section.<br/>
<a id="pl.27.1"></a><var>27.1</var>(c) The commissioner shall provide the reports and plans required by this section to <br/>
<a id="pl.27.2"></a><var>27.2</var>the legislative committees and budget divisions with jurisdiction over health and human <br/>
<a id="pl.27.3"></a><var>27.3</var>services policy and finance by January 15, 2012.<br/>
<br/>
<a id="bill.1.26.0"></a><a id="pl.27.4"></a><var>27.4</var>    Sec. 26. <b>ELDERLY WAIVER CONVERSION.</b><br/>
<a id="pl.27.5"></a><var>27.5</var>    Notwithstanding Minnesota Statutes, section 256B.0915, subdivision 3b, a person <br/>
<a id="pl.27.6"></a><var>27.6</var>age 65 or older with an MT home care rating on January 1, 2010, is eligible for the elderly <br/>
<a id="pl.27.7"></a><var>27.7</var>waiver program and shall be considered a conversion for purposes of accessing monthly <br/>
<a id="pl.27.8"></a><var>27.8</var>budget caps equal to no more than the person's monthly spending under the personal care <br/>
<a id="pl.27.9"></a><var>27.9</var>assistance program on January 1, 2010.<br/>
<br/>
<a id="bill.1.27.0"></a><a id="pl.27.10"></a><var>27.10</var>    Sec. 27. <b>DIRECTION TO COMMISSIONER; CONSULTATION WITH </b><br/>
<a id="pl.27.11"></a><var>27.11</var><b>STAKEHOLDERS.</b><br/>
<a id="pl.27.12"></a><var>27.12</var>    The commissioner shall consult with stakeholders experienced in using and <br/>
<a id="pl.27.13"></a><var>27.13</var>providing services through the consumer-directed community supports option during <br/>
<a id="pl.27.14"></a><var>27.14</var>the identification of data to be used in future development of an individualized budget <br/>
<a id="pl.27.15"></a><var>27.15</var>methodology for the home and community-based waivers for individuals with disabilities <br/>
<a id="pl.27.16"></a><var>27.16</var>under the new comprehensive assessment.<br/>
<br/>
<a id="bill.1.28.0"></a><a id="pl.27.17"></a><var>27.17</var>    Sec. 28. <b>CASE MANAGEMENT REFORM.</b><br/>
<a id="pl.27.18"></a><var>27.18</var>(a) By February 1, 2011, the commissioner of human services shall provide specific <br/>
<a id="pl.27.19"></a><var>27.19</var>recommendations and language for proposed legislation to:<br/>
<a id="pl.27.20"></a><var>27.20</var>(1) define the administrative and the service functions of case management and make <br/>
<a id="pl.27.21"></a><var>27.21</var>changes to improve the funding for administrative functions;<br/>
<a id="pl.27.22"></a><var>27.22</var>(2) standardize and simplify processes, standards, and timelines for administrative <br/>
<a id="pl.27.23"></a><var>27.23</var>functions of case management within the Department of Human Services, Disability <br/>
<a id="pl.27.24"></a><var>27.24</var>Services Division, including eligibility determinations, resource allocation, management <br/>
<a id="pl.27.25"></a><var>27.25</var>of dollars, provision for assignment of one case manager at a time per person, waiting lists, <br/>
<a id="pl.27.26"></a><var>27.26</var>quality assurance, host county concurrence requirements, county of financial responsibility <br/>
<a id="pl.27.27"></a><var>27.27</var>provisions, and waiver compliance; and<br/>
<a id="pl.27.28"></a><var>27.28</var>(3) increase opportunities for consumer choice of case management functions <br/>
<a id="pl.27.29"></a><var>27.29</var>involving service coordination.<br/>
<a id="pl.27.30"></a><var>27.30</var>(b) In developing these recommendations, the commissioner shall consider the <br/>
<a id="pl.27.31"></a><var>27.31</var>recommendations of the 2007 Redesigning Case Management Services for Persons <br/>
<a id="pl.27.32"></a><var>27.32</var>with Disabilities report and consult with existing stakeholder groups, which include <br/>
<a id="pl.28.1"></a><var>28.1</var>representatives of counties, disability and senior advocacy groups, service providers, and <br/>
<a id="pl.28.2"></a><var>28.2</var>representatives of agencies which provide contracted case management.<br/>
<a id="pl.28.3"></a><var>28.3</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.2.0.0"></a>

<a id="bill.2.1.0"></a><a id="pl.28.6"></a><var>28.6</var>    Section 1. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 3, <br/>
<a id="pl.28.7"></a><var>28.7</var>is amended to read:<br/>
<a id="pl.28.8"></a><var>28.8</var>    Subd. 3. <b>Home health aide visits.</b> (a) Home health aide visits must be provided <br/>
<a id="pl.28.9"></a><var>28.9</var>by a certified home health aide using a written plan of care that is updated in compliance <br/>
<a id="pl.28.10"></a><var>28.10</var>with Medicare regulations. A home health aide shall provide hands-on personal care, <br/>
<a id="pl.28.11"></a><var>28.11</var>perform simple procedures as an extension of therapy or nursing services, and assist in <br/>
<a id="pl.28.12"></a><var>28.12</var>instrumental activities of daily living as defined in section 
         <statute_ref>256B.0659</statute_ref>, including assuring <br/>
<a id="pl.28.13"></a><var>28.13</var>that the person gets to medical appointments if identified in the written plan of care. Home <br/>
<a id="pl.28.14"></a><var>28.14</var>health aide visits must be provided in the recipient's home.<br/>
<a id="pl.28.15"></a><var>28.15</var>    (b) All home health aide visits must have authorization under section 
         <statute_ref>256B.0652</statute_ref>. <br/>
<a id="pl.28.16"></a><var>28.16</var>The commissioner shall limit home health aide visits to no more than one visit per day <br/>
<a id="pl.28.17"></a><var>28.17</var>per recipient.<br/>
<a id="pl.28.18"></a><var>28.18</var>    (c) Home health aides must be supervised by a registered nurse or an appropriate <br/>
<a id="pl.28.19"></a><var>28.19</var>therapist when providing services that are an extension of therapy.<br/>
<br/>
<a id="bill.2.2.0"></a><a id="pl.28.20"></a><var>28.20</var>    Sec. 2. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 1, <br/>
<a id="pl.28.21"></a><var>28.21</var>is amended to read:<br/>
<a id="pl.28.22"></a><var>28.22</var>    Subdivision 1. <b>Definitions.</b> (a) For the purposes of this section, the terms defined in <br/>
<a id="pl.28.23"></a><var>28.23</var>paragraphs (b) to (p) (r) have the meanings given unless otherwise provided in text.<br/>
<a id="pl.28.24"></a><var>28.24</var>    (b) "Activities of daily living" means grooming, dressing, bathing, transferring, <br/>
<a id="pl.28.25"></a><var>28.25</var>mobility, positioning, eating, and toileting.<br/>
<a id="pl.28.26"></a><var>28.26</var>    (c) "Behavior," effective January 1, 2010, means a category to determine the home <br/>
<a id="pl.28.27"></a><var>28.27</var>care rating and is based on the criteria found in this section. "Level I behavior" means <br/>
<a id="pl.28.28"></a><var>28.28</var>physical aggression towards self, others, or destruction of property that requires the <br/>
<a id="pl.28.29"></a><var>28.29</var>immediate response of another person.<br/>
<a id="pl.28.30"></a><var>28.30</var>    (d) "Complex health-related needs," effective January 1, 2010, means a category to <br/>
<a id="pl.28.31"></a><var>28.31</var>determine the home care rating and is based on the criteria found in this section.<br/>
<a id="pl.28.32"></a><var>28.32</var>    (e) "Critical activities of daily living," effective January 1, 2010, means transferring, <br/>
<a id="pl.28.33"></a><var>28.33</var>mobility, eating, and toileting.<br/>
<a id="pl.29.1"></a><var>29.1</var>    (f) "Dependency in activities of daily living" means a person requires assistance to <br/>
<a id="pl.29.2"></a><var>29.2</var>begin and complete one or more of the activities of daily living.<br/>
<a id="pl.29.3"></a><var>29.3</var>    (g) "Extended personal care assistance service" means personal care assistance <br/>
<a id="pl.29.4"></a><var>29.4</var>services included in a service plan under one of the home and community-based services <br/>
<a id="pl.29.5"></a><var>29.5</var>waivers authorized under sections 256B.49, 256B.0915, and 256B.092, subdivision <br/>
<a id="pl.29.6"></a><var>29.6</var>5, which exceed the amount, duration, and frequency of the state plan personal care <br/>
<a id="pl.29.7"></a><var>29.7</var>assistance services for participants who:<br/>
<a id="pl.29.8"></a><var>29.8</var>    (1) need assistance provided periodically during a week, but less than daily will not <br/>
<a id="pl.29.9"></a><var>29.9</var>be able to remain in their home without the assistance, and other replacement services <br/>
<a id="pl.29.10"></a><var>29.10</var>are more expensive or are not available when personal care assistance services are to be <br/>
<a id="pl.29.11"></a><var>29.11</var>terminated; or<br/>
<a id="pl.29.12"></a><var>29.12</var>    (2) need additional personal care assistance services beyond the amount authorized <br/>
<a id="pl.29.13"></a><var>29.13</var>by the state plan personal care assistance assessment in order to ensure that their safety, <br/>
