<a id="pl.1.3"></a><var>1.3</var>modifying provisions related to health care, continuing care, nursing facility <br/>
<a id="pl.1.4"></a><var>1.4</var>admission, children and family services, human services licensing, chemical <br/>
<a id="pl.1.5"></a><var>1.5</var>and mental health, program integrity, managed care organizations, waiver <br/>
<a id="pl.1.6"></a><var>1.6</var>provider standards, home care, and the Department of Health; redesigning <br/>
<a id="pl.1.7"></a><var>1.7</var>home and community-based services; establishing community first services and <br/>
<a id="pl.1.8"></a><var>1.8</var>supports and Northstar Care for Children; providing for fraud investigations <br/>
<a id="pl.1.9"></a><var>1.9</var>in the child care assistance program; establishing autism early intensive <br/>
<a id="pl.1.10"></a><var>1.10</var>intervention benefits; creating a human services performance council; making <br/>
<a id="pl.1.11"></a><var>1.11</var>technical changes; requiring a study; requiring reports; appropriating money; <br/>
<a id="pl.1.12"></a><var>1.12</var>repealing MinnesotaCare;amending Minnesota Statutes 2012, sections 13.381, <br/>
<a id="pl.1.13"></a><var>1.13</var>subdivisions 2, 10; 13.411, subdivision 7; 13.461, by adding subdivisions; <br/>
<a id="pl.1.14"></a><var>1.14</var>16A.724, subdivision 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62J.692, <br/>
<a id="pl.1.15"></a><var>1.15</var>subdivisions 1, 3, 4, 5, 7a, 9, by adding a subdivision; 62Q.19, subdivision <br/>
<a id="pl.1.16"></a><var>1.16</var>1; 103I.005, by adding a subdivision; 103I.521; 119B.05, subdivision 1; <br/>
<a id="pl.1.17"></a><var>1.17</var>119B.09, subdivision 5; 119B.125, subdivision 1; 119B.13, subdivisions 1, <br/>
<a id="pl.1.18"></a><var>1.18</var>7; 144.051, by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123, <br/>
<a id="pl.1.19"></a><var>1.19</var>subdivision 1; 144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions <br/>
<a id="pl.1.20"></a><var>1.20</var>3, 4; 144.216, subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5; <br/>
<a id="pl.1.21"></a><var>1.21</var>144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966, subdivisions 2, 3a; 144.98, <br/>
<a id="pl.1.22"></a><var>1.22</var>subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4; 144A.071, <br/>
<a id="pl.1.23"></a><var>1.23</var>subdivision 4b; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4; <br/>
<a id="pl.1.24"></a><var>1.24</var>145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17, <br/>
<a id="pl.1.25"></a><var>1.25</var>subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5, <br/>
<a id="pl.1.26"></a><var>1.26</var>16, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding <br/>
<a id="pl.1.27"></a><var>1.27</var>subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4; <br/>
<a id="pl.1.28"></a><var>1.28</var>149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1, <br/>
<a id="pl.1.29"></a><var>1.29</var>2, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94; <br/>
<a id="pl.1.30"></a><var>1.30</var>149A.96, subdivision 9; 151.01, subdivision 27; 151.19, subdivisions 1, 3; <br/>
<a id="pl.1.31"></a><var>1.31</var>151.26, subdivision 1; 151.37, subdivision 4; 151.47, subdivision 1, by adding <br/>
<a id="pl.1.32"></a><var>1.32</var>a subdivision; 151.49; 152.126; 174.30, subdivision 1; 214.12, by adding <br/>
<a id="pl.1.33"></a><var>1.33</var>a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03, <br/>
<a id="pl.1.34"></a><var>1.34</var>subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682, <br/>
<a id="pl.1.35"></a><var>1.35</var>subdivision 2; 245.4875, subdivision 8; 245.4881, subdivision 1; 245A.02, <br/>
<a id="pl.1.36"></a><var>1.36</var>subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision <br/>
<a id="pl.1.37"></a><var>1.37</var>13; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08, subdivision <br/>
<a id="pl.1.38"></a><var>1.38</var>2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435; 245A.144; <br/>
<a id="pl.1.39"></a><var>1.39</var>245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5; 245A.50; 245C.04, <br/>
<a id="pl.2.1"></a><var>2.1</var>by adding a subdivision; 245C.08, subdivision 1; 245C.32, subdivision <br/>
<a id="pl.2.2"></a><var>2.2</var>2; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09; <br/>
<a id="pl.2.3"></a><var>2.3</var>245D.10; 246.18, subdivision 8, by adding a subdivision; 252.27, subdivision <br/>
<a id="pl.2.4"></a><var>2.4</var>2a; 252.291, by adding a subdivision; 253B.10, subdivision 1; 254B.04, <br/>
<a id="pl.2.5"></a><var>2.5</var>subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions; <br/>
<a id="pl.2.6"></a><var>2.6</var>256.82, subdivision 3; 256.9657, subdivision 3; 256.969, subdivisions 3a, <br/>
<a id="pl.2.7"></a><var>2.7</var>29; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision <br/>
<a id="pl.2.8"></a><var>2.8</var>5, by adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by <br/>
<a id="pl.2.9"></a><var>2.9</var>adding subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision; <br/>
<a id="pl.2.10"></a><var>2.10</var>256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056, <br/>
<a id="pl.2.11"></a><var>2.11</var>subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057, <br/>
<a id="pl.2.12"></a><var>2.12</var>subdivisions 1, 10, by adding a subdivision; 256B.059, subdivision 1; 256B.06, <br/>
<a id="pl.2.13"></a><var>2.13</var>subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 13e, 19c, 31, <br/>
<a id="pl.2.14"></a><var>2.14</var>39, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision 1; 256B.064, <br/>
<a id="pl.2.15"></a><var>2.15</var>subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755, subdivision 3; <br/>
<a id="pl.2.16"></a><var>2.16</var>256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision; <br/>
<a id="pl.2.17"></a><var>2.17</var>256B.0913, subdivision 4, by adding a subdivision; 256B.0915, subdivisions 3a, <br/>
<a id="pl.2.18"></a><var>2.18</var>5, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917, <br/>
<a id="pl.2.19"></a><var>2.19</var>subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 11, 12, by <br/>
<a id="pl.2.20"></a><var>2.20</var>adding a subdivision; 256B.0943, subdivisions 1, 2, 7, by adding a subdivision; <br/>
<a id="pl.2.21"></a><var>2.21</var>256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1, <br/>
<a id="pl.2.22"></a><var>2.22</var>5; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196, subdivision 2; 256B.431, <br/>
<a id="pl.2.23"></a><var>2.23</var>subdivision 44; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.439, <br/>
<a id="pl.2.24"></a><var>2.24</var>subdivisions 1, 2, 3, 4, by adding a subdivision; 256B.441, subdivisions 13, <br/>
<a id="pl.2.25"></a><var>2.25</var>53, 55, 56, 62; 256B.49, subdivisions 11a, 12, 14, 15, by adding subdivisions; <br/>
<a id="pl.2.26"></a><var>2.26</var>256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913, <br/>
<a id="pl.2.27"></a><var>2.27</var>subdivisions 5, 6, by adding a subdivision; 256B.492; 256B.493, subdivision 2; <br/>
<a id="pl.2.28"></a><var>2.28</var>256B.501, by adding a subdivision; 256B.5011, subdivision 2; 256B.5012, by <br/>
<a id="pl.2.29"></a><var>2.29</var>adding a subdivision; 256B.69, subdivisions 5c, 31, by adding a subdivision; <br/>
<a id="pl.2.30"></a><var>2.30</var>256B.694; 256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761; <br/>
<a id="pl.2.31"></a><var>2.31</var>256B.764; 256B.766; 256D.44, subdivision 5; 256I.05, subdivision 1e, by <br/>
<a id="pl.2.32"></a><var>2.32</var>adding a subdivision; 256J.08, subdivision 24; 256J.21, subdivision 3; 256J.24, <br/>
<a id="pl.2.33"></a><var>2.33</var>subdivisions 5, 5a, 7; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01, <br/>
<a id="pl.2.34"></a><var>2.34</var>subdivisions 3a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding <br/>
<a id="pl.2.35"></a><var>2.35</var>subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision; <br/>
<a id="pl.2.36"></a><var>2.36</var>256L.04, subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05, <br/>
<a id="pl.2.37"></a><var>2.37</var>subdivisions 1, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; <br/>
<a id="pl.2.38"></a><var>2.38</var>256L.09, subdivision 2; 256L.11, subdivisions 1, 3; 256L.15, subdivisions 1, 2; <br/>
<a id="pl.2.39"></a><var>2.39</var>256M.40, subdivision 1; 257.75, subdivision 7; 257.85, subdivision 11; 259A.05, <br/>
<a id="pl.2.40"></a><var>2.40</var>subdivision 5; 259A.20, subdivision 4; 260B.007, subdivisions 6, 16; 260C.007, <br/>
<a id="pl.2.41"></a><var>2.41</var>subdivisions 6, 31; 260C.635, subdivision 1; 299C.093; 471.59, subdivision 1; <br/>
<a id="pl.2.42"></a><var>2.42</var>517.001; 518A.60; 524.5-118, subdivision 1, by adding a subdivision; 524.5-303; <br/>
<a id="pl.2.43"></a><var>2.43</var>524.5-316; 524.5-403; 524.5-420; 626.556, subdivisions 2, 3, 10d; 626.557, <br/>
<a id="pl.2.44"></a><var>2.44</var>subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407, <br/>
<a id="pl.2.45"></a><var>2.45</var>article 6, section 116; Laws 2011, First Special Session chapter 9, article 7, <br/>
<a id="pl.2.46"></a><var>2.46</var>section 39, subdivision 14; Laws 2012, chapter 247, article 1, section 28; article <br/>
<a id="pl.2.47"></a><var>2.47</var>6, section 4; Laws 2013, chapter 1, sections 1; 6; proposing coding for new law in <br/>
<a id="pl.2.48"></a><var>2.48</var>Minnesota Statutes, chapters 144; 144A; 145; 149A; 151; 214; 245; 245A; 245D; <br/>
<a id="pl.2.49"></a><var>2.49</var>254B; 256B; 256J; 256L; proposing coding for new law as Minnesota Statutes, <br/>
<a id="pl.2.50"></a><var>2.50</var>chapter 245E; repealing Minnesota Statutes 2012, sections 62J.693; 103I.005, <br/>
<a id="pl.2.51"></a><var>2.51</var>subdivision 20; 144.123, subdivision 2; 144A.46; 144A.461; 149A.025; <br/>
<a id="pl.2.52"></a><var>2.52</var>149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; <br/>
<a id="pl.2.53"></a><var>2.53</var>149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; <br/>
<a id="pl.2.54"></a><var>2.54</var>149A.52, subdivision 5a; 149A.53, subdivision 9; 151.19, subdivision 2; 151.25; <br/>
<a id="pl.2.55"></a><var>2.55</var>151.45; 151.47, subdivision 2; 151.48; 245A.655; 245B.01; 245B.02; 245B.03; <br/>
<a id="pl.2.56"></a><var>2.56</var>245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06; <br/>
<a id="pl.2.57"></a><var>2.57</var>245B.07; 245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056, <br/>
<a id="pl.2.58"></a><var>2.58</var>subdivision 5b; 256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, <br/>
<a id="pl.3.1"></a><var>3.1</var>4c; 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, <br/>
<a id="pl.3.2"></a><var>3.2</var>subdivisions 1, 2, 3, 4; 256B.49, subdivision 16a; 256B.4913, subdivisions 1, 2, <br/>
<a id="pl.3.3"></a><var>3.3</var>3, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256L.01, subdivisions <br/>
<a id="pl.3.4"></a><var>3.4</var>3, 4a; 256L.02, subdivision 3; 256L.03, subdivision 4; 256L.031; 256L.04, <br/>
<a id="pl.3.5"></a><var>3.5</var>subdivisions 1b, 2a, 7a, 9; 256L.07, subdivisions 1, 4, 5, 8, 9; 256L.09, <br/>
<a id="pl.3.6"></a><var>3.6</var>subdivisions 1, 4, 5, 6, 7; 256L.11, subdivisions 2a, 5, 6; 256L.12, subdivisions <br/>
<a id="pl.3.7"></a><var>3.7</var>1, 2, 3, 4, 5, 6, 7, 8, 9a, 9b; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14; <br/>
<a id="pl.3.8"></a><var>3.8</var>609.093; Laws 2011, First Special Session chapter 9, article 7, section 54, as <br/>
<a id="pl.3.9"></a><var>3.9</var>amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; <br/>
<a id="pl.3.10"></a><var>3.10</var>4668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; <br/>
<a id="pl.3.11"></a><var>3.11</var>4668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; <br/>
<a id="pl.3.12"></a><var>3.12</var>4668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140; <br/>
<a id="pl.3.13"></a><var>3.13</var>4668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200; <br/>
<a id="pl.3.14"></a><var>3.14</var>4668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805; <br/>
<a id="pl.3.15"></a><var>3.15</var>4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835; <br/>
<a id="pl.3.16"></a><var>3.16</var>4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870; <br/>
<a id="pl.3.17"></a><var>3.17</var>4669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050.<br/>
<a id="pl.3.18"></a><var>3.18</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.1.0.0"></a>

<a id="pl.3.21"></a><var>3.21</var><b>CARE FOR MORE MINNESOTANS</b><br/>

<a id="bill.1.1.0"></a><a id="pl.3.22"></a><var>3.22</var>    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:<br/>
<a id="pl.3.23"></a><var>3.23</var>    Subd. 3. <b>MinnesotaCare federal receipts.</b> Receipts received as a result of federal <br/>
<a id="pl.3.24"></a><var>3.24</var>participation pertaining to administrative costs of the Minnesota health care reform waiver <br/>
<a id="pl.3.25"></a><var>3.25</var>shall be deposited as nondedicated revenue in the health care access fund. Receipts <br/>
<a id="pl.3.26"></a><var>3.26</var>received as a result of federal participation pertaining to grants shall be deposited in the <br/>
<a id="pl.3.27"></a><var>3.27</var>federal fund and shall offset health care access funds for payments to providers. All federal <br/>
<a id="pl.3.28"></a><var>3.28</var>funding received by Minnesota for implementation and administration of MinnesotaCare <br/>
<a id="pl.3.29"></a><var>3.29</var>as a basic health program, as authorized in section 1331 of the Affordable Care Act, <br/>
<a id="pl.3.30"></a><var>3.30</var>Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and <br/>
<a id="pl.3.31"></a><var>3.31</var>shall be deposited into the health care access fund. Federal funding that is received for <br/>
<a id="pl.3.32"></a><var>3.32</var>implementing and administering MinnesotaCare as a basic health program and deposited in <br/>
<a id="pl.3.33"></a><var>3.33</var>the fund shall be used only for that program to purchase health care coverage for enrollees <br/>
<a id="pl.3.34"></a><var>3.34</var>and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.<br/>
<a id="pl.3.35"></a><var>3.35</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2015.<br/>
<br/>
<a id="bill.1.2.0"></a><a id="pl.3.36"></a><var>3.36</var>    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:<br/>
<a id="pl.3.37"></a><var>3.37</var>    Subdivision 1. <b>Eligibility.</b> (a) Persons eligible for benefits under Code of Federal <br/>
<a id="pl.3.38"></a><var>3.38</var>Regulations, title 25, part 20, persons eligible for medical assistance benefits under <br/>
<a id="pl.3.39"></a><var>3.39</var>sections 
         <statute_ref>256B.055</statute_ref>, 
         <statute_ref>256B.056</statute_ref>, and 
         <statute_ref>256B.057, subdivisions 1, 2, 5, and 6</statute_ref>, or who meet <br/>
<a id="pl.3.40"></a><var>3.40</var>the income standards of section 
         <statute_ref>256B.056, subdivision 4</statute_ref>, and persons eligible for general <br/>
<a id="pl.4.1"></a><var>4.1</var>assistance medical care under section 
         <statute_ref>256D.03, subdivision 3</statute_ref>, are entitled to chemical <br/>
<a id="pl.4.2"></a><var>4.2</var>dependency fund services. State money appropriated for this paragraph must be placed in <br/>
<a id="pl.4.3"></a><var>4.3</var>a separate account established for this purpose.<br/>
<a id="pl.4.4"></a><var>4.4</var>Persons with dependent children who are determined to be in need of chemical <br/>
<a id="pl.4.5"></a><var>4.5</var>dependency treatment pursuant to an assessment under section 
         <statute_ref>626.556, subdivision 10</statute_ref>, or <br/>
<a id="pl.4.6"></a><var>4.6</var>a case plan under section 
         <statute_ref>260C.201, subdivision 6</statute_ref>, or 
         <statute_ref>260C.212</statute_ref>, shall be assisted by the <br/>
<a id="pl.4.7"></a><var>4.7</var>local agency to access needed treatment services. Treatment services must be appropriate <br/>
<a id="pl.4.8"></a><var>4.8</var>for the individual or family, which may include long-term care treatment or treatment in a <br/>
<a id="pl.4.9"></a><var>4.9</var>facility that allows the dependent children to stay in the treatment facility. The county <br/>
<a id="pl.4.10"></a><var>4.10</var>shall pay for out-of-home placement costs, if applicable.<br/>
<a id="pl.4.11"></a><var>4.11</var>(b) A person not entitled to services under paragraph (a), but with family income <br/>
<a id="pl.4.12"></a><var>4.12</var>that is less than 215 percent of the federal poverty guidelines for the applicable family <br/>
<a id="pl.4.13"></a><var>4.13</var>size, shall be eligible to receive chemical dependency fund services within the limit <br/>
<a id="pl.4.14"></a><var>4.14</var>of funds appropriated for this group for the fiscal year. If notified by the state agency <br/>
<a id="pl.4.15"></a><var>4.15</var>of limited funds, a county must give preferential treatment to persons with dependent <br/>
<a id="pl.4.16"></a><var>4.16</var>children who are in need of chemical dependency treatment pursuant to an assessment <br/>
<a id="pl.4.17"></a><var>4.17</var>under section 
         <statute_ref>626.556, subdivision 10</statute_ref>, or a case plan under section 
         <statute_ref>260C.201, subdivision <br/>
<a id="pl.4.18"></a><var>4.18</var>6
         </statute_ref>, or 
         <statute_ref>260C.212</statute_ref>. A county may spend money from its own sources to serve persons under <br/>
<a id="pl.4.19"></a><var>4.19</var>this paragraph. State money appropriated for this paragraph must be placed in a separate <br/>
<a id="pl.4.20"></a><var>4.20</var>account established for this purpose.<br/>
<a id="pl.4.21"></a><var>4.21</var>(c) Persons whose income is between 215 percent and 412 percent of the federal <br/>
<a id="pl.4.22"></a><var>4.22</var>poverty guidelines for the applicable family size shall be eligible for chemical dependency <br/>
<a id="pl.4.23"></a><var>4.23</var>services on a sliding fee basis, within the limit of funds appropriated for this group for the <br/>
<a id="pl.4.24"></a><var>4.24</var>fiscal year. Persons eligible under this paragraph must contribute to the cost of services <br/>
<a id="pl.4.25"></a><var>4.25</var>according to the sliding fee scale established under subdivision 3. A county may spend <br/>
<a id="pl.4.26"></a><var>4.26</var>money from its own sources to provide services to persons under this paragraph. State <br/>
<a id="pl.4.27"></a><var>4.27</var>money appropriated for this paragraph must be placed in a separate account established <br/>
<a id="pl.4.28"></a><var>4.28</var>for this purpose.<br/>
<br/>
<a id="bill.1.3.0"></a><a id="pl.4.29"></a><var>4.29</var>    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.4.30"></a><var>4.30</var>to read:<br/>
<a id="pl.4.31"></a><var>4.31</var>    Subd. 35. <b>Federal approval.</b> (a) The commissioner shall seek federal authority <br/>
<a id="pl.4.32"></a><var>4.32</var>from the U.S. Department of Health and Human Services necessary to operate a health <br/>
<a id="pl.4.33"></a><var>4.33</var>coverage program for Minnesotans with incomes up to 275 percent of the federal poverty <br/>
<a id="pl.4.34"></a><var>4.34</var>guidelines (FPG). The proposal shall seek to secure all federal funding available from at <br/>
<a id="pl.4.35"></a><var>4.35</var>least the following services:<br/>
<a id="pl.5.1"></a><var>5.1</var>(1) all premium tax credits and cost sharing subsidies available under United States <br/>
<a id="pl.5.2"></a><var>5.2</var>Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals <br/>
<a id="pl.5.3"></a><var>5.3</var>with incomes above 133 percent and at or below 275 percent of the federal poverty <br/>
<a id="pl.5.4"></a><var>5.4</var>guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as <br/>
<a id="pl.5.5"></a><var>5.5</var>defined in section 62V.02;<br/>
<a id="pl.5.6"></a><var>5.6</var>(2) Medicaid funding; and <br/>
<a id="pl.5.7"></a><var>5.7</var>(3) other funding sources identified by the commissioner that support coverage or <br/>
<a id="pl.5.8"></a><var>5.8</var>care redesign in Minnesota.<br/>
<a id="pl.5.9"></a><var>5.9</var>(b) Funding received shall be used to design and implement a health coverage <br/>
<a id="pl.5.10"></a><var>5.10</var>program that creates a single streamlined program and meets the needs of Minnesotans with <br/>
<a id="pl.5.11"></a><var>5.11</var>incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:<br/>
<a id="pl.5.12"></a><var>5.12</var>(1) payment reform characteristics included in the health care delivery system and <br/>
<a id="pl.5.13"></a><var>5.13</var>accountable care organization payment models;<br/>
<a id="pl.5.14"></a><var>5.14</var>(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee <br/>
<a id="pl.5.15"></a><var>5.15</var>needs in different income and health status situations and can provide a more seamless <br/>
<a id="pl.5.16"></a><var>5.16</var>transition from public to private health care coverage;<br/>
<a id="pl.5.17"></a><var>5.17</var>(3) flexibility in co-payment or premium structures to incent patients to seek <br/>
<a id="pl.5.18"></a><var>5.18</var>high-quality, low-cost care settings; and<br/>
<a id="pl.5.19"></a><var>5.19</var>(4) flexibility in premium structures to ease the transition from public to private <br/>
<a id="pl.5.20"></a><var>5.20</var>health care coverage.<br/>
<a id="pl.5.21"></a><var>5.21</var>(c) The commissioner shall develop and submit a proposal consistent with the above <br/>
<a id="pl.5.22"></a><var>5.22</var>criteria and shall seek all federal authority necessary to implement the health coverage <br/>
<a id="pl.5.23"></a><var>5.23</var>program. In developing the request, the commissioner shall consult with appropriate <br/>
<a id="pl.5.24"></a><var>5.24</var>stakeholder groups and consumers.<br/>
<a id="pl.5.25"></a><var>5.25</var>(d) The commissioner is authorized to seek any available waivers or federal <br/>
<a id="pl.5.26"></a><var>5.26</var>approvals to accomplish the goals under paragraph (b) prior to 2017.<br/>
<a id="pl.5.27"></a><var>5.27</var>(e) The commissioner shall report to the chairs and ranking minority members of <br/>
<a id="pl.5.28"></a><var>5.28</var>the legislative committees with jurisdiction over health and human services policy and <br/>
<a id="pl.5.29"></a><var>5.29</var>financing by January 15, 2015, on the progress of receiving a federal waiver and shall <br/>
<a id="pl.5.30"></a><var>5.30</var>make recommendations on any legislative changes necessary to accomplish the project <br/>
<a id="pl.5.31"></a><var>5.31</var>in this subdivision. Any implementation of the waiver that requires a state financial <br/>
<a id="pl.5.32"></a><var>5.32</var>contribution shall be contingent on legislative action approving the contribution.<br/>
<a id="pl.5.33"></a><var>5.33</var>(f) The commissioner is authorized to accept and expend federal funds that support <br/>
<a id="pl.5.34"></a><var>5.34</var>the purposes of this subdivision.<br/>
<br/>
<a id="bill.1.4.0"></a><a id="pl.6.1"></a><var>6.1</var>    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision <br/>
<a id="pl.6.2"></a><var>6.2</var>to read:<br/>
<a id="pl.6.3"></a><var>6.3</var>    Subd. 18. <b>Caretaker relative.</b> "Caretaker relative" means a relative, by blood, <br/>
<a id="pl.6.4"></a><var>6.4</var>adoption, or marriage, of a child under age 19 with whom the child is living and who <br/>
<a id="pl.6.5"></a><var>6.5</var>assumes primary responsibility for the child's care.<br/>
<a id="pl.6.6"></a><var>6.6</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.5.0"></a><a id="pl.6.7"></a><var>6.7</var>    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision <br/>
<a id="pl.6.8"></a><var>6.8</var>to read:<br/>
<a id="pl.6.9"></a><var>6.9</var>    Subd. 19. <b>Insurance affordability program.</b> "Insurance affordability program" <br/>
<a id="pl.6.10"></a><var>6.10</var>means one of the following programs:<br/>
<a id="pl.6.11"></a><var>6.11</var>(1) medical assistance under this chapter;<br/>
<a id="pl.6.12"></a><var>6.12</var>(2) a program that provides advance payments of the premium tax credits established <br/>
<a id="pl.6.13"></a><var>6.13</var>under section 36B of the Internal Revenue Code or cost-sharing reductions established <br/>
<a id="pl.6.14"></a><var>6.14</var>under section 1402 of the Affordable Care Act;<br/>
<a id="pl.6.15"></a><var>6.15</var>(3) MinnesotaCare as defined in chapter 256L; and<br/>
<a id="pl.6.16"></a><var>6.16</var>(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.<br/>
<a id="pl.6.17"></a><var>6.17</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.1.6.0"></a><a id="pl.6.18"></a><var>6.18</var>    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:<br/>
<a id="pl.6.19"></a><var>6.19</var>    Subd. 18. <b>Applications for medical assistance.</b> (a) The state agency may take<br/>
<a id="pl.6.20"></a><var>6.20</var> shall accept applications for medical assistance and conduct eligibility determinations for <br/>
<a id="pl.6.21"></a><var>6.21</var>MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web <br/>
<a id="pl.6.22"></a><var>6.22</var>site, and through other commonly available electronic means.<br/>
<a id="pl.6.23"></a><var>6.23</var>    (b) The commissioner of human services shall modify the Minnesota health care <br/>
<a id="pl.6.24"></a><var>6.24</var>programs application form to add a question asking applicants whether they have ever <br/>
<a id="pl.6.25"></a><var>6.25</var>served in the United States military.<br/>
<a id="pl.6.26"></a><var>6.26</var>    (c) For each individual who submits an application or whose eligibility is subject to <br/>
<a id="pl.6.27"></a><var>6.27</var>renewal or whose eligibility is being redetermined pursuant to a change in circumstances, <br/>
<a id="pl.6.28"></a><var>6.28</var>if the agency determines the individual is not eligible for medical assistance, the agency <br/>
<a id="pl.6.29"></a><var>6.29</var>shall determine potential eligibility for other insurance affordability programs.<br/>
<a id="pl.6.30"></a><var>6.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.7.0"></a><a id="pl.6.31"></a><var>6.31</var>    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:<br/>
<a id="pl.7.1"></a><var>7.1</var>    Subd. 3a. <b>Families with children.</b> Beginning July 1, 2002, Medical assistance may <br/>
<a id="pl.7.2"></a><var>7.2</var>be paid for a person who is a child under the age of 18, or age 18 if a full-time student <br/>
<a id="pl.7.3"></a><var>7.3</var>in a secondary school, or in the equivalent level of vocational or technical training, and <br/>
<a id="pl.7.4"></a><var>7.4</var>reasonably expected to complete the program before reaching age 19; the parent or <br/>
<a id="pl.7.5"></a><var>7.5</var>stepparent of a dependent child under the age of 19, including a pregnant woman; or a <br/>
<a id="pl.7.6"></a><var>7.6</var>caretaker relative of a dependent child under the age of 19.<br/>
<a id="pl.7.7"></a><var>7.7</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.7.8"></a><var>7.8</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.7.9"></a><var>7.9</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.8.0"></a><a id="pl.7.10"></a><var>7.10</var>    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:<br/>
<a id="pl.7.11"></a><var>7.11</var>    Subd. 6. <b>Pregnant women; needy unborn child.</b> Medical assistance may be paid <br/>
<a id="pl.7.12"></a><var>7.12</var>for a pregnant woman who has written verification of a positive pregnancy test from a <br/>
<a id="pl.7.13"></a><var>7.13</var>physician or licensed registered nurse, who meets the other eligibility criteria of this <br/>
<a id="pl.7.14"></a><var>7.14</var>section and whose unborn child would be eligible as a needy child under subdivision 10 if <br/>
<a id="pl.7.15"></a><var>7.15</var>born and living with the woman. In accordance with Code of Federal Regulations, title <br/>
<a id="pl.7.16"></a><var>7.16</var>42, section 435.956, the commissioner must accept self-attestation of pregnancy unless <br/>
<a id="pl.7.17"></a><var>7.17</var>the agency has information that is not reasonably compatible with such attestation. For <br/>
<a id="pl.7.18"></a><var>7.18</var>purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.<br/>
<a id="pl.7.19"></a><var>7.19</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.9.0"></a><a id="pl.7.20"></a><var>7.20</var>    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:<br/>
<a id="pl.7.21"></a><var>7.21</var>    Subd. 10. <b>Infants.</b> Medical assistance may be paid for an infant less than one year <br/>
<a id="pl.7.22"></a><var>7.22</var>of age, whose mother was eligible for and receiving medical assistance at the time of birth <br/>
<a id="pl.7.23"></a><var>7.23</var>or who is less than two years of age and is in a family with countable income that is equal <br/>
<a id="pl.7.24"></a><var>7.24</var>to or less than the income standard established under section 
         <statute_ref>256B.057, subdivision 1</statute_ref>.<br/>
<a id="pl.7.25"></a><var>7.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.10.0"></a><a id="pl.7.26"></a><var>7.26</var>    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:<br/>
<a id="pl.7.27"></a><var>7.27</var>    Subd. 15. <b>Adults without children.</b> Medical assistance may be paid for a person <br/>
<a id="pl.7.28"></a><var>7.28</var>who is:<br/>
<a id="pl.7.29"></a><var>7.29</var>(1) at least age 21 and under age 65;<br/>
<a id="pl.7.30"></a><var>7.30</var>(2) not pregnant;<br/>
<a id="pl.7.31"></a><var>7.31</var>(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII <br/>
<a id="pl.7.32"></a><var>7.32</var>of the Social Security Act;<br/>
<a id="pl.8.1"></a><var>8.1</var>(4) not an adult in a family with children as defined in section 
<statute_ref>256L.01, subdivision <br/>
<a id="pl.8.2"></a><var>8.2</var>3a
</statute_ref>; and not otherwise eligible under subdivision 7 as a person who meets the categorical <br/>
<a id="pl.8.3"></a><var>8.3</var>eligibility requirements of the supplemental security income program;<br/>
<a id="pl.8.4"></a><var>8.4</var>(5) not enrolled under subdivision 7 as a person who would meet the categorical <br/>
<a id="pl.8.5"></a><var>8.5</var>eligibility requirements of the supplemental security income program except for excess <br/>
<a id="pl.8.6"></a><var>8.6</var>income or assets; and<br/>
<a id="pl.8.7"></a><var>8.7</var>(5) (6) not described in another subdivision of this section.<br/>
<a id="pl.8.8"></a><var>8.8</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.11.0"></a><a id="pl.8.9"></a><var>8.9</var>    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a <br/>
<a id="pl.8.10"></a><var>8.10</var>subdivision to read:<br/>
<a id="pl.8.11"></a><var>8.11</var>    Subd. 17. <b>Adults who were in foster care at the age of 18.</b> Medical assistance may <br/>
<a id="pl.8.12"></a><var>8.12</var>be paid for a person under 26 years of age who was in foster care under the commissioner's <br/>
<a id="pl.8.13"></a><var>8.13</var>responsibility on the date of attaining 18 years of age, and who was enrolled in medical <br/>
<a id="pl.8.14"></a><var>8.14</var>assistance under the state plan or a waiver of the plan while in foster care, in accordance <br/>
<a id="pl.8.15"></a><var>8.15</var>with section 2004 of the Affordable Care Act.<br/>
<a id="pl.8.16"></a><var>8.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.12.0"></a><a id="pl.8.17"></a><var>8.17</var>    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:<br/>
<a id="pl.8.18"></a><var>8.18</var>    Subdivision 1. <b>Residency.</b> To be eligible for medical assistance, a person must <br/>
<a id="pl.8.19"></a><var>8.19</var>reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,<br/>
<a id="pl.8.20"></a><var>8.20</var> in accordance with the rules of the state agency Code of Federal Regulations, title 42, <br/>
<a id="pl.8.21"></a><var>8.21</var>section 435.403.<br/>
<a id="pl.8.22"></a><var>8.22</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.13.0"></a><a id="pl.8.23"></a><var>8.23</var>    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:<br/>
<a id="pl.8.24"></a><var>8.24</var>    Subd. 1c. <b>Families with children income methodology.</b> (a)(1) [Expired, 1Sp2003 <br/>
<a id="pl.8.25"></a><var>8.25</var>c 14 art 12 s 17]<br/>
<a id="pl.8.26"></a><var>8.26</var>(2) For applications processed within one calendar month prior to July 1, 2003, <br/>
<a id="pl.8.27"></a><var>8.27</var>eligibility shall be determined by applying the income standards and methodologies in <br/>
<a id="pl.8.28"></a><var>8.28</var>effect prior to July 1, 2003, for any months in the six-month budget period before July <br/>
<a id="pl.8.29"></a><var>8.29</var>1, 2003, and the income standards and methodologies in effect on July 1, 2003, for any <br/>
<a id="pl.8.30"></a><var>8.30</var>months in the six-month budget period on or after that date. The income standards for <br/>
<a id="pl.8.31"></a><var>8.31</var>each month shall be added together and compared to the applicant's total countable income <br/>
<a id="pl.8.32"></a><var>8.32</var>for the six-month budget period to determine eligibility.<br/>
<a id="pl.9.1"></a><var>9.1</var>(3) For children ages one through 18 whose eligibility is determined under section <br/>
<a id="pl.9.2"></a><var>9.2</var><statute_ref>256B.057, subdivision 2</statute_ref>, the following deductions shall be applied to income counted <br/>
<a id="pl.9.3"></a><var>9.3</var>toward the child's eligibility as allowed under the state's AFDC plan in effect as of July <br/>
<a id="pl.9.4"></a><var>9.4</var>16, 1996: $90 work expense, dependent care, and child support paid under court order. <br/>
<a id="pl.9.5"></a><var>9.5</var>This clause is effective October 1, 2003.<br/>
<a id="pl.9.6"></a><var>9.6</var>(b) For families with children whose eligibility is determined using the standard <br/>
<a id="pl.9.7"></a><var>9.7</var>specified in section 
<statute_ref>256B.056, subdivision 4</statute_ref>, paragraph (c), 17 percent of countable <br/>
<a id="pl.9.8"></a><var>9.8</var>earned income shall be disregarded for up to four months and the following deductions <br/>
<a id="pl.9.9"></a><var>9.9</var>shall be applied to each individual's income counted toward eligibility as allowed under <br/>
<a id="pl.9.10"></a><var>9.10</var>the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid <br/>
<a id="pl.9.11"></a><var>9.11</var>under court order.<br/>
<a id="pl.9.12"></a><var>9.12</var>(c) If the four-month disregard in paragraph (b) has been applied to the wage <br/>
<a id="pl.9.13"></a><var>9.13</var>earner's income for four months, the disregard shall not be applied again until the wage <br/>
<a id="pl.9.14"></a><var>9.14</var>earner's income has not been considered in determining medical assistance eligibility for <br/>
<a id="pl.9.15"></a><var>9.15</var>12 consecutive months.<br/>
<a id="pl.9.16"></a><var>9.16</var>(d) (b) The commissioner shall adjust the income standards under this section each <br/>
<a id="pl.9.17"></a><var>9.17</var>July 1 by the annual update of the federal poverty guidelines following publication by the <br/>
<a id="pl.9.18"></a><var>9.18</var>United States Department of Health and Human Services except that the income standards <br/>
<a id="pl.9.19"></a><var>9.19</var>shall not go below those in effect on July 1, 2009.<br/>
<a id="pl.9.20"></a><var>9.20</var>(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt <br/>
<a id="pl.9.21"></a><var>9.21</var>organization to or for the benefit of the child with a life-threatening illness must be <br/>
<a id="pl.9.22"></a><var>9.22</var>disregarded from income.<br/>
<br/>
<a id="bill.1.14.0"></a><a id="pl.9.23"></a><var>9.23</var>    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:<br/>
<a id="pl.9.24"></a><var>9.24</var>    Subd. 3. <b>Asset limitations for </b><b>certain </b><b>individuals </b><b>and families</b><b>.</b> (a) To be <br/>
<a id="pl.9.25"></a><var>9.25</var>eligible for medical assistance, a person must not individually own more than $3,000 in <br/>
<a id="pl.9.26"></a><var>9.26</var>assets, or if a member of a household with two family members, husband and wife, or <br/>
<a id="pl.9.27"></a><var>9.27</var>parent and child, the household must not own more than $6,000 in assets, plus $200 for <br/>
<a id="pl.9.28"></a><var>9.28</var>each additional legal dependent. In addition to these maximum amounts, an eligible <br/>
<a id="pl.9.29"></a><var>9.29</var>individual or family may accrue interest on these amounts, but they must be reduced to the <br/>
<a id="pl.9.30"></a><var>9.30</var>maximum at the time of an eligibility redetermination. The accumulation of the clothing <br/>
<a id="pl.9.31"></a><var>9.31</var>and personal needs allowance according to section 
         <statute_ref>256B.35</statute_ref> must also be reduced to the <br/>
<a id="pl.9.32"></a><var>9.32</var>maximum at the time of the eligibility redetermination. The value of assets that are not <br/>
<a id="pl.9.33"></a><var>9.33</var>considered in determining eligibility for medical assistance is the value of those assets <br/>
<a id="pl.9.34"></a><var>9.34</var>excluded under the supplemental security income program for aged, blind, and disabled <br/>
<a id="pl.9.35"></a><var>9.35</var>persons, with the following exceptions:<br/>
<a id="pl.10.1"></a><var>10.1</var>(1) household goods and personal effects are not considered;<br/>
<a id="pl.10.2"></a><var>10.2</var>(2) capital and operating assets of a trade or business that the local agency determines <br/>
<a id="pl.10.3"></a><var>10.3</var>are necessary to the person's ability to earn an income are not considered;<br/>
<a id="pl.10.4"></a><var>10.4</var>(3) motor vehicles are excluded to the same extent excluded by the supplemental <br/>
<a id="pl.10.5"></a><var>10.5</var>security income program;<br/>
<a id="pl.10.6"></a><var>10.6</var>(4) assets designated as burial expenses are excluded to the same extent excluded by <br/>
<a id="pl.10.7"></a><var>10.7</var>the supplemental security income program. Burial expenses funded by annuity contracts <br/>
<a id="pl.10.8"></a><var>10.8</var>or life insurance policies must irrevocably designate the individual's estate as contingent <br/>
<a id="pl.10.9"></a><var>10.9</var>beneficiary to the extent proceeds are not used for payment of selected burial expenses;<br/>
<a id="pl.10.10"></a><var>10.10</var>(5) for a person who no longer qualifies as an employed person with a disability due <br/>
<a id="pl.10.11"></a><var>10.11</var>to loss of earnings, assets allowed while eligible for medical assistance under section <br/>
<statute_ref><a id="pl.10.12"></a><var>10.12</var>256B.057, subdivision 9
         </statute_ref>, are not considered for 12 months, beginning with the first month <br/>
<a id="pl.10.13"></a><var>10.13</var>of ineligibility as an employed person with a disability, to the extent that the person's total <br/>
<a id="pl.10.14"></a><var>10.14</var>assets remain within the allowed limits of section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, paragraph (d);<br/>
<a id="pl.10.15"></a><var>10.15</var>    (6) when a person enrolled in medical assistance under section 
         <statute_ref>256B.057, subdivision <br/>
<a id="pl.10.16"></a><var>10.16</var>9
         </statute_ref>, is age 65 or older and has been enrolled during each of the 24 consecutive months <br/>
<a id="pl.10.17"></a><var>10.17</var>before the person's 65th birthday, the assets owned by the person and the person's spouse <br/>
<a id="pl.10.18"></a><var>10.18</var>must be disregarded, up to the limits of section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, paragraph (d), <br/>
<a id="pl.10.19"></a><var>10.19</var>when determining eligibility for medical assistance under section 
         <statute_ref>256B.055, subdivision <br/>
<a id="pl.10.20"></a><var>10.20</var>7
         </statute_ref>. The income of a spouse of a person enrolled in medical assistance under section <br/>
<statute_ref><a id="pl.10.21"></a><var>10.21</var>256B.057, subdivision 9
         </statute_ref>, during each of the 24 consecutive months before the person's <br/>
<a id="pl.10.22"></a><var>10.22</var>65th birthday must be disregarded when determining eligibility for medical assistance <br/>
<a id="pl.10.23"></a><var>10.23</var>under section 
         <statute_ref>256B.055, subdivision 7</statute_ref>. Persons eligible under this clause are not subject to <br/>
<a id="pl.10.24"></a><var>10.24</var>the provisions in section 
         <statute_ref>256B.059</statute_ref>. A person whose 65th birthday occurs in 2012 or 2013 <br/>
<a id="pl.10.25"></a><var>10.25</var>is required to have qualified for medical assistance under section 
         <statute_ref>256B.057, subdivision 9</statute_ref>, <br/>
<a id="pl.10.26"></a><var>10.26</var>prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and<br/>
<a id="pl.10.27"></a><var>10.27</var>(7) effective July 1, 2009, certain assets owned by American Indians are excluded as <br/>
<a id="pl.10.28"></a><var>10.28</var>required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public <br/>
<a id="pl.10.29"></a><var>10.29</var>Law 111-5. For purposes of this clause, an American Indian is any person who meets the <br/>
<a id="pl.10.30"></a><var>10.30</var>definition of Indian according to Code of Federal Regulations, title 42, section 
         <statute_ref>447.50</statute_ref>.<br/>
<a id="pl.10.31"></a><var>10.31</var>(b) No asset limit shall apply to persons eligible under section 
         <statute_ref>256B.055</statute_ref>, subdivision <br/>
<a id="pl.10.32"></a><var>10.32</var>15.<br/>
<a id="pl.10.33"></a><var>10.33</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.15.0"></a><a id="pl.10.34"></a><var>10.34</var>    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by <br/>
<a id="pl.10.35"></a><var>10.35</var>Laws 2013, chapter 1, section 5, is amended to read:<br/>
<a id="pl.11.1"></a><var>11.1</var>    Subd. 4. <b>Income.</b> (a) To be eligible for medical assistance, a person eligible under <br/>
<a id="pl.11.2"></a><var>11.2</var>section 
         <statute_ref>256B.055, subdivisions 7, 7a, and 12</statute_ref>, may have income up to 100 percent of <br/>
<a id="pl.11.3"></a><var>11.3</var>the federal poverty guidelines. Effective January 1, 2000, and each successive January, <br/>
<a id="pl.11.4"></a><var>11.4</var>recipients of supplemental security income may have an income up to the supplemental <br/>
<a id="pl.11.5"></a><var>11.5</var>security income standard in effect on that date.<br/>
<a id="pl.11.6"></a><var>11.6</var>(b) To be eligible for medical assistance, families and children may have an income <br/>
<a id="pl.11.7"></a><var>11.7</var>up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, <br/>
<a id="pl.11.8"></a><var>11.8</var>AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, <br/>
<a id="pl.11.9"></a><var>11.9</var>1996, shall be increased by three percent.<br/>
<a id="pl.11.10"></a><var>11.10</var>(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section <br/>
<statute_ref><a id="pl.11.11"></a><var>11.11</var>256B.055, subdivision 3a
         </statute_ref>, a parent or caretaker relative may have an income up to 133 <br/>
<a id="pl.11.12"></a><var>11.12</var>percent of the federal poverty guidelines for the household size.<br/>
<a id="pl.11.13"></a><var>11.13</var>(d) (c) To be eligible for medical assistance under section 
         <statute_ref>256B.055, subdivision <br/>
<a id="pl.11.14"></a><var>11.14</var>15
         </statute_ref>, a person may have an income up to 133 percent of federal poverty guidelines for <br/>
<a id="pl.11.15"></a><var>11.15</var>the household size.<br/>
<a id="pl.11.16"></a><var>11.16</var>(e) (d) To be eligible for medical assistance under section 
         <statute_ref>256B.055, subdivision <br/>
<a id="pl.11.17"></a><var>11.17</var>16
         </statute_ref>, a child age 19 to 20 may have an income up to 133 percent of the federal poverty <br/>
<a id="pl.11.18"></a><var>11.18</var>guidelines for the household size.<br/>
<a id="pl.11.19"></a><var>11.19</var>(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a, <br/>
<a id="pl.11.20"></a><var>11.20</var>a child under age 19 may have income up to 275 percent of the federal poverty guidelines <br/>
<a id="pl.11.21"></a><var>11.21</var>for the household size or an equivalent standard when converted using modified adjusted <br/>
<a id="pl.11.22"></a><var>11.22</var>gross income methodology as required under the Affordable Care Act. Children who are <br/>
<a id="pl.11.23"></a><var>11.23</var>enrolled in medical assistance as of December 31, 2013, and are determined ineligible <br/>
<a id="pl.11.24"></a><var>11.24</var>for medical assistance because of the elimination of income disregards under modified <br/>
<a id="pl.11.25"></a><var>11.25</var>adjusted gross income methodology as defined in subdivision 1a remain eligible for <br/>
<a id="pl.11.26"></a><var>11.26</var>medical assistance under the Children's Health Insurance Program Reauthorization Act <br/>
<a id="pl.11.27"></a><var>11.27</var>of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility <br/>
<a id="pl.11.28"></a><var>11.28</var>redetermination as required in section 256B.056, subdivision 7a.<br/>
<a id="pl.11.29"></a><var>11.29</var>(f) In computing income to determine eligibility of persons under paragraphs (a) to <br/>
<a id="pl.11.30"></a><var>11.30</var>(e) who are not residents of long-term care facilities, the commissioner shall disregard <br/>
<a id="pl.11.31"></a><var>11.31</var>increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. <br/>
<a id="pl.11.32"></a><var>11.32</var>For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans <br/>
<a id="pl.11.33"></a><var>11.33</var>Administration unusual medical expense payments are considered income to the recipient.<br/>
<a id="pl.11.34"></a><var>11.34</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.16.0"></a><a id="pl.11.35"></a><var>11.35</var>    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:<br/>
<a id="pl.12.1"></a><var>12.1</var>    Subd. 5c. <b>Excess income standard.</b> (a) The excess income standard for families <br/>
<a id="pl.12.2"></a><var>12.2</var>with children parents and caretaker relatives, pregnant women, infants, and children ages <br/>
<a id="pl.12.3"></a><var>12.3</var>two through 20 is the standard specified in subdivision 4, paragraph (b).<br/>
<a id="pl.12.4"></a><var>12.4</var>(b) The excess income standard for a person whose eligibility is based on blindness, <br/>
<a id="pl.12.5"></a><var>12.5</var>disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the <br/>
<a id="pl.12.6"></a><var>12.6</var>family size. Effective July 1, 2002, the excess income standard for this paragraph shall <br/>
<a id="pl.12.7"></a><var>12.7</var>equal 75 percent of the federal poverty guidelines.<br/>
<a id="pl.12.8"></a><var>12.8</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.17.0"></a><a id="pl.12.9"></a><var>12.9</var>    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a <br/>
<a id="pl.12.10"></a><var>12.10</var>subdivision to read:<br/>
<a id="pl.12.11"></a><var>12.11</var>    Subd. 7a. <b>Periodic renewal of eligibility.</b> (a) The commissioner shall make an <br/>
<a id="pl.12.12"></a><var>12.12</var>annual redetermination of eligibility based on information contained in the enrollee's case <br/>
<a id="pl.12.13"></a><var>12.13</var>file and other information available to the agency, including but not limited to information <br/>
<a id="pl.12.14"></a><var>12.14</var>accessed through an electronic database, without requiring the enrollee to submit any <br/>
<a id="pl.12.15"></a><var>12.15</var>information when sufficient data is available for the agency to renew eligibility.<br/>
<a id="pl.12.16"></a><var>12.16</var>(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), <br/>
<a id="pl.12.17"></a><var>12.17</var>the commissioner must provide the enrollee with a prepopulated renewal form containing <br/>
<a id="pl.12.18"></a><var>12.18</var>eligibility information available to the agency and permit the enrollee to submit the form <br/>
<a id="pl.12.19"></a><var>12.19</var>with any corrections or additional information to the agency and sign the renewal form via <br/>
<a id="pl.12.20"></a><var>12.20</var>any of the modes of submission specified in section 256B.04, subdivision 18.<br/>
<a id="pl.12.21"></a><var>12.21</var>(c) An enrollee who is terminated for failure to complete the renewal process may <br/>
<a id="pl.12.22"></a><var>12.22</var>subsequently submit the renewal form and required information within four months after <br/>
<a id="pl.12.23"></a><var>12.23</var>the date of termination and have coverage reinstated without a lapse, if otherwise eligible <br/>
<a id="pl.12.24"></a><var>12.24</var>under this chapter.<br/>
<a id="pl.12.25"></a><var>12.25</var>(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be <br/>
<a id="pl.12.26"></a><var>12.26</var>required to renew eligibility every six months.<br/>
<a id="pl.12.27"></a><var>12.27</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.18.0"></a><a id="pl.12.28"></a><var>12.28</var>    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:<br/>
<a id="pl.12.29"></a><var>12.29</var>    Subd. 10. <b>Eligibility verification.</b> (a) The commissioner shall require women who <br/>
<a id="pl.12.30"></a><var>12.30</var>are applying for the continuation of medical assistance coverage following the end of the <br/>
<a id="pl.12.31"></a><var>12.31</var>60-day postpartum period to update their income and asset information and to submit <br/>
<a id="pl.12.32"></a><var>12.32</var>any required income or asset verification.<br/>
<a id="pl.13.1"></a><var>13.1</var>    (b) The commissioner shall determine the eligibility of private-sector health care <br/>
<a id="pl.13.2"></a><var>13.2</var>coverage for infants less than one year of age eligible under section 
         <statute_ref>256B.055, subdivision <br/>
<a id="pl.13.3"></a><var>13.3</var>10
         </statute_ref>, or 
         <statute_ref>256B.057, subdivision 1</statute_ref>, paragraph (d), and shall pay for private-sector coverage <br/>
<a id="pl.13.4"></a><var>13.4</var>if this is determined to be cost-effective.<br/>
<a id="pl.13.5"></a><var>13.5</var>    (c) The commissioner shall verify assets and income for all applicants, and for all <br/>
<a id="pl.13.6"></a><var>13.6</var>recipients upon renewal.<br/>
<a id="pl.13.7"></a><var>13.7</var>    (d) The commissioner shall utilize information obtained through the electronic <br/>
<a id="pl.13.8"></a><var>13.8</var>service established by the secretary of the United States Department of Health and Human <br/>
<a id="pl.13.9"></a><var>13.9</var>Services and other available electronic data sources in Code of Federal Regulations, title <br/>
<a id="pl.13.10"></a><var>13.10</var>42, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner <br/>
<a id="pl.13.11"></a><var>13.11</var>shall establish standards to define when information obtained electronically is reasonably <br/>
<a id="pl.13.12"></a><var>13.12</var>compatible with information provided by applicants and enrollees, including use of <br/>
<a id="pl.13.13"></a><var>13.13</var>self-attestation, to accomplish real-time eligibility determinations and maintain program <br/>
<a id="pl.13.14"></a><var>13.14</var>integrity.<br/>
<a id="pl.13.15"></a><var>13.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.19.0"></a><a id="pl.13.16"></a><var>13.16</var>    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:<br/>
<a id="pl.13.17"></a><var>13.17</var>    Subdivision 1. <b>Infants and pregnant women.</b> (a)(1) An infant less than one year<br/>
<a id="pl.13.18"></a><var>13.18</var> two years of age or a pregnant woman who has written verification of a positive pregnancy <br/>
<a id="pl.13.19"></a><var>13.19</var>test from a physician or licensed registered nurse is eligible for medical assistance if the <br/>
<a id="pl.13.20"></a><var>13.20</var>individual's countable family household income is equal to or less than 275 percent of the <br/>
<a id="pl.13.21"></a><var>13.21</var>federal poverty guideline for the same family household size or an equivalent standard <br/>
<a id="pl.13.22"></a><var>13.22</var>when converted using modified adjusted gross income methodology as required under <br/>
<a id="pl.13.23"></a><var>13.23</var>the Affordable Care Act. For purposes of this subdivision, "countable family income" <br/>
<a id="pl.13.24"></a><var>13.24</var>means the amount of income considered available using the methodology of the AFDC <br/>
<a id="pl.13.25"></a><var>13.25</var>program under the state's AFDC plan as of July 16, 1996, as required by the Personal <br/>
<a id="pl.13.26"></a><var>13.26</var>Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public <br/>
<a id="pl.13.27"></a><var>13.27</var>Law 104-193, except for the earned income disregard and employment deductions.<br/>
<a id="pl.13.28"></a><var>13.28</var>    (2) For applications processed within one calendar month prior to the effective date, <br/>
<a id="pl.13.29"></a><var>13.29</var>eligibility shall be determined by applying the income standards and methodologies in <br/>
<a id="pl.13.30"></a><var>13.30</var>effect prior to the effective date for any months in the six-month budget period before <br/>
<a id="pl.13.31"></a><var>13.31</var>that date and the income standards and methodologies in effect on the effective date for <br/>
<a id="pl.13.32"></a><var>13.32</var>any months in the six-month budget period on or after that date. The income standards <br/>
<a id="pl.13.33"></a><var>13.33</var>for each month shall be added together and compared to the applicant's total countable <br/>
<a id="pl.13.34"></a><var>13.34</var>income for the six-month budget period to determine eligibility.<br/>
<a id="pl.13.35"></a><var>13.35</var>    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]<br/>
<a id="pl.14.1"></a><var>14.1</var>    (2) For applications processed within one calendar month prior to July 1, 2003, <br/>
<a id="pl.14.2"></a><var>14.2</var>eligibility shall be determined by applying the income standards and methodologies in <br/>
<a id="pl.14.3"></a><var>14.3</var>effect prior to July 1, 2003, for any months in the six-month budget period before July 1, <br/>
<a id="pl.14.4"></a><var>14.4</var>2003, and the income standards and methodologies in effect on the expiration date for any <br/>
<a id="pl.14.5"></a><var>14.5</var>months in the six-month budget period on or after July 1, 2003. The income standards <br/>
<a id="pl.14.6"></a><var>14.6</var>for each month shall be added together and compared to the applicant's total countable <br/>
<a id="pl.14.7"></a><var>14.7</var>income for the six-month budget period to determine eligibility.<br/>
<a id="pl.14.8"></a><var>14.8</var>    (3) An amount equal to the amount of earned income exceeding 275 percent of <br/>
<a id="pl.14.9"></a><var>14.9</var>the federal poverty guideline, up to a maximum of the amount by which the combined <br/>
<a id="pl.14.10"></a><var>14.10</var>total of 185 percent of the federal poverty guideline plus the earned income disregards <br/>
<a id="pl.14.11"></a><var>14.11</var>and deductions allowed under the state's AFDC plan as of July 16, 1996, as required <br/>
<a id="pl.14.12"></a><var>14.12</var>by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public <br/>
<a id="pl.14.13"></a><var>14.13</var>Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for <br/>
<a id="pl.14.14"></a><var>14.14</var>pregnant women and infants less than one year of age.<br/>
<a id="pl.14.15"></a><var>14.15</var>    (c) Dependent care and child support paid under court order shall be deducted from <br/>
<a id="pl.14.16"></a><var>14.16</var>the countable income of pregnant women.<br/>
<a id="pl.14.17"></a><var>14.17</var>    (d) (b) An infant born to a woman who was eligible for and receiving medical <br/>
<a id="pl.14.18"></a><var>14.18</var>assistance on the date of the child's birth shall continue to be eligible for medical assistance <br/>
<a id="pl.14.19"></a><var>14.19</var>without redetermination until the child's first birthday.<br/>
<a id="pl.14.20"></a><var>14.20</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.20.0"></a><a id="pl.14.21"></a><var>14.21</var>    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:<br/>
<a id="pl.14.22"></a><var>14.22</var>    Subd. 10. <b>Certain persons needing treatment for breast or cervical cancer.</b> (a) <br/>
<a id="pl.14.23"></a><var>14.23</var>Medical assistance may be paid for a person who:<br/>
<a id="pl.14.24"></a><var>14.24</var>(1) has been screened for breast or cervical cancer by the Minnesota breast and <br/>
<a id="pl.14.25"></a><var>14.25</var>cervical cancer control program, and program funds have been used to pay for the person's <br/>
<a id="pl.14.26"></a><var>14.26</var>screening;<br/>
<a id="pl.14.27"></a><var>14.27</var>(2) according to the person's treating health professional, needs treatment, including <br/>
<a id="pl.14.28"></a><var>14.28</var>diagnostic services necessary to determine the extent and proper course of treatment, for <br/>
<a id="pl.14.29"></a><var>14.29</var>breast or cervical cancer, including precancerous conditions and early stage cancer;<br/>
<a id="pl.14.30"></a><var>14.30</var>(3) meets the income eligibility guidelines for the Minnesota breast and cervical <br/>
<a id="pl.14.31"></a><var>14.31</var>cancer control program;<br/>
<a id="pl.14.32"></a><var>14.32</var>(4) is under age 65;<br/>
<a id="pl.14.33"></a><var>14.33</var>(5) is not otherwise eligible for medical assistance under United States Code, title <br/>
<a id="pl.14.34"></a><var>14.34</var>42, section 1396a(a)(10)(A)(i); and<br/>
<a id="pl.15.1"></a><var>15.1</var>(6) is not otherwise covered under creditable coverage, as defined under United <br/>
<a id="pl.15.2"></a><var>15.2</var>States Code, title 42, section 1396a(aa).<br/>
<a id="pl.15.3"></a><var>15.3</var>(b) Medical assistance provided for an eligible person under this subdivision shall <br/>
<a id="pl.15.4"></a><var>15.4</var>be limited to services provided during the period that the person receives treatment for <br/>
<a id="pl.15.5"></a><var>15.5</var>breast or cervical cancer.<br/>
<a id="pl.15.6"></a><var>15.6</var>(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance <br/>
<a id="pl.15.7"></a><var>15.7</var>without meeting the eligibility criteria relating to income and assets in section 256B.056, <br/>
<a id="pl.15.8"></a><var>15.8</var>subdivisions 1a to 5b 5a.<br/>
<a id="pl.15.9"></a><var>15.9</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.21.0"></a><a id="pl.15.10"></a><var>15.10</var>    Sec. 21. Minnesota Statutes 2012, section 256B.057, is amended by adding a <br/>
<a id="pl.15.11"></a><var>15.11</var>subdivision to read:<br/>
<a id="pl.15.12"></a><var>15.12</var>    Subd. 12. <b>Presumptive eligibility determinations made by qualified hospitals.</b><br/>
<a id="pl.15.13"></a><var>15.13</var>The commissioner shall establish a process to qualify hospitals that are participating <br/>
<a id="pl.15.14"></a><var>15.14</var>providers under the medical assistance program to determine presumptive eligibility for <br/>
<a id="pl.15.15"></a><var>15.15</var>medical assistance for applicants who may have a basis of eligibility using the modified <br/>
<a id="pl.15.16"></a><var>15.16</var>adjusted gross income methodology as defined in section 256B.056, subdivision 1a, <br/>
<a id="pl.15.17"></a><var>15.17</var>paragraph (b), clause (1).<br/>
<a id="pl.15.18"></a><var>15.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.22.0"></a><a id="pl.15.19"></a><var>15.19</var>    Sec. 22. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:<br/>
<a id="pl.15.20"></a><var>15.20</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section and sections 
         <statute_ref>256B.058</statute_ref> <br/>
<a id="pl.15.21"></a><var>15.21</var>and 
         <statute_ref>256B.0595</statute_ref>, the terms defined in this subdivision have the meanings given them.<br/>
<a id="pl.15.22"></a><var>15.22</var>    (b) "Community spouse" means the spouse of an institutionalized spouse.<br/>
<a id="pl.15.23"></a><var>15.23</var>    (c) "Spousal share" means one-half of the total value of all assets, to the extent that <br/>
<a id="pl.15.24"></a><var>15.24</var>either the institutionalized spouse or the community spouse had an ownership interest at <br/>
<a id="pl.15.25"></a><var>15.25</var>the time of the first continuous period of institutionalization.<br/>
<a id="pl.15.26"></a><var>15.26</var>    (d) "Assets otherwise available to the community spouse" means assets individually <br/>
<a id="pl.15.27"></a><var>15.27</var>or jointly owned by the community spouse, other than assets excluded by subdivision 5, <br/>
<a id="pl.15.28"></a><var>15.28</var>paragraph (c).<br/>
<a id="pl.15.29"></a><var>15.29</var>    (e) "Community spouse asset allowance" is the value of assets that can be transferred <br/>
<a id="pl.15.30"></a><var>15.30</var>under subdivision 3.<br/>
<a id="pl.15.31"></a><var>15.31</var>    (f) "Institutionalized spouse" means a person who is:<br/>
<a id="pl.15.32"></a><var>15.32</var>    (1) in a hospital, nursing facility, or intermediate care facility for persons with <br/>
<a id="pl.15.33"></a><var>15.33</var>developmental disabilities, or receiving home and community-based services under section <br/>
<statute_ref><a id="pl.16.1"></a><var>16.1</var>256B.0915
         </statute_ref>, 256B.092, or 256B.49 and is expected to remain in the facility or institution <br/>
<a id="pl.16.2"></a><var>16.2</var>or receive the home and community-based services for at least 30 consecutive days; and<br/>
<a id="pl.16.3"></a><var>16.3</var>    (2) married to a person who is not in a hospital, nursing facility, or intermediate <br/>
<a id="pl.16.4"></a><var>16.4</var>care facility for persons with developmental disabilities, and is not receiving home and <br/>
<a id="pl.16.5"></a><var>16.5</var>community-based services under section 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, or 
         <statute_ref>256B.49</statute_ref>.<br/>
<a id="pl.16.6"></a><var>16.6</var>    (g) "For the sole benefit of" means no other individual or entity can benefit in any <br/>
<a id="pl.16.7"></a><var>16.7</var>way from the assets or income at the time of a transfer or at any time in the future.<br/>
<a id="pl.16.8"></a><var>16.8</var>    (h) "Continuous period of institutionalization" means a 30-consecutive-day period <br/>
<a id="pl.16.9"></a><var>16.9</var>of time in which a person is expected to stay in a medical or long-term care facility, or <br/>
<a id="pl.16.10"></a><var>16.10</var>receive home and community-based services that would qualify for coverage under the <br/>
<a id="pl.16.11"></a><var>16.11</var>elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915, <br/>
<a id="pl.16.12"></a><var>16.12</var>256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins <br/>
<a id="pl.16.13"></a><var>16.13</var>on the date of entry into a medical or long-term care facility. For receipt of home and <br/>
<a id="pl.16.14"></a><var>16.14</var>community-based services, the 30-consecutive-day period begins on the date that the <br/>
<a id="pl.16.15"></a><var>16.15</var>following conditions are met:<br/>
<a id="pl.16.16"></a><var>16.16</var>    (1) the person is receiving services that meet the nursing facility level of care <br/>
<a id="pl.16.17"></a><var>16.17</var>determined by a long-term care consultation;<br/>
<a id="pl.16.18"></a><var>16.18</var>    (2) the person has received the long-term care consultation within the past 60 days;<br/>
<a id="pl.16.19"></a><var>16.19</var>    (3) the services are paid by the EW program under section 
         <statute_ref>256B.0915</statute_ref> or the AC <br/>
<a id="pl.16.20"></a><var>16.20</var>program under section
<statute_ref>256B.0913</statute_ref>, 256B.0915, 256B.092, or 256B.49 or would qualify <br/>
<a id="pl.16.21"></a><var>16.21</var>for payment under the EW or AC programs those sections if the person were otherwise <br/>
<a id="pl.16.22"></a><var>16.22</var>eligible for either program, and but for the receipt of such services the person would have <br/>
<a id="pl.16.23"></a><var>16.23</var>resided in a nursing facility; and<br/>
<a id="pl.16.24"></a><var>16.24</var>    (4) the services are provided by a licensed provider qualified to provide home and <br/>
<a id="pl.16.25"></a><var>16.25</var>community-based services.<br/>
<a id="pl.16.26"></a><var>16.26</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.23.0"></a><a id="pl.16.27"></a><var>16.27</var>    Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:<br/>
<a id="pl.16.28"></a><var>16.28</var>    Subd. 4. <b>Citizenship requirements.</b> (a) Eligibility for medical assistance is limited <br/>
<a id="pl.16.29"></a><var>16.29</var>to citizens of the United States, qualified noncitizens as defined in this subdivision, and <br/>
<a id="pl.16.30"></a><var>16.30</var>other persons residing lawfully in the United States. Citizens or nationals of the United <br/>
<a id="pl.16.31"></a><var>16.31</var>States must cooperate in obtaining satisfactory documentary evidence of citizenship or <br/>
<a id="pl.16.32"></a><var>16.32</var>nationality according to the requirements of the federal Deficit Reduction Act of 2005, <br/>
<a id="pl.16.33"></a><var>16.33</var>Public Law 109-171.<br/>
<a id="pl.16.34"></a><var>16.34</var>(b) "Qualified noncitizen" means a person who meets one of the following <br/>
<a id="pl.16.35"></a><var>16.35</var>immigration criteria:<br/>
<a id="pl.17.1"></a><var>17.1</var>(1) admitted for lawful permanent residence according to United States Code, title 8;<br/>
<a id="pl.17.2"></a><var>17.2</var>(2) admitted to the United States as a refugee according to United States Code, <br/>
<a id="pl.17.3"></a><var>17.3</var>title 8, section 1157;<br/>
<a id="pl.17.4"></a><var>17.4</var>(3) granted asylum according to United States Code, title 8, section 1158;<br/>
<a id="pl.17.5"></a><var>17.5</var>(4) granted withholding of deportation according to United States Code, title 8, <br/>
<a id="pl.17.6"></a><var>17.6</var>section 1253(h);<br/>
<a id="pl.17.7"></a><var>17.7</var>(5) paroled for a period of at least one year according to United States Code, title 8, <br/>
<a id="pl.17.8"></a><var>17.8</var>section 1182(d)(5);<br/>
<a id="pl.17.9"></a><var>17.9</var>(6) granted conditional entrant status according to United States Code, title 8, <br/>
<a id="pl.17.10"></a><var>17.10</var>section 1153(a)(7);<br/>
<a id="pl.17.11"></a><var>17.11</var>(7) determined to be a battered noncitizen by the United States Attorney General <br/>
<a id="pl.17.12"></a><var>17.12</var>according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, <br/>
<a id="pl.17.13"></a><var>17.13</var>title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;<br/>
<a id="pl.17.14"></a><var>17.14</var>(8) is a child of a noncitizen determined to be a battered noncitizen by the United <br/>
<a id="pl.17.15"></a><var>17.15</var>States Attorney General according to the Illegal Immigration Reform and Immigrant <br/>
<a id="pl.17.16"></a><var>17.16</var>Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, <br/>
<a id="pl.17.17"></a><var>17.17</var>Public Law 104-200; or<br/>
<a id="pl.17.18"></a><var>17.18</var>(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public <br/>
<a id="pl.17.19"></a><var>17.19</var>Law 96-422, the Refugee Education Assistance Act of 1980.<br/>
<a id="pl.17.20"></a><var>17.20</var>(c) All qualified noncitizens who were residing in the United States before August <br/>
<a id="pl.17.21"></a><var>17.21</var>22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for <br/>
<a id="pl.17.22"></a><var>17.22</var>medical assistance with federal financial participation.<br/>
<a id="pl.17.23"></a><var>17.23</var>(d) Beginning December 1, 1996, qualified noncitizens who entered the United <br/>
<a id="pl.17.24"></a><var>17.24</var>States on or after August 22, 1996, and who otherwise meet the eligibility requirements <br/>
<a id="pl.17.25"></a><var>17.25</var>of this chapter are eligible for medical assistance with federal participation for five years <br/>
<a id="pl.17.26"></a><var>17.26</var>if they meet one of the following criteria:<br/>
<a id="pl.17.27"></a><var>17.27</var>(1) refugees admitted to the United States according to United States Code, title 8, <br/>
<a id="pl.17.28"></a><var>17.28</var>section 1157;<br/>
<a id="pl.17.29"></a><var>17.29</var>(2) persons granted asylum according to United States Code, title 8, section 1158;<br/>
<a id="pl.17.30"></a><var>17.30</var>(3) persons granted withholding of deportation according to United States Code, <br/>
<a id="pl.17.31"></a><var>17.31</var>title 8, section 1253(h);<br/>
<a id="pl.17.32"></a><var>17.32</var>(4) veterans of the United States armed forces with an honorable discharge for <br/>
<a id="pl.17.33"></a><var>17.33</var>a reason other than noncitizen status, their spouses and unmarried minor dependent <br/>
<a id="pl.17.34"></a><var>17.34</var>children; or<br/>
<a id="pl.17.35"></a><var>17.35</var>(5) persons on active duty in the United States armed forces, other than for training, <br/>
<a id="pl.17.36"></a><var>17.36</var>their spouses and unmarried minor dependent children.<br/>
<a id="pl.18.1"></a><var>18.1</var> Beginning July 1, 2010, children and pregnant women who are noncitizens <br/>
<a id="pl.18.2"></a><var>18.2</var>described in paragraph (b) or who are lawfully present in the United States as defined <br/>
<a id="pl.18.3"></a><var>18.3</var>in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet <br/>
<a id="pl.18.4"></a><var>18.4</var>eligibility requirements of this chapter, are eligible for medical assistance with federal <br/>
<a id="pl.18.5"></a><var>18.5</var>financial participation as provided by the federal Children's Health Insurance Program <br/>
<a id="pl.18.6"></a><var>18.6</var>Reauthorization Act of 2009, Public Law 111-3.<br/>
<a id="pl.18.7"></a><var>18.7</var>(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter <br/>
<a id="pl.18.8"></a><var>18.8</var>are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this <br/>
<a id="pl.18.9"></a><var>18.9</var>subdivision, a "nonimmigrant" is a person in one of the classes listed in United States <br/>
<a id="pl.18.10"></a><var>18.10</var>Code, title 8, section 1101(a)(15).<br/>
<a id="pl.18.11"></a><var>18.11</var>(f) Payment shall also be made for care and services that are furnished to noncitizens, <br/>
<a id="pl.18.12"></a><var>18.12</var>regardless of immigration status, who otherwise meet the eligibility requirements of <br/>
<a id="pl.18.13"></a><var>18.13</var>this chapter, if such care and services are necessary for the treatment of an emergency <br/>
<a id="pl.18.14"></a><var>18.14</var>medical condition.<br/>
<a id="pl.18.15"></a><var>18.15</var>(g) For purposes of this subdivision, the term "emergency medical condition" means <br/>
<a id="pl.18.16"></a><var>18.16</var>a medical condition that meets the requirements of United States Code, title 42, section <br/>
<a id="pl.18.17"></a><var>18.17</var>1396b(v).<br/>
<a id="pl.18.18"></a><var>18.18</var>(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment <br/>
<a id="pl.18.19"></a><var>18.19</var>of an emergency medical condition are limited to the following:<br/>
<a id="pl.18.20"></a><var>18.20</var>(i) services delivered in an emergency room or by an ambulance service licensed <br/>
<a id="pl.18.21"></a><var>18.21</var>under chapter 144E that are directly related to the treatment of an emergency medical <br/>
<a id="pl.18.22"></a><var>18.22</var>condition;<br/>
<a id="pl.18.23"></a><var>18.23</var>(ii) services delivered in an inpatient hospital setting following admission from an <br/>
<a id="pl.18.24"></a><var>18.24</var>emergency room or clinic for an acute emergency condition; and<br/>
<a id="pl.18.25"></a><var>18.25</var>(iii) follow-up services that are directly related to the original service provided <br/>
<a id="pl.18.26"></a><var>18.26</var>to treat the emergency medical condition and are covered by the global payment made <br/>
<a id="pl.18.27"></a><var>18.27</var>to the provider.<br/>
<a id="pl.18.28"></a><var>18.28</var>    (2) Services for the treatment of emergency medical conditions do not include:<br/>
<a id="pl.18.29"></a><var>18.29</var>(i) services delivered in an emergency room or inpatient setting to treat a <br/>
<a id="pl.18.30"></a><var>18.30</var>nonemergency condition;<br/>
<a id="pl.18.31"></a><var>18.31</var>(ii) organ transplants, stem cell transplants, and related care;<br/>
<a id="pl.18.32"></a><var>18.32</var>(iii) services for routine prenatal care;<br/>
<a id="pl.18.33"></a><var>18.33</var>(iv) continuing care, including long-term care, nursing facility services, home health <br/>
<a id="pl.18.34"></a><var>18.34</var>care, adult day care, day training, or supportive living services;<br/>
<a id="pl.18.35"></a><var>18.35</var>(v) elective surgery;<br/>
<a id="pl.19.1"></a><var>19.1</var>(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as <br/>
<a id="pl.19.2"></a><var>19.2</var>part of an emergency room visit;<br/>
<a id="pl.19.3"></a><var>19.3</var>(vii) preventative health care and family planning services;<br/>
<a id="pl.19.4"></a><var>19.4</var>(viii) dialysis;<br/>
<a id="pl.19.5"></a><var>19.5</var>(ix) chemotherapy or therapeutic radiation services;<br/>
<a id="pl.19.6"></a><var>19.6</var>(x) rehabilitation services;<br/>
<a id="pl.19.7"></a><var>19.7</var>(xi) physical, occupational, or speech therapy;<br/>
<a id="pl.19.8"></a><var>19.8</var>(xii) transportation services;<br/>
<a id="pl.19.9"></a><var>19.9</var>(xiii) case management;<br/>
<a id="pl.19.10"></a><var>19.10</var>(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;<br/>
<a id="pl.19.11"></a><var>19.11</var>(xv) dental services;<br/>
<a id="pl.19.12"></a><var>19.12</var>(xvi) hospice care;<br/>
<a id="pl.19.13"></a><var>19.13</var>(xvii) audiology services and hearing aids;<br/>
<a id="pl.19.14"></a><var>19.14</var>(xviii) podiatry services;<br/>
<a id="pl.19.15"></a><var>19.15</var>(xix) chiropractic services;<br/>
<a id="pl.19.16"></a><var>19.16</var>(xx) immunizations;<br/>
<a id="pl.19.17"></a><var>19.17</var>(xxi) vision services and eyeglasses;<br/>
<a id="pl.19.18"></a><var>19.18</var>(xxii) waiver services;<br/>
<a id="pl.19.19"></a><var>19.19</var>(xxiii) individualized education programs; or<br/>
<a id="pl.19.20"></a><var>19.20</var>(xxiv) chemical dependency treatment.<br/>
<a id="pl.19.21"></a><var>19.21</var>(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented, <br/>
<a id="pl.19.22"></a><var>19.22</var>nonimmigrants, or lawfully present in the United States as defined in Code of Federal <br/>
<a id="pl.19.23"></a><var>19.23</var>Regulations, title 8, section 103.12, ineligible for federally funded medical assistance <br/>
<a id="pl.19.24"></a><var>19.24</var>because of immigration status are not covered by a group health plan or health insurance <br/>
<a id="pl.19.25"></a><var>19.25</var>coverage according to Code of Federal Regulations, title 42, section 457.310, and who <br/>
<a id="pl.19.26"></a><var>19.26</var>otherwise meet the eligibility requirements of this chapter, are eligible for medical <br/>
<a id="pl.19.27"></a><var>19.27</var>assistance through the period of pregnancy, including labor and delivery, and 60 days <br/>
<a id="pl.19.28"></a><var>19.28</var>postpartum, to the extent federal funds are available under title XXI of the Social Security <br/>
<a id="pl.19.29"></a><var>19.29</var>Act, and the state children's health insurance program.<br/>
<a id="pl.19.30"></a><var>19.30</var>(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation <br/>
<a id="pl.19.31"></a><var>19.31</var>services from a nonprofit center established to serve victims of torture and are otherwise <br/>
<a id="pl.19.32"></a><var>19.32</var>ineligible for medical assistance under this chapter are eligible for medical assistance <br/>
<a id="pl.19.33"></a><var>19.33</var>without federal financial participation. These individuals are eligible only for the period <br/>
<a id="pl.19.34"></a><var>19.34</var>during which they are receiving services from the center. Individuals eligible under this <br/>
<a id="pl.19.35"></a><var>19.35</var>paragraph shall not be required to participate in prepaid medical assistance.<br/>
<a id="pl.19.36"></a><var>19.36</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.24.0"></a><a id="pl.20.1"></a><var>20.1</var>    Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:<br/>
<a id="pl.20.2"></a><var>20.2</var>    Subd. 3. <b>Accountability.</b> (a) Health care delivery systems must accept responsibility <br/>
<a id="pl.20.3"></a><var>20.3</var>for the quality of care based on standards established under subdivision 1, paragraph (b), <br/>
<a id="pl.20.4"></a><var>20.4</var>clause (10), and the cost of care or utilization of services provided to its enrollees under <br/>
<a id="pl.20.5"></a><var>20.5</var>subdivision 1, paragraph (b), clause (1).<br/>
<a id="pl.20.6"></a><var>20.6</var>(b) A health care delivery system may contract and coordinate with providers and <br/>
<a id="pl.20.7"></a><var>20.7</var>clinics for the delivery of services and shall contract with community health clinics, <br/>
<a id="pl.20.8"></a><var>20.8</var>federally qualified health centers, community mental health centers or programs, county <br/>
<a id="pl.20.9"></a><var>20.9</var>agencies, and rural clinics to the extent practicable.<br/>
<a id="pl.20.10"></a><var>20.10</var>(c) A health care delivery system must demonstrate how its services will be <br/>
<a id="pl.20.11"></a><var>20.11</var>coordinated with other services affecting its attributed patients' health, quality of care, and <br/>
<a id="pl.20.12"></a><var>20.12</var>cost of care that are provided by other providers and county agencies in the local service <br/>
<a id="pl.20.13"></a><var>20.13</var>area. The health care delivery system must document how other providers and counties, <br/>
<a id="pl.20.14"></a><var>20.14</var>including county-based purchasing plans, will provide services to attributed patients of <br/>
<a id="pl.20.15"></a><var>20.15</var>the health care delivery system, and how it will address applicable local needs, priorities, <br/>
<a id="pl.20.16"></a><var>20.16</var>and public health goals. As part of this documentation, the health care delivery system <br/>
<a id="pl.20.17"></a><var>20.17</var>must describe the involvement of local providers and counties, including county-based <br/>
<a id="pl.20.18"></a><var>20.18</var>purchasing plans, in developing the application to participate in the demonstration project.<br/>
<a id="pl.20.19"></a><var>20.19</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2013, and applies to health <br/>
<a id="pl.20.20"></a><var>20.20</var>care delivery system contracts entered into on or after that date.<br/>
<br/>
<a id="bill.1.25.0"></a><a id="pl.20.21"></a><var>20.21</var>    Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:<br/>
<a id="pl.20.22"></a><var>20.22</var><b>256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE </b><br/>
<a id="pl.20.23"></a><var>20.23</var><b>CONTRACT.</b><br/>
<a id="pl.20.24"></a><var>20.24</var>    (a) MS 2010 [Expired, 2008 c 364 s 10]<br/>
<a id="pl.20.25"></a><var>20.25</var>    (b) The commissioner shall consider, and may approve, contracting on a <br/>
<a id="pl.20.26"></a><var>20.26</var>single-health plan basis with other county-based purchasing plans, or with other qualified <br/>
<a id="pl.20.27"></a><var>20.27</var>health plans that have coordination arrangements with counties, to serve persons with a <br/>
<a id="pl.20.28"></a><var>20.28</var>disability who voluntarily enroll enrolled in state public health care programs, in order <br/>
<a id="pl.20.29"></a><var>20.29</var>to promote better coordination or integration of health care services, social services and <br/>
<a id="pl.20.30"></a><var>20.30</var>other community-based services, provided that all requirements applicable to health plan <br/>
<a id="pl.20.31"></a><var>20.31</var>purchasing, including those in section 
         <statute_ref>256B.69, subdivision 23</statute_ref>, are satisfied. Nothing in <br/>
<a id="pl.20.32"></a><var>20.32</var>this paragraph supersedes or modifies the requirements in paragraph (a).<br/>
<br/>
<a id="bill.1.26.0"></a><a id="pl.21.1"></a><var>21.1</var>    Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision <br/>
<a id="pl.21.2"></a><var>21.2</var>to read:<br/>
<a id="pl.21.3"></a><var>21.3</var>    Subd. 1b. <b>Affordable Care Act. </b> "Affordable Care Act" means Public Law 111-148, <br/>
<a id="pl.21.4"></a><var>21.4</var>as amended by the federal Health Care and Education Reconciliation Act of 2010, Public <br/>
<a id="pl.21.5"></a><var>21.5</var>Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.<br/>
<br/>
<a id="bill.1.27.0"></a><a id="pl.21.6"></a><var>21.6</var>    Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:<br/>
