Relating to health and human services; establishing the health and human services budget

ARTICLE 1 - AFFORDABLE HEALTH CARE ACT IMPLEMENTATION; BETTER HEALTH CARE FOR MORE MINNESOTANS

Dedicating MinnesotaCare federal receipts; modifying chemical dependency treatment fund services eligibility for children; requiring federal approval to operate a health coverage program for certain persons in poverty; expanding the state agency lien for MinnesotaCare; making technical and conforming changes to the Affordable Care Act; adding and modifying medical assistance (MA) definitions and various eligibility conditions and requirements and clarifying state agency MA duties; modifying the MA health care delivery systems demonstration project and the sole-source or single-plan managed care contract; conforming MinnesotaCare definitions to federal regulations; defining Minnesota insurance marketplace (MNsure) and participating entity; requiring the commissioner of human services to seek federal approval for MinnesotaCare implementation as a basic health program and requiring MinnesotaCare coordination with the Minnesota insurance marketplace (MNsure); modifying MinnesotaCare definitions and defining new terms under MinnesotaCare; modifying MinnesotaCare eligibility conditions and establishing new eligibility requirements; requiring the commissioner to establish a competitive process for entering contracts with participating entities offering standard health plans through MinnesotaCare; modifying MinnesotaCare costs determination; requiring certain state agencies to determine the funding adequacy for MinnesotaCare; requiring a state-based risk adjustment system assessment by the commissioner of health; requiring the commissioner of human services to seek federal authority to continue to allow certain persons to continue to disregard a spousal income and assets; repealing certain MinnesotaCare provisions by a certain date; repealing certain MA eligibility provisions

ARTICLE 2 - CONTINGENT REFORM 2020; REDESIGNING HOME AND COMMUNITY-BASED SERVICES

Modifying home and community-based continuing care services; requiring a one-time critical access study; designating the agencies operating the Senior LinkAge line and the Disability Linkage line as the state aging and disability resource centers under federal code; requiring certain costs reimbursement claims incorporation into federal cost reimbursement claiming processes; modifying nursing facility admission preadmission screening; modifying the medical assistance (MA) reform waiver, long-term care consultation services, the alternative care program, senior's agenda for independent living (SAIL) projects, long-term care service consumer surveys, quality profiles, the value-based nursing facility reimbursement system, and the home and community-based service waiver for the disabled; requiring a home and community-based services report card; modifying the group residential housing supplementary service rate; requiring common entry point use for vulnerable adult maltreatment reporting; specifying a federal approval contingency for all provisions; repealing provisions relating to common entry point vulnerable adult maltreatment reporting federal grants, SAIL, and long-term care consultation services

ARTICLE 3 - SAFE AND HEALTHY DEVELOPMENT OF CHILDREN, YOUTH AND FAMILIES

Establishing new Minnesota family investment child care program (MFIP) definitions and modifying the eligibility redetermination requirement, funding priority, eligibility, subsidy restrictions, provider rates and payments, absent days, immediate suspension expedited hearing, and sudden unexpected infant death in licensed programs and abusive head trauma provisions; establishing family child care diapering area disinfection and family child care infant sleep supervision requirements; requiring child care license holder insurance disclosure; modifying family child care training requirements; changing the services for persons with disabilities parental contribution amount; modifying the public assistance fraud disqualification period; modifying the MFIP income disregard, income exclusions, initial income test, transitional standard, family wage level, assistance amount, work participation cash benefits, and performance base funds; authorizing temporary assistance for needy families (TANF) demonstration projects or waiver from federal rules and regulations; modifying the title of the runaway and homeless youth act to homeless youth act and the mission and funding; modifying vulnerable children and adults act funding and formula; changing the position of ombudsperson for families to multiple positions; modifying the adoption assistance reimbursement for special nonmedical expenses, juvenile delinquency and placement provisions, and child support arrearage collection; prohibiting retailer subsidy for electronic benefit transfer (EBT) supplemental nutrition assistance program transactions; directing the commissioners of human services and the housing finance agency (HFA) to exclude certain income and assets for counting toward income and asset limits in determining or redetermining eligibility for certain specified programs; requiring the Minnesota interagency council on homelessness to make recommendations on strategies to reduce youth homelessness; requiring housing assistance grants to be a forecasted program; requiring a plan for rate setting criteria for group residential housing specialty rate and banked beds; repealing an MFIP family composition, assistance standards, and exit level and juvenile prostitution diversion or child protection proceedings