<a id="pl.29.14"></a><var>29.14</var>health, and welfare are provided for in their homes.<br/>
<a id="pl.29.15"></a><var>29.15</var>    (h) "Health-related procedures and tasks" means procedures and tasks that can <br/>
<a id="pl.29.16"></a><var>29.16</var>be delegated or assigned by a licensed health care professional under state law to be <br/>
<a id="pl.29.17"></a><var>29.17</var>performed by a personal care assistant.<br/>
<a id="pl.29.18"></a><var>29.18</var>    (h) (i) "Instrumental activities of daily living" means activities to include meal <br/>
<a id="pl.29.19"></a><var>29.19</var>planning and preparation; basic assistance with paying bills; shopping for food, clothing, <br/>
<a id="pl.29.20"></a><var>29.20</var>and other essential items; performing household tasks integral to the personal care <br/>
<a id="pl.29.21"></a><var>29.21</var>assistance services; communication by telephone and other media; and traveling, including <br/>
<a id="pl.29.22"></a><var>29.22</var>to medical appointments and to participate in the community.<br/>
<a id="pl.29.23"></a><var>29.23</var>    (i) (j) "Managing employee" has the same definition as Code of Federal Regulations, <br/>
<a id="pl.29.24"></a><var>29.24</var>title 42, section 455.<br/>
<a id="pl.29.25"></a><var>29.25</var>    (j) (k) "Qualified professional" means a professional providing supervision of <br/>
<a id="pl.29.26"></a><var>29.26</var>personal care assistance services and staff as defined in section 
         <statute_ref>256B.0625, subdivision <br/>
<a id="pl.29.27"></a><var>29.27</var>19c
         </statute_ref>.<br/>
<a id="pl.29.28"></a><var>29.28</var>    (k) (l) "Personal care assistance provider agency" means a medical assistance <br/>
<a id="pl.29.29"></a><var>29.29</var>enrolled provider that provides or assists with providing personal care assistance services <br/>
<a id="pl.29.30"></a><var>29.30</var>and includes a personal care assistance provider organization, personal care assistance <br/>
<a id="pl.29.31"></a><var>29.31</var>choice agency, class A licensed nursing agency, and Medicare-certified home health <br/>
<a id="pl.29.32"></a><var>29.32</var>agency.<br/>
<a id="pl.29.33"></a><var>29.33</var>    (l) (m) "Personal care assistant" or "PCA" means an individual employed by a <br/>
<a id="pl.29.34"></a><var>29.34</var>personal care assistance agency who provides personal care assistance services.<br/>
<a id="pl.30.1"></a><var>30.1</var>    (m) (n) "Personal care assistance care plan" means a written description of personal <br/>
<a id="pl.30.2"></a><var>30.2</var>care assistance services developed by the personal care assistance provider according <br/>
<a id="pl.30.3"></a><var>30.3</var>to the service plan.<br/>
<a id="pl.30.4"></a><var>30.4</var>    (n) (o) "Responsible party" means an individual who is capable of providing the <br/>
<a id="pl.30.5"></a><var>30.5</var>support necessary to assist the recipient to live in the community.<br/>
<a id="pl.30.6"></a><var>30.6</var>    (o) (p) "Self-administered medication" means medication taken orally, by injection <br/>
<a id="pl.30.7"></a><var>30.7</var>or insertion, or applied topically without the need for assistance.<br/>
<a id="pl.30.8"></a><var>30.8</var>    (p) (q) "Service plan" means a written summary of the assessment and description of <br/>
<a id="pl.30.9"></a><var>30.9</var>the services needed by the recipient.<br/>
<a id="pl.30.10"></a><var>30.10</var>    (r) "Wages and benefits" means wages and salaries, the employer's share of FICA <br/>
<a id="pl.30.11"></a><var>30.11</var>taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, <br/>
<a id="pl.30.12"></a><var>30.12</var>mileage reimbursement, health and dental insurance, life insurance, disability insurance, <br/>
<a id="pl.30.13"></a><var>30.13</var>long-term care insurance, uniform allowance, and contributions to employee retirement <br/>
<a id="pl.30.14"></a><var>30.14</var>accounts.<br/>
<br/>
<a id="bill.2.3.0"></a><a id="pl.30.15"></a><var>30.15</var>    Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 3, <br/>
<a id="pl.30.16"></a><var>30.16</var>is amended to read:<br/>
<a id="pl.30.17"></a><var>30.17</var>    Subd. 3. <b>Noncovered personal care assistance services.</b> (a) Personal care <br/>
<a id="pl.30.18"></a><var>30.18</var>assistance services are not eligible for medical assistance payment under this section <br/>
<a id="pl.30.19"></a><var>30.19</var>when provided:<br/>
<a id="pl.30.20"></a><var>30.20</var>    (1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal <br/>
<a id="pl.30.21"></a><var>30.21</var>guardian, licensed foster provider, except as allowed under section 
         <statute_ref>256B.0651, subdivision <br/>
<a id="pl.30.22"></a><var>30.22</var>10
         </statute_ref>, or responsible party;<br/>
<a id="pl.30.23"></a><var>30.23</var>    (2) in lieu of other staffing options in a residential or child care setting;<br/>
<a id="pl.30.24"></a><var>30.24</var>    (3) solely as a child care or babysitting service; or<br/>
<a id="pl.30.25"></a><var>30.25</var>    (4) without authorization by the commissioner or the commissioner's designee.<br/>
<a id="pl.30.26"></a><var>30.26</var>    (b) The following personal care services are not eligible for medical assistance <br/>
<a id="pl.30.27"></a><var>30.27</var>payment under this section when provided in residential settings:<br/>
<a id="pl.30.28"></a><var>30.28</var>    (1) effective January 1, 2010, when the provider of home care services who is not <br/>
<a id="pl.30.29"></a><var>30.29</var>related by blood, marriage, or adoption owns or otherwise controls the living arrangement, <br/>
<a id="pl.30.30"></a><var>30.30</var>including licensed or unlicensed services; or<br/>
<a id="pl.30.31"></a><var>30.31</var>    (2) when personal care assistance services are the responsibility of a residential or <br/>
<a id="pl.30.32"></a><var>30.32</var>program license holder under the terms of a service agreement and administrative rules.<br/>
<a id="pl.30.33"></a><var>30.33</var>    (c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible <br/>
<a id="pl.30.34"></a><var>30.34</var>for medical assistance reimbursement for personal care assistance services under this <br/>
<a id="pl.30.35"></a><var>30.35</var>section include:<br/>
<a id="pl.31.1"></a><var>31.1</var>    (1) sterile procedures;<br/>
<a id="pl.31.2"></a><var>31.2</var>    (2) injections of fluids and medications into veins, muscles, or skin;<br/>
<a id="pl.31.3"></a><var>31.3</var>    (3) home maintenance or chore services;<br/>
<a id="pl.31.4"></a><var>31.4</var>    (4) homemaker services not an integral part of assessed personal care assistance <br/>
<a id="pl.31.5"></a><var>31.5</var>services needed by a recipient;<br/>
<a id="pl.31.6"></a><var>31.6</var>    (5) application of restraints or implementation of procedures under section 
         <statute_ref>245.825</statute_ref>;<br/>
<a id="pl.31.7"></a><var>31.7</var>    (6) instrumental activities of daily living for children under the age of 18, except <br/>
<a id="pl.31.8"></a><var>31.8</var>when immediate attention is needed for health or hygiene reasons integral to the personal <br/>
<a id="pl.31.9"></a><var>31.9</var>care services and the need is listed in the service plan by the assessor; and<br/>
<a id="pl.31.10"></a><var>31.10</var>    (7) assessments for personal care assistance services by personal care assistance <br/>
<a id="pl.31.11"></a><var>31.11</var>provider agencies or by independently enrolled registered nurses.<br/>
<br/>
<a id="bill.2.4.0"></a><a id="pl.31.12"></a><var>31.12</var>    Sec. 4. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 4, <br/>
<a id="pl.31.13"></a><var>31.13</var>is amended to read:<br/>
<a id="pl.31.14"></a><var>31.14</var>    Subd. 4. <b>Assessment for personal care assistance services; limitations.</b> (a) An <br/>
<a id="pl.31.15"></a><var>31.15</var>assessment as defined in subdivision 3a must be completed for personal care assistance <br/>
<a id="pl.31.16"></a><var>31.16</var>services.<br/>
<a id="pl.31.17"></a><var>31.17</var>    (b) The following limitations apply to the assessment:<br/>
<a id="pl.31.18"></a><var>31.18</var>    (1) a person must be assessed as dependent in an activity of daily living based on <br/>
<a id="pl.31.19"></a><var>31.19</var>the person's daily need or need on the days during the week the activity is completed, <br/>
<a id="pl.31.20"></a><var>31.20</var>on a daily basis, for:<br/>
<a id="pl.31.21"></a><var>31.21</var>    (i) cuing and constant supervision to complete the task; or<br/>
<a id="pl.31.22"></a><var>31.22</var>    (ii) hands-on assistance to complete the task; and<br/>
<a id="pl.31.23"></a><var>31.23</var>    (2) a child may not be found to be dependent in an activity of daily living if because <br/>
<a id="pl.31.24"></a><var>31.24</var>of the child's age an adult would either perform the activity for the child or assist the child <br/>