<a id="pl.21.7"></a><var>21.7</var>    Subd. 3a. <b>Family </b><b>with children</b><b>.</b> (a) "Family with children" means:<br/>
<a id="pl.21.8"></a><var>21.8</var>(1) parents and their children residing in the same household; or<br/>
<a id="pl.21.9"></a><var>21.9</var>(2) grandparents, foster parents, relative caretakers as defined in the medical <br/>
<a id="pl.21.10"></a><var>21.10</var>assistance program, or legal guardians; and their wards who are children residing in the <br/>
<a id="pl.21.11"></a><var>21.11</var>same household. "Family" has the meaning given for family and family size as defined <br/>
<a id="pl.21.12"></a><var>21.12</var>in Code of Federal Regulations, title 26, section 1.36B-1.<br/>
<a id="pl.21.13"></a><var>21.13</var>(b) The term includes children who are temporarily absent from the household in <br/>
<a id="pl.21.14"></a><var>21.14</var>settings such as schools, camps, or parenting time with noncustodial parents.<br/>
<a id="pl.21.15"></a><var>21.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.21.16"></a><var>21.16</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.21.17"></a><var>21.17</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.28.0"></a><a id="pl.21.18"></a><var>21.18</var>    Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:<br/>
<a id="pl.21.19"></a><var>21.19</var>    Subd. 5. <b>Income.</b> (a) "Income" has the meaning given for earned and unearned <br/>
<a id="pl.21.20"></a><var>21.20</var>income for families and children in the medical assistance program, according to the <br/>
<a id="pl.21.21"></a><var>21.21</var>state's aid to families with dependent children plan in effect as of July 16, 1996. The <br/>
<a id="pl.21.22"></a><var>21.22</var>definition does not include medical assistance income methodologies and deeming <br/>
<a id="pl.21.23"></a><var>21.23</var>requirements. The earned income of full-time and part-time students under age 19 is <br/>
<a id="pl.21.24"></a><var>21.24</var>not counted as income. Public assistance payments and supplemental security income <br/>
<a id="pl.21.25"></a><var>21.25</var>are not excluded income modified adjusted gross income, as defined in Code of Federal <br/>
<a id="pl.21.26"></a><var>21.26</var>Regulations, title 26, section 1.36B-1.<br/>
<a id="pl.21.27"></a><var>21.27</var>(b) For purposes of this subdivision, and unless otherwise specified in this section, <br/>
<a id="pl.21.28"></a><var>21.28</var>the commissioner shall use reasonable methods to calculate gross earned and unearned <br/>
<a id="pl.21.29"></a><var>21.29</var>income including, but not limited to, projecting income based on income received within <br/>
<a id="pl.21.30"></a><var>21.30</var>the past 30 days, the last 90 days, or the last 12 months.<br/>
<a id="pl.21.31"></a><var>21.31</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.21.32"></a><var>21.32</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.21.33"></a><var>21.33</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.29.0"></a><a id="pl.22.1"></a><var>22.1</var>    Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision <br/>
<a id="pl.22.2"></a><var>22.2</var>to read:<br/>
<a id="pl.22.3"></a><var>22.3</var>    Subd. 6. <b>Minnesota Insurance Marketplace.</b> "Minnesota Insurance Marketplace" <br/>
<a id="pl.22.4"></a><var>22.4</var>means the Minnesota Insurance Marketplace as defined in section 62V.02.<br/>
<br/>
<a id="bill.1.30.0"></a><a id="pl.22.5"></a><var>22.5</var>    Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision <br/>
<a id="pl.22.6"></a><var>22.6</var>to read:<br/>
<a id="pl.22.7"></a><var>22.7</var>    Subd. 7. <b>Participating entity.</b> "Participating entity" means a health carrier as <br/>
<a id="pl.22.8"></a><var>22.8</var>defined in section 62A.01, subdivision 2; a county-based purchasing plan established <br/>
<a id="pl.22.9"></a><var>22.9</var>under section 256B.692; an accountable care organization or other entity operating a <br/>
<a id="pl.22.10"></a><var>22.10</var>health care delivery systems demonstration project authorized under section 256B.0755; <br/>
<a id="pl.22.11"></a><var>22.11</var>an entity operating a county integrated health care delivery network pilot project <br/>
<a id="pl.22.12"></a><var>22.12</var>authorized under section 256B.0756; or a network of health care providers established to <br/>
<a id="pl.22.13"></a><var>22.13</var>offer services under MinnesotaCare.<br/>
<a id="pl.22.14"></a><var>22.14</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2015.<br/>
<br/>
<a id="bill.1.31.0"></a><a id="pl.22.15"></a><var>22.15</var>    Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:<br/>
<a id="pl.22.16"></a><var>22.16</var>    Subd. 2. <b>Commissioner's duties.</b> (a) The commissioner shall establish an office <br/>
<a id="pl.22.17"></a><var>22.17</var>for the state administration of this plan. The plan shall be used to provide covered health <br/>
<a id="pl.22.18"></a><var>22.18</var>services for eligible persons. Payment for these services shall be made to all eligible <br/>
<a id="pl.22.19"></a><var>22.19</var>providers participating entities under contract with the commissioner. The commissioner <br/>
<a id="pl.22.20"></a><var>22.20</var>shall adopt rules to administer the MinnesotaCare program. The commissioner shall <br/>
<a id="pl.22.21"></a><var>22.21</var>establish marketing efforts to encourage potentially eligible persons to receive information <br/>
<a id="pl.22.22"></a><var>22.22</var>about the program and about other medical care programs administered or supervised by <br/>
<a id="pl.22.23"></a><var>22.23</var>the Department of Human Services.<br/>
<a id="pl.22.24"></a><var>22.24</var>(b) A toll-free telephone number and Web site must be used to provide information <br/>
<a id="pl.22.25"></a><var>22.25</var>about medical programs and to promote access to the covered services.<br/>
<a id="pl.22.26"></a><var>22.26</var><b>EFFECTIVE DATE.</b>Paragraph (a) is effective January 1, 2015. Paragraph (b) is <br/>
<a id="pl.22.27"></a><var>22.27</var>effective January 1, 2014.<br/>
<br/>
<a id="bill.1.32.0"></a><a id="pl.22.28"></a><var>22.28</var>    Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision <br/>
<a id="pl.22.29"></a><var>22.29</var>to read:<br/>
<a id="pl.22.30"></a><var>22.30</var>    Subd. 6. <b>Federal approval.</b> (a) The commissioner of human services shall seek <br/>
<a id="pl.22.31"></a><var>22.31</var>federal approval to implement the MinnesotaCare program under this chapter as a basic <br/>
<a id="pl.22.32"></a><var>22.32</var>health program. In any agreement with the Centers for Medicare and Medicaid Services <br/>
<a id="pl.23.1"></a><var>23.1</var>to operate MinnesotaCare as a basic health program, the commissioner shall seek to <br/>
<a id="pl.23.2"></a><var>23.2</var>include procedures to ensure that federal funding is predictable, stable, and sufficient <br/>
<a id="pl.23.3"></a><var>23.3</var>to sustain ongoing operation of MinnesotaCare. These procedures must address issues <br/>
<a id="pl.23.4"></a><var>23.4</var>related to the timing of federal payments, payment reconciliation, enrollee risk adjustment, <br/>
<a id="pl.23.5"></a><var>23.5</var>and minimization of state financial risk. The commissioner shall consult with the <br/>
<a id="pl.23.6"></a><var>23.6</var>commissioner of management and budget, when developing the proposal for establishing <br/>
<a id="pl.23.7"></a><var>23.7</var>MinnesotaCare as a basic health program to be submitted to the Centers for Medicare <br/>
<a id="pl.23.8"></a><var>23.8</var>and Medicaid Services.<br/>
<a id="pl.23.9"></a><var>23.9</var>(b) The commissioner of human services, in consultation with the commissioner <br/>
<a id="pl.23.10"></a><var>23.10</var>of management and budget, shall work with the Centers for Medicare and Medicaid <br/>
<a id="pl.23.11"></a><var>23.11</var>Services to establish a process for reconciliation and adjustment of federal payments that <br/>
<a id="pl.23.12"></a><var>23.12</var>balances state and federal liability over time. The commissioner of human services shall <br/>
<a id="pl.23.13"></a><var>23.13</var>request that the United States secretary of health and human services hold the state, and <br/>
<a id="pl.23.14"></a><var>23.14</var>enrollees, harmless in the reconciliation process for the first three years, to allow the state <br/>
<a id="pl.23.15"></a><var>23.15</var>to develop a statistically valid methodology for predicting enrollment trends and their <br/>
<a id="pl.23.16"></a><var>23.16</var>net effect on federal payments.<br/>
<a id="pl.23.17"></a><var>23.17</var>(c) The commissioner of human services, through December 31, 2015, may modify <br/>
<a id="pl.23.18"></a><var>23.18</var>the MinnesotaCare program as specified in this chapter, if it is necessary to enhance <br/>
<a id="pl.23.19"></a><var>23.19</var>health benefits, expand provider access, or reduce cost-sharing and premiums in order <br/>
<a id="pl.23.20"></a><var>23.20</var>to comply with the terms and conditions of federal approval as a basic health program. <br/>
<a id="pl.23.21"></a><var>23.21</var>The commissioner may not reduce benefits, impose greater limits on access to providers, <br/>
<a id="pl.23.22"></a><var>23.22</var>or increase cost-sharing and premiums by enrollees under the authority granted by this <br/>
<a id="pl.23.23"></a><var>23.23</var>paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare <br/>
<a id="pl.23.24"></a><var>23.24</var>under this paragraph, the commissioner shall provide the legislature with notice of <br/>
<a id="pl.23.25"></a><var>23.25</var>implementation of the modifications at least ten working days before notifying enrollees <br/>
<a id="pl.23.26"></a><var>23.26</var>and participating entities. The costs of any changes to the program necessary to comply <br/>
<a id="pl.23.27"></a><var>23.27</var>with federal approval shall not become part of the program's base funding for purposes of <br/>
<a id="pl.23.28"></a><var>23.28</var>future budget forecasts.<br/>
<a id="pl.23.29"></a><var>23.29</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.1.33.0"></a><a id="pl.23.30"></a><var>23.30</var>    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision <br/>
<a id="pl.23.31"></a><var>23.31</var>to read:<br/>
<a id="pl.23.32"></a><var>23.32</var>    Subd. 7. <b>Coordination with Minnesota Insurance Marketplace.</b> MinnesotaCare <br/>
<a id="pl.23.33"></a><var>23.33</var>shall be considered a public health care program for purposes of chapter 62V.<br/>
<a id="pl.23.34"></a><var>23.34</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.34.0"></a><a id="pl.24.1"></a><var>24.1</var>    Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:<br/>
<a id="pl.24.2"></a><var>24.2</var>    Subdivision 1. <b>Covered health services.</b> (a) "Covered health services" means the <br/>
<a id="pl.24.3"></a><var>24.3</var>health services reimbursed under chapter 256B, with the exception of inpatient hospital <br/>
<a id="pl.24.4"></a><var>24.4</var>services, special education services, private duty nursing services, adult dental care <br/>
<a id="pl.24.5"></a><var>24.5</var>services other than services covered under section 
         <statute_ref>256B.0625, subdivision 9</statute_ref>, orthodontic <br/>
<a id="pl.24.6"></a><var>24.6</var>services, nonemergency medical transportation services, personal care assistance and case <br/>
<a id="pl.24.7"></a><var>24.7</var>management services, and nursing home or intermediate care facilities services, inpatient <br/>
<a id="pl.24.8"></a><var>24.8</var>mental health services, and chemical dependency services.<br/>
<a id="pl.24.9"></a><var>24.9</var>    (b) No public funds shall be used for coverage of abortion under MinnesotaCare <br/>
<a id="pl.24.10"></a><var>24.10</var>except where the life of the female would be endangered or substantial and irreversible <br/>
<a id="pl.24.11"></a><var>24.11</var>impairment of a major bodily function would result if the fetus were carried to term; or <br/>
<a id="pl.24.12"></a><var>24.12</var>where the pregnancy is the result of rape or incest.<br/>
<a id="pl.24.13"></a><var>24.13</var>    (c) Covered health services shall be expanded as provided in this section.<br/>
<a id="pl.24.14"></a><var>24.14</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.24.15"></a><var>24.15</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.24.16"></a><var>24.16</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.35.0"></a><a id="pl.24.17"></a><var>24.17</var>    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:<br/>
<a id="pl.24.18"></a><var>24.18</var>    Subd. 1a. <b>Pregnant women and</b><b> Children; MinnesotaCare health care reform </b><br/>
<a id="pl.24.19"></a><var>24.19</var><b>waiver.</b> Beginning January 1, 1999, Children and pregnant women are eligible for coverage <br/>
<a id="pl.24.20"></a><var>24.20</var>of all services that are eligible for reimbursement under the medical assistance program <br/>
<a id="pl.24.21"></a><var>24.21</var>according to chapter 256B, except that abortion services under MinnesotaCare shall be <br/>
<a id="pl.24.22"></a><var>24.22</var>limited as provided under subdivision 1. Pregnant women and Children are exempt from <br/>
<a id="pl.24.23"></a><var>24.23</var>the provisions of subdivision 5, regarding co-payments. Pregnant women and Children <br/>
<a id="pl.24.24"></a><var>24.24</var>who are lawfully residing in the United States but who are not "qualified noncitizens" under <br/>
<a id="pl.24.25"></a><var>24.25</var>title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, <br/>
<a id="pl.24.26"></a><var>24.26</var>Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage <br/>
<a id="pl.24.27"></a><var>24.27</var>of all services provided under the medical assistance program according to chapter 256B.<br/>
<a id="pl.24.28"></a><var>24.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.24.29"></a><var>24.29</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.24.30"></a><var>24.30</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.36.0"></a><a id="pl.24.31"></a><var>24.31</var>    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:<br/>
<a id="pl.24.32"></a><var>24.32</var>    Subd. 3. <b>Inpatient hospital services.</b> (a) Covered health services shall include <br/>
<a id="pl.24.33"></a><var>24.33</var>inpatient hospital services, including inpatient hospital mental health services and inpatient <br/>
<a id="pl.25.1"></a><var>25.1</var>hospital and residential chemical dependency treatment, subject to those limitations <br/>
<a id="pl.25.2"></a><var>25.2</var>necessary to coordinate the provision of these services with eligibility under the medical <br/>
<a id="pl.25.3"></a><var>25.3</var>assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under <br/>
<a id="pl.25.4"></a><var>25.4</var>section 
<statute_ref>256L.04, subdivision 7</statute_ref>, or who qualify under section 
<statute_ref>256L.04, subdivisions 1 and <br/>
<a id="pl.25.5"></a><var>25.5</var>2
</statute_ref>, with family gross income that exceeds 200 percent of the federal poverty guidelines or <br/>
<a id="pl.25.6"></a><var>25.6</var>215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not <br/>
<a id="pl.25.7"></a><var>25.7</var>pregnant, is subject to an annual limit of $10,000.<br/>
<a id="pl.25.8"></a><var>25.8</var>    (b) Admissions for inpatient hospital services paid for under section 
         <statute_ref>256L.11, <br/>
<a id="pl.25.9"></a><var>25.9</var>subdivision 3
         </statute_ref>, must be certified as medically necessary in accordance with Minnesota <br/>
<a id="pl.25.10"></a><var>25.10</var>Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):<br/>
<a id="pl.25.11"></a><var>25.11</var>    (1) all admissions must be certified, except those authorized under rules established <br/>
<a id="pl.25.12"></a><var>25.12</var>under section 
         <statute_ref>254A.03, subdivision 3</statute_ref>, or approved under Medicare; and<br/>
<a id="pl.25.13"></a><var>25.13</var>    (2) payment under section 
         <statute_ref>256L.11, subdivision 3</statute_ref>, shall be reduced by five percent <br/>
<a id="pl.25.14"></a><var>25.14</var>for admissions for which certification is requested more than 30 days after the day of <br/>
<a id="pl.25.15"></a><var>25.15</var>admission. The hospital may not seek payment from the enrollee for the amount of the <br/>
<a id="pl.25.16"></a><var>25.16</var>payment reduction under this clause.<br/>
<a id="pl.25.17"></a><var>25.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.25.18"></a><var>25.18</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.25.19"></a><var>25.19</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.37.0"></a><a id="pl.25.20"></a><var>25.20</var>    Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision <br/>
<a id="pl.25.21"></a><var>25.21</var>to read:<br/>
<a id="pl.25.22"></a><var>25.22</var>    Subd. 4a. <b>Loss ratio.</b> Health coverage provided through the MinnesotaCare <br/>
<a id="pl.25.23"></a><var>25.23</var>program must have a medical loss ratio of at least 85 percent, as defined using the loss <br/>
<a id="pl.25.24"></a><var>25.24</var>ratio methodology described in section 1001 of the Affordable Care Act.<br/>
<a id="pl.25.25"></a><var>25.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2015.<br/>
<br/>
<a id="bill.1.38.0"></a><a id="pl.25.26"></a><var>25.26</var>    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:<br/>
<a id="pl.25.27"></a><var>25.27</var>    Subd. 5. <b>Cost-sharing.</b> (a) Except as otherwise provided in paragraphs (b) and (c)<br/>
<a id="pl.25.28"></a><var>25.28</var> this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing <br/>
<a id="pl.25.29"></a><var>25.29</var>requirements for all enrollees:<br/>
<a id="pl.25.30"></a><var>25.30</var>    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, <br/>
<a id="pl.25.31"></a><var>25.31</var>subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;<br/>
<a id="pl.25.32"></a><var>25.32</var>    (2) (1) $3 per prescription for adult enrollees;<br/>
<a id="pl.25.33"></a><var>25.33</var>    (3) (2) $25 for eyeglasses for adult enrollees;<br/>
<a id="pl.26.1"></a><var>26.1</var>    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means <br/>
<a id="pl.26.2"></a><var>26.2</var>an episode of service which is required because of a recipient's symptoms, diagnosis, or <br/>
<a id="pl.26.3"></a><var>26.3</var>established illness, and which is delivered in an ambulatory setting by a physician or <br/>
<a id="pl.26.4"></a><var>26.4</var>physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, <br/>
<a id="pl.26.5"></a><var>26.5</var>audiologist, optician, or optometrist;<br/>
<a id="pl.26.6"></a><var>26.6</var>    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services <br/>
<a id="pl.26.7"></a><var>26.7</var>provided through December 31, 2010, and $3.50 effective January 1, 2011; and<br/>
<a id="pl.26.8"></a><var>26.8</var>(6) (5) a family deductible equal to the maximum amount allowed under Code of <br/>
<a id="pl.26.9"></a><var>26.9</var>Federal Regulations, title 42, part 447.54.<br/>
<a id="pl.26.10"></a><var>26.10</var>    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of <br/>
<a id="pl.26.11"></a><var>26.11</var>children under the age of 21.<br/>
<a id="pl.26.12"></a><var>26.12</var>    (c) (b) Paragraph (a) does not apply to pregnant women and children under the <br/>
<a id="pl.26.13"></a><var>26.13</var>age of 21.<br/>
<a id="pl.26.14"></a><var>26.14</var>    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.<br/>
<a id="pl.26.15"></a><var>26.15</var>    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal <br/>
<a id="pl.26.16"></a><var>26.16</var>poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, <br/>
<a id="pl.26.17"></a><var>26.17</var>and who are not pregnant shall be financially responsible for the coinsurance amount, if <br/>
<a id="pl.26.18"></a><var>26.18</var>applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.<br/>
<a id="pl.26.19"></a><var>26.19</var>    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, <br/>
<a id="pl.26.20"></a><var>26.20</var>or changes from one prepaid health plan to another during a calendar year, any charges <br/>
<a id="pl.26.21"></a><var>26.21</var>submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket <br/>
<a id="pl.26.22"></a><var>26.22</var>expenses incurred by the enrollee for inpatient services, that were submitted or incurred <br/>
<a id="pl.26.23"></a><var>26.23</var>prior to enrollment, or prior to the change in health plans, shall be disregarded.<br/>
<a id="pl.26.24"></a><var>26.24</var>(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to <br/>
<a id="pl.26.25"></a><var>26.25</var>managed care plans or county-based purchasing plans shall not be increased as a result of <br/>
<a id="pl.26.26"></a><var>26.26</var>the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.<br/>
<a id="pl.26.27"></a><var>26.27</var>(h) (e) The commissioner, through the contracting process under section 
         <statute_ref>256L.12</statute_ref>, <br/>
<a id="pl.26.28"></a><var>26.28</var>may allow managed care plans and county-based purchasing plans to waive the family <br/>
<a id="pl.26.29"></a><var>26.29</var>deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not <br/>
<a id="pl.26.30"></a><var>26.30</var>be included in the capitation payment to managed care plans and county-based purchasing <br/>
<a id="pl.26.31"></a><var>26.31</var>plans. Managed care plans and county-based purchasing plans shall certify annually to the <br/>
<a id="pl.26.32"></a><var>26.32</var>commissioner the dollar value of the family deductible.<br/>
<a id="pl.26.33"></a><var>26.33</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.26.34"></a><var>26.34</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.26.35"></a><var>26.35</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.39.0"></a><a id="pl.27.1"></a><var>27.1</var>    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:<br/>
<a id="pl.27.2"></a><var>27.2</var>    Subd. 6. <b>Lien.</b> When the state agency provides, pays for, or becomes liable for <br/>
<a id="pl.27.3"></a><var>27.3</var>covered health services, the agency shall have a lien for the cost of the covered health <br/>
<a id="pl.27.4"></a><var>27.4</var>services upon any and all causes of action accruing to the enrollee, or to the enrollee's <br/>
<a id="pl.27.5"></a><var>27.5</var>legal representatives, as a result of the occurrence that necessitated the payment for the <br/>
<a id="pl.27.6"></a><var>27.6</var>covered health services. All liens under this section shall be subject to the provisions <br/>
<a id="pl.27.7"></a><var>27.7</var>of section 
         <statute_ref>256.015</statute_ref>. For purposes of this subdivision, "state agency" includes prepaid <br/>
<a id="pl.27.8"></a><var>27.8</var>health plans participating entities, under contract with the commissioner according to <br/>
<a id="pl.27.9"></a><var>27.9</var>sections 
<statute_ref>256B.69</statute_ref>, 
<statute_ref>256D.03, subdivision 4</statute_ref>, paragraph (c), and 
<statute_ref>256L.12</statute_ref>; and county-based <br/>
<a id="pl.27.10"></a><var>27.10</var>purchasing entities under section 
<statute_ref>256B.692</statute_ref> section 
<statute_ref>256L.121</statute_ref>.<br/>
<a id="pl.27.11"></a><var>27.11</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2015.<br/>
<br/>
<a id="bill.1.40.0"></a><a id="pl.27.12"></a><var>27.12</var>    Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:<br/>
<a id="pl.27.13"></a><var>27.13</var>    Subdivision 1. <b>Families with children.</b> (a) Families with children with family <br/>
<a id="pl.27.14"></a><var>27.14</var>income above 133 percent of the federal poverty guidelines and equal to or less than <br/>
<a id="pl.27.15"></a><var>27.15</var>275 200 percent of the federal poverty guidelines for the applicable family size shall be <br/>
<a id="pl.27.16"></a><var>27.16</var>eligible for MinnesotaCare according to this section. All other provisions of sections <br/>
<statute_ref><a id="pl.27.17"></a><var>27.17</var>256L.01
         </statute_ref> to 
         <statute_ref>256L.18</statute_ref>, including the insurance-related barriers to enrollment under section <br/>
<a id="pl.27.18"></a><var>27.18</var><statute_ref>256L.07</statute_ref>, shall apply unless otherwise specified.<br/>
<a id="pl.27.19"></a><var>27.19</var>    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, <br/>
<a id="pl.27.20"></a><var>27.20</var>if the children are eligible. Children may be enrolled separately without enrollment by <br/>
<a id="pl.27.21"></a><var>27.21</var>parents. However, if one parent in the household enrolls, both parents must enroll, unless <br/>
<a id="pl.27.22"></a><var>27.22</var>other insurance is available. If one child from a family is enrolled, all children must <br/>
<a id="pl.27.23"></a><var>27.23</var>be enrolled, unless other insurance is available. If one spouse in a household enrolls, <br/>
<a id="pl.27.24"></a><var>27.24</var>the other spouse in the household must also enroll, unless other insurance is available. <br/>
<a id="pl.27.25"></a><var>27.25</var>Families cannot choose to enroll only certain uninsured members.<br/>
<a id="pl.27.26"></a><var>27.26</var>    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies <br/>
<a id="pl.27.27"></a><var>27.27</var>to the MinnesotaCare program. These persons are no longer counted in the parental <br/>
<a id="pl.27.28"></a><var>27.28</var>household and may apply as a separate household.<br/>
<a id="pl.27.29"></a><var>27.29</var>    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.<br/>
<a id="pl.27.30"></a><var>27.30</var>(e) Children deemed eligible for MinnesotaCare under section 
<statute_ref>256L.07, subdivision <br/>
<a id="pl.27.31"></a><var>27.31</var>8
</statute_ref>, are exempt from the eligibility requirements of this subdivision.<br/>
<a id="pl.27.32"></a><var>27.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.27.33"></a><var>27.33</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.27.34"></a><var>27.34</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.41.0"></a><a id="pl.28.1"></a><var>28.1</var>    Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision <br/>
<a id="pl.28.2"></a><var>28.2</var>to read:<br/>
<a id="pl.28.3"></a><var>28.3</var>    Subd. 1c. <b>General requirements.</b> To be eligible for coverage under MinnesotaCare, <br/>
<a id="pl.28.4"></a><var>28.4</var>a person must meet the eligibility requirements of this section. A person eligible for <br/>
<a id="pl.28.5"></a><var>28.5</var>MinnesotaCare shall not be considered a qualified individual under section 1312 of the <br/>
<a id="pl.28.6"></a><var>28.6</var>Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered <br/>
<a id="pl.28.7"></a><var>28.7</var>through the Minnesota Insurance Marketplace under chapter 62V.<br/>
<a id="pl.28.8"></a><var>28.8</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.42.0"></a><a id="pl.28.9"></a><var>28.9</var>    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:<br/>
<a id="pl.28.10"></a><var>28.10</var>    Subd. 7. <b>Single adults and households with no children.</b> (a) The definition of <br/>
<a id="pl.28.11"></a><var>28.11</var>eligible persons includes all individuals and households families with no children who <br/>
<a id="pl.28.12"></a><var>28.12</var>have gross family incomes that are above 133 percent and equal to or less than 200 percent <br/>
<a id="pl.28.13"></a><var>28.13</var>of the federal poverty guidelines for the applicable family size.<br/>
<a id="pl.28.14"></a><var>28.14</var>    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals <br/>
<a id="pl.28.15"></a><var>28.15</var>and households with no children who have gross family incomes that are equal to or less <br/>
<a id="pl.28.16"></a><var>28.16</var>than 250 percent of the federal poverty guidelines.<br/>
<a id="pl.28.17"></a><var>28.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.28.18"></a><var>28.18</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.28.19"></a><var>28.19</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.43.0"></a><a id="pl.28.20"></a><var>28.20</var>    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:<br/>
<a id="pl.28.21"></a><var>28.21</var>    Subd. 8. <b>Applicants potentially eligible for medical assistance.</b> (a) Individuals <br/>
<a id="pl.28.22"></a><var>28.22</var>who receive supplemental security income or retirement, survivors, or disability benefits <br/>
<a id="pl.28.23"></a><var>28.23</var>due to a disability, or other disability-based pension, who qualify under subdivision 7, but <br/>
<a id="pl.28.24"></a><var>28.24</var>who are potentially eligible for medical assistance without a spenddown shall be allowed <br/>
<a id="pl.28.25"></a><var>28.25</var>to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other <br/>
<a id="pl.28.26"></a><var>28.26</var>conditions of eligibility. The commissioner shall identify and refer the applications of <br/>
<a id="pl.28.27"></a><var>28.27</var>such individuals to their county social service agency. The county and the commissioner <br/>
<a id="pl.28.28"></a><var>28.28</var>shall cooperate to ensure that the individuals obtain medical assistance coverage for any <br/>
<a id="pl.28.29"></a><var>28.29</var>months for which they are eligible.<br/>
<a id="pl.28.30"></a><var>28.30</var>(b) The enrollee must cooperate with the county social service agency in determining <br/>
<a id="pl.28.31"></a><var>28.31</var>medical assistance eligibility within the 60-day enrollment period. Enrollees who do not <br/>
<a id="pl.28.32"></a><var>28.32</var>cooperate with medical assistance within the 60-day enrollment period shall be disenrolled <br/>
<a id="pl.28.33"></a><var>28.33</var>from the plan within one calendar month. Persons disenrolled for nonapplication for <br/>
<a id="pl.29.1"></a><var>29.1</var>medical assistance may not reenroll until they have obtained a medical assistance <br/>
<a id="pl.29.2"></a><var>29.2</var>eligibility determination. Persons disenrolled for noncooperation with medical assistance <br/>
<a id="pl.29.3"></a><var>29.3</var>may not reenroll until they have cooperated with the county agency and have obtained a <br/>
<a id="pl.29.4"></a><var>29.4</var>medical assistance eligibility determination.<br/>
<a id="pl.29.5"></a><var>29.5</var>(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare <br/>
<a id="pl.29.6"></a><var>29.6</var>enrollment sites shall consider MinnesotaCare applications to also be applications for <br/>
<a id="pl.29.7"></a><var>29.7</var>medical assistance. Applicants who are potentially eligible for medical assistance, except <br/>
<a id="pl.29.8"></a><var>29.8</var>for those described in paragraph (a), may choose to enroll in either MinnesotaCare or <br/>
<a id="pl.29.9"></a><var>29.9</var>medical assistance.<br/>
<a id="pl.29.10"></a><var>29.10</var>(d) The commissioner shall redetermine provider payments made under <br/>
<a id="pl.29.11"></a><var>29.11</var>MinnesotaCare to the appropriate medical assistance payments for those enrollees who <br/>
<a id="pl.29.12"></a><var>29.12</var>subsequently become eligible for medical assistance.<br/>
<a id="pl.29.13"></a><var>29.13</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.29.14"></a><var>29.14</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.29.15"></a><var>29.15</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.44.0"></a><a id="pl.29.16"></a><var>29.16</var>    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:<br/>
<a id="pl.29.17"></a><var>29.17</var>    Subd. 10. <b>Citizenship requirements.</b> (a) Eligibility for MinnesotaCare is limited to <br/>
<a id="pl.29.18"></a><var>29.18</var>citizens or nationals of the United States, qualified noncitizens, and other persons residing<br/>
<a id="pl.29.19"></a><var>29.19</var> lawfully in the United States present noncitizens as defined in Code of Federal Regulations, <br/>
<a id="pl.29.20"></a><var>29.20</var>title 8, section 103.12. Undocumented noncitizens and nonimmigrants are ineligible for <br/>
<a id="pl.29.21"></a><var>29.21</var>MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in one <br/>
<a id="pl.29.22"></a><var>29.22</var>or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an <br/>
<a id="pl.29.23"></a><var>29.23</var>undocumented noncitizen is an individual who resides in the United States without the <br/>
<a id="pl.29.24"></a><var>29.24</var>approval or acquiescence of the United States Citizenship and Immigration Services. <br/>
<a id="pl.29.25"></a><var>29.25</var>Families with children who are citizens or nationals of the United States must cooperate in <br/>
<a id="pl.29.26"></a><var>29.26</var>obtaining satisfactory documentary evidence of citizenship or nationality according to the <br/>
<a id="pl.29.27"></a><var>29.27</var>requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.<br/>
<a id="pl.29.28"></a><var>29.28</var>(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and <br/>
<a id="pl.29.29"></a><var>29.29</var>individuals who are lawfully present and ineligible for medical assistance by reason of <br/>
<a id="pl.29.30"></a><var>29.30</var>immigration status and who have incomes equal to or less than 200 percent of federal <br/>
<a id="pl.29.31"></a><var>29.31</var>poverty guidelines.<br/>
<a id="pl.29.32"></a><var>29.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.29.33"></a><var>29.33</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.29.34"></a><var>29.34</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.45.0"></a><a id="pl.30.1"></a><var>30.1</var>    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:<br/>
<a id="pl.30.2"></a><var>30.2</var>    Subd. 12. <b>Persons in detention.</b> Beginning January 1, 1999, An applicant or <br/>
<a id="pl.30.3"></a><var>30.3</var>enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare, <br/>
<a id="pl.30.4"></a><var>30.4</var>unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in <br/>
<a id="pl.30.5"></a><var>30.5</var>a correctional or detention facility is not eligible at renewal of eligibility under section <br/>
<a id="pl.30.6"></a><var>30.6</var><statute_ref>256L.05, subdivision 3a</statute_ref>.<br/>
<a id="pl.30.7"></a><var>30.7</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.46.0"></a><a id="pl.30.8"></a><var>30.8</var>    Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision <br/>
<a id="pl.30.9"></a><var>30.9</var>to read:<br/>
<a id="pl.30.10"></a><var>30.10</var>    Subd. 14. <b>Coordination with medical assistance.</b> (a) Individuals eligible for <br/>
<a id="pl.30.11"></a><var>30.11</var>medical assistance under chapter 256B are not eligible for MinnesotaCare under this <br/>
<a id="pl.30.12"></a><var>30.12</var>section.<br/>
<a id="pl.30.13"></a><var>30.13</var>(b) The commissioner shall coordinate eligibility and coverage to ensure that <br/>
<a id="pl.30.14"></a><var>30.14</var>individuals transitioning between medical assistance and MinnesotaCare have seamless <br/>
<a id="pl.30.15"></a><var>30.15</var>eligibility and access to health care services.<br/>
<a id="pl.30.16"></a><var>30.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.30.17"></a><var>30.17</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.30.18"></a><var>30.18</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.47.0"></a><a id="pl.30.19"></a><var>30.19</var>    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:<br/>
<a id="pl.30.20"></a><var>30.20</var>    Subdivision 1. <b>Application assistance and information availability.</b> (a) Applicants <br/>
<a id="pl.30.21"></a><var>30.21</var>may submit applications online, in person, by mail, or by phone in accordance with the <br/>
<a id="pl.30.22"></a><var>30.22</var>Affordable Care Act, and by any other means by which medical assistance applications <br/>
<a id="pl.30.23"></a><var>30.23</var>may be submitted. Applicants may submit applications through the Minnesota Insurance <br/>
<a id="pl.30.24"></a><var>30.24</var>Marketplace or through the MinnesotaCare program. Applications and application <br/>
<a id="pl.30.25"></a><var>30.25</var>assistance must be made available at provider offices, local human services agencies, <br/>
<a id="pl.30.26"></a><var>30.26</var>school districts, public and private elementary schools in which 25 percent or more of <br/>
<a id="pl.30.27"></a><var>30.27</var>the students receive free or reduced price lunches, community health offices, Women, <br/>
<a id="pl.30.28"></a><var>30.28</var>Infants and Children (WIC) program sites, Head Start program sites, public housing <br/>
<a id="pl.30.29"></a><var>30.29</var>councils, crisis nurseries, child care centers, early childhood education and preschool <br/>
<a id="pl.30.30"></a><var>30.30</var>program sites, legal aid offices, and libraries, and at any other locations at which medical <br/>
<a id="pl.30.31"></a><var>30.31</var>assistance applications must be made available. These sites may accept applications and <br/>
<a id="pl.30.32"></a><var>30.32</var>forward the forms to the commissioner or local county human services agencies that <br/>
<a id="pl.31.1"></a><var>31.1</var>choose to participate as an enrollment site. Otherwise, applicants may apply directly to the <br/>
<a id="pl.31.2"></a><var>31.2</var>commissioner or to participating local county human services agencies.<br/>
<a id="pl.31.3"></a><var>31.3</var>(b) Application assistance must be available for applicants choosing to file an online <br/>
<a id="pl.31.4"></a><var>31.4</var>application through the Minnesota Insurance Marketplace.<br/>
<a id="pl.31.5"></a><var>31.5</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.48.0"></a><a id="pl.31.6"></a><var>31.6</var>    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:<br/>
<a id="pl.31.7"></a><var>31.7</var>    Subd. 2. <b>Commissioner's duties.</b>  The commissioner or county agency shall use <br/>
<a id="pl.31.8"></a><var>31.8</var>electronic verification through the Minnesota Insurance Marketplace as the primary <br/>
<a id="pl.31.9"></a><var>31.9</var>method of income verification. If there is a discrepancy between reported income <br/>
<a id="pl.31.10"></a><var>31.10</var>and electronically verified income, an individual may be required to submit additional <br/>
<a id="pl.31.11"></a><var>31.11</var>verification to the extent permitted under the Affordable Care Act. In addition, the <br/>
<a id="pl.31.12"></a><var>31.12</var>commissioner shall perform random audits to verify reported income and eligibility. The <br/>
<a id="pl.31.13"></a><var>31.13</var>commissioner may execute data sharing arrangements with the Department of Revenue <br/>
<a id="pl.31.14"></a><var>31.14</var>and any other governmental agency in order to perform income verification related to <br/>
<a id="pl.31.15"></a><var>31.15</var>eligibility and premium payment under the MinnesotaCare program.<br/>
<a id="pl.31.16"></a><var>31.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.49.0"></a><a id="pl.31.17"></a><var>31.17</var>    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:<br/>
<a id="pl.31.18"></a><var>31.18</var>    Subd. 3. <b>Effective date of coverage.</b> (a) The effective date of coverage is the <br/>
<a id="pl.31.19"></a><var>31.19</var>first day of the month following the month in which eligibility is approved and the first <br/>
<a id="pl.31.20"></a><var>31.20</var>premium payment has been received. As provided in section 
<statute_ref>256B.057</statute_ref>, coverage for <br/>
<a id="pl.31.21"></a><var>31.21</var>newborns is automatic from the date of birth and must be coordinated with other health <br/>
<a id="pl.31.22"></a><var>31.22</var>coverage. The effective date of coverage for eligible newly adoptive children added to a <br/>
<a id="pl.31.23"></a><var>31.23</var>family receiving covered health services is the month of placement. The effective date <br/>
<a id="pl.31.24"></a><var>31.24</var>of coverage for other new members added to the family is the first day of the month <br/>
<a id="pl.31.25"></a><var>31.25</var>following the month in which the change is reported. All eligibility criteria must be met <br/>
<a id="pl.31.26"></a><var>31.26</var>by the family at the time the new family member is added. The income of the new family <br/>
<a id="pl.31.27"></a><var>31.27</var>member is included with the family's modified adjusted gross income and the adjusted <br/>
<a id="pl.31.28"></a><var>31.28</var>premium begins in the month the new family member is added.<br/>
<a id="pl.31.29"></a><var>31.29</var>(b) The initial premium must be received by the last working day of the month for <br/>
<a id="pl.31.30"></a><var>31.30</var>coverage to begin the first day of the following month.<br/>
<a id="pl.31.31"></a><var>31.31</var>(c) Benefits are not available until the day following discharge if an enrollee is <br/>
<a id="pl.31.32"></a><var>31.32</var>hospitalized on the first day of coverage.<br/>
<a id="pl.32.1"></a><var>32.1</var>(d) (c) Notwithstanding any other law to the contrary, benefits under sections <br/>
<statute_ref><a id="pl.32.2"></a><var>32.2</var>256L.01
         </statute_ref> to 
         <statute_ref>256L.18</statute_ref> are secondary to a plan of insurance or benefit program under which <br/>
<a id="pl.32.3"></a><var>32.3</var>an eligible person may have coverage and the commissioner shall use cost avoidance <br/>
<a id="pl.32.4"></a><var>32.4</var>techniques to ensure coordination of any other health coverage for eligible persons. The <br/>
<a id="pl.32.5"></a><var>32.5</var>commissioner shall identify eligible persons who may have coverage or benefits under <br/>
<a id="pl.32.6"></a><var>32.6</var>other plans of insurance or who become eligible for medical assistance.<br/>
<a id="pl.32.7"></a><var>32.7</var>(e) (d) The effective date of coverage for individuals or families who are exempt <br/>
<a id="pl.32.8"></a><var>32.8</var>from paying premiums under section 
         <statute_ref>256L.15, subdivision 1</statute_ref>, paragraph (d), is the first <br/>
<a id="pl.32.9"></a><var>32.9</var>day of the month following the month in which verification of American Indian status <br/>
<a id="pl.32.10"></a><var>32.10</var>is received or eligibility is approved, whichever is later.<br/>
<a id="pl.32.11"></a><var>32.11</var>(f) (e) The effective date of coverage for children eligible under section 
         <statute_ref>256L.07</statute_ref>, <br/>
<a id="pl.32.12"></a><var>32.12</var>subdivision 8, is the first day of the month following the date of termination from foster <br/>
<a id="pl.32.13"></a><var>32.13</var>care or release from a juvenile residential correctional facility.<br/>
<a id="pl.32.14"></a><var>32.14</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.32.15"></a><var>32.15</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.32.16"></a><var>32.16</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.50.0"></a><a id="pl.32.17"></a><var>32.17</var>    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:<br/>
<a id="pl.32.18"></a><var>32.18</var>    Subd. 3c. <b>Retroactive coverage.</b> Notwithstanding subdivision 3, the effective <br/>
<a id="pl.32.19"></a><var>32.19</var>date of coverage shall be the first day of the month following termination from medical <br/>
<a id="pl.32.20"></a><var>32.20</var>assistance for families and individuals who are eligible for MinnesotaCare and who <br/>
<a id="pl.32.21"></a><var>32.21</var>submitted a written request for retroactive MinnesotaCare coverage with a completed <br/>
<a id="pl.32.22"></a><var>32.22</var>application within 30 days of the mailing of notification of termination from medical <br/>
<a id="pl.32.23"></a><var>32.23</var>assistance. The applicant must provide all required verifications within 30 days of the <br/>
<a id="pl.32.24"></a><var>32.24</var>written request for verification. For retroactive coverage, premiums must be paid in full <br/>
<a id="pl.32.25"></a><var>32.25</var>for any retroactive month, current month, and next month within 30 days of the premium <br/>
<a id="pl.32.26"></a><var>32.26</var>billing. General assistance medical care recipients may qualify for retroactive coverage <br/>
<a id="pl.32.27"></a><var>32.27</var>under this subdivision at six-month renewal.<br/>
<a id="pl.32.28"></a><var>32.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.51.0"></a><a id="pl.32.29"></a><var>32.29</var>    Sec. 51. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:<br/>
<a id="pl.32.30"></a><var>32.30</var>    Subd. 3. <b>Commissioner's duties and payment.</b> (a) Premiums are dedicated to the <br/>
<a id="pl.32.31"></a><var>32.31</var>commissioner for MinnesotaCare.<br/>
<a id="pl.32.32"></a><var>32.32</var>    (b) The commissioner shall develop and implement procedures to: (1) require <br/>
<a id="pl.32.33"></a><var>32.33</var>enrollees to report changes in income; (2) adjust sliding scale premium payments, based <br/>
<a id="pl.33.1"></a><var>33.1</var>upon both increases and decreases in enrollee income, at the time the change in income <br/>
<a id="pl.33.2"></a><var>33.2</var>is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required <br/>
<a id="pl.33.3"></a><var>33.3</var>premiums. Failure to pay includes payment with a dishonored check, a returned automatic <br/>
<a id="pl.33.4"></a><var>33.4</var>bank withdrawal, or a refused credit card or debit card payment. The commissioner may <br/>
<a id="pl.33.5"></a><var>33.5</var>demand a guaranteed form of payment, including a cashier's check or a money order, as <br/>
<a id="pl.33.6"></a><var>33.6</var>the only means to replace a dishonored, returned, or refused payment.<br/>
<a id="pl.33.7"></a><var>33.7</var>    (c) Premiums are calculated on a calendar month basis and may be paid on a <br/>
<a id="pl.33.8"></a><var>33.8</var>monthly, quarterly, or semiannual basis, with the first payment due upon notice from the <br/>
<a id="pl.33.9"></a><var>33.9</var>commissioner of the premium amount required. The commissioner shall inform applicants <br/>
<a id="pl.33.10"></a><var>33.10</var>and enrollees of these premium payment options. Premium payment is required before <br/>
<a id="pl.33.11"></a><var>33.11</var>enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments <br/>
<a id="pl.33.12"></a><var>33.12</var>received before noon are credited the same day. Premium payments received after noon <br/>
<a id="pl.33.13"></a><var>33.13</var>are credited on the next working day.<br/>
<a id="pl.33.14"></a><var>33.14</var>    (d) Nonpayment of the premium will result in disenrollment from the plan effective <br/>
<a id="pl.33.15"></a><var>33.15</var>for the calendar month for which the premium was due. Persons disenrolled for <br/>
<a id="pl.33.16"></a><var>33.16</var>nonpayment or who voluntarily terminate coverage from the program may not reenroll <br/>
<a id="pl.33.17"></a><var>33.17</var>until four calendar months have elapsed. Persons disenrolled for nonpayment who pay <br/>
<a id="pl.33.18"></a><var>33.18</var>all past due premiums as well as current premiums due, including premiums due for the <br/>
<a id="pl.33.19"></a><var>33.19</var>period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively <br/>
<a id="pl.33.20"></a><var>33.20</var>to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily <br/>
<a id="pl.33.21"></a><var>33.21</var>terminate coverage from the program may not reenroll for four calendar months unless <br/>
<a id="pl.33.22"></a><var>33.22</var>the person demonstrates good cause for nonpayment. Good cause does not exist if a <br/>
<a id="pl.33.23"></a><var>33.23</var>person chooses to pay other family expenses instead of the premium. The commissioner <br/>
<a id="pl.33.24"></a><var>33.24</var>shall define good cause in rule.<br/>
<a id="pl.33.25"></a><var>33.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.33.26"></a><var>33.26</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.33.27"></a><var>33.27</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.52.0"></a><a id="pl.33.28"></a><var>33.28</var>    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:<br/>
<a id="pl.33.29"></a><var>33.29</var>    Subdivision 1. <b>General requirements.</b> (a) Children enrolled in the original <br/>
<a id="pl.33.30"></a><var>33.30</var>children's health plan as of September 30, 1992, children who enrolled in the <br/>
<a id="pl.33.31"></a><var>33.31</var>MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, <br/>
<a id="pl.33.32"></a><var>33.32</var>article 4, section 17, and children who have family gross incomes that are equal to or <br/>
<a id="pl.33.33"></a><var>33.33</var>less than 200 percent of the federal poverty guidelines are eligible without meeting the <br/>
<a id="pl.33.34"></a><var>33.34</var>requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as <br/>
<a id="pl.33.35"></a><var>33.35</var>they maintain continuous coverage in the MinnesotaCare program or medical assistance.<br/>
<a id="pl.34.1"></a><var>34.1</var>    Parents Families and individuals enrolled in MinnesotaCare under section 
         <statute_ref>256L.04, <br/>
<a id="pl.34.2"></a><var>34.2</var>subdivision 1
         </statute_ref>, whose income increases above 275 200 percent of the federal poverty <br/>
<a id="pl.34.3"></a><var>34.3</var>guidelines, are no longer eligible for the program and shall be disenrolled by the <br/>
<a id="pl.34.4"></a><var>34.4</var>commissioner. Beginning January 1, 2008, Individuals enrolled in MinnesotaCare under <br/>
<a id="pl.34.5"></a><var>34.5</var>section 
<statute_ref>256L.04, subdivision 7</statute_ref>, whose income increases above 200 percent of the federal <br/>
<a id="pl.34.6"></a><var>34.6</var>poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1, <br/>
<a id="pl.34.7"></a><var>34.7</var>2009, are no longer eligible for the program and shall be disenrolled by the commissioner.<br/>
<a id="pl.34.8"></a><var>34.8</var> For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the <br/>
<a id="pl.34.9"></a><var>34.9</var>last day of the calendar month following the month in which the commissioner determines <br/>
<a id="pl.34.10"></a><var>34.10</var>that the income of a family or individual exceeds program income limits.<br/>
<a id="pl.34.11"></a><var>34.11</var>    (b) Children may remain enrolled in MinnesotaCare if their gross family income as <br/>
<a id="pl.34.12"></a><var>34.12</var>defined in section 
<statute_ref>256L.01, subdivision 4</statute_ref>, is greater than 275 percent of federal poverty <br/>
<a id="pl.34.13"></a><var>34.13</var>guidelines. The premium for children remaining eligible under this paragraph shall be the <br/>
<a id="pl.34.14"></a><var>34.14</var>maximum premium determined under section 
<statute_ref>256L.15, subdivision 2</statute_ref>, paragraph (b).<br/>
<a id="pl.34.15"></a><var>34.15</var>    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if <br/>
<a id="pl.34.16"></a><var>34.16</var>gross household income exceeds $57,500 for the 12-month period of eligibility.<br/>
<a id="pl.34.17"></a><var>34.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.34.18"></a><var>34.18</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.34.19"></a><var>34.19</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.53.0"></a><a id="pl.34.20"></a><var>34.20</var>    Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:<br/>
<a id="pl.34.21"></a><var>34.21</var>    Subd. 2. <b>Must not have access to employer-subsidized</b><b> minimum essential</b><br/>
<a id="pl.34.22"></a><var>34.22</var><b> coverage.</b> (a) To be eligible, a family or individual must not have access to subsidized <br/>
<a id="pl.34.23"></a><var>34.23</var>health coverage through an employer and must not have had access to employer-subsidized <br/>
<a id="pl.34.24"></a><var>34.24</var>coverage through a current employer for 18 months prior to application or reapplication. <br/>
<a id="pl.34.25"></a><var>34.25</var>A family or individual whose employer-subsidized coverage is lost due to an employer <br/>
<a id="pl.34.26"></a><var>34.26</var>terminating health care coverage as an employee benefit during the previous 18 months is <br/>
<a id="pl.34.27"></a><var>34.27</var>not eligible that is affordable and provides minimum value as defined in Code of Federal <br/>
<a id="pl.34.28"></a><var>34.28</var>Regulations, title 26, section 1.36B-2.<br/>
<a id="pl.34.29"></a><var>34.29</var>(b) This subdivision does not apply to a family or individual who was enrolled <br/>
<a id="pl.34.30"></a><var>34.30</var>in MinnesotaCare within six months or less of reapplication and who no longer has <br/>
<a id="pl.34.31"></a><var>34.31</var>employer-subsidized coverage due to the employer terminating health care coverage as an <br/>
<a id="pl.34.32"></a><var>34.32</var>employee benefit. This subdivision does not apply to children with family gross incomes <br/>
<a id="pl.34.33"></a><var>34.33</var>that are equal to or less than 200 percent of federal poverty guidelines.<br/>
<a id="pl.34.34"></a><var>34.34</var>(c) For purposes of this requirement, subsidized health coverage means health <br/>
<a id="pl.34.35"></a><var>34.35</var>coverage for which the employer pays at least 50 percent of the cost of coverage for <br/>
<a id="pl.35.1"></a><var>35.1</var>the employee or dependent, or a higher percentage as specified by the commissioner. <br/>
<a id="pl.35.2"></a><var>35.2</var>Children are eligible for employer-subsidized coverage through either parent, including <br/>
<a id="pl.35.3"></a><var>35.3</var>the noncustodial parent. The commissioner must treat employer contributions to Internal <br/>
<a id="pl.35.4"></a><var>35.4</var>Revenue Code Section 125 plans and any other employer benefits intended to pay <br/>
<a id="pl.35.5"></a><var>35.5</var>health care costs as qualified employer subsidies toward the cost of health coverage for <br/>
<a id="pl.35.6"></a><var>35.6</var>employees for purposes of this subdivision.<br/>
<a id="pl.35.7"></a><var>35.7</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.35.8"></a><var>35.8</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.35.9"></a><var>35.9</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.54.0"></a><a id="pl.35.10"></a><var>35.10</var>    Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:<br/>
<a id="pl.35.11"></a><var>35.11</var>    Subd. 3. <b>Other health coverage.</b> (a) Families and individuals enrolled in the <br/>
<a id="pl.35.12"></a><var>35.12</var>MinnesotaCare program must have no To be eligible, a family or individual must not have <br/>
<a id="pl.35.13"></a><var>35.13</var>minimum essential health coverage while enrolled, as defined by section 5000A of the <br/>
<a id="pl.35.14"></a><var>35.14</var>Internal Revenue Code. Children with family gross incomes equal to or greater than 200 <br/>
<a id="pl.35.15"></a><var>35.15</var>percent of federal poverty guidelines, and adults, must have had no health coverage for <br/>
<a id="pl.35.16"></a><var>35.16</var>at least four months prior to application and renewal. Children enrolled in the original <br/>
<a id="pl.35.17"></a><var>35.17</var>children's health plan and children in families with income equal to or less than 200 <br/>
<a id="pl.35.18"></a><var>35.18</var>percent of the federal poverty guidelines, who have other health insurance, are eligible if <br/>
<a id="pl.35.19"></a><var>35.19</var>the coverage:<br/>
<a id="pl.35.20"></a><var>35.20</var>(1) lacks two or more of the following:<br/>
<a id="pl.35.21"></a><var>35.21</var>(i) basic hospital insurance;<br/>
<a id="pl.35.22"></a><var>35.22</var>(ii) medical-surgical insurance;<br/>
<a id="pl.35.23"></a><var>35.23</var>(iii) prescription drug coverage;<br/>
<a id="pl.35.24"></a><var>35.24</var>(iv) dental coverage; or<br/>
<a id="pl.35.25"></a><var>35.25</var>(v) vision coverage;<br/>
<a id="pl.35.26"></a><var>35.26</var>(2) requires a deductible of $100 or more per person per year; or<br/>
<a id="pl.35.27"></a><var>35.27</var>(3) lacks coverage because the child has exceeded the maximum coverage for a <br/>
<a id="pl.35.28"></a><var>35.28</var>particular diagnosis or the policy excludes a particular diagnosis.<br/>
<a id="pl.35.29"></a><var>35.29</var>The commissioner may change this eligibility criterion for sliding scale premiums <br/>
<a id="pl.35.30"></a><var>35.30</var>in order to remain within the limits of available appropriations. The requirement of no <br/>
<a id="pl.35.31"></a><var>35.31</var>health coverage does not apply to newborns.<br/>
<a id="pl.35.32"></a><var>35.32</var>(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical <br/>
<a id="pl.35.33"></a><var>35.33</var>assistance, and the Civilian Health and Medical Program of the Uniformed Service, <br/>
<a id="pl.35.34"></a><var>35.34</var>CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A, <br/>
<a id="pl.36.1"></a><var>36.1</var>part II, chapter 55, are not considered insurance or health coverage for purposes of the <br/>
<a id="pl.36.2"></a><var>36.2</var>four-month requirement described in this subdivision.<br/>
<a id="pl.36.3"></a><var>36.3</var>(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to <br/>
<a id="pl.36.4"></a><var>36.4</var>Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social <br/>
<a id="pl.36.5"></a><var>36.5</var>Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered <br/>
<a id="pl.36.6"></a><var>36.6</var>to have minimum essential health coverage. An applicant or enrollee who is entitled to <br/>
<a id="pl.36.7"></a><var>36.7</var>premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage <br/>
<a id="pl.36.8"></a><var>36.8</var>to establish eligibility for MinnesotaCare.<br/>
<a id="pl.36.9"></a><var>36.9</var>(d) Applicants who were recipients of medical assistance within one month of <br/>
<a id="pl.36.10"></a><var>36.10</var>application must meet the provisions of this subdivision and subdivision 2.<br/>
<a id="pl.36.11"></a><var>36.11</var>(e) Cost-effective health insurance that was paid for by medical assistance is not <br/>
<a id="pl.36.12"></a><var>36.12</var>considered health coverage for purposes of the four-month requirement under this <br/>
<a id="pl.36.13"></a><var>36.13</var>section, except if the insurance continued after medical assistance no longer considered it <br/>
<a id="pl.36.14"></a><var>36.14</var>cost-effective or after medical assistance closed.<br/>
<a id="pl.36.15"></a><var>36.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.36.16"></a><var>36.16</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.36.17"></a><var>36.17</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.55.0"></a><a id="pl.36.18"></a><var>36.18</var>    Sec. 55. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:<br/>
<a id="pl.36.19"></a><var>36.19</var>    Subd. 2. <b>Residency requirement.</b> To be eligible for health coverage under the <br/>
<a id="pl.36.20"></a><var>36.20</var>MinnesotaCare program, pregnant women, individuals, and families with children must <br/>
<a id="pl.36.21"></a><var>36.21</var>meet the residency requirements as provided by Code of Federal Regulations, title 42, <br/>
<a id="pl.36.22"></a><var>36.22</var>section 435.403, except that the provisions of section 
<statute_ref>256B.056, subdivision 1</statute_ref>, shall apply <br/>
<a id="pl.36.23"></a><var>36.23</var>upon receipt of federal approval.<br/>
<a id="pl.36.24"></a><var>36.24</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.36.25"></a><var>36.25</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.36.26"></a><var>36.26</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.56.0"></a><a id="pl.36.27"></a><var>36.27</var>    Sec. 56. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:<br/>
<a id="pl.36.28"></a><var>36.28</var>    Subdivision 1. <b>Medical assistance rate to be used.</b> (a) Payment to providers <br/>
<a id="pl.36.29"></a><var>36.29</var>under sections 
<statute_ref>256L.01</statute_ref> to 
<statute_ref>256L.11</statute_ref> this chapter shall be at the same rates and conditions <br/>
<a id="pl.36.30"></a><var>36.30</var>established for medical assistance, except as provided in subdivisions 2 to 6 this section.<br/>
<a id="pl.36.31"></a><var>36.31</var>(b) Effective for services provided on or after July 1, 2009, total payments for basic <br/>
<a id="pl.36.32"></a><var>36.32</var>care services shall be reduced by three percent, in accordance with section 
<statute_ref>256B.766</statute_ref>. <br/>
<a id="pl.37.1"></a><var>37.1</var>Payments made to managed care and county-based purchasing plans shall be reduced for <br/>
<a id="pl.37.2"></a><var>37.2</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.37.3"></a><var>37.3</var>(c) Effective for services provided on or after July 1, 2009, payment rates for <br/>
<a id="pl.37.4"></a><var>37.4</var>physician and professional services shall be reduced as described under section 
<statute_ref>256B.76</statute_ref>, <br/>
<a id="pl.37.5"></a><var>37.5</var>subdivision 1, paragraph (c). Payments made to managed care and county-based <br/>
<a id="pl.37.6"></a><var>37.6</var>purchasing plans shall be reduced for services provided on or after October 1, 2009, <br/>
<a id="pl.37.7"></a><var>37.7</var>to reflect this reduction.<br/>
<a id="pl.37.8"></a><var>37.8</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.57.0"></a><a id="pl.37.9"></a><var>37.9</var>    Sec. 57. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:<br/>
<a id="pl.37.10"></a><var>37.10</var>    Subd. 3. <b>Inpatient hospital services.</b> Inpatient hospital services provided under <br/>
<a id="pl.37.11"></a><var>37.11</var>section 
         <statute_ref>256L.03, subdivision 3</statute_ref>, shall be paid for as provided in subdivisions 4 to 6 at the <br/>
<a id="pl.37.12"></a><var>37.12</var>medical assistance rate.<br/>
<a id="pl.37.13"></a><var>37.13</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.1.58.0"></a><a id="pl.37.14"></a><var>37.14</var>    Sec. 58. <b>[256L.121] SERVICE DELIVERY.</b><br/>
<a id="pl.37.15"></a><var>37.15</var>    Subdivision 1. <b>Competitive process.</b> The commissioner of human services shall <br/>
<a id="pl.37.16"></a><var>37.16</var>establish a competitive process for entering into contracts with participating entities for <br/>
<a id="pl.37.17"></a><var>37.17</var>the offering of standard health plans through MinnesotaCare. Coverage through standard <br/>
<a id="pl.37.18"></a><var>37.18</var>health plans must be available to enrollees beginning January 1, 2015. Each standard health <br/>
<a id="pl.37.19"></a><var>37.19</var>plan must cover the health services listed in, and meet the requirements of, section 256L.03. <br/>
<a id="pl.37.20"></a><var>37.20</var>The competitive process must meet the requirements of section 1331 of the Affordable <br/>
<a id="pl.37.21"></a><var>37.21</var>Care Act and be designed to ensure enrollee access to high-quality health care coverage <br/>
<a id="pl.37.22"></a><var>37.22</var>options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have <br/>
<a id="pl.37.23"></a><var>37.23</var>a choice of coverage from more than one participating entity within a geographic area.<br/>
<a id="pl.37.24"></a><var>37.24</var>    Subd. 2. <b>Other requirements for participating entities.</b> The commissioner shall <br/>
<a id="pl.37.25"></a><var>37.25</var>require participating entities, as a condition of contract, to document to the commissioner:<br/>
<a id="pl.37.26"></a><var>37.26</var>(1) the provision of culturally and linguistically appropriate services, including <br/>
<a id="pl.37.27"></a><var>37.27</var>marketing materials, to MinnesotaCare enrollees; and<br/>
<a id="pl.37.28"></a><var>37.28</var>(2) the inclusion in provider networks of providers designated as essential <br/>
<a id="pl.37.29"></a><var>37.29</var>community providers under section 62Q.19.<br/>
<a id="pl.37.30"></a><var>37.30</var>    Subd. 3. <b>Coordination with state-administered health programs.</b> The <br/>
<a id="pl.37.31"></a><var>37.31</var>commissioner shall coordinate the administration of the MinnesotaCare program with <br/>
<a id="pl.37.32"></a><var>37.32</var>medical assistance to maximize efficiency and improve the continuity of care. This <br/>
<a id="pl.37.33"></a><var>37.33</var>includes, but is not limited to:<br/>
<a id="pl.38.1"></a><var>38.1</var>(1) establishing geographic areas for MinnesotaCare that are consistent with the <br/>
<a id="pl.38.2"></a><var>38.2</var>geographic areas of the medical assistance program, within which participating entities <br/>
<a id="pl.38.3"></a><var>38.3</var>may offer health plans;<br/>
<a id="pl.38.4"></a><var>38.4</var>(2) requiring, as a condition of participation in MinnesotaCare, participating entities <br/>
<a id="pl.38.5"></a><var>38.5</var>to also participate in the medical assistance program;<br/>
<a id="pl.38.6"></a><var>38.6</var>    (3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and <br/>
<a id="pl.38.7"></a><var>38.7</var>256B.694 when contracting with MinnesotaCare participating entities;<br/>
<a id="pl.38.8"></a><var>38.8</var>(4) providing MinnesotaCare enrollees, to the extent possible, with the option to <br/>
<a id="pl.38.9"></a><var>38.9</var>remain in the same health plan and provider network, if they later become eligible for <br/>
<a id="pl.38.10"></a><var>38.10</var>medical assistance or coverage through the Minnesota Insurance Marketplace and if, in <br/>
<a id="pl.38.11"></a><var>38.11</var>the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health <br/>
<a id="pl.38.12"></a><var>38.12</var>plan is also a medical assistance health plan in the enrollee's county of residence; and<br/>
<a id="pl.38.13"></a><var>38.13</var>(5) establishing requirements and criteria for selection that ensure that covered <br/>
<a id="pl.38.14"></a><var>38.14</var>health care services will be coordinated with local public health, social services, long-term <br/>
<a id="pl.38.15"></a><var>38.15</var>care services, mental health services, and other local services affecting enrollees' health, <br/>
<a id="pl.38.16"></a><var>38.16</var>access, and quality of care.<br/>
<a id="pl.38.17"></a><var>38.17</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.1.59.0"></a><a id="pl.38.18"></a><var>38.18</var>    Sec. 59. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:<br/>
<a id="pl.38.19"></a><var>38.19</var>    Subdivision 1. <b>Premium determination.</b> (a) Families with children and individuals <br/>
<a id="pl.38.20"></a><var>38.20</var>shall pay a premium determined according to subdivision 2.<br/>
<a id="pl.38.21"></a><var>38.21</var>    (b) Pregnant women and children under age two are exempt from the provisions <br/>
<a id="pl.38.22"></a><var>38.22</var>of section 
<statute_ref>256L.06, subdivision 3</statute_ref>, paragraph (b), clause (3), requiring disenrollment <br/>
<a id="pl.38.23"></a><var>38.23</var>for failure to pay premiums. For pregnant women, this exemption continues until the <br/>
<a id="pl.38.24"></a><var>38.24</var>first day of the month following the 60th day postpartum. Women who remain enrolled <br/>
<a id="pl.38.25"></a><var>38.25</var>during pregnancy or the postpartum period, despite nonpayment of premiums, shall be <br/>
<a id="pl.38.26"></a><var>38.26</var>disenrolled on the first of the month following the 60th day postpartum for the penalty <br/>
<a id="pl.38.27"></a><var>38.27</var>period that otherwise applies under section 
<statute_ref>256L.06</statute_ref>, unless they begin paying premiums.<br/>
<a id="pl.38.28"></a><var>38.28</var>    (c) (b) Members of the military and their families who meet the eligibility criteria <br/>
<a id="pl.38.29"></a><var>38.29</var>for MinnesotaCare upon eligibility approval made within 24 months following the end <br/>
<a id="pl.38.30"></a><var>38.30</var>of the member's tour of active duty shall have their premiums paid by the commissioner. <br/>
<a id="pl.38.31"></a><var>38.31</var>The effective date of coverage for an individual or family who meets the criteria of this <br/>
<a id="pl.38.32"></a><var>38.32</var>paragraph shall be the first day of the month following the month in which eligibility is <br/>
<a id="pl.38.33"></a><var>38.33</var>approved. This exemption applies for 12 months.<br/>
<a id="pl.38.34"></a><var>38.34</var>(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and <br/>
<a id="pl.38.35"></a><var>38.35</var>their families shall have their premiums waived by the commissioner in accordance with <br/>
<a id="pl.39.1"></a><var>39.1</var>section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. <br/>
<a id="pl.39.2"></a><var>39.2</var>An individual must document status as an American Indian, as defined under Code of <br/>
<a id="pl.39.3"></a><var>39.3</var>Federal Regulations, title 42, section 
         <statute_ref>447.50</statute_ref>, to qualify for the waiver of premiums.<br/>
<a id="pl.39.4"></a><var>39.4</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.39.5"></a><var>39.5</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.39.6"></a><var>39.6</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.60.0"></a><a id="pl.39.7"></a><var>39.7</var>    Sec. 60. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:<br/>
<a id="pl.39.8"></a><var>39.8</var>    Subd. 2. <b>Sliding fee scale; </b><b>monthly gross</b><b> individual or family income.</b> (a) The <br/>
<a id="pl.39.9"></a><var>39.9</var>commissioner shall establish a sliding fee scale to determine the percentage of monthly<br/>
<a id="pl.39.10"></a><var>39.10</var> gross individual or family income that households at different income levels must pay to <br/>
<a id="pl.39.11"></a><var>39.11</var>obtain coverage through the MinnesotaCare program. The sliding fee scale must be based <br/>
<a id="pl.39.12"></a><var>39.12</var>on the enrollee's monthly gross individual or family income. The sliding fee scale must <br/>
<a id="pl.39.13"></a><var>39.13</var>contain separate tables based on enrollment of one, two, or three or more persons. Until <br/>
<a id="pl.39.14"></a><var>39.14</var>June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross <br/>
<a id="pl.39.15"></a><var>39.15</var>individual or family income for individuals or families with incomes below the limits for <br/>
<a id="pl.39.16"></a><var>39.16</var>the medical assistance program for families and children in effect on January 1, 1999, and <br/>
<a id="pl.39.17"></a><var>39.17</var>proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and <br/>
<a id="pl.39.18"></a><var>39.18</var>8.8 percent. These percentages are matched to evenly spaced income steps ranging from <br/>
<a id="pl.39.19"></a><var>39.19</var>the medical assistance income limit for families and children in effect on January 1, 1999, <br/>
<a id="pl.39.20"></a><var>39.20</var>to 275 200 percent of the federal poverty guidelines for the applicable family size, up to a <br/>
<a id="pl.39.21"></a><var>39.21</var>family size of five. The sliding fee scale for a family of five must be used for families of <br/>
<a id="pl.39.22"></a><var>39.22</var>more than five. The sliding fee scale and percentages are not subject to the provisions of <br/>
<a id="pl.39.23"></a><var>39.23</var>chapter 14. If a family or individual reports increased income after enrollment, premiums <br/>
<a id="pl.39.24"></a><var>39.24</var>shall be adjusted at the time the change in income is reported.<br/>
<a id="pl.39.25"></a><var>39.25</var>    (b) Children in families whose gross income is above 275 percent of the federal <br/>
<a id="pl.39.26"></a><var>39.26</var>poverty guidelines shall pay the maximum premium. The maximum premium is defined <br/>
<a id="pl.39.27"></a><var>39.27</var>as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare <br/>
<a id="pl.39.28"></a><var>39.28</var>cases paid the maximum premium, the total revenue would equal the total cost of <br/>
<a id="pl.39.29"></a><var>39.29</var>MinnesotaCare medical coverage and administration. In this calculation, administrative <br/>
<a id="pl.39.30"></a><var>39.30</var>costs shall be assumed to equal ten percent of the total. The costs of medical coverage <br/>
<a id="pl.39.31"></a><var>39.31</var>for pregnant women and children under age two and the enrollees in these groups shall <br/>
<a id="pl.39.32"></a><var>39.32</var>be excluded from the total. The maximum premium for two enrollees shall be twice the <br/>
<a id="pl.39.33"></a><var>39.33</var>maximum premium for one, and the maximum premium for three or more enrollees shall <br/>
<a id="pl.39.34"></a><var>39.34</var>be three times the maximum premium for one.<br/>
<a id="pl.40.1"></a><var>40.1</var>    (c) Beginning July 1, 2009, (b) MinnesotaCare enrollees shall pay premiums <br/>
<a id="pl.40.2"></a><var>40.2</var>according to the premium scale specified in paragraph (d) (c), with the exception that <br/>
<a id="pl.40.3"></a><var>40.3</var>children in families with income at or below 200 percent of the federal poverty guidelines <br/>
<a id="pl.40.4"></a><var>40.4</var>shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly <br/>
<a id="pl.40.5"></a><var>40.5</var>premium of $4.<br/>
<a id="pl.40.6"></a><var>40.6</var>    (d) the following premium scale is established for individuals and families with <br/>
<a id="pl.40.7"></a><var>40.7</var>gross family incomes of 275 percent of the federal poverty guidelines or less:<br/>
<table>
<col width="50px"/>
<col width=""/>
<col width=""/>
<tr>
<td><a id="pl.40.8"></a><var>40.8</var><br/>
</td>
<td><b>Federal Poverty Guideline Range</b><br/>
</td>
<td><b>Percent of Average Gross Monthly Income</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.40.9"></a><var>40.9</var><br/>
</td>
<td>0-45%<br/>
</td>
<td>minimum<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.10"></a><var>40.10</var><br/>
<a id="pl.40.11"></a><var>40.11</var><br/>
</td>
<td valign="top">46-54%<br/>
</td>
<td valign="top">$4 or 1.1% of family income, whichever is <br/>
greater<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.12"></a><var>40.12</var><br/>
</td>
<td>55-81%<br/>
</td>
<td>1.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.13"></a><var>40.13</var><br/>
</td>
<td>82-109%<br/>
</td>
<td>2.2%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.14"></a><var>40.14</var><br/>
</td>
<td>110-136%<br/>
</td>
<td>2.9%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.15"></a><var>40.15</var><br/>
</td>
<td>137-164%<br/>
</td>
<td>3.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.16"></a><var>40.16</var><br/>
</td>
<td>165-191%<br/>
</td>
<td>4.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.17"></a><var>40.17</var><br/>
</td>
<td>192-219%<br/>
</td>
<td>5.6%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.18"></a><var>40.18</var><br/>
</td>
<td>220-248%<br/>
</td>
<td>6.5%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.19"></a><var>40.19</var><br/>
</td>
<td>249-275%<br/>
</td>
<td>7.2%<br/>
</td>
</tr>
</table><a id="pl.40.20"></a><var>40.20</var>(c) Effective January 1, 2014, the following premium scale is established for <br/>
<a id="pl.40.21"></a><var>40.21</var>individuals and families with incomes of 200 percent of federal poverty guidelines or less:<br/>
<table>
<col width="50px"/>
<col width=""/>
<col width=""/>
<tr>
<td><a id="pl.40.22"></a><var>40.22</var><br/>
</td>
<td><b>Federal Poverty Guideline Range</b><br/>
</td>
<td><b>Percent of Average Income</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.40.23"></a><var>40.23</var><br/>
</td>
<td>0-45%<br/>
</td>
<td>minimum<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.24"></a><var>40.24</var><br/>
<a id="pl.40.25"></a><var>40.25</var><br/>
</td>
<td valign="top">46-54%<br/>
</td>
<td valign="top">$4 or .25% of family income, whichever is <br/>
greater<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.26"></a><var>40.26</var><br/>
</td>
<td>55-81%<br/>
</td>
<td>.5%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.27"></a><var>40.27</var><br/>
</td>
<td>82-109%<br/>
</td>
<td>1.0%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.28"></a><var>40.28</var><br/>
</td>
<td>110-136%<br/>
</td>
<td>1.5%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.29"></a><var>40.29</var><br/>
</td>
<td>137-164%<br/>
</td>
<td>2.0%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.30"></a><var>40.30</var><br/>
</td>
<td>165-191%<br/>
</td>
<td>2.5%<br/>
</td>
</tr>
<tr>
<td><a id="pl.40.31"></a><var>40.31</var><br/>
</td>
<td>192-200%<br/>
</td>
<td>3.0%<br/>
</td>
</tr>
</table><a id="pl.40.32"></a><var>40.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014, or upon federal <br/>
<a id="pl.40.33"></a><var>40.33</var>approval, whichever is later. The commissioner of human services shall notify the revisor <br/>
<a id="pl.40.34"></a><var>40.34</var>of statutes when federal approval is obtained.<br/>
<br/>
<a id="bill.1.61.0"></a><a id="pl.40.35"></a><var>40.35</var>    Sec. 61. Laws 2013, chapter 1, section 1, the effective date, is amended to read:<br/>
<a id="pl.40.36"></a><var>40.36</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014 July 1, 2013.<br/>
<br/>
<a id="bill.1.62.0"></a><a id="pl.41.1"></a><var>41.1</var>    Sec. 62. <b>DETERMINATION OF FUNDING ADEQUACY FOR </b><br/>
<a id="pl.41.2"></a><var>41.2</var><b>MINNESOTACARE.</b><br/>
<a id="pl.41.3"></a><var>41.3</var>The commissioners of revenue and management and budget, in consultation with <br/>
<a id="pl.41.4"></a><var>41.4</var>the commissioner of human services, shall conduct an assessment of health care taxes, <br/>
<a id="pl.41.5"></a><var>41.5</var>including the gross premiums tax, the provider tax, and Medicaid surcharges, and their <br/>
<a id="pl.41.6"></a><var>41.6</var>relationship to the long-term solvency of the health care access fund, as part of the state <br/>
<a id="pl.41.7"></a><var>41.7</var>revenue and expenditure forecast in November 2013. The commissioners shall determine <br/>
<a id="pl.41.8"></a><var>41.8</var>the amount of state funding that will be required after December 31, 2019, in addition <br/>
<a id="pl.41.9"></a><var>41.9</var>to the federal payments made available under section 1331 of the Affordable Care Act, <br/>
<a id="pl.41.10"></a><var>41.10</var>for the MinnesotaCare program. The commissioners shall evaluate the stability and <br/>
<a id="pl.41.11"></a><var>41.11</var>likelihood of long-term federal funding for the MinnesotaCare program under section <br/>
<a id="pl.41.12"></a><var>41.12</var>1331. The commissioners shall report the results of this assessment to the chairs and <br/>
<a id="pl.41.13"></a><var>41.13</var>ranking minority members of the legislative committees with jurisdiction over human <br/>
<a id="pl.41.14"></a><var>41.14</var>services, finances, and taxes by January 15, 2014, along with recommendations for <br/>
<a id="pl.41.15"></a><var>41.15</var>changes to state revenue for the health care access fund, if state funding continues to <br/>
<a id="pl.41.16"></a><var>41.16</var>be required beyond December 31, 2019. <br/>
<br/>
<a id="bill.1.63.0"></a><a id="pl.41.17"></a><var>41.17</var>    Sec. 63. <b>REVISOR'S INSTRUCTION.</b><br/>
<a id="pl.41.18"></a><var>41.18</var>The revisor shall remove cross-references to the sections repealed in this act <br/>
<a id="pl.41.19"></a><var>41.19</var>wherever they appear in Minnesota Statutes and Minnesota Rules and make changes <br/>
<a id="pl.41.20"></a><var>41.20</var>necessary to correct the punctuation, grammar, or structure of the remaining text and <br/>
<a id="pl.41.21"></a><var>41.21</var>preserve its meaning.<br/>
<br/>
<a id="bill.1.64.0"></a><a id="pl.41.22"></a><var>41.22</var>    Sec. 64. <b> REPEALER.</b><br/>
<a id="pl.41.23"></a><var>41.23</var>(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.02, subdivision <br/>
<a id="pl.41.24"></a><var>41.24</var>3; 256L.031; 256L.04, subdivisions 1b, 7a, and 9; and 256L.11, subdivisions 2a, 5, and <br/>
<a id="pl.41.25"></a><var>41.25</var>6, are repealed, effective January 1, 2014.<br/>
<a id="pl.41.26"></a><var>41.26</var>(b) Minnesota Statutes 2012, sections 256L.01, subdivision 3; 256L.03, subdivision <br/>
<a id="pl.41.27"></a><var>41.27</var>4; 256L.04, subdivision 2a; 256L.07, subdivisions 1, 4, 5, 8, and 9; 256L.09, subdivisions <br/>
<a id="pl.41.28"></a><var>41.28</var>1, 4, 5, 6, and 7; 256L.12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9a, and 9b; and 256L.17, <br/>
<a id="pl.41.29"></a><var>41.29</var>subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2015.<br/>
<a id="pl.41.30"></a><var>41.30</var>(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b; <br/>
<a id="pl.41.31"></a><var>41.31</var>256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed.<br/>
<br/>
<a id="bill.2.0.0"></a>

<a id="pl.42.3"></a><var>42.3</var><b>COMMUNITY-BASED SERVICES</b><br/>

<a id="bill.2.1.0"></a><a id="pl.42.4"></a><var>42.4</var>    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:<br/>
<a id="pl.42.5"></a><var>42.5</var>    Subd. 4. <b>Resident assessment schedule.</b> (a) A facility must conduct and <br/>
<a id="pl.42.6"></a><var>42.6</var>electronically submit to the commissioner of health case mix assessments that conform <br/>
<a id="pl.42.7"></a><var>42.7</var>with the assessment schedule defined by Code of Federal Regulations, title 42, section <br/>
<a id="pl.42.8"></a><var>42.8</var>483.20, and published by the United States Department of Health and Human Services, <br/>