ARTICLE 4 - STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

Modifying the adult and the children's mental health acts and the state operated services account funds; increasing the county cost of care liability reimbursement and removing the exception for the Minnesota extended treatment options program; modifying civil commitment procedure administrative requirements and chemical dependency (navigator) pilot projects; authorizing continuum of care pilot projects for chemical health care; authorizing home and community-based services transitions grants and medical assistance (MA) to cover mental health certified family peer specialists services; modifying and extending MA coverage for adult rehabilitative mental health services, psychiatric consultation and primary care practitioners, and in-reach community-based service coordination; establishing MA coverage for family psychoeducation services, mental health clinical care consultation, and waiver allocations for transition populations; defining mental health service plan development; modifying MA children's therapeutic services and supports, treatment foster care, nursing facility home and community-based service waivers for the disabled, and the mental health services reimbursement; requiring recommendations for the state-operated child and adolescent behavioral health services facility and a pilot provider input survey of pediatric services and children's mental health services; requiring the commissioner of human services to convene the mentally ill and dangerous commitments stakeholders group for recommendations; requiring the commissioner to work with counties requesting assistance for timely discharge from Anoka metro regional treatment center and the Minnesota security hospital

ARTICLE 5 - DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY

Requiring a department of human services electronic process for regular transfer of new criminal case information added to the court information system; requiring agency review of predatory offender registration background study and criminal case information; establishing child care provider and recipient fraud investigations within the child care assistance program; modifying department of human services provider medical assistance (MA) enrollment duties and requiring application fee collection; modifying MA sanctions and monetary recovery; authorizing commissioner of human services bureau of criminal apprehension database access; modifying county delivery of essential human services; requiring establishment of a performance management system for human services; establishing and requiring a human services performance council; modifying conditions for commissioner power to remedy failure to meet essential human services performance outcomes; providing instructions to the commissioner to develop clear and consistent standards for state-operated services

ARTICLE 6 - HEALTH CARE

Authorizing two deputy human services commissioners; modifying the base for the health maintenance organization (HMO) and community integrated service network (CISN) surcharge; modifying the hospital, HMO, and CISN surcharge payment schedule; modifying the inpatient hospital reimbursement for fee increase for the early hearing detection and intervention program; requiring the commissioner to execute an interagency agreement to recover the state cost attributable to medical assistance (MA) eligibility for inmates of public institutions admitted to medical institutions as inpatients; extending MA emergency medical condition coverage to dialysis, chemotherapy, and therapeutic radiation; extending MA coverage to certain dental services, certain drugs, doula services, and electronic tablets used for communication; requiring a payment rate discount for certain drugs; requiring the commissioner to implement a point-of-sale preferred diabetic testing supply program under MA; modifying early and periodic screening, diagnosis, and treatment (EPSDT) services and payment for multiple services provided on the same day; allowing the Hennepin county pilot program to waive co-payments; allowing the commissioner to identify individuals to be enrolled in the Hennepin and Ramsey Counties health care delivery network pilot programs; requiring a Hennepin county medical center (HCMC)ambulance services upper payment limit; modifying managed care plan and county-based purchasing plan eligible administrative costs for prepaid health plans, managed care financial reporting, and the maximum aggregate trend increase limit; requiring a supplemental recovery program for third-party liabilities; increasing the physician, dental, family planning services, basic care services, and critical access dental providers reimbursements; requiring payment for certain primary care services and immunization administration services; specifying the Medicare payment limit for durable medical equipment, prosthetics, orthotics, and supplies; requiring the commissioner to determine the difference between actual and forecasted costs to MA for adding 19 and 20 year olds and related caretaker populations with certain income levels; requiring the commissioner to identify alternatives for and make recommendations for health care and coverage for certain uninsured and program ineligible populations; requiring a dental access and reimbursement report