<a id="pl.31.25"></a><var>31.25</var>with the activity. Assistance needed is the assistance appropriate for a typical child of <br/>
<a id="pl.31.26"></a><var>31.26</var>the same age.<br/>
<a id="pl.31.27"></a><var>31.27</var>    (c) Assessment for complex health-related needs must meet the criteria in this <br/>
<a id="pl.31.28"></a><var>31.28</var>paragraph. During the assessment process, a recipient qualifies as having complex <br/>
<a id="pl.31.29"></a><var>31.29</var>health-related needs if the recipient has one or more of the interventions that are ordered by <br/>
<a id="pl.31.30"></a><var>31.30</var>a physician, specified in a personal care assistance care plan, and found in the following:<br/>
<a id="pl.31.31"></a><var>31.31</var>    (1) tube feedings requiring:<br/>
<a id="pl.31.32"></a><var>31.32</var>    (i) a gastro/jejunostomy gastrojejunostomy tube; or<br/>
<a id="pl.31.33"></a><var>31.33</var>    (ii) continuous tube feeding lasting longer than 12 hours per day;<br/>
<a id="pl.31.34"></a><var>31.34</var>    (2) wounds described as:<br/>
<a id="pl.31.35"></a><var>31.35</var>    (i) stage III or stage IV;<br/>
<a id="pl.32.1"></a><var>32.1</var>    (ii) multiple wounds;<br/>
<a id="pl.32.2"></a><var>32.2</var>    (iii) requiring sterile or clean dressing changes or a wound vac; or<br/>
<a id="pl.32.3"></a><var>32.3</var>    (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require <br/>
<a id="pl.32.4"></a><var>32.4</var>specialized care;<br/>
<a id="pl.32.5"></a><var>32.5</var>    (3) parenteral therapy described as:<br/>
<a id="pl.32.6"></a><var>32.6</var>    (i) IV therapy more than two times per week lasting longer than four hours for <br/>
<a id="pl.32.7"></a><var>32.7</var>each treatment; or<br/>
<a id="pl.32.8"></a><var>32.8</var>    (ii) total parenteral nutrition (TPN) daily;<br/>
<a id="pl.32.9"></a><var>32.9</var>    (4) respiratory interventions including:<br/>
<a id="pl.32.10"></a><var>32.10</var>    (i) oxygen required more than eight hours per day;<br/>
<a id="pl.32.11"></a><var>32.11</var>    (ii) respiratory vest more than one time per day;<br/>
<a id="pl.32.12"></a><var>32.12</var>    (iii) bronchial drainage treatments more than two times per day;<br/>
<a id="pl.32.13"></a><var>32.13</var>    (iv) sterile or clean suctioning more than six times per day;<br/>
<a id="pl.32.14"></a><var>32.14</var>    (v) dependence on another to apply respiratory ventilation augmentation devices <br/>
<a id="pl.32.15"></a><var>32.15</var>such as BiPAP and CPAP; and<br/>
<a id="pl.32.16"></a><var>32.16</var>    (vi) ventilator dependence under section 
         <statute_ref>256B.0652</statute_ref>;<br/>
<a id="pl.32.17"></a><var>32.17</var>    (5) insertion and maintenance of catheter including:<br/>
<a id="pl.32.18"></a><var>32.18</var>    (i) sterile catheter changes more than one time per month;<br/>
<a id="pl.32.19"></a><var>32.19</var>    (ii) clean self-catheterization more than six times per day; or<br/>
<a id="pl.32.20"></a><var>32.20</var>    (iii) bladder irrigations;<br/>
<a id="pl.32.21"></a><var>32.21</var>    (6) bowel program more than two times per week requiring more than 30 minutes to <br/>
<a id="pl.32.22"></a><var>32.22</var>perform each time;<br/>
<a id="pl.32.23"></a><var>32.23</var>    (7) neurological intervention including:<br/>
<a id="pl.32.24"></a><var>32.24</var>    (i) seizures more than two times per week and requiring significant physical <br/>
<a id="pl.32.25"></a><var>32.25</var>assistance to maintain safety; or<br/>
<a id="pl.32.26"></a><var>32.26</var>    (ii) swallowing disorders diagnosed by a physician and requiring specialized <br/>
<a id="pl.32.27"></a><var>32.27</var>assistance from another on a daily basis; and<br/>
<a id="pl.32.28"></a><var>32.28</var>    (8) other congenital or acquired diseases creating a need for significantly increased <br/>
<a id="pl.32.29"></a><var>32.29</var>direct hands-on assistance and interventions in six to eight activities of daily living.<br/>
<a id="pl.32.30"></a><var>32.30</var>    (d) An assessment of behaviors must meet the criteria in this paragraph. A recipient <br/>
<a id="pl.32.31"></a><var>32.31</var>qualifies as having a need for assistance due to behaviors if the recipient's behavior requires <br/>
<a id="pl.32.32"></a><var>32.32</var>assistance at least four times per week and shows one or more of the following behaviors:<br/>
<a id="pl.32.33"></a><var>32.33</var>    (1) physical aggression towards self or others, or destruction of property that requires <br/>
<a id="pl.32.34"></a><var>32.34</var>the immediate response of another person;<br/>
<a id="pl.32.35"></a><var>32.35</var>    (2) increased vulnerability due to cognitive deficits or socially inappropriate <br/>
<a id="pl.32.36"></a><var>32.36</var>behavior; or<br/>
<a id="pl.33.1"></a><var>33.1</var>    (3) verbally aggressive and resistive to care.<br/>
<br/>
<a id="bill.2.5.0"></a><a id="pl.33.2"></a><var>33.2</var>    Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11, <br/>
<a id="pl.33.3"></a><var>33.3</var>is amended to read:<br/>
<a id="pl.33.4"></a><var>33.4</var>    Subd. 11. <b>Personal care assistant; requirements.</b> (a) A personal care assistant <br/>
<a id="pl.33.5"></a><var>33.5</var>must meet the following requirements:<br/>
<a id="pl.33.6"></a><var>33.6</var>    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years <br/>
<a id="pl.33.7"></a><var>33.7</var>of age with these additional requirements:<br/>
<a id="pl.33.8"></a><var>33.8</var>    (i) supervision by a qualified professional every 60 days; and<br/>
<a id="pl.33.9"></a><var>33.9</var>    (ii) employment by only one personal care assistance provider agency responsible <br/>
<a id="pl.33.10"></a><var>33.10</var>for compliance with current labor laws;<br/>
<a id="pl.33.11"></a><var>33.11</var>    (2) be employed by a personal care assistance provider agency;<br/>
<a id="pl.33.12"></a><var>33.12</var>    (3) enroll with the department as a personal care assistant after clearing a background <br/>
<a id="pl.33.13"></a><var>33.13</var>study. Before a personal care assistant provides services, the personal care assistance <br/>
<a id="pl.33.14"></a><var>33.14</var>provider agency must initiate a background study on the personal care assistant under <br/>
<a id="pl.33.15"></a><var>33.15</var>chapter 245C, and the personal care assistance provider agency must have received a <br/>
<a id="pl.33.16"></a><var>33.16</var>notice from the commissioner that the personal care assistant is:<br/>
<a id="pl.33.17"></a><var>33.17</var>    (i) not disqualified under section 
         <statute_ref>245C.14</statute_ref>; or<br/>
<a id="pl.33.18"></a><var>33.18</var>    (ii) is disqualified, but the personal care assistant has received a set aside of the <br/>
<a id="pl.33.19"></a><var>33.19</var>disqualification under section 
         <statute_ref>245C.22</statute_ref>;<br/>
<a id="pl.33.20"></a><var>33.20</var>    (4) be able to effectively communicate with the recipient and personal care <br/>
<a id="pl.33.21"></a><var>33.21</var>assistance provider agency;<br/>
<a id="pl.33.22"></a><var>33.22</var>    (5) be able to provide covered personal care assistance services according to the <br/>
<a id="pl.33.23"></a><var>33.23</var>recipient's personal care assistance care plan, respond appropriately to recipient needs, <br/>
<a id="pl.33.24"></a><var>33.24</var>and report changes in the recipient's condition to the supervising qualified professional <br/>
<a id="pl.33.25"></a><var>33.25</var>or physician;<br/>
<a id="pl.33.26"></a><var>33.26</var>    (6) not be a consumer of personal care assistance services;<br/>
<a id="pl.33.27"></a><var>33.27</var>    (7) maintain daily written records including, but not limited to, time sheets under <br/>
<a id="pl.33.28"></a><var>33.28</var>subdivision 12;<br/>
<a id="pl.33.29"></a><var>33.29</var>    (8) effective January 1, 2010, complete standardized training as determined <br/>
<a id="pl.33.30"></a><var>33.30</var>by the commissioner before completing enrollment. The training must be available <br/>
<a id="pl.33.31"></a><var>33.31</var>in languages other than English and to those who need accommodations due to <br/>
<a id="pl.33.32"></a><var>33.32</var>disabilities. Personal care assistant training must include successful completion of the <br/>
<a id="pl.33.33"></a><var>33.33</var>following training components: basic first aid, vulnerable adult, child maltreatment, <br/>
<a id="pl.33.34"></a><var>33.34</var>OSHA universal precautions, basic roles and responsibilities of personal care assistants <br/>
<a id="pl.33.35"></a><var>33.35</var>including information about assistance with lifting and transfers for recipients, emergency <br/>
<a id="pl.34.1"></a><var>34.1</var>preparedness, orientation to positive behavioral practices, fraud issues, and completion of <br/>
<a id="pl.34.2"></a><var>34.2</var>time sheets. Upon completion of the training components, the personal care assistant must <br/>