<a id="pl.42.9"></a><var>42.9</var>Centers for Medicare and Medicaid Services, in the Long Term Care Assessment <br/>
<a id="pl.42.10"></a><var>42.10</var>Instrument User's Manual, version 3.0, and subsequent updates when issued by the <br/>
<a id="pl.42.11"></a><var>42.11</var>Centers for Medicare and Medicaid Services. The commissioner of health may substitute <br/>
<a id="pl.42.12"></a><var>42.12</var>successor manuals or question and answer documents published by the United States <br/>
<a id="pl.42.13"></a><var>42.13</var>Department of Health and Human Services, Centers for Medicare and Medicaid Services, <br/>
<a id="pl.42.14"></a><var>42.14</var>to replace or supplement the current version of the manual or document.<br/>
<a id="pl.42.15"></a><var>42.15</var>(b) The assessments used to determine a case mix classification for reimbursement <br/>
<a id="pl.42.16"></a><var>42.16</var>include the following:<br/>
<a id="pl.42.17"></a><var>42.17</var>(1) a new admission assessment must be completed by day 14 following admission;<br/>
<a id="pl.42.18"></a><var>42.18</var>(2) an annual assessment which must have an assessment reference date (ARD) <br/>
<a id="pl.42.19"></a><var>42.19</var>within 366 days of the ARD of the last comprehensive assessment;<br/>
<a id="pl.42.20"></a><var>42.20</var>(3) a significant change assessment must be completed within 14 days of the <br/>
<a id="pl.42.21"></a><var>42.21</var>identification of a significant change; and<br/>
<a id="pl.42.22"></a><var>42.22</var>(4) all quarterly assessments must have an assessment reference date (ARD) within <br/>
<a id="pl.42.23"></a><var>42.23</var>92 days of the ARD of the previous assessment.<br/>
<a id="pl.42.24"></a><var>42.24</var>(c) In addition to the assessments listed in paragraph (b), the assessments used to <br/>
<a id="pl.42.25"></a><var>42.25</var>determine nursing facility level of care include the following:<br/>
<a id="pl.42.26"></a><var>42.26</var>(1) preadmission screening completed under section 
         <statute_ref>256B.0911, subdivision 4a</statute_ref>, by a <br/>
<a id="pl.42.27"></a><var>42.27</var>county, tribe, or managed care organization under contract with the Department of Human <br/>
<a id="pl.42.28"></a><var>42.28</var>Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line <br/>
<a id="pl.42.29"></a><var>42.29</var>or other organization under contract with the Minnesota Board on Aging; and<br/>
<a id="pl.42.30"></a><var>42.30</var>(2) a nursing facility level of care determination as provided for under section <br/>
<a id="pl.42.31"></a><var>42.31</var>256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment <br/>
<a id="pl.42.32"></a><var>42.32</var>completed under section 
         <statute_ref>256B.0911, subdivision 3a</statute_ref>, 3b, or 4d, by a county, tribe, or <br/>
<a id="pl.42.33"></a><var>42.33</var>managed care organization under contract with the Department of Human Services.<br/>
<br/>
<a id="bill.2.2.0"></a><a id="pl.43.1"></a><var>43.1</var>    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:<br/>
<a id="pl.43.2"></a><var>43.2</var><b>144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: </b><br/>
<a id="pl.43.3"></a><var>43.3</var><b>REPORT </b><b>AND STUDY </b><b>REQUIRED.</b><br/>
<a id="pl.43.4"></a><var>43.4</var>    Subdivision 1. <b>Report requirements.</b> The commissioners of health and human <br/>
<a id="pl.43.5"></a><var>43.5</var>services, with the cooperation of counties and in consultation with stakeholders, including <br/>
<a id="pl.43.6"></a><var>43.6</var>persons who need or are using long-term care services and supports, lead agencies, <br/>
<a id="pl.43.7"></a><var>43.7</var>regional entities, senior, disability, and mental health organization representatives, service <br/>
<a id="pl.43.8"></a><var>43.8</var>providers, and community members shall prepare a report to the legislature by August 15, <br/>
<a id="pl.43.9"></a><var>43.9</var>2013, and biennially thereafter, regarding the status of the full range of long-term care <br/>
<a id="pl.43.10"></a><var>43.10</var>services and supports for the elderly and children and adults with disabilities and mental <br/>
<a id="pl.43.11"></a><var>43.11</var>illnesses in Minnesota. The report shall address:<br/>
<a id="pl.43.12"></a><var>43.12</var>    (1) demographics and need for long-term care services and supports in Minnesota;<br/>
<a id="pl.43.13"></a><var>43.13</var>    (2) summary of county and regional reports on long-term care gaps, surpluses, <br/>
<a id="pl.43.14"></a><var>43.14</var>imbalances, and corrective action plans;<br/>
<a id="pl.43.15"></a><var>43.15</var>    (3) status of long-term care services and related mental health services, housing <br/>
<a id="pl.43.16"></a><var>43.16</var>options, and supports by county and region including:<br/>
<a id="pl.43.17"></a><var>43.17</var>    (i) changes in availability of the range of long-term care services and housing options;<br/>
<a id="pl.43.18"></a><var>43.18</var>    (ii) access problems, including access to the least restrictive and most integrated <br/>
<a id="pl.43.19"></a><var>43.19</var>services and settings, regarding long-term care services; and<br/>
<a id="pl.43.20"></a><var>43.20</var>    (iii) comparative measures of long-term care services availability, including serving <br/>
<a id="pl.43.21"></a><var>43.21</var>people in their home areas near family, and changes over time; and<br/>
<a id="pl.43.22"></a><var>43.22</var>    (4) recommendations regarding goals for the future of long-term care services and <br/>
<a id="pl.43.23"></a><var>43.23</var>supports, policy and fiscal changes, and resource development and transition needs.<br/>
<a id="pl.43.24"></a><var>43.24</var>    Subd. 2. <b>Critical access study.</b> The commissioner shall conduct a onetime study to <br/>
<a id="pl.43.25"></a><var>43.25</var>assess local capacity and availability of home and community-based services for older <br/>
<a id="pl.43.26"></a><var>43.26</var>adults, people with disabilities, and people with mental illnesses. The study must assess <br/>
<a id="pl.43.27"></a><var>43.27</var>critical access at the community level and identify potential strategies to build home and <br/>
<a id="pl.43.28"></a><var>43.28</var>community-based service capacity in critical access areas. The report shall be submitted <br/>
<a id="pl.43.29"></a><var>43.29</var>to the legislature no later than August 15, 2015.<br/>
<br/>
<a id="bill.2.3.0"></a><a id="pl.43.30"></a><var>43.30</var>    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:<br/>
<a id="pl.43.31"></a><var>43.31</var>    Subd. 4a. <b>City, county, and state social workers.</b> (a) Beginning July 1, 2016, the <br/>
<a id="pl.43.32"></a><var>43.32</var>licensure of city, county, and state agency social workers is voluntary, except an individual <br/>
<a id="pl.43.33"></a><var>43.33</var>who is newly employed by a city or state agency after July 1, 2016, must be licensed <br/>
<a id="pl.43.34"></a><var>43.34</var>if the individual who provides social work services, as those services are defined in <br/>
<a id="pl.44.1"></a><var>44.1</var>section 
         <statute_ref>148E.010, subdivision 11</statute_ref>, paragraph (b), is presented to the public by any title <br/>
<a id="pl.44.2"></a><var>44.2</var>incorporating the words "social work" or "social worker."<br/>
<a id="pl.44.3"></a><var>44.3</var>(b) City, county, and state agencies employing social workers and staff who are <br/>
<a id="pl.44.4"></a><var>44.4</var>designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and <br/>
<a id="pl.44.5"></a><var>44.5</var>256.01, subdivision 24, are not required to employ licensed social workers.<br/>
<br/>
<a id="bill.2.4.0"></a><a id="pl.44.6"></a><var>44.6</var>    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:<br/>
<a id="pl.44.7"></a><var>44.7</var>    Subd. 2. <b>Specific powers.</b> Subject to the provisions of section 
         <statute_ref>241.021, subdivision <br/>
<a id="pl.44.8"></a><var>44.8</var>2
         </statute_ref>, the commissioner of human services shall carry out the specific duties in paragraphs (a) <br/>
<a id="pl.44.9"></a><var>44.9</var>through (cc) (dd):<br/>
<a id="pl.44.10"></a><var>44.10</var>    (a) Administer and supervise all forms of public assistance provided for by state law <br/>
<a id="pl.44.11"></a><var>44.11</var>and other welfare activities or services as are vested in the commissioner. Administration <br/>
<a id="pl.44.12"></a><var>44.12</var>and supervision of human services activities or services includes, but is not limited to, <br/>
<a id="pl.44.13"></a><var>44.13</var>assuring timely and accurate distribution of benefits, completeness of service, and quality <br/>
<a id="pl.44.14"></a><var>44.14</var>program management. In addition to administering and supervising human services <br/>
<a id="pl.44.15"></a><var>44.15</var>activities vested by law in the department, the commissioner shall have the authority to:<br/>
<a id="pl.44.16"></a><var>44.16</var>    (1) require county agency participation in training and technical assistance programs <br/>
<a id="pl.44.17"></a><var>44.17</var>to promote compliance with statutes, rules, federal laws, regulations, and policies <br/>
<a id="pl.44.18"></a><var>44.18</var>governing human services;<br/>
<a id="pl.44.19"></a><var>44.19</var>    (2) monitor, on an ongoing basis, the performance of county agencies in the <br/>
<a id="pl.44.20"></a><var>44.20</var>operation and administration of human services, enforce compliance with statutes, rules, <br/>
<a id="pl.44.21"></a><var>44.21</var>federal laws, regulations, and policies governing welfare services and promote excellence <br/>
<a id="pl.44.22"></a><var>44.22</var>of administration and program operation;<br/>
<a id="pl.44.23"></a><var>44.23</var>    (3) develop a quality control program or other monitoring program to review county <br/>
<a id="pl.44.24"></a><var>44.24</var>performance and accuracy of benefit determinations;<br/>
<a id="pl.44.25"></a><var>44.25</var>    (4) require county agencies to make an adjustment to the public assistance benefits <br/>
<a id="pl.44.26"></a><var>44.26</var>issued to any individual consistent with federal law and regulation and state law and rule <br/>
<a id="pl.44.27"></a><var>44.27</var>and to issue or recover benefits as appropriate;<br/>
<a id="pl.44.28"></a><var>44.28</var>    (5) delay or deny payment of all or part of the state and federal share of benefits and <br/>
<a id="pl.44.29"></a><var>44.29</var>administrative reimbursement according to the procedures set forth in section 
         <statute_ref>256.017</statute_ref>;<br/>
<a id="pl.44.30"></a><var>44.30</var>    (6) make contracts with and grants to public and private agencies and organizations, <br/>
<a id="pl.44.31"></a><var>44.31</var>both profit and nonprofit, and individuals, using appropriated funds; and<br/>
<a id="pl.44.32"></a><var>44.32</var>    (7) enter into contractual agreements with federally recognized Indian tribes with <br/>
<a id="pl.44.33"></a><var>44.33</var>a reservation in Minnesota to the extent necessary for the tribe to operate a federally <br/>
<a id="pl.44.34"></a><var>44.34</var>approved family assistance program or any other program under the supervision of the <br/>
<a id="pl.44.35"></a><var>44.35</var>commissioner. The commissioner shall consult with the affected county or counties in <br/>
<a id="pl.45.1"></a><var>45.1</var>the contractual agreement negotiations, if the county or counties wish to be included, <br/>
<a id="pl.45.2"></a><var>45.2</var>in order to avoid the duplication of county and tribal assistance program services. The <br/>
<a id="pl.45.3"></a><var>45.3</var>commissioner may establish necessary accounts for the purposes of receiving and <br/>
<a id="pl.45.4"></a><var>45.4</var>disbursing funds as necessary for the operation of the programs.<br/>
<a id="pl.45.5"></a><var>45.5</var>    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, <br/>
<a id="pl.45.6"></a><var>45.6</var>regulation, and policy necessary to county agency administration of the programs.<br/>
<a id="pl.45.7"></a><var>45.7</var>    (c) Administer and supervise all child welfare activities; promote the enforcement of <br/>
<a id="pl.45.8"></a><var>45.8</var>laws protecting disabled, dependent, neglected and delinquent children, and children born <br/>
<a id="pl.45.9"></a><var>45.9</var>to mothers who were not married to the children's fathers at the times of the conception <br/>
<a id="pl.45.10"></a><var>45.10</var>nor at the births of the children; license and supervise child-caring and child-placing <br/>
<a id="pl.45.11"></a><var>45.11</var>agencies and institutions; supervise the care of children in boarding and foster homes or <br/>
<a id="pl.45.12"></a><var>45.12</var>in private institutions; and generally perform all functions relating to the field of child <br/>
<a id="pl.45.13"></a><var>45.13</var>welfare now vested in the State Board of Control.<br/>
<a id="pl.45.14"></a><var>45.14</var>    (d) Administer and supervise all noninstitutional service to disabled persons, <br/>
<a id="pl.45.15"></a><var>45.15</var>including those who are visually impaired, hearing impaired, or physically impaired <br/>
<a id="pl.45.16"></a><var>45.16</var>or otherwise disabled. The commissioner may provide and contract for the care and <br/>
<a id="pl.45.17"></a><var>45.17</var>treatment of qualified indigent children in facilities other than those located and available <br/>
<a id="pl.45.18"></a><var>45.18</var>at state hospitals when it is not feasible to provide the service in state hospitals.<br/>
<a id="pl.45.19"></a><var>45.19</var>    (e) Assist and actively cooperate with other departments, agencies and institutions, <br/>
<a id="pl.45.20"></a><var>45.20</var>local, state, and federal, by performing services in conformity with the purposes of Laws <br/>
<a id="pl.45.21"></a><var>45.21</var>1939, chapter 431.<br/>
<a id="pl.45.22"></a><var>45.22</var>    (f) Act as the agent of and cooperate with the federal government in matters of <br/>
<a id="pl.45.23"></a><var>45.23</var>mutual concern relative to and in conformity with the provisions of Laws 1939, chapter <br/>
<a id="pl.45.24"></a><var>45.24</var>431, including the administration of any federal funds granted to the state to aid in the <br/>
<a id="pl.45.25"></a><var>45.25</var>performance of any functions of the commissioner as specified in Laws 1939, chapter 431, <br/>
<a id="pl.45.26"></a><var>45.26</var>and including the promulgation of rules making uniformly available medical care benefits <br/>
<a id="pl.45.27"></a><var>45.27</var>to all recipients of public assistance, at such times as the federal government increases its <br/>
<a id="pl.45.28"></a><var>45.28</var>participation in assistance expenditures for medical care to recipients of public assistance, <br/>
<a id="pl.45.29"></a><var>45.29</var>the cost thereof to be borne in the same proportion as are grants of aid to said recipients.<br/>
<a id="pl.45.30"></a><var>45.30</var>    (g) Establish and maintain any administrative units reasonably necessary for the <br/>
<a id="pl.45.31"></a><var>45.31</var>performance of administrative functions common to all divisions of the department.<br/>
<a id="pl.45.32"></a><var>45.32</var>    (h) Act as designated guardian of both the estate and the person of all the wards of <br/>
<a id="pl.45.33"></a><var>45.33</var>the state of Minnesota, whether by operation of law or by an order of court, without any <br/>
<a id="pl.45.34"></a><var>45.34</var>further act or proceeding whatever, except as to persons committed as developmentally <br/>
<a id="pl.45.35"></a><var>45.35</var>disabled. For children under the guardianship of the commissioner or a tribe in Minnesota <br/>
<a id="pl.45.36"></a><var>45.36</var>recognized by the Secretary of the Interior whose interests would be best served by <br/>
<a id="pl.46.1"></a><var>46.1</var>adoptive placement, the commissioner may contract with a licensed child-placing agency <br/>
<a id="pl.46.2"></a><var>46.2</var>or a Minnesota tribal social services agency to provide adoption services. A contract <br/>
<a id="pl.46.3"></a><var>46.3</var>with a licensed child-placing agency must be designed to supplement existing county <br/>
<a id="pl.46.4"></a><var>46.4</var>efforts and may not replace existing county programs or tribal social services, unless the <br/>
<a id="pl.46.5"></a><var>46.5</var>replacement is agreed to by the county board and the appropriate exclusive bargaining <br/>
<a id="pl.46.6"></a><var>46.6</var>representative, tribal governing body, or the commissioner has evidence that child <br/>
<a id="pl.46.7"></a><var>46.7</var>placements of the county continue to be substantially below that of other counties. Funds <br/>
<a id="pl.46.8"></a><var>46.8</var>encumbered and obligated under an agreement for a specific child shall remain available <br/>
<a id="pl.46.9"></a><var>46.9</var>until the terms of the agreement are fulfilled or the agreement is terminated.<br/>
<a id="pl.46.10"></a><var>46.10</var>    (i) Act as coordinating referral and informational center on requests for service for <br/>
<a id="pl.46.11"></a><var>46.11</var>newly arrived immigrants coming to Minnesota.<br/>
<a id="pl.46.12"></a><var>46.12</var>    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no <br/>
<a id="pl.46.13"></a><var>46.13</var>way be construed to be a limitation upon the general transfer of powers herein contained.<br/>
<a id="pl.46.14"></a><var>46.14</var>    (k) Establish county, regional, or statewide schedules of maximum fees and charges <br/>
<a id="pl.46.15"></a><var>46.15</var>which may be paid by county agencies for medical, dental, surgical, hospital, nursing and <br/>
<a id="pl.46.16"></a><var>46.16</var>nursing home care and medicine and medical supplies under all programs of medical <br/>
<a id="pl.46.17"></a><var>46.17</var>care provided by the state and for congregate living care under the income maintenance <br/>
<a id="pl.46.18"></a><var>46.18</var>programs.<br/>
<a id="pl.46.19"></a><var>46.19</var>    (l) Have the authority to conduct and administer experimental projects to test methods <br/>
<a id="pl.46.20"></a><var>46.20</var>and procedures of administering assistance and services to recipients or potential recipients <br/>
<a id="pl.46.21"></a><var>46.21</var>of public welfare. To carry out such experimental projects, it is further provided that the <br/>
<a id="pl.46.22"></a><var>46.22</var>commissioner of human services is authorized to waive the enforcement of existing specific <br/>
<a id="pl.46.23"></a><var>46.23</var>statutory program requirements, rules, and standards in one or more counties. The order <br/>
<a id="pl.46.24"></a><var>46.24</var>establishing the waiver shall provide alternative methods and procedures of administration, <br/>
<a id="pl.46.25"></a><var>46.25</var>shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and <br/>
<a id="pl.46.26"></a><var>46.26</var>in no event shall the duration of a project exceed four years. It is further provided that no <br/>
<a id="pl.46.27"></a><var>46.27</var>order establishing an experimental project as authorized by the provisions of this section <br/>
<a id="pl.46.28"></a><var>46.28</var>shall become effective until the following conditions have been met:<br/>
<a id="pl.46.29"></a><var>46.29</var>    (1) the secretary of health and human services of the United States has agreed, for <br/>
<a id="pl.46.30"></a><var>46.30</var>the same project, to waive state plan requirements relative to statewide uniformity; and<br/>
<a id="pl.46.31"></a><var>46.31</var>    (2) a comprehensive plan, including estimated project costs, shall be approved by <br/>
<a id="pl.46.32"></a><var>46.32</var>the Legislative Advisory Commission and filed with the commissioner of administration.<br/>
<a id="pl.46.33"></a><var>46.33</var>    (m) According to federal requirements, establish procedures to be followed by <br/>
<a id="pl.46.34"></a><var>46.34</var>local welfare boards in creating citizen advisory committees, including procedures for <br/>
<a id="pl.46.35"></a><var>46.35</var>selection of committee members.<br/>
<a id="pl.47.1"></a><var>47.1</var>    (n) Allocate federal fiscal disallowances or sanctions which are based on quality <br/>
<a id="pl.47.2"></a><var>47.2</var>control error rates for the aid to families with dependent children program formerly <br/>
<a id="pl.47.3"></a><var>47.3</var>codified in sections 
         <statute_ref>256.72</statute_ref> to 
         <statute_ref>256.87</statute_ref>, medical assistance, or food stamp program in the <br/>
<a id="pl.47.4"></a><var>47.4</var>following manner:<br/>
<a id="pl.47.5"></a><var>47.5</var>    (1) one-half of the total amount of the disallowance shall be borne by the county <br/>
<a id="pl.47.6"></a><var>47.6</var>boards responsible for administering the programs. For the medical assistance and the <br/>
<a id="pl.47.7"></a><var>47.7</var>AFDC program formerly codified in sections 
         <statute_ref>256.72</statute_ref> to 
         <statute_ref>256.87</statute_ref>, disallowances shall be <br/>
<a id="pl.47.8"></a><var>47.8</var>shared by each county board in the same proportion as that county's expenditures for the <br/>
<a id="pl.47.9"></a><var>47.9</var>sanctioned program are to the total of all counties' expenditures for the AFDC program <br/>
<a id="pl.47.10"></a><var>47.10</var>formerly codified in sections 
         <statute_ref>256.72</statute_ref> to 
         <statute_ref>256.87</statute_ref>, and medical assistance programs. For the <br/>
<a id="pl.47.11"></a><var>47.11</var>food stamp program, sanctions shall be shared by each county board, with 50 percent of <br/>
<a id="pl.47.12"></a><var>47.12</var>the sanction being distributed to each county in the same proportion as that county's <br/>
<a id="pl.47.13"></a><var>47.13</var>administrative costs for food stamps are to the total of all food stamp administrative costs <br/>
<a id="pl.47.14"></a><var>47.14</var>for all counties, and 50 percent of the sanctions being distributed to each county in the <br/>
<a id="pl.47.15"></a><var>47.15</var>same proportion as that county's value of food stamp benefits issued are to the total of <br/>
<a id="pl.47.16"></a><var>47.16</var>all benefits issued for all counties. Each county shall pay its share of the disallowance <br/>
<a id="pl.47.17"></a><var>47.17</var>to the state of Minnesota. When a county fails to pay the amount due hereunder, the <br/>
<a id="pl.47.18"></a><var>47.18</var>commissioner may deduct the amount from reimbursement otherwise due the county, or <br/>
<a id="pl.47.19"></a><var>47.19</var>the attorney general, upon the request of the commissioner, may institute civil action <br/>
<a id="pl.47.20"></a><var>47.20</var>to recover the amount due; and<br/>
<a id="pl.47.21"></a><var>47.21</var>    (2) notwithstanding the provisions of clause (1), if the disallowance results from <br/>
<a id="pl.47.22"></a><var>47.22</var>knowing noncompliance by one or more counties with a specific program instruction, and <br/>
<a id="pl.47.23"></a><var>47.23</var>that knowing noncompliance is a matter of official county board record, the commissioner <br/>
<a id="pl.47.24"></a><var>47.24</var>may require payment or recover from the county or counties, in the manner prescribed in <br/>
<a id="pl.47.25"></a><var>47.25</var>clause (1), an amount equal to the portion of the total disallowance which resulted from the <br/>
<a id="pl.47.26"></a><var>47.26</var>noncompliance, and may distribute the balance of the disallowance according to clause (1).<br/>
<a id="pl.47.27"></a><var>47.27</var>    (o) Develop and implement special projects that maximize reimbursements and <br/>
<a id="pl.47.28"></a><var>47.28</var>result in the recovery of money to the state. For the purpose of recovering state money, <br/>
<a id="pl.47.29"></a><var>47.29</var>the commissioner may enter into contracts with third parties. Any recoveries that result <br/>
<a id="pl.47.30"></a><var>47.30</var>from projects or contracts entered into under this paragraph shall be deposited in the <br/>
<a id="pl.47.31"></a><var>47.31</var>state treasury and credited to a special account until the balance in the account reaches <br/>
<a id="pl.47.32"></a><var>47.32</var>$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be <br/>
<a id="pl.47.33"></a><var>47.33</var>transferred and credited to the general fund. All money in the account is appropriated to <br/>
<a id="pl.47.34"></a><var>47.34</var>the commissioner for the purposes of this paragraph.<br/>
<a id="pl.47.35"></a><var>47.35</var>    (p) Have the authority to make direct payments to facilities providing shelter <br/>
<a id="pl.47.36"></a><var>47.36</var>to women and their children according to section 
         <statute_ref>256D.05, subdivision 3</statute_ref>. Upon <br/>
<a id="pl.48.1"></a><var>48.1</var>the written request of a shelter facility that has been denied payments under section <br/>
<statute_ref><a id="pl.48.2"></a><var>48.2</var>256D.05, subdivision 3
         </statute_ref>, the commissioner shall review all relevant evidence and make <br/>
<a id="pl.48.3"></a><var>48.3</var>a determination within 30 days of the request for review regarding issuance of direct <br/>
<a id="pl.48.4"></a><var>48.4</var>payments to the shelter facility. Failure to act within 30 days shall be considered a <br/>
<a id="pl.48.5"></a><var>48.5</var>determination not to issue direct payments.<br/>
<a id="pl.48.6"></a><var>48.6</var>    (q) Have the authority to establish and enforce the following county reporting <br/>
<a id="pl.48.7"></a><var>48.7</var>requirements:<br/>
<a id="pl.48.8"></a><var>48.8</var>    (1) the commissioner shall establish fiscal and statistical reporting requirements <br/>
<a id="pl.48.9"></a><var>48.9</var>necessary to account for the expenditure of funds allocated to counties for human <br/>
<a id="pl.48.10"></a><var>48.10</var>services programs. When establishing financial and statistical reporting requirements, the <br/>
<a id="pl.48.11"></a><var>48.11</var>commissioner shall evaluate all reports, in consultation with the counties, to determine if <br/>
<a id="pl.48.12"></a><var>48.12</var>the reports can be simplified or the number of reports can be reduced;<br/>
<a id="pl.48.13"></a><var>48.13</var>    (2) the county board shall submit monthly or quarterly reports to the department <br/>
<a id="pl.48.14"></a><var>48.14</var>as required by the commissioner. Monthly reports are due no later than 15 working days <br/>
<a id="pl.48.15"></a><var>48.15</var>after the end of the month. Quarterly reports are due no later than 30 calendar days after <br/>
<a id="pl.48.16"></a><var>48.16</var>the end of the quarter, unless the commissioner determines that the deadline must be <br/>
<a id="pl.48.17"></a><var>48.17</var>shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines <br/>
<a id="pl.48.18"></a><var>48.18</var>or risking a loss of federal funding. Only reports that are complete, legible, and in the <br/>
<a id="pl.48.19"></a><var>48.19</var>required format shall be accepted by the commissioner;<br/>
<a id="pl.48.20"></a><var>48.20</var>    (3) if the required reports are not received by the deadlines established in clause (2), <br/>
<a id="pl.48.21"></a><var>48.21</var>the commissioner may delay payments and withhold funds from the county board until <br/>
<a id="pl.48.22"></a><var>48.22</var>the next reporting period. When the report is needed to account for the use of federal <br/>
<a id="pl.48.23"></a><var>48.23</var>funds and the late report results in a reduction in federal funding, the commissioner shall <br/>
<a id="pl.48.24"></a><var>48.24</var>withhold from the county boards with late reports an amount equal to the reduction in <br/>
<a id="pl.48.25"></a><var>48.25</var>federal funding until full federal funding is received;<br/>
<a id="pl.48.26"></a><var>48.26</var>    (4) a county board that submits reports that are late, illegible, incomplete, or not <br/>
<a id="pl.48.27"></a><var>48.27</var>in the required format for two out of three consecutive reporting periods is considered <br/>
<a id="pl.48.28"></a><var>48.28</var>noncompliant. When a county board is found to be noncompliant, the commissioner <br/>
<a id="pl.48.29"></a><var>48.29</var>shall notify the county board of the reason the county board is considered noncompliant <br/>
<a id="pl.48.30"></a><var>48.30</var>and request that the county board develop a corrective action plan stating how the <br/>
<a id="pl.48.31"></a><var>48.31</var>county board plans to correct the problem. The corrective action plan must be submitted <br/>
<a id="pl.48.32"></a><var>48.32</var>to the commissioner within 45 days after the date the county board received notice <br/>
<a id="pl.48.33"></a><var>48.33</var>of noncompliance;<br/>
<a id="pl.48.34"></a><var>48.34</var>    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year <br/>
<a id="pl.48.35"></a><var>48.35</var>after the date the report was originally due. If the commissioner does not receive a report <br/>
<a id="pl.48.36"></a><var>48.36</var>by the final deadline, the county board forfeits the funding associated with the report for <br/>
<a id="pl.49.1"></a><var>49.1</var>that reporting period and the county board must repay any funds associated with the <br/>
<a id="pl.49.2"></a><var>49.2</var>report received for that reporting period;<br/>
<a id="pl.49.3"></a><var>49.3</var>    (6) the commissioner may not delay payments, withhold funds, or require repayment <br/>
<a id="pl.49.4"></a><var>49.4</var>under clause (3) or (5) if the county demonstrates that the commissioner failed to <br/>
<a id="pl.49.5"></a><var>49.5</var>provide appropriate forms, guidelines, and technical assistance to enable the county to <br/>
<a id="pl.49.6"></a><var>49.6</var>comply with the requirements. If the county board disagrees with an action taken by the <br/>
<a id="pl.49.7"></a><var>49.7</var>commissioner under clause (3) or (5), the county board may appeal the action according <br/>
<a id="pl.49.8"></a><var>49.8</var>to sections 
         <statute_ref>14.57</statute_ref> to 
         <statute_ref>14.69</statute_ref>; and<br/>
<a id="pl.49.9"></a><var>49.9</var>    (7) counties subject to withholding of funds under clause (3) or forfeiture or <br/>
<a id="pl.49.10"></a><var>49.10</var>repayment of funds under clause (5) shall not reduce or withhold benefits or services to <br/>
<a id="pl.49.11"></a><var>49.11</var>clients to cover costs incurred due to actions taken by the commissioner under clause <br/>
<a id="pl.49.12"></a><var>49.12</var>(3) or (5).<br/>
<a id="pl.49.13"></a><var>49.13</var>    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when <br/>
<a id="pl.49.14"></a><var>49.14</var>federal fiscal disallowances or sanctions are based on a statewide random sample in direct <br/>
<a id="pl.49.15"></a><var>49.15</var>proportion to each county's claim for that period.<br/>
<a id="pl.49.16"></a><var>49.16</var>    (s) Be responsible for ensuring the detection, prevention, investigation, and <br/>
<a id="pl.49.17"></a><var>49.17</var>resolution of fraudulent activities or behavior by applicants, recipients, and other <br/>
<a id="pl.49.18"></a><var>49.18</var>participants in the human services programs administered by the department.<br/>
<a id="pl.49.19"></a><var>49.19</var>    (t) Require county agencies to identify overpayments, establish claims, and utilize <br/>
<a id="pl.49.20"></a><var>49.20</var>all available and cost-beneficial methodologies to collect and recover these overpayments <br/>
<a id="pl.49.21"></a><var>49.21</var>in the human services programs administered by the department.<br/>
<a id="pl.49.22"></a><var>49.22</var>    (u) Have the authority to administer a drug rebate program for drugs purchased <br/>
<a id="pl.49.23"></a><var>49.23</var>pursuant to the prescription drug program established under section 
         <statute_ref>256.955</statute_ref> after the <br/>
<a id="pl.49.24"></a><var>49.24</var>beneficiary's satisfaction of any deductible established in the program. The commissioner <br/>
<a id="pl.49.25"></a><var>49.25</var>shall require a rebate agreement from all manufacturers of covered drugs as defined in <br/>
<a id="pl.49.26"></a><var>49.26</var>section 
         <statute_ref>256B.0625, subdivision 13</statute_ref>. Rebate agreements for prescription drugs delivered on <br/>
<a id="pl.49.27"></a><var>49.27</var>or after July 1, 2002, must include rebates for individuals covered under the prescription <br/>
<a id="pl.49.28"></a><var>49.28</var>drug program who are under 65 years of age. For each drug, the amount of the rebate shall <br/>
<a id="pl.49.29"></a><var>49.29</var>be equal to the rebate as defined for purposes of the federal rebate program in United <br/>
<a id="pl.49.30"></a><var>49.30</var>States Code, title 42, section 1396r-8. The manufacturers must provide full payment <br/>
<a id="pl.49.31"></a><var>49.31</var>within 30 days of receipt of the state invoice for the rebate within the terms and conditions <br/>
<a id="pl.49.32"></a><var>49.32</var>used for the federal rebate program established pursuant to section 1927 of title XIX of <br/>
<a id="pl.49.33"></a><var>49.33</var>the Social Security Act. The manufacturers must provide the commissioner with any <br/>
<a id="pl.49.34"></a><var>49.34</var>information necessary to verify the rebate determined per drug. The rebate program shall <br/>
<a id="pl.49.35"></a><var>49.35</var>utilize the terms and conditions used for the federal rebate program established pursuant to <br/>
<a id="pl.49.36"></a><var>49.36</var>section 1927 of title XIX of the Social Security Act.<br/>
<a id="pl.50.1"></a><var>50.1</var>    (v) Have the authority to administer the federal drug rebate program for drugs <br/>
<a id="pl.50.2"></a><var>50.2</var>purchased under the medical assistance program as allowed by section 1927 of title XIX <br/>
<a id="pl.50.3"></a><var>50.3</var>of the Social Security Act and according to the terms and conditions of section 1927. <br/>
<a id="pl.50.4"></a><var>50.4</var>Rebates shall be collected for all drugs that have been dispensed or administered in an <br/>
<a id="pl.50.5"></a><var>50.5</var>outpatient setting and that are from manufacturers who have signed a rebate agreement <br/>
<a id="pl.50.6"></a><var>50.6</var>with the United States Department of Health and Human Services.<br/>
<a id="pl.50.7"></a><var>50.7</var>    (w) Have the authority to administer a supplemental drug rebate program for drugs <br/>
<a id="pl.50.8"></a><var>50.8</var>purchased under the medical assistance program. The commissioner may enter into <br/>
<a id="pl.50.9"></a><var>50.9</var>supplemental rebate contracts with pharmaceutical manufacturers and may require prior <br/>
<a id="pl.50.10"></a><var>50.10</var>authorization for drugs that are from manufacturers that have not signed a supplemental <br/>
<a id="pl.50.11"></a><var>50.11</var>rebate contract. Prior authorization of drugs shall be subject to the provisions of section <br/>
<statute_ref><a id="pl.50.12"></a><var>50.12</var>256B.0625, subdivision 13
         </statute_ref>.<br/>
<a id="pl.50.13"></a><var>50.13</var>    (x) Operate the department's communication systems account established in Laws <br/>
<a id="pl.50.14"></a><var>50.14</var>1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared <br/>
<a id="pl.50.15"></a><var>50.15</var>communication costs necessary for the operation of the programs the commissioner <br/>
<a id="pl.50.16"></a><var>50.16</var>supervises. A communications account may also be established for each regional <br/>
<a id="pl.50.17"></a><var>50.17</var>treatment center which operates communications systems. Each account must be used <br/>
<a id="pl.50.18"></a><var>50.18</var>to manage shared communication costs necessary for the operations of the programs the <br/>
<a id="pl.50.19"></a><var>50.19</var>commissioner supervises. The commissioner may distribute the costs of operating and <br/>
<a id="pl.50.20"></a><var>50.20</var>maintaining communication systems to participants in a manner that reflects actual usage. <br/>
<a id="pl.50.21"></a><var>50.21</var>Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and <br/>
<a id="pl.50.22"></a><var>50.22</var>other costs as determined by the commissioner. Nonprofit organizations and state, county, <br/>
<a id="pl.50.23"></a><var>50.23</var>and local government agencies involved in the operation of programs the commissioner <br/>
<a id="pl.50.24"></a><var>50.24</var>supervises may participate in the use of the department's communications technology and <br/>
<a id="pl.50.25"></a><var>50.25</var>share in the cost of operation. The commissioner may accept on behalf of the state any <br/>
<a id="pl.50.26"></a><var>50.26</var>gift, bequest, devise or personal property of any kind, or money tendered to the state for <br/>
<a id="pl.50.27"></a><var>50.27</var>any lawful purpose pertaining to the communication activities of the department. Any <br/>
<a id="pl.50.28"></a><var>50.28</var>money received for this purpose must be deposited in the department's communication <br/>
<a id="pl.50.29"></a><var>50.29</var>systems accounts. Money collected by the commissioner for the use of communication <br/>
<a id="pl.50.30"></a><var>50.30</var>systems must be deposited in the state communication systems account and is appropriated <br/>
<a id="pl.50.31"></a><var>50.31</var>to the commissioner for purposes of this section.<br/>
<a id="pl.50.32"></a><var>50.32</var>    (y) Receive any federal matching money that is made available through the medical <br/>
<a id="pl.50.33"></a><var>50.33</var>assistance program for the consumer satisfaction survey. Any federal money received for <br/>
<a id="pl.50.34"></a><var>50.34</var>the survey is appropriated to the commissioner for this purpose. The commissioner may <br/>
<a id="pl.50.35"></a><var>50.35</var>expend the federal money received for the consumer satisfaction survey in either year of <br/>
<a id="pl.50.36"></a><var>50.36</var>the biennium.<br/>
<a id="pl.51.1"></a><var>51.1</var>    (z) Designate community information and referral call centers and incorporate <br/>
<a id="pl.51.2"></a><var>51.2</var>cost reimbursement claims from the designated community information and referral <br/>
<a id="pl.51.3"></a><var>51.3</var>call centers into the federal cost reimbursement claiming processes of the department <br/>
<a id="pl.51.4"></a><var>51.4</var>according to federal law, rule, and regulations. Existing information and referral centers <br/>
<a id="pl.51.5"></a><var>51.5</var>provided by Greater Twin Cities United Way or existing call centers for which Greater <br/>
<a id="pl.51.6"></a><var>51.6</var>Twin Cities United Way has legal authority to represent, shall be included in these <br/>
<a id="pl.51.7"></a><var>51.7</var>designations upon review by the commissioner and assurance that these services are <br/>
<a id="pl.51.8"></a><var>51.8</var>accredited and in compliance with national standards. Any reimbursement is appropriated <br/>
<a id="pl.51.9"></a><var>51.9</var>to the commissioner and all designated information and referral centers shall receive <br/>
<a id="pl.51.10"></a><var>51.10</var>payments according to normal department schedules established by the commissioner <br/>
<a id="pl.51.11"></a><var>51.11</var>upon final approval of allocation methodologies from the United States Department of <br/>
<a id="pl.51.12"></a><var>51.12</var>Health and Human Services Division of Cost Allocation or other appropriate authorities.<br/>
<a id="pl.51.13"></a><var>51.13</var>    (aa) Develop recommended standards for foster care homes that address the <br/>
<a id="pl.51.14"></a><var>51.14</var>components of specialized therapeutic services to be provided by foster care homes with <br/>
<a id="pl.51.15"></a><var>51.15</var>those services.<br/>
<a id="pl.51.16"></a><var>51.16</var>    (bb) Authorize the method of payment to or from the department as part of the <br/>
<a id="pl.51.17"></a><var>51.17</var>human services programs administered by the department. This authorization includes the <br/>
<a id="pl.51.18"></a><var>51.18</var>receipt or disbursement of funds held by the department in a fiduciary capacity as part of <br/>
<a id="pl.51.19"></a><var>51.19</var>the human services programs administered by the department.<br/>
<a id="pl.51.20"></a><var>51.20</var>    (cc) Have the authority to administer a drug rebate program for drugs purchased for <br/>
<a id="pl.51.21"></a><var>51.21</var>persons eligible for general assistance medical care under section 
         <statute_ref>256D.03, subdivision 3</statute_ref>. <br/>
<a id="pl.51.22"></a><var>51.22</var>For manufacturers that agree to participate in the general assistance medical care rebate <br/>
<a id="pl.51.23"></a><var>51.23</var>program, the commissioner shall enter into a rebate agreement for covered drugs as <br/>
<a id="pl.51.24"></a><var>51.24</var>defined in section 
         <statute_ref>256B.0625, subdivisions 13 and 13d</statute_ref>. For each drug, the amount of the <br/>
<a id="pl.51.25"></a><var>51.25</var>rebate shall be equal to the rebate as defined for purposes of the federal rebate program in <br/>
<a id="pl.51.26"></a><var>51.26</var>United States Code, title 42, section 1396r-8. The manufacturers must provide payment <br/>
<a id="pl.51.27"></a><var>51.27</var>within the terms and conditions used for the federal rebate program established under <br/>
<a id="pl.51.28"></a><var>51.28</var>section 1927 of title XIX of the Social Security Act. The rebate program shall utilize <br/>
<a id="pl.51.29"></a><var>51.29</var>the terms and conditions used for the federal rebate program established under section <br/>
<a id="pl.51.30"></a><var>51.30</var>1927 of title XIX of the Social Security Act.<br/>
<a id="pl.51.31"></a><var>51.31</var>    Effective January 1, 2006, drug coverage under general assistance medical care shall <br/>
<a id="pl.51.32"></a><var>51.32</var>be limited to those prescription drugs that:<br/>
<a id="pl.51.33"></a><var>51.33</var>    (1) are covered under the medical assistance program as described in section <br/>
<statute_ref><a id="pl.51.34"></a><var>51.34</var>256B.0625, subdivisions 13 and 13d
         </statute_ref>; and<br/>
<a id="pl.51.35"></a><var>51.35</var>    (2) are provided by manufacturers that have fully executed general assistance <br/>
<a id="pl.51.36"></a><var>51.36</var>medical care rebate agreements with the commissioner and comply with such agreements. <br/>
<a id="pl.52.1"></a><var>52.1</var>Prescription drug coverage under general assistance medical care shall conform to <br/>
<a id="pl.52.2"></a><var>52.2</var>coverage under the medical assistance program according to section 
         <statute_ref>256B.0625, <br/>
<a id="pl.52.3"></a><var>52.3</var>subdivisions 13 to 13g
         </statute_ref>.<br/>
<a id="pl.52.4"></a><var>52.4</var>    The rebate revenues collected under the drug rebate program are deposited in the <br/>
<a id="pl.52.5"></a><var>52.5</var>general fund.<br/>
<a id="pl.52.6"></a><var>52.6</var>(dd) Designate the agencies that operate the Senior LinkAge Line under section <br/>
<a id="pl.52.7"></a><var>52.7</var>256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state <br/>
<a id="pl.52.8"></a><var>52.8</var>of Minnesota Aging and the Disability Resource Centers under United States Code, title <br/>
<a id="pl.52.9"></a><var>52.9</var>42, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost <br/>
<a id="pl.52.10"></a><var>52.10</var>reimbursement claims from the designated centers into the federal cost reimbursement <br/>
<a id="pl.52.11"></a><var>52.11</var>claiming processes of the department according to federal law, rule, and regulations. Any <br/>
<a id="pl.52.12"></a><var>52.12</var>reimbursement must be appropriated to the commissioner and all Aging and Disability <br/>
<a id="pl.52.13"></a><var>52.13</var>Resource Center designated agencies shall receive payments of grant funding that supports <br/>
<a id="pl.52.14"></a><var>52.14</var>the activity and generates the federal financial participation according to Board on Aging <br/>
<a id="pl.52.15"></a><var>52.15</var>administrative granting mechanisms.<br/>
<br/>
<a id="bill.2.5.0"></a><a id="pl.52.16"></a><var>52.16</var>    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:<br/>
<a id="pl.52.17"></a><var>52.17</var>    Subd. 24. <b>Disability Linkage Line.</b> The commissioner shall establish the Disability <br/>
<a id="pl.52.18"></a><var>52.18</var>Linkage Line, to which shall serve people with disabilities as the designated Aging and <br/>
<a id="pl.52.19"></a><var>52.19</var>Disability Resource Center under United States Code, title 42, section 3001, the Older <br/>
<a id="pl.52.20"></a><var>52.20</var>Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and <br/>
<a id="pl.52.21"></a><var>52.21</var>shall serve as Minnesota's neutral access point for statewide disability information and <br/>
<a id="pl.52.22"></a><var>52.22</var>assistance and must be available during business hours through a statewide toll-free <br/>
<a id="pl.52.23"></a><var>52.23</var>number and the Internet. The Disability Linkage Line shall:<br/>
<a id="pl.52.24"></a><var>52.24</var>(1) deliver information and assistance based on national and state standards;<br/>
<a id="pl.52.25"></a><var>52.25</var>    (2) provide information about state and federal eligibility requirements, benefits, <br/>
<a id="pl.52.26"></a><var>52.26</var>and service options;<br/>
<a id="pl.52.27"></a><var>52.27</var>(3) provide benefits and options counseling;<br/>
<a id="pl.52.28"></a><var>52.28</var>    (4) make referrals to appropriate support entities;<br/>
<a id="pl.52.29"></a><var>52.29</var>    (5) educate people on their options so they can make well-informed choices and link <br/>
<a id="pl.52.30"></a><var>52.30</var>them to quality profiles;<br/>
<a id="pl.52.31"></a><var>52.31</var>    (6) help support the timely resolution of service access and benefit issues;<br/>
<a id="pl.52.32"></a><var>52.32</var>(7) inform people of their long-term community services and supports;<br/>
<a id="pl.52.33"></a><var>52.33</var>(8) provide necessary resources and supports that can lead to employment and <br/>
<a id="pl.52.34"></a><var>52.34</var>increased economic stability of people with disabilities; and<br/>
<a id="pl.53.1"></a><var>53.1</var>(9) serve as the technical assistance and help center for the Web-based tool, <br/>
<a id="pl.53.2"></a><var>53.2</var>Minnesota's Disability Benefits 101.org.; and<br/>
<a id="pl.53.3"></a><var>53.3</var>(10) provide preadmission screening for individuals under 60 years of age using <br/>
<a id="pl.53.4"></a><var>53.4</var>the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911, <br/>
<a id="pl.53.5"></a><var>53.5</var>subdivision 4d.<br/>
<br/>
<a id="bill.2.6.0"></a><a id="pl.53.6"></a><var>53.6</var>    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:<br/>
<a id="pl.53.7"></a><var>53.7</var>    Subd. 7. <b>Consumer information and assistance and long-term care options </b><br/>
<a id="pl.53.8"></a><var>53.8</var><b>counseling; Senior LinkAge Line.</b> (a) The Minnesota Board on Aging shall operate a <br/>
<a id="pl.53.9"></a><var>53.9</var>statewide service to aid older Minnesotans and their families in making informed choices <br/>
<a id="pl.53.10"></a><var>53.10</var>about long-term care options and health care benefits. Language services to persons <br/>
<a id="pl.53.11"></a><var>53.11</var>with limited English language skills may be made available. The service, known as <br/>
<a id="pl.53.12"></a><var>53.12</var>Senior LinkAge Line, shall serve older adults as the designated Aging and Disability <br/>
<a id="pl.53.13"></a><var>53.13</var>Resource Center under United States Code, title 42, section 3001, the Older Americans <br/>
<a id="pl.53.14"></a><var>53.14</var>Act Amendments of 2006, in partnership with the Disability LinkAge Line under section <br/>
<a id="pl.53.15"></a><var>53.15</var>256.01, subdivision 24, and must be available during business hours through a statewide <br/>
<a id="pl.53.16"></a><var>53.16</var>toll-free number and must also be available through the Internet. The Minnesota Board <br/>
<a id="pl.53.17"></a><var>53.17</var>on Aging shall consult with, and when appropriate work through, the area agencies on <br/>
<a id="pl.53.18"></a><var>53.18</var>aging to provide and maintain the telephone infrastructure and related support for the <br/>
<a id="pl.53.19"></a><var>53.19</var>Aging and Disability Resource Center partners that agree by memorandum to access the <br/>
<a id="pl.53.20"></a><var>53.20</var>infrastructure, including the designated providers of the Senior LinkAge Line and the <br/>
<a id="pl.53.21"></a><var>53.21</var>Disability Linkage Line.<br/>
<a id="pl.53.22"></a><var>53.22</var>    (b) The service must provide long-term care options counseling by assisting older <br/>
<a id="pl.53.23"></a><var>53.23</var>adults, caregivers, and providers in accessing information and options counseling about <br/>
<a id="pl.53.24"></a><var>53.24</var>choices in long-term care services that are purchased through private providers or available <br/>
<a id="pl.53.25"></a><var>53.25</var>through public options. The service must:<br/>
<a id="pl.53.26"></a><var>53.26</var>    (1) develop a comprehensive database that includes detailed listings in both <br/>
<a id="pl.53.27"></a><var>53.27</var>consumer- and provider-oriented formats;<br/>
<a id="pl.53.28"></a><var>53.28</var>    (2) make the database accessible on the Internet and through other telecommunication <br/>
<a id="pl.53.29"></a><var>53.29</var>and media-related tools;<br/>
<a id="pl.53.30"></a><var>53.30</var>    (3) link callers to interactive long-term care screening tools and make these tools <br/>
<a id="pl.53.31"></a><var>53.31</var>available through the Internet by integrating the tools with the database;<br/>
<a id="pl.53.32"></a><var>53.32</var>    (4) develop community education materials with a focus on planning for long-term <br/>
<a id="pl.53.33"></a><var>53.33</var>care and evaluating independent living, housing, and service options;<br/>
<a id="pl.53.34"></a><var>53.34</var>    (5) conduct an outreach campaign to assist older adults and their caregivers in <br/>
<a id="pl.53.35"></a><var>53.35</var>finding information on the Internet and through other means of communication;<br/>
<a id="pl.54.1"></a><var>54.1</var>    (6) implement a messaging system for overflow callers and respond to these callers <br/>
<a id="pl.54.2"></a><var>54.2</var>by the next business day;<br/>
<a id="pl.54.3"></a><var>54.3</var>    (7) link callers with county human services and other providers to receive more <br/>
<a id="pl.54.4"></a><var>54.4</var>in-depth assistance and consultation related to long-term care options;<br/>
<a id="pl.54.5"></a><var>54.5</var>    (8) link callers with quality profiles for nursing facilities and other home and <br/>
<a id="pl.54.6"></a><var>54.6</var>community-based services providers developed by the commissioner commissioners of <br/>
<a id="pl.54.7"></a><var>54.7</var>health and human services;<br/>
<a id="pl.54.8"></a><var>54.8</var>    (9) incorporate information about the availability of housing options, as well as <br/>
<a id="pl.54.9"></a><var>54.9</var>registered housing with services and consumer rights within the MinnesotaHelp.info <br/>
<a id="pl.54.10"></a><var>54.10</var>network long-term care database to facilitate consumer comparison of services and costs <br/>
<a id="pl.54.11"></a><var>54.11</var>among housing with services establishments and with other in-home services and to <br/>
<a id="pl.54.12"></a><var>54.12</var>support financial self-sufficiency as long as possible. Housing with services establishments <br/>
<a id="pl.54.13"></a><var>54.13</var>and their arranged home care providers shall provide information that will facilitate price <br/>
<a id="pl.54.14"></a><var>54.14</var>comparisons, including delineation of charges for rent and for services available. The <br/>
<a id="pl.54.15"></a><var>54.15</var>commissioners of health and human services shall align the data elements required by <br/>
<a id="pl.54.16"></a><var>54.16</var>section 
         <statute_ref>144G.06</statute_ref>, the Uniform Consumer Information Guide, and this section to provide <br/>
<a id="pl.54.17"></a><var>54.17</var>consumers standardized information and ease of comparison of long-term care options. <br/>
<a id="pl.54.18"></a><var>54.18</var>The commissioner of human services shall provide the data to the Minnesota Board on <br/>
<a id="pl.54.19"></a><var>54.19</var>Aging for inclusion in the MinnesotaHelp.info network long-term care database;<br/>
<a id="pl.54.20"></a><var>54.20</var>(10) provide long-term care options counseling. Long-term care options counselors <br/>
<a id="pl.54.21"></a><var>54.21</var>shall:<br/>
<a id="pl.54.22"></a><var>54.22</var>(i) for individuals not eligible for case management under a public program or public <br/>
<a id="pl.54.23"></a><var>54.23</var>funding source, provide interactive decision support under which consumers, family <br/>
<a id="pl.54.24"></a><var>54.24</var>members, or other helpers are supported in their deliberations to determine appropriate <br/>
<a id="pl.54.25"></a><var>54.25</var>long-term care choices in the context of the consumer's needs, preferences, values, and <br/>
<a id="pl.54.26"></a><var>54.26</var>individual circumstances, including implementing a community support plan;<br/>
<a id="pl.54.27"></a><var>54.27</var>(ii) provide Web-based educational information and collateral written materials to <br/>
<a id="pl.54.28"></a><var>54.28</var>familiarize consumers, family members, or other helpers with the long-term care basics, <br/>
<a id="pl.54.29"></a><var>54.29</var>issues to be considered, and the range of options available in the community;<br/>
<a id="pl.54.30"></a><var>54.30</var>(iii) provide long-term care futures planning, which means providing assistance to <br/>
<a id="pl.54.31"></a><var>54.31</var>individuals who anticipate having long-term care needs to develop a plan for the more <br/>
<a id="pl.54.32"></a><var>54.32</var>distant future; and<br/>
<a id="pl.54.33"></a><var>54.33</var>(iv) provide expertise in benefits and financing options for long-term care, including <br/>
<a id="pl.54.34"></a><var>54.34</var>Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, <br/>
<a id="pl.54.35"></a><var>54.35</var>private pay options, and ways to access low or no-cost services or benefits through <br/>
<a id="pl.54.36"></a><var>54.36</var>volunteer-based or charitable programs;<br/>
<a id="pl.55.1"></a><var>55.1</var>(11) using risk management and support planning protocols, provide long-term care <br/>
<a id="pl.55.2"></a><var>55.2</var>options counseling to current residents of nursing homes deemed appropriate for discharge <br/>
<a id="pl.55.3"></a><var>55.3</var>by the commissioner and older adults who request service after consultation with the <br/>
<a id="pl.55.4"></a><var>55.4</var>Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior <br/>
<a id="pl.55.5"></a><var>55.5</var>LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The <br/>
<a id="pl.55.6"></a><var>55.6</var>Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge <br/>
<a id="pl.55.7"></a><var>55.7</var>by developing targeting criteria in consultation with the commissioner who shall provide <br/>
<a id="pl.55.8"></a><var>55.8</var>designated Senior LinkAge Line contact centers with a list of nursing home residents that <br/>
<a id="pl.55.9"></a><var>55.9</var>meet the criteria as being appropriate for discharge planning via a secure Web portal. <br/>
<a id="pl.55.10"></a><var>55.10</var>Senior LinkAge Line shall provide these residents, if they indicate a preference to <br/>
<a id="pl.55.11"></a><var>55.11</var>receive long-term care options counseling, with initial assessment, review of risk factors, <br/>
<a id="pl.55.12"></a><var>55.12</var>independent living support consultation, or and, if appropriate, a referral to:<br/>
<a id="pl.55.13"></a><var>55.13</var>(i) long-term care consultation services under section 
         <statute_ref>256B.0911</statute_ref>;<br/>
<a id="pl.55.14"></a><var>55.14</var>(ii) designated care coordinators of contracted entities under section 
         <statute_ref>256B.035</statute_ref> for <br/>
<a id="pl.55.15"></a><var>55.15</var>persons who are enrolled in a managed care plan; or<br/>
<a id="pl.55.16"></a><var>55.16</var>(iii) the long-term care consultation team for those who are appropriate eligible<br/>
<a id="pl.55.17"></a><var>55.17</var> for relocation service coordination due to high-risk factors or psychological or physical <br/>
<a id="pl.55.18"></a><var>55.18</var>disability; and<br/>
<a id="pl.55.19"></a><var>55.19</var>(12) develop referral protocols and processes that will assist certified health care <br/>
<a id="pl.55.20"></a><var>55.20</var>homes and hospitals to identify at-risk older adults and determine when to refer these <br/>
<a id="pl.55.21"></a><var>55.21</var>individuals to the Senior LinkAge Line for long-term care options counseling under this <br/>
<a id="pl.55.22"></a><var>55.22</var>section. The commissioner is directed to work with the commissioner of health to develop <br/>
<a id="pl.55.23"></a><var>55.23</var>protocols that would comply with the health care home designation criteria and protocols <br/>
<a id="pl.55.24"></a><var>55.24</var>available at the time of hospital discharge. The commissioner shall keep a record of the <br/>
<a id="pl.55.25"></a><var>55.25</var>number of people who choose long-term care options counseling as a result of this section.<br/>
<br/>
<a id="bill.2.7.0"></a><a id="pl.55.26"></a><var>55.26</var>    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision <br/>
<a id="pl.55.27"></a><var>55.27</var>to read:<br/>
<a id="pl.55.28"></a><var>55.28</var>    Subd. 7a. <b>Preadmission screening activities related to nursing facility </b><br/>
<a id="pl.55.29"></a><var>55.29</var><b>admissions.</b> (a) All individuals seeking admission to Medicaid certified nursing facilities, <br/>
<a id="pl.55.30"></a><var>55.30</var>including certified boarding care facilities, must be screened prior to admission regardless <br/>
<a id="pl.55.31"></a><var>55.31</var>of income, assets, or funding sources for nursing facility care, except as described in <br/>
<a id="pl.55.32"></a><var>55.32</var>subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the <br/>
<a id="pl.55.33"></a><var>55.33</var>need for nursing facility level of care as described in section 256B.0911, subdivision <br/>
<a id="pl.55.34"></a><var>55.34</var>4e, and to complete activities required under federal law related to mental illness and <br/>
<a id="pl.55.35"></a><var>55.35</var>developmental disability as outlined in paragraph (b).<br/>
<a id="pl.56.1"></a><var>56.1</var>(b) A person who has a diagnosis or possible diagnosis of mental illness or <br/>
<a id="pl.56.2"></a><var>56.2</var>developmental disability must receive a preadmission screening before admission <br/>
<a id="pl.56.3"></a><var>56.3</var>regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify <br/>
<a id="pl.56.4"></a><var>56.4</var>the need for further evaluation and specialized services, unless the admission prior to <br/>
<a id="pl.56.5"></a><var>56.5</var>screening is authorized by the local mental health authority or the local developmental <br/>
<a id="pl.56.6"></a><var>56.6</var>disabilities case manager, or unless authorized by the county agency according to Public <br/>
<a id="pl.56.7"></a><var>56.7</var>Law 101-508.<br/>
<a id="pl.56.8"></a><var>56.8</var>(c) The following criteria apply to the preadmission screening:<br/>
<a id="pl.56.9"></a><var>56.9</var>(1) requests for preadmission screenings must be submitted via an online form <br/>
<a id="pl.56.10"></a><var>56.10</var>developed by the commissioner;<br/>
<a id="pl.56.11"></a><var>56.11</var>(2) the Senior LinkAge Line must use forms and criteria developed by the <br/>
<a id="pl.56.12"></a><var>56.12</var>commissioner to identify persons who require referral for further evaluation and <br/>
<a id="pl.56.13"></a><var>56.13</var>determination of the need for specialized services; and<br/>
<a id="pl.56.14"></a><var>56.14</var>(3) the evaluation and determination of the need for specialized services must be <br/>
<a id="pl.56.15"></a><var>56.15</var>done by:<br/>
<a id="pl.56.16"></a><var>56.16</var>(i) a qualified independent mental health professional, for persons with a primary or <br/>
<a id="pl.56.17"></a><var>56.17</var>secondary diagnosis of a serious mental illness; or<br/>
<a id="pl.56.18"></a><var>56.18</var>(ii) a qualified developmental disability professional, for persons with a primary or <br/>
<a id="pl.56.19"></a><var>56.19</var>secondary diagnosis of developmental disability. For purposes of this requirement, a <br/>
<a id="pl.56.20"></a><var>56.20</var>qualified developmental disability professional must meet the standards for a qualified <br/>
<a id="pl.56.21"></a><var>56.21</var>developmental disability professional under Code of Federal Regulations, title 42, section <br/>
<a id="pl.56.22"></a><var>56.22</var>483.430.<br/>
<a id="pl.56.23"></a><var>56.23</var>(d) The local county mental health authority or the state developmental disability <br/>
<a id="pl.56.24"></a><var>56.24</var>authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a <br/>
<a id="pl.56.25"></a><var>56.25</var>nursing facility if the individual does not meet the nursing facility level of care criteria or <br/>
<a id="pl.56.26"></a><var>56.26</var>needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For <br/>
<a id="pl.56.27"></a><var>56.27</var>purposes of this section, "specialized services" for a person with developmental disability <br/>
<a id="pl.56.28"></a><var>56.28</var>means active treatment as that term is defined under Code of Federal Regulations, title <br/>
<a id="pl.56.29"></a><var>56.29</var>42, section 483.440(a)(1).<br/>
<a id="pl.56.30"></a><var>56.30</var>(e) In assessing a person's needs, the screener shall:<br/>
<a id="pl.56.31"></a><var>56.31</var>(1) use an automated system designated by the commissioner;<br/>
<a id="pl.56.32"></a><var>56.32</var>(2) consult with care transitions coordinators or physician; and<br/>
<a id="pl.56.33"></a><var>56.33</var>(3) consider the assessment of the individual's physician.<br/>
<a id="pl.56.34"></a><var>56.34</var>Other personnel may be included in the level of care determination as deemed <br/>
<a id="pl.56.35"></a><var>56.35</var>necessary by the screener.<br/>
<a id="pl.56.36"></a><var>56.36</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013.<br/>
<br/>
<a id="bill.2.8.0"></a><a id="pl.57.1"></a><var>57.1</var>    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision <br/>
<a id="pl.57.2"></a><var>57.2</var>to read:<br/>
<a id="pl.57.3"></a><var>57.3</var>    Subd. 7b. <b>Exemptions and emergency admissions.</b> (a) Exemptions from the federal <br/>
<a id="pl.57.4"></a><var>57.4</var>screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:<br/>
<a id="pl.57.5"></a><var>57.5</var>(1) a person who, having entered an acute care facility from a certified nursing <br/>
<a id="pl.57.6"></a><var>57.6</var>facility, is returning to a certified nursing facility; or<br/>
<a id="pl.57.7"></a><var>57.7</var>(2) a person transferring from one certified nursing facility in Minnesota to another <br/>
<a id="pl.57.8"></a><var>57.8</var>certified nursing facility in Minnesota.<br/>
<a id="pl.57.9"></a><var>57.9</var>(b) Persons who are exempt from preadmission screening for purposes of level of <br/>
<a id="pl.57.10"></a><var>57.10</var>care determination include:<br/>
<a id="pl.57.11"></a><var>57.11</var>(1) persons described in paragraph (a);<br/>
<a id="pl.57.12"></a><var>57.12</var>(2) an individual who has a contractual right to have nursing facility care paid for <br/>
<a id="pl.57.13"></a><var>57.13</var>indefinitely by the Veterans' Administration;<br/>
<a id="pl.57.14"></a><var>57.14</var>(3) an individual enrolled in a demonstration project under section 256B.69, <br/>
<a id="pl.57.15"></a><var>57.15</var>subdivision 8, at the time of application to a nursing facility; and<br/>
<a id="pl.57.16"></a><var>57.16</var>(4) an individual currently being served under the alternative care program or under <br/>
<a id="pl.57.17"></a><var>57.17</var>a home and community-based services waiver authorized under section 1915(c) of the <br/>
<a id="pl.57.18"></a><var>57.18</var>federal Social Security Act.<br/>
<a id="pl.57.19"></a><var>57.19</var>(c) Persons admitted to a Medicaid-certified nursing facility from the community <br/>
<a id="pl.57.20"></a><var>57.20</var>on an emergency basis as described in paragraph (d) or from an acute care facility on a <br/>
<a id="pl.57.21"></a><var>57.21</var>nonworking day must be screened the first working day after admission.<br/>
<a id="pl.57.22"></a><var>57.22</var>(d) Emergency admission to a nursing facility prior to screening is permitted when <br/>
<a id="pl.57.23"></a><var>57.23</var>all of the following conditions are met:<br/>
<a id="pl.57.24"></a><var>57.24</var>(1) a person is admitted from the community to a certified nursing or certified <br/>
<a id="pl.57.25"></a><var>57.25</var>boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and <br/>
<a id="pl.57.26"></a><var>57.26</var>older and Disability Linkage Line nonworking hours for under age 60;<br/>
<a id="pl.57.27"></a><var>57.27</var>(2) a physician has determined that delaying admission until preadmission screening <br/>
<a id="pl.57.28"></a><var>57.28</var>is completed would adversely affect the person's health and safety;<br/>
<a id="pl.57.29"></a><var>57.29</var>(3) there is a recent precipitating event that precludes the client from living safely in <br/>
<a id="pl.57.30"></a><var>57.30</var>the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's <br/>
<a id="pl.57.31"></a><var>57.31</var>inability to continue to provide care;<br/>
<a id="pl.57.32"></a><var>57.32</var>(4) the attending physician has authorized the emergency placement and has <br/>
<a id="pl.57.33"></a><var>57.33</var>documented the reason that the emergency placement is recommended; and<br/>
<a id="pl.57.34"></a><var>57.34</var>(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first <br/>
<a id="pl.57.35"></a><var>57.35</var>working day following the emergency admission.<br/>
<a id="pl.58.1"></a><var>58.1</var>Transfer of a patient from an acute care hospital to a nursing facility is not considered <br/>
<a id="pl.58.2"></a><var>58.2</var>an emergency except for a person who has received hospital services in the following <br/>
<a id="pl.58.3"></a><var>58.3</var>situations: hospital admission for observation, care in an emergency room without hospital <br/>
<a id="pl.58.4"></a><var>58.4</var>admission, or following hospital 24-hour bed care and from whom admission is being <br/>
<a id="pl.58.5"></a><var>58.5</var>sought on a nonworking day.<br/>
<a id="pl.58.6"></a><var>58.6</var>(e) A nursing facility must provide written information to all persons admitted <br/>
<a id="pl.58.7"></a><var>58.7</var>regarding the person's right to request and receive long-term care consultation services as <br/>
<a id="pl.58.8"></a><var>58.8</var>defined in section 256B.0911, subdivision 1a. The information must be provided prior to <br/>
<a id="pl.58.9"></a><var>58.9</var>the person's discharge from the facility and in a format specified by the commissioner.<br/>
<a id="pl.58.10"></a><var>58.10</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013.<br/>
<br/>
<a id="bill.2.9.0"></a><a id="pl.58.11"></a><var>58.11</var>    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision <br/>
<a id="pl.58.12"></a><var>58.12</var>to read:<br/>
<a id="pl.58.13"></a><var>58.13</var>    Subd. 7c. <b>Screening requirements.</b> (a) A person may be screened for nursing <br/>
<a id="pl.58.14"></a><var>58.14</var>facility admission by telephone or in a face-to-face screening interview. The Senior <br/>
<a id="pl.58.15"></a><var>58.15</var>LinkAge Line shall identify each individual's needs using the following categories:<br/>
<a id="pl.58.16"></a><var>58.16</var>(1) the person needs no face-to-face long-term care consultation assessment <br/>
<a id="pl.58.17"></a><var>58.17</var>completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or <br/>
<a id="pl.58.18"></a><var>58.18</var>managed care organization under contract with the Department of Human Services to <br/>
<a id="pl.58.19"></a><var>58.19</var>determine the need for nursing facility level of care based on information obtained from <br/>
<a id="pl.58.20"></a><var>58.20</var>other health care professionals;<br/>
<a id="pl.58.21"></a><var>58.21</var>(2) the person needs an immediate face-to-face long-term care consultation <br/>
<a id="pl.58.22"></a><var>58.22</var>assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, <br/>
<a id="pl.58.23"></a><var>58.23</var>tribe, or managed care organization under contract with the Department of Human <br/>
<a id="pl.58.24"></a><var>58.24</var>Services to determine the need for nursing facility level of care and complete activities <br/>
<a id="pl.58.25"></a><var>58.25</var>required under subdivision 7a; or<br/>
<a id="pl.58.26"></a><var>58.26</var>(3) the person may be exempt from screening requirements as outlined in subdivision <br/>
<a id="pl.58.27"></a><var>58.27</var>7b, but will need transitional assistance after admission or in-person follow-along after <br/>
<a id="pl.58.28"></a><var>58.28</var>a return home.<br/>
<a id="pl.58.29"></a><var>58.29</var>(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities <br/>
<a id="pl.58.30"></a><var>58.30</var>with only a telephone screening must receive a face-to-face assessment from the long-term <br/>
<a id="pl.58.31"></a><var>58.31</var>care consultation team member of the county in which the facility is located or from the <br/>
<a id="pl.58.32"></a><var>58.32</var>recipient's county case manager within 40 calendar days of admission as described in <br/>
<a id="pl.58.33"></a><var>58.33</var>section 256B.0911, subdivision 4d, paragraph (c).<br/>
<a id="pl.58.34"></a><var>58.34</var>(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing <br/>
<a id="pl.58.35"></a><var>58.35</var>facility must be screened prior to admission.<br/>
<a id="pl.59.1"></a><var>59.1</var>(d) Screenings provided by the Senior LinkAge Line must include processes <br/>
<a id="pl.59.2"></a><var>59.2</var>to identify persons who may require transition assistance described in subdivision 7, <br/>
<a id="pl.59.3"></a><var>59.3</var>paragraph (b), clause (12), and section 256B.0911, subdivision 3b.<br/>
<a id="pl.59.4"></a><var>59.4</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013.<br/>
<br/>
<a id="bill.2.10.0"></a><a id="pl.59.5"></a><var>59.5</var>    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision <br/>
<a id="pl.59.6"></a><var>59.6</var>to read:<br/>
<a id="pl.59.7"></a><var>59.7</var>    Subd. 7d. <b>Payment for preadmission screening.</b> Funding for preadmission <br/>
<a id="pl.59.8"></a><var>59.8</var>screening shall be provided to the Minnesota Board on Aging for the population 60 <br/>
<a id="pl.59.9"></a><var>59.9</var>years of age and older by the Department of Human Services to cover screener salaries <br/>
<a id="pl.59.10"></a><var>59.10</var>and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota <br/>
<a id="pl.59.11"></a><var>59.11</var>Board on Aging shall employ, or contract with other agencies to employ, within the limits <br/>
<a id="pl.59.12"></a><var>59.12</var>of available funding, sufficient personnel to provide preadmission screening and level of <br/>
<a id="pl.59.13"></a><var>59.13</var>care determination services and shall seek to maximize federal funding for the service as <br/>
<a id="pl.59.14"></a><var>59.14</var>provided under section 256.01, subdivision 2, paragraph (dd).<br/>
<a id="pl.59.15"></a><var>59.15</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013.<br/>
<br/>
<a id="bill.2.11.0"></a><a id="pl.59.16"></a><var>59.16</var>    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a <br/>
<a id="pl.59.17"></a><var>59.17</var>subdivision to read:<br/>
<a id="pl.59.18"></a><var>59.18</var>    Subd. 3a. <b>Priority for other grants.</b> The commissioner of health shall give <br/>
<a id="pl.59.19"></a><var>59.19</var>priority to a grantee selected under subdivision 3 when awarding technology-related <br/>
<a id="pl.59.20"></a><var>59.20</var>grants, if the grantee is using technology as a part of a proposal, unless that priority <br/>
<a id="pl.59.21"></a><var>59.21</var>conflicts with existing state or federal guidance related to grant awards by the Department <br/>
<a id="pl.59.22"></a><var>59.22</var>of Health. The commissioner of transportation shall give priority to a grantee selected <br/>
<a id="pl.59.23"></a><var>59.23</var>under subdivision 3 when distributing transportation-related funds to create transportation <br/>
<a id="pl.59.24"></a><var>59.24</var>options for older adults.<br/>
<br/>
<a id="bill.2.12.0"></a><a id="pl.59.25"></a><var>59.25</var>    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a <br/>
<a id="pl.59.26"></a><var>59.26</var>subdivision to read:<br/>
<a id="pl.59.27"></a><var>59.27</var>    Subd. 3b. <b>State waivers.</b> The commissioner of health may waive applicable state <br/>
<a id="pl.59.28"></a><var>59.28</var>laws and rules on a time-limited basis if the commissioner of health determines that a <br/>
<a id="pl.59.29"></a><var>59.29</var>participating grantee requires a waiver in order to achieve demonstration project goals.<br/>
<br/>
<a id="bill.2.13.0"></a><a id="pl.59.30"></a><var>59.30</var>    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:<br/>
<a id="pl.60.1"></a><var>60.1</var>    Subd. 5. <b>Grant preference.</b> The commissioner of human services shall give <br/>
<a id="pl.60.2"></a><var>60.2</var>preference when awarding grants under this section to areas where nursing facility <br/>
<a id="pl.60.3"></a><var>60.3</var>closures have occurred or are occurring or areas with service needs identified by section <br/>
<a id="pl.60.4"></a><var>60.4</var>144A.351. The commissioner may award grants to the extent grant funds are available <br/>
<a id="pl.60.5"></a><var>60.5</var>and to the extent applications are approved by the commissioner. Denial of approval of an <br/>
<a id="pl.60.6"></a><var>60.6</var>application in one year does not preclude submission of an application in a subsequent <br/>
<a id="pl.60.7"></a><var>60.7</var>year. The maximum grant amount is limited to $750,000.<br/>
<br/>
<a id="bill.2.14.0"></a><a id="pl.60.8"></a><var>60.8</var>    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a <br/>
<a id="pl.60.9"></a><var>60.9</var>subdivision to read:<br/>
<a id="pl.60.10"></a><var>60.10</var>    Subd. 4a. <b>Evaluation.</b> The commissioner shall evaluate the projects contained in <br/>
<a id="pl.60.11"></a><var>60.11</var>subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:<br/>
<a id="pl.60.12"></a><var>60.12</var>(1) an impact assessment focusing on program outcomes, especially those <br/>
<a id="pl.60.13"></a><var>60.13</var>experienced directly by the person receiving services;<br/>
<a id="pl.60.14"></a><var>60.14</var>(2) study samples drawn from the population of interest for each project; and<br/>
<a id="pl.60.15"></a><var>60.15</var>(3) a time series analysis to examine aggregate trends in average monthly <br/>
<a id="pl.60.16"></a><var>60.16</var>utilization, expenditures, and other outcomes in the targeted populations before and after <br/>
<a id="pl.60.17"></a><var>60.17</var>implementation of the initiatives.<br/>
<br/>
<a id="bill.2.15.0"></a><a id="pl.60.18"></a><var>60.18</var>    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a <br/>
<a id="pl.60.19"></a><var>60.19</var>subdivision to read:<br/>
<a id="pl.60.20"></a><var>60.20</var>    Subd. 6. <b>Work, empower, and encourage independence.</b> As provided under <br/>
<a id="pl.60.21"></a><var>60.21</var>subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a <br/>
<a id="pl.60.22"></a><var>60.22</var>demonstration project to provide navigation, employment supports, and benefits planning <br/>
<a id="pl.60.23"></a><var>60.23</var>services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014. <br/>
<a id="pl.60.24"></a><var>60.24</var>This demonstration shall promote economic stability, increase independence, and reduce <br/>
<a id="pl.60.25"></a><var>60.25</var>applications for disability benefits while providing a positive impact on the health and <br/>
<a id="pl.60.26"></a><var>60.26</var>future of participants.<br/>
<br/>
<a id="bill.2.16.0"></a><a id="pl.60.27"></a><var>60.27</var>    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a <br/>
<a id="pl.60.28"></a><var>60.28</var>subdivision to read:<br/>
<a id="pl.60.29"></a><var>60.29</var>    Subd. 7. <b>Housing stabilization.</b> As provided under subdivision 4, paragraph (e), <br/>
<a id="pl.60.30"></a><var>60.30</var>upon federal approval, the commissioner shall establish a demonstration project to provide <br/>
<a id="pl.60.31"></a><var>60.31</var>service coordination, outreach, in-reach, tenancy support, and community living assistance <br/>
<a id="pl.60.32"></a><var>60.32</var>to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This <br/>
<a id="pl.61.1"></a><var>61.1</var>demonstration shall promote housing stability, reduce costly medical interventions, and <br/>
<a id="pl.61.2"></a><var>61.2</var>increase opportunities for independent community living.<br/>
<br/>
<a id="bill.2.17.0"></a><a id="pl.61.3"></a><var>61.3</var>    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:<br/>
<a id="pl.61.4"></a><var>61.4</var>    Subdivision 1. <b>Purpose and goal.</b> (a) The purpose of long-term care consultation <br/>
<a id="pl.61.5"></a><var>61.5</var>services is to assist persons with long-term or chronic care needs in making care <br/>
<a id="pl.61.6"></a><var>61.6</var>decisions and selecting support and service options that meet their needs and reflect <br/>
<a id="pl.61.7"></a><var>61.7</var>their preferences. The availability of, and access to, information and other types of <br/>
<a id="pl.61.8"></a><var>61.8</var>assistance, including assessment and support planning, is also intended to prevent or delay <br/>
<a id="pl.61.9"></a><var>61.9</var>institutional placements and to provide access to transition assistance after admission. <br/>
<a id="pl.61.10"></a><var>61.10</var>Further, the goal of these services is to contain costs associated with unnecessary <br/>
<a id="pl.61.11"></a><var>61.11</var>institutional admissions. Long-term consultation services must be available to any person <br/>
<a id="pl.61.12"></a><var>61.12</var>regardless of public program eligibility. The commissioner of human services shall seek <br/>
<a id="pl.61.13"></a><var>61.13</var>to maximize use of available federal and state funds and establish the broadest program <br/>
<a id="pl.61.14"></a><var>61.14</var>possible within the funding available.<br/>
<a id="pl.61.15"></a><var>61.15</var>(b) These services must be coordinated with long-term care options counseling <br/>
<a id="pl.61.16"></a><var>61.16</var>provided under subdivision 4d, section 
         <statute_ref>256.975, subdivision subdivisions 7</statute_ref> to 7c, and <br/>
<a id="pl.61.17"></a><var>61.17</var>section 
         <statute_ref>256.01, subdivision 24</statute_ref>. The lead agency providing long-term care consultation <br/>
<a id="pl.61.18"></a><var>61.18</var>services shall encourage the use of volunteers from families, religious organizations, social <br/>
<a id="pl.61.19"></a><var>61.19</var>clubs, and similar civic and service organizations to provide community-based services.<br/>
<br/>
<a id="bill.2.18.0"></a><a id="pl.61.20"></a><var>61.20</var>    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to <br/>
<a id="pl.61.21"></a><var>61.21</var>read:<br/>
<a id="pl.61.22"></a><var>61.22</var>    Subd. 1a. <b>Definitions.</b> For purposes of this section, the following definitions apply:<br/>
<a id="pl.61.23"></a><var>61.23</var>    (a) Until additional requirements apply under paragraph (b), "long-term care <br/>
<a id="pl.61.24"></a><var>61.24</var>consultation services" means:<br/>
<a id="pl.61.25"></a><var>61.25</var>    (1) intake for and access to assistance in identifying services needed to maintain an <br/>
<a id="pl.61.26"></a><var>61.26</var>individual in the most inclusive environment;<br/>
<a id="pl.61.27"></a><var>61.27</var>    (2) providing recommendations for and referrals to cost-effective community <br/>
<a id="pl.61.28"></a><var>61.28</var>services that are available to the individual;<br/>
<a id="pl.61.29"></a><var>61.29</var>    (3) development of an individual's person-centered community support plan;<br/>
<a id="pl.61.30"></a><var>61.30</var>    (4) providing information regarding eligibility for Minnesota health care programs;<br/>
<a id="pl.61.31"></a><var>61.31</var>    (5) face-to-face long-term care consultation assessments, which may be completed <br/>