ARTICLE 7 - CONTINUING CARE

Modifying late or nonsubmission resident reimbursement penalties, layaway bed removal, and the child foster care licensing moratorium; requiring a Nicollet county additional bed certification; increasing the intermediate care facility for developmental disabilities (ICF/DD) license surcharge; modifying elderly waiver cost limits; establishing on the elderly waiver the new service of individual community living support (ICLS) upon federal approval available; specifying county and tribal agencies responsibility for excess allocation spending; allowing screening teams to develop services for persons with developmental disabilities in a less restrictive alternative setting; allowing greater flexibility in statewide priorities for waivered services for the developmentally disabled; requiring consultations for persons receiving home and community-based services with two or more mental health related emergency room visits or hospital admissions; establishing the essential community supports program for certain elderly persons; providing a new autism early intensive intervention benefit; modifying certain medical assistance (MA) quality assurance provisions and removing the expiration date for the quality assurance system and the quality assurance commission; providing a nursing facility property rate increase for nursing facilities in McLeod and Dakota counties; providing a property rate adjustment for a Hennepin county boarding care facility; specifying nursing facilities case mix payment rates and certain nursing facility rate adjustments; removing the planned closure rate adjustment to allow for property payments for new nursing facilities or additions; modifying the quality profile system for nursing facilities and including home and community-based services providers in the profiles and applying quality measurement tools to nursing facilities and home and community-based services; establishing consumer surveys for home and community-based services; implementing a home and community-based services performance based incentive payment program; requiring a calculation of home and community-based services quality score and a calculation of a home and community-based services quality add-on payment; modifying the quality score calculation; requiring quality add-ons to facility operating payment rates and a quality improvement incentive system; providing a rate adjustment for a Cottonwood county ICF/DD; allowing a total operating payment rate facility increase; allowing ICF/DD rate increases; requiring initiatives to improve early screening, diagnosis, and treatment of children with autism spectrum disorder (ASD) and other developmental conditions; establishing and providing for community first services and supports; clarifying housing and services limits; modifying a prior appropriation for rates reduction for congregate living for individuals with lower needs; requiring recommendations for home and community-based settings concentration limits; modifying autism service provider training; requiring spousal disregard use continuance; requiring application for applied behavioral analysis services for children with ASD; requiring recommendations on raising the asset limits for seniors and persons with disabilities, a nursing home level of care report, assistive technology equipment recommendations, a provider rate and grant increase, a safety net for home and community-based services waivers request, a shared living model development, and a money follows the person grant submission; repealing provisions relating to Seniors' Agenda for Independent Living (sail) projects essential community support grants, the quality management, assurance, and improvement systems for Minnesotans receiving disability services, spousal contribution, an ICF/DD rate decrease, and contingency provider rate and grant reductions

ARTICLE 8 - WAIVER PROVIDER STANDARDS

Requiring positive support strategies, safety interventions, and emergency use of manual restraint use in licensed facilities; requiring manual restraint use reporting; defining and redefining terms; redesigning home and community-based services standards; modifying license or certification fees for certain programs; establishing psychotropic medication use and monitoring, emergency use of manual restraints, service planning and delivery with intensive support services, program coordination, evaluation, and oversight, intervention services, record requirements, policies and procedures with intensive support services, facility licensure requirements and application process, facility sanitation and health, community residential settings and day services requirements, alternative licensing inspections, adult mental health certification standards; making conforming changes; requiring a report on transfer of vulnerable adult maltreatment investigation duties and an integrated licensing system for home care and home and community-based services; repealing services for developmental disabilities and record requirements

ARTICLE 9 - WAIVER PROVIDER STANDARDS TECHNICAL CHANGES

Making technical changes; repealing home and community-based services for the disabled services and supports

ARTICLE 10 - HEALTH-RELATED LICENSING BOARDS

Decreasing licensed marriage and family therapist licensure fees; changing licensure requirements for businesses regulated by the board of pharmacy; modifying sales of federally restricted medical gases; requiring drug manufacturer licensing and specifying fees and prohibitions; modifying drug use for research and wholesale drug distributor regulations; establishing a criminal background check process for individuals licensed by the health-related licensing boards; requiring continuing education requirements for health related licensed boards to include parental depression; including advanced dental therapists in the definition of health care provider; requiring the department of health to require occupational therapy practitioners, speech-language pathologists, audiologists, and hearing instrument dispensers applying for licensure to submit to criminal history records check under certain conditions; repealing certain provisions relating to nonresident pharmacies registration fees, registration of manufacturers fee prohibitions, the wholesale drug distributor advisory task force, wholesale drug distributor licensing federal law conformity, and out-of-state wholesale drug distributor licensing

ARTICLE 11 - HOME CARE PROVIDERS

Clarifying health occupations and home care and hospice provider data; classifying department of health data and regulating data release; modifying the home care program, the home care bill of rights, and home care services regulation; requiring and providing for home care provider and home care services licensure and requiring periodic surveys and investigations; specifying enforcement, background studies, compliance, innovation variance, home care provider responsibilities, business operation, medication management, treatment and therapy management services, client record requirements, staffing, orientation and annual training requirements, provision of services, and employee health status; requiring a department of health licensed home care provider advisory council; specifying a home care licensing implementation for new licensees and transition period for current licensees; requiring home management providers registration, an agency quality improvement program, an integrated licensing system for home care and home and community-based services, and a study of a correction order appeal process; repealing home care program licensure