<a id="pl.34.3"></a><var>34.3</var>demonstrate the competency to provide assistance to recipients;<br/>
<a id="pl.34.4"></a><var>34.4</var>    (9) complete training and orientation on the needs of the recipient within the first <br/>
<a id="pl.34.5"></a><var>34.5</var>seven days after the services begin; and<br/>
<a id="pl.34.6"></a><var>34.6</var>    (10) be limited to providing and being paid for up to 310 hours per month of personal <br/>
<a id="pl.34.7"></a><var>34.7</var>care assistance services regardless of the number of recipients being served or the number <br/>
<a id="pl.34.8"></a><var>34.8</var>of personal care assistance provider agencies enrolled with. The number of hours worked <br/>
<a id="pl.34.9"></a><var>34.9</var>per day shall not be disallowed by the department unless in violation of the law.<br/>
<a id="pl.34.10"></a><var>34.10</var>    (b) A legal guardian may be a personal care assistant if the guardian is not being paid <br/>
<a id="pl.34.11"></a><var>34.11</var>for the guardian services and meets the criteria for personal care assistants in paragraph (a).<br/>
<a id="pl.34.12"></a><var>34.12</var>    (c) Effective January 1, 2010, persons who do not qualify as a personal care assistant <br/>
<a id="pl.34.13"></a><var>34.13</var>include parents and stepparents of minors, spouses, paid legal guardians, family foster <br/>
<a id="pl.34.14"></a><var>34.14</var>care providers, except as otherwise allowed in section 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>, or <br/>
<a id="pl.34.15"></a><var>34.15</var>staff of a residential setting.<br/>
<br/>
<a id="bill.2.6.0"></a><a id="pl.34.16"></a><var>34.16</var>    Sec. 6. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 13, <br/>
<a id="pl.34.17"></a><var>34.17</var>is amended to read:<br/>
<a id="pl.34.18"></a><var>34.18</var>    Subd. 13. <b>Qualified professional; qualifications.</b> (a) The qualified professional <br/>
<a id="pl.34.19"></a><var>34.19</var>must be employed by a personal care assistance provider agency and meet the definition <br/>
<a id="pl.34.20"></a><var>34.20</var>under section 
         <statute_ref>256B.0625, subdivision 19c</statute_ref>. Before a qualified professional provides <br/>
<a id="pl.34.21"></a><var>34.21</var>services, the personal care assistance provider agency must initiate a background study on <br/>
<a id="pl.34.22"></a><var>34.22</var>the qualified professional under chapter 245C, and the personal care assistance provider <br/>
<a id="pl.34.23"></a><var>34.23</var>agency must have received a notice from the commissioner that the qualified professional:<br/>
<a id="pl.34.24"></a><var>34.24</var>    (1) is not disqualified under section 
         <statute_ref>245C.14</statute_ref>; or<br/>
<a id="pl.34.25"></a><var>34.25</var>    (2) is disqualified, but the qualified professional has received a set aside of the <br/>
<a id="pl.34.26"></a><var>34.26</var>disqualification under section 
         <statute_ref>245C.22</statute_ref>.<br/>
<a id="pl.34.27"></a><var>34.27</var>    (b) The qualified professional shall perform the duties of training, supervision, and <br/>
<a id="pl.34.28"></a><var>34.28</var>evaluation of the personal care assistance staff and evaluation of the effectiveness of <br/>
<a id="pl.34.29"></a><var>34.29</var>personal care assistance services. The qualified professional shall:<br/>
<a id="pl.34.30"></a><var>34.30</var>    (1) develop and monitor with the recipient a personal care assistance care plan based <br/>
<a id="pl.34.31"></a><var>34.31</var>on the service plan and individualized needs of the recipient;<br/>
<a id="pl.34.32"></a><var>34.32</var>    (2) develop and monitor with the recipient a monthly plan for the use of personal <br/>
<a id="pl.34.33"></a><var>34.33</var>care assistance services;<br/>
<a id="pl.34.34"></a><var>34.34</var>    (3) review documentation of personal care assistance services provided;<br/>
<a id="pl.35.1"></a><var>35.1</var>    (4) provide training and ensure competency for the personal care assistant in the <br/>
<a id="pl.35.2"></a><var>35.2</var>individual needs of the recipient; and<br/>
<a id="pl.35.3"></a><var>35.3</var>    (5) document all training, communication, evaluations, and needed actions to <br/>
<a id="pl.35.4"></a><var>35.4</var>improve performance of the personal care assistants.<br/>
<a id="pl.35.5"></a><var>35.5</var>    (c) Effective January July 1, 2010, the qualified professional shall complete the <br/>
<a id="pl.35.6"></a><var>35.6</var>provider training with basic information about the personal care assistance program <br/>
<a id="pl.35.7"></a><var>35.7</var>approved by the commissioner within six months of the date hired by a personal care <br/>
<a id="pl.35.8"></a><var>35.8</var>assistance provider agency. Qualified professionals who have completed the required <br/>
<a id="pl.35.9"></a><var>35.9</var>trainings as an employee with a personal care assistance provider agency do not need to <br/>
<a id="pl.35.10"></a><var>35.10</var>repeat the required trainings if they are hired by another agency, if they have completed the <br/>
<a id="pl.35.11"></a><var>35.11</var>training within the last three years. The required training shall be available in languages <br/>
<a id="pl.35.12"></a><var>35.12</var>other than English and to those who need accommodations due to disabilities, online, or <br/>
<a id="pl.35.13"></a><var>35.13</var>by electronic remote connection, and provide for competency testing to demonstrate an <br/>
<a id="pl.35.14"></a><var>35.14</var>understanding of the content without attending in-person training. A qualified professional <br/>
<a id="pl.35.15"></a><var>35.15</var>is allowed to be employed and is not subject to the training requirement until the training is <br/>
<a id="pl.35.16"></a><var>35.16</var>offered online or through remote electronic connection. A qualified professional employed <br/>
<a id="pl.35.17"></a><var>35.17</var>by a personal care assistance provider agency certified for participation in Medicare as <br/>
<a id="pl.35.18"></a><var>35.18</var>a home health agency is exempt from the training required in this subdivision. The <br/>
<a id="pl.35.19"></a><var>35.19</var>commissioner shall ensure there is a mechanism in place to verify the identity of persons <br/>
<a id="pl.35.20"></a><var>35.20</var>completing the competency testing electronically.<br/>
<br/>
<a id="bill.2.7.0"></a><a id="pl.35.21"></a><var>35.21</var>    Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 14, <br/>
<a id="pl.35.22"></a><var>35.22</var>is amended to read:<br/>
<a id="pl.35.23"></a><var>35.23</var>    Subd. 14. <b>Qualified professional; duties.</b> (a) Effective January 1, 2010, all personal <br/>
<a id="pl.35.24"></a><var>35.24</var>care assistants must be supervised by a qualified professional.<br/>
<a id="pl.35.25"></a><var>35.25</var>    (b) Through direct training, observation, return demonstrations, and consultation <br/>
<a id="pl.35.26"></a><var>35.26</var>with the staff and the recipient, the qualified professional must ensure and document <br/>
<a id="pl.35.27"></a><var>35.27</var>that the personal care assistant is:<br/>
<a id="pl.35.28"></a><var>35.28</var>    (1) capable of providing the required personal care assistance services;<br/>
<a id="pl.35.29"></a><var>35.29</var>    (2) knowledgeable about the plan of personal care assistance services before services <br/>
<a id="pl.35.30"></a><var>35.30</var>are performed; and<br/>
<a id="pl.35.31"></a><var>35.31</var>    (3) able to identify conditions that should be immediately brought to the attention of <br/>
<a id="pl.35.32"></a><var>35.32</var>the qualified professional.<br/>
<a id="pl.35.33"></a><var>35.33</var>    (c) The qualified professional shall evaluate the personal care assistant within the first <br/>
<a id="pl.35.34"></a><var>35.34</var>14 days of starting to provide regularly scheduled services for a recipient except for the <br/>
<a id="pl.35.35"></a><var>35.35</var>personal care assistance choice option under subdivision 19, paragraph (a), clause (4). For <br/>
<a id="pl.36.1"></a><var>36.1</var>the initial evaluation, the qualified professional shall evaluate the personal care assistance <br/>
<a id="pl.36.2"></a><var>36.2</var>services for a recipient through direct observation of a personal care assistant's work. <br/>
<a id="pl.36.3"></a><var>36.3</var>Subsequent visits to evaluate the personal care assistance services provided to a recipient <br/>
<a id="pl.36.4"></a><var>36.4</var>do not require direct observation of each personal care assistant's work and shall occur:<br/>
<a id="pl.36.5"></a><var>36.5</var>    (1) at least every 90 days thereafter for the first year of a recipient's services; and<br/>
<a id="pl.36.6"></a><var>36.6</var>    (2) every 120 days after the first year of a recipient's service or whenever needed for <br/>