<a id="pl.61.32"></a><var>61.32</var>in a hospital, nursing facility, intermediate care facility for persons with developmental <br/>
<a id="pl.61.33"></a><var>61.33</var>disabilities (ICF/DDs), regional treatment centers, or the person's current or planned <br/>
<a id="pl.61.34"></a><var>61.34</var>residence;<br/>
<a id="pl.62.1"></a><var>62.1</var>    (6) federally mandated preadmission screening activities described under <br/>
<a id="pl.62.2"></a><var>62.2</var>subdivisions 4a and 4b;<br/>
<a id="pl.62.3"></a><var>62.3</var>    (7) (6) determination of home and community-based waiver and other service <br/>
<a id="pl.62.4"></a><var>62.4</var>eligibility as required under sections 
         <statute_ref>256B.0913</statute_ref>, 
         <statute_ref>256B.0915</statute_ref>, and 
         <statute_ref>256B.49</statute_ref>, including level <br/>
<a id="pl.62.5"></a><var>62.5</var>of care determination for individuals who need an institutional level of care as determined <br/>
<a id="pl.62.6"></a><var>62.6</var>under section 
         <statute_ref>256B.0911</statute_ref>, subdivision 4a, paragraph (d) 4e, based on assessment and <br/>
<a id="pl.62.7"></a><var>62.7</var>community support plan development, appropriate referrals to obtain necessary diagnostic <br/>
<a id="pl.62.8"></a><var>62.8</var>information, and including an eligibility determination for consumer-directed community <br/>
<a id="pl.62.9"></a><var>62.9</var>supports;<br/>
<a id="pl.62.10"></a><var>62.10</var>    (8) (7) providing recommendations for institutional placement when there are no <br/>
<a id="pl.62.11"></a><var>62.11</var>cost-effective community services available;<br/>
<a id="pl.62.12"></a><var>62.12</var>    (9) (8) providing access to assistance to transition people back to community settings <br/>
<a id="pl.62.13"></a><var>62.13</var>after institutional admission; and<br/>
<a id="pl.62.14"></a><var>62.14</var>(10) (9) providing information about competitive employment, with or without <br/>
<a id="pl.62.15"></a><var>62.15</var>supports, for school-age youth and working-age adults and referrals to the Disability <br/>
<a id="pl.62.16"></a><var>62.16</var>Linkage Line and Disability Benefits 101 to ensure that an informed choice about <br/>
<a id="pl.62.17"></a><var>62.17</var>competitive employment can be made. For the purposes of this subdivision, "competitive <br/>
<a id="pl.62.18"></a><var>62.18</var>employment" means work in the competitive labor market that is performed on a full-time <br/>
<a id="pl.62.19"></a><var>62.19</var>or part-time basis in an integrated setting, and for which an individual is compensated at or <br/>
<a id="pl.62.20"></a><var>62.20</var>above the minimum wage, but not less than the customary wage and level of benefits paid <br/>
<a id="pl.62.21"></a><var>62.21</var>by the employer for the same or similar work performed by individuals without disabilities.<br/>
<a id="pl.62.22"></a><var>62.22</var>(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, <br/>
<a id="pl.62.23"></a><var>62.23</var>2c, and 3a, "long-term care consultation services" also means:<br/>
<a id="pl.62.24"></a><var>62.24</var>(1) service eligibility determination for state plan home care services identified in:<br/>
<a id="pl.62.25"></a><var>62.25</var>(i) section 
         <statute_ref>256B.0625, subdivisions 7</statute_ref>, 19a, and 19c;<br/>
<a id="pl.62.26"></a><var>62.26</var>(ii) section 
         <statute_ref>256B.0657</statute_ref>; or<br/>
<a id="pl.62.27"></a><var>62.27</var>(iii) consumer support grants under section 
         <statute_ref>256.476</statute_ref>;<br/>
<a id="pl.62.28"></a><var>62.28</var>(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, <br/>
<a id="pl.62.29"></a><var>62.29</var>determination of eligibility for case management services available under sections <br/>
<statute_ref><a id="pl.62.30"></a><var>62.30</var>256B.0621, subdivision 2
         </statute_ref>, paragraph (4), and 
         <statute_ref>256B.0924</statute_ref> and Minnesota Rules, part <br/>
<a id="pl.62.31"></a><var>62.31</var>9525.0016;<br/>
<a id="pl.62.32"></a><var>62.32</var>(3) determination of institutional level of care, home and community-based service <br/>
<a id="pl.62.33"></a><var>62.33</var>waiver, and other service eligibility as required under section 
         <statute_ref>256B.092</statute_ref>, determination <br/>
<a id="pl.62.34"></a><var>62.34</var>of eligibility for family support grants under section 
         <statute_ref>252.32</statute_ref>, semi-independent living <br/>
<a id="pl.62.35"></a><var>62.35</var>services under section 
         <statute_ref>252.275</statute_ref>, and day training and habilitation services under section <br/>
<statute_ref><a id="pl.62.36"></a><var>62.36</var>256B.092
         </statute_ref>; and<br/>
<a id="pl.63.1"></a><var>63.1</var>(4) obtaining necessary diagnostic information to determine eligibility under clauses <br/>
<a id="pl.63.2"></a><var>63.2</var>(2) and (3).<br/>
<a id="pl.63.3"></a><var>63.3</var>    (c) "Long-term care options counseling" means the services provided by the linkage <br/>
<a id="pl.63.4"></a><var>63.4</var>lines as mandated by sections 
         <statute_ref>256.01, subdivision 24,</statute_ref> and 
         <statute_ref>256.975, subdivision 7</statute_ref>, and <br/>
<a id="pl.63.5"></a><var>63.5</var>also includes telephone assistance and follow up once a long-term care consultation <br/>
<a id="pl.63.6"></a><var>63.6</var>assessment has been completed.<br/>
<a id="pl.63.7"></a><var>63.7</var>    (d) "Minnesota health care programs" means the medical assistance program under <br/>
<a id="pl.63.8"></a><var>63.8</var>chapter 256B and the alternative care program under section 
         <statute_ref>256B.0913</statute_ref>.<br/>
<a id="pl.63.9"></a><var>63.9</var>    (e) "Lead agencies" means counties administering or tribes and health plans under <br/>
<a id="pl.63.10"></a><var>63.10</var>contract with the commissioner to administer long-term care consultation assessment and <br/>
<a id="pl.63.11"></a><var>63.11</var>support planning services.<br/>
<br/>
<a id="bill.2.19.0"></a><a id="pl.63.12"></a><var>63.12</var>    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to <br/>
<a id="pl.63.13"></a><var>63.13</var>read:<br/>
<a id="pl.63.14"></a><var>63.14</var>    Subd. 3a. <b>Assessment and support planning.</b> (a) Persons requesting assessment, <br/>
<a id="pl.63.15"></a><var>63.15</var>services planning, or other assistance intended to support community-based living, <br/>
<a id="pl.63.16"></a><var>63.16</var>including persons who need assessment in order to determine waiver or alternative care <br/>
<a id="pl.63.17"></a><var>63.17</var>program eligibility, must be visited by a long-term care consultation team within 20 <br/>
<a id="pl.63.18"></a><var>63.18</var>calendar days after the date on which an assessment was requested or recommended. <br/>
<a id="pl.63.19"></a><var>63.19</var>Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also <br/>
<a id="pl.63.20"></a><var>63.20</var>applies to an assessment of a person requesting personal care assistance services and <br/>
<a id="pl.63.21"></a><var>63.21</var>private duty nursing. The commissioner shall provide at least a 90-day notice to lead <br/>
<a id="pl.63.22"></a><var>63.22</var>agencies prior to the effective date of this requirement. Face-to-face assessments must be <br/>
<a id="pl.63.23"></a><var>63.23</var>conducted according to paragraphs (b) to (i).<br/>
<a id="pl.63.24"></a><var>63.24</var>    (b) The lead agency may utilize a team of either the social worker or public health <br/>
<a id="pl.63.25"></a><var>63.25</var>nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall <br/>
<a id="pl.63.26"></a><var>63.26</var>use certified assessors to conduct the assessment. The consultation team members must <br/>
<a id="pl.63.27"></a><var>63.27</var>confer regarding the most appropriate care for each individual screened or assessed. For <br/>
<a id="pl.63.28"></a><var>63.28</var>a person with complex health care needs, a public health or registered nurse from the <br/>
<a id="pl.63.29"></a><var>63.29</var>team must be consulted.<br/>
<a id="pl.63.30"></a><var>63.30</var>    (c) The assessment must be comprehensive and include a person-centered assessment <br/>
<a id="pl.63.31"></a><var>63.31</var>of the health, psychological, functional, environmental, and social needs of referred <br/>
<a id="pl.63.32"></a><var>63.32</var>individuals and provide information necessary to develop a community support plan that <br/>
<a id="pl.63.33"></a><var>63.33</var>meets the consumers needs, using an assessment form provided by the commissioner.<br/>
<a id="pl.63.34"></a><var>63.34</var>    (d) The assessment must be conducted in a face-to-face interview with the person <br/>
<a id="pl.63.35"></a><var>63.35</var>being assessed and the person's legal representative, and other individuals as requested by <br/>
<a id="pl.64.1"></a><var>64.1</var>the person, who can provide information on the needs, strengths, and preferences of the <br/>
<a id="pl.64.2"></a><var>64.2</var>person necessary to develop a community support plan that ensures the person's health and <br/>
<a id="pl.64.3"></a><var>64.3</var>safety, but who is not a provider of service or has any financial interest in the provision <br/>
<a id="pl.64.4"></a><var>64.4</var>of services. For persons who are to be assessed for elderly waiver customized living <br/>
<a id="pl.64.5"></a><var>64.5</var>services under section 
         <statute_ref>256B.0915</statute_ref>, with the permission of the person being assessed or <br/>
<a id="pl.64.6"></a><var>64.6</var>the person's designated or legal representative, the client's current or proposed provider <br/>
<a id="pl.64.7"></a><var>64.7</var>of services may submit a copy of the provider's nursing assessment or written report <br/>
<a id="pl.64.8"></a><var>64.8</var>outlining its recommendations regarding the client's care needs. The person conducting <br/>
<a id="pl.64.9"></a><var>64.9</var>the assessment will notify the provider of the date by which this information is to be <br/>
<a id="pl.64.10"></a><var>64.10</var>submitted. This information shall be provided to the person conducting the assessment <br/>
<a id="pl.64.11"></a><var>64.11</var>prior to the assessment.<br/>
<a id="pl.64.12"></a><var>64.12</var>    (e) If the person chooses to use community-based services, the person or the person's <br/>
<a id="pl.64.13"></a><var>64.13</var>legal representative must be provided with a written community support plan within 40 <br/>
<a id="pl.64.14"></a><var>64.14</var>calendar days of the assessment visit, regardless of whether the individual is eligible for <br/>
<a id="pl.64.15"></a><var>64.15</var>Minnesota health care programs. The written community support plan must include:<br/>
<a id="pl.64.16"></a><var>64.16</var>(1) a summary of assessed needs as defined in paragraphs (c) and (d);<br/>
<a id="pl.64.17"></a><var>64.17</var>(2) the individual's options and choices to meet identified needs, including all <br/>
<a id="pl.64.18"></a><var>64.18</var>available options for case management services and providers;<br/>
<a id="pl.64.19"></a><var>64.19</var>(3) identification of health and safety risks and how those risks will be addressed, <br/>
<a id="pl.64.20"></a><var>64.20</var>including personal risk management strategies;<br/>
<a id="pl.64.21"></a><var>64.21</var>(4) referral information; and<br/>
<a id="pl.64.22"></a><var>64.22</var>(5) informal caregiver supports, if applicable.<br/>
<a id="pl.64.23"></a><var>64.23</var>For a person determined eligible for state plan home care under subdivision 1a, <br/>
<a id="pl.64.24"></a><var>64.24</var>paragraph (b), clause (1), the person or person's representative must also receive a copy of <br/>
<a id="pl.64.25"></a><var>64.25</var>the home care service plan developed by the certified assessor.<br/>
<a id="pl.64.26"></a><var>64.26</var>(f) A person may request assistance in identifying community supports without <br/>
<a id="pl.64.27"></a><var>64.27</var>participating in a complete assessment. Upon a request for assistance identifying <br/>
<a id="pl.64.28"></a><var>64.28</var>community support, the person must be transferred or referred to long-term care options <br/>
<a id="pl.64.29"></a><var>64.29</var>counseling services available under sections 
         <statute_ref>256.975, subdivision 7</statute_ref>, and 
         <statute_ref>256.01</statute_ref>, <br/>
<a id="pl.64.30"></a><var>64.30</var>subdivision 24, for telephone assistance and follow up.<br/>
<a id="pl.64.31"></a><var>64.31</var>    (g) The person has the right to make the final decision between institutional <br/>
<a id="pl.64.32"></a><var>64.32</var>placement and community placement after the recommendations have been provided, <br/>
<a id="pl.64.33"></a><var>64.33</var>except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).<br/>
<a id="pl.64.34"></a><var>64.34</var>    (h) The lead agency must give the person receiving assessment or support planning, <br/>
<a id="pl.64.35"></a><var>64.35</var>or the person's legal representative, materials, and forms supplied by the commissioner <br/>
<a id="pl.64.36"></a><var>64.36</var>containing the following information:<br/>
<a id="pl.65.1"></a><var>65.1</var>    (1) written recommendations for community-based services and consumer-directed <br/>
<a id="pl.65.2"></a><var>65.2</var>options;<br/>
<a id="pl.65.3"></a><var>65.3</var>(2) documentation that the most cost-effective alternatives available were offered to <br/>
<a id="pl.65.4"></a><var>65.4</var>the individual. For purposes of this clause, "cost-effective" means community services and <br/>
<a id="pl.65.5"></a><var>65.5</var>living arrangements that cost the same as or less than institutional care. For an individual <br/>
<a id="pl.65.6"></a><var>65.6</var>found to meet eligibility criteria for home and community-based service programs under <br/>
<a id="pl.65.7"></a><var>65.7</var>section 
         <statute_ref>256B.0915</statute_ref> or 
         <statute_ref>256B.49</statute_ref>, "cost-effectiveness" has the meaning found in the federally <br/>
<a id="pl.65.8"></a><var>65.8</var>approved waiver plan for each program;<br/>
<a id="pl.65.9"></a><var>65.9</var>(3) the need for and purpose of preadmission screening conducted by long-term care <br/>
<a id="pl.65.10"></a><var>65.10</var>options counselors according to sections 256.975, subdivisions 7a to 7c, and 256.01, <br/>
<a id="pl.65.11"></a><var>65.11</var>subdivision 24, if the person selects nursing facility placement. If the individual selects <br/>
<a id="pl.65.12"></a><var>65.12</var>nursing facility placement, the lead agency shall forward information needed to complete <br/>
<a id="pl.65.13"></a><var>65.13</var>the level of care determinations and screening for developmental disability and mental <br/>
<a id="pl.65.14"></a><var>65.14</var>illness collected during the assessment to the long-term care options counselor using forms <br/>
<a id="pl.65.15"></a><var>65.15</var>provided by the commissioner;<br/>
<a id="pl.65.16"></a><var>65.16</var>    (4) the role of long-term care consultation assessment and support planning in <br/>
<a id="pl.65.17"></a><var>65.17</var>eligibility determination for waiver and alternative care programs, and state plan home <br/>
<a id="pl.65.18"></a><var>65.18</var>care, case management, and other services as defined in subdivision 1a, paragraphs (a), <br/>
<a id="pl.65.19"></a><var>65.19</var>clause (7), and (b);<br/>
<a id="pl.65.20"></a><var>65.20</var>    (5) information about Minnesota health care programs;<br/>
<a id="pl.65.21"></a><var>65.21</var>    (6) the person's freedom to accept or reject the recommendations of the team;<br/>
<a id="pl.65.22"></a><var>65.22</var>    (7) the person's right to confidentiality under the Minnesota Government Data <br/>
<a id="pl.65.23"></a><var>65.23</var>Practices Act, chapter 13;<br/>
<a id="pl.65.24"></a><var>65.24</var>    (8) the certified assessor's decision regarding the person's need for institutional level <br/>
<a id="pl.65.25"></a><var>65.25</var>of care as determined under criteria established in section 256B.0911, subdivision 4a, <br/>
<a id="pl.65.26"></a><var>65.26</var>paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services <br/>
<a id="pl.65.27"></a><var>65.27</var>and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and<br/>
<a id="pl.65.28"></a><var>65.28</var>    (9) the person's right to appeal the certified assessor's decision regarding eligibility <br/>
<a id="pl.65.29"></a><var>65.29</var>for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and <br/>
<a id="pl.65.30"></a><var>65.30</var>(b), and incorporating the decision regarding the need for institutional level of care or the <br/>
<a id="pl.65.31"></a><var>65.31</var>lead agency's final decisions regarding public programs eligibility according to section <br/>
<statute_ref><a id="pl.65.32"></a><var>65.32</var>256.045, subdivision 3
         </statute_ref>.<br/>
<a id="pl.65.33"></a><var>65.33</var>    (i) Face-to-face assessment completed as part of eligibility determination for <br/>
<a id="pl.65.34"></a><var>65.34</var>the alternative care, elderly waiver, community alternatives for disabled individuals, <br/>
<a id="pl.65.35"></a><var>65.35</var>community alternative care, and brain injury waiver programs under sections 
         <statute_ref>256B.0913</statute_ref>, <br/>
<statute_ref><a id="pl.66.1"></a><var>66.1</var>256B.0915
         </statute_ref>, and 
         <statute_ref>256B.49</statute_ref> is valid to establish service eligibility for no more than 60 <br/>
<a id="pl.66.2"></a><var>66.2</var>calendar days after the date of assessment.<br/>
<a id="pl.66.3"></a><var>66.3</var>(j) The effective eligibility start date for programs in paragraph (i) can never be <br/>
<a id="pl.66.4"></a><var>66.4</var>prior to the date of assessment. If an assessment was completed more than 60 days <br/>
<a id="pl.66.5"></a><var>66.5</var>before the effective waiver or alternative care program eligibility start date, assessment <br/>
<a id="pl.66.6"></a><var>66.6</var>and support plan information must be updated in a face-to-face visit and documented in <br/>
<a id="pl.66.7"></a><var>66.7</var>the department's Medicaid Management Information System (MMIS). Notwithstanding <br/>
<a id="pl.66.8"></a><var>66.8</var>retroactive medical assistance coverage of state plan services, the effective date of <br/>
<a id="pl.66.9"></a><var>66.9</var>eligibility for programs included in paragraph (i) cannot be prior to the date the most <br/>
<a id="pl.66.10"></a><var>66.10</var>recent updated assessment is completed.<br/>
<br/>
<a id="bill.2.20.0"></a><a id="pl.66.11"></a><var>66.11</var>    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to <br/>
<a id="pl.66.12"></a><var>66.12</var>read:<br/>
<a id="pl.66.13"></a><var>66.13</var>    Subd. 4d. <b>Preadmission screening of individuals under </b><b>65</b><b> 60</b><b> years of age.</b> (a) <br/>
<a id="pl.66.14"></a><var>66.14</var>It is the policy of the state of Minnesota to ensure that individuals with disabilities or <br/>
<a id="pl.66.15"></a><var>66.15</var>chronic illness are served in the most integrated setting appropriate to their needs and have <br/>
<a id="pl.66.16"></a><var>66.16</var>the necessary information to make informed choices about home and community-based <br/>
<a id="pl.66.17"></a><var>66.17</var>service options.<br/>
<a id="pl.66.18"></a><var>66.18</var>    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified<br/>
<a id="pl.66.19"></a><var>66.19</var> nursing facility from a hospital must be screened prior to admission as outlined in <br/>
<a id="pl.66.20"></a><var>66.20</var>subdivisions 4a through 4c according to the requirements outlined in section 256.975, <br/>
<a id="pl.66.21"></a><var>66.21</var>subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required <br/>
<a id="pl.66.22"></a><var>66.22</var>under section 256.01, subdivision 24.<br/>
<a id="pl.66.23"></a><var>66.23</var>    (c) Individuals under 65 years of age who are admitted to nursing facilities with <br/>
<a id="pl.66.24"></a><var>66.24</var>only a telephone screening must receive a face-to-face assessment from the long-term <br/>
<a id="pl.66.25"></a><var>66.25</var>care consultation team member of the county in which the facility is located or from the <br/>
<a id="pl.66.26"></a><var>66.26</var>recipient's county case manager within 40 calendar days of admission.<br/>
<a id="pl.66.27"></a><var>66.27</var>    (d) Individuals under 65 years of age who are admitted to a nursing facility <br/>
<a id="pl.66.28"></a><var>66.28</var>without preadmission screening according to the exemption described in subdivision 4b, <br/>
<a id="pl.66.29"></a><var>66.29</var>paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive <br/>
<a id="pl.66.30"></a><var>66.30</var>a face-to-face assessment within 40 days of admission.<br/>
<a id="pl.66.31"></a><var>66.31</var>    (e) (d) At the face-to-face assessment, the long-term care consultation team member <br/>
<a id="pl.66.32"></a><var>66.32</var>or county case manager must perform the activities required under subdivision 3b.<br/>
<a id="pl.66.33"></a><var>66.33</var>    (f) (e) For individuals under 21 years of age, a screening interview which <br/>
<a id="pl.66.34"></a><var>66.34</var>recommends nursing facility admission must be face-to-face and approved by the <br/>
<a id="pl.66.35"></a><var>66.35</var>commissioner before the individual is admitted to the nursing facility.<br/>
<a id="pl.67.1"></a><var>67.1</var>    (g) (f) In the event that an individual under 65 60 years of age is admitted to a <br/>
<a id="pl.67.2"></a><var>67.2</var>nursing facility on an emergency basis, the county Disability Linkage Line must be <br/>
<a id="pl.67.3"></a><var>67.3</var>notified of the admission on the next working day, and a face-to-face assessment as <br/>
<a id="pl.67.4"></a><var>67.4</var>described in paragraph (c) must be conducted within 40 calendar days of admission.<br/>
<a id="pl.67.5"></a><var>67.5</var>    (h) (g) At the face-to-face assessment, the long-term care consultation team member <br/>
<a id="pl.67.6"></a><var>67.6</var>or the case manager must present information about home and community-based options, <br/>
<a id="pl.67.7"></a><var>67.7</var>including consumer-directed options, so the individual can make informed choices. If the <br/>
<a id="pl.67.8"></a><var>67.8</var>individual chooses home and community-based services, the long-term care consultation <br/>
<a id="pl.67.9"></a><var>67.9</var>team member or case manager must complete a written relocation plan within 20 working <br/>
<a id="pl.67.10"></a><var>67.10</var>days of the visit. The plan shall describe the services needed to move out of the facility <br/>
<a id="pl.67.11"></a><var>67.11</var>and a time line for the move which is designed to ensure a smooth transition to the <br/>
<a id="pl.67.12"></a><var>67.12</var>individual's home and community.<br/>
<a id="pl.67.13"></a><var>67.13</var>    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive <br/>
<a id="pl.67.14"></a><var>67.14</var>a face-to-face assessment at least every 12 months to review the person's service choices <br/>
<a id="pl.67.15"></a><var>67.15</var>and available alternatives unless the individual indicates, in writing, that annual visits are <br/>
<a id="pl.67.16"></a><var>67.16</var>not desired. In this case, the individual must receive a face-to-face assessment at least <br/>
<a id="pl.67.17"></a><var>67.17</var>once every 36 months for the same purposes.<br/>
<a id="pl.67.18"></a><var>67.18</var>    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay <br/>
<a id="pl.67.19"></a><var>67.19</var>county agencies directly for face-to-face assessments for individuals under 65 years of age <br/>
<a id="pl.67.20"></a><var>67.20</var>who are being considered for placement or residing in a nursing facility. Until September <br/>
<a id="pl.67.21"></a><var>67.21</var>30, 2013, payments for individuals under 65 years of age shall be made as described <br/>
<a id="pl.67.22"></a><var>67.22</var>in this subdivision.<br/>
<a id="pl.67.23"></a><var>67.23</var>(j) Funding for preadmission screening shall be provided to the Disability Linkage <br/>
<a id="pl.67.24"></a><var>67.24</var>Line for the under 60 population by the Department of Human Services to cover screener <br/>
<a id="pl.67.25"></a><var>67.25</var>salaries and expenses to provide the services described in subdivisions 7a to 7c. The <br/>
<a id="pl.67.26"></a><var>67.26</var>Disability Linkage Line shall employ, or contract with other agencies to employ, within <br/>
<a id="pl.67.27"></a><var>67.27</var>the limits of available funding, sufficient personnel to provide preadmission screening and <br/>
<a id="pl.67.28"></a><var>67.28</var>level of care determination services and shall seek to maximize federal funding for the <br/>
<a id="pl.67.29"></a><var>67.29</var>service as provided under section 256.01, subdivision 2, paragraph (dd).<br/>
<a id="pl.67.30"></a><var>67.30</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013.<br/>
<br/>
<a id="bill.2.21.0"></a><a id="pl.67.31"></a><var>67.31</var>    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a <br/>
<a id="pl.67.32"></a><var>67.32</var>subdivision to read:<br/>
<a id="pl.67.33"></a><var>67.33</var>    Subd. 4e. <b>Determination of institutional level of care.</b> The determination of the <br/>
<a id="pl.67.34"></a><var>67.34</var>need for nursing facility, hospital, and intermediate care facility levels of care must be <br/>
<a id="pl.67.35"></a><var>67.35</var>made according to criteria developed by the commissioner, and in section 256B.092, <br/>
<a id="pl.68.1"></a><var>68.1</var>using forms developed by the commissioner. Effective January 1, 2014, for individuals <br/>
<a id="pl.68.2"></a><var>68.2</var>age 21 and older, the determination of need for nursing facility level of care shall be <br/>
<a id="pl.68.3"></a><var>68.3</var>based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the <br/>
<a id="pl.68.4"></a><var>68.4</var>determination of the need for nursing facility level of care must be made according to <br/>
<a id="pl.68.5"></a><var>68.5</var>criteria developed by the commissioner until criteria in section 144.0724, subdivision 11, <br/>
<a id="pl.68.6"></a><var>68.6</var>becomes effective on or after October 1, 2019.<br/>
<br/>
<a id="bill.2.22.0"></a><a id="pl.68.7"></a><var>68.7</var>    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:<br/>
<a id="pl.68.8"></a><var>68.8</var>    Subd. 6. <b>Payment for long-term care consultation services.</b> (a) Until September <br/>
<a id="pl.68.9"></a><var>68.9</var>30, 2013, payment for long-term care consultation face-to-face assessment shall be made <br/>
<a id="pl.68.10"></a><var>68.10</var>as described in this subdivision.<br/>
<a id="pl.68.11"></a><var>68.11</var>    (b) The total payment for each county must be paid monthly by certified nursing <br/>
<a id="pl.68.12"></a><var>68.12</var>facilities in the county. The monthly amount to be paid by each nursing facility for each <br/>
<a id="pl.68.13"></a><var>68.13</var>fiscal year must be determined by dividing the county's annual allocation for long-term <br/>
<a id="pl.68.14"></a><var>68.14</var>care consultation services by 12 to determine the monthly payment and allocating the <br/>
<a id="pl.68.15"></a><var>68.15</var>monthly payment to each nursing facility based on the number of licensed beds in the <br/>
<a id="pl.68.16"></a><var>68.16</var>nursing facility. Payments to counties in which there is no certified nursing facility must be <br/>
<a id="pl.68.17"></a><var>68.17</var>made by increasing the payment rate of the two facilities located nearest to the county seat.<br/>
<a id="pl.68.18"></a><var>68.18</var>    (b) (c) The commissioner shall include the total annual payment determined under <br/>
<a id="pl.68.19"></a><var>68.19</var>paragraph (a) for each nursing facility reimbursed under section 
         <statute_ref>256B.431</statute_ref>, 
         <statute_ref>256B.434</statute_ref>, <br/>
<a id="pl.68.20"></a><var>68.20</var>or 
         <statute_ref>256B.441</statute_ref>.<br/>
<a id="pl.68.21"></a><var>68.21</var>    (c) (d) In the event of the layaway, delicensure and decertification, or removal <br/>
<a id="pl.68.22"></a><var>68.22</var>from layaway of 25 percent or more of the beds in a facility, the commissioner may <br/>
<a id="pl.68.23"></a><var>68.23</var>adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly <br/>
<a id="pl.68.24"></a><var>68.24</var>payment amount in paragraph (a) (b). The effective date of an adjustment made under this <br/>
<a id="pl.68.25"></a><var>68.25</var>paragraph shall be on or after the first day of the month following the effective date of the <br/>
<a id="pl.68.26"></a><var>68.26</var>layaway, delicensure and decertification, or removal from layaway.<br/>
<a id="pl.68.27"></a><var>68.27</var>    (d) (e) Payments for long-term care consultation services are available to the county <br/>
<a id="pl.68.28"></a><var>68.28</var>or counties to cover staff salaries and expenses to provide the services described in <br/>
<a id="pl.68.29"></a><var>68.29</var>subdivision 1a. The county shall employ, or contract with other agencies to employ, <br/>
<a id="pl.68.30"></a><var>68.30</var>within the limits of available funding, sufficient personnel to provide long-term care <br/>
<a id="pl.68.31"></a><var>68.31</var>consultation services while meeting the state's long-term care outcomes and objectives as <br/>
<a id="pl.68.32"></a><var>68.32</var>defined in subdivision 1. The county shall be accountable for meeting local objectives <br/>
<a id="pl.68.33"></a><var>68.33</var>as approved by the commissioner in the biennial home and community-based services <br/>
<a id="pl.68.34"></a><var>68.34</var>quality assurance plan on a form provided by the commissioner.<br/>
<a id="pl.69.1"></a><var>69.1</var>    (e) (f) Notwithstanding section 
         <statute_ref>256B.0641</statute_ref>, overpayments attributable to payment <br/>
<a id="pl.69.2"></a><var>69.2</var>of the screening costs under the medical assistance program may not be recovered from <br/>
<a id="pl.69.3"></a><var>69.3</var>a facility.<br/>
<a id="pl.69.4"></a><var>69.4</var>    (f) (g) The commissioner of human services shall amend the Minnesota medical <br/>
<a id="pl.69.5"></a><var>69.5</var>assistance plan to include reimbursement for the local consultation teams.<br/>
<a id="pl.69.6"></a><var>69.6</var>    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented, <br/>
<a id="pl.69.7"></a><var>69.7</var>the county may bill, as case management services, assessments, support planning, and <br/>
<a id="pl.69.8"></a><var>69.8</var>follow-along provided to persons determined to be eligible for case management under <br/>
<a id="pl.69.9"></a><var>69.9</var>Minnesota health care programs. No individual or family member shall be charged for an <br/>
<a id="pl.69.10"></a><var>69.10</var>initial assessment or initial support plan development provided under subdivision 3a or 3b.<br/>
<a id="pl.69.11"></a><var>69.11</var>(h) (i) The commissioner shall develop an alternative payment methodology, <br/>
<a id="pl.69.12"></a><var>69.12</var>effective on October 1, 2013, for long-term care consultation services that includes <br/>
<a id="pl.69.13"></a><var>69.13</var>the funding available under this subdivision, and for assessments authorized under <br/>
<a id="pl.69.14"></a><var>69.14</var>sections 
         <statute_ref>256B.092</statute_ref> and 
         <statute_ref>256B.0659</statute_ref>. In developing the new payment methodology, the <br/>
<a id="pl.69.15"></a><var>69.15</var>commissioner shall consider the maximization of other funding sources, including federal <br/>
<a id="pl.69.16"></a><var>69.16</var>administrative reimbursement through federal financial participation funding, for all <br/>
<a id="pl.69.17"></a><var>69.17</var>long-term care consultation and preadmission screening activity. The alternative payment <br/>
<a id="pl.69.18"></a><var>69.18</var>methodology shall include the use of the appropriate time studies and the state financing <br/>
<a id="pl.69.19"></a><var>69.19</var>of nonfederal share as part of the state's medical assistance program.<br/>
<br/>
<a id="bill.2.23.0"></a><a id="pl.69.20"></a><var>69.20</var>    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:<br/>
<a id="pl.69.21"></a><var>69.21</var>    Subd. 7. <b>Reimbursement for certified nursing facilities.</b> (a) Medical assistance <br/>
<a id="pl.69.22"></a><var>69.22</var>reimbursement for nursing facilities shall be authorized for a medical assistance recipient <br/>
<a id="pl.69.23"></a><var>69.23</var>only if a preadmission screening has been conducted prior to admission or the county has <br/>
<a id="pl.69.24"></a><var>69.24</var>authorized an exemption. Medical assistance reimbursement for nursing facilities shall <br/>
<a id="pl.69.25"></a><var>69.25</var>not be provided for any recipient who the local screener has determined does not meet the <br/>
<a id="pl.69.26"></a><var>69.26</var>level of care criteria for nursing facility placement in section 
         <statute_ref>144.0724, subdivision 11</statute_ref>, or, <br/>
<a id="pl.69.27"></a><var>69.27</var>if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus <br/>
<a id="pl.69.28"></a><var>69.28</var>Budget Reconciliation Act of 1987 completed unless an admission for a recipient with <br/>
<a id="pl.69.29"></a><var>69.29</var>mental illness is approved by the local mental health authority or an admission for a <br/>
<a id="pl.69.30"></a><var>69.30</var>recipient with developmental disability is approved by the state developmental disability <br/>
<a id="pl.69.31"></a><var>69.31</var>authority.<br/>
<a id="pl.69.32"></a><var>69.32</var>    (b) The nursing facility must not bill a person who is not a medical assistance <br/>
<a id="pl.69.33"></a><var>69.33</var>recipient for resident days that preceded the date of completion of screening activities <br/>
<a id="pl.69.34"></a><var>69.34</var>as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing <br/>
<a id="pl.70.1"></a><var>70.1</var>facility must include unreimbursed resident days in the nursing facility resident day totals <br/>
<a id="pl.70.2"></a><var>70.2</var>reported to the commissioner.<br/>
<br/>
<a id="bill.2.24.0"></a><a id="pl.70.3"></a><var>70.3</var>    Sec. 24. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:<br/>
<a id="pl.70.4"></a><var>70.4</var>    Subd. 4. <b>Eligibility for funding for services for nonmedical assistance recipients.</b><br/>
<a id="pl.70.5"></a><var>70.5</var>    (a) Funding for services under the alternative care program is available to persons who <br/>
<a id="pl.70.6"></a><var>70.6</var>meet the following criteria:<br/>
<a id="pl.70.7"></a><var>70.7</var>    (1) the person has been determined by a community assessment under section <br/>
<statute_ref><a id="pl.70.8"></a><var>70.8</var>256B.0911
         </statute_ref> to be a person who would require the level of care provided in a nursing <br/>
<a id="pl.70.9"></a><var>70.9</var>facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for <br/>
<a id="pl.70.10"></a><var>70.10</var>the provision of services under the alternative care program;<br/>
<a id="pl.70.11"></a><var>70.11</var>    (2) the person is age 65 or older;<br/>
<a id="pl.70.12"></a><var>70.12</var>    (3) the person would be eligible for medical assistance within 135 days of admission <br/>
<a id="pl.70.13"></a><var>70.13</var>to a nursing facility;<br/>
<a id="pl.70.14"></a><var>70.14</var>    (4) the person is not ineligible for the payment of long-term care services by the <br/>
<a id="pl.70.15"></a><var>70.15</var>medical assistance program due to an asset transfer penalty under section 
         <statute_ref>256B.0595</statute_ref> or <br/>
<a id="pl.70.16"></a><var>70.16</var>equity interest in the home exceeding $500,000 as stated in section 
         <statute_ref>256B.056</statute_ref>;<br/>
<a id="pl.70.17"></a><var>70.17</var>    (5) the person needs long-term care services that are not funded through other <br/>
<a id="pl.70.18"></a><var>70.18</var>state or federal funding, or other health insurance or other third-party insurance such as <br/>
<a id="pl.70.19"></a><var>70.19</var>long-term care insurance;<br/>
<a id="pl.70.20"></a><var>70.20</var>    (6) except for individuals described in clause (7), the monthly cost of the alternative <br/>
<a id="pl.70.21"></a><var>70.21</var>care services funded by the program for this person does not exceed 75 percent of the <br/>
<a id="pl.70.22"></a><var>70.22</var>monthly limit described under section 
         <statute_ref>256B.0915, subdivision 3a</statute_ref>. This monthly limit <br/>
<a id="pl.70.23"></a><var>70.23</var>does not prohibit the alternative care client from payment for additional services, but in no <br/>
<a id="pl.70.24"></a><var>70.24</var>case may the cost of additional services purchased under this section exceed the difference <br/>
<a id="pl.70.25"></a><var>70.25</var>between the client's monthly service limit defined under section 
         <statute_ref>256B.0915, subdivision <br/>
<a id="pl.70.26"></a><var>70.26</var>3
         </statute_ref>, and the alternative care program monthly service limit defined in this paragraph. If <br/>
<a id="pl.70.27"></a><var>70.27</var>care-related supplies and equipment or environmental modifications and adaptations are or <br/>
<a id="pl.70.28"></a><var>70.28</var>will be purchased for an alternative care services recipient, the costs may be prorated on a <br/>
<a id="pl.70.29"></a><var>70.29</var>monthly basis for up to 12 consecutive months beginning with the month of purchase. <br/>
<a id="pl.70.30"></a><var>70.30</var>If the monthly cost of a recipient's other alternative care services exceeds the monthly <br/>
<a id="pl.70.31"></a><var>70.31</var>limit established in this paragraph, the annual cost of the alternative care services shall be <br/>
<a id="pl.70.32"></a><var>70.32</var>determined. In this event, the annual cost of alternative care services shall not exceed 12 <br/>
<a id="pl.70.33"></a><var>70.33</var>times the monthly limit described in this paragraph;<br/>
<a id="pl.70.34"></a><var>70.34</var>    (7) for individuals assigned a case mix classification A as described under section <br/>
<statute_ref><a id="pl.70.35"></a><var>70.35</var>256B.0915, subdivision 3a
         </statute_ref>, paragraph (a), with (i) no dependencies in activities of daily <br/>
<a id="pl.71.1"></a><var>71.1</var>living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating <br/>
<a id="pl.71.2"></a><var>71.2</var>when the dependency score in eating is three or greater as determined by an assessment <br/>
<a id="pl.71.3"></a><var>71.3</var>performed under section 
         <statute_ref>256B.0911</statute_ref>, the monthly cost of alternative care services funded <br/>
<a id="pl.71.4"></a><var>71.4</var>by the program cannot exceed $593 per month for all new participants enrolled in <br/>
<a id="pl.71.5"></a><var>71.5</var>the program on or after July 1, 2011. This monthly limit shall be applied to all other <br/>
<a id="pl.71.6"></a><var>71.6</var>participants who meet this criteria at reassessment. This monthly limit shall be increased <br/>
<a id="pl.71.7"></a><var>71.7</var>annually as described in section 
         <statute_ref>256B.0915, subdivision 3a</statute_ref>, paragraph (a). This monthly <br/>
<a id="pl.71.8"></a><var>71.8</var>limit does not prohibit the alternative care client from payment for additional services, but <br/>
<a id="pl.71.9"></a><var>71.9</var>in no case may the cost of additional services purchased exceed the difference between the <br/>
<a id="pl.71.10"></a><var>71.10</var>client's monthly service limit defined in this clause and the limit described in clause (6) <br/>
<a id="pl.71.11"></a><var>71.11</var>for case mix classification A; and<br/>
<a id="pl.71.12"></a><var>71.12</var>(8) the person is making timely payments of the assessed monthly fee.<br/>
<a id="pl.71.13"></a><var>71.13</var>A person is ineligible if payment of the fee is over 60 days past due, unless the person <br/>
<a id="pl.71.14"></a><var>71.14</var>agrees to:<br/>
<a id="pl.71.15"></a><var>71.15</var>    (i) the appointment of a representative payee;<br/>
<a id="pl.71.16"></a><var>71.16</var>    (ii) automatic payment from a financial account;<br/>
<a id="pl.71.17"></a><var>71.17</var>    (iii) the establishment of greater family involvement in the financial management of <br/>
<a id="pl.71.18"></a><var>71.18</var>payments; or<br/>
<a id="pl.71.19"></a><var>71.19</var>    (iv) another method acceptable to the lead agency to ensure prompt fee payments.<br/>
<a id="pl.71.20"></a><var>71.20</var>    The lead agency may extend the client's eligibility as necessary while making <br/>
<a id="pl.71.21"></a><var>71.21</var>arrangements to facilitate payment of past-due amounts and future premium payments. <br/>
<a id="pl.71.22"></a><var>71.22</var>Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be <br/>
<a id="pl.71.23"></a><var>71.23</var>reinstated for a period of 30 days.<br/>
<a id="pl.71.24"></a><var>71.24</var>    (b) Alternative care funding under this subdivision is not available for a person who <br/>
<a id="pl.71.25"></a><var>71.25</var>is a medical assistance recipient or who would be eligible for medical assistance without a <br/>
<a id="pl.71.26"></a><var>71.26</var>spenddown or waiver obligation. A person whose initial application for medical assistance <br/>
<a id="pl.71.27"></a><var>71.27</var>and the elderly waiver program is being processed may be served under the alternative care <br/>
<a id="pl.71.28"></a><var>71.28</var>program for a period up to 60 days. If the individual is found to be eligible for medical <br/>
<a id="pl.71.29"></a><var>71.29</var>assistance, medical assistance must be billed for services payable under the federally <br/>
<a id="pl.71.30"></a><var>71.30</var>approved elderly waiver plan and delivered from the date the individual was found eligible <br/>
<a id="pl.71.31"></a><var>71.31</var>for the federally approved elderly waiver plan. Notwithstanding this provision, alternative <br/>
<a id="pl.71.32"></a><var>71.32</var>care funds may not be used to pay for any service the cost of which: (i) is payable by <br/>
<a id="pl.71.33"></a><var>71.33</var>medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to <br/>
<a id="pl.71.34"></a><var>71.34</var>pay a medical assistance income spenddown for a person who is eligible to participate in the <br/>
<a id="pl.71.35"></a><var>71.35</var>federally approved elderly waiver program under the special income standard provision.<br/>
<a id="pl.72.1"></a><var>72.1</var>    (c) Alternative care funding is not available for a person who resides in a licensed <br/>
<a id="pl.72.2"></a><var>72.2</var>nursing home, certified boarding care home, hospital, or intermediate care facility, except <br/>
<a id="pl.72.3"></a><var>72.3</var>for case management services which are provided in support of the discharge planning <br/>
<a id="pl.72.4"></a><var>72.4</var>process for a nursing home resident or certified boarding care home resident to assist with <br/>
<a id="pl.72.5"></a><var>72.5</var>a relocation process to a community-based setting.<br/>
<a id="pl.72.6"></a><var>72.6</var>    (d) Alternative care funding is not available for a person whose income is greater <br/>
<a id="pl.72.7"></a><var>72.7</var>than the maintenance needs allowance under section 
         <statute_ref>256B.0915, subdivision 1d</statute_ref>, but equal <br/>
<a id="pl.72.8"></a><var>72.8</var>to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal <br/>
<a id="pl.72.9"></a><var>72.9</var>year for which alternative care eligibility is determined, who would be eligible for the <br/>
<a id="pl.72.10"></a><var>72.10</var>elderly waiver with a waiver obligation.<br/>
<br/>
<a id="bill.2.25.0"></a><a id="pl.72.11"></a><var>72.11</var>    Sec. 25. Minnesota Statutes 2012, section 256B.0913, is amended by adding a <br/>
<a id="pl.72.12"></a><var>72.12</var>subdivision to read:<br/>
<a id="pl.72.13"></a><var>72.13</var>    Subd. 17. <b>Essential community supports grants.</b> (a) Notwithstanding subdivisions <br/>
<a id="pl.72.14"></a><var>72.14</var>1 to 14, the purpose of the essential community supports grant program is to provide <br/>
<a id="pl.72.15"></a><var>72.15</var>targeted services to persons age 65 and older who need essential community support, but <br/>
<a id="pl.72.16"></a><var>72.16</var>whose needs do not meet the level of care required for nursing facility placement under <br/>
<a id="pl.72.17"></a><var>72.17</var>section 144.0724, subdivision 11.<br/>
<a id="pl.72.18"></a><var>72.18</var>(b) Essential community supports grants are available not to exceed $400 per person <br/>
<a id="pl.72.19"></a><var>72.19</var>per month. Essential community supports service grants may be used as authorized within <br/>
<a id="pl.72.20"></a><var>72.20</var>an authorization period not to exceed 12 months. Grants must be available to a person who:<br/>
<a id="pl.72.21"></a><var>72.21</var>(1) is age 65 or older;<br/>
<a id="pl.72.22"></a><var>72.22</var>(2) is not eligible for medical assistance;<br/>
<a id="pl.72.23"></a><var>72.23</var>(3) would otherwise be financially eligible for the alternative care program under <br/>
<a id="pl.72.24"></a><var>72.24</var>subdivision 4;<br/>
<a id="pl.72.25"></a><var>72.25</var>(4) has received a community assessment under section 256B.0911, subdivision 3a <br/>
<a id="pl.72.26"></a><var>72.26</var>or 3b, and does not require the level of care provided in a nursing facility;<br/>
<a id="pl.72.27"></a><var>72.27</var>(5) has a community support plan; and<br/>
<a id="pl.72.28"></a><var>72.28</var>(6) has been determined by a community assessment under section 256B.0911, <br/>
<a id="pl.72.29"></a><var>72.29</var>subdivision 3a or 3b, to be a person who would require provision of at least one of the <br/>
<a id="pl.72.30"></a><var>72.30</var>following services, as defined in the approved elderly waiver plan, in order to maintain <br/>
<a id="pl.72.31"></a><var>72.31</var>their community residence:<br/>
<a id="pl.72.32"></a><var>72.32</var>(i) caregiver support;<br/>
<a id="pl.72.33"></a><var>72.33</var>(ii) homemaker support;<br/>
<a id="pl.72.34"></a><var>72.34</var>(iii) chores; or<br/>
<a id="pl.72.35"></a><var>72.35</var>(iv) a personal emergency response device or system.<br/>
<a id="pl.73.1"></a><var>73.1</var>(c) The person receiving any of the essential community supports in this subdivision <br/>
<a id="pl.73.2"></a><var>73.2</var>must also receive service coordination, not to exceed $600 in a 12-month authorization <br/>
<a id="pl.73.3"></a><var>73.3</var>period, as part of their community support plan.<br/>
<a id="pl.73.4"></a><var>73.4</var>(d) A person who has been determined to be eligible for an essential community <br/>
<a id="pl.73.5"></a><var>73.5</var>supports grant must be reassessed at least annually and continue to meet the criteria in <br/>
<a id="pl.73.6"></a><var>73.6</var>paragraph (b) to remain eligible for an essential community supports grant.<br/>
<a id="pl.73.7"></a><var>73.7</var>(e) The commissioner is authorized to use federal matching funds for essential <br/>
<a id="pl.73.8"></a><var>73.8</var>community supports as necessary and to meet demand for essential community supports <br/>
<a id="pl.73.9"></a><var>73.9</var>grants as outlined in paragraphs (f) and (g), and that amount of federal funds is <br/>
<a id="pl.73.10"></a><var>73.10</var>appropriated to the commissioner for this purpose.<br/>
<a id="pl.73.11"></a><var>73.11</var>(f) Upon federal approval and following a reasonable implementation period <br/>
<a id="pl.73.12"></a><var>73.12</var>determined by the commissioner, essential community supports are available to an <br/>
<a id="pl.73.13"></a><var>73.13</var>individual who:<br/>
<a id="pl.73.14"></a><var>73.14</var>(1) is receiving nursing facility services or home and community-based long-term <br/>
<a id="pl.73.15"></a><var>73.15</var>services and supports under section 256B.0915 or 256B.49 on the effective date of <br/>
<a id="pl.73.16"></a><var>73.16</var>implementation of the revised nursing facility level of care under section 144.0724, <br/>
<a id="pl.73.17"></a><var>73.17</var>subdivision 11;<br/>
<a id="pl.73.18"></a><var>73.18</var>(2) meets one of the following criteria:<br/>
<a id="pl.73.19"></a><var>73.19</var>(i) due to the implementation of the revised nursing facility level of care, loses <br/>
<a id="pl.73.20"></a><var>73.20</var>eligibility for continuing medical assistance payment of nursing facility services at the <br/>
<a id="pl.73.21"></a><var>73.21</var>first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or <br/>
<a id="pl.73.22"></a><var>73.22</var>after the effective date of the revised nursing facility level of care criteria under section <br/>
<a id="pl.73.23"></a><var>73.23</var>144.0724, subdivision 11; or<br/>
<a id="pl.73.24"></a><var>73.24</var>(ii) due to the implementation of the revised nursing facility level of care, loses <br/>
<a id="pl.73.25"></a><var>73.25</var>eligibility for continuing medical assistance payment of home and community-based <br/>
<a id="pl.73.26"></a><var>73.26</var>long-term services and supports under section 256B.0915 or 256B.49 at the first <br/>
<a id="pl.73.27"></a><var>73.27</var>reassessment required under those sections that occurs on or after the effective date of <br/>
<a id="pl.73.28"></a><var>73.28</var>implementation of the revised nursing facility level of care under section 144.0724, <br/>
<a id="pl.73.29"></a><var>73.29</var>subdivision 11;<br/>
<a id="pl.73.30"></a><var>73.30</var>(3) is not eligible for personal care attendant services; and<br/>
<a id="pl.73.31"></a><var>73.31</var>(4) has an assessed need for one or more of the supportive services offered under <br/>
<a id="pl.73.32"></a><var>73.32</var>essential community supports.<br/>
<a id="pl.73.33"></a><var>73.33</var>Individuals eligible under this paragraph includes individuals who continue to be <br/>
<a id="pl.73.34"></a><var>73.34</var>eligible for medical assistance state plan benefits and those who are not or are no longer <br/>
<a id="pl.73.35"></a><var>73.35</var>financially eligible for medical assistance.<br/>
<a id="pl.74.1"></a><var>74.1</var>(g) Upon federal approval and following a reasonable implementation period <br/>
<a id="pl.74.2"></a><var>74.2</var>determined by the commissioner, the services available through essential community <br/>
<a id="pl.74.3"></a><var>74.3</var>supports include the services and grants provided in paragraphs (b) and (c), home-delivered <br/>
<a id="pl.74.4"></a><var>74.4</var>meals, and community living assistance as defined by the commissioner. These services <br/>
<a id="pl.74.5"></a><var>74.5</var>are available to all eligible recipients including those outlined in paragraphs (b) and (f). <br/>
<a id="pl.74.6"></a><var>74.6</var>Recipients are eligible if they have a need for any of these services and meet all other <br/>
<a id="pl.74.7"></a><var>74.7</var>eligibility criteria.<br/>
<br/>
<a id="bill.2.26.0"></a><a id="pl.74.8"></a><var>74.8</var>    Sec. 26. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:<br/>
<a id="pl.74.9"></a><var>74.9</var>    Subd. 5. <b>Assessments and reassessments for waiver clients.</b> (a) Each client <br/>
<a id="pl.74.10"></a><var>74.10</var>shall receive an initial assessment of strengths, informal supports, and need for services <br/>
<a id="pl.74.11"></a><var>74.11</var>in accordance with section 
         <statute_ref>256B.0911, subdivisions 3, 3a, and 3b</statute_ref>. A reassessment of a <br/>
<a id="pl.74.12"></a><var>74.12</var>client served under the elderly waiver must be conducted at least every 12 months and at <br/>
<a id="pl.74.13"></a><var>74.13</var>other times when the case manager determines that there has been significant change in <br/>
<a id="pl.74.14"></a><var>74.14</var>the client's functioning. This may include instances where the client is discharged from <br/>
<a id="pl.74.15"></a><var>74.15</var>the hospital. There must be a determination that the client requires nursing facility level <br/>
<a id="pl.74.16"></a><var>74.16</var>of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and <br/>
<a id="pl.74.17"></a><var>74.17</var>subsequent assessments to initiate and maintain participation in the waiver program.<br/>
<a id="pl.74.18"></a><var>74.18</var>(b) Regardless of other assessments identified in section 
         <statute_ref>144.0724</statute_ref>, subdivision <br/>
<a id="pl.74.19"></a><var>74.19</var>4, as appropriate to determine nursing facility level of care for purposes of medical <br/>
<a id="pl.74.20"></a><var>74.20</var>assistance payment for nursing facility services, only face-to-face assessments conducted <br/>
<a id="pl.74.21"></a><var>74.21</var>according to section 
         <statute_ref>256B.0911, subdivisions 3a</statute_ref> and 3b, that result in a nursing facility <br/>
<a id="pl.74.22"></a><var>74.22</var>level of care determination will be accepted for purposes of initial and ongoing access to <br/>
<a id="pl.74.23"></a><var>74.23</var>waiver service payment.<br/>
<br/>
<a id="bill.2.27.0"></a><a id="pl.74.24"></a><var>74.24</var>    Sec. 27. Minnesota Statutes 2012, section 256B.0917, is amended by adding a <br/>
<a id="pl.74.25"></a><var>74.25</var>subdivision to read:<br/>
<a id="pl.74.26"></a><var>74.26</var>    Subd. 1a. <b>Home and community-based services for older adults.</b> (a) The purpose <br/>
<a id="pl.74.27"></a><var>74.27</var>of projects selected by the commissioner of human services under this section is to <br/>
<a id="pl.74.28"></a><var>74.28</var>make strategic changes in the long-term services and supports system for older adults <br/>
<a id="pl.74.29"></a><var>74.29</var>including statewide capacity for local service development and technical assistance, and <br/>
<a id="pl.74.30"></a><var>74.30</var>statewide availability of home and community-based services for older adult services, <br/>
<a id="pl.74.31"></a><var>74.31</var>caregiver support and respite care services, and other supports in the state of Minnesota. <br/>
<a id="pl.74.32"></a><var>74.32</var>These projects are intended to create incentives for new and expanded home and <br/>
<a id="pl.74.33"></a><var>74.33</var>community-based services in Minnesota in order to:<br/>
<a id="pl.75.1"></a><var>75.1</var>(1) reach older adults early in the progression of their need for long-term services <br/>
<a id="pl.75.2"></a><var>75.2</var>and supports, providing them with low-cost, high-impact services that will prevent or <br/>
<a id="pl.75.3"></a><var>75.3</var>delay the use of more costly services;<br/>
<a id="pl.75.4"></a><var>75.4</var>(2) support older adults to live in the most integrated, least restrictive community <br/>
<a id="pl.75.5"></a><var>75.5</var>setting;<br/>
<a id="pl.75.6"></a><var>75.6</var>(3) support the informal caregivers of older adults;<br/>
<a id="pl.75.7"></a><var>75.7</var>(4) develop and implement strategies to integrate long-term services and supports <br/>
<a id="pl.75.8"></a><var>75.8</var>with health care services, in order to improve the quality of care and enhance the quality <br/>
<a id="pl.75.9"></a><var>75.9</var>of life of older adults and their informal caregivers;<br/>
<a id="pl.75.10"></a><var>75.10</var>(5) ensure cost-effective use of financial and human resources;<br/>
<a id="pl.75.11"></a><var>75.11</var>(6) build community-based approaches and community commitment to delivering <br/>
<a id="pl.75.12"></a><var>75.12</var>long-term services and supports for older adults in their own homes;<br/>
<a id="pl.75.13"></a><var>75.13</var>(7) achieve a broad awareness and use of lower-cost in-home services as an <br/>
<a id="pl.75.14"></a><var>75.14</var>alternative to nursing homes and other residential services;<br/>
<a id="pl.75.15"></a><var>75.15</var>(8) strengthen and develop additional home and community-based services and <br/>
<a id="pl.75.16"></a><var>75.16</var>alternatives to nursing homes and other residential services; and<br/>
<a id="pl.75.17"></a><var>75.17</var>(9) strengthen programs that use volunteers.<br/>
<a id="pl.75.18"></a><var>75.18</var>(b) The services provided by these projects are available to older adults who are <br/>
<a id="pl.75.19"></a><var>75.19</var>eligible for medical assistance and the elderly waiver under section 256B.0915, the <br/>
<a id="pl.75.20"></a><var>75.20</var>alternative care program under section 256B.0913, or essential community supports grant <br/>
<a id="pl.75.21"></a><var>75.21</var>under subdivision 14, paragraph (b), and to persons who have their own funds to pay for <br/>
<a id="pl.75.22"></a><var>75.22</var>services.<br/>
<br/>
<a id="bill.2.28.0"></a><a id="pl.75.23"></a><var>75.23</var>    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a <br/>
<a id="pl.75.24"></a><var>75.24</var>subdivision to read:<br/>
<a id="pl.75.25"></a><var>75.25</var>    Subd. 1b. <b>Definitions.</b> (a) For purposes of this section, the following terms have <br/>
<a id="pl.75.26"></a><var>75.26</var>the meanings given.<br/>
<a id="pl.75.27"></a><var>75.27</var>(b) "Community" means a town; township; city; or targeted neighborhood within a <br/>
<a id="pl.75.28"></a><var>75.28</var>city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.<br/>
<a id="pl.75.29"></a><var>75.29</var>(c) "Core home and community-based services provider" means a Faith in Action, <br/>
<a id="pl.75.30"></a><var>75.30</var>Living at Home Block Nurse, Congregational Nurse, or similar community-based <br/>
<a id="pl.75.31"></a><var>75.31</var>program governed by a board, the majority of whose members reside within the program's <br/>
<a id="pl.75.32"></a><var>75.32</var>service area, that organizes and uses volunteers and paid staff to deliver nonmedical <br/>
<a id="pl.75.33"></a><var>75.33</var>services intended to assist older adults to identify and manage risks and to maintain their <br/>
<a id="pl.75.34"></a><var>75.34</var>community living and integration in the community.<br/>
<a id="pl.76.1"></a><var>76.1</var>(d) "Eldercare development partnership" means a team of representatives of county <br/>
<a id="pl.76.2"></a><var>76.2</var>social service and public health agencies, the area agency on aging, local nursing home <br/>
<a id="pl.76.3"></a><var>76.3</var>providers, local home care providers, and other appropriate home and community-based <br/>
<a id="pl.76.4"></a><var>76.4</var>providers in the area agency's planning and service area.<br/>
<a id="pl.76.5"></a><var>76.5</var>(e) "Long-term services and supports" means any service available under the <br/>
<a id="pl.76.6"></a><var>76.6</var>elderly waiver program or alternative care grant programs, nursing facility services, <br/>
<a id="pl.76.7"></a><var>76.7</var>transportation services, caregiver support and respite care services, and other home and <br/>
<a id="pl.76.8"></a><var>76.8</var>community-based services identified as necessary either to maintain lifestyle choices for <br/>
<a id="pl.76.9"></a><var>76.9</var>older adults or to support them to remain in their own home.<br/>
<a id="pl.76.10"></a><var>76.10</var>(f) "Older adult" refers to an individual who is 65 years of age or older.<br/>
<br/>
<a id="bill.2.29.0"></a><a id="pl.76.11"></a><var>76.11</var>    Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a <br/>
<a id="pl.76.12"></a><var>76.12</var>subdivision to read:<br/>
<a id="pl.76.13"></a><var>76.13</var>    Subd. 1c. <b>Eldercare development partnerships.</b> The commissioner of human <br/>
<a id="pl.76.14"></a><var>76.14</var>services shall select and contract with eldercare development partnerships sufficient to <br/>
<a id="pl.76.15"></a><var>76.15</var>provide statewide availability of service development and technical assistance using a <br/>
<a id="pl.76.16"></a><var>76.16</var>request for proposals process. Eldercare development partnerships shall:<br/>
<a id="pl.76.17"></a><var>76.17</var>(1) develop a local long-term services and supports strategy consistent with state <br/>
<a id="pl.76.18"></a><var>76.18</var>goals and objectives;<br/>
<a id="pl.76.19"></a><var>76.19</var>(2) identify and use existing local skills, knowledge, and relationships, and build <br/>
<a id="pl.76.20"></a><var>76.20</var>on these assets;<br/>
<a id="pl.76.21"></a><var>76.21</var>(3) coordinate planning for funds to provide services to older adults, including funds <br/>
<a id="pl.76.22"></a><var>76.22</var>received under Title III of the Older Americans Act, Title XX of the Social Security Act, <br/>
<a id="pl.76.23"></a><var>76.23</var>and the Local Public Health Act;<br/>
<a id="pl.76.24"></a><var>76.24</var>(4) target service development and technical assistance where nursing facility <br/>
<a id="pl.76.25"></a><var>76.25</var>closures have occurred or are occurring or in areas where service needs have been <br/>
<a id="pl.76.26"></a><var>76.26</var>identified through activities under section 144A.351;<br/>
<a id="pl.76.27"></a><var>76.27</var>(5) provide sufficient staff for development and technical support in its designated <br/>
<a id="pl.76.28"></a><var>76.28</var>area; and<br/>
<a id="pl.76.29"></a><var>76.29</var>(6) designate a single public or nonprofit member of the eldercare development <br/>
<a id="pl.76.30"></a><var>76.30</var>partnerships to apply grant funding and manage the project.<br/>
<br/>
<a id="bill.2.30.0"></a><a id="pl.76.31"></a><var>76.31</var>    Sec. 30. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:<br/>
<a id="pl.76.32"></a><var>76.32</var>    Subd. 6. <b>Caregiver support and respite care projects.</b> (a) The commissioner <br/>
<a id="pl.76.33"></a><var>76.33</var>shall establish up to 36 projects to expand the respite care network in the state and to <br/>
<a id="pl.76.34"></a><var>76.34</var>support caregivers in their responsibilities for care. The purpose of each project shall <br/>
<a id="pl.77.1"></a><var>77.1</var>be to availability of caregiver support and respite care services for family and other <br/>
<a id="pl.77.2"></a><var>77.2</var>caregivers. The commissioner shall use a request for proposals to select nonprofit entities <br/>
<a id="pl.77.3"></a><var>77.3</var>to administer the projects. Projects shall:<br/>
<a id="pl.77.4"></a><var>77.4</var>(1) establish a local coordinated network of volunteer and paid respite workers;<br/>
<a id="pl.77.5"></a><var>77.5</var>(2) coordinate assignment of respite workers care services to clients and care <br/>
<a id="pl.77.6"></a><var>77.6</var>receivers and assure the health and safety of the client; and caregivers of older adults;<br/>
<a id="pl.77.7"></a><var>77.7</var>(3) provide training for caregivers and ensure that support groups are available <br/>
<a id="pl.77.8"></a><var>77.8</var>in the community.<br/>
<a id="pl.77.9"></a><var>77.9</var>(b) The caregiver support and respite care funds shall be available to the four to six <br/>
<a id="pl.77.10"></a><var>77.10</var>local long-term care strategy projects designated in subdivisions 1 to 5.<br/>
<a id="pl.77.11"></a><var>77.11</var>(c) The commissioner shall publish a notice in the State Register to solicit proposals <br/>
<a id="pl.77.12"></a><var>77.12</var>from public or private nonprofit agencies for the projects not included in the four to six <br/>
<a id="pl.77.13"></a><var>77.13</var>local long-term care strategy projects defined in subdivision 2. A county agency may, <br/>
<a id="pl.77.14"></a><var>77.14</var>alone or in combination with other county agencies, apply for caregiver support and <br/>
<a id="pl.77.15"></a><var>77.15</var>respite care project funds. A public or nonprofit agency within a designated SAIL project <br/>
<a id="pl.77.16"></a><var>77.16</var>area may apply for project funds if the agency has a letter of agreement with the county <br/>
<a id="pl.77.17"></a><var>77.17</var>or counties in which services will be developed, stating the intention of the county or <br/>
<a id="pl.77.18"></a><var>77.18</var>counties to coordinate their activities with the agency requesting a grant.<br/>
<a id="pl.77.19"></a><var>77.19</var>(d) The commissioner shall select grantees based on the following criteria:<br/>
<a id="pl.77.20"></a><var>77.20</var>(1) the ability of the proposal to demonstrate need in the area served, as evidenced <br/>
<a id="pl.77.21"></a><var>77.21</var>by a community needs assessment or other demographic data;<br/>
<a id="pl.77.22"></a><var>77.22</var>(2) the ability of the proposal to clearly describe how the project<br/>
<a id="pl.77.23"></a><var>77.23</var>(3) assure the health and safety of the older adults;<br/>
<a id="pl.77.24"></a><var>77.24</var>(4) identify at-risk caregivers;<br/>
<a id="pl.77.25"></a><var>77.25</var>(5) provide information, education, and training for caregivers in the designated <br/>
<a id="pl.77.26"></a><var>77.26</var>community; and<br/>
<a id="pl.77.27"></a><var>77.27</var>(6) demonstrate the need in the proposed service area particularly where nursing <br/>
<a id="pl.77.28"></a><var>77.28</var>facility closures have occurred or are occurring or areas with service needs identified <br/>
<a id="pl.77.29"></a><var>77.29</var>by section 144A.351. Preference must be given for projects that reach underserved <br/>
<a id="pl.77.30"></a><var>77.30</var>populations.<br/>
<a id="pl.77.31"></a><var>77.31</var>(b) Projects must clearly describe:<br/>
<a id="pl.77.32"></a><var>77.32</var>(1) how they will achieve the their purpose defined in paragraph (b);<br/>
<a id="pl.77.33"></a><var>77.33</var>(3) the ability of the proposal to reach underserved populations;<br/>
<a id="pl.77.34"></a><var>77.34</var>(4) the ability of the proposal to demonstrate community commitment to the project, <br/>
<a id="pl.77.35"></a><var>77.35</var>as evidenced by letters of support and cooperation as well as formation of a community <br/>
<a id="pl.77.36"></a><var>77.36</var>task force;<br/>
<a id="pl.78.1"></a><var>78.1</var>(5) the ability of the proposal to clearly describe (2) the process for recruiting, <br/>
<a id="pl.78.2"></a><var>78.2</var>training, and retraining volunteers; and<br/>
<a id="pl.78.3"></a><var>78.3</var>(6) the inclusion in the proposal of the (3) a plan to promote the project in the <br/>
<a id="pl.78.4"></a><var>78.4</var>designated community, including outreach to persons needing the services.<br/>
<a id="pl.78.5"></a><var>78.5</var>(e) (c) Funds for all projects under this subdivision may be used to:<br/>
<a id="pl.78.6"></a><var>78.6</var>(1) hire a coordinator to develop a coordinated network of volunteer and paid respite <br/>
<a id="pl.78.7"></a><var>78.7</var>care services and assign workers to clients;<br/>
<a id="pl.78.8"></a><var>78.8</var>(2) recruit and train volunteer providers;<br/>
<a id="pl.78.9"></a><var>78.9</var>(3) train provide information, training, and education to caregivers;<br/>
<a id="pl.78.10"></a><var>78.10</var>(4) ensure the development of support groups for caregivers;<br/>
<a id="pl.78.11"></a><var>78.11</var>(5) (4) advertise the availability of the caregiver support and respite care project; and<br/>
<a id="pl.78.12"></a><var>78.12</var>(6) (5) purchase equipment to maintain a system of assigning workers to clients.<br/>
<a id="pl.78.13"></a><var>78.13</var>(f) (d) Project funds may not be used to supplant existing funding sources.<br/>
<br/>
<a id="bill.2.31.0"></a><a id="pl.78.14"></a><var>78.14</var>    Sec. 31. Minnesota Statutes 2012, section 256B.0917, is amended by adding a <br/>
<a id="pl.78.15"></a><var>78.15</var>subdivision to read:<br/>
<a id="pl.78.16"></a><var>78.16</var>    Subd. 7a. <b>Core home and community-based services.</b> The commissioner shall <br/>
<a id="pl.78.17"></a><var>78.17</var>select and contract with core home and community-based services providers for projects <br/>
<a id="pl.78.18"></a><var>78.18</var>to provide services and supports to older adults both with and without family and other <br/>
<a id="pl.78.19"></a><var>78.19</var>informal caregivers using a request for proposals process. Projects must:<br/>
<a id="pl.78.20"></a><var>78.20</var>(1) have a credible, public, or private nonprofit sponsor providing ongoing financial <br/>
<a id="pl.78.21"></a><var>78.21</var>support;<br/>
<a id="pl.78.22"></a><var>78.22</var>(2) have a specific, clearly defined geographic service area;<br/>
<a id="pl.78.23"></a><var>78.23</var>(3) use a practice framework designed to identify high-risk older adults and help them <br/>
<a id="pl.78.24"></a><var>78.24</var>take action to better manage their chronic conditions and maintain their community living;<br/>
<a id="pl.78.25"></a><var>78.25</var>(4) have a team approach to coordination and care, ensuring that the older adult <br/>
<a id="pl.78.26"></a><var>78.26</var>participants, their families, and the formal and informal providers are all part of planning <br/>
<a id="pl.78.27"></a><var>78.27</var>and providing services;<br/>
<a id="pl.78.28"></a><var>78.28</var>(5) provide information, support services, homemaking services, counseling, and <br/>
<a id="pl.78.29"></a><var>78.29</var>training for the older adults and family caregivers;<br/>
<a id="pl.78.30"></a><var>78.30</var>(6) encourage service area or neighborhood residents and local organizations to <br/>
<a id="pl.78.31"></a><var>78.31</var>collaborate in meeting the needs of older adults in their geographic service areas;<br/>
<a id="pl.78.32"></a><var>78.32</var>(7) recruit, train, and direct the use of volunteers to provide informal services and <br/>
<a id="pl.78.33"></a><var>78.33</var>other appropriate support to older adults and their caregivers; and<br/>
<a id="pl.78.34"></a><var>78.34</var>(8) provide coordination and management of formal and informal services to older <br/>
<a id="pl.78.35"></a><var>78.35</var>adults and their families using less expensive alternatives.<br/>
<br/>
<a id="bill.2.32.0"></a><a id="pl.79.1"></a><var>79.1</var>    Sec. 32. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to <br/>
<a id="pl.79.2"></a><var>79.2</var>read:<br/>
<a id="pl.79.3"></a><var>79.3</var>    Subd. 13. <b>Community service grants.</b> The commissioner shall award contracts <br/>
<a id="pl.79.4"></a><var>79.4</var>for grants to public and private nonprofit agencies to establish services that strengthen <br/>
<a id="pl.79.5"></a><var>79.5</var>a community's ability to provide a system of home and community-based services <br/>
<a id="pl.79.6"></a><var>79.6</var>for elderly persons. The commissioner shall use a request for proposal process. The <br/>
<a id="pl.79.7"></a><var>79.7</var>commissioner shall give preference when awarding grants under this section to areas <br/>
<a id="pl.79.8"></a><var>79.8</var>where nursing facility closures have occurred or are occurring or to areas with service <br/>
<a id="pl.79.9"></a><var>79.9</var>needs identified under section 144A.351. The commissioner shall consider grants for:<br/>
<a id="pl.79.10"></a><var>79.10</var>(1) caregiver support and respite care projects under subdivision 6;<br/>
<a id="pl.79.11"></a><var>79.11</var>(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and<br/>
<a id="pl.79.12"></a><var>79.12</var>(3) services identified as needed for community transition.<br/>
<br/>
<a id="bill.2.33.0"></a><a id="pl.79.13"></a><var>79.13</var>    Sec. 33. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:<br/>
<a id="pl.79.14"></a><var>79.14</var>    Subdivision 1. <b>Development and implementation of quality profiles.</b> (a) The <br/>
<a id="pl.79.15"></a><var>79.15</var>commissioner of human services, in cooperation with the commissioner of health, <br/>
<a id="pl.79.16"></a><var>79.16</var>shall develop and implement a quality profile system profiles for nursing facilities and, <br/>
<a id="pl.79.17"></a><var>79.17</var>beginning not later than July 1, 2004 2014, other providers of long-term care services, <br/>
<a id="pl.79.18"></a><var>79.18</var>except when the quality profile system would duplicate requirements under section <br/>
<statute_ref><a id="pl.79.19"></a><var>79.19</var>256B.5011
         </statute_ref>, 
         <statute_ref>256B.5012</statute_ref>, or 
         <statute_ref>256B.5013</statute_ref>. The system quality profiles  must be developed <br/>
<a id="pl.79.20"></a><var>79.20</var>and implemented to the extent possible without the collection of significant amounts of <br/>
<a id="pl.79.21"></a><var>79.21</var>new data. To the extent possible, the system using existing data sets maintained by the <br/>
<a id="pl.79.22"></a><var>79.22</var>commissioners of health and human services to the extent possible. The profiles  must <br/>
<a id="pl.79.23"></a><var>79.23</var>incorporate or be coordinated with information on quality maintained by area agencies on <br/>
<a id="pl.79.24"></a><var>79.24</var>aging, long-term care trade associations, the ombudsman offices, counties, tribes, health <br/>
<a id="pl.79.25"></a><var>79.25</var>plans, and other entities and the long-term care database maintained under section 256.975, <br/>
<a id="pl.79.26"></a><var>79.26</var>subdivision 7. The system profiles must be designed to provide information on quality to:<br/>
<a id="pl.79.27"></a><var>79.27</var>(1) consumers and their families to facilitate informed choices of service providers;<br/>
<a id="pl.79.28"></a><var>79.28</var>(2) providers to enable them to measure the results of their quality improvement <br/>
<a id="pl.79.29"></a><var>79.29</var>efforts and compare quality achievements with other service providers; and<br/>
<a id="pl.79.30"></a><var>79.30</var>(3) public and private purchasers of long-term care services to enable them to <br/>
<a id="pl.79.31"></a><var>79.31</var>purchase high-quality care.<br/>
<a id="pl.79.32"></a><var>79.32</var>(b) The system profiles must be developed in consultation with the long-term care <br/>
<a id="pl.79.33"></a><var>79.33</var>task force, area agencies on aging, and representatives of consumers, providers, and labor <br/>
<a id="pl.79.34"></a><var>79.34</var>unions. Within the limits of available appropriations, the commissioners may employ <br/>
<a id="pl.79.35"></a><var>79.35</var>consultants to assist with this project.<br/>
<br/>
<a id="bill.2.34.0"></a><a id="pl.80.1"></a><var>80.1</var>    Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:<br/>
<a id="pl.80.2"></a><var>80.2</var>    Subd. 2. <b>Quality measurement tools.</b> The commissioners shall identify and apply <br/>
<a id="pl.80.3"></a><var>80.3</var>existing quality measurement tools to:<br/>
<a id="pl.80.4"></a><var>80.4</var>(1) emphasize quality of care and its relationship to quality of life; and<br/>
<a id="pl.80.5"></a><var>80.5</var>(2) address the needs of various users of long-term care services, including, but not <br/>
<a id="pl.80.6"></a><var>80.6</var>limited to, short-stay residents, persons with behavioral problems, persons with dementia, <br/>
<a id="pl.80.7"></a><var>80.7</var>and persons who are members of minority groups.<br/>
<a id="pl.80.8"></a><var>80.8</var>    The tools must be identified and applied, to the extent possible, without requiring <br/>
<a id="pl.80.9"></a><var>80.9</var>providers to supply information beyond current state and federal requirements.<br/>
<br/>
<a id="bill.2.35.0"></a><a id="pl.80.10"></a><var>80.10</var>    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:<br/>
<a id="pl.80.11"></a><var>80.11</var>    Subd. 3. <b>Consumer surveys</b><b> of nursing facilities residents</b><b>.</b> Following <br/>
<a id="pl.80.12"></a><var>80.12</var>identification of the quality measurement tool, the commissioners shall conduct surveys <br/>
<a id="pl.80.13"></a><var>80.13</var>of long-term care service consumers of nursing facilities to develop quality profiles <br/>
<a id="pl.80.14"></a><var>80.14</var>of providers. To the extent possible, surveys must be conducted face-to-face by state <br/>
<a id="pl.80.15"></a><var>80.15</var>employees or contractors. At the discretion of the commissioners, surveys may be <br/>
<a id="pl.80.16"></a><var>80.16</var>conducted by telephone or by provider staff. Surveys must be conducted periodically to <br/>
<a id="pl.80.17"></a><var>80.17</var>update quality profiles of individual service nursing facilities providers.<br/>
<br/>
<a id="bill.2.36.0"></a><a id="pl.80.18"></a><var>80.18</var>    Sec. 36. Minnesota Statutes 2012, section 256B.439, is amended by adding a <br/>
<a id="pl.80.19"></a><var>80.19</var>subdivision to read:<br/>
<a id="pl.80.20"></a><var>80.20</var>    Subd. 3a. <b>Home and community-based services report card in cooperation with </b><br/>
<a id="pl.80.21"></a><var>80.21</var><b>the commissioner of health.</b> The commissioner shall work with existing Department <br/>
<a id="pl.80.22"></a><var>80.22</var>of Human Services advisory groups to develop recommendations for a home and <br/>
<a id="pl.80.23"></a><var>80.23</var>community-based services report card. Health and human services staff that regulate <br/>
<a id="pl.80.24"></a><var>80.24</var>home and community-based services as provided in chapter 245D and licensed home care <br/>
<a id="pl.80.25"></a><var>80.25</var>as provided in chapter 144A shall be consulted. The advisory groups shall consider the <br/>
<a id="pl.80.26"></a><var>80.26</var>requirements from the Minnesota consumer information guide under section 144G.06 as a <br/>
<a id="pl.80.27"></a><var>80.27</var>base for development of the home and community-based services report card to compare <br/>
<a id="pl.80.28"></a><var>80.28</var>the housing options available to consumers. Other items to be considered by the advisory <br/>
<a id="pl.80.29"></a><var>80.29</var>groups in developing recommendations include:<br/>
<a id="pl.80.30"></a><var>80.30</var>(1) defining the goals of the report card, including measuring outcomes, providing <br/>
<a id="pl.80.31"></a><var>80.31</var>consumer information, and defining vehicle-for-pay performance;<br/>
<a id="pl.80.32"></a><var>80.32</var>(2) developing separate measures for programs for the elderly population and for <br/>
<a id="pl.80.33"></a><var>80.33</var>persons with disabilities;<br/>
<a id="pl.80.34"></a><var>80.34</var>(3) the sources of information needed that are standardized and contain sufficient data;<br/>
<a id="pl.81.1"></a><var>81.1</var>(4) the financial support needed for creating and publicizing the housing information <br/>
<a id="pl.81.2"></a><var>81.2</var>guide, and ongoing funding for data collection and staffing to monitor, report, and analyze;<br/>
<a id="pl.81.3"></a><var>81.3</var>(5) a recognition that home and community-based services settings exist with <br/>
<a id="pl.81.4"></a><var>81.4</var>significant variations in size, settings, and services available;<br/>
<a id="pl.81.5"></a><var>81.5</var>(6) ensuring that consumer choice and consumer information is retained and valued; <br/>
<a id="pl.81.6"></a><var>81.6</var>and<br/>
<a id="pl.81.7"></a><var>81.7</var>(7) the applicability of these measures to providers based on payor source, size, and <br/>
<a id="pl.81.8"></a><var>81.8</var>population served.<br/>
<a id="pl.81.9"></a><var>81.9</var>The advisory groups shall discuss whether there are additional funding, resources, <br/>
<a id="pl.81.10"></a><var>81.10</var>and research needed. The commissioner shall report recommendations to the chairs and <br/>
<a id="pl.81.11"></a><var>81.11</var>ranking minority members of the legislative committees and divisions with jurisdiction <br/>
<a id="pl.81.12"></a><var>81.12</var>over health and human services issues by August 1, 2014. The report card shall be <br/>
<a id="pl.81.13"></a><var>81.13</var>available on July 1, 2015.<br/>
<br/>
<a id="bill.2.37.0"></a><a id="pl.81.14"></a><var>81.14</var>    Sec. 37. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:<br/>
<a id="pl.81.15"></a><var>81.15</var>    Subd. 4. <b>Dissemination of quality profiles.</b> By July 1, 2003 2014, the <br/>
<a id="pl.81.16"></a><var>81.16</var>commissioners shall implement a system public awareness effort to disseminate the quality <br/>
<a id="pl.81.17"></a><var>81.17</var>profiles developed from consumer surveys using the quality measurement tool. Profiles <br/>
<a id="pl.81.18"></a><var>81.18</var>may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and <br/>
<a id="pl.81.19"></a><var>81.19</var>to consumers, providers, and purchasers of long-term care services through all feasible <br/>
<a id="pl.81.20"></a><var>81.20</var>printed and electronic outlets. The commissioners may conduct a public awareness <br/>
<a id="pl.81.21"></a><var>81.21</var>campaign to inform potential users regarding profile contents and potential uses.<br/>
<br/>
<a id="bill.2.38.0"></a><a id="pl.81.22"></a><var>81.22</var>    Sec. 38. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:<br/>
<a id="pl.81.23"></a><var>81.23</var>    Subd. 13. <b>External fixed costs.</b> "External fixed costs" means costs related to the <br/>
<a id="pl.81.24"></a><var>81.24</var>nursing home surcharge under section 
         <statute_ref>256.9657, subdivision 1</statute_ref>; licensure fees under <br/>