ARTICLE 12 - HEALTH DEPARTMENT

Requiring the commissioner of management and budget (MMB) to transfer certain amounts from the health care access fund to the medical education and research costs fund; requiring the state employee group insurance program (SEGIP) and health insurance plans to provide autism spectrum disorder (ASD) coverage for plan participants; expanding the clinical medical education program to include training of dental therapists and advanced dental therapists, psychologists, clinical social workers, community paramedics, and community health workers; modifying health care cost containment distribution of funds, reporting, and eligible providers review; modifying essential community providers designations; defining bored geothermal heat exchanger and fees accreditation; allowing the commissioner of health to enter contracts for fee charging for costs recovery; requiring licensed hospital and licensed birthing centers to provide newborn critical congenital heart disease (CCHD) screening; modifying vital statistics definitions and creating the office of vital records under the state registrar; specifying security of the vital records system; regulating vital records amendment and correction procedure; establishing criteria for comprehensive, primary, and acute stroke centers and hospitals; regulating designation of stroke centers and hospitals; specifying health care facilities architectural, mechanical, and electrical review and approval fees; extending the newborn hearing screening advisory committee; modifying early hearing detection and intervention program family support services; lowering the environmental laboratories accreditation fees; requiring a selection committee for recommending approval of qualified laboratory assessors and assessment bodies; authorizing administrative penalty orders to certified lead firms; establishing the position of director of child sex trafficking prevention; specifying duties of the director; providing for regional navigator grants to various regions of the state; requiring the director to conduct a comprehensive evaluation of the statewide program for safe harbor for sexually exploited youth; defining maternal depression; modifying the statewide health improvement program; modifying family home visiting program goals; defining alkaline hydrolysis and relevant terms; requiring a license to operate an alkaline hydrolysis facility and specifying regulations; modifying membership, duties, and reporting of the Minnesota task force on prematurity; requiring review of statutory requirements for funeral establishment branch locations; requiring a health equity report, a guaranteed renewability study, a capital reserves limits study, Minnesota comprehensive health association (MCHA) study and recommendations, and a certain attorney general legal opinion; requiring the department of commerce to request inclusion of autism services in Minnesota's essential health benefits; repealing medical research, a well boring definition, certain mortuary science statutes, and a vital statistic statute

ARTICLE 13 - PAYMENT METHODOLOGIES FOR HOME AND COMMUNITY-BASED SERVICES

Modifying medical assistance (MA) home and community-based waivers providers payment methodology for services for persons with developmental disabilities and the disabled; establishing a new home and community-based waivers rate setting; repealing medical assistance (MA) payment methodology development; providing transition authority to the commissioner of human services to manage the disability home and community-based service waiver programs with federal requirements; repealing service principles and rate setting procedures, payment rates, and MA payment methodology development and payment for person with special needs

ARTICLE 14 - HEALTH AND HUMAN SERVICES APPROPRIATIONS

Appropriating money to the commissioner of human services for supplemental nutrition assistance, temporary assistance for needy families (TANF) maintenance of effort (MOE), working family credit expenditures, health care, continuing care, chemical and mental health, the Minnesota family investment program (MFIP) diversionary work program (DWP), child care assistance, general assistance (GA), supplemental assistance, group residential housing, MinnesotaCare, medical assistance (MA), deaf and hard-of-hearing services, alternative care, CD treatment, work study, MFIP teen parents home visiting collaborations, county performance bonus funds, child support, adoption assistance, child and economic support grants, health care grants, advocating change together, adult and child mental health grants, the sex offender program, to the commissioner of health for health improvement, compliance, health protection, to the health-related boards, to the emergency medical services regulatory board, to the council on disability, to the ombudsman for mental health and developmental disabilities, and to the ombudsperson for families; specifying federal administrative reimbursement use; authorizing certain transfers and adjustments

ARTICLE 15 - REFORM 2020 CONTINGENT APPROPRIATIONS

Appropriating money to the commissioner of human services for children and families, continuing care, group residential housing, medical assistance (MA), alternative care, child and community service grants, and aging and adult services grants; specifying a federal approval contingency; requiring commissioner of management and budget (MMB) appropriations adjustment

ARTICLE 16 - HUMAN SERVICES FORECAST ADJUSTMENT

Appropriating money to the commissioner of human services for the Minnesota family investment program (MFIP), diversionary work program (DWIP), child care assistance, general assistance (GA), supplemental aid, group residential housing, MinnesotaCare, medical assistance (MA), alternative care, and CD entitlement

ARTICLE 17 - NORTHSTAR CARE FOR CHILDREN

Modifying contracts for child foster care services, payments, and standard rates; "Northstar Care for Children Act"; providing a public policy; authorizing certain benefits to support a child in need who is served by the Minnesota child welfare system and who is the responsibility of the state, local county social service agencies, or tribal social service agencies or otherwise eligible for federal adoption assistance, specifying scope of the act and providing regulations; expanding certain criteria for relative custody assistance under the parentage act; prohibiting new execution of adoption assistance agreements; regulating financial responsibility requirements for pre-Northstar Care for children foster care programs; specifying initial clothing allowance availability requirements; repealing child support state payments rules, and juvenile costs and payments and certain rules
(rt)