<a id="pl.36.7"></a><var>36.7</var>response to a recipient's request for increased supervision of the personal care assistance <br/>
<a id="pl.36.8"></a><var>36.8</var>staff; and<br/>
<a id="pl.36.9"></a><var>36.9</var>    (3) after the first 180 days of a recipient's service, supervisory visits may alternate <br/>
<a id="pl.36.10"></a><var>36.10</var>between unscheduled phone or Internet technology and in-person visits, unless the <br/>
<a id="pl.36.11"></a><var>36.11</var>in-person visits are needed according to the care plan.<br/>
<a id="pl.36.12"></a><var>36.12</var>    (d) Communication with the recipient is a part of the evaluation process of the <br/>
<a id="pl.36.13"></a><var>36.13</var>personal care assistance staff.<br/>
<a id="pl.36.14"></a><var>36.14</var>    (e) At each supervisory visit, the qualified professional shall evaluate personal care <br/>
<a id="pl.36.15"></a><var>36.15</var>assistance services including the following information:<br/>
<a id="pl.36.16"></a><var>36.16</var>    (1) satisfaction level of the recipient with personal care assistance services;<br/>
<a id="pl.36.17"></a><var>36.17</var>    (2) review of the month-to-month plan for use of personal care assistance services;<br/>
<a id="pl.36.18"></a><var>36.18</var>    (3) review of documentation of personal care assistance services provided;<br/>
<a id="pl.36.19"></a><var>36.19</var>    (4) whether the personal care assistance services are meeting the goals of the service <br/>
<a id="pl.36.20"></a><var>36.20</var>as stated in the personal care assistance care plan and service plan;<br/>
<a id="pl.36.21"></a><var>36.21</var>    (5) a written record of the results of the evaluation and actions taken to correct any <br/>
<a id="pl.36.22"></a><var>36.22</var>deficiencies in the work of a personal care assistant; and<br/>
<a id="pl.36.23"></a><var>36.23</var>    (6) revision of the personal care assistance care plan as necessary in consultation <br/>
<a id="pl.36.24"></a><var>36.24</var>with the recipient or responsible party, to meet the needs of the recipient.<br/>
<a id="pl.36.25"></a><var>36.25</var>    (f) The qualified professional shall complete the required documentation in the <br/>
<a id="pl.36.26"></a><var>36.26</var>agency recipient and employee files and the recipient's home, including the following <br/>
<a id="pl.36.27"></a><var>36.27</var>documentation:<br/>
<a id="pl.36.28"></a><var>36.28</var>    (1) the personal care assistance care plan based on the service plan and individualized <br/>
<a id="pl.36.29"></a><var>36.29</var>needs of the recipient;<br/>
<a id="pl.36.30"></a><var>36.30</var>    (2) a month-to-month plan for use of personal care assistance services;<br/>
<a id="pl.36.31"></a><var>36.31</var>    (3) changes in need of the recipient requiring a change to the level of service and the <br/>
<a id="pl.36.32"></a><var>36.32</var>personal care assistance care plan;<br/>
<a id="pl.36.33"></a><var>36.33</var>    (4) evaluation results of supervision visits and identified issues with personal care <br/>
<a id="pl.36.34"></a><var>36.34</var>assistance staff with actions taken;<br/>
<a id="pl.36.35"></a><var>36.35</var>    (5) all communication with the recipient and personal care assistance staff; and<br/>
<a id="pl.36.36"></a><var>36.36</var>    (6) hands-on training or individualized training for the care of the recipient.<br/>
<a id="pl.37.1"></a><var>37.1</var>    (g) The documentation in paragraph (f) must be done on agency forms.<br/>
<a id="pl.37.2"></a><var>37.2</var>    (h) The services that are not eligible for payment as qualified professional services <br/>
<a id="pl.37.3"></a><var>37.3</var>include:<br/>
<a id="pl.37.4"></a><var>37.4</var>    (1) direct professional nursing tasks that could be assessed and authorized as skilled <br/>
<a id="pl.37.5"></a><var>37.5</var>nursing tasks;<br/>
<a id="pl.37.6"></a><var>37.6</var>    (2) supervision of personal care assistance completed by telephone;<br/>
<a id="pl.37.7"></a><var>37.7</var>    (3) agency administrative activities;<br/>
<a id="pl.37.8"></a><var>37.8</var>    (4) training other than the individualized training required to provide care for a <br/>
<a id="pl.37.9"></a><var>37.9</var>recipient; and<br/>
<a id="pl.37.10"></a><var>37.10</var>    (5) any other activity that is not described in this section.<br/>
<br/>
<a id="bill.2.8.0"></a><a id="pl.37.11"></a><var>37.11</var>    Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 18, <br/>
<a id="pl.37.12"></a><var>37.12</var>is amended to read:<br/>
<a id="pl.37.13"></a><var>37.13</var>    Subd. 18. <b>Personal care assistance choice option; generally.</b> (a) The <br/>
<a id="pl.37.14"></a><var>37.14</var>commissioner may allow a recipient of personal care assistance services to use a fiscal <br/>
<a id="pl.37.15"></a><var>37.15</var>intermediary to assist the recipient in paying and accounting for medically necessary <br/>
<a id="pl.37.16"></a><var>37.16</var>covered personal care assistance services. Unless otherwise provided in this section, all <br/>
<a id="pl.37.17"></a><var>37.17</var>other statutory and regulatory provisions relating to personal care assistance services apply <br/>
<a id="pl.37.18"></a><var>37.18</var>to a recipient using the personal care assistance choice option.<br/>
<a id="pl.37.19"></a><var>37.19</var>    (b) Personal care assistance choice is an option of the personal care assistance <br/>
<a id="pl.37.20"></a><var>37.20</var>program that allows the recipient who receives personal care assistance services to be <br/>
<a id="pl.37.21"></a><var>37.21</var>responsible for the hiring, training, scheduling, and firing of personal care assistants <br/>
<a id="pl.37.22"></a><var>37.22</var>according to the terms of the written agreement with the personal care assistance choice <br/>
<a id="pl.37.23"></a><var>37.23</var>agency required under subdivision 20, paragraph (a). This program offers greater control <br/>
<a id="pl.37.24"></a><var>37.24</var>and choice for the recipient in who provides the personal care assistance service and when <br/>
<a id="pl.37.25"></a><var>37.25</var>the service is scheduled. The recipient or the recipient's responsible party must choose a <br/>
<a id="pl.37.26"></a><var>37.26</var>personal care assistance choice provider agency as a fiscal intermediary. This personal <br/>
<a id="pl.37.27"></a><var>37.27</var>care assistance choice provider agency manages payroll, invoices the state, is responsible <br/>
<a id="pl.37.28"></a><var>37.28</var>for all payroll-related taxes and insurance, and is responsible for providing the consumer <br/>
<a id="pl.37.29"></a><var>37.29</var>training and support in managing the recipient's personal care assistance services.<br/>
<br/>
<a id="bill.2.9.0"></a><a id="pl.37.30"></a><var>37.30</var>    Sec. 9. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 19, <br/>
<a id="pl.37.31"></a><var>37.31</var>is amended to read:<br/>
<a id="pl.37.32"></a><var>37.32</var>    Subd. 19. <b>Personal care assistance choice option; qualifications; duties.</b> (a) <br/>
<a id="pl.37.33"></a><var>37.33</var>Under personal care assistance choice, the recipient or responsible party shall:<br/>
<a id="pl.38.1"></a><var>38.1</var>    (1) recruit, hire, schedule, and terminate personal care assistants and a qualified <br/>
<a id="pl.38.2"></a><var>38.2</var>professional according to the terms of the written agreement required under subdivision <br/>
<a id="pl.38.3"></a><var>38.3</var>20, paragraph (a);<br/>
<a id="pl.38.4"></a><var>38.4</var>    (2) develop a personal care assistance care plan based on the assessed needs <br/>
<a id="pl.38.5"></a><var>38.5</var>and addressing the health and safety of the recipient with the assistance of a qualified <br/>
<a id="pl.38.6"></a><var>38.6</var>professional as needed;<br/>
<a id="pl.38.7"></a><var>38.7</var>    (3) orient and train the personal care assistant with assistance as needed from the <br/>
<a id="pl.38.8"></a><var>38.8</var>qualified professional;<br/>
<a id="pl.38.9"></a><var>38.9</var>    (4) effective January 1, 2010, supervise and evaluate the personal care assistant with <br/>
<a id="pl.38.10"></a><var>38.10</var>the qualified professional, who is required to visit the recipient at least every 180 days;<br/>
<a id="pl.38.11"></a><var>38.11</var>    (5) monitor and verify in writing and report to the personal care assistance choice <br/>
<a id="pl.38.12"></a><var>38.12</var>agency the number of hours worked by the personal care assistant and the qualified <br/>
<a id="pl.38.13"></a><var>38.13</var>professional;<br/>
<a id="pl.38.14"></a><var>38.14</var>    (6) engage in an annual face-to-face reassessment to determine continuing eligibility <br/>
<a id="pl.38.15"></a><var>38.15</var>and service authorization; and<br/>
<a id="pl.38.16"></a><var>38.16</var>    (7) use the same personal care assistance choice provider agency if shared personal <br/>