<a id="pl.81.25"></a><var>81.25</var>section 
         <statute_ref>144.122</statute_ref>; until September 30, 2013, long-term care consultation fees under <br/>
<a id="pl.81.26"></a><var>81.26</var>section 
         <statute_ref>256B.0911, subdivision 6</statute_ref>; family advisory council fee under section 
         <statute_ref>144A.33</statute_ref>; <br/>
<a id="pl.81.27"></a><var>81.27</var>scholarships under section 
         <statute_ref>256B.431, subdivision 36</statute_ref>; planned closure rate adjustments <br/>
<a id="pl.81.28"></a><var>81.28</var>under section 
         <statute_ref>256B.437</statute_ref>; or single bed room incentives under section 
         <statute_ref>256B.431, <br/>
<a id="pl.81.29"></a><var>81.29</var>subdivision 42
         </statute_ref>; property taxes and property insurance; and PERA.<br/>
<br/>
<a id="bill.2.39.0"></a><a id="pl.81.30"></a><var>81.30</var>    Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:<br/>
<a id="pl.81.31"></a><var>81.31</var>    Subd. 53. <b>Calculation of payment rate for external fixed costs.</b> The commissioner <br/>
<a id="pl.81.32"></a><var>81.32</var>shall calculate a payment rate for external fixed costs.<br/>
<a id="pl.82.1"></a><var>82.1</var>    (a) For a facility licensed as a nursing home, the portion related to section 
         <statute_ref>256.9657 <br/>
</statute_ref><a id="pl.82.2"></a><var>82.2</var>shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care <br/>
<a id="pl.82.3"></a><var>82.3</var>home, the portion related to section 
         <statute_ref>256.9657</statute_ref> shall be equal to $8.86 multiplied by the <br/>
<a id="pl.82.4"></a><var>82.4</var>result of its number of nursing home beds divided by its total number of licensed beds.<br/>
<a id="pl.82.5"></a><var>82.5</var>    (b) The portion related to the licensure fee under section 
         <statute_ref>144.122</statute_ref>, paragraph (d), <br/>
<a id="pl.82.6"></a><var>82.6</var>shall be the amount of the fee divided by actual resident days.<br/>
<a id="pl.82.7"></a><var>82.7</var>    (c) The portion related to scholarships shall be determined under section 
         <statute_ref>256B.431</statute_ref>, <br/>
<a id="pl.82.8"></a><var>82.8</var>subdivision 36.<br/>
<a id="pl.82.9"></a><var>82.9</var>    (d)  Until September 30, 2013, the portion related to long-term care consultation shall <br/>
<a id="pl.82.10"></a><var>82.10</var>be determined according to section 
         <statute_ref>256B.0911, subdivision 6</statute_ref>.<br/>
<a id="pl.82.11"></a><var>82.11</var>    (e) The portion related to development and education of resident and family advisory <br/>
<a id="pl.82.12"></a><var>82.12</var>councils under section 
         <statute_ref>144A.33</statute_ref> shall be $5 divided by 365.<br/>
<a id="pl.82.13"></a><var>82.13</var>    (f) The portion related to planned closure rate adjustments shall be as determined <br/>
<a id="pl.82.14"></a><var>82.14</var>under section 
         <statute_ref>256B.437, subdivision 6</statute_ref>, and Minnesota Statutes 2010, section 
         <statute_ref>256B.436</statute_ref>. <br/>
<a id="pl.82.15"></a><var>82.15</var>Planned closure rate adjustments that take effect before October 1, 2014, shall no longer <br/>
<a id="pl.82.16"></a><var>82.16</var>be included in the payment rate for external fixed costs beginning October 1, 2016. <br/>
<a id="pl.82.17"></a><var>82.17</var>Planned closure rate adjustments that take effect on or after October 1, 2014, shall no <br/>
<a id="pl.82.18"></a><var>82.18</var>longer be included in the payment rate for external fixed costs beginning on October 1 of <br/>
<a id="pl.82.19"></a><var>82.19</var>the first year not less than two years after their effective date.<br/>
<a id="pl.82.20"></a><var>82.20</var>    (g) The portions related to property insurance, real estate taxes, special assessments, <br/>
<a id="pl.82.21"></a><var>82.21</var>and payments made in lieu of real estate taxes directly identified or allocated to the nursing <br/>
<a id="pl.82.22"></a><var>82.22</var>facility shall be the actual amounts divided by actual resident days.<br/>
<a id="pl.82.23"></a><var>82.23</var>    (h) The portion related to the Public Employees Retirement Association shall be <br/>
<a id="pl.82.24"></a><var>82.24</var>actual costs divided by resident days.<br/>
<a id="pl.82.25"></a><var>82.25</var>    (i) The single bed room incentives shall be as determined under section 
         <statute_ref>256B.431</statute_ref>, <br/>
<a id="pl.82.26"></a><var>82.26</var>subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall <br/>
<a id="pl.82.27"></a><var>82.27</var>no longer be included in the payment rate for external fixed costs beginning October 1, <br/>
<a id="pl.82.28"></a><var>82.28</var>2016. Single bed room incentives that take effect on or after October 1, 2014, shall no <br/>
<a id="pl.82.29"></a><var>82.29</var>longer be included in the payment rate for external fixed costs beginning on October 1 of <br/>
<a id="pl.82.30"></a><var>82.30</var>the first year not less than two years after their effective date.<br/>
<a id="pl.82.31"></a><var>82.31</var>    (j) The payment rate for external fixed costs shall be the sum of the amounts in <br/>
<a id="pl.82.32"></a><var>82.32</var>paragraphs (a) to (i).<br/>
<br/>
<a id="bill.2.40.0"></a><a id="pl.82.33"></a><var>82.33</var>    Sec. 40. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:<br/>
<a id="pl.82.34"></a><var>82.34</var>    Subd. 12. <b>Informed choice.</b> Persons who are determined likely to require the level <br/>
<a id="pl.82.35"></a><var>82.35</var>of care provided in a nursing facility as determined under section 256B.0911, subdivision <br/>
<a id="pl.83.1"></a><var>83.1</var>4e, or a hospital shall be informed of the home and community-based support alternatives <br/>
<a id="pl.83.2"></a><var>83.2</var>to the provision of inpatient hospital services or nursing facility services. Each person <br/>
<a id="pl.83.3"></a><var>83.3</var>must be given the choice of either institutional or home and community-based services <br/>
<a id="pl.83.4"></a><var>83.4</var>using the provisions described in section 
         <statute_ref>256B.77, subdivision 2</statute_ref>, paragraph (p).<br/>
<br/>
<a id="bill.2.41.0"></a><a id="pl.83.5"></a><var>83.5</var>    Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:<br/>
<a id="pl.83.6"></a><var>83.6</var>    Subd. 14. <b>Assessment and reassessment.</b> (a) Assessments and reassessments <br/>
<a id="pl.83.7"></a><var>83.7</var>shall be conducted by certified assessors according to section 256B.0911, subdivision 2b. <br/>
<a id="pl.83.8"></a><var>83.8</var>With the permission of the recipient or the recipient's designated legal representative, <br/>
<a id="pl.83.9"></a><var>83.9</var>the recipient's current provider of services may submit a written report outlining their <br/>
<a id="pl.83.10"></a><var>83.10</var>recommendations regarding the recipient's care needs prepared by a direct service <br/>
<a id="pl.83.11"></a><var>83.11</var>employee with at least 20 hours of service to that client. The person conducting the <br/>
<a id="pl.83.12"></a><var>83.12</var>assessment or reassessment must notify the provider of the date by which this information <br/>
<a id="pl.83.13"></a><var>83.13</var>is to be submitted. This information shall be provided to the person conducting the <br/>
<a id="pl.83.14"></a><var>83.14</var>assessment and the person or the person's legal representative and must be considered <br/>
<a id="pl.83.15"></a><var>83.15</var>prior to the finalization of the assessment or reassessment.<br/>
<a id="pl.83.16"></a><var>83.16</var>(b) There must be a determination that the client requires a hospital level of care or a <br/>
<a id="pl.83.17"></a><var>83.17</var>nursing facility level of care as defined in section 
         <statute_ref>256B.0911</statute_ref>, subdivision 4a, paragraph <br/>
<a id="pl.83.18"></a><var>83.18</var>(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the <br/>
<a id="pl.83.19"></a><var>83.19</var>waiver program.<br/>
<a id="pl.83.20"></a><var>83.20</var>(c) Regardless of other assessments identified in section 
         <statute_ref>144.0724, subdivision 4</statute_ref>, as <br/>
<a id="pl.83.21"></a><var>83.21</var>appropriate to determine nursing facility level of care for purposes of medical assistance <br/>
<a id="pl.83.22"></a><var>83.22</var>payment for nursing facility services, only face-to-face assessments conducted according <br/>
<a id="pl.83.23"></a><var>83.23</var>to section 
         <statute_ref>256B.0911, subdivisions 3a</statute_ref>, 3b, and 4d, that result in a hospital level of care <br/>
<a id="pl.83.24"></a><var>83.24</var>determination or a nursing facility level of care determination must be accepted for <br/>
<a id="pl.83.25"></a><var>83.25</var>purposes of initial and ongoing access to waiver services payment.<br/>
<a id="pl.83.26"></a><var>83.26</var>(d) Recipients who are found eligible for home and community-based services under <br/>
<a id="pl.83.27"></a><var>83.27</var>this section before their 65th birthday may remain eligible for these services after their <br/>
<a id="pl.83.28"></a><var>83.28</var>65th birthday if they continue to meet all other eligibility factors.<br/>
<a id="pl.83.29"></a><var>83.29</var>(e) The commissioner shall develop criteria to identify recipients whose level of <br/>
<a id="pl.83.30"></a><var>83.30</var>functioning is reasonably expected to improve and reassess these recipients to establish <br/>
<a id="pl.83.31"></a><var>83.31</var>a baseline assessment. Recipients who meet these criteria must have a comprehensive <br/>
<a id="pl.83.32"></a><var>83.32</var>transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be <br/>
<a id="pl.83.33"></a><var>83.33</var>reassessed every six months until there has been no significant change in the recipient's <br/>
<a id="pl.83.34"></a><var>83.34</var>functioning for at least 12 months. After there has been no significant change in the <br/>
<a id="pl.83.35"></a><var>83.35</var>recipient's functioning for at least 12 months, reassessments of the recipient's strengths, <br/>
<a id="pl.84.1"></a><var>84.1</var>informal support systems, and need for services shall be conducted at least every 12 <br/>
<a id="pl.84.2"></a><var>84.2</var>months and at other times when there has been a significant change in the recipient's <br/>
<a id="pl.84.3"></a><var>84.3</var>functioning. Counties, case managers, and service providers are responsible for <br/>
<a id="pl.84.4"></a><var>84.4</var>conducting these reassessments and shall complete the reassessments out of existing funds.<br/>
<br/>
<a id="bill.2.42.0"></a><a id="pl.84.5"></a><var>84.5</var>    Sec. 42. <b>[256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.</b><br/>
<a id="pl.84.6"></a><var>84.6</var>    Subdivision 1. <b>Basis and scope.</b> (a) Upon federal approval, the commissioner <br/>
<a id="pl.84.7"></a><var>84.7</var>shall establish a medical assistance state plan option for the provision of home and <br/>
<a id="pl.84.8"></a><var>84.8</var>community-based personal assistance service and supports called "community first <br/>
<a id="pl.84.9"></a><var>84.9</var>services and supports (CFSS)."<br/>
<a id="pl.84.10"></a><var>84.10</var>(b) CFSS is a participant-controlled method of selecting and providing services <br/>
<a id="pl.84.11"></a><var>84.11</var>and supports that allows the participant maximum control of the services and supports. <br/>
<a id="pl.84.12"></a><var>84.12</var>Participants may choose the degree to which they direct and manage their supports by <br/>
<a id="pl.84.13"></a><var>84.13</var>choosing to have a significant and meaningful role in the management of services and <br/>
<a id="pl.84.14"></a><var>84.14</var>supports including by directly employing support workers with the necessary supports <br/>
<a id="pl.84.15"></a><var>84.15</var>to perform that function.<br/>
<a id="pl.84.16"></a><var>84.16</var>(c) CFSS is available statewide to eligible individuals to assist with accomplishing <br/>
<a id="pl.84.17"></a><var>84.17</var>activities of daily living (ADLs), instrumental activities of daily living (IADLs), and <br/>
<a id="pl.84.18"></a><var>84.18</var>health-related procedures and tasks through hands-on assistance to accomplish the task <br/>
<a id="pl.84.19"></a><var>84.19</var>or constant supervision and cueing to accomplish the task; and to assist with acquiring, <br/>
<a id="pl.84.20"></a><var>84.20</var>maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and <br/>
<a id="pl.84.21"></a><var>84.21</var>health-related procedures and tasks. CFSS allows payment for certain supports and goods <br/>
<a id="pl.84.22"></a><var>84.22</var>such as environmental modifications and technology that are intended to replace or <br/>
<a id="pl.84.23"></a><var>84.23</var>decrease the need for human assistance.<br/>
<a id="pl.84.24"></a><var>84.24</var>(d) Upon federal approval, CFSS will replace the personal care assistance program <br/>
<a id="pl.84.25"></a><var>84.25</var>under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.<br/>
<a id="pl.84.26"></a><var>84.26</var>    Subd. 2. <b>Definitions.</b> (a) For the purposes of this section, the terms defined in <br/>
<a id="pl.84.27"></a><var>84.27</var>this subdivision have the meanings given.<br/>
<a id="pl.84.28"></a><var>84.28</var>(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, <br/>
<a id="pl.84.29"></a><var>84.29</var>dressing, bathing, mobility, positioning, and transferring.<br/>
<a id="pl.84.30"></a><var>84.30</var>(c) "Agency-provider model" means a method of CFSS under which a qualified <br/>
<a id="pl.84.31"></a><var>84.31</var>agency provides services and supports through the agency's own employees and policies. <br/>
<a id="pl.84.32"></a><var>84.32</var>The agency must allow the participant to have a significant role in the selection and <br/>
<a id="pl.84.33"></a><var>84.33</var>dismissal of support workers of their choice for the delivery of their specific services <br/>
<a id="pl.84.34"></a><var>84.34</var>and supports.<br/>
<a id="pl.85.1"></a><var>85.1</var>(d) "Behavior" means a description of a need for services and supports used to <br/>
<a id="pl.85.2"></a><var>85.2</var>determine the home care rating and additional service units. The presence of Level I <br/>
<a id="pl.85.3"></a><var>85.3</var>behavior is used to determine the home care rating. "Level I behavior" means physical <br/>
<a id="pl.85.4"></a><var>85.4</var>aggression towards self or others or destruction of property that requires the immediate <br/>
<a id="pl.85.5"></a><var>85.5</var>response of another person. If qualified for a home care rating as described in subdivision <br/>
<a id="pl.85.6"></a><var>85.6</var>8, additional service units can be added as described in subdivision 8, paragraph (f), for <br/>
<a id="pl.85.7"></a><var>85.7</var>the following behaviors:<br/>
<a id="pl.85.8"></a><var>85.8</var>(1) Level I behavior;<br/>
<a id="pl.85.9"></a><var>85.9</var>(2) increased vulnerability due to cognitive deficits or socially inappropriate <br/>
<a id="pl.85.10"></a><var>85.10</var>behavior; or<br/>
<a id="pl.85.11"></a><var>85.11</var>(3) increased need for assistance for recipients who are verbally aggressive or <br/>
<a id="pl.85.12"></a><var>85.12</var>resistive to care so that time needed to perform activities of daily living is increased.<br/>
<a id="pl.85.13"></a><var>85.13</var>(e) "Complex health-related needs" means an intervention listed in clauses (1) to <br/>
<a id="pl.85.14"></a><var>85.14</var>(8) that has been ordered by a physician, and is specified in a community support plan, <br/>
<a id="pl.85.15"></a><var>85.15</var>including:<br/>
<a id="pl.85.16"></a><var>85.16</var>(1) tube feedings requiring:<br/>
<a id="pl.85.17"></a><var>85.17</var>(i) a gastrojejunostomy tube; or<br/>
<a id="pl.85.18"></a><var>85.18</var>(ii) continuous tube feeding lasting longer than 12 hours per day;<br/>
<a id="pl.85.19"></a><var>85.19</var>(2) wounds described as:<br/>
<a id="pl.85.20"></a><var>85.20</var>(i) stage III or stage IV; <br/>
<a id="pl.85.21"></a><var>85.21</var>(ii) multiple wounds;<br/>
<a id="pl.85.22"></a><var>85.22</var>(iii) requiring sterile or clean dressing changes or a wound vac; or<br/>
<a id="pl.85.23"></a><var>85.23</var>(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require <br/>
<a id="pl.85.24"></a><var>85.24</var>specialized  care;<br/>
<a id="pl.85.25"></a><var>85.25</var>(3) parenteral therapy described as:<br/>
<a id="pl.85.26"></a><var>85.26</var>(i) IV therapy more than two times per week lasting longer than four hours for <br/>
<a id="pl.85.27"></a><var>85.27</var>each  treatment; or<br/>
<a id="pl.85.28"></a><var>85.28</var>(ii) total parenteral nutrition (TPN) daily; <br/>
<a id="pl.85.29"></a><var>85.29</var>(4) respiratory interventions, including:<br/>
<a id="pl.85.30"></a><var>85.30</var>(i) oxygen required more than eight hours per day;<br/>
<a id="pl.85.31"></a><var>85.31</var>(ii) respiratory vest more than one time per day;  <br/>
<a id="pl.85.32"></a><var>85.32</var>(iii) bronchial drainage treatments more than two times per day;<br/>
<a id="pl.85.33"></a><var>85.33</var>(iv) sterile or clean suctioning more than six times per day;<br/>
<a id="pl.85.34"></a><var>85.34</var>(v) dependence on another to apply respiratory ventilation augmentation devices <br/>
<a id="pl.85.35"></a><var>85.35</var>such as  BiPAP and CPAP; and<br/>
<a id="pl.85.36"></a><var>85.36</var>(vi) ventilator dependence under section 256B.0652;<br/>
<a id="pl.86.1"></a><var>86.1</var>(5) insertion and maintenance of catheter, including: <br/>
<a id="pl.86.2"></a><var>86.2</var>(i) sterile catheter changes more than one time per month;<br/>
<a id="pl.86.3"></a><var>86.3</var>(ii) clean intermittent catheterization, and including self-catheterization more than <br/>
<a id="pl.86.4"></a><var>86.4</var>six times  per day; or<br/>
<a id="pl.86.5"></a><var>86.5</var>(iii) bladder irrigations;<br/>
<a id="pl.86.6"></a><var>86.6</var>(6) bowel program more than two times per week requiring more than 30 minutes to <br/>
<a id="pl.86.7"></a><var>86.7</var>perform  each time;<br/>
<a id="pl.86.8"></a><var>86.8</var>(7) neurological intervention, including: <br/>
<a id="pl.86.9"></a><var>86.9</var>(i) seizures more than two times per week and requiring significant physical <br/>
<a id="pl.86.10"></a><var>86.10</var>assistance  to maintain safety; or<br/>
<a id="pl.86.11"></a><var>86.11</var>(ii) swallowing disorders diagnosed by a physician and requiring specialized <br/>
<a id="pl.86.12"></a><var>86.12</var>assistance  from another on a daily basis; and<br/>
<a id="pl.86.13"></a><var>86.13</var>(8) other congenital or acquired diseases creating a need for significantly increased <br/>
<a id="pl.86.14"></a><var>86.14</var>direct  hands-on assistance and interventions in six to eight activities of daily living.<br/>
<a id="pl.86.15"></a><var>86.15</var>(f) "Community first services and supports" or "CFSS" means the assistance and <br/>
<a id="pl.86.16"></a><var>86.16</var>supports program under this section needed for accomplishing activities of daily living, <br/>
<a id="pl.86.17"></a><var>86.17</var>instrumental activities of daily living, and health-related tasks through hands-on assistance <br/>
<a id="pl.86.18"></a><var>86.18</var>to complete the task or supervision and cueing to complete the task, or the purchase of <br/>
<a id="pl.86.19"></a><var>86.19</var>goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for <br/>
<a id="pl.86.20"></a><var>86.20</var>human assistance.<br/>
<a id="pl.86.21"></a><var>86.21</var>(g) "Community first services and supports service delivery plan" or "service delivery <br/>
<a id="pl.86.22"></a><var>86.22</var>plan" means a written summary of the services and supports, that is based on the community <br/>
<a id="pl.86.23"></a><var>86.23</var>support plan identified in section 256B.0911 and coordinated services and support plan <br/>
<a id="pl.86.24"></a><var>86.24</var>and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined <br/>
<a id="pl.86.25"></a><var>86.25</var>by the participant to meet the assessed needs, using a person-centered planning process.<br/>
<a id="pl.86.26"></a><var>86.26</var>(h) "Critical activities of daily living" means transferring, mobility, eating, and <br/>
<a id="pl.86.27"></a><var>86.27</var>toileting.<br/>
<a id="pl.86.28"></a><var>86.28</var>(i) "Dependency" in activities of daily living means a person requires hands-on <br/>
<a id="pl.86.29"></a><var>86.29</var>assistance or constant supervision and cueing to accomplish  one or more of the activities <br/>
<a id="pl.86.30"></a><var>86.30</var>of daily living every day or on the days during the week that the activity is performed; <br/>
<a id="pl.86.31"></a><var>86.31</var>however, a child may not be found to be dependent in an activity of daily living if, <br/>
<a id="pl.86.32"></a><var>86.32</var>because of the child's age, an adult would either perform the activity for the child or assist <br/>
<a id="pl.86.33"></a><var>86.33</var>the child with the activity. Assistance needed is the assistance appropriate for a typical <br/>
<a id="pl.86.34"></a><var>86.34</var>child of the same age.<br/>
<a id="pl.86.35"></a><var>86.35</var>(j) "Extended CFSS" means CFSS services and supports under the agency–provider <br/>
<a id="pl.86.36"></a><var>86.36</var>model included in a service plan through one of the home and community-based services <br/>
<a id="pl.87.1"></a><var>87.1</var>waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49, <br/>
<a id="pl.87.2"></a><var>87.2</var>which exceed the amount, duration, and frequency of the state plan CFSS services for <br/>
<a id="pl.87.3"></a><var>87.3</var>participants.<br/>
<a id="pl.87.4"></a><var>87.4</var>(k) "Financial management services contractor or vendor" means a qualified <br/>
<a id="pl.87.5"></a><var>87.5</var>organization having a written contract with the department to provide services necessary to <br/>
<a id="pl.87.6"></a><var>87.6</var>use the budget model under subdivision 13, that include but are not limited to: participant <br/>
<a id="pl.87.7"></a><var>87.7</var>education and technical assistance; CFSS service delivery planning and budgeting; billing, <br/>
<a id="pl.87.8"></a><var>87.8</var>making payments, and monitoring of spending; and assisting the participant in fulfilling <br/>
<a id="pl.87.9"></a><var>87.9</var>employer-related requirements in accordance with Section 3504 of the IRS code and <br/>
<a id="pl.87.10"></a><var>87.10</var>the IRS Revenue Procedure 70-6.<br/>
<a id="pl.87.11"></a><var>87.11</var>(l) "Budget model" means a service delivery method of CFSS that uses an <br/>
<a id="pl.87.12"></a><var>87.12</var>individualized CFSS service delivery plan and service budget and assistance from the <br/>
<a id="pl.87.13"></a><var>87.13</var>financial management services contractor to facilitate participant employment of support <br/>
<a id="pl.87.14"></a><var>87.14</var>workers and the acquisition of supports and goods.<br/>
<a id="pl.87.15"></a><var>87.15</var>(m) "Health-related procedures and tasks" means procedures and tasks related to <br/>
<a id="pl.87.16"></a><var>87.16</var>the specific needs of an individual that can be delegated or assigned by a state-licensed <br/>
<a id="pl.87.17"></a><var>87.17</var>healthcare or behavioral health professional and performed by a support worker.<br/>
<a id="pl.87.18"></a><var>87.18</var>(n) "Instrumental activities of daily living" means activities related to living <br/>
<a id="pl.87.19"></a><var>87.19</var>independently in the community, including but not limited to: meal planning, preparation, <br/>
<a id="pl.87.20"></a><var>87.20</var>and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning; <br/>
<a id="pl.87.21"></a><var>87.21</var>assistance with medications; managing money; communicating needs, preferences, and <br/>
<a id="pl.87.22"></a><var>87.22</var>activities; arranging supports; and assistance with traveling around and participating <br/>
<a id="pl.87.23"></a><var>87.23</var>in the community.<br/>
<a id="pl.87.24"></a><var>87.24</var>(o) "Legal representative" means parent of a minor, a court-appointed guardian, or <br/>
<a id="pl.87.25"></a><var>87.25</var>another representative with legal authority to make decisions about services and supports <br/>
<a id="pl.87.26"></a><var>87.26</var>for the participant. Other representatives with legal authority to make decisions include <br/>
<a id="pl.87.27"></a><var>87.27</var>but are not limited to a health care agent or an attorney-in-fact authorized through a health <br/>
<a id="pl.87.28"></a><var>87.28</var>care directive or power of attorney.<br/>
<a id="pl.87.29"></a><var>87.29</var>(p) "Medication assistance" means providing verbal or visual reminders to take  <br/>
<a id="pl.87.30"></a><var>87.30</var>regularly scheduled medication, and includes any of the following supports listed in clauses <br/>
<a id="pl.87.31"></a><var>87.31</var>(1) to (3) and other types of assistance, except that a support worker may not determine <br/>
<a id="pl.87.32"></a><var>87.32</var>medication dose or time for medication or inject medications into veins, muscles, or skin:<br/>
<a id="pl.87.33"></a><var>87.33</var>(1) under the direction of the participant or the participant's representative, bringing  <br/>
<a id="pl.87.34"></a><var>87.34</var>medications to the participant including medications given through a nebulizer, opening a  <br/>
<a id="pl.87.35"></a><var>87.35</var>container of previously set-up medications, emptying the container into the participant's  <br/>
<a id="pl.88.1"></a><var>88.1</var>hand, opening and giving the medication in the original container to the participant, or  <br/>
<a id="pl.88.2"></a><var>88.2</var>bringing to the participant liquids or food to accompany the medication;<br/>
<a id="pl.88.3"></a><var>88.3</var>(2) organizing medications as directed by the participant or the participant's  <br/>
<a id="pl.88.4"></a><var>88.4</var>representative; and<br/>
<a id="pl.88.5"></a><var>88.5</var>(3) providing verbal or visual reminders to perform regularly scheduled medications.<br/>
<a id="pl.88.6"></a><var>88.6</var>(q) "Participant's representative" means a parent, family member, advocate, or <br/>
<a id="pl.88.7"></a><var>88.7</var>other adult authorized by the participant to serve as a representative in connection with <br/>
<a id="pl.88.8"></a><var>88.8</var>the provision of CFSS. This authorization must be in writing or by another method <br/>
<a id="pl.88.9"></a><var>88.9</var>that clearly indicates the participant's free choice. The participant's representative must <br/>
<a id="pl.88.10"></a><var>88.10</var>have no financial interest in the provision of any services included in the participant's <br/>
<a id="pl.88.11"></a><var>88.11</var>service delivery plan and must be capable of providing the support necessary to assist <br/>
<a id="pl.88.12"></a><var>88.12</var>the participant in the use of CFSS. If through the assessment process described in <br/>
<a id="pl.88.13"></a><var>88.13</var>subdivision 5 a participant is determined to be in need of a participant's representative, one <br/>
<a id="pl.88.14"></a><var>88.14</var>must be selected. If the participant is unable to assist in the selection of a participant's <br/>
<a id="pl.88.15"></a><var>88.15</var>representative, the legal representative shall appoint one. Two persons may be designated <br/>
<a id="pl.88.16"></a><var>88.16</var>as a participant's representative for reasons such as divided households and court-ordered <br/>
<a id="pl.88.17"></a><var>88.17</var>custodies. Duties of a participant's representatives may include:<br/>
<a id="pl.88.18"></a><var>88.18</var>(1) being available while care is provided in a method agreed upon by the participant <br/>
<a id="pl.88.19"></a><var>88.19</var>or the participant's legal representative and documented in the participant's CFSS service <br/>
<a id="pl.88.20"></a><var>88.20</var>delivery plan;<br/>
<a id="pl.88.21"></a><var>88.21</var>(2) monitoring CFSS services to ensure the participant's CFSS service delivery <br/>
<a id="pl.88.22"></a><var>88.22</var>plan is being followed; and<br/>
<a id="pl.88.23"></a><var>88.23</var>(3) reviewing and signing CFSS time sheets after services are provided to provide <br/>
<a id="pl.88.24"></a><var>88.24</var>verification of the CFSS services.<br/>
<a id="pl.88.25"></a><var>88.25</var>(r) "Person-centered planning process" means a process that is driven by the <br/>
<a id="pl.88.26"></a><var>88.26</var>participant for discovering and planning services and supports that ensures the participant <br/>
<a id="pl.88.27"></a><var>88.27</var>makes informed choices and decisions. The person-centered planning process must:<br/>
<a id="pl.88.28"></a><var>88.28</var>(1) include people chosen by the participant;<br/>
<a id="pl.88.29"></a><var>88.29</var>(2) provide necessary information and support to ensure that the participant directs <br/>
<a id="pl.88.30"></a><var>88.30</var>the process to the maximum extent possible, and is enabled to make informed choices <br/>
<a id="pl.88.31"></a><var>88.31</var>and decisions;<br/>
<a id="pl.88.32"></a><var>88.32</var>(3) be timely and occur at time and locations of convenience to the participant;<br/>
<a id="pl.88.33"></a><var>88.33</var>(4) reflect cultural considerations of the participant;<br/>
<a id="pl.88.34"></a><var>88.34</var>(5) include strategies for solving conflict or disagreement within the process, <br/>
<a id="pl.88.35"></a><var>88.35</var>including clear conflict-of-interest guidelines for all planning;<br/>
<a id="pl.89.1"></a><var>89.1</var>(6) offer choices to the participant regarding the services and supports they receive <br/>
<a id="pl.89.2"></a><var>89.2</var>and from whom;<br/>
<a id="pl.89.3"></a><var>89.3</var>(7) include a method for the participant to request updates to the plan; and<br/>
<a id="pl.89.4"></a><var>89.4</var>(8) record the alternative home and community-based settings that were considered <br/>
<a id="pl.89.5"></a><var>89.5</var>by the participant.<br/>
<a id="pl.89.6"></a><var>89.6</var>(s) "Shared services" means the provision of CFSS services by the same CFSS <br/>
<a id="pl.89.7"></a><var>89.7</var>support worker to two or three participants who voluntarily enter into an agreement to <br/>
<a id="pl.89.8"></a><var>89.8</var>receive services at the same time and in the same setting by the same provider.<br/>
<a id="pl.89.9"></a><var>89.9</var>(t) "Support specialist" means a professional with the skills and ability to assist the <br/>
<a id="pl.89.10"></a><var>89.10</var>participant using either the agency provider model under subdivision 11 or the flexible <br/>
<a id="pl.89.11"></a><var>89.11</var>spending model under subdivision 13, in services including but not limited to assistance <br/>
<a id="pl.89.12"></a><var>89.12</var>regarding:<br/>
<a id="pl.89.13"></a><var>89.13</var>(1) the development, implementation, and evaluation of the CFSS service delivery <br/>
<a id="pl.89.14"></a><var>89.14</var>plan under subdivision 6;<br/>
<a id="pl.89.15"></a><var>89.15</var>(2) recruitment, training, or supervision, including supervision of health-related <br/>
<a id="pl.89.16"></a><var>89.16</var>tasks or behavioral supports appropriately delegated by a health care professional, and <br/>
<a id="pl.89.17"></a><var>89.17</var>evaluation of support workers; and<br/>
<a id="pl.89.18"></a><var>89.18</var>(3) facilitating the use of informal and community supports, goods, or resources.<br/>
<a id="pl.89.19"></a><var>89.19</var>(u) "Support worker" means an employee of the agency provider or of the participant <br/>
<a id="pl.89.20"></a><var>89.20</var>who has direct contact with the participant and provides services as specified within the <br/>
<a id="pl.89.21"></a><var>89.21</var>participant's service delivery plan.<br/>
<a id="pl.89.22"></a><var>89.22</var>(v) "Wages and benefits" means the hourly wages and salaries, the employer's <br/>
<a id="pl.89.23"></a><var>89.23</var>share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' <br/>
<a id="pl.89.24"></a><var>89.24</var>compensation, mileage reimbursement, health and dental insurance, life insurance, <br/>
<a id="pl.89.25"></a><var>89.25</var>disability insurance, long-term care insurance, uniform allowance, contributions to <br/>
<a id="pl.89.26"></a><var>89.26</var>employee retirement accounts, or other forms of employee compensation and benefits.<br/>
<a id="pl.89.27"></a><var>89.27</var>    Subd. 3. <b>Eligibility.</b> (a) CFSS is available to a person who meets one of the <br/>
<a id="pl.89.28"></a><var>89.28</var>following:<br/>
<a id="pl.89.29"></a><var>89.29</var>(1) is a recipient of medical assistance as determined under section 256B.055, <br/>
<a id="pl.89.30"></a><var>89.30</var>256B.056, or 256B.057, subdivisions 5 and 9;<br/>
<a id="pl.89.31"></a><var>89.31</var>(2) is a recipient of the alternative care program under section 256B.0913;<br/>
<a id="pl.89.32"></a><var>89.32</var>(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093, <br/>
<a id="pl.89.33"></a><var>89.33</var>or 256B.49; or<br/>
<a id="pl.89.34"></a><var>89.34</var>(4) has medical services identified in a participant's individualized education <br/>
<a id="pl.89.35"></a><var>89.35</var>program and is eligible for services as determined in section 256B.0625, subdivision 26.<br/>
<a id="pl.90.1"></a><var>90.1</var>(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also <br/>
<a id="pl.90.2"></a><var>90.2</var>meet all of the following:<br/>
<a id="pl.90.3"></a><var>90.3</var>(1) require assistance and be determined dependent in one activity of daily living or <br/>
<a id="pl.90.4"></a><var>90.4</var>Level I behavior based on assessment under section 256B.0911;<br/>
<a id="pl.90.5"></a><var>90.5</var>(2) is not a recipient under the family support grant under section 252.32;<br/>
<a id="pl.90.6"></a><var>90.6</var>(3) lives in the person's own apartment or home including a family foster care setting <br/>
<a id="pl.90.7"></a><var>90.7</var>licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a <br/>
<a id="pl.90.8"></a><var>90.8</var>noncertified boarding care or boarding and lodging establishments under chapter 157. <br/>
<a id="pl.90.9"></a><var>90.9</var>    Subd. 4. <b>Eligibility for other services.</b> Selection of CFSS by a participant must not <br/>
<a id="pl.90.10"></a><var>90.10</var>restrict access to other medically necessary care and services furnished under the state <br/>
<a id="pl.90.11"></a><var>90.11</var>plan medical assistance benefit or other services available through alternative care.<br/>
<a id="pl.90.12"></a><var>90.12</var>    Subd. 5. <b>Assessment requirements.</b> (a) The assessment of functional need must:<br/>
<a id="pl.90.13"></a><var>90.13</var>(1) be conducted by a certified assessor according to the criteria established in <br/>
<a id="pl.90.14"></a><var>90.14</var>section 256B.0911, subdivision 3a;<br/>
<a id="pl.90.15"></a><var>90.15</var>(2) be conducted face-to-face, initially and at least annually thereafter, or when there <br/>
<a id="pl.90.16"></a><var>90.16</var>is a significant change in the participant's condition or a change in the need for services <br/>
<a id="pl.90.17"></a><var>90.17</var>and supports; and<br/>
<a id="pl.90.18"></a><var>90.18</var>(3) be completed using the format established by the commissioner.<br/>
<a id="pl.90.19"></a><var>90.19</var>(b) A participant who is residing in a facility may be assessed and choose CFSS for <br/>
<a id="pl.90.20"></a><var>90.20</var>the purpose of using CFSS to return to the community as described in subdivisions 3 <br/>
<a id="pl.90.21"></a><var>90.21</var>and 7, paragraph (a), clause (5).<br/>
<a id="pl.90.22"></a><var>90.22</var>(c) The results of the assessment and any recommendations and authorizations for <br/>
<a id="pl.90.23"></a><var>90.23</var>CFSS must be determined and communicated in writing by the lead agency's certified <br/>
<a id="pl.90.24"></a><var>90.24</var>assessor as defined in section 256B.0911 to the participant and the agency-provider or <br/>
<a id="pl.90.25"></a><var>90.25</var>financial management services provider chosen by the participant within 40 calendar days <br/>
<a id="pl.90.26"></a><var>90.26</var>and must include the participant's right to appeal under section 256.045, subdivision 3.<br/>
<a id="pl.90.27"></a><var>90.27</var>(d)  The lead agency assessor may request a temporary authorization for CFSS <br/>
<a id="pl.90.28"></a><var>90.28</var>services. Authorization for a temporary level of CFSS services is limited to the time <br/>
<a id="pl.90.29"></a><var>90.29</var>specified by the commissioner, but shall not exceed 45 days. The level of services <br/>
<a id="pl.90.30"></a><var>90.30</var>authorized under this provision shall have no bearing on a future authorization.<br/>
<a id="pl.90.31"></a><var>90.31</var>    Subd. 6. <b>Community first services and support service delivery plan.</b> (a) The <br/>
<a id="pl.90.32"></a><var>90.32</var>CFSS service delivery plan must be developed, implemented, and evaluated through a <br/>
<a id="pl.90.33"></a><var>90.33</var>person-centered planning process by the participant, or the participant's representative <br/>
<a id="pl.90.34"></a><var>90.34</var>or legal representative who may be assisted by a support specialist. The CFSS service <br/>
<a id="pl.90.35"></a><var>90.35</var>delivery plan must reflect the services and supports that are important to the participant <br/>
<a id="pl.90.36"></a><var>90.36</var>and for the participant to meet the needs assessed by the certified assessor and identified <br/>
<a id="pl.91.1"></a><var>91.1</var>in the community support plan under section 256B.0911 or the coordinated services and <br/>
<a id="pl.91.2"></a><var>91.2</var>support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS <br/>
<a id="pl.91.3"></a><var>91.3</var>service delivery plan must be reviewed by the participant and the agency-provider or <br/>
<a id="pl.91.4"></a><var>91.4</var>financial management services contractor at least annually upon reassessment, or when <br/>
<a id="pl.91.5"></a><var>91.5</var>there is a significant change in the participant's condition, or a change in the need for <br/>
<a id="pl.91.6"></a><var>91.6</var>services and supports.<br/>
<a id="pl.91.7"></a><var>91.7</var>(b) The commissioner shall establish the format and criteria for the CFSS service <br/>
<a id="pl.91.8"></a><var>91.8</var>delivery plan.<br/>
<a id="pl.91.9"></a><var>91.9</var>(c) The CFSS service delivery plan must be person-centered and:<br/>
<a id="pl.91.10"></a><var>91.10</var>(1) specify the agency-provider or financial management services contractor selected <br/>
<a id="pl.91.11"></a><var>91.11</var>by the participant;<br/>
<a id="pl.91.12"></a><var>91.12</var>(2) reflect the setting in which the participant resides that is chosen by the participant;<br/>
<a id="pl.91.13"></a><var>91.13</var>(3) reflect the participant's strengths and preferences;<br/>
<a id="pl.91.14"></a><var>91.14</var>(4) include the means to address the clinical and support needs as identified through <br/>
<a id="pl.91.15"></a><var>91.15</var>an assessment of functional needs;<br/>
<a id="pl.91.16"></a><var>91.16</var>(5) include individually identified goals and desired outcomes;<br/>
<a id="pl.91.17"></a><var>91.17</var>(6) reflect the services and supports, paid and unpaid, that will assist the participant <br/>
<a id="pl.91.18"></a><var>91.18</var>to achieve identified goals, and the providers of those services and supports, including <br/>
<a id="pl.91.19"></a><var>91.19</var>natural supports;<br/>
<a id="pl.91.20"></a><var>91.20</var>(7) identify the amount and frequency of face-to-face supports and amount and <br/>
<a id="pl.91.21"></a><var>91.21</var>frequency of remote supports and technology that will be used;<br/>
<a id="pl.91.22"></a><var>91.22</var>(8) identify risk factors and measures in place to minimize them, including <br/>
<a id="pl.91.23"></a><var>91.23</var>individualized backup plans;<br/>
<a id="pl.91.24"></a><var>91.24</var>(9) be understandable to the participant and the individuals providing support;<br/>
<a id="pl.91.25"></a><var>91.25</var>(10) identify the individual or entity responsible for monitoring the plan;<br/>
<a id="pl.91.26"></a><var>91.26</var>(11) be finalized and agreed to in writing by the participant and signed by all <br/>
<a id="pl.91.27"></a><var>91.27</var>individuals and providers responsible for its implementation;<br/>
<a id="pl.91.28"></a><var>91.28</var>(12) be distributed to the participant and other people involved in the plan; and<br/>
<a id="pl.91.29"></a><var>91.29</var>(13) prevent the provision of unnecessary or inappropriate care.<br/>
<a id="pl.91.30"></a><var>91.30</var>(d) The total units of agency-provider services or the budget allocation amount for <br/>
<a id="pl.91.31"></a><var>91.31</var>the budget model include both annual totals and a monthly average amount that cover <br/>
<a id="pl.91.32"></a><var>91.32</var>the number of months of the service authorization. The amount used each month may <br/>
<a id="pl.91.33"></a><var>91.33</var>vary, but additional funds must not be provided above the annual service authorization <br/>
<a id="pl.91.34"></a><var>91.34</var>amount unless a change in condition is assessed and authorized by the certified assessor <br/>
<a id="pl.91.35"></a><var>91.35</var>and documented in the community support plan, coordinated services and supports plan, <br/>
<a id="pl.91.36"></a><var>91.36</var>and service delivery plan.<br/>
<a id="pl.92.1"></a><var>92.1</var>    Subd. 7. <b>Community first services and supports; covered services.</b>  Services <br/>
<a id="pl.92.2"></a><var>92.2</var>and supports covered under CFSS include:<br/>
<a id="pl.92.3"></a><var>92.3</var>(1) assistance to accomplish activities of daily living (ADLs), instrumental activities <br/>
<a id="pl.92.4"></a><var>92.4</var>of daily living (IADLs), and health-related procedures and tasks through hands-on <br/>
<a id="pl.92.5"></a><var>92.5</var>assistance to complete the task or supervision and cueing to complete the task;<br/>
<a id="pl.92.6"></a><var>92.6</var>(2) assistance to acquire, maintain, or enhance the skills necessary for the participant <br/>
<a id="pl.92.7"></a><var>92.7</var>to accomplish activities of daily living, instrumental activities of daily living, or <br/>
<a id="pl.92.8"></a><var>92.8</var>health-related tasks;<br/>
<a id="pl.92.9"></a><var>92.9</var>(3) expenditures for items, services, supports, environmental modifications, or <br/>
<a id="pl.92.10"></a><var>92.10</var>goods, including assistive technology. These expenditures must:<br/>
<a id="pl.92.11"></a><var>92.11</var>(i) relate to a need identified in a participant's CFSS service delivery plan; <br/>
<a id="pl.92.12"></a><var>92.12</var>(ii) increase independence or substitute for human assistance to the extent that <br/>
<a id="pl.92.13"></a><var>92.13</var>expenditures would otherwise be made for human assistance for the participant's assessed <br/>
<a id="pl.92.14"></a><var>92.14</var>needs; <br/>
<a id="pl.92.15"></a><var>92.15</var>(4) observation and redirection for behavior or symptoms where there is a need for <br/>
<a id="pl.92.16"></a><var>92.16</var>assistance. A recipient qualifies as having a need for assistance due to behaviors if the <br/>
<a id="pl.92.17"></a><var>92.17</var>recipient's behavior requires assistance at least four times per week and shows one or <br/>
<a id="pl.92.18"></a><var>92.18</var>more of the following behaviors:<br/>
<a id="pl.92.19"></a><var>92.19</var>(i) physical aggression towards self or others, or destruction of property that requires <br/>
<a id="pl.92.20"></a><var>92.20</var>the immediate response of another person;<br/>
<a id="pl.92.21"></a><var>92.21</var>(ii) increased vulnerability due to cognitive deficits or socially inappropriate <br/>
<a id="pl.92.22"></a><var>92.22</var>behavior; or<br/>
<a id="pl.92.23"></a><var>92.23</var>(iii) increased need for assistance for recipients who are verbally aggressive or <br/>
<a id="pl.92.24"></a><var>92.24</var>resistive to care so that time needed to perform activities of daily living is increased;<br/>
<a id="pl.92.25"></a><var>92.25</var>(5) back-up systems or mechanisms, such as the use of pagers or other electronic <br/>
<a id="pl.92.26"></a><var>92.26</var>devices, to ensure continuity of the participant's services and supports;<br/>
<a id="pl.92.27"></a><var>92.27</var>(6) transition costs, including:<br/>
<a id="pl.92.28"></a><var>92.28</var>(i) deposits for rent and utilities;<br/>
<a id="pl.92.29"></a><var>92.29</var>(ii) first month's rent and utilities;<br/>
<a id="pl.92.30"></a><var>92.30</var>(iii) bedding;<br/>
<a id="pl.92.31"></a><var>92.31</var>(iv) basic kitchen supplies;<br/>
<a id="pl.92.32"></a><var>92.32</var>(v) other necessities, to the extent that these necessities are not otherwise covered <br/>
<a id="pl.92.33"></a><var>92.33</var>under any other funding that the participant is eligible to receive; and<br/>
<a id="pl.92.34"></a><var>92.34</var>(vi) other required necessities for an individual to make the transition from a nursing <br/>
<a id="pl.92.35"></a><var>92.35</var>facility, institution for mental diseases, or intermediate care facility for persons with <br/>
<a id="pl.93.1"></a><var>93.1</var>developmental disabilities to a community-based home setting where the participant <br/>
<a id="pl.93.2"></a><var>93.2</var>resides; and<br/>
<a id="pl.93.3"></a><var>93.3</var>(7) services by a support specialist defined under subdivision 2 that are chosen <br/>
<a id="pl.93.4"></a><var>93.4</var>by the participant.<br/>
<a id="pl.93.5"></a><var>93.5</var>    Subd. 8. <b>Determination of CFSS service methodology.</b> (a) All community first <br/>
<a id="pl.93.6"></a><var>93.6</var>services and supports must be authorized by the commissioner or the commissioner's  <br/>
<a id="pl.93.7"></a><var>93.7</var>designee before services begin, except for the assessments established in section  <br/>
<a id="pl.93.8"></a><var>93.8</var>256B.0911. The authorization for CFSS must be completed as soon as possible following <br/>
<a id="pl.93.9"></a><var>93.9</var>an assessment but no later than 40 calendar days from the date of the assessment.<br/>
<a id="pl.93.10"></a><var>93.10</var>(b) The amount of CFSS authorized must be based on the recipient's home  care <br/>
<a id="pl.93.11"></a><var>93.11</var>rating described in subdivision 8, paragraphs (d) and (e), and any additional service units <br/>
<a id="pl.93.12"></a><var>93.12</var>for which the person qualifies as described in subdivision 8, paragraph (f). <br/>
<a id="pl.93.13"></a><var>93.13</var>(c) The home care rating shall be determined by the commissioner or the  <br/>
<a id="pl.93.14"></a><var>93.14</var>commissioner's designee based on information submitted to the commissioner identifying  <br/>
<a id="pl.93.15"></a><var>93.15</var>the following for a recipient:<br/>
<a id="pl.93.16"></a><var>93.16</var>(1) the total number of dependencies of activities of daily living as defined in  <br/>
<a id="pl.93.17"></a><var>93.17</var>subdivision 2, paragraph (b);<br/>
<a id="pl.93.18"></a><var>93.18</var>(2) the presence of complex health-related needs as defined in subdivision 2, <br/>
<a id="pl.93.19"></a><var>93.19</var>paragraph (e); and<br/>
<a id="pl.93.20"></a><var>93.20</var>(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d), <br/>
<a id="pl.93.21"></a><var>93.21</var>clause (1).<br/>
<a id="pl.93.22"></a><var>93.22</var>(d) The methodology to determine  the total service units for CFSS for each home <br/>
<a id="pl.93.23"></a><var>93.23</var>care rating is based on the median paid units  per day for each home care rating from <br/>
<a id="pl.93.24"></a><var>93.24</var>fiscal year 2007 data for the PCA program.<br/>
<a id="pl.93.25"></a><var>93.25</var>(e) Each  home care rating is designated by the letters P through Z and EN and  has <br/>
<a id="pl.93.26"></a><var>93.26</var>the following base number of service units assigned:<br/>
<a id="pl.93.27"></a><var>93.27</var>(i) P home care rating requires Level 1 behavior or one to three dependencies in <br/>
<a id="pl.93.28"></a><var>93.28</var>ADLs and qualifies one for five service units;<br/>
<a id="pl.93.29"></a><var>93.29</var>(ii) Q home care rating requires Level 1 behavior and one to three dependencies in <br/>
<a id="pl.93.30"></a><var>93.30</var>ADLs and qualifies one for six service units;  <br/>
<a id="pl.93.31"></a><var>93.31</var>(iii) R home care rating requires complex health-related needs and one to three <br/>
<a id="pl.93.32"></a><var>93.32</var>dependencies in ADLs and qualifies one for seven service units; <br/>
<a id="pl.93.33"></a><var>93.33</var>(iv) S home care rating requires four to six dependencies in ADLs and qualifies <br/>
<a id="pl.93.34"></a><var>93.34</var>one for ten service units;<br/>
<a id="pl.93.35"></a><var>93.35</var>(v) T home care rating requires four to six dependencies in ADLs and Level 1 <br/>
<a id="pl.93.36"></a><var>93.36</var>behavior and qualifies one for 11 service units;<br/>
<a id="pl.94.1"></a><var>94.1</var>(vi) U home care rating requires four to six dependencies in ADLs and a complex <br/>
<a id="pl.94.2"></a><var>94.2</var>health need and qualifies one for 14 service units;<br/>
<a id="pl.94.3"></a><var>94.3</var>(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies <br/>
<a id="pl.94.4"></a><var>94.4</var>one for 17 service units; <br/>
<a id="pl.94.5"></a><var>94.5</var>(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1 <br/>
<a id="pl.94.6"></a><var>94.6</var>behavior and qualifies one for 20 service units;<br/>
<a id="pl.94.7"></a><var>94.7</var>(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex <br/>
<a id="pl.94.8"></a><var>94.8</var>health related need and qualifies one for 30 service units; and<br/>
<a id="pl.94.9"></a><var>94.9</var>(x) EN home care rating includes ventilator dependency as defined in section <br/>
<a id="pl.94.10"></a><var>94.10</var>256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of <br/>
<a id="pl.94.11"></a><var>94.11</var>ventilator-dependent and the EN home care rating and utilize a combination of CFSS <br/>
<a id="pl.94.12"></a><var>94.12</var>and other home care services are limited to a total of 96 service units per day for those <br/>
<a id="pl.94.13"></a><var>94.13</var>services in combination. Additional units may be authorized when a recipient's assessment <br/>
<a id="pl.94.14"></a><var>94.14</var>indicates a need for two staff to perform activities. Additional time is limited to 16 service <br/>
<a id="pl.94.15"></a><var>94.15</var>units per day.<br/>
<a id="pl.94.16"></a><var>94.16</var>(f) Additional service units are provided  through the assessment and identification of <br/>
<a id="pl.94.17"></a><var>94.17</var>the following:<br/>
<a id="pl.94.18"></a><var>94.18</var>(1) 30 additional minutes per day for a dependency in each critical activity of daily  <br/>
<a id="pl.94.19"></a><var>94.19</var>living as defined in subdivision 2, paragraph (h);<br/>
<a id="pl.94.20"></a><var>94.20</var>(2) 30 additional minutes per day for each complex health-related function as  <br/>
<a id="pl.94.21"></a><var>94.21</var>defined in subdivision 2, paragraph (e); and   <br/>
<a id="pl.94.22"></a><var>94.22</var>(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2, <br/>
<a id="pl.94.23"></a><var>94.23</var>paragraph (d). <br/>
<a id="pl.94.24"></a><var>94.24</var>    Subd. 9. <b>Noncovered services.</b> (a) Services or supports that are not eligible for <br/>
<a id="pl.94.25"></a><var>94.25</var>payment under this section include those that:<br/>
<a id="pl.94.26"></a><var>94.26</var>(1) are not authorized by the certified assessor or included in the written service <br/>
<a id="pl.94.27"></a><var>94.27</var>delivery plan;<br/>
<a id="pl.94.28"></a><var>94.28</var>(2) are provided prior to the authorization of services and the approval of the written <br/>
<a id="pl.94.29"></a><var>94.29</var>CFSS service delivery plan;<br/>
<a id="pl.94.30"></a><var>94.30</var>(3) are duplicative of other paid services in the written service delivery plan;<br/>
<a id="pl.94.31"></a><var>94.31</var>(4) supplant natural unpaid supports that appropriately meet a need in the service <br/>
<a id="pl.94.32"></a><var>94.32</var>plan, are provided voluntarily to the participant and are selected by the participant in lieu <br/>
<a id="pl.94.33"></a><var>94.33</var>of other services and supports;<br/>
<a id="pl.94.34"></a><var>94.34</var>(5) are not effective means to meet the participant's needs; and<br/>
<a id="pl.94.35"></a><var>94.35</var>(6) are available through other funding sources, including, but not limited to, funding <br/>
<a id="pl.94.36"></a><var>94.36</var>through Title IV-E of the Social Security Act.<br/>
<a id="pl.95.1"></a><var>95.1</var>(b) Additional services, goods, or supports that are not covered include:<br/>
<a id="pl.95.2"></a><var>95.2</var>(1) those that are not for the direct benefit of the participant, except that services for <br/>
<a id="pl.95.3"></a><var>95.3</var>caregivers such as training to improve the ability to provide CFSS are considered to directly <br/>
<a id="pl.95.4"></a><var>95.4</var>benefit the participant if chosen by the participant and approved in the support plan;<br/>
<a id="pl.95.5"></a><var>95.5</var>(2) any fees incurred by the participant, such as Minnesota health care programs fees <br/>
<a id="pl.95.6"></a><var>95.6</var>and co-pays, legal fees, or costs related to advocate agencies;<br/>
<a id="pl.95.7"></a><var>95.7</var>(3) insurance, except for insurance costs related to employee coverage;<br/>
<a id="pl.95.8"></a><var>95.8</var>(4) room and board costs for the participant with the exception of allowable <br/>
<a id="pl.95.9"></a><var>95.9</var>transition costs in subdivision 7, clause (6);<br/>
<a id="pl.95.10"></a><var>95.10</var>(5) services, supports, or goods that are not related to the assessed needs;<br/>
<a id="pl.95.11"></a><var>95.11</var>(6) special education and related services provided under the Individuals with <br/>
<a id="pl.95.12"></a><var>95.12</var>Disabilities Education Act and vocational rehabilitation services provided under the <br/>
<a id="pl.95.13"></a><var>95.13</var>Rehabilitation Act of 1973;<br/>
<a id="pl.95.14"></a><var>95.14</var>(7) assistive technology devices and assistive technology services other than those <br/>
<a id="pl.95.15"></a><var>95.15</var>for back-up systems or mechanisms to ensure continuity of service and supports listed in <br/>
<a id="pl.95.16"></a><var>95.16</var>subdivision 7;<br/>
<a id="pl.95.17"></a><var>95.17</var>(8) medical supplies and equipment;<br/>
<a id="pl.95.18"></a><var>95.18</var>(9) environmental modifications, except as specified in subdivision 7;<br/>
<a id="pl.95.19"></a><var>95.19</var>(10) expenses for travel, lodging, or meals related to training the participant, the <br/>
<a id="pl.95.20"></a><var>95.20</var>participant's representative, legal representative, or paid or unpaid caregivers that exceed <br/>
<a id="pl.95.21"></a><var>95.21</var>$500 in a 12-month period;<br/>
<a id="pl.95.22"></a><var>95.22</var>(11) experimental treatments;<br/>
<a id="pl.95.23"></a><var>95.23</var>(12) any service or good covered by other medical assistance state plan services, <br/>
<a id="pl.95.24"></a><var>95.24</var>including prescription and over-the-counter medications, compounds, and solutions and <br/>
<a id="pl.95.25"></a><var>95.25</var>related fees, including premiums and co-payments;<br/>
<a id="pl.95.26"></a><var>95.26</var>(13) membership dues or costs, except when the service is necessary and appropriate <br/>
<a id="pl.95.27"></a><var>95.27</var>to treat a physical condition or to improve or maintain the participant's physical condition. <br/>
<a id="pl.95.28"></a><var>95.28</var>The condition must be identified in the participant's CFSS plan and monitored by a <br/>
<a id="pl.95.29"></a><var>95.29</var>physician enrolled in a Minnesota health care program;<br/>
<a id="pl.95.30"></a><var>95.30</var>(14) vacation expenses other than the cost of direct services;<br/>
<a id="pl.95.31"></a><var>95.31</var>(15) vehicle maintenance or modifications not related to the disability, health <br/>
<a id="pl.95.32"></a><var>95.32</var>condition, or physical need; and<br/>
<a id="pl.95.33"></a><var>95.33</var>(16) tickets and related costs to attend sporting or other recreational or entertainment <br/>
<a id="pl.95.34"></a><var>95.34</var>events.<br/>
<a id="pl.96.1"></a><var>96.1</var>    Subd. 10. <b>Provider qualifications and general requirements.</b> (a) <br/>
<a id="pl.96.2"></a><var>96.2</var>Agency-providers delivering services under the agency-provider model under subdivision <br/>
<a id="pl.96.3"></a><var>96.3</var>11 or financial management service (FMS) contractors under subdivision 13 shall:<br/>
<a id="pl.96.4"></a><var>96.4</var>(1) enroll as a medical assistance Minnesota health care programs provider and meet <br/>
<a id="pl.96.5"></a><var>96.5</var>all applicable provider standards;<br/>
<a id="pl.96.6"></a><var>96.6</var>(2) comply with medical assistance provider enrollment requirements;<br/>
<a id="pl.96.7"></a><var>96.7</var>(3) demonstrate compliance with law and policies of CFSS as determined by the <br/>
<a id="pl.96.8"></a><var>96.8</var>commissioner;<br/>
<a id="pl.96.9"></a><var>96.9</var>(4) comply with background study requirements under chapter 245C;<br/>
<a id="pl.96.10"></a><var>96.10</var>(5) verify and maintain records of all services and expenditures by the participant, <br/>
<a id="pl.96.11"></a><var>96.11</var>including hours worked by support workers and support specialists;<br/>
<a id="pl.96.12"></a><var>96.12</var>(6) not engage in any agency-initiated direct contact or marketing in person, by <br/>
<a id="pl.96.13"></a><var>96.13</var>telephone, or other electronic means to potential participants, guardians, family member, <br/>
<a id="pl.96.14"></a><var>96.14</var>or participants' representatives;<br/>
<a id="pl.96.15"></a><var>96.15</var>(7) pay support workers and support specialists based upon actual hours of services <br/>
<a id="pl.96.16"></a><var>96.16</var>provided;<br/>
<a id="pl.96.17"></a><var>96.17</var>(8) withhold and pay all applicable federal and state payroll taxes;<br/>
<a id="pl.96.18"></a><var>96.18</var>(9) make arrangements and pay unemployment insurance, taxes, workers' <br/>
<a id="pl.96.19"></a><var>96.19</var>compensation, liability insurance, and other benefits, if any;<br/>
<a id="pl.96.20"></a><var>96.20</var>(10) enter into a written agreement with the participant, participant's representative, <br/>
<a id="pl.96.21"></a><var>96.21</var>or legal representative that assigns roles and responsibilities to be performed before <br/>
<a id="pl.96.22"></a><var>96.22</var>services, supports, or goods are provided using a format established by the commissioner;<br/>
<a id="pl.96.23"></a><var>96.23</var>(11) report maltreatment as required under sections 626.556 and 626.557; and<br/>
<a id="pl.96.24"></a><var>96.24</var>(12) provide the participant with a copy of the service-related rights under <br/>
<a id="pl.96.25"></a><var>96.25</var>subdivision 19 at the start of services and supports.<br/>
<a id="pl.96.26"></a><var>96.26</var>(b) The commissioner shall develop policies and procedures designed to ensure <br/>
<a id="pl.96.27"></a><var>96.27</var>program integrity and fiscal accountability for goods and services provided in this section <br/>
<a id="pl.96.28"></a><var>96.28</var>in consultation with the implementation council described in subdivision 21.<br/>
<a id="pl.96.29"></a><var>96.29</var>    Subd. 11. <b>Agency-provider model.</b> (a) The agency-provider model is limited to  <br/>
<a id="pl.96.30"></a><var>96.30</var>the services provided by support workers and support specialists who are employed by <br/>
<a id="pl.96.31"></a><var>96.31</var>an agency-provider that is licensed according to chapter 245A or meets other criteria <br/>
<a id="pl.96.32"></a><var>96.32</var>established by the commissioner, including required training.<br/>
<a id="pl.96.33"></a><var>96.33</var>(b) The agency-provider shall allow the participant to have a significant role in the <br/>
<a id="pl.96.34"></a><var>96.34</var>selection and dismissal of the support workers for the delivery of the   services and supports <br/>
<a id="pl.96.35"></a><var>96.35</var>specified in the participant's service delivery plan.<br/>
<a id="pl.97.1"></a><var>97.1</var>(c) A participant may use authorized units of CFSS services as needed within  a <br/>
<a id="pl.97.2"></a><var>97.2</var>service authorization that is not greater than 12 months. Using authorized units in a <br/>
<a id="pl.97.3"></a><var>97.3</var>flexible manner in either the agency-provider model or the budget model  does not increase <br/>
<a id="pl.97.4"></a><var>97.4</var>the total amount of services and supports authorized for a  participant or included in the <br/>
<a id="pl.97.5"></a><var>97.5</var>participant's service delivery plan.<br/>
<a id="pl.97.6"></a><var>97.6</var>(d) A participant may share CFSS services. Two or three CFSS participants may  <br/>
<a id="pl.97.7"></a><var>97.7</var>share services at the same time provided by the same support worker.<br/>
<a id="pl.97.8"></a><var>97.8</var>(e) The agency-provider must use a minimum of 72.5 percent of the revenue  <br/>
<a id="pl.97.9"></a><var>97.9</var>generated by the medical assistance payment for CFSS for support worker wages and <br/>
<a id="pl.97.10"></a><var>97.10</var>benefits. The agency-provider must document how this requirement is being met. The <br/>
<a id="pl.97.11"></a><var>97.11</var>revenue generated by the support specialist and the reasonable costs associated with the <br/>
<a id="pl.97.12"></a><var>97.12</var>support specialist must not be used in making this calculation.<br/>
<a id="pl.97.13"></a><var>97.13</var>(f) The agency-provider model must be used by individuals who have been restricted <br/>
<a id="pl.97.14"></a><var>97.14</var>by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 <br/>
<a id="pl.97.15"></a><var>97.15</var>to 9505.2245.<br/>
<a id="pl.97.16"></a><var>97.16</var>    Subd. 12. <b>Requirements for initial enrollment of CFSS provider agencies.</b>  (a)  <br/>
<a id="pl.97.17"></a><var>97.17</var>All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider  <br/>
<a id="pl.97.18"></a><var>97.18</var>agency in a format determined by the commissioner, information and documentation that  <br/>
<a id="pl.97.19"></a><var>97.19</var>includes, but is not limited to, the following:<br/>
<a id="pl.97.20"></a><var>97.20</var>(1) the CFSS provider agency's current contact information including address,  <br/>
<a id="pl.97.21"></a><var>97.21</var>telephone number, and e-mail address;<br/>
<a id="pl.97.22"></a><var>97.22</var>(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the  <br/>
<a id="pl.97.23"></a><var>97.23</var>provider's payments from Medicaid in the previous year, whichever is less;<br/>
<a id="pl.97.24"></a><var>97.24</var>(3) proof of fidelity bond coverage in the amount of $20,000;<br/>
<a id="pl.97.25"></a><var>97.25</var>(4) proof of workers' compensation insurance coverage;<br/>
<a id="pl.97.26"></a><var>97.26</var>(5) proof of liability insurance;<br/>
<a id="pl.97.27"></a><var>97.27</var>(6) a description of the CFSS provider agency's organization identifying the names  <br/>
<a id="pl.97.28"></a><var>97.28</var>or all owners, managing employees, staff, board of directors, and the affiliations of the  <br/>
<a id="pl.97.29"></a><var>97.29</var>directors, owners, or staff to other service providers;<br/>
<a id="pl.97.30"></a><var>97.30</var>(7) a copy of the CFSS provider agency's written policies and procedures including:  <br/>
<a id="pl.97.31"></a><var>97.31</var>hiring of employees; training requirements; service delivery; and employee and consumer  <br/>
<a id="pl.97.32"></a><var>97.32</var>safety including process for notification and resolution of consumer grievances,  <br/>
<a id="pl.97.33"></a><var>97.33</var>identification and prevention of communicable diseases, and employee misconduct;<br/>
<a id="pl.97.34"></a><var>97.34</var>(8) copies of all other forms the CFSS provider agency uses in the course of daily  <br/>
<a id="pl.97.35"></a><var>97.35</var>business including, but not limited to:<br/>
<a id="pl.98.1"></a><var>98.1</var>(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from  <br/>
<a id="pl.98.2"></a><var>98.2</var>the standard time sheet for CFSS services approved by the commissioner, and a letter  <br/>
<a id="pl.98.3"></a><var>98.3</var>requesting approval of the CFSS provider agency's nonstandard time sheet;<br/>
<a id="pl.98.4"></a><var>98.4</var>(ii) the CFSS provider agency's template for the CFSS care plan; and<br/>
<a id="pl.98.5"></a><var>98.5</var>(iii) the CFSS provider agency's template for the written agreement in subdivision <br/>
<a id="pl.98.6"></a><var>98.6</var>21 for recipients using the CFSS choice option, if applicable;<br/>
<a id="pl.98.7"></a><var>98.7</var>(9) a list of all training and classes that the CFSS provider agency requires of its  <br/>
<a id="pl.98.8"></a><var>98.8</var>staff providing CFSS services;<br/>
<a id="pl.98.9"></a><var>98.9</var>(10) documentation that the CFSS provider agency and staff have successfully  <br/>
<a id="pl.98.10"></a><var>98.10</var>completed all the training required by this section;<br/>
<a id="pl.98.11"></a><var>98.11</var>(11) documentation of the agency's marketing practices;<br/>
<a id="pl.98.12"></a><var>98.12</var>(12) disclosure of ownership, leasing, or management of all residential properties   <br/>
<a id="pl.98.13"></a><var>98.13</var>that is used or could be used for providing home care services;<br/>
<a id="pl.98.14"></a><var>98.14</var>(13) documentation that the agency will use the following percentages of revenue  <br/>
<a id="pl.98.15"></a><var>98.15</var>generated from the medical assistance rate paid for CFSS services for employee personal  <br/>
<a id="pl.98.16"></a><var>98.16</var>care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The  <br/>
<a id="pl.98.17"></a><var>98.17</var>revenue generated by the support specialist and the reasonable costs associated with the  <br/>
<a id="pl.98.18"></a><var>98.18</var>support specialist shall not be used in making this calculation; and <br/>
<a id="pl.98.19"></a><var>98.19</var>(14) documentation that the agency does not burden recipients' free exercise of their  <br/>
<a id="pl.98.20"></a><var>98.20</var>right to choose service providers by requiring personal care assistants to sign an agreement  <br/>
<a id="pl.98.21"></a><var>98.21</var>not to work with any particular CFSS recipient or for another CFSS provider agency after  <br/>
<a id="pl.98.22"></a><var>98.22</var>leaving the agency and that the agency is not taking action on any such agreements or <br/>
<a id="pl.98.23"></a><var>98.23</var>requirements regardless of the date signed.<br/>
<a id="pl.98.24"></a><var>98.24</var>(b) CFSS provider agencies shall provide to the commissioner the information <br/>
<a id="pl.98.25"></a><var>98.25</var>specified in paragraph (a).<br/>
<a id="pl.98.26"></a><var>98.26</var>(c) All CFSS provider agencies shall require all employees in management and <br/>
<a id="pl.98.27"></a><var>98.27</var>supervisory positions and owners of the agency who are active in the day-to-day <br/>
<a id="pl.98.28"></a><var>98.28</var>management and operations of the agency to complete mandatory training as determined <br/>
<a id="pl.98.29"></a><var>98.29</var>by the commissioner. Employees in management and supervisory positions and owners <br/>
<a id="pl.98.30"></a><var>98.30</var>who are active in the day-to-day operations of an agency who have completed the required  <br/>
<a id="pl.98.31"></a><var>98.31</var>training as an employee with a CFSS provider agency do not need to repeat the required <br/>
<a id="pl.98.32"></a><var>98.32</var>training if they are hired by another agency, if they have completed the training within <br/>
<a id="pl.98.33"></a><var>98.33</var>the past three years. CFSS provider agency billing staff shall complete training about <br/>
<a id="pl.98.34"></a><var>98.34</var>CFSS program financial management. Any new owners or employees in management <br/>
<a id="pl.98.35"></a><var>98.35</var>and supervisory positions involved in the day-to-day operations are required to complete <br/>
<a id="pl.98.36"></a><var>98.36</var>mandatory training as a requisite of working for the agency. CFSS provider agencies <br/>
<a id="pl.99.1"></a><var>99.1</var>certified for participation in Medicare as home health agencies are exempt from the <br/>
<a id="pl.99.2"></a><var>99.2</var>training required in this subdivision. <br/>
<a id="pl.99.3"></a><var>99.3</var>    Subd. 13. <b>Budget model.</b>  (a) Under the budget model participants can exercise <br/>
<a id="pl.99.4"></a><var>99.4</var>more responsibility and control over the services and supports described and budgeted <br/>
<a id="pl.99.5"></a><var>99.5</var>within the CFSS service delivery plan. Under this model, participants may use their <br/>
<a id="pl.99.6"></a><var>99.6</var>budget allocation to:<br/>
<a id="pl.99.7"></a><var>99.7</var>(1) directly employ support workers;<br/>
<a id="pl.99.8"></a><var>99.8</var>(2) obtain supports and goods as defined in subdivision 7; and<br/>
<a id="pl.99.9"></a><var>99.9</var>(3) choose a range of support assistance services from the financial management <br/>
<a id="pl.99.10"></a><var>99.10</var>services (FMS) contractor related to:<br/>
<a id="pl.99.11"></a><var>99.11</var>(i) assistance in managing the budget to meet the service delivery plan needs, <br/>
<a id="pl.99.12"></a><var>99.12</var>consistent with federal and state laws and regulations;<br/>
<a id="pl.99.13"></a><var>99.13</var>(ii) the employment, training, supervision, and evaluation of workers by the <br/>
<a id="pl.99.14"></a><var>99.14</var>participant;<br/>
<a id="pl.99.15"></a><var>99.15</var>(iii) acquisition and payment for supports and goods; and<br/>
<a id="pl.99.16"></a><var>99.16</var>(iv) evaluation of individual service outcomes as needed for the scope of the  <br/>
<a id="pl.99.17"></a><var>99.17</var>participant's degree of control and responsibility.<br/>
<a id="pl.99.18"></a><var>99.18</var>(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) <br/>
<a id="pl.99.19"></a><var>99.19</var>may authorize a legal representative or participant's representative to do so on their behalf.<br/>
<a id="pl.99.20"></a><var>99.20</var>(c) The FMS contractor shall not provide CFSS services and supports under the  <br/>
<a id="pl.99.21"></a><var>99.21</var>agency-provider service model. The FMS contractor shall provide service functions as <br/>
<a id="pl.99.22"></a><var>99.22</var>determined by the commissioner that include but are not limited to:<br/>
<a id="pl.99.23"></a><var>99.23</var>(1) information and consultation about CFSS;<br/>
<a id="pl.99.24"></a><var>99.24</var>(2) assistance with the development of the service delivery plan and budget model <br/>
<a id="pl.99.25"></a><var>99.25</var>as requested by the participant;<br/>
<a id="pl.99.26"></a><var>99.26</var>(3) billing and making payments for budget model expenditures;<br/>
<a id="pl.99.27"></a><var>99.27</var>(4) assisting participants in fulfilling employer-related requirements according to <br/>
<a id="pl.99.28"></a><var>99.28</var>Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,  <br/>
<a id="pl.99.29"></a><var>99.29</var>regulation 137036-08, which includes assistance with filing and paying payroll taxes, and <br/>
<a id="pl.99.30"></a><var>99.30</var>obtaining worker compensation coverage;<br/>
<a id="pl.99.31"></a><var>99.31</var>(5) data recording and reporting of participant spending; and<br/>
<a id="pl.99.32"></a><var>99.32</var>(6) other duties established in the contract with the department.<br/>
<a id="pl.99.33"></a><var>99.33</var>(d) A participant who requests to purchase goods and supports along with support  <br/>
<a id="pl.99.34"></a><var>99.34</var>worker services under the agency-provider model must use the budget model  with <br/>
<a id="pl.99.35"></a><var>99.35</var>a service delivery plan that specifies the amount of services to be authorized to the <br/>
<a id="pl.99.36"></a><var>99.36</var>agency-provider and the expenditures to be paid by the FMS contractor.<br/>
<a id="pl.100.1"></a><var>100.1</var>(e) The FMS contractor shall:<br/>
<a id="pl.100.2"></a><var>100.2</var>(1) not limit or restrict the participant's choice of service or support providers or  <br/>
<a id="pl.100.3"></a><var>100.3</var>service delivery models consistent with any applicable state and federal requirements;<br/>
<a id="pl.100.4"></a><var>100.4</var>(2) provide the participant and the targeted case manager, if applicable, with a <br/>
<a id="pl.100.5"></a><var>100.5</var>monthly written summary of the spending for services and supports that were billed <br/>
<a id="pl.100.6"></a><var>100.6</var>against the spending budget;<br/>
<a id="pl.100.7"></a><var>100.7</var>(3) be knowledgeable of state and federal employment regulations under the Fair <br/>
<a id="pl.100.8"></a><var>100.8</var>Labor Standards Act of 1938, and comply with the requirements under the Internal <br/>
<a id="pl.100.9"></a><var>100.9</var>Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax <br/>
<a id="pl.100.10"></a><var>100.10</var>Liability for vendor or fiscal employer agent, and any requirements necessary to process <br/>
<a id="pl.100.11"></a><var>100.11</var>employer and employee deductions, provide appropriate and timely submission of <br/>
<a id="pl.100.12"></a><var>100.12</var>employer tax liabilities, and maintain documentation to support medical assistance claims;<br/>
<a id="pl.100.13"></a><var>100.13</var>(4) have current and adequate liability insurance and bonding and sufficient cash <br/>
<a id="pl.100.14"></a><var>100.14</var>flow as determined by the commissioner and have on staff or under contract a certified <br/>
<a id="pl.100.15"></a><var>100.15</var>public accountant or an individual with a baccalaureate degree in accounting;<br/>
<a id="pl.100.16"></a><var>100.16</var>(5) assume fiscal accountability for state funds designated for the program; and<br/>
<a id="pl.100.17"></a><var>100.17</var>(6) maintain documentation of receipts, invoices, and bills to track all services and <br/>
<a id="pl.100.18"></a><var>100.18</var>supports expenditures for any goods purchased and maintain time records of support <br/>
<a id="pl.100.19"></a><var>100.19</var>workers. The documentation and time records must be maintained for a minimum of <br/>
<a id="pl.100.20"></a><var>100.20</var>five years from the claim date and be available for audit or review upon request by the <br/>
<a id="pl.100.21"></a><var>100.21</var>commissioner. Claims submitted by the FMS contractor to the commissioner for payment <br/>
<a id="pl.100.22"></a><var>100.22</var>must correspond with services, amounts, and time periods as authorized in the participant's <br/>
<a id="pl.100.23"></a><var>100.23</var>spending budget and service plan.<br/>
<a id="pl.100.24"></a><var>100.24</var>(f) The commissioner of human services shall:<br/>
<a id="pl.100.25"></a><var>100.25</var>(1) establish rates and payment methodology for the FMS contractor;<br/>
<a id="pl.100.26"></a><var>100.26</var>(2) identify a process to ensure quality and performance standards for the FMS <br/>
<a id="pl.100.27"></a><var>100.27</var>contractor and ensure statewide access to FMS contractors; and <br/>
<a id="pl.100.28"></a><var>100.28</var>(3) establish a uniform protocol for delivering and administering CFSS services <br/>
<a id="pl.100.29"></a><var>100.29</var>to be used by eligible FMS contractors.<br/>
<a id="pl.100.30"></a><var>100.30</var>(g) The commissioner of human services shall disenroll or exclude participants from <br/>
<a id="pl.100.31"></a><var>100.31</var>the budget model and transfer them to the agency-provider model under the following <br/>
<a id="pl.100.32"></a><var>100.32</var>circumstances that include but are not limited to:<br/>
<a id="pl.100.33"></a><var>100.33</var>(1) when a participant has been restricted by the Minnesota restricted recipient <br/>
<a id="pl.100.34"></a><var>100.34</var>program, the participant may be excluded for a specified time period under Minnesota <br/>
<a id="pl.100.35"></a><var>100.35</var>Rules, parts 9505.2160 to 9505.2245;<br/>
<a id="pl.101.1"></a><var>101.1</var>(2) when a participant exits the budget model during the participant's service plan <br/>
<a id="pl.101.2"></a><var>101.2</var>year. Upon transfer, the participant shall not access the budget  model for the remainder of <br/>
<a id="pl.101.3"></a><var>101.3</var>that service plan year; or <br/>
<a id="pl.101.4"></a><var>101.4</var>(3) when the department determines that the participant or participant's representative <br/>
<a id="pl.101.5"></a><var>101.5</var>or legal representative cannot manage participant responsibilities under the budget model. <br/>
<a id="pl.101.6"></a><var>101.6</var>The commissioner must develop policies for determining if a participant  is unable to <br/>
<a id="pl.101.7"></a><var>101.7</var>manage responsibilities under a budget model.<br/>
<a id="pl.101.8"></a><var>101.8</var>(h) A participant may appeal under section 256.045, subdivision 3, in writing to the <br/>
<a id="pl.101.9"></a><var>101.9</var>department to contest the department's decision under paragraph (c), clause (3), to remove <br/>
<a id="pl.101.10"></a><var>101.10</var>or exclude the participant from the budget model.<br/>
<a id="pl.101.11"></a><var>101.11</var>    Subd. 14. <b>Participant's responsibilities under budget model.</b> (a) A  participant <br/>
<a id="pl.101.12"></a><var>101.12</var>using the budget model must use an FMS contractor or vendor that is  under contract with <br/>
<a id="pl.101.13"></a><var>101.13</var>the department. Upon a determination of eligibility and completion of the assessment and <br/>
<a id="pl.101.14"></a><var>101.14</var>community support plan, the participant shall choose a FMS contractor from a list of <br/>
<a id="pl.101.15"></a><var>101.15</var>eligible vendors maintained by the department.<br/>
<a id="pl.101.16"></a><var>101.16</var>(b) When the participant, participant's representative, or legal representative chooses <br/>
<a id="pl.101.17"></a><var>101.17</var>to be the employer of the support worker, they are responsible for the hiring and supervision <br/>
<a id="pl.101.18"></a><var>101.18</var>of the support worker, including, but not limited to, recruiting, interviewing, training, and <br/>
<a id="pl.101.19"></a><var>101.19</var>discharging the support worker consistent with federal  and state laws and regulations.<br/>
<a id="pl.101.20"></a><var>101.20</var>(c) In addition to the employer responsibilities in paragraph (b), the participant,  <br/>
<a id="pl.101.21"></a><var>101.21</var>participant's representative, or legal representative is responsible for:<br/>
<a id="pl.101.22"></a><var>101.22</var>(1) tracking the services provided and all expenditures for goods or other supports;<br/>
<a id="pl.101.23"></a><var>101.23</var>(2) preparing and submitting time sheets, signed by both the participant and support <br/>
<a id="pl.101.24"></a><var>101.24</var>worker, to the FMS contractor on a regular basis and in a timely manner according to <br/>
<a id="pl.101.25"></a><var>101.25</var>the FMS contractor's procedures;  <br/>
<a id="pl.101.26"></a><var>101.26</var>(3) notifying the FMS contractor within ten days of any changes in circumstances  <br/>
<a id="pl.101.27"></a><var>101.27</var>affecting the CFSS service plan or in the participant's place of residence including, but  <br/>
<a id="pl.101.28"></a><var>101.28</var>not limited to, any hospitalization of the participant or change in the participant's address,  <br/>
<a id="pl.101.29"></a><var>101.29</var>telephone number, or employment;<br/>
<a id="pl.101.30"></a><var>101.30</var>(4) notifying the FMS contractor of any changes in the employment status of each <br/>
<a id="pl.101.31"></a><var>101.31</var>participant support worker; and  <br/>
<a id="pl.101.32"></a><var>101.32</var>(5) reporting any problems resulting from the quality of services rendered by the  <br/>
<a id="pl.101.33"></a><var>101.33</var>support worker to the FMS contractor. If the participant is unable to resolve any problems  <br/>
<a id="pl.101.34"></a><var>101.34</var>resulting from the quality of service rendered by the support worker with the assistance of  <br/>
<a id="pl.101.35"></a><var>101.35</var>the FMS contractor, the participant shall report the situation to the department.  <br/>
<a id="pl.102.1"></a><var>102.1</var>    Subd. 15. <b>Documentation of support services provided.</b> (a) Support services <br/>
<a id="pl.102.2"></a><var>102.2</var>provided to a participant by a support worker employed by either an agency-provider <br/>
<a id="pl.102.3"></a><var>102.3</var>or the participant acting as the employer must be documented daily by each support <br/>