<a id="pl.38.17"></a><var>38.17</var>assistance care is being used.<br/>
<a id="pl.38.18"></a><var>38.18</var>    (b) The personal care assistance choice provider agency shall:<br/>
<a id="pl.38.19"></a><var>38.19</var>    (1) meet all personal care assistance provider agency standards;<br/>
<a id="pl.38.20"></a><var>38.20</var>    (2) enter into a written agreement with the recipient, responsible party, and personal <br/>
<a id="pl.38.21"></a><var>38.21</var>care assistants;<br/>
<a id="pl.38.22"></a><var>38.22</var>    (3) not be related as a parent, child, sibling, or spouse to the recipient, qualified <br/>
<a id="pl.38.23"></a><var>38.23</var>professional, or the personal care assistant; and<br/>
<a id="pl.38.24"></a><var>38.24</var>    (4) ensure arm's-length transactions without undue influence or coercion with the <br/>
<a id="pl.38.25"></a><var>38.25</var>recipient and personal care assistant.<br/>
<a id="pl.38.26"></a><var>38.26</var>    (c) The duties of the personal care assistance choice provider agency are to:<br/>
<a id="pl.38.27"></a><var>38.27</var>    (1) be the employer of the personal care assistant and the qualified professional for <br/>
<a id="pl.38.28"></a><var>38.28</var>employment law and related regulations including, but not limited to, purchasing and <br/>
<a id="pl.38.29"></a><var>38.29</var>maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, <br/>
<a id="pl.38.30"></a><var>38.30</var>and liability insurance, and submit any or all necessary documentation including, but not <br/>
<a id="pl.38.31"></a><var>38.31</var>limited to, workers' compensation and unemployment insurance;<br/>
<a id="pl.38.32"></a><var>38.32</var>    (2) bill the medical assistance program for personal care assistance services and <br/>
<a id="pl.38.33"></a><var>38.33</var>qualified professional services;<br/>
<a id="pl.38.34"></a><var>38.34</var>    (3) request and complete background studies that comply with the requirements for <br/>
<a id="pl.38.35"></a><var>38.35</var>personal care assistants and qualified professionals;<br/>
<a id="pl.39.1"></a><var>39.1</var>    (4) pay the personal care assistant and qualified professional based on actual hours <br/>
<a id="pl.39.2"></a><var>39.2</var>of services provided;<br/>
<a id="pl.39.3"></a><var>39.3</var>    (5) withhold and pay all applicable federal and state taxes;<br/>
<a id="pl.39.4"></a><var>39.4</var>    (6) verify and keep records of hours worked by the personal care assistant and <br/>
<a id="pl.39.5"></a><var>39.5</var>qualified professional;<br/>
<a id="pl.39.6"></a><var>39.6</var>    (7) make the arrangements and pay taxes and other benefits, if any, and comply with <br/>
<a id="pl.39.7"></a><var>39.7</var>any legal requirements for a Minnesota employer;<br/>
<a id="pl.39.8"></a><var>39.8</var>    (8) enroll in the medical assistance program as a personal care assistance choice <br/>
<a id="pl.39.9"></a><var>39.9</var>agency; and<br/>
<a id="pl.39.10"></a><var>39.10</var>    (9) enter into a written agreement as specified in subdivision 20 before services <br/>
<a id="pl.39.11"></a><var>39.11</var>are provided.<br/>
<br/>
<a id="bill.2.10.0"></a><a id="pl.39.12"></a><var>39.12</var>    Sec. 10. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 20, <br/>
<a id="pl.39.13"></a><var>39.13</var>is amended to read:<br/>
<a id="pl.39.14"></a><var>39.14</var>    Subd. 20. <b>Personal care assistance choice option; administration.</b> (a) Before <br/>
<a id="pl.39.15"></a><var>39.15</var>services commence under the personal care assistance choice option, and annually <br/>
<a id="pl.39.16"></a><var>39.16</var>thereafter, the personal care assistance choice provider agency, recipient, or responsible <br/>
<a id="pl.39.17"></a><var>39.17</var>party, each personal care assistant, and the qualified professional and the recipient or <br/>
<a id="pl.39.18"></a><var>39.18</var>responsible party shall enter into a written agreement. The annual agreement must be <br/>
<a id="pl.39.19"></a><var>39.19</var>provided to the recipient or responsible party, each personal care assistant, and the <br/>
<a id="pl.39.20"></a><var>39.20</var>qualified professional when completed, and include at a minimum:<br/>
<a id="pl.39.21"></a><var>39.21</var>    (1) duties of the recipient, qualified professional, personal care assistant, and <br/>
<a id="pl.39.22"></a><var>39.22</var>personal care assistance choice provider agency;<br/>
<a id="pl.39.23"></a><var>39.23</var>    (2) salary and benefits for the personal care assistant and the qualified professional;<br/>
<a id="pl.39.24"></a><var>39.24</var>    (3) administrative fee of the personal care assistance choice provider agency and <br/>
<a id="pl.39.25"></a><var>39.25</var>services paid for with that fee, including background study fees;<br/>
<a id="pl.39.26"></a><var>39.26</var>    (4) grievance procedures to respond to complaints;<br/>
<a id="pl.39.27"></a><var>39.27</var>    (5) procedures for hiring and terminating the personal care assistant; and<br/>
<a id="pl.39.28"></a><var>39.28</var>    (6) documentation requirements including, but not limited to, time sheets, activity <br/>
<a id="pl.39.29"></a><var>39.29</var>records, and the personal care assistance care plan.<br/>
<a id="pl.39.30"></a><var>39.30</var>    (b) Effective January 1, 2010, except for the administrative fee of the personal care <br/>
<a id="pl.39.31"></a><var>39.31</var>assistance choice provider agency as reported on the written agreement, the remainder <br/>
<a id="pl.39.32"></a><var>39.32</var>of the rates paid to the personal care assistance choice provider agency must be used to <br/>
<a id="pl.39.33"></a><var>39.33</var>pay for the salary and benefits for the personal care assistant or the qualified professional. <br/>
<a id="pl.39.34"></a><var>39.34</var>The provider agency must use a minimum of 72.5 percent of the revenue generated by <br/>
<a id="pl.40.1"></a><var>40.1</var>the medical assistance rate for personal care assistance services for employee personal <br/>
<a id="pl.40.2"></a><var>40.2</var>care assistant wages and benefits.<br/>
<a id="pl.40.3"></a><var>40.3</var>    (c) The commissioner shall deny, revoke, or suspend the authorization to use the <br/>
<a id="pl.40.4"></a><var>40.4</var>personal care assistance choice option if:<br/>
<a id="pl.40.5"></a><var>40.5</var>    (1) it has been determined by the qualified professional or public health nurse that <br/>
<a id="pl.40.6"></a><var>40.6</var>the use of this option jeopardizes the recipient's health and safety;<br/>
<a id="pl.40.7"></a><var>40.7</var>    (2) the parties have failed to comply with the written agreement specified in this <br/>
<a id="pl.40.8"></a><var>40.8</var>subdivision;<br/>
<a id="pl.40.9"></a><var>40.9</var>    (3) the use of the option has led to abusive or fraudulent billing for personal care <br/>
<a id="pl.40.10"></a><var>40.10</var>assistance services; or<br/>
<a id="pl.40.11"></a><var>40.11</var>    (4) the department terminates the personal care assistance choice option.<br/>
<a id="pl.40.12"></a><var>40.12</var>    (d) The recipient or responsible party may appeal the commissioner's decision in <br/>
<a id="pl.40.13"></a><var>40.13</var>paragraph (c) according to section 
         <statute_ref>256.045</statute_ref>. The denial, revocation, or suspension to <br/>
<a id="pl.40.14"></a><var>40.14</var>use the personal care assistance choice option must not affect the recipient's authorized <br/>
<a id="pl.40.15"></a><var>40.15</var>level of personal care assistance services.<br/>
<br/>
<a id="bill.2.11.0"></a><a id="pl.40.16"></a><var>40.16</var>    Sec. 11. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 21, <br/>
<a id="pl.40.17"></a><var>40.17</var>is amended to read:<br/>
<a id="pl.40.18"></a><var>40.18</var>    Subd. 21. <b>Requirements for initial enrollment of personal care assistance </b><br/>
<a id="pl.40.19"></a><var>40.19</var><b>provider agencies.</b> (a) All personal care assistance provider agencies must provide, at the <br/>
<a id="pl.40.20"></a><var>40.20</var>time of enrollment as a personal care assistance provider agency in a format determined <br/>
<a id="pl.40.21"></a><var>40.21</var>by the commissioner, information and documentation that includes, but is not limited to, <br/>
<a id="pl.40.22"></a><var>40.22</var>the following:<br/>
<a id="pl.40.23"></a><var>40.23</var>    (1) the personal care assistance provider agency's current contact information <br/>
<a id="pl.40.24"></a><var>40.24</var>including address, telephone number, and e-mail address;<br/>
<a id="pl.40.25"></a><var>40.25</var>    (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the <br/>
<a id="pl.40.26"></a><var>40.26</var>provider's payments from Medicaid in the previous year, whichever is less;<br/>
<a id="pl.40.27"></a><var>40.27</var>    (3) proof of fidelity bond coverage in the amount of $20,000;<br/>