<a id="pl.102.4"></a><var>102.4</var>worker, on a time sheet form approved by the commissioner. All documentation may be <br/>
<a id="pl.102.5"></a><var>102.5</var>Web-based, electronic, or paper documentation. The completed form must be submitted <br/>
<a id="pl.102.6"></a><var>102.6</var>on a monthly basis to the provider or the participant and the FMS contractor selected by <br/>
<a id="pl.102.7"></a><var>102.7</var>the participant to provide assistance with meeting the participant's employer obligations <br/>
<a id="pl.102.8"></a><var>102.8</var>and kept in the recipient's health record.<br/>
<a id="pl.102.9"></a><var>102.9</var>(b) The activity documentation must correspond to the written service delivery plan <br/>
<a id="pl.102.10"></a><var>102.10</var>and be reviewed by the agency provider or the participant and the FMS contractor when <br/>
<a id="pl.102.11"></a><var>102.11</var>the participant is acting as the employer of the support worker.<br/>
<a id="pl.102.12"></a><var>102.12</var>(c) The time sheet must be on a form approved by the commissioner documenting <br/>
<a id="pl.102.13"></a><var>102.13</var>time the support worker provides services in the home. The following criteria must be <br/>
<a id="pl.102.14"></a><var>102.14</var>included in the time sheet:<br/>
<a id="pl.102.15"></a><var>102.15</var>(1) full name of the support worker and individual provider number;<br/>
<a id="pl.102.16"></a><var>102.16</var>(2) provider name and telephone numbers, if an agency-provider is responsible for <br/>
<a id="pl.102.17"></a><var>102.17</var>delivery services under the written service plan;<br/>
<a id="pl.102.18"></a><var>102.18</var>(3) full name of the participant;<br/>
<a id="pl.102.19"></a><var>102.19</var>(4) consecutive dates, including month, day, and year, and arrival and departure <br/>
<a id="pl.102.20"></a><var>102.20</var>times with a.m. or p.m. notations;<br/>
<a id="pl.102.21"></a><var>102.21</var>(5) signatures of the participant or the participant's representative;<br/>
<a id="pl.102.22"></a><var>102.22</var>(6) personal signature of the support worker;<br/>
<a id="pl.102.23"></a><var>102.23</var>(7) any shared care provided, if applicable;<br/>
<a id="pl.102.24"></a><var>102.24</var>(8) a statement that it is a federal crime to provide false information on CFSS <br/>
<a id="pl.102.25"></a><var>102.25</var>billings for medical assistance payments; and<br/>
<a id="pl.102.26"></a><var>102.26</var>(9) dates and location of recipient stays in a hospital, care facility, or incarceration.<br/>
<a id="pl.102.27"></a><var>102.27</var>    Subd. 16. <b>Support workers requirements.</b> (a) Support workers shall:<br/>
<a id="pl.102.28"></a><var>102.28</var>(1) enroll with the department as a support worker after a background study under <br/>
<a id="pl.102.29"></a><var>102.29</var>chapter 245C has been completed and the support worker has received a notice from the <br/>
<a id="pl.102.30"></a><var>102.30</var>commissioner that:<br/>
<a id="pl.102.31"></a><var>102.31</var>(i) the support worker is not disqualified under section 245C.14; or<br/>
<a id="pl.102.32"></a><var>102.32</var>(ii) is disqualified, but the support worker has received a set-aside of the <br/>
<a id="pl.102.33"></a><var>102.33</var>disqualification under section 245C.22; <br/>
<a id="pl.102.34"></a><var>102.34</var>(2) have the ability to effectively communicate with the participant or the  <br/>
<a id="pl.102.35"></a><var>102.35</var>participant's representative;<br/>
<a id="pl.103.1"></a><var>103.1</var>(3) have the skills and ability to provide the services and supports according to the <br/>
<a id="pl.103.2"></a><var>103.2</var>person's CFSS service delivery plan and respond appropriately to the participant's needs;<br/>
<a id="pl.103.3"></a><var>103.3</var>(4) not be a participant of CFSS, unless the support services provided by the support <br/>
<a id="pl.103.4"></a><var>103.4</var>worker differ from those provided to the support worker;<br/>
<a id="pl.103.5"></a><var>103.5</var>(5) complete the basic standardized training as determined by the commissioner <br/>
<a id="pl.103.6"></a><var>103.6</var>before completing enrollment. The training must be available in languages other than <br/>
<a id="pl.103.7"></a><var>103.7</var>English and to those who need accommodations due to disabilities. Support worker <br/>
<a id="pl.103.8"></a><var>103.8</var>training must include successful completion of the following training components: basic <br/>
<a id="pl.103.9"></a><var>103.9</var>first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles <br/>
<a id="pl.103.10"></a><var>103.10</var>and responsibilities of support workers including information about basic body mechanics,  <br/>
<a id="pl.103.11"></a><var>103.11</var>emergency preparedness, orientation to positive behavioral practices, orientation to <br/>
<a id="pl.103.12"></a><var>103.12</var>responding to a mental health crisis, fraud issues, time cards and documentation, and an <br/>
<a id="pl.103.13"></a><var>103.13</var>overview of person-centered planning and self-direction. Upon completion of the training <br/>
<a id="pl.103.14"></a><var>103.14</var>components, the support worker must pass the certification test to provide assistance <br/>
<a id="pl.103.15"></a><var>103.15</var>to participants;<br/>
<a id="pl.103.16"></a><var>103.16</var>(6) complete training and orientation on the participant's individual needs; and<br/>
<a id="pl.103.17"></a><var>103.17</var>(7) maintain the privacy and confidentiality of the participant, and not independently <br/>
<a id="pl.103.18"></a><var>103.18</var>determine the medication dose or time for medications for the participant.<br/>
<a id="pl.103.19"></a><var>103.19</var>(b) The commissioner may deny or terminate a support worker's provider enrollment <br/>
<a id="pl.103.20"></a><var>103.20</var>and provider number if the support worker:<br/>
<a id="pl.103.21"></a><var>103.21</var>(1) lacks the skills, knowledge, or ability to adequately or safely perform the  <br/>
<a id="pl.103.22"></a><var>103.22</var>required work;<br/>
<a id="pl.103.23"></a><var>103.23</var>(2) fails to provide the authorized services required by the participant employer;<br/>
<a id="pl.103.24"></a><var>103.24</var>(3) has been intoxicated by alcohol or drugs while providing authorized services to  <br/>
<a id="pl.103.25"></a><var>103.25</var>the participant or while in the participant's home;<br/>
<a id="pl.103.26"></a><var>103.26</var>(4) has manufactured or distributed drugs while providing authorized services to the  <br/>
<a id="pl.103.27"></a><var>103.27</var>participant or while in the participant's home; or<br/>
<a id="pl.103.28"></a><var>103.28</var>(5) has been excluded as a provider by the commissioner of human services, or the  <br/>
<a id="pl.103.29"></a><var>103.29</var>United States Department of Health and Human Services, Office of Inspector General,  <br/>
<a id="pl.103.30"></a><var>103.30</var>from participation in Medicaid, Medicare, or any other federal health care program.<br/>
<a id="pl.103.31"></a><var>103.31</var>(c) A support worker may appeal in writing to the commissioner to contest the <br/>
<a id="pl.103.32"></a><var>103.32</var>decision to terminate the support worker's provider enrollment and provider number.<br/>
<a id="pl.103.33"></a><var>103.33</var>    Subd. 17. <b>Support specialist requirements and payments.</b> The commissioner <br/>
<a id="pl.103.34"></a><var>103.34</var>shall develop qualifications, scope of functions, and payment rates and service limits for a <br/>
<a id="pl.103.35"></a><var>103.35</var>support specialist that may provide additional or specialized assistance necessary to plan, <br/>
<a id="pl.103.36"></a><var>103.36</var>implement, arrange, augment, or evaluate services and supports.<br/>
<a id="pl.104.1"></a><var>104.1</var>    Subd. 18. <b>Service unit and budget allocation requirements and limits.</b> (a) For the  <br/>
<a id="pl.104.2"></a><var>104.2</var>agency-provider model, services will be authorized in units of service. The total service  <br/>
<a id="pl.104.3"></a><var>104.3</var>unit amount must be established based upon the assessed need for CFSS services, and  must <br/>
<a id="pl.104.4"></a><var>104.4</var>not exceed the maximum number of units available as determined under  subdivision 8.<br/>
<a id="pl.104.5"></a><var>104.5</var>(b) For the budget model, the budget allocation allowed for services and supports <br/>
<a id="pl.104.6"></a><var>104.6</var>is established by multiplying the number of units authorized under subdivision 8 by the <br/>
<a id="pl.104.7"></a><var>104.7</var>payment rate established by the commissioner.<br/>
<a id="pl.104.8"></a><var>104.8</var>    Subd. 19. <b>Support system.</b> (a) The commissioner shall provide information, <br/>
<a id="pl.104.9"></a><var>104.9</var>consultation, training, and assistance to ensure the participant is able to manage the   <br/>
<a id="pl.104.10"></a><var>104.10</var>services and supports and budgets, if applicable. This support shall include individual <br/>
<a id="pl.104.11"></a><var>104.11</var>consultation on how to select and employ workers, manage responsibilities under CFSS, <br/>
<a id="pl.104.12"></a><var>104.12</var>and evaluate personal outcomes.<br/>
<a id="pl.104.13"></a><var>104.13</var>(b) The commissioner shall provide assistance with the development of risk   <br/>
<a id="pl.104.14"></a><var>104.14</var>management agreements.<br/>
<a id="pl.104.15"></a><var>104.15</var>    Subd. 20. <b>Service-related rights.</b> (a) Participants must be provided with adequate <br/>
<a id="pl.104.16"></a><var>104.16</var>information, counseling, training, and assistance, as needed, to ensure that the participant <br/>
<a id="pl.104.17"></a><var>104.17</var>is able to choose and manage services, models, and budgets. This support shall include  <br/>
<a id="pl.104.18"></a><var>104.18</var>information regarding:<br/>
<a id="pl.104.19"></a><var>104.19</var>(1) person-centered planning;<br/>
<a id="pl.104.20"></a><var>104.20</var>(2) the range and scope of individual choices;<br/>
<a id="pl.104.21"></a><var>104.21</var>(3) the process for changing plans, services and budgets;<br/>
<a id="pl.104.22"></a><var>104.22</var>(4) the grievance  process;<br/>
<a id="pl.104.23"></a><var>104.23</var>(5) individual rights;<br/>
<a id="pl.104.24"></a><var>104.24</var>(6) identifying and assessing appropriate services;<br/>
<a id="pl.104.25"></a><var>104.25</var>(7) risks and responsibilities; and<br/>
<a id="pl.104.26"></a><var>104.26</var>(8) risk management.<br/>
<a id="pl.104.27"></a><var>104.27</var>(b) The commissioner must ensure that the participant has a copy of the most recent <br/>
<a id="pl.104.28"></a><var>104.28</var>community support plan and service delivery plan.<br/>
<a id="pl.104.29"></a><var>104.29</var>(c) A participant who appeals a reduction in previously authorized CFSS services <br/>
<a id="pl.104.30"></a><var>104.30</var>may continue previously authorized services pending an appeal in accordance with section <br/>
<a id="pl.104.31"></a><var>104.31</var>256.045.<br/>
<a id="pl.104.32"></a><var>104.32</var>(d) If the units of service or budget allocation for CFSS are reduced, denied, or <br/>
<a id="pl.104.33"></a><var>104.33</var>terminated, the commissioner must provide notice of the reasons for the reduction in the <br/>
<a id="pl.104.34"></a><var>104.34</var>participant's notice of denial, termination, or reduction.<br/>
<a id="pl.104.35"></a><var>104.35</var>(e) If all or part of a service delivery plan is denied approval, the commissioner must <br/>
<a id="pl.104.36"></a><var>104.36</var>provide a notice that describes the basis of the denial.<br/>
<a id="pl.105.1"></a><var>105.1</var>    Subd. 21. <b>Development and Implementation Council.</b> The commissioner <br/>
<a id="pl.105.2"></a><var>105.2</var>shall establish a Development and Implementation Council of which the majority of  <br/>
<a id="pl.105.3"></a><var>105.3</var>members are individuals with disabilities, elderly individuals, and their representatives. <br/>
<a id="pl.105.4"></a><var>105.4</var>The commissioner shall consult and collaborate with the council when developing and <br/>
<a id="pl.105.5"></a><var>105.5</var>implementing this section for at least the first five years of operation. The commissioner, <br/>
<a id="pl.105.6"></a><var>105.6</var>in consultation with the council, shall provide recommendations on how to improve the <br/>
<a id="pl.105.7"></a><var>105.7</var>quality and integrity of CFSS, reduce the paper documentation required in subdivisions <br/>
<a id="pl.105.8"></a><var>105.8</var>10, 12, and 15, make use of electronic means of documentation and online reporting in <br/>
<a id="pl.105.9"></a><var>105.9</var>order to reduce administrative costs and improve training to the legislative chairs of the <br/>
<a id="pl.105.10"></a><var>105.10</var>health and human services policy and finance committees by February 1, 2014.<br/>
<a id="pl.105.11"></a><var>105.11</var>    Subd. 22. <b>Quality assurance and risk management system.</b> (a) The commissioner <br/>
<a id="pl.105.12"></a><var>105.12</var>shall establish quality assurance and risk management measures for use in developing and <br/>
<a id="pl.105.13"></a><var>105.13</var>implementing CFSS, including those that (1) recognize the roles and responsibilities of <br/>
<a id="pl.105.14"></a><var>105.14</var>those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and <br/>
<a id="pl.105.15"></a><var>105.15</var>budgets based upon a recipient's resources and capabilities. Risk management measures <br/>
<a id="pl.105.16"></a><var>105.16</var>must include background studies, and backup and emergency plans, including disaster <br/>
<a id="pl.105.17"></a><var>105.17</var>planning.<br/>
<a id="pl.105.18"></a><var>105.18</var>(b) The commissioner shall provide ongoing technical assistance and resource and  <br/>
<a id="pl.105.19"></a><var>105.19</var>educational materials for CFSS participants. <br/>
<a id="pl.105.20"></a><var>105.20</var>(c) Performance assessment measures, such as a participant's satisfaction with the <br/>
<a id="pl.105.21"></a><var>105.21</var>services and supports, and ongoing monitoring of health and well-being shall be identified <br/>
<a id="pl.105.22"></a><var>105.22</var>in consultation with the council established in subdivision 21.<br/>
<a id="pl.105.23"></a><var>105.23</var>(d) Data reporting requirements will be developed in consultation with the council <br/>
<a id="pl.105.24"></a><var>105.24</var>established in subdivision 21.<br/>
<a id="pl.105.25"></a><var>105.25</var>    Subd. 23. <b>Commissioner's access.</b> When the commissioner is investigating a  <br/>
<a id="pl.105.26"></a><var>105.26</var>possible overpayment of Medicaid funds, the commissioner must be given immediate <br/>
<a id="pl.105.27"></a><var>105.27</var>access without prior notice to the agency provider or FMS contractor's office during  <br/>
<a id="pl.105.28"></a><var>105.28</var>regular business hours and to documentation and records related to services provided and <br/>
<a id="pl.105.29"></a><var>105.29</var>submission of claims for services provided. Denying the commissioner access to records <br/>
<a id="pl.105.30"></a><var>105.30</var>is cause for immediate suspension of payment and terminating the agency provider's  <br/>
<a id="pl.105.31"></a><var>105.31</var>enrollment according to section 256B.064 or terminating the FMS contract.<br/>
<a id="pl.105.32"></a><var>105.32</var>    Subd. 24. <b>CFSS agency-providers; background studies.</b> CFSS agency-providers <br/>
<a id="pl.105.33"></a><var>105.33</var>enrolled to provide personal care assistance services under the medical assistance program <br/>
<a id="pl.105.34"></a><var>105.34</var>shall comply with the following:<br/>
<a id="pl.105.35"></a><var>105.35</var>(1) owners who have a five percent interest or more and all managing employees <br/>
<a id="pl.105.36"></a><var>105.36</var>are subject to a background study as provided in chapter 245C. This applies to currently <br/>
<a id="pl.106.1"></a><var>106.1</var>enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS <br/>
<a id="pl.106.2"></a><var>106.2</var>agency-provider. "Managing employee" has the same meaning as Code of Federal  <br/>
<a id="pl.106.3"></a><var>106.3</var>Regulations, title 42, section 455. An organization is barred from enrollment if:<br/>
<a id="pl.106.4"></a><var>106.4</var>(i) the organization has not initiated background studies on owners managing <br/>
<a id="pl.106.5"></a><var>106.5</var>employees; or<br/>
<a id="pl.106.6"></a><var>106.6</var>(ii) the organization has initiated background studies on owners and managing <br/>
<a id="pl.106.7"></a><var>106.7</var>employees, but the commissioner has sent the organization a notice that an owner or <br/>
<a id="pl.106.8"></a><var>106.8</var>managing employee of the organization has been disqualified under section 245C.14, and <br/>
<a id="pl.106.9"></a><var>106.9</var>the owner or managing employee has not received a set-aside of the disqualification <br/>
<a id="pl.106.10"></a><var>106.10</var>under section 245C.22;<br/>
<a id="pl.106.11"></a><var>106.11</var>(2) a background study must be initiated and completed for all support specialists; and<br/>
<a id="pl.106.12"></a><var>106.12</var>(3) a background study must be initiated and completed for all support workers.<br/>
<a id="pl.106.13"></a><var>106.13</var><b>EFFECTIVE DATE.</b>This section is effective upon federal approval but no earlier <br/>
<a id="pl.106.14"></a><var>106.14</var>than January 1, 2014. The service will begin 90 days after federal approval or January 1, <br/>
<a id="pl.106.15"></a><var>106.15</var>2014, whichever is later. The commissioner of human services shall notify the revisor of <br/>
<a id="pl.106.16"></a><var>106.16</var>statutes when this occurs.<br/>
<br/>
<a id="bill.2.43.0"></a><a id="pl.106.17"></a><var>106.17</var>    Sec. 43. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision <br/>
<a id="pl.106.18"></a><var>106.18</var>to read:<br/>
<a id="pl.106.19"></a><var>106.19</var>    Subd. 1o. <b>Supplementary service rate; exemptions.</b> A county agency shall not <br/>
<a id="pl.106.20"></a><var>106.20</var>negotiate a supplementary service rate under this section for any individual that has been <br/>
<a id="pl.106.21"></a><var>106.21</var>determined to be eligible for Housing Stability Services as approved by the Centers <br/>
<a id="pl.106.22"></a><var>106.22</var>for Medicare and Medicaid Services, and who resides in an establishment voluntarily <br/>
<a id="pl.106.23"></a><var>106.23</var>registered under section 144D.025, as a supportive housing establishment or participates <br/>
<a id="pl.106.24"></a><var>106.24</var>in the Minnesota supportive housing demonstration program under section 256I.04, <br/>
<a id="pl.106.25"></a><var>106.25</var>subdivision 3, paragraph (a), clause (4).<br/>
<br/>
<a id="bill.2.44.0"></a><a id="pl.106.26"></a><var>106.26</var>    Sec. 44. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:<br/>
<a id="pl.106.27"></a><var>106.27</var>    Subd. 4. <b>Reporting.</b> (a) Except as provided in paragraph (b), a mandated reporter <br/>
<a id="pl.106.28"></a><var>106.28</var>shall immediately make an oral report to the common entry point. The common entry <br/>
<a id="pl.106.29"></a><var>106.29</var>point may accept electronic reports submitted through a Web-based reporting system <br/>
<a id="pl.106.30"></a><var>106.30</var>established by the commissioner. Use of a telecommunications device for the deaf or other <br/>
<a id="pl.106.31"></a><var>106.31</var>similar device shall be considered an oral report. The common entry point may not require <br/>
<a id="pl.106.32"></a><var>106.32</var>written reports. To the extent possible, the report must be of sufficient content to identify <br/>
<a id="pl.106.33"></a><var>106.33</var>the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, <br/>
<a id="pl.106.34"></a><var>106.34</var>any evidence of previous maltreatment, the name and address of the reporter, the time, <br/>
<a id="pl.107.1"></a><var>107.1</var>date, and location of the incident, and any other information that the reporter believes <br/>
<a id="pl.107.2"></a><var>107.2</var>might be helpful in investigating the suspected maltreatment. A mandated reporter may <br/>
<a id="pl.107.3"></a><var>107.3</var>disclose not public data, as defined in section 
         <statute_ref>13.02</statute_ref>, and medical records under sections <br/>
<statute_ref><a id="pl.107.4"></a><var>107.4</var>144.291
         </statute_ref> to 144.298, to the extent necessary to comply with this subdivision.<br/>
<a id="pl.107.5"></a><var>107.5</var>(b) A boarding care home that is licensed under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref> and <br/>
<a id="pl.107.6"></a><var>107.6</var>certified under Title 19 of the Social Security Act, a nursing home that is licensed under <br/>
<a id="pl.107.7"></a><var>107.7</var>section 
         <statute_ref>144A.02</statute_ref> and certified under Title 18 or Title 19 of the Social Security Act, or a <br/>
<a id="pl.107.8"></a><var>107.8</var>hospital that is licensed under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref> and has swing beds certified under <br/>
<a id="pl.107.9"></a><var>107.9</var>Code of Federal Regulations, title 42, section 
         <statute_ref>482.66</statute_ref>, may submit a report electronically <br/>
<a id="pl.107.10"></a><var>107.10</var>to the common entry point instead of submitting an oral report. The report may be a <br/>
<a id="pl.107.11"></a><var>107.11</var>duplicate of the initial report the facility submits electronically to the commissioner of <br/>
<a id="pl.107.12"></a><var>107.12</var>health to comply with the reporting requirements under Code of Federal Regulations, title <br/>
<a id="pl.107.13"></a><var>107.13</var>42, section 
         <statute_ref>483.13</statute_ref>. The commissioner of health may modify these reporting requirements <br/>
<a id="pl.107.14"></a><var>107.14</var>to include items required under paragraph (a) that are not currently included in the <br/>
<a id="pl.107.15"></a><var>107.15</var>electronic reporting form.<br/>
<a id="pl.107.16"></a><var>107.16</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2014.<br/>
<br/>
<a id="bill.2.45.0"></a><a id="pl.107.17"></a><var>107.17</var>    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:<br/>
<a id="pl.107.18"></a><var>107.18</var>    Subd. 9. <b>Common entry point designation.</b> (a) Each county board shall designate <br/>
<a id="pl.107.19"></a><var>107.19</var>a common entry point for reports of suspected maltreatment. Two or more county boards <br/>
<a id="pl.107.20"></a><var>107.20</var>may jointly designate a single The commissioner of human services shall establish a<br/>
<a id="pl.107.21"></a><var>107.21</var> common entry point effective July 1, 2014. The common entry point is the unit responsible <br/>
<a id="pl.107.22"></a><var>107.22</var>for receiving the report of suspected maltreatment under this section.<br/>
<a id="pl.107.23"></a><var>107.23</var>(b) The common entry point must be available 24 hours per day to take calls from <br/>
<a id="pl.107.24"></a><var>107.24</var>reporters of suspected maltreatment. The common entry point shall use a standard intake <br/>
<a id="pl.107.25"></a><var>107.25</var>form that includes:<br/>
<a id="pl.107.26"></a><var>107.26</var>(1) the time and date of the report;<br/>
<a id="pl.107.27"></a><var>107.27</var>(2) the name, address, and telephone number of the person reporting;<br/>
<a id="pl.107.28"></a><var>107.28</var>(3) the time, date, and location of the incident;<br/>
<a id="pl.107.29"></a><var>107.29</var>(4) the names of the persons involved, including but not limited to, perpetrators, <br/>
<a id="pl.107.30"></a><var>107.30</var>alleged victims, and witnesses;<br/>
<a id="pl.107.31"></a><var>107.31</var>(5) whether there was a risk of imminent danger to the alleged victim;<br/>
<a id="pl.107.32"></a><var>107.32</var>(6) a description of the suspected maltreatment;<br/>
<a id="pl.107.33"></a><var>107.33</var>(7) the disability, if any, of the alleged victim;<br/>
<a id="pl.107.34"></a><var>107.34</var>(8) the relationship of the alleged perpetrator to the alleged victim;<br/>
<a id="pl.107.35"></a><var>107.35</var>(9) whether a facility was involved and, if so, which agency licenses the facility;<br/>
<a id="pl.108.1"></a><var>108.1</var>(10) any action taken by the common entry point;<br/>
<a id="pl.108.2"></a><var>108.2</var>(11) whether law enforcement has been notified;<br/>
<a id="pl.108.3"></a><var>108.3</var>(12) whether the reporter wishes to receive notification of the initial and final <br/>
<a id="pl.108.4"></a><var>108.4</var>reports; and<br/>
<a id="pl.108.5"></a><var>108.5</var>(13) if the report is from a facility with an internal reporting procedure, the name, <br/>
<a id="pl.108.6"></a><var>108.6</var>mailing address, and telephone number of the person who initiated the report internally.<br/>
<a id="pl.108.7"></a><var>108.7</var>(c) The common entry point is not required to complete each item on the form prior <br/>
<a id="pl.108.8"></a><var>108.8</var>to dispatching the report to the appropriate lead investigative agency.<br/>
<a id="pl.108.9"></a><var>108.9</var>(d) The common entry point shall immediately report to a law enforcement agency <br/>
<a id="pl.108.10"></a><var>108.10</var>any incident in which there is reason to believe a crime has been committed.<br/>
<a id="pl.108.11"></a><var>108.11</var>(e) If a report is initially made to a law enforcement agency or a lead investigative <br/>
<a id="pl.108.12"></a><var>108.12</var>agency, those agencies shall take the report on the appropriate common entry point intake <br/>
<a id="pl.108.13"></a><var>108.13</var>forms and immediately forward a copy to the common entry point.<br/>
<a id="pl.108.14"></a><var>108.14</var>(f) The common entry point staff must receive training on how to screen and <br/>
<a id="pl.108.15"></a><var>108.15</var>dispatch reports efficiently and in accordance with this section.<br/>
<a id="pl.108.16"></a><var>108.16</var>(g) The commissioner of human services shall maintain a centralized database <br/>
<a id="pl.108.17"></a><var>108.17</var>for the collection of common entry point data, lead investigative agency data including <br/>
<a id="pl.108.18"></a><var>108.18</var>maltreatment report disposition, and appeals data. The common entry point shall <br/>
<a id="pl.108.19"></a><var>108.19</var>have access to the centralized database and must log the reports into the database and <br/>
<a id="pl.108.20"></a><var>108.20</var>immediately identify and locate prior reports of abuse, neglect, or exploitation.<br/>
<a id="pl.108.21"></a><var>108.21</var>(h) When appropriate, the common entry point staff must refer calls that do not <br/>
<a id="pl.108.22"></a><var>108.22</var>allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations <br/>
<a id="pl.108.23"></a><var>108.23</var>that might resolve the reporter's concerns.<br/>
<a id="pl.108.24"></a><var>108.24</var>(i) a common entry point must be operated in a manner that enables the <br/>
<a id="pl.108.25"></a><var>108.25</var>commissioner of human services to:<br/>
<a id="pl.108.26"></a><var>108.26</var>(1) track critical steps in the reporting, evaluation, referral, response, disposition, <br/>
<a id="pl.108.27"></a><var>108.27</var>and investigative process to ensure compliance with all requirements for all reports;<br/>
<a id="pl.108.28"></a><var>108.28</var>(2) maintain data to facilitate the production of aggregate statistical reports for <br/>
<a id="pl.108.29"></a><var>108.29</var>monitoring patterns of abuse, neglect, or exploitation;<br/>
<a id="pl.108.30"></a><var>108.30</var>(3) serve as a resource for the evaluation, management, and planning of preventative <br/>
<a id="pl.108.31"></a><var>108.31</var>and remedial services for vulnerable adults who have been subject to abuse, neglect, <br/>
<a id="pl.108.32"></a><var>108.32</var>or exploitation;<br/>
<a id="pl.108.33"></a><var>108.33</var>(4) set standards, priorities, and policies to maximize the efficiency and effectiveness <br/>
<a id="pl.108.34"></a><var>108.34</var>of the common entry point; and<br/>
<a id="pl.108.35"></a><var>108.35</var>(5) track and manage consumer complaints related to the common entry point.<br/>
<a id="pl.109.1"></a><var>109.1</var>(j) The commissioners of human services and health shall collaborate on the <br/>
<a id="pl.109.2"></a><var>109.2</var>creation of a system for referring reports to the lead investigative agencies. This system <br/>
<a id="pl.109.3"></a><var>109.3</var>shall enable the commissioner of human services to track critical steps in the reporting, <br/>
<a id="pl.109.4"></a><var>109.4</var>evaluation, referral, response, disposition, investigation, notification, determination, and <br/>
<a id="pl.109.5"></a><var>109.5</var>appeal processes.<br/>
<br/>
<a id="bill.2.46.0"></a><a id="pl.109.6"></a><var>109.6</var>    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:<br/>
<a id="pl.109.7"></a><var>109.7</var>    Subd. 9e. <b>Education requirements.</b> (a) The commissioners of health, human <br/>
<a id="pl.109.8"></a><var>109.8</var>services, and public safety shall cooperate in the development of a joint program for <br/>
<a id="pl.109.9"></a><var>109.9</var>education of lead investigative agency investigators in the appropriate techniques for <br/>
<a id="pl.109.10"></a><var>109.10</var>investigation of complaints of maltreatment. This program must be developed by July <br/>
<a id="pl.109.11"></a><var>109.11</var>1, 1996. The program must include but need not be limited to the following areas: (1) <br/>
<a id="pl.109.12"></a><var>109.12</var>information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4) <br/>
<a id="pl.109.13"></a><var>109.13</var>conclusions based on evidence; (5) interviewing skills, including specialized training to <br/>
<a id="pl.109.14"></a><var>109.14</var>interview people with unique needs; (6) report writing; (7) coordination and referral <br/>
<a id="pl.109.15"></a><var>109.15</var>to other necessary agencies such as law enforcement and judicial agencies; (8) human <br/>
<a id="pl.109.16"></a><var>109.16</var>relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family <br/>
<a id="pl.109.17"></a><var>109.17</var>systems and the appropriate methods for interviewing relatives in the course of the <br/>
<a id="pl.109.18"></a><var>109.18</var>assessment or investigation; (10) the protective social services that are available to protect <br/>
<a id="pl.109.19"></a><var>109.19</var>alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by <br/>
<a id="pl.109.20"></a><var>109.20</var>which lead investigative agency investigators and law enforcement workers cooperate in <br/>
<a id="pl.109.21"></a><var>109.21</var>conducting assessments and investigations in order to avoid duplication of efforts; and <br/>
<a id="pl.109.22"></a><var>109.22</var>(12) data practices laws and procedures, including provisions for sharing data.<br/>
<a id="pl.109.23"></a><var>109.23</var>(b) The commissioner of human services shall conduct an outreach campaign to <br/>
<a id="pl.109.24"></a><var>109.24</var>promote the common entry point for reporting vulnerable adult maltreatment. This <br/>
<a id="pl.109.25"></a><var>109.25</var>campaign shall use the Internet and other means of communication.<br/>
<a id="pl.109.26"></a><var>109.26</var>(b) (c) The commissioners of health, human services, and public safety shall offer at <br/>
<a id="pl.109.27"></a><var>109.27</var>least annual education to others on the requirements of this section, on how this section is <br/>
<a id="pl.109.28"></a><var>109.28</var>implemented, and investigation techniques.<br/>
<a id="pl.109.29"></a><var>109.29</var>(c) (d) The commissioner of human services, in coordination with the commissioner <br/>
<a id="pl.109.30"></a><var>109.30</var>of public safety shall provide training for the common entry point staff as required in this <br/>
<a id="pl.109.31"></a><var>109.31</var>subdivision and the program courses described in this subdivision, at least four times <br/>
<a id="pl.109.32"></a><var>109.32</var>per year. At a minimum, the training shall be held twice annually in the seven-county <br/>
<a id="pl.109.33"></a><var>109.33</var>metropolitan area and twice annually outside the seven-county metropolitan area. The <br/>
<a id="pl.109.34"></a><var>109.34</var>commissioners shall give priority in the program areas cited in paragraph (a) to persons <br/>
<a id="pl.109.35"></a><var>109.35</var>currently performing assessments and investigations pursuant to this section.<br/>
<a id="pl.110.1"></a><var>110.1</var>(d) (e) The commissioner of public safety shall notify in writing law enforcement <br/>
<a id="pl.110.2"></a><var>110.2</var>personnel of any new requirements under this section. The commissioner of public <br/>
<a id="pl.110.3"></a><var>110.3</var>safety shall conduct regional training for law enforcement personnel regarding their <br/>
<a id="pl.110.4"></a><var>110.4</var>responsibility under this section.<br/>
<a id="pl.110.5"></a><var>110.5</var>(e) (f) Each lead investigative agency investigator must complete the education <br/>
<a id="pl.110.6"></a><var>110.6</var>program specified by this subdivision within the first 12 months of work as a lead <br/>
<a id="pl.110.7"></a><var>110.7</var>investigative agency investigator.<br/>
<a id="pl.110.8"></a><var>110.8</var>A lead investigative agency investigator employed when these requirements take <br/>
<a id="pl.110.9"></a><var>110.9</var>effect must complete the program within the first year after training is available or as soon <br/>
<a id="pl.110.10"></a><var>110.10</var>as training is available.<br/>
<a id="pl.110.11"></a><var>110.11</var>All lead investigative agency investigators having responsibility for investigation <br/>
<a id="pl.110.12"></a><var>110.12</var>duties under this section must receive a minimum of eight hours of continuing education <br/>
<a id="pl.110.13"></a><var>110.13</var>or in-service training each year specific to their duties under this section.<br/>
<br/>
<a id="bill.2.47.0"></a><a id="pl.110.14"></a><var>110.14</var>    Sec. 47. <b>FEDERAL APPROVAL.</b><br/>
<a id="pl.110.15"></a><var>110.15</var>This article is contingent on federal approval.<br/>
<br/>
<a id="bill.2.48.0"></a><a id="pl.110.16"></a><var>110.16</var>    Sec. 48. <b> REPEALER.</b><br/>
<a id="pl.110.17"></a><var>110.17</var>(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2, <br/>
<a id="pl.110.18"></a><var>110.18</var>3, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.<br/>
<a id="pl.110.19"></a><var>110.19</var>(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are <br/>
<a id="pl.110.20"></a><var>110.20</var>repealed effective October 1, 2013.<br/>
<br/>
<a id="bill.3.0.0"></a>

<a id="pl.110.23"></a><var>110.23</var><b>YOUTH, AND FAMILIES</b><br/>

<a id="bill.3.1.0"></a><a id="pl.110.24"></a><var>110.24</var>    Section 1. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:<br/>
<a id="pl.110.25"></a><var>110.25</var>    Subdivision 1. <b>Eligible participants.</b> Families eligible for child care assistance <br/>
<a id="pl.110.26"></a><var>110.26</var>under the MFIP child care program are:<br/>
<a id="pl.110.27"></a><var>110.27</var>    (1) MFIP participants who are employed or in job search and meet the requirements <br/>
<a id="pl.110.28"></a><var>110.28</var>of section 
         <statute_ref>119B.10</statute_ref>;<br/>
<a id="pl.110.29"></a><var>110.29</var>    (2) persons who are members of transition year families under section 
         <statute_ref>119B.011, <br/>
<a id="pl.110.30"></a><var>110.30</var>subdivision 20
         </statute_ref>, and meet the requirements of section 
         <statute_ref>119B.10</statute_ref>;<br/>
<a id="pl.110.31"></a><var>110.31</var>    (3) families who are participating in employment orientation or job search, or <br/>
<a id="pl.110.32"></a><var>110.32</var>other employment or training activities that are included in an approved employability <br/>
<a id="pl.110.33"></a><var>110.33</var>development plan under section 
         <statute_ref>256J.95</statute_ref>;<br/>
<a id="pl.111.1"></a><var>111.1</var>    (4) MFIP families who are participating in work job search, job support, <br/>
<a id="pl.111.2"></a><var>111.2</var>employment, or training activities as required in their employment plan, or in appeals, <br/>
<a id="pl.111.3"></a><var>111.3</var>hearings, assessments, or orientations according to chapter 256J;<br/>
<a id="pl.111.4"></a><var>111.4</var>    (5) MFIP families who are participating in social services activities under chapter <br/>
<a id="pl.111.5"></a><var>111.5</var>256J or mental health treatment as required in their employment plan approved according <br/>
<a id="pl.111.6"></a><var>111.6</var>to chapter 256J;<br/>
<a id="pl.111.7"></a><var>111.7</var>    (6) families who are participating in services or activities that are included in an <br/>
<a id="pl.111.8"></a><var>111.8</var>approved family stabilization plan under section 
         <statute_ref>256J.575</statute_ref>;<br/>
<a id="pl.111.9"></a><var>111.9</var>    (7) MFIP child-only cases under section 256J.88, for up to 20 hours of child care <br/>
<a id="pl.111.10"></a><var>111.10</var>per child per week under the following conditions: (i) child care will be authorized if the <br/>
<a id="pl.111.11"></a><var>111.11</var>child's primary caregiver is receiving SSI for a disability related to depression or other <br/>
<a id="pl.111.12"></a><var>111.12</var>serious mental illness; and (ii) child care will only be authorized for children five years <br/>
<a id="pl.111.13"></a><var>111.13</var>of age or younger. The child's authorized care under this clause is not conditional based <br/>
<a id="pl.111.14"></a><var>111.14</var>on the primary caregiver participating in an authorized activity under section 119B.07 or <br/>
<a id="pl.111.15"></a><var>111.15</var>119B.11. Medical appointments, treatment, or therapy are considered authorized activities <br/>
<a id="pl.111.16"></a><var>111.16</var>for participants in this category;<br/>
<a id="pl.111.17"></a><var>111.17</var>    (8) families who are participating in programs as required in tribal contracts under <br/>
<a id="pl.111.18"></a><var>111.18</var>section 
         <statute_ref>119B.02, subdivision 2</statute_ref>, or 
         <statute_ref>256.01, subdivision 2</statute_ref>; and<br/>
<a id="pl.111.19"></a><var>111.19</var>    (8) (9) families who are participating in the transition year extension under section <br/>
<statute_ref><a id="pl.111.20"></a><var>111.20</var>119B.011, subdivision 20a
         </statute_ref>.<br/>
<br/>
<a id="bill.3.2.0"></a><a id="pl.111.21"></a><var>111.21</var>    Sec. 2. Minnesota Statutes 2012, section 119B.09, subdivision 5, is amended to read:<br/>
<a id="pl.111.22"></a><var>111.22</var>    Subd. 5. <b>Provider choice.</b> Parents may choose child care providers as defined under <br/>
<a id="pl.111.23"></a><var>111.23</var>section 
         <statute_ref>119B.011, subdivision 19</statute_ref>, that best meet the needs of their family. Beginning <br/>
<a id="pl.111.24"></a><var>111.24</var>July 1, 2018, parents or guardians must choose a rated provider under section 124D.142 <br/>
<a id="pl.111.25"></a><var>111.25</var>for their children not yet attending kindergarten, unless a waiver is granted by the <br/>
<a id="pl.111.26"></a><var>111.26</var>commissioner of human services. Counties shall make resources available to parents in <br/>
<a id="pl.111.27"></a><var>111.27</var>choosing quality child care services. Counties may require a parent to sign a release <br/>
<a id="pl.111.28"></a><var>111.28</var>stating their knowledge and responsibilities in choosing a legal provider described under <br/>
<a id="pl.111.29"></a><var>111.29</var>section 
         <statute_ref>119B.011, subdivision 19</statute_ref>. When a county knows that a particular provider is <br/>
<a id="pl.111.30"></a><var>111.30</var>unsafe, or that the circumstances of the child care arrangement chosen by the parent are <br/>
<a id="pl.111.31"></a><var>111.31</var>unsafe, the county may deny a child care subsidy. A county may not restrict access to a <br/>
<a id="pl.111.32"></a><var>111.32</var>general category of provider allowed under section 
         <statute_ref>119B.011, subdivision 19</statute_ref>.<br/>
<br/>
<a id="bill.3.3.0"></a><a id="pl.111.33"></a><var>111.33</var>    Sec. 3. Minnesota Statutes 2012, section 119B.125, subdivision 1, is amended to read:<br/>
<a id="pl.112.1"></a><var>112.1</var>    Subdivision 1. <b>Authorization.</b> (a) Except as provided in subdivision 5, a county <br/>
<a id="pl.112.2"></a><var>112.2</var>must authorize the provider chosen by an applicant or a participant before the county can <br/>
<a id="pl.112.3"></a><var>112.3</var>authorize payment for care provided by that provider. The commissioner must establish <br/>
<a id="pl.112.4"></a><var>112.4</var>the requirements necessary for authorization of providers. <br/>
<a id="pl.112.5"></a><var>112.5</var>(b) In order to be authorized, a provider must:<br/>
<a id="pl.112.6"></a><var>112.6</var>(1) beginning July 1, 2018, participate in the quality rating and improvement system <br/>
<a id="pl.112.7"></a><var>112.7</var>under section 124D.142; and<br/>
<a id="pl.112.8"></a><var>112.8</var>(2) beginning July 1, 2020, have at least a one- or two-star rating in the quality <br/>
<a id="pl.112.9"></a><var>112.9</var>rating and improvement system.<br/>
<a id="pl.112.10"></a><var>112.10</var>(c) In order to comply with federal regulations, the requirements in paragraph (b) do <br/>
<a id="pl.112.11"></a><var>112.11</var>not apply to unlicensed or license-exempt providers. In addition, the commissioner has <br/>
<a id="pl.112.12"></a><var>112.12</var>the authority to waive the requirements in paragraph (b), if: (1) the parents' authorized <br/>
<a id="pl.112.13"></a><var>112.13</var>activities occur during times when care is not available from providers participating in <br/>
<a id="pl.112.14"></a><var>112.14</var>the quality rating and improvement system, (2) a family lives in an area where care from <br/>
<a id="pl.112.15"></a><var>112.15</var>providers participating in the quality rating and improvement system is not available, or <br/>
<a id="pl.112.16"></a><var>112.16</var>(3) no providers participating in the quality rating and improvement system are willing <br/>
<a id="pl.112.17"></a><var>112.17</var>or able to care for one or all of the children in the family.<br/>
<a id="pl.112.18"></a><var>112.18</var>(d) A provider must be reauthorized every two years. A legal, nonlicensed family <br/>
<a id="pl.112.19"></a><var>112.19</var>child care provider also must be reauthorized when another person over the age of 13 joins <br/>
<a id="pl.112.20"></a><var>112.20</var>the household, a current household member turns 13, or there is reason to believe that a <br/>
<a id="pl.112.21"></a><var>112.21</var>household member has a factor that prevents authorization. The provider is required to <br/>
<a id="pl.112.22"></a><var>112.22</var>report all family changes that would require reauthorization. When a provider has been <br/>
<a id="pl.112.23"></a><var>112.23</var>authorized for payment for providing care for families in more than one county, the county <br/>
<a id="pl.112.24"></a><var>112.24</var>responsible for reauthorization of that provider is the county of the family with a current <br/>
<a id="pl.112.25"></a><var>112.25</var>authorization for that provider and who has used the provider for the longest length of time.<br/>
<br/>
<a id="bill.3.4.0"></a><a id="pl.112.26"></a><var>112.26</var>    Sec. 4. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:<br/>
<a id="pl.112.27"></a><var>112.27</var>    Subdivision 1. <b>Subsidy restrictions.</b> (a) Beginning October 31, 2011 July 1, 2014, <br/>
<a id="pl.112.28"></a><var>112.28</var>the maximum rate paid for child care assistance in any county or multicounty region under <br/>
<a id="pl.112.29"></a><var>112.29</var>the child care fund shall be the rate for like-care arrangements in the county effective July <br/>
<a id="pl.112.30"></a><var>112.30</var>1, 2006 2012, decreased increased  by 2.5 two percent.<br/>
<a id="pl.112.31"></a><var>112.31</var>    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged <br/>
<a id="pl.112.32"></a><var>112.32</var>by child care providers in Minnesota to determine the 75th percentile for like-care <br/>
<a id="pl.112.33"></a><var>112.33</var>arrangements in counties. When the commissioner determines that, using the <br/>
<a id="pl.112.34"></a><var>112.34</var>commissioner's established protocol, the number of providers responding to the survey is <br/>
<a id="pl.112.35"></a><var>112.35</var>too small to determine the 75th percentile rate for like-care arrangements in a county or <br/>
<a id="pl.113.1"></a><var>113.1</var>multicounty region, the commissioner may establish the 75th percentile maximum rate <br/>
<a id="pl.113.2"></a><var>113.2</var>based on like-care arrangements in a county, region, or category that the commissioner <br/>
<a id="pl.113.3"></a><var>113.3</var>deems to be similar.<br/>
<a id="pl.113.4"></a><var>113.4</var>    (c) A rate which includes a special needs rate paid under subdivision 3 or under a <br/>
<a id="pl.113.5"></a><var>113.5</var>school readiness service agreement paid under section 119B.231, may be in excess of the <br/>
<a id="pl.113.6"></a><var>113.6</var>maximum rate allowed under this subdivision.<br/>
<a id="pl.113.7"></a><var>113.7</var>    (d) The department shall monitor the effect of this paragraph on provider rates. The <br/>
<a id="pl.113.8"></a><var>113.8</var>county shall pay the provider's full charges for every child in care up to the maximum <br/>
<a id="pl.113.9"></a><var>113.9</var>established. The commissioner shall determine the maximum rate for each type of care <br/>
<a id="pl.113.10"></a><var>113.10</var>on an hourly, full-day, and weekly basis, including special needs and disability care. The <br/>
<a id="pl.113.11"></a><var>113.11</var>maximum payment to a provider for one day of care must not exceed the daily rate. The <br/>
<a id="pl.113.12"></a><var>113.12</var>maximum payment to a provider for one week of care must not exceed the weekly rate.<br/>
<a id="pl.113.13"></a><var>113.13</var>(e) Child care providers receiving reimbursement under this chapter must not be <br/>
<a id="pl.113.14"></a><var>113.14</var>paid activity fees or an additional amount above the maximum rates for care provided <br/>
<a id="pl.113.15"></a><var>113.15</var>during nonstandard hours for families receiving assistance.<br/>
<a id="pl.113.16"></a><var>113.16</var>    (f) When the provider charge is greater than the maximum provider rate allowed, <br/>
<a id="pl.113.17"></a><var>113.17</var>the parent is responsible for payment of the difference in the rates in addition to any <br/>
<a id="pl.113.18"></a><var>113.18</var>family co-payment fee.<br/>
<a id="pl.113.19"></a><var>113.19</var>    (g) All maximum provider rates changes shall be implemented on the Monday <br/>
<a id="pl.113.20"></a><var>113.20</var>following the effective date of the maximum provider rate.<br/>
<br/>
<a id="bill.3.5.0"></a><a id="pl.113.21"></a><var>113.21</var>    Sec. 5. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:<br/>
<a id="pl.113.22"></a><var>113.22</var>    Subd. 7. <b>Absent days.</b> (a) Licensed child care providers and license-exempt centers <br/>
<a id="pl.113.23"></a><var>113.23</var>must not be reimbursed for more than ten 25 full-day absent days per child, excluding <br/>
<a id="pl.113.24"></a><var>113.24</var>holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal <br/>
<a id="pl.113.25"></a><var>113.25</var>nonlicensed family child care providers must not be reimbursed for absent days. If a child <br/>
<a id="pl.113.26"></a><var>113.26</var>attends for part of the time authorized to be in care in a day, but is absent for part of the <br/>
<a id="pl.113.27"></a><var>113.27</var>time authorized to be in care in that same day, the absent time must be reimbursed but the <br/>
<a id="pl.113.28"></a><var>113.28</var>time must not count toward the ten 25 absent day days limit. Child care providers must <br/>
<a id="pl.113.29"></a><var>113.29</var>only be reimbursed for absent days if the provider has a written policy for child absences <br/>
<a id="pl.113.30"></a><var>113.30</var>and charges all other families in care for similar absences.<br/>
<a id="pl.113.31"></a><var>113.31</var>(b) Notwithstanding paragraph (a), children in families may exceed the ten 25 absent <br/>
<a id="pl.113.32"></a><var>113.32</var>days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school <br/>
<a id="pl.113.33"></a><var>113.33</var>or general equivalency diploma; and (3) is a student in a school district or another similar <br/>
<a id="pl.113.34"></a><var>113.34</var>program that provides or arranges for child care, parenting support, social services, career <br/>
<a id="pl.113.35"></a><var>113.35</var>and employment supports, and academic support to achieve high school graduation, upon <br/>
<a id="pl.114.1"></a><var>114.1</var>request of the program and approval of the county. If a child attends part of an authorized <br/>
<a id="pl.114.2"></a><var>114.2</var>day, payment to the provider must be for the full amount of care authorized for that day.<br/>
<a id="pl.114.3"></a><var>114.3</var>    (c) Child care providers must be reimbursed for up to ten federal or state holidays or <br/>
<a id="pl.114.4"></a><var>114.4</var>designated holidays per year when the provider charges all families for these days and the <br/>
<a id="pl.114.5"></a><var>114.5</var>holiday or designated holiday falls on a day when the child is authorized to be in attendance. <br/>
<a id="pl.114.6"></a><var>114.6</var>Parents may substitute other cultural or religious holidays for the ten recognized state and <br/>
<a id="pl.114.7"></a><var>114.7</var>federal holidays. Holidays do not count toward the ten 25 absent day days limit.<br/>
<a id="pl.114.8"></a><var>114.8</var>    (d) A family or child care provider must not be assessed an overpayment for an <br/>
<a id="pl.114.9"></a><var>114.9</var>absent day payment unless (1) there was an error in the amount of care authorized for the <br/>
<a id="pl.114.10"></a><var>114.10</var>family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) <br/>
<a id="pl.114.11"></a><var>114.11</var>the family or provider did not timely report a change as required under law.<br/>
<a id="pl.114.12"></a><var>114.12</var>    (e) The provider and family shall receive notification of the number of absent days <br/>
<a id="pl.114.13"></a><var>114.13</var>used upon initial provider authorization for a family and ongoing notification of the <br/>
<a id="pl.114.14"></a><var>114.14</var>number of absent days used as of the date of the notification.<br/>
<br/>
<a id="bill.3.6.0"></a><a id="pl.114.15"></a><var>114.15</var>    Sec. 6. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:<br/>
<a id="pl.114.16"></a><var>114.16</var>    Subd. 2a. <b>Immediate suspension expedited hearing.</b> (a) Within five working days <br/>
<a id="pl.114.17"></a><var>114.17</var>of receipt of the license holder's timely appeal, the commissioner shall request assignment <br/>
<a id="pl.114.18"></a><var>114.18</var>of an administrative law judge. The request must include a proposed date, time, and place <br/>
<a id="pl.114.19"></a><var>114.19</var>of a hearing. A hearing must be conducted by an administrative law judge within 30 <br/>
<a id="pl.114.20"></a><var>114.20</var>calendar days of the request for assignment, unless an extension is requested by either <br/>
<a id="pl.114.21"></a><var>114.21</var>party and granted by the administrative law judge for good cause. The commissioner shall <br/>
<a id="pl.114.22"></a><var>114.22</var>issue a notice of hearing by certified mail or personal service at least ten working days <br/>
<a id="pl.114.23"></a><var>114.23</var>before the hearing. The scope of the hearing shall be limited solely to the issue of whether <br/>
<a id="pl.114.24"></a><var>114.24</var>the temporary immediate suspension should remain in effect pending the commissioner's <br/>
<a id="pl.114.25"></a><var>114.25</var>final order under section 
         <statute_ref>245A.08</statute_ref>, regarding a licensing sanction issued under subdivision <br/>
<a id="pl.114.26"></a><var>114.26</var>3 following the immediate suspension. The burden of proof in expedited hearings under <br/>
<a id="pl.114.27"></a><var>114.27</var>this subdivision shall be limited to the commissioner's demonstration that reasonable <br/>
<a id="pl.114.28"></a><var>114.28</var>cause exists to believe that the license holder's actions or failure to comply with applicable <br/>
<a id="pl.114.29"></a><var>114.29</var>law or rule poses, or if the actions of other individuals or conditions in the program <br/>
<a id="pl.114.30"></a><var>114.30</var>poses an imminent risk of harm to the health, safety, or rights of persons served by the <br/>
<a id="pl.114.31"></a><var>114.31</var>program. "Reasonable cause" means there exist specific articulable facts or circumstances <br/>
<a id="pl.114.32"></a><var>114.32</var>which provide the commissioner with a reasonable suspicion that there is an imminent <br/>
<a id="pl.114.33"></a><var>114.33</var>risk of harm to the health, safety, or rights of persons served by the program. When the <br/>
<a id="pl.114.34"></a><var>114.34</var>commissioner has determined there is reasonable cause to order the temporary immediate <br/>
<a id="pl.114.35"></a><var>114.35</var>suspension of a license based on a violation of safe sleep requirements, as defined in <br/>
<a id="pl.115.1"></a><var>115.1</var>section 245A.1435, the commissioner is not required to demonstrate that an infant died or <br/>
<a id="pl.115.2"></a><var>115.2</var>was injured as a result of the safe sleep violations.<br/>
<a id="pl.115.3"></a><var>115.3</var>    (b) The administrative law judge shall issue findings of fact, conclusions, and a <br/>
<a id="pl.115.4"></a><var>115.4</var>recommendation within ten working days from the date of hearing. The parties shall have <br/>
<a id="pl.115.5"></a><var>115.5</var>ten calendar days to submit exceptions to the administrative law judge's report. The <br/>
<a id="pl.115.6"></a><var>115.6</var>record shall close at the end of the ten-day period for submission of exceptions. The <br/>
<a id="pl.115.7"></a><var>115.7</var>commissioner's final order shall be issued within ten working days from the close of the <br/>
<a id="pl.115.8"></a><var>115.8</var>record. Within 90 calendar days after a final order affirming an immediate suspension, the <br/>
<a id="pl.115.9"></a><var>115.9</var>commissioner shall make a determination regarding whether a final licensing sanction <br/>
<a id="pl.115.10"></a><var>115.10</var>shall be issued under subdivision 3. The license holder shall continue to be prohibited <br/>
<a id="pl.115.11"></a><var>115.11</var>from operation of the program during this 90-day period.<br/>
<a id="pl.115.12"></a><var>115.12</var>    (c) When the final order under paragraph (b) affirms an immediate suspension, and a <br/>
<a id="pl.115.13"></a><var>115.13</var>final licensing sanction is issued under subdivision 3 and the license holder appeals that <br/>
<a id="pl.115.14"></a><var>115.14</var>sanction, the license holder continues to be prohibited from operation of the program <br/>
<a id="pl.115.15"></a><var>115.15</var>pending a final commissioner's order under section 
         <statute_ref>245A.08, subdivision 5</statute_ref>, regarding the <br/>
<a id="pl.115.16"></a><var>115.16</var>final licensing sanction.<br/>
<br/>
<a id="bill.3.7.0"></a><a id="pl.115.17"></a><var>115.17</var>    Sec. 7. Minnesota Statutes 2012, section 245A.1435, is amended to read:<br/>
<a id="pl.115.18"></a><var>115.18</var><b>245A.1435 REDUCTION OF RISK OF SUDDEN</b><b> UNEXPECTED</b><b> INFANT </b><br/>
<a id="pl.115.19"></a><var>115.19</var><b>DEATH </b><b>SYNDROME</b><b> IN LICENSED PROGRAMS.</b><br/>
<a id="pl.115.20"></a><var>115.20</var>    (a) When a license holder is placing an infant to sleep, the license holder must <br/>
<a id="pl.115.21"></a><var>115.21</var>place the infant on the infant's back, unless the license holder has documentation from <br/>
<a id="pl.115.22"></a><var>115.22</var>the infant's parent physician directing an alternative sleeping position for the infant. The <br/>
<a id="pl.115.23"></a><var>115.23</var>parent physician directive must be on a form approved by the commissioner and must <br/>
<a id="pl.115.24"></a><var>115.24</var>include a statement that the parent or legal guardian has read the information provided by <br/>
<a id="pl.115.25"></a><var>115.25</var>the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance <br/>
<a id="pl.115.26"></a><var>115.26</var>of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file <br/>
<a id="pl.115.27"></a><var>115.27</var>at the licensed location. An infant who independently rolls onto its stomach after being <br/>
<a id="pl.115.28"></a><var>115.28</var>placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant <br/>
<a id="pl.115.29"></a><var>115.29</var>is at least six months of age or the license holder has a signed statement from the parent <br/>
<a id="pl.115.30"></a><var>115.30</var>indicating that the infant regularly rolls over at home.<br/>
<a id="pl.115.31"></a><var>115.31</var>(b) The license holder must place the infant in a crib directly on a firm mattress with <br/>
<a id="pl.115.32"></a><var>115.32</var>a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be <br/>
<a id="pl.115.33"></a><var>115.33</var>dislodged by pulling on the corner of the sheet. The license holder must not place pillows, <br/>
<a id="pl.115.34"></a><var>115.34</var>quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib <br/>
<a id="pl.115.35"></a><var>115.35</var>with the infant The license holder must place the infant in a crib directly on a firm mattress <br/>
<a id="pl.116.1"></a><var>116.1</var>with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, <br/>
<a id="pl.116.2"></a><var>116.2</var>and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner <br/>
<a id="pl.116.3"></a><var>116.3</var>of the sheet with reasonable effort. The license holder must not place anything in the crib <br/>
<a id="pl.116.4"></a><var>116.4</var>with the infant except for the infant's pacifier. The requirements of this section apply to <br/>
<a id="pl.116.5"></a><var>116.5</var>license holders serving infants up to and including 12 months younger than one year of age. <br/>
<a id="pl.116.6"></a><var>116.6</var>Licensed child care providers must meet the crib requirements under section 
         <statute_ref>245A.146</statute_ref>.<br/>
<a id="pl.116.7"></a><var>116.7</var>(c) If an infant falls asleep before being placed in a crib, the license holder must <br/>
<a id="pl.116.8"></a><var>116.8</var>move the infant to a crib as soon as practicable, and must keep the infant within sight of <br/>
<a id="pl.116.9"></a><var>116.9</var>the license holder until the infant is placed in a crib. When an infant falls asleep while <br/>
<a id="pl.116.10"></a><var>116.10</var>being held, the license holder must consider the supervision needs of other children in <br/>
<a id="pl.116.11"></a><var>116.11</var>care when determining how long to hold the infant before placing the infant in a crib to <br/>
<a id="pl.116.12"></a><var>116.12</var>sleep. The sleeping infant must not be in a position where the airway may be blocked or <br/>
<a id="pl.116.13"></a><var>116.13</var>with anything covering the infant's face.<br/>
<a id="pl.116.14"></a><var>116.14</var>(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended <br/>
<a id="pl.116.15"></a><var>116.15</var>for an infant of any age and is prohibited for any infant who has begun to roll over <br/>
<a id="pl.116.16"></a><var>116.16</var>independently. However, with the written consent of a parent or guardian according to this <br/>
<a id="pl.116.17"></a><var>116.17</var>paragraph, a license holder may place the infant who has not yet begun to roll over on its <br/>
<a id="pl.116.18"></a><var>116.18</var>own down to sleep in a one-piece sleeper equipped with an attached system that fastens <br/>
<a id="pl.116.19"></a><var>116.19</var>securely only across the upper torso, with no constriction of the hips or legs, to create a <br/>
<a id="pl.116.20"></a><var>116.20</var>swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter, <br/>
<a id="pl.116.21"></a><var>116.21</var>the license holder must obtain informed written consent for the use of swaddling from the <br/>
<a id="pl.116.22"></a><var>116.22</var>parent or guardian of the infant on a form provided by the commissioner and prepared in <br/>
<a id="pl.116.23"></a><var>116.23</var>partnership with the Minnesota Sudden Infant Death Center.<br/>
<br/>
<a id="bill.3.8.0"></a><a id="pl.116.24"></a><var>116.24</var>    Sec. 8. Minnesota Statutes 2012, section 245A.144, is amended to read:<br/>
<a id="pl.116.25"></a><var>116.25</var><b>245A.144 </b><b>TRAINING ON RISK OF </b><b>SUDDEN </b><b>UNEXPECTED </b><b>INFANT </b><br/>
<a id="pl.116.26"></a><var>116.26</var><b>DEATH AND </b><b>SHAKEN BABY SYNDROME</b><b> ABUSIVE HEAD TRAUMA</b><b> FOR </b><br/>
<a id="pl.116.27"></a><var>116.27</var><b>CHILD FOSTER CARE PROVIDERS.</b><br/>
<a id="pl.116.28"></a><var>116.28</var>    (a) Licensed child foster care providers that care for infants or children through five <br/>
<a id="pl.116.29"></a><var>116.29</var>years of age must document that before staff persons and caregivers assist in the care <br/>
<a id="pl.116.30"></a><var>116.30</var>of infants or children through five years of age, they are instructed on the standards in <br/>
<a id="pl.116.31"></a><var>116.31</var>section 
         <statute_ref>245A.1435</statute_ref> and receive training on reducing the risk of sudden unexpected infant <br/>
<a id="pl.116.32"></a><var>116.32</var>death syndrome and shaken baby syndrome for abusive head trauma from shaking infants <br/>
<a id="pl.116.33"></a><var>116.33</var>and young children. This section does not apply to emergency relative placement under <br/>
<a id="pl.116.34"></a><var>116.34</var>section 
         <statute_ref>245A.035</statute_ref>. The training on reducing the risk of sudden unexpected infant death <br/>
<a id="pl.116.35"></a><var>116.35</var>syndrome and shaken baby syndrome abusive head trauma may be provided as:<br/>
<a id="pl.117.1"></a><var>117.1</var>    (1) orientation training to child foster care providers, who care for infants or children <br/>
<a id="pl.117.2"></a><var>117.2</var>through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or<br/>
<a id="pl.117.3"></a><var>117.3</var>    (2) in-service training to child foster care providers, who care for infants or children <br/>
<a id="pl.117.4"></a><var>117.4</var>through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.<br/>
<a id="pl.117.5"></a><var>117.5</var>    (b) Training required under this section must be at least one hour in length and must <br/>
<a id="pl.117.6"></a><var>117.6</var>be completed at least once every five years. At a minimum, the training must address <br/>
<a id="pl.117.7"></a><var>117.7</var>the risk factors related to sudden unexpected infant death syndrome and shaken baby <br/>
<a id="pl.117.8"></a><var>117.8</var>syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant <br/>
<a id="pl.117.9"></a><var>117.9</var>death syndrome and shaken baby syndrome abusive head trauma, and license holder <br/>
<a id="pl.117.10"></a><var>117.10</var>communication with parents regarding reducing the risk of sudden unexpected infant <br/>
<a id="pl.117.11"></a><var>117.11</var>death syndrome and shaken baby syndrome abusive head trauma.<br/>
<a id="pl.117.12"></a><var>117.12</var>    (c) Training for child foster care providers must be approved by the county or <br/>
<a id="pl.117.13"></a><var>117.13</var>private licensing agency that is responsible for monitoring the child foster care provider <br/>
<a id="pl.117.14"></a><var>117.14</var>under section 
         <statute_ref>245A.16</statute_ref>. The approved training fulfills, in part, training required under <br/>
<a id="pl.117.15"></a><var>117.15</var>Minnesota Rules, part 2960.3070.<br/>
<br/>
<a id="bill.3.9.0"></a><a id="pl.117.16"></a><var>117.16</var>    Sec. 9. Minnesota Statutes 2012, section 245A.1444, is amended to read:<br/>
<a id="pl.117.17"></a><var>117.17</var><b>245A.1444 TRAINING ON RISK OF SUDDEN </b><b>UNEXPECTED </b><b>INFANT </b><br/>
<a id="pl.117.18"></a><var>117.18</var><b>DEATH </b><b>SYNDROME</b><b> AND </b><b>SHAKEN BABY SYNDROME</b><b> ABUSIVE HEAD </b><br/>
<a id="pl.117.19"></a><var>117.19</var><b>TRAUMA</b><b> BY OTHER PROGRAMS.</b><br/>
<a id="pl.117.20"></a><var>117.20</var>    A licensed chemical dependency treatment program that serves clients with infants <br/>
<a id="pl.117.21"></a><var>117.21</var>or children through five years of age, who sleep at the program and a licensed children's <br/>
<a id="pl.117.22"></a><var>117.22</var>residential facility that serves infants or children through five years of age, must document <br/>
<a id="pl.117.23"></a><var>117.23</var>that before program staff persons or volunteers assist in the care of infants or children <br/>
<a id="pl.117.24"></a><var>117.24</var>through five years of age, they are instructed on the standards in section 
         <statute_ref>245A.1435</statute_ref> and <br/>
<a id="pl.117.25"></a><var>117.25</var>receive training on reducing the risk of sudden unexpected infant death syndrome and <br/>
<a id="pl.117.26"></a><var>117.26</var>shaken baby syndrome abusive head trauma from shaking infants and young children. The <br/>
<a id="pl.117.27"></a><var>117.27</var>training conducted under this section may be used to fulfill training requirements under <br/>
<a id="pl.117.28"></a><var>117.28</var>Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.<br/>
<a id="pl.117.29"></a><var>117.29</var>    This section does not apply to child care centers or family child care programs <br/>
<a id="pl.117.30"></a><var>117.30</var>governed by sections 
         <statute_ref>245A.40</statute_ref> and 
         <statute_ref>245A.50</statute_ref>.<br/>
<br/>
<a id="bill.3.10.0"></a><a id="pl.117.31"></a><var>117.31</var>    Sec. 10. <b>[245A.1446] FAMILY CHILD CARE DIAPERING AREA </b><br/>
<a id="pl.117.32"></a><var>117.32</var><b>DISINFECTION.</b><br/>
<a id="pl.117.33"></a><var>117.33</var>Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may <br/>
<a id="pl.117.34"></a><var>117.34</var>disinfect the diaper changing surface with either a solution of at least two teaspoons <br/>
<a id="pl.118.1"></a><var>118.1</var>of chlorine bleach to one quart of water or with a surface disinfectant that meets the <br/>
<a id="pl.118.2"></a><var>118.2</var>following criteria:<br/>
<a id="pl.118.3"></a><var>118.3</var>(1) the manufacturer's label or instructions state that the product is registered with <br/>
<a id="pl.118.4"></a><var>118.4</var>the United States Environmental Protection Agency;<br/>
<a id="pl.118.5"></a><var>118.5</var>(2) the manufacturer's label or instructions state that the disinfectant is effective <br/>
<a id="pl.118.6"></a><var>118.6</var>against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;<br/>
<a id="pl.118.7"></a><var>118.7</var>(3) the manufacturer's label or instructions state that the disinfectant is effective with <br/>
<a id="pl.118.8"></a><var>118.8</var>a ten minute or less contact time;<br/>
<a id="pl.118.9"></a><var>118.9</var>(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing <br/>
<a id="pl.118.10"></a><var>118.10</var>and use;<br/>
<a id="pl.118.11"></a><var>118.11</var>(5) the disinfectant is used only in accordance with the manufacturer's directions; and<br/>
<a id="pl.118.12"></a><var>118.12</var>(6) the product does not include triclosan or derivatives of triclosan.<br/>
<br/>
<a id="bill.3.11.0"></a><a id="pl.118.13"></a><var>118.13</var>    Sec. 11. <b>[245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION </b><br/>
<a id="pl.118.14"></a><var>118.14</var><b>REQUIREMENTS.</b><br/>
<a id="pl.118.15"></a><var>118.15</var>    Subdivision 1. <b>In-person checks on infants.</b> (a) License holders that serve infants <br/>
<a id="pl.118.16"></a><var>118.16</var>are encouraged to monitor sleeping infants by conducting in-person checks on each infant <br/>
<a id="pl.118.17"></a><var>118.17</var>in their care every 30 minutes.<br/>
<a id="pl.118.18"></a><var>118.18</var>(b) Upon enrollment of an infant in a family child care program, the license holder is <br/>
<a id="pl.118.19"></a><var>118.19</var>encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during <br/>
<a id="pl.118.20"></a><var>118.20</var>the first four months of care.<br/>
<a id="pl.118.21"></a><var>118.21</var>(c) When an infant has an upper respiratory infection, the license holder is <br/>
<a id="pl.118.22"></a><var>118.22</var>encouraged to conduct in-person checks on the sleeping infant every 15 minutes <br/>
<a id="pl.118.23"></a><var>118.23</var>throughout the hours of sleep.<br/>
<a id="pl.118.24"></a><var>118.24</var>    Subd. 2. <b>Use of audio or visual monitoring devices.</b> In addition to conducting <br/>
<a id="pl.118.25"></a><var>118.25</var>the in-person checks encouraged under subdivision 1, license holders serving infants are <br/>
<a id="pl.118.26"></a><var>118.26</var>encouraged to use and maintain an audio or visual monitoring device to monitor each <br/>
<a id="pl.118.27"></a><var>118.27</var>sleeping infant in care during all hours of sleep.<br/>
<br/>
<a id="bill.3.12.0"></a><a id="pl.118.28"></a><var>118.28</var>    Sec. 12. <b>[245A.152] CHILD CARE LICENSE HOLDER INSURANCE.</b><br/>
<a id="pl.118.29"></a><var>118.29</var>(a) A license holder must provide a written notice to all parents or guardians of all <br/>
<a id="pl.118.30"></a><var>118.30</var>children to be accepted for care prior to admission stating whether the license holder has <br/>
<a id="pl.118.31"></a><var>118.31</var>liability insurance. This notice may be incorporated into and provided on the admission <br/>
<a id="pl.118.32"></a><var>118.32</var>form used by the license holder.<br/>
<a id="pl.118.33"></a><var>118.33</var>(b) If the license holder has liability insurance:<br/>
<a id="pl.119.1"></a><var>119.1</var>(1) the license holder shall inform parents in writing that a current certificate of <br/>
<a id="pl.119.2"></a><var>119.2</var>coverage for insurance is available for inspection to all parents or guardians of children <br/>
<a id="pl.119.3"></a><var>119.3</var>receiving services and to all parents seeking services from the family child care program;<br/>
<a id="pl.119.4"></a><var>119.4</var>(2) the notice must provide the parent or guardian with the date of expiration or <br/>
<a id="pl.119.5"></a><var>119.5</var>next renewal of the policy; and<br/>
<a id="pl.119.6"></a><var>119.6</var>(3) upon the expiration date of the policy, the license holder must provide a new <br/>
<a id="pl.119.7"></a><var>119.7</var>written notice indicating whether the insurance policy has lapsed or whether the license <br/>
<a id="pl.119.8"></a><var>119.8</var>holder has renewed the policy.<br/>
<a id="pl.119.9"></a><var>119.9</var>If the policy was renewed, the license holder must provide the new expiration date of the <br/>
<a id="pl.119.10"></a><var>119.10</var>policy in writing to the parents or guardians.<br/>
<a id="pl.119.11"></a><var>119.11</var>(c) If the license holder does not have liability insurance, the license holder must <br/>
<a id="pl.119.12"></a><var>119.12</var>provide an annual notice on a form developed and made available by the commissioner, <br/>
<a id="pl.119.13"></a><var>119.13</var>to the parents or guardians of children in care indicating that the license holder does not <br/>
<a id="pl.119.14"></a><var>119.14</var>carry liability insurance.<br/>
<a id="pl.119.15"></a><var>119.15</var>(d) The license holder must notify all parents and guardians in writing immediately <br/>
<a id="pl.119.16"></a><var>119.16</var>of any change in insurance status.<br/>
<a id="pl.119.17"></a><var>119.17</var>(e) The license holder must make available upon request the certificate of liability <br/>
<a id="pl.119.18"></a><var>119.18</var>insurance to the parents of children in care, to the commissioner, and to county licensing <br/>
<a id="pl.119.19"></a><var>119.19</var>agents.<br/>
<a id="pl.119.20"></a><var>119.20</var>(f) The license holder must document, with the signature of the parent or guardian, <br/>
<a id="pl.119.21"></a><var>119.21</var>that the parent or guardian received the notices required by this section.<br/>
<br/>
<a id="bill.3.13.0"></a><a id="pl.119.22"></a><var>119.22</var>    Sec. 13. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:<br/>
<a id="pl.119.23"></a><var>119.23</var>    Subd. 5. <b>Sudden </b><b>unexpected </b><b>infant death </b><b>syndrome</b><b> and </b><b>shaken baby syndrome</b><br/>
<a id="pl.119.24"></a><var>119.24</var><b> </b><b>abusive head trauma </b><b>training.</b> (a) License holders must document that before staff <br/>
<a id="pl.119.25"></a><var>119.25</var>persons and volunteers care for infants, they are instructed on the standards in section <br/>
<statute_ref><a id="pl.119.26"></a><var>119.26</var>245A.1435
         </statute_ref> and receive training on reducing the risk of sudden unexpected infant death <br/>
<a id="pl.119.27"></a><var>119.27</var>syndrome. In addition, license holders must document that before staff persons care for <br/>
<a id="pl.119.28"></a><var>119.28</var>infants or children under school age, they receive training on the risk of shaken baby <br/>
<a id="pl.119.29"></a><var>119.29</var>syndrome abusive head trauma from shaking infants and young children. The training <br/>
<a id="pl.119.30"></a><var>119.30</var>in this subdivision may be provided as orientation training under subdivision 1 and <br/>
<a id="pl.119.31"></a><var>119.31</var>in-service training under subdivision 7.<br/>
<a id="pl.119.32"></a><var>119.32</var>    (b) Sudden unexpected infant death syndrome reduction training required under <br/>
<a id="pl.119.33"></a><var>119.33</var>this subdivision must be at least one-half hour in length and must be completed at least <br/>
<a id="pl.119.34"></a><var>119.34</var>once every five years year. At a minimum, the training must address the risk factors <br/>
<a id="pl.119.35"></a><var>119.35</var>related to sudden unexpected infant death syndrome, means of reducing the risk of sudden <br/>
<a id="pl.120.1"></a><var>120.1</var>unexpected infant death syndrome in child care, and license holder communication with <br/>
<a id="pl.120.2"></a><var>120.2</var>parents regarding reducing the risk of sudden unexpected infant death syndrome.<br/>
<a id="pl.120.3"></a><var>120.3</var>    (c) Shaken baby syndrome Abusive head trauma training under this subdivision <br/>
<a id="pl.120.4"></a><var>120.4</var>must be at least one-half hour in length and must be completed at least once every five <br/>
<a id="pl.120.5"></a><var>120.5</var>years year. At a minimum, the training must address the risk factors related to shaken <br/>
<a id="pl.120.6"></a><var>120.6</var>baby syndrome for shaking infants and young children, means to reduce the risk of shaken <br/>
<a id="pl.120.7"></a><var>120.7</var>baby syndrome abusive head trauma in child care, and license holder communication with <br/>
<a id="pl.120.8"></a><var>120.8</var>parents regarding reducing the risk of shaken baby syndrome abusive head trauma.<br/>
<a id="pl.120.9"></a><var>120.9</var>(d) The commissioner shall make available for viewing a video presentation on the <br/>
<a id="pl.120.10"></a><var>120.10</var>dangers associated with shaking infants and young children. The video presentation must <br/>
<a id="pl.120.11"></a><var>120.11</var>be part of the orientation and annual in-service training of licensed child care center <br/>
<a id="pl.120.12"></a><var>120.12</var>staff persons caring for children under school age. The commissioner shall provide to <br/>
<a id="pl.120.13"></a><var>120.13</var>child care providers and interested individuals, at cost, copies of a video approved by the <br/>
<a id="pl.120.14"></a><var>120.14</var>commissioner of health under section 
         <statute_ref>144.574</statute_ref> on the dangers associated with shaking <br/>
<a id="pl.120.15"></a><var>120.15</var>infants and young children.<br/>
<br/>
<a id="bill.3.14.0"></a><a id="pl.120.16"></a><var>120.16</var>    Sec. 14. Minnesota Statutes 2012, section 245A.50, is amended to read:<br/>
<a id="pl.120.17"></a><var>120.17</var><b>245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.</b><br/>
<a id="pl.120.18"></a><var>120.18</var>    Subdivision 1. <b>Initial training.</b> (a) License holders, caregivers, and substitutes must <br/>
<a id="pl.120.19"></a><var>120.19</var>comply with the training requirements in this section.<br/>
<a id="pl.120.20"></a><var>120.20</var>    (b) Helpers who assist with care on a regular basis must complete six hours of <br/>
<a id="pl.120.21"></a><var>120.21</var>training within one year after the date of initial employment.<br/>
<a id="pl.120.22"></a><var>120.22</var>    Subd. 2. <b>Child growth and development </b><b>and behavior guidance </b><b>training.</b> (a) For <br/>
<a id="pl.120.23"></a><var>120.23</var>purposes of family and group family child care, the license holder and each adult caregiver <br/>
<a id="pl.120.24"></a><var>120.24</var>who provides care in the licensed setting for more than 30 days in any 12-month period <br/>
<a id="pl.120.25"></a><var>120.25</var>shall complete and document at least two four hours of child growth and development <br/>
<a id="pl.120.26"></a><var>120.26</var>and behavior guidance training within the first year of prior to initial licensure, and before <br/>
<a id="pl.120.27"></a><var>120.27</var>caring for children. For purposes of this subdivision, "child growth and development <br/>
<a id="pl.120.28"></a><var>120.28</var>training" means training in understanding how children acquire language and develop <br/>
<a id="pl.120.29"></a><var>120.29</var>physically, cognitively, emotionally, and socially. "Behavior guidance training" means <br/>
<a id="pl.120.30"></a><var>120.30</var>training in the understanding of the functions of child behavior and strategies for managing <br/>
<a id="pl.120.31"></a><var>120.31</var>challenging situations. Child growth and development and behavior guidance training <br/>
<a id="pl.120.32"></a><var>120.32</var>must be repeated annually. Training curriculum shall be developed or approved by the <br/>
<a id="pl.120.33"></a><var>120.33</var>commissioner of human services by January 1, 2014.<br/>
<a id="pl.120.34"></a><var>120.34</var>    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if <br/>
<a id="pl.120.35"></a><var>120.35</var>they:<br/>
<a id="pl.121.1"></a><var>121.1</var>    (1) have taken a three-credit course on early childhood development within the <br/>
<a id="pl.121.2"></a><var>121.2</var>past five years;<br/>
<a id="pl.121.3"></a><var>121.3</var>    (2) have received a baccalaureate or master's degree in early childhood education or <br/>
<a id="pl.121.4"></a><var>121.4</var>school-age child care within the past five years;<br/>
<a id="pl.121.5"></a><var>121.5</var>    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood <br/>
<a id="pl.121.6"></a><var>121.6</var>educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early <br/>
<a id="pl.121.7"></a><var>121.7</var>childhood special education teacher, or an elementary teacher with a kindergarten <br/>
<a id="pl.121.8"></a><var>121.8</var>endorsement; or<br/>
<a id="pl.121.9"></a><var>121.9</var>    (4) have received a baccalaureate degree with a Montessori certificate within the <br/>
<a id="pl.121.10"></a><var>121.10</var>past five years.<br/>
<a id="pl.121.11"></a><var>121.11</var>    Subd. 3. <b>First aid.</b> (a) When children are present in a family child care home <br/>
<a id="pl.121.12"></a><var>121.12</var>governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person <br/>
<a id="pl.121.13"></a><var>121.13</var>must be present in the home who has been trained in first aid. The first aid training must <br/>
<a id="pl.121.14"></a><var>121.14</var>have been provided by an individual approved to provide first aid instruction. First aid <br/>
<a id="pl.121.15"></a><var>121.15</var>training may be less than eight hours and persons qualified to provide first aid training <br/>
<a id="pl.121.16"></a><var>121.16</var>include individuals approved as first aid instructors. First aid training must be repeated <br/>
<a id="pl.121.17"></a><var>121.17</var>every two years.<br/>
<a id="pl.121.18"></a><var>121.18</var>    (b) A family child care provider is exempt from the first aid training requirements <br/>
<a id="pl.121.19"></a><var>121.19</var>under this subdivision related to any substitute caregiver who provides less than 30 hours <br/>
<a id="pl.121.20"></a><var>121.20</var>of care during any 12-month period.<br/>
<a id="pl.121.21"></a><var>121.21</var>    (c) Video training reviewed and approved by the county licensing agency satisfies <br/>
<a id="pl.121.22"></a><var>121.22</var>the training requirement of this subdivision.<br/>
<a id="pl.121.23"></a><var>121.23</var>    Subd. 4. <b>Cardiopulmonary resuscitation.</b> (a) When children are present in a family <br/>
<a id="pl.121.24"></a><var>121.24</var>child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least <br/>
<a id="pl.121.25"></a><var>121.25</var>one staff person must be present in the home who has been trained in cardiopulmonary <br/>
<a id="pl.121.26"></a><var>121.26</var>resuscitation (CPR) and in the treatment of obstructed airways that includes CPR <br/>
<a id="pl.121.27"></a><var>121.27</var>techniques for infants and children. The CPR training must have been provided by an <br/>
<a id="pl.121.28"></a><var>121.28</var>individual approved to provide CPR instruction, must be repeated at least once every three<br/>
<a id="pl.121.29"></a><var>121.29</var> two years, and must be documented in the staff person's records.<br/>
<a id="pl.121.30"></a><var>121.30</var>    (b) A family child care provider is exempt from the CPR training requirement in <br/>
<a id="pl.121.31"></a><var>121.31</var>this subdivision related to any substitute caregiver who provides less than 30 hours of <br/>
<a id="pl.121.32"></a><var>121.32</var>care during any 12-month period.<br/>
<a id="pl.121.33"></a><var>121.33</var>    (c) Video training reviewed and approved by the county licensing agency satisfies <br/>
<a id="pl.121.34"></a><var>121.34</var>the training requirement of this subdivision. Persons providing CPR training must use <br/>
<a id="pl.121.35"></a><var>121.35</var>CPR training that has been developed:<br/>
<a id="pl.122.1"></a><var>122.1</var>    (1) by the American Heart Association or the American Red Cross and incorporates <br/>
<a id="pl.122.2"></a><var>122.2</var>psychomotor skills to support the instruction; or<br/>
<a id="pl.122.3"></a><var>122.3</var>    (2) using nationally recognized, evidence-based guidelines for CPR training and <br/>
<a id="pl.122.4"></a><var>122.4</var>incorporates psychomotor skills to support the instruction.<br/>
<a id="pl.122.5"></a><var>122.5</var>    Subd. 5. <b>Sudden</b><b> unexpected</b><b> infant death </b><b>syndrome</b><b> and </b><b>shaken baby syndrome</b><br/>
<a id="pl.122.6"></a><var>122.6</var><b> abusive head trauma</b><b> training.</b> (a) License holders must document that before staff <br/>
<a id="pl.122.7"></a><var>122.7</var>persons, caregivers, and helpers assist in the care of infants, they are instructed on the <br/>
<a id="pl.122.8"></a><var>122.8</var>standards in section 
         <statute_ref>245A.1435</statute_ref> and receive training on reducing the risk of sudden <br/>
<a id="pl.122.9"></a><var>122.9</var>unexpected infant death syndrome. In addition, license holders must document that before <br/>
<a id="pl.122.10"></a><var>122.10</var>staff persons, caregivers, and helpers assist in the care of infants and children under <br/>
<a id="pl.122.11"></a><var>122.11</var>school age, they receive training on reducing the risk of shaken baby syndrome abusive <br/>
<a id="pl.122.12"></a><var>122.12</var>head trauma from shaking infants and young children. The training in this subdivision <br/>
<a id="pl.122.13"></a><var>122.13</var>may be provided as initial training under subdivision 1 or ongoing annual training under <br/>
<a id="pl.122.14"></a><var>122.14</var>subdivision 7.<br/>
<a id="pl.122.15"></a><var>122.15</var>    (b) Sudden unexpected infant death syndrome reduction training required under this <br/>
<a id="pl.122.16"></a><var>122.16</var>subdivision must be at least one-half hour in length and must be completed in person<br/>
<a id="pl.122.17"></a><var>122.17</var> at least once every five years two years. On the years when the license holder is not <br/>
<a id="pl.122.18"></a><var>122.18</var>receiving the in-person training on sudden unexpected infant death reduction, the license <br/>
<a id="pl.122.19"></a><var>122.19</var>holder must receive sudden unexpected infant death reduction training through a video <br/>
<a id="pl.122.20"></a><var>122.20</var>of no more than one hour in length developed or approved by the commissioner. At a <br/>
<a id="pl.122.21"></a><var>122.21</var>minimum, the training must address the risk factors related to sudden unexpected infant <br/>
<a id="pl.122.22"></a><var>122.22</var>death syndrome, means of reducing the risk of sudden unexpected infant death syndrome<br/>
<a id="pl.122.23"></a><var>122.23</var> in child care, and license holder communication with parents regarding reducing the risk <br/>
<a id="pl.122.24"></a><var>122.24</var>of sudden unexpected infant death syndrome.<br/>
<a id="pl.122.25"></a><var>122.25</var>    (c) Shaken baby syndrome Abusive head trauma training required under this <br/>
<a id="pl.122.26"></a><var>122.26</var>subdivision must be at least one-half hour in length and must be completed at least once <br/>
<a id="pl.122.27"></a><var>122.27</var>every five years year. At a minimum, the training must address the risk factors related <br/>
<a id="pl.122.28"></a><var>122.28</var>to shaken baby syndrome shaking infants and young children, means of reducing the <br/>
<a id="pl.122.29"></a><var>122.29</var>risk of shaken baby syndrome abusive head trauma in child care, and license holder <br/>
<a id="pl.122.30"></a><var>122.30</var>communication with parents regarding reducing the risk of shaken baby syndrome abusive <br/>
<a id="pl.122.31"></a><var>122.31</var>head trauma.<br/>
<a id="pl.122.32"></a><var>122.32</var>(d) Training for family and group family child care providers must be developed <br/>
<a id="pl.122.33"></a><var>122.33</var>by the commissioner in conjunction with the Minnesota Sudden Infant Death Center <br/>
<a id="pl.122.34"></a><var>122.34</var>and approved by the county licensing agency by the Minnesota Center for Professional <br/>
<a id="pl.122.35"></a><var>122.35</var>Development.<br/>
<a id="pl.123.1"></a><var>123.1</var>    (e) The commissioner shall make available for viewing by all licensed child care <br/>
<a id="pl.123.2"></a><var>123.2</var>providers a video presentation on the dangers associated with shaking infants and young <br/>
<a id="pl.123.3"></a><var>123.3</var>children. The video presentation shall be part of the initial and ongoing annual training of <br/>
<a id="pl.123.4"></a><var>123.4</var>licensed child care providers, caregivers, and helpers caring for children under school age. <br/>
<a id="pl.123.5"></a><var>123.5</var>The commissioner shall provide to child care providers and interested individuals, at cost, <br/>
<a id="pl.123.6"></a><var>123.6</var>copies of a video approved by the commissioner of health under section 
<statute_ref>144.574</statute_ref> on the <br/>
<a id="pl.123.7"></a><var>123.7</var>dangers associated with shaking infants and young children.<br/>
<a id="pl.123.8"></a><var>123.8</var>    Subd. 6. <b>Child passenger restraint systems; training requirement.</b> (a) A license <br/>
<a id="pl.123.9"></a><var>123.9</var>holder must comply with all seat belt and child passenger restraint system requirements <br/>
<a id="pl.123.10"></a><var>123.10</var>under section 
         <statute_ref>169.685</statute_ref>.<br/>
<a id="pl.123.11"></a><var>123.11</var>    (b) Family and group family child care programs licensed by the Department of <br/>
<a id="pl.123.12"></a><var>123.12</var>Human Services that serve a child or children under nine years of age must document <br/>
<a id="pl.123.13"></a><var>123.13</var>training that fulfills the requirements in this subdivision.<br/>
<a id="pl.123.14"></a><var>123.14</var>    (1) Before a license holder, staff person, caregiver, or helper transports a child or <br/>
<a id="pl.123.15"></a><var>123.15</var>children under age nine in a motor vehicle, the person placing the child or children in a <br/>
<a id="pl.123.16"></a><var>123.16</var>passenger restraint must satisfactorily complete training on the proper use and installation <br/>
<a id="pl.123.17"></a><var>123.17</var>of child restraint systems in motor vehicles. Training completed under this subdivision may <br/>
<a id="pl.123.18"></a><var>123.18</var>be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.<br/>
<a id="pl.123.19"></a><var>123.19</var>    (2) Training required under this subdivision must be at least one hour in length, <br/>
<a id="pl.123.20"></a><var>123.20</var>completed at initial training, and repeated at least once every five years. At a minimum, <br/>
<a id="pl.123.21"></a><var>123.21</var>the training must address the proper use of child restraint systems based on the child's <br/>
<a id="pl.123.22"></a><var>123.22</var>size, weight, and age, and the proper installation of a car seat or booster seat in the motor <br/>
<a id="pl.123.23"></a><var>123.23</var>vehicle used by the license holder to transport the child or children.<br/>
<a id="pl.123.24"></a><var>123.24</var>    (3) Training under this subdivision must be provided by individuals who are certified <br/>
<a id="pl.123.25"></a><var>123.25</var>and approved by the Department of Public Safety, Office of Traffic Safety. License holders <br/>
<a id="pl.123.26"></a><var>123.26</var>may obtain a list of certified and approved trainers through the Department of Public <br/>
<a id="pl.123.27"></a><var>123.27</var>Safety Web site or by contacting the agency.<br/>
<a id="pl.123.28"></a><var>123.28</var>    (c) Child care providers that only transport school-age children as defined in section <br/>
<statute_ref><a id="pl.123.29"></a><var>123.29</var>245A.02, subdivision 19
         </statute_ref>, paragraph (f), in child care buses as defined in section 
         <statute_ref>169.448</statute_ref>, <br/>
<a id="pl.123.30"></a><var>123.30</var>subdivision 1, paragraph (e), are exempt from this subdivision.<br/>
<a id="pl.123.31"></a><var>123.31</var>    Subd. 7. <b>Training requirements for family and group family child care.</b> For <br/>
<a id="pl.123.32"></a><var>123.32</var>purposes of family and group family child care, the license holder and each primary <br/>
<a id="pl.123.33"></a><var>123.33</var>caregiver must complete eight 16 hours of ongoing training each year. For purposes <br/>
<a id="pl.123.34"></a><var>123.34</var>of this subdivision, a primary caregiver is an adult caregiver who provides services in <br/>
<a id="pl.123.35"></a><var>123.35</var>the licensed setting for more than 30 days in any 12-month period. Repeat of topical <br/>
<a id="pl.123.36"></a><var>123.36</var>training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training <br/>
<a id="pl.124.1"></a><var>124.1</var>requirement. Additional ongoing training subjects to meet the annual 16-hour training <br/>
<a id="pl.124.2"></a><var>124.2</var>requirement must be selected from the following areas:<br/>
<a id="pl.124.3"></a><var>124.3</var>    (1) "child growth and development training" has the meaning given in under<br/>
<a id="pl.124.4"></a><var>124.4</var> subdivision 2, paragraph (a);<br/>
<a id="pl.124.5"></a><var>124.5</var>    (2) "learning environment and curriculum" includes, including training in <br/>
<a id="pl.124.6"></a><var>124.6</var>establishing an environment and providing activities that provide learning experiences to <br/>
<a id="pl.124.7"></a><var>124.7</var>meet each child's needs, capabilities, and interests;<br/>
<a id="pl.124.8"></a><var>124.8</var>    (3) "assessment and planning for individual needs" includes, including training in <br/>
<a id="pl.124.9"></a><var>124.9</var>observing and assessing what children know and can do in order to provide curriculum <br/>
<a id="pl.124.10"></a><var>124.10</var>and instruction that addresses their developmental and learning needs, including children <br/>
<a id="pl.124.11"></a><var>124.11</var>with special needs and bilingual children or children for whom English is not their <br/>
<a id="pl.124.12"></a><var>124.12</var>primary language;<br/>
<a id="pl.124.13"></a><var>124.13</var>    (4) "interactions with children" includes, including training in establishing <br/>
<a id="pl.124.14"></a><var>124.14</var>supportive relationships with children, guiding them as individuals and as part of a group;<br/>
<a id="pl.124.15"></a><var>124.15</var>    (5) "families and communities" includes, including training in working <br/>
<a id="pl.124.16"></a><var>124.16</var>collaboratively with families and agencies or organizations to meet children's needs and to <br/>
<a id="pl.124.17"></a><var>124.17</var>encourage the community's involvement;<br/>
<a id="pl.124.18"></a><var>124.18</var>    (6) "health, safety, and nutrition" includes, including training in establishing and <br/>
<a id="pl.124.19"></a><var>124.19</var>maintaining an environment that ensures children's health, safety, and nourishment, <br/>
<a id="pl.124.20"></a><var>124.20</var>including child abuse, maltreatment, prevention, and reporting; home and fire safety; child <br/>
<a id="pl.124.21"></a><var>124.21</var>injury prevention; communicable disease prevention and control; first aid; and CPR; and<br/>
<a id="pl.124.22"></a><var>124.22</var>    (7) "program planning and evaluation" includes, including training in establishing, <br/>
<a id="pl.124.23"></a><var>124.23</var>implementing, evaluating, and enhancing program operations.; and <br/>
<a id="pl.124.24"></a><var>124.24</var>(8) behavior guidance, including training in the understanding of the functions of <br/>
<a id="pl.124.25"></a><var>124.25</var>child behavior and strategies for managing behavior.<br/>
<a id="pl.124.26"></a><var>124.26</var>    Subd. 8. <b>Other required training requirements.</b> (a) The training required of <br/>
<a id="pl.124.27"></a><var>124.27</var>family and group family child care providers and staff must include training in the cultural <br/>
<a id="pl.124.28"></a><var>124.28</var>dynamics of early childhood development and child care. The cultural dynamics and <br/>
<a id="pl.124.29"></a><var>124.29</var>disabilities training and skills development of child care providers must be designed to <br/>
<a id="pl.124.30"></a><var>124.30</var>achieve outcomes for providers of child care that include, but are not limited to:<br/>
<a id="pl.124.31"></a><var>124.31</var>    (1) an understanding and support of the importance of culture and differences in <br/>
<a id="pl.124.32"></a><var>124.32</var>ability in children's identity development;<br/>
<a id="pl.124.33"></a><var>124.33</var>    (2) understanding the importance of awareness of cultural differences and <br/>
<a id="pl.124.34"></a><var>124.34</var>similarities in working with children and their families;<br/>
<a id="pl.124.35"></a><var>124.35</var>    (3) understanding and support of the needs of families and children with differences <br/>
<a id="pl.124.36"></a><var>124.36</var>in ability;<br/>
<a id="pl.125.1"></a><var>125.1</var>    (4) developing skills to help children develop unbiased attitudes about cultural <br/>
<a id="pl.125.2"></a><var>125.2</var>differences and differences in ability;<br/>
<a id="pl.125.3"></a><var>125.3</var>    (5) developing skills in culturally appropriate caregiving; and<br/>
<a id="pl.125.4"></a><var>125.4</var>    (6) developing skills in appropriate caregiving for children of different abilities.<br/>
<a id="pl.125.5"></a><var>125.5</var>    The commissioner shall approve the curriculum for cultural dynamics and disability <br/>
<a id="pl.125.6"></a><var>125.6</var>training.<br/>
<a id="pl.125.7"></a><var>125.7</var>    (b) The provider must meet the training requirement in section 
         <statute_ref>245A.14, subdivision <br/>
<a id="pl.125.8"></a><var>125.8</var>11
         </statute_ref>, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child <br/>
<a id="pl.125.9"></a><var>125.9</var>care or group family child care home to use the swimming pool located at the home.<br/>
<a id="pl.125.10"></a><var>125.10</var>    Subd. 9. <b>Supervising for safety; training requirement.</b> Effective July 1, 2014, <br/>
<a id="pl.125.11"></a><var>125.11</var>all family child care license holders and each adult caregiver who provides care in the <br/>
<a id="pl.125.12"></a><var>125.12</var>licensed family child care home for more than 30 days in any 12-month period shall <br/>
<a id="pl.125.13"></a><var>125.13</var>complete and document at least six hours approved training on supervising for safety <br/>
<a id="pl.125.14"></a><var>125.14</var>prior to initial licensure, and before caring for children. At least two hours of training <br/>
<a id="pl.125.15"></a><var>125.15</var>on supervising for safety must be repeated annually. For purposes of this subdivision, <br/>
<a id="pl.125.16"></a><var>125.16</var>"supervising for safety" includes supervision basics, supervision outdoors, equipment and <br/>
<a id="pl.125.17"></a><var>125.17</var>materials, illness, injuries, and disaster preparedness. The commissioner shall develop <br/>
<a id="pl.125.18"></a><var>125.18</var>the supervising for safety curriculum by January 1, 2014.<br/>
<a id="pl.125.19"></a><var>125.19</var>    Subd. 10. <b>Approved training.</b> (a) County licensing staff must accept training <br/>
<a id="pl.125.20"></a><var>125.20</var>approved by the Minnesota Center for Professional Development, including:<br/>
<a id="pl.125.21"></a><var>125.21</var>(1) face-to-face or classroom training;<br/>
<a id="pl.125.22"></a><var>125.22</var>(2) online training; and<br/>
<a id="pl.125.23"></a><var>125.23</var>(3) relationship-based professional development, such as mentoring, coaching, <br/>
<a id="pl.125.24"></a><var>125.24</var>and consulting.<br/>
<a id="pl.125.25"></a><var>125.25</var>(b) New and increased training requirements under this section must not be imposed <br/>
<a id="pl.125.26"></a><var>125.26</var>on providers until the commissioner establishes statewide accessibility to the required <br/>
<a id="pl.125.27"></a><var>125.27</var>provider training.<br/>
<br/>
<a id="bill.3.15.0"></a><a id="pl.125.28"></a><var>125.28</var>    Sec. 15. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:<br/>
<a id="pl.125.29"></a><var>125.29</var>    Subd. 2a. <b>Contribution amount.</b> (a) The natural or adoptive parents of a minor <br/>
<a id="pl.125.30"></a><var>125.30</var>child, including a child determined eligible for medical assistance without consideration of <br/>
<a id="pl.125.31"></a><var>125.31</var>parental income, must contribute to the cost of services used by making monthly payments <br/>
<a id="pl.125.32"></a><var>125.32</var>on a sliding scale based on income, unless the child is married or has been married, parental <br/>
<a id="pl.125.33"></a><var>125.33</var>rights have been terminated, or the child's adoption is subsidized according to section <br/>
<statute_ref><a id="pl.125.34"></a><var>125.34</var>259.67
         </statute_ref> or through title IV-E of the Social Security Act. The parental contribution is a partial <br/>
<a id="pl.125.35"></a><var>125.35</var>or full payment for medical services provided for diagnostic, therapeutic, curing, treating, <br/>
<a id="pl.126.1"></a><var>126.1</var>mitigating, rehabilitation, maintenance, and personal care services as defined in United <br/>
<a id="pl.126.2"></a><var>126.2</var>States Code, title 26, section 213, needed by the child with a chronic illness or disability.<br/>
<a id="pl.126.3"></a><var>126.3</var>    (b) For households with adjusted gross income equal to or greater than 100 percent <br/>
<a id="pl.126.4"></a><var>126.4</var>of federal poverty guidelines, the parental contribution shall be computed by applying the <br/>
<a id="pl.126.5"></a><var>126.5</var>following schedule of rates to the adjusted gross income of the natural or adoptive parents:<br/>
<a id="pl.126.6"></a><var>126.6</var>    (1) if the adjusted gross income is equal to or greater than 100 percent of federal <br/>
<a id="pl.126.7"></a><var>126.7</var>poverty guidelines and less than 175 percent of federal poverty guidelines, the parental <br/>
<a id="pl.126.8"></a><var>126.8</var>contribution is $4 per month;<br/>
<a id="pl.126.9"></a><var>126.9</var>    (2) if the adjusted gross income is equal to or greater than 175 percent of federal <br/>
<a id="pl.126.10"></a><var>126.10</var>poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, <br/>
<a id="pl.126.11"></a><var>126.11</var>the parental contribution shall be determined using a sliding fee scale established by the <br/>
<a id="pl.126.12"></a><var>126.12</var>commissioner of human services which begins at one percent of adjusted gross income <br/>
<a id="pl.126.13"></a><var>126.13</var>at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted <br/>
<a id="pl.126.14"></a><var>126.14</var>gross income for those with adjusted gross income up to 545 percent of federal poverty <br/>
<a id="pl.126.15"></a><var>126.15</var>guidelines;<br/>
<a id="pl.126.16"></a><var>126.16</var>    (3) if the adjusted gross income is greater than 545 percent of federal poverty <br/>
<a id="pl.126.17"></a><var>126.17</var>guidelines and less than 675 percent of federal poverty guidelines, the parental <br/>
<a id="pl.126.18"></a><var>126.18</var>contribution shall be 7.5 percent of adjusted gross income;<br/>
<a id="pl.126.19"></a><var>126.19</var>    (4) if the adjusted gross income is equal to or greater than 675 percent of federal <br/>
<a id="pl.126.20"></a><var>126.20</var>poverty guidelines and less than 975 percent of federal poverty guidelines, the parental <br/>
<a id="pl.126.21"></a><var>126.21</var>contribution shall be determined using a sliding fee scale established by the commissioner <br/>
<a id="pl.126.22"></a><var>126.22</var>of human services which begins at 7.5 percent of adjusted gross income at 675 percent of <br/>
<a id="pl.126.23"></a><var>126.23</var>federal poverty guidelines and increases to ten percent of adjusted gross income for those <br/>
<a id="pl.126.24"></a><var>126.24</var>with adjusted gross income up to 975 percent of federal poverty guidelines; and<br/>
<a id="pl.126.25"></a><var>126.25</var>    (5) if the adjusted gross income is equal to or greater than 975 percent of federal <br/>
<a id="pl.126.26"></a><var>126.26</var>poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.<br/>
<a id="pl.126.27"></a><var>126.27</var>    If the child lives with the parent, the annual adjusted gross income is reduced by <br/>
<a id="pl.126.28"></a><var>126.28</var>$2,400 prior to calculating the parental contribution. If the child resides in an institution <br/>
<a id="pl.126.29"></a><var>126.29</var>specified in section 
         <statute_ref>256B.35</statute_ref>, the parent is responsible for the personal needs allowance <br/>
<a id="pl.126.30"></a><var>126.30</var>specified under that section in addition to the parental contribution determined under this <br/>
<a id="pl.126.31"></a><var>126.31</var>section. The parental contribution is reduced by any amount required to be paid directly to <br/>
<a id="pl.126.32"></a><var>126.32</var>the child pursuant to a court order, but only if actually paid.<br/>
<a id="pl.126.33"></a><var>126.33</var>    (c) The household size to be used in determining the amount of contribution under <br/>
<a id="pl.126.34"></a><var>126.34</var>paragraph (b) includes natural and adoptive parents and their dependents, including the <br/>
<a id="pl.126.35"></a><var>126.35</var>child receiving services. Adjustments in the contribution amount due to annual changes <br/>
<a id="pl.127.1"></a><var>127.1</var>in the federal poverty guidelines shall be implemented on the first day of July following <br/>
<a id="pl.127.2"></a><var>127.2</var>publication of the changes.<br/>
<a id="pl.127.3"></a><var>127.3</var>    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the <br/>
<a id="pl.127.4"></a><var>127.4</var>natural or adoptive parents determined according to the previous year's federal tax form, <br/>
<a id="pl.127.5"></a><var>127.5</var>except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds <br/>
<a id="pl.127.6"></a><var>127.6</var>have been used to purchase a home shall not be counted as income.<br/>
<a id="pl.127.7"></a><var>127.7</var>    (e) The contribution shall be explained in writing to the parents at the time eligibility <br/>
<a id="pl.127.8"></a><var>127.8</var>for services is being determined. The contribution shall be made on a monthly basis <br/>
<a id="pl.127.9"></a><var>127.9</var>effective with the first month in which the child receives services. Annually upon <br/>
<a id="pl.127.10"></a><var>127.10</var>redetermination or at termination of eligibility, if the contribution exceeded the cost of <br/>
<a id="pl.127.11"></a><var>127.11</var>services provided, the local agency or the state shall reimburse that excess amount to <br/>
<a id="pl.127.12"></a><var>127.12</var>the parents, either by direct reimbursement if the parent is no longer required to pay a <br/>
<a id="pl.127.13"></a><var>127.13</var>contribution, or by a reduction in or waiver of parental fees until the excess amount is <br/>
<a id="pl.127.14"></a><var>127.14</var>exhausted. All reimbursements must include a notice that the amount reimbursed may be <br/>
<a id="pl.127.15"></a><var>127.15</var>taxable income if the parent paid for the parent's fees through an employer's health care <br/>
<a id="pl.127.16"></a><var>127.16</var>flexible spending account under the Internal Revenue Code, section 125, and that the <br/>
<a id="pl.127.17"></a><var>127.17</var>parent is responsible for paying the taxes owed on the amount reimbursed.<br/>
<a id="pl.127.18"></a><var>127.18</var>    (f) The monthly contribution amount must be reviewed at least every 12 months; <br/>
<a id="pl.127.19"></a><var>127.19</var>when there is a change in household size; and when there is a loss of or gain in income <br/>
<a id="pl.127.20"></a><var>127.20</var>from one month to another in excess of ten percent. The local agency shall mail a written <br/>
<a id="pl.127.21"></a><var>127.21</var>notice 30 days in advance of the effective date of a change in the contribution amount. <br/>
<a id="pl.127.22"></a><var>127.22</var>A decrease in the contribution amount is effective in the month that the parent verifies a <br/>
<a id="pl.127.23"></a><var>127.23</var>reduction in income or change in household size.<br/>
<a id="pl.127.24"></a><var>127.24</var>    (g) Parents of a minor child who do not live with each other shall each pay the <br/>
<a id="pl.127.25"></a><var>127.25</var>contribution required under paragraph (a). An amount equal to the annual court-ordered <br/>
<a id="pl.127.26"></a><var>127.26</var>child support payment actually paid on behalf of the child receiving services shall be <br/>
<a id="pl.127.27"></a><var>127.27</var>deducted from the adjusted gross income of the parent making the payment prior to <br/>
<a id="pl.127.28"></a><var>127.28</var>calculating the parental contribution under paragraph (b).<br/>
<a id="pl.127.29"></a><var>127.29</var>    (h) The contribution under paragraph (b) shall be increased by an additional five <br/>
<a id="pl.127.30"></a><var>127.30</var>percent if the local agency determines that insurance coverage is available but not <br/>
<a id="pl.127.31"></a><var>127.31</var>obtained for the child. For purposes of this section, "available" means the insurance is a <br/>
<a id="pl.127.32"></a><var>127.32</var>benefit of employment for a family member at an annual cost of no more than five percent <br/>
<a id="pl.127.33"></a><var>127.33</var>of the family's annual income. For purposes of this section, "insurance" means health <br/>
<a id="pl.127.34"></a><var>127.34</var>and accident insurance coverage, enrollment in a nonprofit health service plan, health <br/>
<a id="pl.127.35"></a><var>127.35</var>maintenance organization, self-insured plan, or preferred provider organization.<br/>
<a id="pl.128.1"></a><var>128.1</var>    Parents who have more than one child receiving services shall not be required <br/>
<a id="pl.128.2"></a><var>128.2</var>to pay more than the amount for the child with the highest expenditures. There shall <br/>
<a id="pl.128.3"></a><var>128.3</var>be no resource contribution from the parents. The parent shall not be required to pay <br/>
<a id="pl.128.4"></a><var>128.4</var>a contribution in excess of the cost of the services provided to the child, not counting <br/>
<a id="pl.128.5"></a><var>128.5</var>payments made to school districts for education-related services. Notice of an increase in <br/>
<a id="pl.128.6"></a><var>128.6</var>fee payment must be given at least 30 days before the increased fee is due.<br/>
<a id="pl.128.7"></a><var>128.7</var>    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, <br/>
<a id="pl.128.8"></a><var>128.8</var>in the 12 months prior to July 1:<br/>
<a id="pl.128.9"></a><var>128.9</var>    (1) the parent applied for insurance for the child;<br/>
<a id="pl.128.10"></a><var>128.10</var>    (2) the insurer denied insurance;<br/>
<a id="pl.128.11"></a><var>128.11</var>    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted <br/>
<a id="pl.128.12"></a><var>128.12</var>a complaint or appeal, in writing, to the commissioner of health or the commissioner of <br/>
<a id="pl.128.13"></a><var>128.13</var>commerce, or litigated the complaint or appeal; and<br/>
<a id="pl.128.14"></a><var>128.14</var>    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.<br/>
<a id="pl.128.15"></a><var>128.15</var>    For purposes of this section, "insurance" has the meaning given in paragraph (h).<br/>
<a id="pl.128.16"></a><var>128.16</var>    A parent who has requested a reduction in the contribution amount under this <br/>
<a id="pl.128.17"></a><var>128.17</var>paragraph shall submit proof in the form and manner prescribed by the commissioner or <br/>
<a id="pl.128.18"></a><var>128.18</var>county agency, including, but not limited to, the insurer's denial of insurance, the written <br/>
<a id="pl.128.19"></a><var>128.19</var>letter or complaint of the parents, court documents, and the written response of the insurer <br/>
<a id="pl.128.20"></a><var>128.20</var>approving insurance. The determinations of the commissioner or county agency under this <br/>
<a id="pl.128.21"></a><var>128.21</var>paragraph are not rules subject to chapter 14.<br/>
<a id="pl.128.22"></a><var>128.22</var>(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, <br/>
<a id="pl.128.23"></a><var>128.23</var>2015, the parental contribution shall be computed by applying the following contribution <br/>
<a id="pl.128.24"></a><var>128.24</var>schedule to the adjusted gross income of the natural or adoptive parents:<br/>
<a id="pl.128.25"></a><var>128.25</var>(1) if the adjusted gross income is equal to or greater than 100 percent of federal <br/>
<a id="pl.128.26"></a><var>128.26</var>poverty guidelines and less than 175 percent of federal poverty guidelines, the parental <br/>
<a id="pl.128.27"></a><var>128.27</var>contribution is $4 per month;<br/>
<a id="pl.128.28"></a><var>128.28</var>(2) if the adjusted gross income is equal to or greater than 175 percent of federal <br/>
<a id="pl.128.29"></a><var>128.29</var>poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, <br/>
<a id="pl.128.30"></a><var>128.30</var>the parental contribution shall be determined using a sliding fee scale established by the <br/>
<a id="pl.128.31"></a><var>128.31</var>commissioner of human services which begins at one percent of adjusted gross income <br/>
<a id="pl.128.32"></a><var>128.32</var>at 175 percent of federal poverty guidelines and increases to eight percent of adjusted <br/>
<a id="pl.128.33"></a><var>128.33</var>gross income for those with adjusted gross income up to 525 percent of federal poverty <br/>
<a id="pl.128.34"></a><var>128.34</var>guidelines;<br/>
<a id="pl.129.1"></a><var>129.1</var>(3) if the adjusted gross income is greater than 525 percent of federal poverty <br/>
<a id="pl.129.2"></a><var>129.2</var>guidelines and less than 675 percent of federal poverty guidelines, the parental <br/>
<a id="pl.129.3"></a><var>129.3</var>contribution shall be 9.5 percent of adjusted gross income;<br/>
<a id="pl.129.4"></a><var>129.4</var>(4) if the adjusted gross income is equal to or greater than 675 percent of federal <br/>
<a id="pl.129.5"></a><var>129.5</var>poverty guidelines and less than 900 percent of federal poverty guidelines, the parental <br/>
<a id="pl.129.6"></a><var>129.6</var>contribution shall be determined using a sliding fee scale established by the commissioner <br/>
<a id="pl.129.7"></a><var>129.7</var>of human services which begins at 9.5 percent of adjusted gross income at 675 percent of <br/>
<a id="pl.129.8"></a><var>129.8</var>federal poverty guidelines and increases to 12 percent of adjusted gross income for those <br/>
<a id="pl.129.9"></a><var>129.9</var>with adjusted gross income up to 900 percent of federal poverty guidelines; and<br/>
<a id="pl.129.10"></a><var>129.10</var>(5) if the adjusted gross income is equal to or greater than 900 percent of federal <br/>
<a id="pl.129.11"></a><var>129.11</var>poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross <br/>
<a id="pl.129.12"></a><var>129.12</var>income. If the child lives with the parent, the annual adjusted gross income is reduced by <br/>
<a id="pl.129.13"></a><var>129.13</var>$2,400 prior to calculating the parental contribution. If the child resides in an institution <br/>
<a id="pl.129.14"></a><var>129.14</var>specified in section 
<statute_ref>256B.35</statute_ref>, the parent is responsible for the personal needs allowance <br/>
<a id="pl.129.15"></a><var>129.15</var>specified under that section in addition to the parental contribution determined under this <br/>
<a id="pl.129.16"></a><var>129.16</var>section. The parental contribution is reduced by any amount required to be paid directly to <br/>
<a id="pl.129.17"></a><var>129.17</var>the child pursuant to a court order, but only if actually paid.<br/>
<br/>
<a id="bill.3.16.0"></a><a id="pl.129.18"></a><var>129.18</var>    Sec. 16. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:<br/>
<a id="pl.129.19"></a><var>129.19</var>    Subd. 3. <b>Setting foster care standard rates.</b> The commissioner shall annually <br/>
<a id="pl.129.20"></a><var>129.20</var>establish minimum standard maintenance rates for foster care maintenance and difficulty <br/>
<a id="pl.129.21"></a><var>129.21</var>of care payments for all children in foster care. Any increase in rates shall in no case <br/>
<a id="pl.129.22"></a><var>129.22</var>exceed three percent per annum. The foster care rates in effect on January 1, 2013, shall <br/>
<a id="pl.129.23"></a><var>129.23</var>remain in effect until December 13, 2015.<br/>
<br/>
<a id="bill.3.17.0"></a><a id="pl.129.24"></a><var>129.24</var>    Sec. 17. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:<br/>
<a id="pl.129.25"></a><var>129.25</var>    Subd. 24. <b>Disregard.</b> "Disregard" means earned income that is not counted when <br/>
<a id="pl.129.26"></a><var>129.26</var>determining initial eligibility in the initial income test in section 256J.21, subdivision 3,<br/>
<a id="pl.129.27"></a><var>129.27</var> or income that is not counted when determining ongoing eligibility and calculating the <br/>
<a id="pl.129.28"></a><var>129.28</var>amount of the assistance payment for participants. The commissioner shall determine <br/>
<a id="pl.129.29"></a><var>129.29</var>the amount of the disregard according to section 
<statute_ref>256J.24, subdivision 10</statute_ref> for ongoing <br/>
<a id="pl.129.30"></a><var>129.30</var>eligibility shall be 50 percent of gross earned income.<br/>
<a id="pl.129.31"></a><var>129.31</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013, or upon approval <br/>
<a id="pl.129.32"></a><var>129.32</var>from the United States Department of Agriculture, whichever is later.<br/>
<br/>
<a id="bill.3.18.0"></a><a id="pl.129.33"></a><var>129.33</var>    Sec. 18. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:<br/>
<a id="pl.130.1"></a><var>130.1</var>    Subd. 3. <b>Initial income test.</b> The county agency shall determine initial eligibility <br/>
<a id="pl.130.2"></a><var>130.2</var>by considering all earned and unearned income that is not excluded under subdivision 2. <br/>
<a id="pl.130.3"></a><var>130.3</var>To be eligible for MFIP, the assistance unit's countable income minus the disregards in <br/>
<a id="pl.130.4"></a><var>130.4</var>paragraphs (a) and (b) must be below the transitional standard of assistance family wage <br/>
<a id="pl.130.5"></a><var>130.5</var>level according to section 
         <statute_ref>256J.24</statute_ref> for that size assistance unit.<br/>
<a id="pl.130.6"></a><var>130.6</var>(a) The initial eligibility determination must disregard the following items:<br/>
<a id="pl.130.7"></a><var>130.7</var>(1) the employment disregard is 18 percent of the gross earned income whether or <br/>
<a id="pl.130.8"></a><var>130.8</var>not the member is working full time or part time;<br/>
<a id="pl.130.9"></a><var>130.9</var>(2) dependent care costs must be deducted from gross earned income for the actual <br/>
<a id="pl.130.10"></a><var>130.10</var>amount paid for dependent care up to a maximum of $200 per month for each child less <br/>
<a id="pl.130.11"></a><var>130.11</var>than two years of age, and $175 per month for each child two years of age and older under <br/>
<a id="pl.130.12"></a><var>130.12</var>this chapter and chapter 119B;<br/>
<a id="pl.130.13"></a><var>130.13</var>(3) all payments made according to a court order for spousal support or the support <br/>
<a id="pl.130.14"></a><var>130.14</var>of children not living in the assistance unit's household shall be disregarded from the <br/>
<a id="pl.130.15"></a><var>130.15</var>income of the person with the legal obligation to pay support, provided that, if there has <br/>
<a id="pl.130.16"></a><var>130.16</var>been a change in the financial circumstances of the person with the legal obligation to pay <br/>
<a id="pl.130.17"></a><var>130.17</var>support since the support order was entered, the person with the legal obligation to pay <br/>
<a id="pl.130.18"></a><var>130.18</var>support has petitioned for a modification of the support order; and<br/>
<a id="pl.130.19"></a><var>130.19</var>(4) an allocation for the unmet need of an ineligible spouse or an ineligible child <br/>
<a id="pl.130.20"></a><var>130.20</var>under the age of 21 for whom the caregiver is financially responsible and who lives with <br/>
<a id="pl.130.21"></a><var>130.21</var>the caregiver according to section 
         <statute_ref>256J.36</statute_ref>.<br/>
<a id="pl.130.22"></a><var>130.22</var>(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant <br/>
<a id="pl.130.23"></a><var>130.23</var>units when at least one member has received MFIP in this state within four months of <br/>
<a id="pl.130.24"></a><var>130.24</var>the most recent application for MFIP, apply the disregard as defined in section 
         <statute_ref>256J.08, <br/>
<a id="pl.130.25"></a><var>130.25</var>subdivision 24
         </statute_ref>, for all unit members.<br/>
<a id="pl.130.26"></a><var>130.26</var>After initial eligibility is established, the assistance payment calculation is based on <br/>
<a id="pl.130.27"></a><var>130.27</var>the monthly income test.<br/>
<a id="pl.130.28"></a><var>130.28</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013, or upon approval <br/>
<a id="pl.130.29"></a><var>130.29</var>from the United States Department of Agriculture, whichever is later.<br/>
<br/>
<a id="bill.3.19.0"></a><a id="pl.130.30"></a><var>130.30</var>    Sec. 19. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:<br/>
<a id="pl.130.31"></a><var>130.31</var>    Subd. 5. <b>MFIP transitional standard.</b> The MFIP transitional standard is based <br/>
<a id="pl.130.32"></a><var>130.32</var>on the number of persons in the assistance unit eligible for both food and cash assistance <br/>
<a id="pl.130.33"></a><var>130.33</var>unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the <br/>
<a id="pl.130.34"></a><var>130.34</var>transitional standard is published annually by the Department of Human Services.<br/>
<a id="pl.131.1"></a><var>131.1</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2014.<br/>
<br/>
<a id="bill.3.20.0"></a><a id="pl.131.2"></a><var>131.2</var>    Sec. 20. Minnesota Statutes 2012, section 256J.24, subdivision 5a, is amended to read:<br/>
<a id="pl.131.3"></a><var>131.3</var>    Subd. 5a. <b>Food portion of</b><b> </b><b>Adjustments to the </b><b>MFIP transitional standard.</b> (a) <br/>
<a id="pl.131.4"></a><var>131.4</var>Effective October 1, 2015, the commissioner shall adjust the MFIP transitional standard as <br/>
<a id="pl.131.5"></a><var>131.5</var>needed to reflect a onetime increase in the cash portion of 16 percent.<br/>
<a id="pl.131.6"></a><var>131.6</var>(b) When any adjustments are made in the Supplemental Nutrition Assistance <br/>
<a id="pl.131.7"></a><var>131.7</var>Program, the commissioner shall adjust the food portion of the MFIP transitional standard <br/>
<a id="pl.131.8"></a><var>131.8</var>as needed to reflect adjustments to the Supplemental Nutrition Assistance Program. The <br/>
<a id="pl.131.9"></a><var>131.9</var>commissioner shall publish the transitional standard including a breakdown of the cash <br/>
<a id="pl.131.10"></a><var>131.10</var>and food portions for an assistance unit of sizes one to ten in the State Register whenever <br/>
<a id="pl.131.11"></a><var>131.11</var>an adjustment is made.<br/>
<br/>
<a id="bill.3.21.0"></a><a id="pl.131.12"></a><var>131.12</var>    Sec. 21. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:<br/>
<a id="pl.131.13"></a><var>131.13</var>    Subd. 7. <b>Family wage level.</b> The family wage level is 110 percent of the transitional <br/>
<a id="pl.131.14"></a><var>131.14</var>standard under subdivision 5 or 6, when applicable, and is the standard used when there is <br/>
<a id="pl.131.15"></a><var>131.15</var>earned income in the assistance unit. As specified in section 
<statute_ref>256J.21</statute_ref>. If there is earned <br/>
<a id="pl.131.16"></a><var>131.16</var>income in the assistance unit, earned income is subtracted from the family wage level to <br/>
<a id="pl.131.17"></a><var>131.17</var>determine the amount of the assistance payment, as specified in section 256J.21. The <br/>
<a id="pl.131.18"></a><var>131.18</var>assistance payment may not exceed the transitional standard under subdivision 5 or 6, <br/>
<a id="pl.131.19"></a><var>131.19</var>or the shared household standard under subdivision 9, whichever is applicable, for the <br/>
<a id="pl.131.20"></a><var>131.20</var>assistance unit.<br/>
<a id="pl.131.21"></a><var>131.21</var><b>EFFECTIVE DATE.</b>This section is effective October 1, 2013, or upon approval <br/>
<a id="pl.131.22"></a><var>131.22</var>from the United States Department of Agriculture, whichever is later.<br/>
<br/>
<a id="bill.3.22.0"></a><a id="pl.131.23"></a><var>131.23</var>    Sec. 22. Minnesota Statutes 2012, section 256J.621, is amended to read:<br/>
<a id="pl.131.24"></a><var>131.24</var><b>256J.621 WORK PARTICIPATION CASH BENEFITS.</b><br/>
<a id="pl.131.25"></a><var>131.25</var>    Subdivision 1. <b>Program characteristics.</b> (a) Effective October 1, 2009, upon <br/>
<a id="pl.131.26"></a><var>131.26</var>exiting the diversionary work program (DWP) or upon terminating the Minnesota family <br/>
<a id="pl.131.27"></a><var>131.27</var>investment program with earnings, a participant who is employed may be eligible for work <br/>
<a id="pl.131.28"></a><var>131.28</var>participation cash benefits of $25 per month to assist in meeting the family's basic needs <br/>
<a id="pl.131.29"></a><var>131.29</var>as the participant continues to move toward self-sufficiency.<br/>
<a id="pl.131.30"></a><var>131.30</var>    (b) To be eligible for work participation cash benefits, the participant shall not <br/>
<a id="pl.131.31"></a><var>131.31</var>receive MFIP or diversionary work program assistance during the month and the <br/>
<a id="pl.131.32"></a><var>131.32</var>participant or participants must meet the following work requirements:<br/>
<a id="pl.132.1"></a><var>132.1</var>    (1) if the participant is a single caregiver and has a child under six years of age, the <br/>
<a id="pl.132.2"></a><var>132.2</var>participant must be employed at least 87 hours per month;<br/>
<a id="pl.132.3"></a><var>132.3</var>    (2) if the participant is a single caregiver and does not have a child under six years of <br/>
<a id="pl.132.4"></a><var>132.4</var>age, the participant must be employed at least 130 hours per month; or<br/>
<a id="pl.132.5"></a><var>132.5</var>    (3) if the household is a two-parent family, at least one of the parents must be <br/>
<a id="pl.132.6"></a><var>132.6</var>employed 130 hours per month.<br/>
<a id="pl.132.7"></a><var>132.7</var>    Whenever a participant exits the diversionary work program or is terminated from <br/>
<a id="pl.132.8"></a><var>132.8</var>MFIP and meets the other criteria in this section, work participation cash benefits are <br/>
<a id="pl.132.9"></a><var>132.9</var>available for up to 24 consecutive months.<br/>
<a id="pl.132.10"></a><var>132.10</var>    (c) Expenditures on the program are maintenance of effort state funds under <br/>
<a id="pl.132.11"></a><var>132.11</var>a separate state program for participants under paragraph (b), clauses (1) and (2). <br/>
<a id="pl.132.12"></a><var>132.12</var>Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort <br/>
<a id="pl.132.13"></a><var>132.13</var>funds. Months in which a participant receives work participation cash benefits under this <br/>
<a id="pl.132.14"></a><var>132.14</var>section do not count toward the participant's MFIP 60-month time limit.<br/>
<a id="pl.132.15"></a><var>132.15</var>    Subd. 2. <b>Program suspension.</b> (a) Effective December 1, 2013, the work <br/>
<a id="pl.132.16"></a><var>132.16</var>participation cash benefits program shall be suspended.<br/>
<a id="pl.132.17"></a><var>132.17</var>(b) The commissioner of human services may reinstate the work participation cash <br/>
<a id="pl.132.18"></a><var>132.18</var>benefits program if the United States Department of Human Services determines that the <br/>
<a id="pl.132.19"></a><var>132.19</var>state of Minnesota did not meet the federal TANF work participation rate and sends a <br/>
<a id="pl.132.20"></a><var>132.20</var>notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I <br/>
<a id="pl.132.21"></a><var>132.21</var>of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation <br/>
<a id="pl.132.22"></a><var>132.22</var>Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.<br/>
<a id="pl.132.23"></a><var>132.23</var>(c) The commissioner shall notify the chairs and ranking minority members of the <br/>
<a id="pl.132.24"></a><var>132.24</var>legislative committees with jurisdiction over human services policy and finance of the <br/>
<a id="pl.132.25"></a><var>132.25</var>potential penalty and the commissioner's plans to reinstate the work participation cash <br/>
<a id="pl.132.26"></a><var>132.26</var>benefit program within 30 days of the date the commissioner receives notification that <br/>
<a id="pl.132.27"></a><var>132.27</var>the state failed to meet the federal work participation rate.<br/>
<br/>
<a id="bill.3.23.0"></a><a id="pl.132.28"></a><var>132.28</var>    Sec. 23. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:<br/>
<a id="pl.132.29"></a><var>132.29</var>    Subd. 7. <b>Performance base funds.</b> (a) For the purpose of this section, the following <br/>
<a id="pl.132.30"></a><var>132.30</var>terms have the meanings given.<br/>
<a id="pl.132.31"></a><var>132.31</var>(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota <br/>
<a id="pl.132.32"></a><var>132.32</var>TANF and separate state program caseload has fallen relative to federal fiscal year 2005 <br/>
<a id="pl.132.33"></a><var>132.33</var>based on caseload data from October 1 to September 30.<br/>
<a id="pl.132.34"></a><var>132.34</var>(2) "TANF participation rate target" means a 50 percent participation rate reduced by <br/>
<a id="pl.132.35"></a><var>132.35</var>the CRC for the previous year.<br/>
<a id="pl.133.1"></a><var>133.1</var>(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will<br/>
<a id="pl.133.2"></a><var>133.2</var> must be allocated 95 percent of their initial calendar year allocation. Allocations for <br/>
<a id="pl.133.3"></a><var>133.3</var>counties and tribes will must be allocated additional funds adjusted based on performance <br/>
<a id="pl.133.4"></a><var>133.4</var>as follows:<br/>
<a id="pl.133.5"></a><var>133.5</var>    (1) a county or tribe that achieves the TANF participation rate target or a five <br/>
<a id="pl.133.6"></a><var>133.6</var>percentage point improvement over the previous year's TANF participation rate under <br/>
<a id="pl.133.7"></a><var>133.7</var>section 
<statute_ref>256J.751, subdivision 2</statute_ref>, clause (7), as averaged across 12 consecutive months for <br/>
<a id="pl.133.8"></a><var>133.8</var>the most recent year for which the measurements are available, will receive an additional <br/>
<a id="pl.133.9"></a><var>133.9</var>allocation equal to 2.5 percent of its initial allocation;<br/>
<a id="pl.133.10"></a><var>133.10</var>    (2) (1) a county or tribe that performs within or above its range of expected <br/>
<a id="pl.133.11"></a><var>133.11</var>performance on the annualized three-year self-support index under section 
         <statute_ref>256J.751, <br/>
<a id="pl.133.12"></a><var>133.12</var>subdivision 2
         </statute_ref>, clause (6), will must receive an additional allocation equal to 2.5 five <br/>
<a id="pl.133.13"></a><var>133.13</var>percent of its initial allocation; and<br/>
<a id="pl.133.14"></a><var>133.14</var>    (3) a county or tribe that does not achieve the TANF participation rate target or <br/>
<a id="pl.133.15"></a><var>133.15</var>a five percentage point improvement over the previous year's TANF participation rate <br/>
<a id="pl.133.16"></a><var>133.16</var>under section 
<statute_ref>256J.751, subdivision 2</statute_ref>, clause (7), as averaged across 12 consecutive <br/>
<a id="pl.133.17"></a><var>133.17</var>months for the most recent year for which the measurements are available, will not <br/>
<a id="pl.133.18"></a><var>133.18</var>receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear <br/>
<a id="pl.133.19"></a><var>133.19</var>improvement plan with the commissioner; or<br/>
<a id="pl.133.20"></a><var>133.20</var>    (4) (2) a county or tribe that does not perform within or above performs below its <br/>
<a id="pl.133.21"></a><var>133.21</var>range of expected performance on the annualized three-year self-support index under <br/>
<a id="pl.133.22"></a><var>133.22</var>section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, clause (6), will not receive an additional allocation equal <br/>
<a id="pl.133.23"></a><var>133.23</var>to 2.5 percent of its initial allocation until after negotiating for a single year, may receive <br/>
<a id="pl.133.24"></a><var>133.24</var>an additional allocation of up to five percent of its initial allocation. A county or tribe that <br/>
<a id="pl.133.25"></a><var>133.25</var>continues to perform below its range of expected performance for two consecutive years <br/>
<a id="pl.133.26"></a><var>133.26</var>must negotiate  a multiyear improvement plan with the commissioner. If no improvement <br/>
<a id="pl.133.27"></a><var>133.27</var>is shown by the end of the multiyear plan, the commissioner may decrease the county's or <br/>
<a id="pl.133.28"></a><var>133.28</var>tribe's performance-based funds by up to five percent. The decrease must remain in effect <br/>
<a id="pl.133.29"></a><var>133.29</var>until the county or tribe performs within or above its range of expected performance.<br/>
<a id="pl.133.30"></a><var>133.30</var>    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds <br/>
<a id="pl.133.31"></a><var>133.31</var>for a federally approved tribal TANF program in which the state and tribe have in place a <br/>
<a id="pl.133.32"></a><var>133.32</var>contract under section 
         <statute_ref>256.01</statute_ref>, addressing consolidated funding, will must be allocated <br/>
<a id="pl.133.33"></a><var>133.33</var>as follows:<br/>
<a id="pl.133.34"></a><var>133.34</var>    (1) a tribe that achieves the participation rate approved in its federal TANF plan <br/>
<a id="pl.133.35"></a><var>133.35</var>using the average of 12 consecutive months for the most recent year for which the <br/>
<a id="pl.134.1"></a><var>134.1</var>measurements are available, will receive an additional allocation equal to 2.5 percent of <br/>
<a id="pl.134.2"></a><var>134.2</var>its initial allocation; and<br/>
<a id="pl.134.3"></a><var>134.3</var>    (2) (1) a tribe that performs within or above its range of expected performance on the <br/>
<a id="pl.134.4"></a><var>134.4</var>annualized three-year self-support index under section 
         <statute_ref>256J.751, subdivision 2</statute_ref>, clause (6), <br/>
<a id="pl.134.5"></a><var>134.5</var>will must receive an additional allocation equal to 2.5 percent of its initial allocation; or<br/>
<a id="pl.134.6"></a><var>134.6</var>    (3) a tribe that does not achieve the participation rate approved in its federal TANF <br/>
<a id="pl.134.7"></a><var>134.7</var>plan using the average of 12 consecutive months for the most recent year for which the <br/>
<a id="pl.134.8"></a><var>134.8</var>measurements are available, will not receive an additional allocation equal to 2.5 percent <br/>
<a id="pl.134.9"></a><var>134.9</var>of its initial allocation until after negotiating a multiyear improvement plan with the <br/>
<a id="pl.134.10"></a><var>134.10</var>commissioner; or<br/>
<a id="pl.134.11"></a><var>134.11</var>    (4) (2) a tribe that does not perform within or above performs below its range of <br/>
<a id="pl.134.12"></a><var>134.12</var>expected performance on the annualized three-year self-support index under section <br/>
<statute_ref><a id="pl.134.13"></a><var>134.13</var>256J.751, subdivision 2
         </statute_ref>, clause (6), will not receive an additional allocation equal to 2.5 <br/>
<a id="pl.134.14"></a><var>134.14</var>percent until after negotiating for a single year may receive an additional allocation of up <br/>
<a id="pl.134.15"></a><var>134.15</var>to five percent of its initial allocation. A county or tribe that continues to perform below <br/>
<a id="pl.134.16"></a><var>134.16</var>its range of expected performance for two consecutive years must negotiate  a multiyear <br/>
<a id="pl.134.17"></a><var>134.17</var>improvement plan with the commissioner. If no improvement is shown by the end of the <br/>
<a id="pl.134.18"></a><var>134.18</var>multiyear plan, the commissioner may decrease the tribe's performance-based funds by <br/>
<a id="pl.134.19"></a><var>134.19</var>up to five percent. The decrease must remain in effect until the tribe performs within or <br/>
<a id="pl.134.20"></a><var>134.20</var>above its range of expected performance.<br/>
<a id="pl.134.21"></a><var>134.21</var>    (d) (c) Funds remaining unallocated after the performance-based allocations in <br/>
<a id="pl.134.22"></a><var>134.22</var>paragraph paragraphs (a) and (b) are available to the commissioner for innovation projects <br/>
<a id="pl.134.23"></a><var>134.23</var>under subdivision 5.<br/>
<a id="pl.134.24"></a><var>134.24</var>     (1) (d) If available funds are insufficient to meet county and tribal allocations under <br/>
<a id="pl.134.25"></a><var>134.25</var>paragraph paragraphs (a) and (b), the commissioner may make available for allocation <br/>
<a id="pl.134.26"></a><var>134.26</var>funds that are unobligated and available from the innovation projects through the end of <br/>
<a id="pl.134.27"></a><var>134.27</var>the current biennium shall proportionally prorate funds to counties and tribes that qualify <br/>
<a id="pl.134.28"></a><var>134.28</var>for an additional allocation under paragraphs (a), clause (1), and (b), clause (1).<br/>
<a id="pl.134.29"></a><var>134.29</var>    (2) If after the application of clause (1) funds remain insufficient to meet county and <br/>
<a id="pl.134.30"></a><var>134.30</var>tribal allocations under paragraph (b), the commissioner must proportionally reduce the <br/>
<a id="pl.134.31"></a><var>134.31</var>allocation of each county and tribe with respect to their maximum allocation available <br/>
<a id="pl.134.32"></a><var>134.32</var>under paragraph (b).<br/>
<br/>
<a id="bill.3.24.0"></a><a id="pl.134.33"></a><var>134.33</var>    Sec. 24. <b>[256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM </b><br/>
<a id="pl.134.34"></a><var>134.34</var><b>FEDERAL RULES AND REGULATIONS.</b><br/>
<a id="pl.135.1"></a><var>135.1</var>    Subdivision 1. <b>Duties of the commissioner.</b> The commissioner of human services <br/>
<a id="pl.135.2"></a><var>135.2</var>may pursue TANF demonstration projects or waivers of TANF requirements from the <br/>
<a id="pl.135.3"></a><var>135.3</var>United States Department of Health and Human Services as needed to allow the state to <br/>
<a id="pl.135.4"></a><var>135.4</var>build a more results-oriented Minnesota Family Investment Program to better meet the <br/>
<a id="pl.135.5"></a><var>135.5</var>needs of Minnesota families.<br/>
<a id="pl.135.6"></a><var>135.6</var>    Subd. 2. <b>Purpose.</b> The purpose of the TANF demonstration projects or waivers is to:<br/>
<a id="pl.135.7"></a><var>135.7</var>(1) replace the federal TANF process measure and its complex administrative <br/>
<a id="pl.135.8"></a><var>135.8</var>requirements with state-developed outcomes measures that track adult employment and <br/>
<a id="pl.135.9"></a><var>135.9</var>exits from MFIP cash assistance;<br/>
<a id="pl.135.10"></a><var>135.10</var>(2) simplify programmatic and administrative requirements; and<br/>
<a id="pl.135.11"></a><var>135.11</var>(3) make other policy or programmatic changes that improve the performance of the <br/>
<a id="pl.135.12"></a><var>135.12</var>program and the outcomes for participants.<br/>
<a id="pl.135.13"></a><var>135.13</var>    Subd. 3. <b>Report to legislature.</b> The commissioner shall report to the members of <br/>
<a id="pl.135.14"></a><var>135.14</var>the legislative committees having jurisdiction over human services issues by March 1, <br/>
<a id="pl.135.15"></a><var>135.15</var>2014, regarding the progress of this waiver or demonstration project.<br/>
<a id="pl.135.16"></a><var>135.16</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.3.25.0"></a><a id="pl.135.17"></a><var>135.17</var>    Sec. 25. Minnesota Statutes 2012, section 256K.45, is amended to read:<br/>
<a id="pl.135.18"></a><var>135.18</var><b>256K.45 </b><b>RUNAWAY AND</b><b> HOMELESS YOUTH ACT.</b><br/>
<a id="pl.135.19"></a><var>135.19</var>    Subdivision 1. <b>Grant program established.</b> The commissioner of human services <br/>
<a id="pl.135.20"></a><var>135.20</var>shall establish a Homeless Youth Act fund and award grants to providers who are <br/>
<a id="pl.135.21"></a><var>135.21</var>committed to serving homeless youth and youth at risk of homelessness, to provide <br/>
<a id="pl.135.22"></a><var>135.22</var>street and community outreach and drop-in programs, emergency shelter programs, <br/>
<a id="pl.135.23"></a><var>135.23</var>and integrated supportive housing and transitional living programs, consistent with the <br/>
<a id="pl.135.24"></a><var>135.24</var>program descriptions in this act to reduce the incidence of homelessness among youth.<br/>
<a id="pl.135.25"></a><var>135.25</var>    Subdivision 1. Subd. 1a. <b>Definitions.</b> (a) The definitions in this subdivision apply <br/>
<a id="pl.135.26"></a><var>135.26</var>to this section.<br/>
<a id="pl.135.27"></a><var>135.27</var>(b) "Commissioner" means the commissioner of human services.<br/>
<a id="pl.135.28"></a><var>135.28</var>(c) "Homeless youth" means a person 21 years of age or younger who is <br/>
<a id="pl.135.29"></a><var>135.29</var>unaccompanied by a parent or guardian and is without shelter where appropriate care and <br/>
<a id="pl.135.30"></a><var>135.30</var>supervision are available, whose parent or legal guardian is unable or unwilling to provide <br/>
<a id="pl.135.31"></a><var>135.31</var>shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The <br/>
<a id="pl.135.32"></a><var>135.32</var>following are not fixed, regular, or adequate nighttime residences:<br/>
<a id="pl.135.33"></a><var>135.33</var>(1) a supervised publicly or privately operated shelter designed to provide temporary <br/>
<a id="pl.135.34"></a><var>135.34</var>living accommodations;<br/>
<a id="pl.136.1"></a><var>136.1</var>(2) an institution or a publicly or privately operated shelter designed to provide <br/>
<a id="pl.136.2"></a><var>136.2</var>temporary living accommodations;<br/>
<a id="pl.136.3"></a><var>136.3</var>(3) transitional housing;<br/>
<a id="pl.136.4"></a><var>136.4</var>(4) a temporary placement with a peer, friend, or family member that has not offered <br/>
<a id="pl.136.5"></a><var>136.5</var>permanent residence, a residential lease, or temporary lodging for more than 30 days; or<br/>
<a id="pl.136.6"></a><var>136.6</var>(5) a public or private place not designed for, nor ordinarily used as, a regular <br/>
<a id="pl.136.7"></a><var>136.7</var>sleeping accommodation for human beings.<br/>
<a id="pl.136.8"></a><var>136.8</var>Homeless youth does not include persons incarcerated or otherwise detained under <br/>
<a id="pl.136.9"></a><var>136.9</var>federal or state law.<br/>
<a id="pl.136.10"></a><var>136.10</var>(d) "Youth at risk of homelessness" means a person 21 years of age or younger <br/>
<a id="pl.136.11"></a><var>136.11</var>whose status or circumstances indicate a significant danger of experiencing homelessness <br/>
<a id="pl.136.12"></a><var>136.12</var>in the near future. Status or circumstances that indicate a significant danger may include: <br/>
<a id="pl.136.13"></a><var>136.13</var>(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3) <br/>
<a id="pl.136.14"></a><var>136.14</var>youth whose parents or primary caregivers are or were previously homeless; (4) youth <br/>
<a id="pl.136.15"></a><var>136.15</var>who are exposed to abuse and neglect in their homes; (5) youth who experience conflict <br/>
<a id="pl.136.16"></a><var>136.16</var>with parents due to chemical or alcohol dependency, mental health disabilities, or other <br/>
<a id="pl.136.17"></a><var>136.17</var>disabilities; and (6) runaways.<br/>
<a id="pl.136.18"></a><var>136.18</var>(e) "Runaway" means an unmarried child under the age of 18 years who is absent <br/>
<a id="pl.136.19"></a><var>136.19</var>from the home of a parent or guardian or other lawful placement without the consent of <br/>
<a id="pl.136.20"></a><var>136.20</var>the parent, guardian, or lawful custodian.<br/>
<a id="pl.136.21"></a><var>136.21</var>    Subd. 2. <b>Homeless </b><b>and runaway</b><b> youth report.</b> The commissioner shall develop a<br/>
<a id="pl.136.22"></a><var>136.22</var> report for homeless youth, youth at risk of homelessness, and runaways. The report shall <br/>
<a id="pl.136.23"></a><var>136.23</var>include coordination of services as defined under subdivisions 3 to 5 prepare a biennial <br/>
<a id="pl.136.24"></a><var>136.24</var>report, beginning in February 2015, which provides meaningful information to the <br/>
<a id="pl.136.25"></a><var>136.25</var>legislative committees having jurisdiction over the issue of homeless youth, that includes, <br/>
<a id="pl.136.26"></a><var>136.26</var>but is not limited to: (1) a list of the areas of the state with the greatest need for services <br/>
<a id="pl.136.27"></a><var>136.27</var>and housing for homeless youth, and the level and nature of the needs identified; (2) details <br/>
<a id="pl.136.28"></a><var>136.28</var>about grants made; (3) the distribution of funds throughout the state based on population <br/>
<a id="pl.136.29"></a><var>136.29</var>need; (4) follow-up information, if available, on the status of homeless youth and whether <br/>
<a id="pl.136.30"></a><var>136.30</var>they have stable housing two years after services are provided; and (5) any other outcomes <br/>
<a id="pl.136.31"></a><var>136.31</var>for populations served to determine the effectiveness of the programs and use of funding.<br/>
<a id="pl.136.32"></a><var>136.32</var>    Subd. 3. <b>Street and community outreach and drop-in program.</b> Youth drop-in <br/>
<a id="pl.136.33"></a><var>136.33</var>centers must provide walk-in access to crisis intervention and ongoing supportive services <br/>
<a id="pl.136.34"></a><var>136.34</var>including one-to-one case management services on a self-referral basis. Street and <br/>
<a id="pl.136.35"></a><var>136.35</var>community outreach programs must locate, contact, and provide information, referrals, <br/>
<a id="pl.137.1"></a><var>137.1</var>and services to homeless youth, youth at risk of homelessness, and runaways. Information, <br/>
<a id="pl.137.2"></a><var>137.2</var>referrals, and services provided may include, but are not limited to:<br/>
<a id="pl.137.3"></a><var>137.3</var>(1) family reunification services;<br/>
<a id="pl.137.4"></a><var>137.4</var>(2) conflict resolution or mediation counseling;<br/>
<a id="pl.137.5"></a><var>137.5</var>(3) assistance in obtaining temporary emergency shelter;<br/>
<a id="pl.137.6"></a><var>137.6</var>(4) assistance in obtaining food, clothing, medical care, or mental health counseling;<br/>
<a id="pl.137.7"></a><var>137.7</var>(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted <br/>
<a id="pl.137.8"></a><var>137.8</var>diseases, and pregnancy;<br/>
<a id="pl.137.9"></a><var>137.9</var>(6) referrals to other agencies that provide support services to homeless youth, <br/>
<a id="pl.137.10"></a><var>137.10</var>youth at risk of homelessness, and runaways;<br/>
<a id="pl.137.11"></a><var>137.11</var>(7) assistance with education, employment, and independent living skills;<br/>
<a id="pl.137.12"></a><var>137.12</var>(8) aftercare services;<br/>
<a id="pl.137.13"></a><var>137.13</var>(9) specialized services for highly vulnerable runaways and homeless youth, <br/>
<a id="pl.137.14"></a><var>137.14</var>including teen parents, emotionally disturbed and mentally ill youth, and sexually <br/>
<a id="pl.137.15"></a><var>137.15</var>exploited youth; and<br/>
<a id="pl.137.16"></a><var>137.16</var>(10) homelessness prevention.<br/>
<a id="pl.137.17"></a><var>137.17</var>    Subd. 4. <b>Emergency shelter program.</b> (a) Emergency shelter programs must <br/>
<a id="pl.137.18"></a><var>137.18</var>provide homeless youth and runaways with referral and walk-in access to emergency, <br/>
<a id="pl.137.19"></a><var>137.19</var>short-term residential care. The program shall provide homeless youth and runaways with <br/>
<a id="pl.137.20"></a><var>137.20</var>safe, dignified shelter, including private shower facilities, beds, and at least one meal each <br/>
<a id="pl.137.21"></a><var>137.21</var>day; and shall assist a runaway and homeless youth with reunification with the family or <br/>
<a id="pl.137.22"></a><var>137.22</var>legal guardian when required or appropriate.<br/>
<a id="pl.137.23"></a><var>137.23</var>(b) The services provided at emergency shelters may include, but are not limited to:<br/>
<a id="pl.137.24"></a><var>137.24</var>(1) family reunification services;<br/>
<a id="pl.137.25"></a><var>137.25</var>(2) individual, family, and group counseling;<br/>
<a id="pl.137.26"></a><var>137.26</var>(3) assistance obtaining clothing;<br/>
<a id="pl.137.27"></a><var>137.27</var>(4) access to medical and dental care and mental health counseling;<br/>
<a id="pl.137.28"></a><var>137.28</var>(5) education and employment services;<br/>
<a id="pl.137.29"></a><var>137.29</var>(6) recreational activities;<br/>
<a id="pl.137.30"></a><var>137.30</var>(7) advocacy and referral services;<br/>
<a id="pl.137.31"></a><var>137.31</var>(8) independent living skills training;<br/>
<a id="pl.137.32"></a><var>137.32</var>(9) aftercare and follow-up services;<br/>
<a id="pl.137.33"></a><var>137.33</var>(10) transportation; and<br/>
<a id="pl.137.34"></a><var>137.34</var>(11) homelessness prevention.<br/>
<a id="pl.137.35"></a><var>137.35</var>    Subd. 5. <b>Supportive housing and transitional living programs.</b> Transitional <br/>
<a id="pl.137.36"></a><var>137.36</var>living programs must help homeless youth and youth at risk of homelessness to find and <br/>
<a id="pl.138.1"></a><var>138.1</var>maintain safe, dignified housing. The program may also provide rental assistance and <br/>
<a id="pl.138.2"></a><var>138.2</var>related supportive services, or refer youth to other organizations or agencies that provide <br/>
<a id="pl.138.3"></a><var>138.3</var>such services. Services provided may include, but are not limited to:<br/>
<a id="pl.138.4"></a><var>138.4</var>(1) educational assessment and referrals to educational programs;<br/>
<a id="pl.138.5"></a><var>138.5</var>(2) career planning, employment, work skill training, and independent living skills <br/>
<a id="pl.138.6"></a><var>138.6</var>training;<br/>
<a id="pl.138.7"></a><var>138.7</var>(3) job placement;<br/>
<a id="pl.138.8"></a><var>138.8</var>(4) budgeting and money management;<br/>
<a id="pl.138.9"></a><var>138.9</var>(5) assistance in securing housing appropriate to needs and income;<br/>
<a id="pl.138.10"></a><var>138.10</var>(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted <br/>
<a id="pl.138.11"></a><var>138.11</var>diseases, and pregnancy;<br/>
<a id="pl.138.12"></a><var>138.12</var>(7) referral for medical services or chemical dependency treatment;<br/>
<a id="pl.138.13"></a><var>138.13</var>(8) parenting skills;<br/>
<a id="pl.138.14"></a><var>138.14</var>(9) self-sufficiency support services or life skill training;<br/>
<a id="pl.138.15"></a><var>138.15</var>(10) aftercare and follow-up services; and<br/>
<a id="pl.138.16"></a><var>138.16</var>(11) homelessness prevention.<br/>
<a id="pl.138.17"></a><var>138.17</var>    Subd. 6. <b>Funding.</b> Any Funds appropriated for this section may be expended on <br/>
<a id="pl.138.18"></a><var>138.18</var>programs described under subdivisions 3 to 5, technical assistance, and capacity building. <br/>
<a id="pl.138.19"></a><var>138.19</var>Up to four percent of funds appropriated may be used for the purpose of monitoring and <br/>
<a id="pl.138.20"></a><var>138.20</var>evaluating runaway and homeless youth programs receiving funding under this section. <br/>
<a id="pl.138.21"></a><var>138.21</var>Funding shall be directed to meet the greatest need, with a significant share of the funding <br/>
<a id="pl.138.22"></a><var>138.22</var>focused on homeless youth providers in greater Minnesota to meet the greatest need <br/>
<a id="pl.138.23"></a><var>138.23</var>on a statewide basis.<br/>
<br/>
<a id="bill.3.26.0"></a><a id="pl.138.24"></a><var>138.24</var>    Sec. 26. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:<br/>
<a id="pl.138.25"></a><var>138.25</var>    Subdivision 1. <b>Formula.</b> The commissioner shall allocate state funds appropriated <br/>
<a id="pl.138.26"></a><var>138.26</var>under this chapter to each county board on a calendar year basis in an amount determined <br/>
<a id="pl.138.27"></a><var>138.27</var>according to the formula in paragraphs (a) to (e).<br/>
<a id="pl.138.28"></a><var>138.28</var>(a) For calendar years 2011 and 2012, the commissioner shall allocate available <br/>
<a id="pl.138.29"></a><var>138.29</var>funds to each county in proportion to that county's share in calendar year 2010.<br/>
<a id="pl.138.30"></a><var>138.30</var>(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall <br/>
<a id="pl.138.31"></a><var>138.31</var>allocate available funds to each county as follows:<br/>
<a id="pl.138.32"></a><var>138.32</var>(1) 75 percent must be distributed on the basis of the county share in calendar year <br/>
<a id="pl.138.33"></a><var>138.33</var>2012;<br/>
<a id="pl.138.34"></a><var>138.34</var>(2) five percent must be distributed on the basis of the number of persons residing in <br/>
<a id="pl.138.35"></a><var>138.35</var>the county as determined by the most recent data of the state demographer;<br/>
<a id="pl.139.1"></a><var>139.1</var>(3) ten percent must be distributed on the basis of the number of vulnerable children <br/>
<a id="pl.139.2"></a><var>139.2</var>that are subjects of reports under chapter 260C and sections 
         <statute_ref>626.556</statute_ref> and 
         <statute_ref>626.5561</statute_ref>, and in <br/>
<a id="pl.139.3"></a><var>139.3</var>the county as determined by the most recent data of the commissioner; and<br/>
<a id="pl.139.4"></a><var>139.4</var>(4) ten percent must be distributed on the basis of the number of vulnerable adults <br/>
<a id="pl.139.5"></a><var>139.5</var>that are subjects of reports under section 
         <statute_ref>626.557</statute_ref> in the county as determined by the most <br/>
<a id="pl.139.6"></a><var>139.6</var>recent data of the commissioner.<br/>
<a id="pl.139.7"></a><var>139.7</var>(c) For calendar year 2014, the commissioner shall allocate available funds to each <br/>
<a id="pl.139.8"></a><var>139.8</var>county as follows:<br/>
<a id="pl.139.9"></a><var>139.9</var>(1) 50 percent must be distributed on the basis of the county share in calendar year <br/>
<a id="pl.139.10"></a><var>139.10</var>2012;<br/>
<a id="pl.139.11"></a><var>139.11</var>(2) Ten percent must be distributed on the basis of the number of persons residing in <br/>
<a id="pl.139.12"></a><var>139.12</var>the county as determined by the most recent data of the state demographer;<br/>
<a id="pl.139.13"></a><var>139.13</var>(3) 20 percent must be distributed on the basis of the number of vulnerable children <br/>
<a id="pl.139.14"></a><var>139.14</var>that are subjects of reports under chapter 260C and sections 
<statute_ref>626.556</statute_ref> and 
<statute_ref>626.5561</statute_ref>, in the <br/>
<a id="pl.139.15"></a><var>139.15</var>county as determined by the most recent data of the commissioner; and<br/>
<a id="pl.139.16"></a><var>139.16</var>(4) 20 percent must be distributed on the basis of the number of vulnerable adults <br/>
<a id="pl.139.17"></a><var>139.17</var>that are subjects of reports under section 
<statute_ref>626.557</statute_ref> in the county as determined by the <br/>
<a id="pl.139.18"></a><var>139.18</var>most recent data of the commissioner The commissioner is precluded from changing the <br/>
<a id="pl.139.19"></a><var>139.19</var>formula under this subdivision or recommending a change to the legislature without <br/>
<a id="pl.139.20"></a><var>139.20</var>public review and input.<br/>
<a id="pl.139.21"></a><var>139.21</var>(d) For calendar year 2015, the commissioner shall allocate available funds to each <br/>
<a id="pl.139.22"></a><var>139.22</var>county as follows:<br/>
<a id="pl.139.23"></a><var>139.23</var>(1) 25 percent must be distributed on the basis of the county share in calendar year <br/>
<a id="pl.139.24"></a><var>139.24</var>2012;<br/>
<a id="pl.139.25"></a><var>139.25</var>(2) 15 percent must be distributed on the basis of the number of persons residing in <br/>
<a id="pl.139.26"></a><var>139.26</var>the county as determined by the most recent data of the state demographer;<br/>
<a id="pl.139.27"></a><var>139.27</var>(3) 30 percent must be distributed on the basis of the number of vulnerable children <br/>
<a id="pl.139.28"></a><var>139.28</var>that are subjects of reports under chapter 260C and sections 
<statute_ref>626.556</statute_ref> and 
<statute_ref>626.5561</statute_ref>, in the <br/>
<a id="pl.139.29"></a><var>139.29</var>county as determined by the most recent data of the commissioner; and<br/>
<a id="pl.139.30"></a><var>139.30</var>(4) 30 percent must be distributed on the basis of the number of vulnerable adults <br/>
<a id="pl.139.31"></a><var>139.31</var>that are subjects of reports under section 
<statute_ref>626.557</statute_ref> in the county as determined by the most <br/>
<a id="pl.139.32"></a><var>139.32</var>recent data of the commissioner.<br/>
<a id="pl.139.33"></a><var>139.33</var>(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall <br/>
<a id="pl.139.34"></a><var>139.34</var>allocate available funds to each county as follows:<br/>
<a id="pl.139.35"></a><var>139.35</var>(1) 20 percent must be distributed on the basis of the number of persons residing in <br/>
<a id="pl.139.36"></a><var>139.36</var>the county as determined by the most recent data of the state demographer;<br/>
<a id="pl.140.1"></a><var>140.1</var>(2) 40 percent must be distributed on the basis of the number of vulnerable children <br/>
<a id="pl.140.2"></a><var>140.2</var>that are subjects of reports under chapter 260C and sections 
<statute_ref>626.556</statute_ref> and 
<statute_ref>626.5561</statute_ref>, in the <br/>
<a id="pl.140.3"></a><var>140.3</var>county as determined by the most recent data of the commissioner; and<br/>
<a id="pl.140.4"></a><var>140.4</var>(3) 40 percent must be distributed on the basis of the number of vulnerable adults <br/>
<a id="pl.140.5"></a><var>140.5</var>that are subjects of reports under section 
<statute_ref>626.557</statute_ref> in the county as determined by the most <br/>
<a id="pl.140.6"></a><var>140.6</var>recent data of the commissioner.<br/>
<br/>
<a id="bill.3.27.0"></a><a id="pl.140.7"></a><var>140.7</var>    Sec. 27. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:<br/>
<a id="pl.140.8"></a><var>140.8</var>    Subd. 11. <b>Financial considerations.</b> (a) Payment of relative custody assistance <br/>
<a id="pl.140.9"></a><var>140.9</var>under a relative custody assistance agreement is subject to the availability of state funds <br/>
<a id="pl.140.10"></a><var>140.10</var>and payments may be reduced or suspended on order of the commissioner if insufficient <br/>
<a id="pl.140.11"></a><var>140.11</var>funds are available Beginning July 1, 2013, relative custody assistance shall be a forecasted <br/>
<a id="pl.140.12"></a><var>140.12</var>program, and the commissioner, with the approval of the commissioner of management <br/>
<a id="pl.140.13"></a><var>140.13</var>and budget, may transfer unencumbered appropriation balances within fiscal years of <br/>
<a id="pl.140.14"></a><var>140.14</var>each biennium to other forecasted programs of the Department of Human Services. The <br/>
<a id="pl.140.15"></a><var>140.15</var>commissioner shall inform the chairs and ranking minority members of the senate Health <br/>
<a id="pl.140.16"></a><var>140.16</var>and Human Services Finance Division and the house of representatives Health and Human <br/>
<a id="pl.140.17"></a><var>140.17</var>Services Finance Committee quarterly about transfers made under this provision.<br/>
<a id="pl.140.18"></a><var>140.18</var>(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner <br/>
<a id="pl.140.19"></a><var>140.19</var>shall reimburse the local agency in an amount equal to 100 percent of the relative custody <br/>
<a id="pl.140.20"></a><var>140.20</var>assistance payments provided to relative custodians. The local agency may not seek and <br/>
<a id="pl.140.21"></a><var>140.21</var>the commissioner shall not provide reimbursement for the administrative costs associated <br/>
<a id="pl.140.22"></a><var>140.22</var>with performing the duties described in subdivision 4.<br/>
<a id="pl.140.23"></a><var>140.23</var>(c) For the purposes of determining eligibility or payment amounts under MFIP, <br/>
<a id="pl.140.24"></a><var>140.24</var>relative custody assistance payments shall be excluded in determining the family's <br/>
<a id="pl.140.25"></a><var>140.25</var>available income.<br/>
<br/>
<a id="bill.3.28.0"></a><a id="pl.140.26"></a><var>140.26</var>    Sec. 28. Minnesota Statutes 2012, section 259A.05, subdivision 5, is amended to read:<br/>
<a id="pl.140.27"></a><var>140.27</var>    Subd. 5. <b>Transfer of funds.</b> The commissioner of human services may transfer <br/>
<a id="pl.140.28"></a><var>140.28</var>funds into the adoption assistance account when a deficit in the adoption assistance <br/>
<a id="pl.140.29"></a><var>140.29</var>program occurs Beginning July 1, 2013, adoption assistance shall be a forecasted program <br/>
<a id="pl.140.30"></a><var>140.30</var>and the commissioner, with the approval of the commissioner of management and budget, <br/>
<a id="pl.140.31"></a><var>140.31</var>may transfer unencumbered appropriation balances within fiscal years of each biennium to <br/>
<a id="pl.140.32"></a><var>140.32</var>other forecasted programs of the Department of Human Services. The commissioner shall <br/>
<a id="pl.140.33"></a><var>140.33</var>inform the chairs and ranking minority members of the senate Health and Human Services <br/>
<a id="pl.141.1"></a><var>141.1</var>Finance Division and the house of representatives Health and Human Services Finance <br/>
<a id="pl.141.2"></a><var>141.2</var>Committee quarterly about transfers made under this provision.<br/>
<br/>
<a id="bill.3.29.0"></a><a id="pl.141.3"></a><var>141.3</var>    Sec. 29. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:<br/>