<a id="pl.40.28"></a><var>40.28</var>    (4) proof of workers' compensation insurance coverage;<br/>
<a id="pl.40.29"></a><var>40.29</var>    (5) a description of the personal care assistance provider agency's organization <br/>
<a id="pl.40.30"></a><var>40.30</var>identifying the names of all owners, managing employees, staff, board of directors, and <br/>
<a id="pl.40.31"></a><var>40.31</var>the affiliations of the directors, owners, or staff to other service providers;<br/>
<a id="pl.40.32"></a><var>40.32</var>    (6) a copy of the personal care assistance provider agency's written policies and <br/>
<a id="pl.40.33"></a><var>40.33</var>procedures including: hiring of employees; training requirements; service delivery; <br/>
<a id="pl.40.34"></a><var>40.34</var>and employee and consumer safety including process for notification and resolution <br/>
<a id="pl.41.1"></a><var>41.1</var>of consumer grievances, identification and prevention of communicable diseases, and <br/>
<a id="pl.41.2"></a><var>41.2</var>employee misconduct;<br/>
<a id="pl.41.3"></a><var>41.3</var>    (7) copies of all other forms the personal care assistance provider agency uses in <br/>
<a id="pl.41.4"></a><var>41.4</var>the course of daily business including, but not limited to:<br/>
<a id="pl.41.5"></a><var>41.5</var>    (i) a copy of the personal care assistance provider agency's time sheet if the time <br/>
<a id="pl.41.6"></a><var>41.6</var>sheet varies from the standard time sheet for personal care assistance services approved <br/>
<a id="pl.41.7"></a><var>41.7</var>by the commissioner, and a letter requesting approval of the personal care assistance <br/>
<a id="pl.41.8"></a><var>41.8</var>provider agency's nonstandard time sheet;<br/>
<a id="pl.41.9"></a><var>41.9</var>    (ii) the personal care assistance provider agency's template for the personal care <br/>
<a id="pl.41.10"></a><var>41.10</var>assistance care plan; and<br/>
<a id="pl.41.11"></a><var>41.11</var>    (iii) the personal care assistance provider agency's template for the written <br/>
<a id="pl.41.12"></a><var>41.12</var>agreement in subdivision 20 for recipients using the personal care assistance choice <br/>
<a id="pl.41.13"></a><var>41.13</var>option, if applicable;<br/>
<a id="pl.41.14"></a><var>41.14</var>    (8) a list of all trainings and classes that the personal care assistance provider agency <br/>
<a id="pl.41.15"></a><var>41.15</var>requires of its staff providing personal care assistance services;<br/>
<a id="pl.41.16"></a><var>41.16</var>    (9) documentation that the personal care assistance provider agency and staff have <br/>
<a id="pl.41.17"></a><var>41.17</var>successfully completed all the training required by this section;<br/>
<a id="pl.41.18"></a><var>41.18</var>    (10) documentation of the agency's marketing practices;<br/>
<a id="pl.41.19"></a><var>41.19</var>    (11) disclosure of ownership, leasing, or management of all residential properties <br/>
<a id="pl.41.20"></a><var>41.20</var>that is used or could be used for providing home care services; and<br/>
<a id="pl.41.21"></a><var>41.21</var>    (12) documentation that the agency will use the following percentages of revenue <br/>
<a id="pl.41.22"></a><var>41.22</var>generated from the medical assistance rate paid for personal care assistance services <br/>
<a id="pl.41.23"></a><var>41.23</var>for employee personal care assistant wages and benefits: 72.5 percent of revenue in the <br/>
<a id="pl.41.24"></a><var>41.24</var>personal care assistance choice option and 72.5 percent of revenue from other personal <br/>
<a id="pl.41.25"></a><var>41.25</var>care assistance providers; and<br/>
<a id="pl.41.26"></a><var>41.26</var>    (13) effective the day following final enactment, documentation that the agency does <br/>
<a id="pl.41.27"></a><var>41.27</var>not burden recipients' free exercise of their right to choose service providers by requiring <br/>
<a id="pl.41.28"></a><var>41.28</var>personal care assistants to sign an agreement not to work with any particular personal <br/>
<a id="pl.41.29"></a><var>41.29</var>care assistance recipient or for another personal care assistance provider agency after <br/>
<a id="pl.41.30"></a><var>41.30</var>leaving the agency and that the agency is not taking action on any such agreements or <br/>
<a id="pl.41.31"></a><var>41.31</var>requirements regardless of the date signed.<br/>
<a id="pl.41.32"></a><var>41.32</var>    (b) Personal care assistance provider agencies shall provide the information specified <br/>
<a id="pl.41.33"></a><var>41.33</var>in paragraph (a) to the commissioner at the time the personal care assistance provider <br/>
<a id="pl.41.34"></a><var>41.34</var>agency enrolls as a vendor or upon request from the commissioner. The commissioner <br/>
<a id="pl.41.35"></a><var>41.35</var>shall collect the information specified in paragraph (a) from all personal care assistance <br/>
<a id="pl.41.36"></a><var>41.36</var>providers beginning July 1, 2009.<br/>
<a id="pl.42.1"></a><var>42.1</var>    (c) All personal care assistance provider agencies shall require all employees in <br/>
<a id="pl.42.2"></a><var>42.2</var>management and supervisory positions and owners of the agency who are active in the <br/>
<a id="pl.42.3"></a><var>42.3</var>day-to-day management and operations of the agency to complete mandatory training as <br/>
<a id="pl.42.4"></a><var>42.4</var>determined by the commissioner before enrollment of the agency as a provider. Personal <br/>
<a id="pl.42.5"></a><var>42.5</var>care assistance provider agencies are required to send all owners, qualified professionals <br/>
<a id="pl.42.6"></a><var>42.6</var>employed by the agency, and all other managing employees to the initial and subsequent <br/>
<a id="pl.42.7"></a><var>42.7</var>trainings. Employees in management and supervisory positions and owners who are <br/>
<a id="pl.42.8"></a><var>42.8</var>active in the day-to-day operations of an agency who have completed the required training <br/>
<a id="pl.42.9"></a><var>42.9</var>as an employee with a personal care assistance provider agency do not need to repeat <br/>
<a id="pl.42.10"></a><var>42.10</var>the required training if they are hired by another agency, if they have completed the <br/>
<a id="pl.42.11"></a><var>42.11</var>training within the past three years. By September 1, 2010, the required training must be <br/>
<a id="pl.42.12"></a><var>42.12</var>available in languages other than English and to those who need accommodations due <br/>
<a id="pl.42.13"></a><var>42.13</var>to disabilities, online, or by electronic remote connection, and provide for competency <br/>
<a id="pl.42.14"></a><var>42.14</var>testing. Personal care assistance provider agency billing staff shall complete training <br/>
<a id="pl.42.15"></a><var>42.15</var>about personal care assistance program financial management. This training is effective <br/>
<a id="pl.42.16"></a><var>42.16</var>July 1, 2009. Any personal care assistance provider agency enrolled before that date <br/>
<a id="pl.42.17"></a><var>42.17</var>shall, if it has not already, complete the provider training within 18 months of July 1, <br/>
<a id="pl.42.18"></a><var>42.18</var>2009. Any new owners, new qualified professionals, and new managing or employees in <br/>
<a id="pl.42.19"></a><var>42.19</var>management and supervisory positions involved in the day-to-day operations are required <br/>
<a id="pl.42.20"></a><var>42.20</var>to complete mandatory training as a requisite of hiring working for the agency. Personal <br/>
<a id="pl.42.21"></a><var>42.21</var>care assistance provider agencies certified for participation in Medicare as home health <br/>
<a id="pl.42.22"></a><var>42.22</var>agencies are exempt from the training required in this subdivision.<br/>
<br/>
<a id="bill.2.12.0"></a><a id="pl.42.23"></a><var>42.23</var>    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 24, <br/>
<a id="pl.42.24"></a><var>42.24</var>is amended to read:<br/>
<a id="pl.42.25"></a><var>42.25</var>    Subd. 24. <b>Personal care assistance provider agency; general duties.</b> A personal <br/>
<a id="pl.42.26"></a><var>42.26</var>care assistance provider agency shall:<br/>
<a id="pl.42.27"></a><var>42.27</var>    (1) enroll as a Medicaid provider meeting all provider standards, including <br/>
<a id="pl.42.28"></a><var>42.28</var>completion of the required provider training;<br/>
<a id="pl.42.29"></a><var>42.29</var>    (2) comply with general medical assistance coverage requirements;<br/>
<a id="pl.42.30"></a><var>42.30</var>    (3) demonstrate compliance with law and policies of the personal care assistance <br/>
<a id="pl.42.31"></a><var>42.31</var>program to be determined by the commissioner;<br/>
<a id="pl.42.32"></a><var>42.32</var>    (4) comply with background study requirements;<br/>
<a id="pl.42.33"></a><var>42.33</var>    (5) verify and keep records of hours worked by the personal care assistant and <br/>
<a id="pl.42.34"></a><var>42.34</var>qualified professional;<br/>
<a id="pl.43.1"></a><var>43.1</var>    (6) market agency services only through printed information in brochures and on <br/>
<a id="pl.43.2"></a><var>43.2</var>Web sites and not engage in any agency-initiated direct contact or marketing in person, by <br/>
<a id="pl.43.3"></a><var>43.3</var>phone, or other electronic means to potential recipients, guardians, or family members;<br/>
<a id="pl.43.4"></a><var>43.4</var>    (7) pay the personal care assistant and qualified professional based on actual hours <br/>
<a id="pl.43.5"></a><var>43.5</var>of services provided;<br/>
<a id="pl.43.6"></a><var>43.6</var>    (8) withhold and pay all applicable federal and state taxes;<br/>
<a id="pl.43.7"></a><var>43.7</var>    (9) effective January 1, 2010, document that the agency uses a minimum of 72.5 <br/>
<a id="pl.43.8"></a><var>43.8</var>percent of the revenue generated by the medical assistance rate for personal care assistance <br/>
<a id="pl.43.9"></a><var>43.9</var>services for employee personal care assistant wages and benefits;<br/>
<a id="pl.43.10"></a><var>43.10</var>    (10) make the arrangements and pay unemployment insurance, taxes, workers' <br/>
<a id="pl.43.11"></a><var>43.11</var>compensation, liability insurance, and other benefits, if any;<br/>
<a id="pl.43.12"></a><var>43.12</var>    (11) enter into a written agreement under subdivision 20 before services are provided;<br/>
<a id="pl.43.13"></a><var>43.13</var>    (12) report suspected neglect and abuse to the common entry point according to <br/>
<a id="pl.43.14"></a><var>43.14</var>section 
         <statute_ref>256B.0651</statute_ref>;<br/>
<a id="pl.43.15"></a><var>43.15</var>    (13) provide the recipient with a copy of the home care bill of rights at start of <br/>
<a id="pl.43.16"></a><var>43.16</var>service; and<br/>
<a id="pl.43.17"></a><var>43.17</var>    (14) request reassessments at least 60 days prior to the end of the current <br/>
<a id="pl.43.18"></a><var>43.18</var>authorization for personal care assistance services, on forms provided by the commissioner.<br/>
<br/>
<a id="bill.2.13.0"></a><a id="pl.43.19"></a><var>43.19</var>    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 27, <br/>
<a id="pl.43.20"></a><var>43.20</var>is amended to read:<br/>
<a id="pl.43.21"></a><var>43.21</var>    Subd. 27. <b>Personal care assistance provider agency</b><b>; ventilator training</b><b>.</b> (a) The <br/>
<a id="pl.43.22"></a><var>43.22</var>personal care assistance provider agency is required to provide training for the personal <br/>
<a id="pl.43.23"></a><var>43.23</var>care assistant responsible for working with a recipient who is ventilator dependent. All <br/>
<a id="pl.43.24"></a><var>43.24</var>training must be administered by a respiratory therapist, nurse, or physician. Qualified <br/>
<a id="pl.43.25"></a><var>43.25</var>professional supervision by a nurse must be completed and documented on file in the <br/>
<a id="pl.43.26"></a><var>43.26</var>personal care assistant's employment record and the recipient's health record. If offering <br/>
<a id="pl.43.27"></a><var>43.27</var>personal care services to a ventilator-dependent recipient, the personal care assistance <br/>
<a id="pl.43.28"></a><var>43.28</var>provider agency shall demonstrate and document the ability to:<br/>
<a id="pl.43.29"></a><var>43.29</var>    (1) train the personal care assistant;<br/>
<a id="pl.43.30"></a><var>43.30</var>    (2) supervise the personal care assistant in ventilator operation and maintenance the <br/>
<a id="pl.43.31"></a><var>43.31</var>care of a ventilator-dependent recipient; and<br/>
<a id="pl.43.32"></a><var>43.32</var>    (3) supervise the recipient and responsible party in ventilator operation and <br/>
<a id="pl.43.33"></a><var>43.33</var>maintenance the care of a ventilator-dependent recipient; and<br/>
<a id="pl.43.34"></a><var>43.34</var>    (4) provide documentation of the training and supervision in clauses (1) to (3) <br/>
<a id="pl.43.35"></a><var>43.35</var>upon request.<br/>
<a id="pl.44.1"></a><var>44.1</var>    (b) A personal care assistant shall not undertake any clinical services, patient <br/>
<a id="pl.44.2"></a><var>44.2</var>assessment, patient evaluation, or clinical education regarding the ventilator or the patient <br/>
<a id="pl.44.3"></a><var>44.3</var>on the ventilator. These services may only be provided by health care professionals <br/>
<a id="pl.44.4"></a><var>44.4</var>licensed or registered in this state.<br/>
<a id="pl.44.5"></a><var>44.5</var>    (c) A personal care assistant may only perform tasks associated with ventilator <br/>
<a id="pl.44.6"></a><var>44.6</var>maintenance that are approved by the Board of Medical Practice in consultation with the <br/>
<a id="pl.44.7"></a><var>44.7</var>Respiratory Care Practitioner Advisory Council and the Department of Human Services.<br/>
<br/>
<a id="bill.2.14.0"></a><a id="pl.44.8"></a><var>44.8</var>    Sec. 14. Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 30, <br/>
<a id="pl.44.9"></a><var>44.9</var>is amended to read:<br/>
<a id="pl.44.10"></a><var>44.10</var>    Subd. 30. <b>Notice of service changes to recipients.</b> The commissioner must provide:<br/>
<a id="pl.44.11"></a><var>44.11</var>    (1) by October 31, 2009, information to recipients likely to be affected that (i) <br/>
<a id="pl.44.12"></a><var>44.12</var>describes the changes to the personal care assistance program that may result in the <br/>
<a id="pl.44.13"></a><var>44.13</var>loss of access to personal care assistance services, and (ii) includes resources to obtain <br/>
<a id="pl.44.14"></a><var>44.14</var>further information; and<br/>
<a id="pl.44.15"></a><var>44.15</var>    (2) notice of changes in medical assistance home care services to each affected <br/>
<a id="pl.44.16"></a><var>44.16</var>recipient at least 30 days before the effective date of the change.<br/>
<a id="pl.44.17"></a><var>44.17</var>The notice shall include how to get further information on the changes, how to get help to <br/>
<a id="pl.44.18"></a><var>44.18</var>obtain other services, a list of community resources, and appeal rights. Notwithstanding <br/>
<a id="pl.44.19"></a><var>44.19</var>section 
         <statute_ref>256.045</statute_ref>, a recipient may request continued services pending appeal within the <br/>
<a id="pl.44.20"></a><var>44.20</var>time period allowed to request an appeal; and<br/>
<a id="pl.44.21"></a><var>44.21</var>    (3) a service agreement authorizing personal care assistance hours of service at <br/>
<a id="pl.44.22"></a><var>44.22</var>the previously authorized level, throughout the appeal process period, when a recipient <br/>
<a id="pl.44.23"></a><var>44.23</var>requests services pending an appeal.<br/>
<br/>
<a id="bill.2.15.0"></a><a id="pl.44.24"></a><var>44.24</var>    Sec. 15. Minnesota Statutes 2008, section 256B.092, subdivision 4d, is amended to <br/>
<a id="pl.44.25"></a><var>44.25</var>read:<br/>
<a id="pl.44.26"></a><var>44.26</var>    Subd. 4d. <b>Medicaid reimbursement; licensed provider; related individuals.</b> The <br/>
<a id="pl.44.27"></a><var>44.27</var>commissioner shall seek a federal amendment to the home and community-based services <br/>
<a id="pl.44.28"></a><var>44.28</var>waiver for individuals with developmental disabilities, to allow Medicaid reimbursement <br/>
<a id="pl.44.29"></a><var>44.29</var>for the provision of supported living services to a related individual is allowed when the <br/>
<a id="pl.44.30"></a><var>44.30</var>following conditions have been met: specified in section 245A.03, subdivision 9, are met. <br/>
<a id="pl.44.31"></a><var>44.31</var>    (1) the individual is 18 years of age or older;<br/>
<a id="pl.44.32"></a><var>44.32</var>    (2) the provider is certified initially and annually thereafter, by the county, as <br/>
<a id="pl.44.33"></a><var>44.33</var>meeting the provider standards established in chapter 245B and the federal waiver plan;<br/>
<a id="pl.45.1"></a><var>45.1</var>    (3) the provider has been certified by the county as meeting the adult foster care <br/>
<a id="pl.45.2"></a><var>45.2</var>provider standards established in Minnesota Rules, parts 9555.5105 to 9555.6265;<br/>
<a id="pl.45.3"></a><var>45.3</var>    (4) the provider is not the legal guardian or conservator of the related individual; and<br/>
<a id="pl.45.4"></a><var>45.4</var>    (5) the individual's service plan meets the standards of this section 
<statute_ref></statute_ref> and specifies any <br/>
<a id="pl.45.5"></a><var>45.5</var>special conditions necessary to prevent a conflict of interest for the provider.<br/>
<br/>
<a id="bill.2.16.0"></a><a id="pl.45.6"></a><var>45.6</var>    Sec. 16. <b> REPEALER.</b><br/>
<a id="pl.45.7"></a><var>45.7</var>Minnesota Statutes 2008, section 256B.0919, subdivision 4, is repealed.<br/>