<a id="pl.141.4"></a><var>141.4</var>    Subd. 4. <b>Reimbursement for special nonmedical expenses.</b> (a) Reimbursement <br/>
<a id="pl.141.5"></a><var>141.5</var>for special nonmedical expenses is available to children, except those eligible for adoption <br/>
<a id="pl.141.6"></a><var>141.6</var>assistance based on being an at-risk child.<br/>
<a id="pl.141.7"></a><var>141.7</var>(b) Reimbursements under this paragraph shall be made only after the adoptive <br/>
<a id="pl.141.8"></a><var>141.8</var>parent documents that the requested service was denied by the local social service agency, <br/>
<a id="pl.141.9"></a><var>141.9</var>community agencies, the local school district, the local public health department, the <br/>
<a id="pl.141.10"></a><var>141.10</var>parent's insurance provider, or the child's program. The denial must be for an eligible <br/>
<a id="pl.141.11"></a><var>141.11</var>service or qualified item under the program requirements of the applicable agency or <br/>
<a id="pl.141.12"></a><var>141.12</var>organization.<br/>
<a id="pl.141.13"></a><var>141.13</var>(c) Reimbursements must be previously authorized, adhere to the requirements and <br/>
<a id="pl.141.14"></a><var>141.14</var>procedures prescribed by the commissioner, and be limited to:<br/>
<a id="pl.141.15"></a><var>141.15</var>(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a <br/>
<a id="pl.141.16"></a><var>141.16</var>documented disability that requires special instruction for and services by the child care <br/>
<a id="pl.141.17"></a><var>141.17</var>provider. Child care reimbursements may be made if all available adult caregivers are <br/>
<a id="pl.141.18"></a><var>141.18</var>employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,<br/>
<a id="pl.141.19"></a><var>141.19</var> or attending educational or vocational training programs. Documentation from a qualified <br/>
<a id="pl.141.20"></a><var>141.20</var>expert that is dated within the last 12 months must be provided to verify the disability. If a <br/>
<a id="pl.141.21"></a><var>141.21</var>parent is attending an educational or vocational training program, child care reimbursement <br/>
<a id="pl.141.22"></a><var>141.22</var>is limited to no more than the time necessary to complete the credit requirements for an <br/>
<a id="pl.141.23"></a><var>141.23</var>associate or baccalaureate degree as determined by the educational institution. Child <br/>
<a id="pl.141.24"></a><var>141.24</var>care reimbursement is not limited for an adoptive parent completing basic or remedial <br/>
<a id="pl.141.25"></a><var>141.25</var>education programs needed to prepare for postsecondary education or employment;<br/>
<a id="pl.141.26"></a><var>141.26</var>(2) respite care provided for the relief of the child's parent up to 504 hours of respite <br/>
<a id="pl.141.27"></a><var>141.27</var>care annually;<br/>
<a id="pl.141.28"></a><var>141.28</var>(3) camping up to 14 days per state fiscal year for a child to attend a special needs <br/>
<a id="pl.141.29"></a><var>141.29</var>camp. The camp must be accredited by the American Camp Association as a special needs <br/>
<a id="pl.141.30"></a><var>141.30</var>camp in order to be eligible for camp reimbursement;<br/>
<a id="pl.141.31"></a><var>141.31</var>(4) postadoption counseling to promote the child's integration into the adoptive <br/>
<a id="pl.141.32"></a><var>141.32</var>family that is provided by the placing agency during the first year following the date of the <br/>
<a id="pl.141.33"></a><var>141.33</var>adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;<br/>
<a id="pl.141.34"></a><var>141.34</var>(5) family counseling that is required to meet the child's special needs. <br/>
<a id="pl.141.35"></a><var>141.35</var>Reimbursement is limited to the prorated portion of the counseling fees allotted to the <br/>
<a id="pl.142.1"></a><var>142.1</var>family when the adoptive parent's health insurance or Medicaid pays for the child's <br/>
<a id="pl.142.2"></a><var>142.2</var>counseling but does not cover counseling for the rest of the family members;<br/>
<a id="pl.142.3"></a><var>142.3</var>(6) home modifications to accommodate the child's special needs upon which <br/>
<a id="pl.142.4"></a><var>142.4</var>eligibility for adoption assistance was approved. Reimbursement is limited to once every <br/>
<a id="pl.142.5"></a><var>142.5</var>five years per child;<br/>
<a id="pl.142.6"></a><var>142.6</var>(7) vehicle modifications to accommodate the child's special needs upon which <br/>
<a id="pl.142.7"></a><var>142.7</var>eligibility for adoption assistance was approved. Reimbursement is limited to once every <br/>
<a id="pl.142.8"></a><var>142.8</var>five years per family; and<br/>
<a id="pl.142.9"></a><var>142.9</var>(8) burial expenses up to $1,000, if the special needs, upon which eligibility for <br/>
<a id="pl.142.10"></a><var>142.10</var>adoption assistance was approved, resulted in the death of the child.<br/>
<a id="pl.142.11"></a><var>142.11</var>(d) The adoptive parent shall submit statements for expenses incurred between July <br/>
<a id="pl.142.12"></a><var>142.12</var>1 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days <br/>
<a id="pl.142.13"></a><var>142.13</var>after the end of the fiscal year in order for reimbursement to occur.<br/>
<br/>
<a id="bill.3.30.0"></a><a id="pl.142.14"></a><var>142.14</var>    Sec. 30. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:<br/>
<a id="pl.142.15"></a><var>142.15</var>    Subd. 6. <b>Delinquent child.</b> (a) Except as otherwise provided in paragraphs (b) <br/>
<a id="pl.142.16"></a><var>142.16</var>and (c), "delinquent child" means a child:<br/>
<a id="pl.142.17"></a><var>142.17</var>(1) who has violated any state or local law, except as provided in section 
         <statute_ref>260B.225, <br/>
<a id="pl.142.18"></a><var>142.18</var>subdivision 1
         </statute_ref>, and except for juvenile offenders as described in subdivisions 16 to 18;<br/>
<a id="pl.142.19"></a><var>142.19</var>(2) who has violated a federal law or a law of another state and whose case has been <br/>
<a id="pl.142.20"></a><var>142.20</var>referred to the juvenile court if the violation would be an act of delinquency if committed <br/>
<a id="pl.142.21"></a><var>142.21</var>in this state or a crime or offense if committed by an adult;<br/>
<a id="pl.142.22"></a><var>142.22</var>(3) who has escaped from confinement to a state juvenile correctional facility after <br/>
<a id="pl.142.23"></a><var>142.23</var>being committed to the custody of the commissioner of corrections; or<br/>
<a id="pl.142.24"></a><var>142.24</var>(4) who has escaped from confinement to a local juvenile correctional facility after <br/>
<a id="pl.142.25"></a><var>142.25</var>being committed to the facility by the court.<br/>
<a id="pl.142.26"></a><var>142.26</var>(b) The term delinquent child does not include a child alleged to have committed <br/>
<a id="pl.142.27"></a><var>142.27</var>murder in the first degree after becoming 16 years of age, but the term delinquent child <br/>
<a id="pl.142.28"></a><var>142.28</var>does include a child alleged to have committed attempted murder in the first degree.<br/>
<a id="pl.142.29"></a><var>142.29</var>(c) The term delinquent child does not include a child under the age of 16 years<br/>
<a id="pl.142.30"></a><var>142.30</var> alleged to have engaged in conduct which would, if committed by an adult, violate any <br/>
<a id="pl.142.31"></a><var>142.31</var>federal, state, or local law relating to being hired, offering to be hired, or agreeing to be <br/>
<a id="pl.142.32"></a><var>142.32</var>hired by another individual to engage in sexual penetration or sexual conduct.<br/>
<a id="pl.142.33"></a><var>142.33</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2014, and applies to <br/>
<a id="pl.142.34"></a><var>142.34</var>offenses committed on or after that date.<br/>
<br/>
<a id="bill.3.31.0"></a><a id="pl.143.1"></a><var>143.1</var>    Sec. 31. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:<br/>
<a id="pl.143.2"></a><var>143.2</var>    Subd. 16. <b>Juvenile petty offender; juvenile petty offense.</b> (a) "Juvenile petty <br/>
<a id="pl.143.3"></a><var>143.3</var>offense" includes a juvenile alcohol offense, a juvenile controlled substance offense, <br/>
<a id="pl.143.4"></a><var>143.4</var>a violation of section 
         <statute_ref>609.685</statute_ref>, or a violation of a local ordinance, which by its terms <br/>
<a id="pl.143.5"></a><var>143.5</var>prohibits conduct by a child under the age of 18 years which would be lawful conduct if <br/>
<a id="pl.143.6"></a><var>143.6</var>committed by an adult.<br/>
<a id="pl.143.7"></a><var>143.7</var>(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also <br/>
<a id="pl.143.8"></a><var>143.8</var>includes an offense that would be a misdemeanor if committed by an adult.<br/>
<a id="pl.143.9"></a><var>143.9</var>(c) "Juvenile petty offense" does not include any of the following:<br/>
<a id="pl.143.10"></a><var>143.10</var>(1) a misdemeanor-level violation of section 
         <statute_ref>518B.01</statute_ref>, 
         <statute_ref>588.20</statute_ref>, 
         <statute_ref>609.224</statute_ref>, 
         <statute_ref>609.2242</statute_ref>, <br/>
<statute_ref><a id="pl.143.11"></a><var>143.11</var>609.324
         </statute_ref>, subdivision 2 or 3,
<statute_ref>609.5632</statute_ref>, 
         <statute_ref>609.576</statute_ref>, 
         <statute_ref>609.66</statute_ref>, 
         <statute_ref>609.746</statute_ref>, 
         <statute_ref>609.748</statute_ref>, 
         <statute_ref>609.79</statute_ref>, <br/>
<a id="pl.143.12"></a><var>143.12</var>or 
         <statute_ref>617.23</statute_ref>;<br/>
<a id="pl.143.13"></a><var>143.13</var>(2) a major traffic offense or an adult court traffic offense, as described in section <br/>
<statute_ref><a id="pl.143.14"></a><var>143.14</var>260B.225
         </statute_ref>;<br/>
<a id="pl.143.15"></a><var>143.15</var>(3) a misdemeanor-level offense committed by a child whom the juvenile court <br/>
<a id="pl.143.16"></a><var>143.16</var>previously has found to have committed a misdemeanor, gross misdemeanor, or felony <br/>
<a id="pl.143.17"></a><var>143.17</var>offense; or<br/>
<a id="pl.143.18"></a><var>143.18</var>(4) a misdemeanor-level offense committed by a child whom the juvenile court <br/>
<a id="pl.143.19"></a><var>143.19</var>has found to have committed a misdemeanor-level juvenile petty offense on two or <br/>
<a id="pl.143.20"></a><var>143.20</var>more prior occasions, unless the county attorney designates the child on the petition <br/>
<a id="pl.143.21"></a><var>143.21</var>as a juvenile petty offender notwithstanding this prior record. As used in this clause, <br/>
<a id="pl.143.22"></a><var>143.22</var>"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that <br/>
<a id="pl.143.23"></a><var>143.23</var>would have been a juvenile petty offense if it had been committed on or after July 1, 1995.<br/>
<a id="pl.143.24"></a><var>143.24</var>(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The <br/>
<a id="pl.143.25"></a><var>143.25</var>term juvenile petty offender does not include a child under the age of 16 years alleged <br/>
<a id="pl.143.26"></a><var>143.26</var>to have violated any law relating to being hired, offering to be hired, or agreeing to be <br/>
<a id="pl.143.27"></a><var>143.27</var>hired by another individual to engage in sexual penetration or sexual conduct which, if <br/>
<a id="pl.143.28"></a><var>143.28</var>committed by an adult, would be a misdemeanor.<br/>
<a id="pl.143.29"></a><var>143.29</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2014, and applies to <br/>
<a id="pl.143.30"></a><var>143.30</var>offenses committed on or after that date.<br/>
<br/>
<a id="bill.3.32.0"></a><a id="pl.143.31"></a><var>143.31</var>    Sec. 32. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:<br/>
<a id="pl.143.32"></a><var>143.32</var>    Subd. 6. <b>Child in need of protection or services.</b> "Child in need of protection or <br/>
<a id="pl.143.33"></a><var>143.33</var>services" means a child who is in need of protection or services because the child:<br/>
<a id="pl.143.34"></a><var>143.34</var>    (1) is abandoned or without parent, guardian, or custodian;<br/>
<a id="pl.144.1"></a><var>144.1</var>    (2)(i) has been a victim of physical or sexual abuse as defined in section 
         <statute_ref>626.556</statute_ref>, <br/>
<a id="pl.144.2"></a><var>144.2</var>subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in <br/>
<a id="pl.144.3"></a><var>144.3</var>subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or <br/>
<a id="pl.144.4"></a><var>144.4</var>would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or <br/>
<a id="pl.144.5"></a><var>144.5</var>child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment <br/>
<a id="pl.144.6"></a><var>144.6</var>as defined in subdivision 15;<br/>
<a id="pl.144.7"></a><var>144.7</var>    (3) is without necessary food, clothing, shelter, education, or other required care <br/>
<a id="pl.144.8"></a><var>144.8</var>for the child's physical or mental health or morals because the child's parent, guardian, <br/>
<a id="pl.144.9"></a><var>144.9</var>or custodian is unable or unwilling to provide that care;<br/>
<a id="pl.144.10"></a><var>144.10</var>    (4) is without the special care made necessary by a physical, mental, or emotional <br/>
<a id="pl.144.11"></a><var>144.11</var>condition because the child's parent, guardian, or custodian is unable or unwilling to <br/>
<a id="pl.144.12"></a><var>144.12</var>provide that care;<br/>
<a id="pl.144.13"></a><var>144.13</var>    (5) is medically neglected, which includes, but is not limited to, the withholding of <br/>
<a id="pl.144.14"></a><var>144.14</var>medically indicated treatment from a disabled infant with a life-threatening condition. The <br/>
<a id="pl.144.15"></a><var>144.15</var>term "withholding of medically indicated treatment" means the failure to respond to the <br/>
<a id="pl.144.16"></a><var>144.16</var>infant's life-threatening conditions by providing treatment, including appropriate nutrition, <br/>
<a id="pl.144.17"></a><var>144.17</var>hydration, and medication which, in the treating physician's or physicians' reasonable <br/>
<a id="pl.144.18"></a><var>144.18</var>medical judgment, will be most likely to be effective in ameliorating or correcting all <br/>
<a id="pl.144.19"></a><var>144.19</var>conditions, except that the term does not include the failure to provide treatment other <br/>
<a id="pl.144.20"></a><var>144.20</var>than appropriate nutrition, hydration, or medication to an infant when, in the treating <br/>
<a id="pl.144.21"></a><var>144.21</var>physician's or physicians' reasonable medical judgment:<br/>
<a id="pl.144.22"></a><var>144.22</var>    (i) the infant is chronically and irreversibly comatose;<br/>
<a id="pl.144.23"></a><var>144.23</var>    (ii) the provision of the treatment would merely prolong dying, not be effective in <br/>
<a id="pl.144.24"></a><var>144.24</var>ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be <br/>
<a id="pl.144.25"></a><var>144.25</var>futile in terms of the survival of the infant; or<br/>
<a id="pl.144.26"></a><var>144.26</var>    (iii) the provision of the treatment would be virtually futile in terms of the survival <br/>
<a id="pl.144.27"></a><var>144.27</var>of the infant and the treatment itself under the circumstances would be inhumane;<br/>
<a id="pl.144.28"></a><var>144.28</var>    (6) is one whose parent, guardian, or other custodian for good cause desires to be <br/>
<a id="pl.144.29"></a><var>144.29</var>relieved of the child's care and custody, including a child who entered foster care under a <br/>
<a id="pl.144.30"></a><var>144.30</var>voluntary placement agreement between the parent and the responsible social services <br/>
<a id="pl.144.31"></a><var>144.31</var>agency under section 
         <statute_ref>260C.227</statute_ref>;<br/>
<a id="pl.144.32"></a><var>144.32</var>    (7) has been placed for adoption or care in violation of law;<br/>
<a id="pl.144.33"></a><var>144.33</var>    (8) is without proper parental care because of the emotional, mental, or physical <br/>
<a id="pl.144.34"></a><var>144.34</var>disability, or state of immaturity of the child's parent, guardian, or other custodian;<br/>
<a id="pl.145.1"></a><var>145.1</var>    (9) is one whose behavior, condition, or environment is such as to be injurious or <br/>
<a id="pl.145.2"></a><var>145.2</var>dangerous to the child or others. An injurious or dangerous environment may include, but <br/>
<a id="pl.145.3"></a><var>145.3</var>is not limited to, the exposure of a child to criminal activity in the child's home;<br/>
<a id="pl.145.4"></a><var>145.4</var>    (10) is experiencing growth delays, which may be referred to as failure to thrive, that <br/>
<a id="pl.145.5"></a><var>145.5</var>have been diagnosed by a physician and are due to parental neglect;<br/>
<a id="pl.145.6"></a><var>145.6</var>    (11) has engaged in prostitution as defined in section 
<statute_ref>609.321, subdivision 9</statute_ref> is a <br/>
<a id="pl.145.7"></a><var>145.7</var>sexually exploited youth;<br/>
<a id="pl.145.8"></a><var>145.8</var>    (12) has committed a delinquent act or a juvenile petty offense before becoming <br/>
<a id="pl.145.9"></a><var>145.9</var>ten years old;<br/>
<a id="pl.145.10"></a><var>145.10</var>    (13) is a runaway;<br/>
<a id="pl.145.11"></a><var>145.11</var>    (14) is a habitual truant;<br/>
<a id="pl.145.12"></a><var>145.12</var>    (15) has been found incompetent to proceed or has been found not guilty by reason <br/>
<a id="pl.145.13"></a><var>145.13</var>of mental illness or mental deficiency in connection with a delinquency proceeding, a <br/>
<a id="pl.145.14"></a><var>145.14</var>certification under section 
         <statute_ref>260B.125</statute_ref>, an extended jurisdiction juvenile prosecution, or a <br/>
<a id="pl.145.15"></a><var>145.15</var>proceeding involving a juvenile petty offense; or<br/>
<a id="pl.145.16"></a><var>145.16</var>(16) has a parent whose parental rights to one or more other children were <br/>
<a id="pl.145.17"></a><var>145.17</var>involuntarily terminated or whose custodial rights to another child have been involuntarily <br/>
<a id="pl.145.18"></a><var>145.18</var>transferred to a relative and there is a case plan prepared by the responsible social services <br/>
<a id="pl.145.19"></a><var>145.19</var>agency documenting a compelling reason why filing the termination of parental rights <br/>
<a id="pl.145.20"></a><var>145.20</var>petition under section 
         <statute_ref>260C.301, subdivision 3</statute_ref>, is not in the best interests of the child; or.<br/>
<a id="pl.145.21"></a><var>145.21</var>(17) is a sexually exploited youth.<br/>
<a id="pl.145.22"></a><var>145.22</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2014.<br/>
<br/>
<a id="bill.3.33.0"></a><a id="pl.145.23"></a><var>145.23</var>    Sec. 33. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:<br/>
<a id="pl.145.24"></a><var>145.24</var>    Subd. 31. <b>Sexually exploited youth.</b> "Sexually exploited youth" means an <br/>
<a id="pl.145.25"></a><var>145.25</var>individual who:<br/>
<a id="pl.145.26"></a><var>145.26</var>(1) is alleged to have engaged in conduct which would, if committed by an adult, <br/>
<a id="pl.145.27"></a><var>145.27</var>violate any federal, state, or local law relating to being hired, offering to be hired, or <br/>
<a id="pl.145.28"></a><var>145.28</var>agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;<br/>
<a id="pl.145.29"></a><var>145.29</var>(2) is a victim of a crime described in section 
         <statute_ref>609.342</statute_ref>, 
         <statute_ref>609.343</statute_ref>, 609.344,
<statute_ref>609.345</statute_ref>, <br/>
<statute_ref><a id="pl.145.30"></a><var>145.30</var>609.3451
         </statute_ref>, 
         <statute_ref>609.3453</statute_ref>, 
         <statute_ref>609.352</statute_ref>, 
         <statute_ref>617.246</statute_ref>, or 
         <statute_ref>617.247</statute_ref>;<br/>
<a id="pl.145.31"></a><var>145.31</var>(3) is a victim of a crime described in United States Code, title 18, section 2260; <br/>
<a id="pl.145.32"></a><var>145.32</var>2421; 2422; 2423; 2425; 2425A; or 2256; or<br/>
<a id="pl.145.33"></a><var>145.33</var>(4) is a sex trafficking victim as defined in section 
         <statute_ref>609.321, subdivision 7b</statute_ref>.<br/>
<a id="pl.145.34"></a><var>145.34</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.3.34.0"></a><a id="pl.146.1"></a><var>146.1</var>    Sec. 34. Minnesota Statutes 2012, section 518A.60, is amended to read:<br/>
<a id="pl.146.2"></a><var>146.2</var><b>518A.60 COLLECTION; ARREARS ONLY.</b><br/>
<a id="pl.146.3"></a><var>146.3</var>(a) Remedies available for the collection and enforcement of support in this chapter <br/>
<a id="pl.146.4"></a><var>146.4</var>and chapters 256, 257, 518, and 518C also apply to cases in which the child or children <br/>
<a id="pl.146.5"></a><var>146.5</var>for whom support is owed are emancipated and the obligor owes past support or has an <br/>
<a id="pl.146.6"></a><var>146.6</var>accumulated arrearage as of the date of the youngest child's emancipation. Child support <br/>
<a id="pl.146.7"></a><var>146.7</var>arrearages under this section include arrearages for child support, medical support, child <br/>
<a id="pl.146.8"></a><var>146.8</var>care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in <br/>
<a id="pl.146.9"></a><var>146.9</var>section 
         <statute_ref>518A.41, subdivision 1, paragraph (h)</statute_ref>.<br/>
<a id="pl.146.10"></a><var>146.10</var>(b) This section applies retroactively to any support arrearage that accrued on or <br/>
<a id="pl.146.11"></a><var>146.11</var>before June 3, 1997, and to all arrearages accruing after June 3, 1997.<br/>
<a id="pl.146.12"></a><var>146.12</var>(c) Past support or pregnancy and confinement expenses ordered for which the <br/>
<a id="pl.146.13"></a><var>146.13</var>obligor has specific court ordered terms for repayment may not be enforced using <br/>
<a id="pl.146.14"></a><var>146.14</var>drivers' and occupational or professional license suspension, credit bureau reporting, and <br/>
<a id="pl.146.15"></a><var>146.15</var>additional income withholding under section 
         <statute_ref>518A.53, subdivision 10</statute_ref>, paragraph (a), <br/>
<a id="pl.146.16"></a><var>146.16</var>unless the obligor fails to comply with the terms of the court order for repayment.<br/>
<a id="pl.146.17"></a><var>146.17</var>(d) If an arrearage exists at the time a support order would otherwise terminate <br/>
<a id="pl.146.18"></a><var>146.18</var>and section 
         <statute_ref>518A.53, subdivision 10</statute_ref>, paragraph (c), does not apply to this section, the <br/>
<a id="pl.146.19"></a><var>146.19</var>arrearage shall be repaid in an amount equal to the current support order until all arrears <br/>
<a id="pl.146.20"></a><var>146.20</var>have been paid in full, absent a court order to the contrary.<br/>
<a id="pl.146.21"></a><var>146.21</var>(e) If an arrearage exists according to a support order which fails to establish a <br/>
<a id="pl.146.22"></a><var>146.22</var>monthly support obligation in a specific dollar amount, the public authority, if it provides <br/>
<a id="pl.146.23"></a><var>146.23</var>child support services, or the obligee, may establish a payment agreement which shall <br/>
<a id="pl.146.24"></a><var>146.24</var>equal what the obligor would pay for current support after application of section 
         <statute_ref>518A.34</statute_ref>, <br/>
<a id="pl.146.25"></a><var>146.25</var>plus an additional 20 percent of the current support obligation, until all arrears have been <br/>
<a id="pl.146.26"></a><var>146.26</var>paid in full. If the obligor fails to enter into or comply with a payment agreement, the <br/>
<a id="pl.146.27"></a><var>146.27</var>public authority, if it provides child support services, or the obligee, may move the district <br/>
<a id="pl.146.28"></a><var>146.28</var>court or child support magistrate, if section 
         <statute_ref>484.702</statute_ref> applies, for an order establishing <br/>
<a id="pl.146.29"></a><var>146.29</var>repayment terms.<br/>
<a id="pl.146.30"></a><var>146.30</var>(f) If there is no longer a current support order because all of the children of the <br/>
<a id="pl.146.31"></a><var>146.31</var>order are emancipated, the public authority may discontinue child support services and <br/>
<a id="pl.146.32"></a><var>146.32</var>close its case under title IV-D of the Social Security Act if:<br/>
<a id="pl.146.33"></a><var>146.33</var>(1) the arrearage is under $500; or<br/>
<a id="pl.146.34"></a><var>146.34</var>(2) the arrearage is considered unenforceable by the public authority because there <br/>
<a id="pl.146.35"></a><var>146.35</var>have been no collections for three years, and all administrative and legal remedies have <br/>
<a id="pl.146.36"></a><var>146.36</var>been attempted or are determined by the public authority to be ineffective because the <br/>
<a id="pl.147.1"></a><var>147.1</var>obligor is unable to pay, the obligor has no known income or assets, and there is no <br/>
<a id="pl.147.2"></a><var>147.2</var>reasonable prospect that the obligor will be able to pay in the foreseeable future.<br/>
<a id="pl.147.3"></a><var>147.3</var>    (g) At least 60 calendar days before the discontinuation of services under paragraph <br/>
<a id="pl.147.4"></a><var>147.4</var>(f), the public authority must mail a written notice to the obligee and obligor at the <br/>
<a id="pl.147.5"></a><var>147.5</var>obligee's and obligor's last known addresses that the public authority intends to close the <br/>
<a id="pl.147.6"></a><var>147.6</var>child support enforcement case and explaining each party's rights. Seven calendar days <br/>
<a id="pl.147.7"></a><var>147.7</var>after the first notice is mailed, the public authority must mail a second notice under this <br/>
<a id="pl.147.8"></a><var>147.8</var>paragraph to the obligee.<br/>
<a id="pl.147.9"></a><var>147.9</var>    (h) The case must be kept open if the obligee responds before case closure and <br/>
<a id="pl.147.10"></a><var>147.10</var>provides information that could reasonably lead to collection of arrears. If the case is <br/>
<a id="pl.147.11"></a><var>147.11</var>closed, the obligee may later request that the case be reopened by completing a new <br/>
<a id="pl.147.12"></a><var>147.12</var>application for services, if there is a change in circumstances that could reasonably lead to <br/>
<a id="pl.147.13"></a><var>147.13</var>the collection of arrears.<br/>
<br/>
<a id="bill.3.35.0"></a><a id="pl.147.14"></a><var>147.14</var>    Sec. 35. Laws 1998, chapter 407, article 6, section 116, is amended to read:<br/>
<a id="pl.147.15"></a><var>147.15</var>    Sec. 116. <b>EBT TRANSACTION COSTS</b><b>; APPROVAL FROM LEGISLATURE</b><b>.</b><br/>
<a id="pl.147.16"></a><var>147.16</var>    The commissioner of human services shall request and receive approval from the <br/>
<a id="pl.147.17"></a><var>147.17</var>legislature before adjusting the payment to discontinue the state subsidy to retailers for <br/>
<a id="pl.147.18"></a><var>147.18</var>electronic benefit transfer transaction costs Supplemental Nutrition Assistance Program <br/>
<a id="pl.147.19"></a><var>147.19</var>transactions when the federal government discontinues the federal subsidy to the same.<br/>
<br/>
<a id="bill.3.36.0"></a><a id="pl.147.20"></a><var>147.20</var>    Sec. 36. <b>DIRECTION TO COMMISSIONERS; INCOME AND ASSET </b><br/>
<a id="pl.147.21"></a><var>147.21</var><b>EXCLUSION.</b><br/>
<a id="pl.147.22"></a><var>147.22</var>(a) The commissioner of human services shall not count conditional cash transfers <br/>
<a id="pl.147.23"></a><var>147.23</var>made to families participating in a family independence demonstration as income or <br/>
<a id="pl.147.24"></a><var>147.24</var>assets for purposes of determining or redetermining eligibility for child care assistance <br/>
<a id="pl.147.25"></a><var>147.25</var>programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota <br/>
<a id="pl.147.26"></a><var>147.26</var>Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I; <br/>
<a id="pl.147.27"></a><var>147.27</var>the Minnesota family investment program, work benefit program, or diversionary work <br/>
<a id="pl.147.28"></a><var>147.28</var>program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.<br/>
<a id="pl.147.29"></a><var>147.29</var>(b) The commissioner of human services shall not count conditional cash transfers <br/>
<a id="pl.147.30"></a><var>147.30</var>made to families participating in a family independence demonstration as income or assets <br/>
<a id="pl.147.31"></a><var>147.31</var>for purposes of determining or redetermining eligibility for medical assistance under <br/>
<a id="pl.147.32"></a><var>147.32</var>Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter <br/>
<a id="pl.147.33"></a><var>147.33</var>256L, except that for enrollees subject to a modified adjusted gross income calculation to <br/>
<a id="pl.147.34"></a><var>147.34</var>determine eligibility, the conditional cash transfer payments shall be counted as income if <br/>
<a id="pl.148.1"></a><var>148.1</var>they are included on the enrollee's federal tax return as income, or if the payments can be <br/>
<a id="pl.148.2"></a><var>148.2</var>taken into account in the month of receipt as a lump sum payment.<br/>
<a id="pl.148.3"></a><var>148.3</var>(c) The commissioner of the Minnesota Housing Finance Agency shall not count <br/>
<a id="pl.148.4"></a><var>148.4</var>conditional cash transfers made to families participating in a family independence <br/>
<a id="pl.148.5"></a><var>148.5</var>demonstration as income or assets for purposes of determining or redetermining eligibility <br/>
<a id="pl.148.6"></a><var>148.6</var>for housing assistance programs under Minnesota Statutes, section 462A.201, during <br/>
<a id="pl.148.7"></a><var>148.7</var>the duration of the demonstration.<br/>
<a id="pl.148.8"></a><var>148.8</var>(d) For the purposes of this section:<br/>
<a id="pl.148.9"></a><var>148.9</var>(1) "conditional cash transfer" means a payment made to a participant in a family <br/>
<a id="pl.148.10"></a><var>148.10</var>independence demonstration by a sponsoring organization to incent, support, or facilitate <br/>
<a id="pl.148.11"></a><var>148.11</var>participation; and <br/>
<a id="pl.148.12"></a><var>148.12</var>(2) "family independence demonstration" means an initiative sponsored or <br/>
<a id="pl.148.13"></a><var>148.13</var>cosponsored by a governmental or nongovernmental organization, the goal of which is <br/>
<a id="pl.148.14"></a><var>148.14</var>to facilitate individualized goal-setting and peer support for cohorts of no more than 12 <br/>
<a id="pl.148.15"></a><var>148.15</var>families each toward the development of financial and nonfinancial assets that enable the <br/>
<a id="pl.148.16"></a><var>148.16</var>participating families to achieve financial independence.<br/>
<a id="pl.148.17"></a><var>148.17</var>(e) The citizens league shall provide a report to the legislative committees having <br/>
<a id="pl.148.18"></a><var>148.18</var>jurisdiction over human services issues by July 1, 2016, informing the legislature on the <br/>
<a id="pl.148.19"></a><var>148.19</var>progress and outcomes of the demonstration under this section.<br/>
<br/>
<a id="bill.3.37.0"></a><a id="pl.148.20"></a><var>148.20</var>    Sec. 37. <b>UNIFORM BENEFITS FOR CHILDREN IN FOSTER CARE, </b><br/>
<a id="pl.148.21"></a><var>148.21</var><b>PERMANENT RELATIVE CARE, AND ADOPTION ASSISTANCE.</b><br/>
<a id="pl.148.22"></a><var>148.22</var>Using available resources, the commissioner of human services, in consultation with <br/>
<a id="pl.148.23"></a><var>148.23</var>representatives of the judicial branch, county human services, and tribes participating in <br/>
<a id="pl.148.24"></a><var>148.24</var>the American Indian child welfare initiative under Minnesota Statutes, section 256.01, <br/>
<a id="pl.148.25"></a><var>148.25</var>subdivision 14b, together with other appropriate stakeholders, which might include <br/>
<a id="pl.148.26"></a><var>148.26</var>communities of color; youth in foster care or those who have aged out of care; kinship <br/>
<a id="pl.148.27"></a><var>148.27</var>caregivers, foster parents, adoptive parents, foster and adoptive agencies; guardians ad <br/>
<a id="pl.148.28"></a><var>148.28</var>litem; and experts in permanency, adoption, child development, and the effects of trauma, <br/>
<a id="pl.148.29"></a><var>148.29</var>and the use of medical assistance home and community-based waivers for persons with <br/>
<a id="pl.148.30"></a><var>148.30</var>disabilities, shall analyze benefits and services available to children in family foster care <br/>
<a id="pl.148.31"></a><var>148.31</var>under Minnesota Rules, parts 9560.0650 to 9560.0656, relative custody assistance under <br/>
<a id="pl.148.32"></a><var>148.32</var>Minnesota Statutes, section 257.85, and adoption assistance under Minnesota Statutes, <br/>
<a id="pl.148.33"></a><var>148.33</var>chapter 259A. The goal of the analysis is to establish a uniform set of benefits available <br/>
<a id="pl.148.34"></a><var>148.34</var>to children in foster care, permanent relative care, and adoption so that the benefits <br/>
<a id="pl.148.35"></a><var>148.35</var>can follow the child rather than being tied to the child's legal status. Included in the <br/>
<a id="pl.149.1"></a><var>149.1</var>analysis is possible accessing of federal title IV-E through guardianship assistance. The <br/>
<a id="pl.149.2"></a><var>149.2</var>commissioner shall report findings and conclusions to the chairs and ranking minority <br/>
<a id="pl.149.3"></a><var>149.3</var>members of the legislative committees and divisions with jurisdiction over health and <br/>
<a id="pl.149.4"></a><var>149.4</var>human services policy and finance by January 15, 2014, and include draft legislation <br/>
<a id="pl.149.5"></a><var>149.5</var>establishing uniform benefits.<br/>
<br/>
<a id="bill.3.38.0"></a><a id="pl.149.6"></a><var>149.6</var>    Sec. 38. <b>WAIVER PROCESS RELATED TO CHILD CARE PROVIDER </b><br/>
<a id="pl.149.7"></a><var>149.7</var><b>CHOICE.</b><br/>
<a id="pl.149.8"></a><var>149.8</var>The commissioner of human services, within available appropriations, shall develop <br/>
<a id="pl.149.9"></a><var>149.9</var>a simple waiver process related to Minnesota Statutes, section 119B.09, subdivision 5, <br/>
<a id="pl.149.10"></a><var>149.10</var>that requires the parent or guardian to submit notice of a preferred alternative child care <br/>
<a id="pl.149.11"></a><var>149.11</var>arrangement. The commissioner must monitor the waiver process and report on the usage <br/>
<a id="pl.149.12"></a><var>149.12</var>of waivers to the legislature.<br/>
<br/>
<a id="bill.3.39.0"></a><a id="pl.149.13"></a><var>149.13</var>    Sec. 39. <b> REPEALER.</b><br/>
<a id="pl.149.14"></a><var>149.14</var>(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed effective <br/>
<a id="pl.149.15"></a><var>149.15</var>July 1, 2014.<br/>
<a id="pl.149.16"></a><var>149.16</var>(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following <br/>
<a id="pl.149.17"></a><var>149.17</var>final enactment.<br/>
<br/>
<a id="bill.4.0.0"></a>

<a id="bill.4.1.0"></a><a id="pl.149.20"></a><var>149.20</var>    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:<br/>
<a id="pl.149.21"></a><var>149.21</var>    Subd. 20. <b>Mental illness.</b> (a) "Mental illness" means an organic disorder of the brain <br/>
<a id="pl.149.22"></a><var>149.22</var>or a clinically significant disorder of thought, mood, perception, orientation, memory, or <br/>
<a id="pl.149.23"></a><var>149.23</var>behavior that is detailed in a diagnostic codes list published by the commissioner, and that <br/>
<a id="pl.149.24"></a><var>149.24</var>seriously limits a person's capacity to function in primary aspects of daily living such as <br/>
<a id="pl.149.25"></a><var>149.25</var>personal relations, living arrangements, work, and recreation.<br/>
<a id="pl.149.26"></a><var>149.26</var>    (b) An "adult with acute mental illness" means an adult who has a mental illness that <br/>
<a id="pl.149.27"></a><var>149.27</var>is serious enough to require prompt intervention.<br/>
<a id="pl.149.28"></a><var>149.28</var>    (c) For purposes of case management and community support services, a "person <br/>
<a id="pl.149.29"></a><var>149.29</var>with serious and persistent mental illness" means an adult who has a mental illness and <br/>
<a id="pl.149.30"></a><var>149.30</var>meets at least one of the following criteria:<br/>
<a id="pl.149.31"></a><var>149.31</var>    (1) the adult has undergone two or more episodes of inpatient care for a mental <br/>
<a id="pl.149.32"></a><var>149.32</var>illness within the preceding 24 months;<br/>
<a id="pl.150.1"></a><var>150.1</var>    (2) the adult has experienced a continuous psychiatric hospitalization or residential <br/>
<a id="pl.150.2"></a><var>150.2</var>treatment exceeding six months' duration within the preceding 12 months;<br/>
<a id="pl.150.3"></a><var>150.3</var>    (3) the adult has been treated by a crisis team two or more times within the preceding <br/>
<a id="pl.150.4"></a><var>150.4</var>24 months;<br/>
<a id="pl.150.5"></a><var>150.5</var>    (4) the adult:<br/>
<a id="pl.150.6"></a><var>150.6</var>    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, <br/>
<a id="pl.150.7"></a><var>150.7</var>schizoaffective disorder, or borderline personality disorder;<br/>
<a id="pl.150.8"></a><var>150.8</var>    (ii) indicates a significant impairment in functioning; and<br/>
<a id="pl.150.9"></a><var>150.9</var>    (iii) has a written opinion from a mental health professional, in the last three years, <br/>
<a id="pl.150.10"></a><var>150.10</var>stating that the adult is reasonably likely to have future episodes requiring inpatient or <br/>
<a id="pl.150.11"></a><var>150.11</var>residential treatment, of a frequency described in clause (1) or (2), unless ongoing case <br/>
<a id="pl.150.12"></a><var>150.12</var>management or community support services are provided;<br/>
<a id="pl.150.13"></a><var>150.13</var>    (5) the adult has, in the last three years, been committed by a court as a person who is <br/>
<a id="pl.150.14"></a><var>150.14</var>mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or<br/>
<a id="pl.150.15"></a><var>150.15</var>    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period <br/>
<a id="pl.150.16"></a><var>150.16</var>has expired or the adult was eligible as a child under section 
         <statute_ref>245.4871, subdivision 6</statute_ref>; and <br/>
<a id="pl.150.17"></a><var>150.17</var>(ii) has a written opinion from a mental health professional, in the last three years, stating <br/>
<a id="pl.150.18"></a><var>150.18</var>that the adult is reasonably likely to have future episodes requiring inpatient or residential <br/>
<a id="pl.150.19"></a><var>150.19</var>treatment, of a frequency described in clause (1) or (2), unless ongoing case management <br/>
<a id="pl.150.20"></a><var>150.20</var>or community support services are provided; or<br/>
<a id="pl.150.21"></a><var>150.21</var>    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is <br/>
<a id="pl.150.22"></a><var>150.22</var>age 21 or younger.<br/>
<br/>
<a id="bill.4.2.0"></a><a id="pl.150.23"></a><var>150.23</var>    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:<br/>
<a id="pl.150.24"></a><var>150.24</var>    Subd. 5. <b>Planning for pilot projects.</b> (a) Each local plan for a pilot project, with <br/>
<a id="pl.150.25"></a><var>150.25</var>the exception of the placement of a Minnesota specialty treatment facility as defined in <br/>
<a id="pl.150.26"></a><var>150.26</var>paragraph (c), must be developed under the direction of the county board, or multiple <br/>
<a id="pl.150.27"></a><var>150.27</var>county boards acting jointly, as the local mental health authority. The planning process <br/>
<a id="pl.150.28"></a><var>150.28</var>for each pilot shall include, but not be limited to, mental health consumers, families, <br/>
<a id="pl.150.29"></a><var>150.29</var>advocates, local mental health advisory councils, local and state providers, representatives <br/>
<a id="pl.150.30"></a><var>150.30</var>of state and local public employee bargaining units, and the department of human services. <br/>
<a id="pl.150.31"></a><var>150.31</var>As part of the planning process, the county board or boards shall designate a managing <br/>
<a id="pl.150.32"></a><var>150.32</var>entity responsible for receipt of funds and management of the pilot project.<br/>
<a id="pl.150.33"></a><var>150.33</var>(b) For Minnesota specialty treatment facilities, the commissioner shall issue a <br/>
<a id="pl.150.34"></a><var>150.34</var>request for proposal for regions in which a need has been identified for services.<br/>
<a id="pl.151.1"></a><var>151.1</var>(c) For purposes of this section, Minnesota specialty treatment facility is defined as <br/>
<a id="pl.151.2"></a><var>151.2</var>an intensive rehabilitative mental health service under section 256B.0622, subdivision 2, <br/>
<a id="pl.151.3"></a><var>151.3</var>paragraph (b).<br/>
<br/>
<a id="bill.4.3.0"></a><a id="pl.151.4"></a><var>151.4</var>    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:<br/>
<a id="pl.151.5"></a><var>151.5</var>    Subd. 6. <b>Duties of commissioner.</b> (a) For purposes of the pilot projects, the <br/>
<a id="pl.151.6"></a><var>151.6</var>commissioner shall facilitate integration of funds or other resources as needed and <br/>
<a id="pl.151.7"></a><var>151.7</var>requested by each project. These resources may include:<br/>
<a id="pl.151.8"></a><var>151.8</var>(1) residential services funds administered under Minnesota Rules, parts 9535.2000 <br/>
<a id="pl.151.9"></a><var>151.9</var>to 9535.3000, in an amount to be determined by mutual agreement between the project's <br/>
<a id="pl.151.10"></a><var>151.10</var>managing entity and the commissioner of human services after an examination of the <br/>
<a id="pl.151.11"></a><var>151.11</var>county's historical utilization of facilities located both within and outside of the county <br/>
<a id="pl.151.12"></a><var>151.12</var>and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;<br/>
<a id="pl.151.13"></a><var>151.13</var>(2) community support services funds administered under Minnesota Rules, parts <br/>
<a id="pl.151.14"></a><var>151.14</var>9535.1700 to 9535.1760;<br/>
<a id="pl.151.15"></a><var>151.15</var>(3) other mental health special project funds;<br/>
<a id="pl.151.16"></a><var>151.16</var>(4) medical assistance, general assistance medical care, MinnesotaCare and group <br/>
<a id="pl.151.17"></a><var>151.17</var>residential housing if requested by the project's managing entity, and if the commissioner <br/>
<a id="pl.151.18"></a><var>151.18</var>determines this would be consistent with the state's overall health care reform efforts; and<br/>
<a id="pl.151.19"></a><var>151.19</var>(5) regional treatment center resources consistent with section 
         <statute_ref>246.0136, subdivision <br/>
<a id="pl.151.20"></a><var>151.20</var>1
         </statute_ref>.; and<br/>
<a id="pl.151.21"></a><var>151.21</var>(6) funds transferred from section 246.18, subdivision 8, for grants to providers to <br/>
<a id="pl.151.22"></a><var>151.22</var>participate in mental health specialty treatment services, awarded to providers through <br/>
<a id="pl.151.23"></a><var>151.23</var>a request for proposal process.<br/>
<a id="pl.151.24"></a><var>151.24</var>(b) The commissioner shall consider the following criteria in awarding start-up and <br/>
<a id="pl.151.25"></a><var>151.25</var>implementation grants for the pilot projects:<br/>
<a id="pl.151.26"></a><var>151.26</var>(1) the ability of the proposed projects to accomplish the objectives described in <br/>
<a id="pl.151.27"></a><var>151.27</var>subdivision 2;<br/>
<a id="pl.151.28"></a><var>151.28</var>(2) the size of the target population to be served; and<br/>
<a id="pl.151.29"></a><var>151.29</var>(3) geographical distribution.<br/>
<a id="pl.151.30"></a><var>151.30</var>(c) The commissioner shall review overall status of the projects initiatives at least <br/>
<a id="pl.151.31"></a><var>151.31</var>every two years and recommend any legislative changes needed by January 15 of each <br/>
<a id="pl.151.32"></a><var>151.32</var>odd-numbered year.<br/>
<a id="pl.151.33"></a><var>151.33</var>(d) The commissioner may waive administrative rule requirements which are <br/>
<a id="pl.151.34"></a><var>151.34</var>incompatible with the implementation of the pilot project.<br/>
<a id="pl.152.1"></a><var>152.1</var>(e) The commissioner may exempt the participating counties from fiscal sanctions <br/>
<a id="pl.152.2"></a><var>152.2</var>for noncompliance with requirements in laws and rules which are incompatible with the <br/>
<a id="pl.152.3"></a><var>152.3</var>implementation of the pilot project.<br/>
<a id="pl.152.4"></a><var>152.4</var>(f) The commissioner may award grants to an entity designated by a county board or <br/>
<a id="pl.152.5"></a><var>152.5</var>group of county boards to pay for start-up and implementation costs of the pilot project.<br/>
<br/>
<a id="bill.4.4.0"></a><a id="pl.152.6"></a><var>152.6</var>    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:<br/>
<a id="pl.152.7"></a><var>152.7</var>    Subd. 2. <b>General provisions.</b> (a) In the design and implementation of reforms to <br/>
<a id="pl.152.8"></a><var>152.8</var>the mental health system, the commissioner shall:<br/>
<a id="pl.152.9"></a><var>152.9</var>    (1) consult with consumers, families, counties, tribes, advocates, providers, and <br/>
<a id="pl.152.10"></a><var>152.10</var>other stakeholders;<br/>
<a id="pl.152.11"></a><var>152.11</var>    (2) bring to the legislature, and the State Advisory Council on Mental Health, by <br/>
<a id="pl.152.12"></a><var>152.12</var>January 15, 2008, recommendations for legislation to update the role of counties and to <br/>
<a id="pl.152.13"></a><var>152.13</var>clarify the case management roles, functions, and decision-making authority of health <br/>
<a id="pl.152.14"></a><var>152.14</var>plans and counties, and to clarify county retention of the responsibility for the delivery of <br/>
<a id="pl.152.15"></a><var>152.15</var>social services as required under subdivision 3, paragraph (a);<br/>
<a id="pl.152.16"></a><var>152.16</var>    (3) withhold implementation of any recommended changes in case management <br/>
<a id="pl.152.17"></a><var>152.17</var>roles, functions, and decision-making authority until after the release of the report due <br/>
<a id="pl.152.18"></a><var>152.18</var>January 15, 2008;<br/>
<a id="pl.152.19"></a><var>152.19</var>    (4) ensure continuity of care for persons affected by these reforms including <br/>
<a id="pl.152.20"></a><var>152.20</var>ensuring client choice of provider by requiring broad provider networks and developing <br/>
<a id="pl.152.21"></a><var>152.21</var>mechanisms to facilitate a smooth transition of service responsibilities;<br/>
<a id="pl.152.22"></a><var>152.22</var>    (5) provide accountability for the efficient and effective use of public and private <br/>
<a id="pl.152.23"></a><var>152.23</var>resources in achieving positive outcomes for consumers;<br/>
<a id="pl.152.24"></a><var>152.24</var>    (6) ensure client access to applicable protections and appeals; and<br/>
<a id="pl.152.25"></a><var>152.25</var>    (7) make budget transfers necessary to implement the reallocation of services and <br/>
<a id="pl.152.26"></a><var>152.26</var>client responsibilities between counties and health care programs that do not increase the <br/>
<a id="pl.152.27"></a><var>152.27</var>state and county costs and efficiently allocate state funds.<br/>
<a id="pl.152.28"></a><var>152.28</var>    (b) When making transfers under paragraph (a) necessary to implement movement <br/>
<a id="pl.152.29"></a><var>152.29</var>of responsibility for clients and services between counties and health care programs, <br/>
<a id="pl.152.30"></a><var>152.30</var>the commissioner, in consultation with counties, shall ensure that any transfer of state <br/>
<a id="pl.152.31"></a><var>152.31</var>grants to health care programs, including the value of case management transfer grants <br/>
<a id="pl.152.32"></a><var>152.32</var>under section 
         <statute_ref>256B.0625, subdivision 20</statute_ref>, does not exceed the value of the services being <br/>
<a id="pl.152.33"></a><var>152.33</var>transferred for the latest 12-month period for which data is available. The commissioner <br/>
<a id="pl.152.34"></a><var>152.34</var>may make quarterly adjustments based on the availability of additional data during the <br/>
<a id="pl.152.35"></a><var>152.35</var>first four quarters after the transfers first occur. If case management transfer grants under <br/>
<a id="pl.153.1"></a><var>153.1</var>section 
         <statute_ref>256B.0625, subdivision 20</statute_ref>, are repealed and the value, based on the last year prior <br/>
<a id="pl.153.2"></a><var>153.2</var>to repeal, exceeds the value of the services being transferred, the difference becomes an <br/>
<a id="pl.153.3"></a><var>153.3</var>ongoing part of each county's adult and children's mental health grants under sections <br/>
<statute_ref><a id="pl.153.4"></a><var>153.4</var>245.4661
         </statute_ref>, 
<statute_ref>245.4889</statute_ref>, and 
         <statute_ref>256E.12</statute_ref>.<br/>
<a id="pl.153.5"></a><var>153.5</var>    (c) This appropriation is not authorized to be expended after December 31, 2010, <br/>
<a id="pl.153.6"></a><var>153.6</var>unless approved by the legislature.<br/>
<br/>
<a id="bill.4.5.0"></a><a id="pl.153.7"></a><var>153.7</var>    Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:<br/>
<a id="pl.153.8"></a><var>153.8</var>    Subd. 8. <b>Transition services.</b> The county board may continue to provide mental <br/>
<a id="pl.153.9"></a><var>153.9</var>health services as defined in sections 
         <statute_ref>245.487</statute_ref> to 
         <statute_ref>245.4889</statute_ref> to persons over 18 years of <br/>
<a id="pl.153.10"></a><var>153.10</var>age, but under 21 years of age, if the person was receiving case management or family <br/>
<a id="pl.153.11"></a><var>153.11</var>community support services prior to age 18, and if one of the following conditions is met:<br/>
<a id="pl.153.12"></a><var>153.12</var>(1) the person is receiving special education services through the local school <br/>
<a id="pl.153.13"></a><var>153.13</var>district; or<br/>
<a id="pl.153.14"></a><var>153.14</var>(2) it is in the best interest of the person to continue services defined in sections <br/>
<statute_ref><a id="pl.153.15"></a><var>153.15</var>245.487
         </statute_ref> to 
         <statute_ref>245.4889; or<br/>
</statute_ref><a id="pl.153.16"></a><var>153.16</var>(3) the person is requesting services and the services are medically necessary.<br/>
<br/>
<a id="bill.4.6.0"></a><a id="pl.153.17"></a><var>153.17</var>    Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:<br/>
<a id="pl.153.18"></a><var>153.18</var>    Subdivision 1. <b>Availability of case management services.</b> (a) The county board <br/>
<a id="pl.153.19"></a><var>153.19</var>shall provide case management services for each child with severe emotional disturbance <br/>
<a id="pl.153.20"></a><var>153.20</var>who is a resident of the county and the child's family who request or consent to the services. <br/>
<a id="pl.153.21"></a><var>153.21</var>Case management services may be continued must be offered to be provided for a child with <br/>
<a id="pl.153.22"></a><var>153.22</var>a serious emotional disturbance who is over the age of 18 consistent with section 
         <statute_ref>245.4875, <br/>
<a id="pl.153.23"></a><var>153.23</var>subdivision 8
         </statute_ref>, or the child's legal representative, provided the child's service needs can be <br/>
<a id="pl.153.24"></a><var>153.24</var>met within the children's service system. Before discontinuing case management services <br/>
<a id="pl.153.25"></a><var>153.25</var>under this subdivision for children between the ages of 17 and 21, a transition plan <br/>
<a id="pl.153.26"></a><var>153.26</var>must be developed. The transition plan must be developed with the child and, with the <br/>
<a id="pl.153.27"></a><var>153.27</var>consent of a child age 18 or over, the child's parent, guardian, or legal representative. The <br/>
<a id="pl.153.28"></a><var>153.28</var>transition plan should include plans for health insurance, housing, education, employment, <br/>
<a id="pl.153.29"></a><var>153.29</var>and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case <br/>
<a id="pl.153.30"></a><var>153.30</var>manager must meet the requirements in section 
         <statute_ref>245.4871, subdivision 4</statute_ref>.<br/>
<a id="pl.153.31"></a><var>153.31</var>(b) Except as permitted by law and the commissioner under demonstration projects, <br/>
<a id="pl.153.32"></a><var>153.32</var>case management services provided to children with severe emotional disturbance eligible <br/>
<a id="pl.153.33"></a><var>153.33</var>for medical assistance must be billed to the medical assistance program under sections <br/>
<statute_ref><a id="pl.153.34"></a><var>153.34</var>256B.02, subdivision 8
         </statute_ref>, and 
         <statute_ref>256B.0625</statute_ref>.<br/>
<a id="pl.154.1"></a><var>154.1</var>(c) Case management services are eligible for reimbursement under the medical <br/>
<a id="pl.154.2"></a><var>154.2</var>assistance program. Costs of mentoring, supervision, and continuing education may be <br/>
<a id="pl.154.3"></a><var>154.3</var>included in the reimbursement rate methodology used for case management services under <br/>
<a id="pl.154.4"></a><var>154.4</var>the medical assistance program.<br/>
<br/>
<a id="bill.4.7.0"></a><a id="pl.154.5"></a><var>154.5</var>    Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:<br/>
<a id="pl.154.6"></a><var>154.6</var>    Subd. 8. <b>State-operated services account.</b> (a) The state-operated services account is <br/>
<a id="pl.154.7"></a><var>154.7</var>established in the special revenue fund. Revenue generated by new state-operated services <br/>
<a id="pl.154.8"></a><var>154.8</var>listed under this section established after July 1, 2010, that are not enterprise activities must <br/>
<a id="pl.154.9"></a><var>154.9</var>be deposited into the state-operated services account, unless otherwise specified in law:<br/>
<a id="pl.154.10"></a><var>154.10</var>(1) intensive residential treatment services;<br/>
<a id="pl.154.11"></a><var>154.11</var>(2) foster care services; and<br/>
<a id="pl.154.12"></a><var>154.12</var>(3) psychiatric extensive recovery treatment services.<br/>
<a id="pl.154.13"></a><var>154.13</var>(b) Funds deposited in the state-operated services account are available to the <br/>
<a id="pl.154.14"></a><var>154.14</var>commissioner of human services for the purposes of:<br/>
<a id="pl.154.15"></a><var>154.15</var>(1) providing services needed to transition individuals from institutional settings <br/>
<a id="pl.154.16"></a><var>154.16</var>within state-operated services to the community when those services have no other <br/>
<a id="pl.154.17"></a><var>154.17</var>adequate funding source; <br/>
<a id="pl.154.18"></a><var>154.18</var>(2) grants to providers participating in mental health specialty treatment services <br/>
<a id="pl.154.19"></a><var>154.19</var>under section 245.4661; and<br/>
<a id="pl.154.20"></a><var>154.20</var>(3) to fund the operation of the Intensive Residential Treatment Service program in <br/>
<a id="pl.154.21"></a><var>154.21</var>Willmar.<br/>
<br/>
<a id="bill.4.8.0"></a><a id="pl.154.22"></a><var>154.22</var>    Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision <br/>
<a id="pl.154.23"></a><var>154.23</var>to read:<br/>
<a id="pl.154.24"></a><var>154.24</var>    Subd. 9. <b>Transfers.</b> The commissioner may transfer state mental health grant funds <br/>
<a id="pl.154.25"></a><var>154.25</var>to the account in subdivision 8 for noncovered allowable costs of a provider certified and <br/>
<a id="pl.154.26"></a><var>154.26</var>licensed under section 256B.0622 and operating under section 246.014.<br/>
<br/>
<a id="bill.4.9.0"></a><a id="pl.154.27"></a><var>154.27</var>    Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:<br/>
<a id="pl.154.28"></a><var>154.28</var>    Subdivision 1. <b>Administrative requirements.</b> (a) When a person is committed, <br/>
<a id="pl.154.29"></a><var>154.29</var>the court shall issue a warrant or an order committing the patient to the custody of the <br/>
<a id="pl.154.30"></a><var>154.30</var>head of the treatment facility. The warrant or order shall state that the patient meets the <br/>
<a id="pl.154.31"></a><var>154.31</var>statutory criteria for civil commitment. <br/>
<a id="pl.154.32"></a><var>154.32</var>(b) The commissioner shall prioritize patients being admitted from jail or a <br/>
<a id="pl.154.33"></a><var>154.33</var>correctional institution who are:<br/>
<a id="pl.155.1"></a><var>155.1</var>(1) ordered confined in a state hospital for an examination under Minnesota Rules of <br/>
<a id="pl.155.2"></a><var>155.2</var>Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;<br/>
<a id="pl.155.3"></a><var>155.3</var>(2) under civil commitment for competency treatment and continuing supervision <br/>
<a id="pl.155.4"></a><var>155.4</var>under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;<br/>
<a id="pl.155.5"></a><var>155.5</var>(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal <br/>
<a id="pl.155.6"></a><var>155.6</var>Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be <br/>
<a id="pl.155.7"></a><var>155.7</var>detained in a state hospital or other facility pending completion of the civil commitment <br/>
<a id="pl.155.8"></a><var>155.8</var>proceedings; or<br/>
<a id="pl.155.9"></a><var>155.9</var>(4) committed under this chapter to the commissioner after dismissal of the patient's <br/>
<a id="pl.155.10"></a><var>155.10</var>criminal charges.<br/>
<a id="pl.155.11"></a><var>155.11</var>Patients described in this paragraph must be admitted to a service operated by the <br/>
<a id="pl.155.12"></a><var>155.12</var>commissioner within 48 hours. The commitment must be ordered by the court as provided <br/>
<a id="pl.155.13"></a><var>155.13</var>in section 253B.09, subdivision 1, paragraph (c).<br/>
<a id="pl.155.14"></a><var>155.14</var>(c) Upon the arrival of a patient at the designated treatment facility, the head of the <br/>
<a id="pl.155.15"></a><var>155.15</var>facility shall retain the duplicate of the warrant and endorse receipt upon the original <br/>
<a id="pl.155.16"></a><var>155.16</var>warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment <br/>
<a id="pl.155.17"></a><var>155.17</var>must be filed in the court of commitment. After arrival, the patient shall be under the <br/>
<a id="pl.155.18"></a><var>155.18</var>control and custody of the head of the treatment facility.<br/>
<a id="pl.155.19"></a><var>155.19</var>(d) Copies of the petition for commitment, the court's findings of fact and <br/>
<a id="pl.155.20"></a><var>155.20</var>conclusions of law, the court order committing the patient, the report of the examiners, <br/>
<a id="pl.155.21"></a><var>155.21</var>and the prepetition report shall be provided promptly to the treatment facility.<br/>
<br/>
<a id="bill.4.10.0"></a><a id="pl.155.22"></a><var>155.22</var>    Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:<br/>
<a id="pl.155.23"></a><var>155.23</var><b>254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.</b><br/>
<a id="pl.155.24"></a><var>155.24</var>    Subdivision 1. <b>Authorization for </b><b>navigator </b><b>pilot projects.</b> The commissioner may <br/>
<a id="pl.155.25"></a><var>155.25</var>approve and implement navigator pilot projects developed under the planning process <br/>
<a id="pl.155.26"></a><var>155.26</var>required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and <br/>
<a id="pl.155.27"></a><var>155.27</var>enhance coordination of the delivery of chemical health services required under section <br/>
<statute_ref><a id="pl.155.28"></a><var>155.28</var>254B.03
         </statute_ref>.<br/>
<a id="pl.155.29"></a><var>155.29</var>    Subd. 2. <b>Program design and implementation.</b> (a) The commissioner and <br/>
<a id="pl.155.30"></a><var>155.30</var>counties participating in the navigator pilot projects shall continue to work in partnership <br/>
<a id="pl.155.31"></a><var>155.31</var>to refine and implement the navigator pilot projects initiated under Laws 2009, chapter <br/>
<a id="pl.155.32"></a><var>155.32</var>79, article 7, section 26.<br/>
<a id="pl.155.33"></a><var>155.33</var>(b) The commissioner and counties participating in the navigator pilot projects shall <br/>
<a id="pl.155.34"></a><var>155.34</var>complete the planning phase by June 30, 2010, and, if approved by the commissioner for <br/>
<a id="pl.156.1"></a><var>156.1</var>implementation, enter into agreements governing the operation of the navigator pilot <br/>
<a id="pl.156.2"></a><var>156.2</var>projects with implementation scheduled no earlier than July 1, 2010.<br/>
<a id="pl.156.3"></a><var>156.3</var>    Subd. 2a. <b>Eligibility for navigator pilot program.</b> (a) To be considered for <br/>
<a id="pl.156.4"></a><var>156.4</var>participation in a navigator pilot program, an individual must:<br/>
<a id="pl.156.5"></a><var>156.5</var>(1) be a resident of a county with an approved navigator program;<br/>
<a id="pl.156.6"></a><var>156.6</var>(2) be eligible for consolidated chemical dependency treatment fund services;<br/>
<a id="pl.156.7"></a><var>156.7</var>(3) be a voluntary participant in the navigator program;<br/>
<a id="pl.156.8"></a><var>156.8</var>(4) satisfy one of the following items:<br/>
<a id="pl.156.9"></a><var>156.9</var>(i) have at least one severity rating of three or above in dimension four, five, or six in <br/>
<a id="pl.156.10"></a><var>156.10</var>a comprehensive assessment under Minnesota Rules, part 9530.6422; or<br/>
<a id="pl.156.11"></a><var>156.11</var>(ii) have at least one severity rating of two or above in dimension four, five, or six in <br/>
<a id="pl.156.12"></a><var>156.12</var>a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently <br/>
<a id="pl.156.13"></a><var>156.13</var>participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to <br/>
<a id="pl.156.14"></a><var>156.14</var>9530.6505, or be within 60 days following discharge after participation in a Rule 31 <br/>
<a id="pl.156.15"></a><var>156.15</var>treatment program; and<br/>
<a id="pl.156.16"></a><var>156.16</var>(5) have had at least two treatment episodes in the past two years, not limited <br/>
<a id="pl.156.17"></a><var>156.17</var>to episodes reimbursed by the consolidated chemical dependency treatment funds. An <br/>
<a id="pl.156.18"></a><var>156.18</var>admission to an emergency room, a detoxification program, or a hospital may be substituted <br/>
<a id="pl.156.19"></a><var>156.19</var>for one treatment episode if it resulted from the individual's substance use disorder.<br/>
<a id="pl.156.20"></a><var>156.20</var>(b) New eligibility criteria may be added as mutually agreed upon by the <br/>
<a id="pl.156.21"></a><var>156.21</var>commissioner and participating navigator programs.<br/>
<a id="pl.156.22"></a><var>156.22</var>    Subd. 3. <b>Program evaluation.</b> The commissioner shall evaluate navigator pilot <br/>
<a id="pl.156.23"></a><var>156.23</var>projects under this section and report the results of the evaluation to the chairs and <br/>
<a id="pl.156.24"></a><var>156.24</var>ranking minority members of the legislative committees with jurisdiction over chemical <br/>
<a id="pl.156.25"></a><var>156.25</var>health issues by January 15, 2014. Evaluation of the navigator pilot projects must be <br/>
<a id="pl.156.26"></a><var>156.26</var>based on outcome evaluation criteria negotiated with the navigator pilot projects prior <br/>
<a id="pl.156.27"></a><var>156.27</var>to implementation.<br/>
<a id="pl.156.28"></a><var>156.28</var>    Subd. 4. <b>Notice of </b><b>navigator pilot </b><b>project discontinuation.</b> Each county's <br/>
<a id="pl.156.29"></a><var>156.29</var>participation in the navigator pilot project may be discontinued for any reason by the county <br/>
<a id="pl.156.30"></a><var>156.30</var>or the commissioner of human services after 30 days' written notice to the other party. <br/>
<a id="pl.156.31"></a><var>156.31</var>Any unspent funds held for the exiting county's pro rata share in the special revenue fund <br/>
<a id="pl.156.32"></a><var>156.32</var>under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated <br/>
<a id="pl.156.33"></a><var>156.33</var>chemical dependency treatment fund following discontinuation of the pilot project.<br/>
<a id="pl.156.34"></a><var>156.34</var>    Subd. 5. <b>Duties of commissioner.</b> (a) Notwithstanding any other provisions in <br/>
<a id="pl.156.35"></a><var>156.35</var>this chapter, the commissioner may authorize navigator pilot projects to use chemical <br/>
<a id="pl.156.36"></a><var>156.36</var>dependency treatment funds to pay for nontreatment navigator pilot services:<br/>
<a id="pl.157.1"></a><var>157.1</var>(1) in addition to those authorized under section 
         <statute_ref>254B.03, subdivision 2</statute_ref>, paragraph <br/>
<a id="pl.157.2"></a><var>157.2</var>(a); and<br/>
<a id="pl.157.3"></a><var>157.3</var>(2) by vendors in addition to those authorized under section 
         <statute_ref>254B.05</statute_ref> when not <br/>
<a id="pl.157.4"></a><var>157.4</var>providing chemical dependency treatment services.<br/>
<a id="pl.157.5"></a><var>157.5</var>(b) For purposes of this section, "nontreatment navigator pilot services" include <br/>
<a id="pl.157.6"></a><var>157.6</var>navigator services, peer support, family engagement and support, housing support, rent <br/>
<a id="pl.157.7"></a><var>157.7</var>subsidies, supported employment, and independent living skills.<br/>
<a id="pl.157.8"></a><var>157.8</var>(c) State expenditures for chemical dependency services and nontreatment navigator <br/>
<a id="pl.157.9"></a><var>157.9</var>pilot services provided by or through the navigator pilot projects must not be greater than <br/>
<a id="pl.157.10"></a><var>157.10</var>the chemical dependency treatment fund expected share of forecasted expenditures in the <br/>
<a id="pl.157.11"></a><var>157.11</var>absence of the navigator pilot projects. The commissioner may restructure the schedule of <br/>
<a id="pl.157.12"></a><var>157.12</var>payments between the state and participating counties under the local agency share and <br/>
<a id="pl.157.13"></a><var>157.13</var>division of cost provisions under section 
         <statute_ref>254B.03, subdivisions 3</statute_ref> and 4, as necessary to <br/>
<a id="pl.157.14"></a><var>157.14</var>facilitate the operation of the navigator pilot projects.<br/>
<a id="pl.157.15"></a><var>157.15</var>(d) To the extent that state fiscal year expenditures within a pilot project are less <br/>
<a id="pl.157.16"></a><var>157.16</var>than the expected share of forecasted expenditures in the absence of the pilot projects, <br/>
<a id="pl.157.17"></a><var>157.17</var>the commissioner shall deposit the unexpended funds in a separate account within the <br/>
<a id="pl.157.18"></a><var>157.18</var>consolidated chemical dependency treatment fund, and make these funds available for <br/>
<a id="pl.157.19"></a><var>157.19</var>expenditure by the pilot projects the following year. To the extent that treatment and <br/>
<a id="pl.157.20"></a><var>157.20</var>nontreatment pilot services expenditures within the pilot project exceed the amount <br/>
<a id="pl.157.21"></a><var>157.21</var>expected in the absence of the pilot projects, the pilot project county or counties are <br/>
<a id="pl.157.22"></a><var>157.22</var>responsible for the portion of nontreatment pilot services expenditures in excess of the <br/>
<a id="pl.157.23"></a><var>157.23</var>otherwise expected share of forecasted expenditures.<br/>
<a id="pl.157.24"></a><var>157.24</var>(e) (d) The commissioner may waive administrative rule requirements that are <br/>
<a id="pl.157.25"></a><var>157.25</var>incompatible with the implementation of the navigator pilot project, except that any <br/>
<a id="pl.157.26"></a><var>157.26</var>chemical dependency treatment funded under this section must continue to be provided <br/>
<a id="pl.157.27"></a><var>157.27</var>by a licensed treatment provider.<br/>
<a id="pl.157.28"></a><var>157.28</var>(f) (e) The commissioner shall not approve or enter into any agreement related to <br/>
<a id="pl.157.29"></a><var>157.29</var>navigator pilot projects authorized under this section that puts current or future federal <br/>
<a id="pl.157.30"></a><var>157.30</var>funding at risk.<br/>
<a id="pl.157.31"></a><var>157.31</var>(f) The commissioner shall provide participating navigator pilot projects with <br/>
<a id="pl.157.32"></a><var>157.32</var>transactional data, reports, provider data, and other data generated by county activity to <br/>
<a id="pl.157.33"></a><var>157.33</var>assess and measure outcomes. This information must be transmitted or made available in <br/>
<a id="pl.157.34"></a><var>157.34</var>an acceptable form to participating navigator pilot projects at least once every six months <br/>
<a id="pl.157.35"></a><var>157.35</var>or within a reasonable time following the commissioner's receipt of information from the <br/>
<a id="pl.157.36"></a><var>157.36</var>counties needed to comply with this paragraph.<br/>
<a id="pl.158.1"></a><var>158.1</var>    Subd. 6. <b>Duties of county board.</b> The county board, or other county entity that <br/>
<a id="pl.158.2"></a><var>158.2</var>is approved to administer a navigator pilot project, shall:<br/>
<a id="pl.158.3"></a><var>158.3</var>(1) administer the navigator pilot project in a manner consistent with the objectives <br/>
<a id="pl.158.4"></a><var>158.4</var>described in subdivision 2 and the planning process in subdivision 5;<br/>
<a id="pl.158.5"></a><var>158.5</var>(2) ensure that no one is denied chemical dependency treatment services for which <br/>
<a id="pl.158.6"></a><var>158.6</var>they would otherwise be eligible under section 
         <statute_ref>254A.03, subdivision 3</statute_ref>; and<br/>
<a id="pl.158.7"></a><var>158.7</var>(3) provide the commissioner with timely and pertinent information as negotiated in <br/>
<a id="pl.158.8"></a><var>158.8</var>agreements governing operation of the navigator pilot projects.<br/>
<a id="pl.158.9"></a><var>158.9</var>    Subd. 7. <b>Managed care.</b> An individual who is eligible for the navigator pilot <br/>
<a id="pl.158.10"></a><var>158.10</var>program under subdivision 2a is excluded from mandatory enrollment in managed care <br/>
<a id="pl.158.11"></a><var>158.11</var>until these services are included in the health plan's benefit set.<br/>
<a id="pl.158.12"></a><var>158.12</var>    Subd. 8. <b>Authorization for continuation of navigator pilots.</b> The navigator pilot <br/>
<a id="pl.158.13"></a><var>158.13</var>projects implemented pursuant to subdivision 1 are authorized to continue operation after <br/>
<a id="pl.158.14"></a><var>158.14</var>July 1, 2013, under existing agreements governing operation of the pilot projects.<br/>
<a id="pl.158.15"></a><var>158.15</var><b>EFFECTIVE DATE.</b>The amendments to subdivisions 1 to 6 and 8 are effective <br/>
<a id="pl.158.16"></a><var>158.16</var>August 1, 2013. Subdivision 7 is effective July 1, 2013.<br/>
<br/>
<a id="bill.4.11.0"></a><a id="pl.158.17"></a><var>158.17</var>    Sec. 11. <b>[254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL </b><br/>
<a id="pl.158.18"></a><var>158.18</var><b>HEALTH CARE.</b><br/>
<a id="pl.158.19"></a><var>158.19</var>    Subdivision 1. <b>Authorization for continuum of care pilot projects.</b> The <br/>
<a id="pl.158.20"></a><var>158.20</var>commissioner shall establish chemical dependency continuum of care pilot projects to <br/>
<a id="pl.158.21"></a><var>158.21</var>begin implementing the measures developed with stakeholder input and identified in the <br/>
<a id="pl.158.22"></a><var>158.22</var>report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot <br/>
<a id="pl.158.23"></a><var>158.23</var>projects are intended to improve the effectiveness and efficiency of the service continuum <br/>
<a id="pl.158.24"></a><var>158.24</var>for chemically dependent individuals in Minnesota while reducing duplication of efforts <br/>
<a id="pl.158.25"></a><var>158.25</var>and promoting scientifically supported practices.<br/>
<a id="pl.158.26"></a><var>158.26</var>    Subd. 2. <b>Program implementation.</b> (a) The commissioner, in coordination with <br/>
<a id="pl.158.27"></a><var>158.27</var>representatives of the Minnesota Association of County Social Service Administrators <br/>
<a id="pl.158.28"></a><var>158.28</var>and the Minnesota Inter-County Association, shall develop a process for identifying and <br/>
<a id="pl.158.29"></a><var>158.29</var>selecting interested counties and providers for participation in the continuum of care pilot <br/>
<a id="pl.158.30"></a><var>158.30</var>projects. There will be three pilot projects; one representing the northern region, one for <br/>
<a id="pl.158.31"></a><var>158.31</var>the metro region, and one for the southern region. The selection process of counties and <br/>
<a id="pl.158.32"></a><var>158.32</var>providers must include consideration of population size, geographic distribution, cultural <br/>
<a id="pl.158.33"></a><var>158.33</var>and racial demographics, and provider accessibility. The commissioner shall identify <br/>
<a id="pl.158.34"></a><var>158.34</var>counties and providers that are selected for participation in the continuum of care pilot <br/>
<a id="pl.158.35"></a><var>158.35</var>projects no later than September 30, 2013.<br/>
<a id="pl.159.1"></a><var>159.1</var>(b) The commissioner and entities participating in the continuum of care pilot <br/>
<a id="pl.159.2"></a><var>159.2</var>projects shall enter into agreements governing the operation of the continuum of care pilot <br/>
<a id="pl.159.3"></a><var>159.3</var>projects. The agreements shall identify pilot project outcomes and include timelines for <br/>
<a id="pl.159.4"></a><var>159.4</var>implementation and beginning operation of the pilot projects.<br/>
<a id="pl.159.5"></a><var>159.5</var>(c) Entities that are currently participating in the navigator pilot project are <br/>
<a id="pl.159.6"></a><var>159.6</var>eligible to participate in the continuum of care pilot project subsequent to or instead of <br/>
<a id="pl.159.7"></a><var>159.7</var>participating in the navigator pilot project.<br/>
<a id="pl.159.8"></a><var>159.8</var>(d) The commissioner may waive administrative rule requirements that are <br/>
<a id="pl.159.9"></a><var>159.9</var>incompatible with implementation of the continuum of care pilot projects.<br/>
<a id="pl.159.10"></a><var>159.10</var>(e) Notwithstanding section 254A.19, the commissioner may designate noncounty <br/>
<a id="pl.159.11"></a><var>159.11</var>entities to complete chemical use assessments and placement authorizations required <br/>
<a id="pl.159.12"></a><var>159.12</var>under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section <br/>
<a id="pl.159.13"></a><var>159.13</var>254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the <br/>
<a id="pl.159.14"></a><var>159.14</var>discretion of the commissioner.<br/>
<a id="pl.159.15"></a><var>159.15</var>    Subd. 3. <b>Program design.</b> (a) The operation of the pilot projects shall include:<br/>
<a id="pl.159.16"></a><var>159.16</var>(1) new services that are responsive to the chronic nature of substance use disorder;<br/>
<a id="pl.159.17"></a><var>159.17</var>(2) telehealth services, when appropriate to address barriers to services;<br/>
<a id="pl.159.18"></a><var>159.18</var>(3) services that assure integration with the mental health delivery system when <br/>
<a id="pl.159.19"></a><var>159.19</var>appropriate;<br/>
<a id="pl.159.20"></a><var>159.20</var>(4) services that address the needs of diverse populations; and<br/>
<a id="pl.159.21"></a><var>159.21</var>(5) an assessment and access process that permits clients to present directly to a <br/>
<a id="pl.159.22"></a><var>159.22</var>service provider for a substance use disorder assessment and authorization of services.<br/>
<a id="pl.159.23"></a><var>159.23</var>(b) Prior to implementation of the continuum of care pilot projects, a utilization <br/>
<a id="pl.159.24"></a><var>159.24</var>review process must be developed and agreed to by the commissioner, participating <br/>
<a id="pl.159.25"></a><var>159.25</var>counties, and providers. The utilization review process shall be described in the <br/>
<a id="pl.159.26"></a><var>159.26</var>agreements governing operation of the continuum of care pilot projects.<br/>
<a id="pl.159.27"></a><var>159.27</var>    Subd. 4. <b>Notice of project discontinuation.</b> Each entity's participation in the <br/>
<a id="pl.159.28"></a><var>159.28</var>continuum of care pilot project may be discontinued for any reason by the county or the <br/>
<a id="pl.159.29"></a><var>159.29</var>commissioner after 30 days' written notice to the entity.<br/>
<a id="pl.159.30"></a><var>159.30</var>    Subd. 5. <b>Duties of commissioner.</b> (a) Notwithstanding any other provisions in this <br/>
<a id="pl.159.31"></a><var>159.31</var>chapter, the commissioner may authorize chemical dependency treatment funds to pay for <br/>
<a id="pl.159.32"></a><var>159.32</var>nontreatment services arranged by continuum of care pilot projects. Individuals who are <br/>
<a id="pl.159.33"></a><var>159.33</var>currently accessing Rule 31 treatment services are eligible for concurrent participation in <br/>
<a id="pl.159.34"></a><var>159.34</var>the continuum of care pilot projects.<br/>
<a id="pl.160.1"></a><var>160.1</var>(b) County expenditures for continuum of care pilot project services shall not <br/>
<a id="pl.160.2"></a><var>160.2</var>be greater than their expected share of forecasted expenditures in the absence of the <br/>
<a id="pl.160.3"></a><var>160.3</var>continuum of care pilot projects.<br/>
<a id="pl.160.4"></a><var>160.4</var><b>EFFECTIVE DATE.</b>This section is effective August 1, 2013.<br/>
<br/>
<a id="bill.4.12.0"></a><a id="pl.160.5"></a><var>160.5</var>    Sec. 12. <b>[256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER </b><br/>
<a id="pl.160.6"></a><var>160.6</var><b>SPECIALIST.</b><br/>
<a id="pl.160.7"></a><var>160.7</var>    Subdivision 1. <b>Scope.</b> Medical assistance covers mental health certified family peer <br/>
<a id="pl.160.8"></a><var>160.8</var>specialists services, as established in subdivision 2, subject to federal approval, if provided <br/>
<a id="pl.160.9"></a><var>160.9</var>to recipients who have an emotional disturbance or severe emotional disturbance under <br/>
<a id="pl.160.10"></a><var>160.10</var>chapter 245, and are provided by a certified family peer specialist who has completed the <br/>
<a id="pl.160.11"></a><var>160.11</var>training under subdivision 5. A family peer specialist cannot provide services to the <br/>
<a id="pl.160.12"></a><var>160.12</var>peer specialist's family.<br/>
<a id="pl.160.13"></a><var>160.13</var>    Subd. 2. <b>Establishment.</b> The commissioner of human services shall establish a <br/>
<a id="pl.160.14"></a><var>160.14</var>certified family peer specialists program model which:<br/>
<a id="pl.160.15"></a><var>160.15</var>(1) provides nonclinical family peer support counseling, building on the strengths <br/>
<a id="pl.160.16"></a><var>160.16</var>of families and helping them achieve desired outcomes;<br/>
<a id="pl.160.17"></a><var>160.17</var>(2) collaborates with others providing care or support to the family;<br/>
<a id="pl.160.18"></a><var>160.18</var>(3) provides nonadversarial advocacy;<br/>
<a id="pl.160.19"></a><var>160.19</var>(4) promotes the individual family culture in the treatment milieu;<br/>
<a id="pl.160.20"></a><var>160.20</var>(5) links parents to other parents in the community;<br/>
<a id="pl.160.21"></a><var>160.21</var>(6) offers support and encouragement;<br/>
<a id="pl.160.22"></a><var>160.22</var>(7) assists parents in developing coping mechanisms and problem-solving skills;<br/>
<a id="pl.160.23"></a><var>160.23</var>(8) promotes resiliency, self-advocacy, development of natural supports, and <br/>
<a id="pl.160.24"></a><var>160.24</var>maintenance of skills learned in other support services;<br/>
<a id="pl.160.25"></a><var>160.25</var>(9) establishes and provides peer led parent support groups; and<br/>
<a id="pl.160.26"></a><var>160.26</var>(10) increases the child's ability to function better within the child's home, school, <br/>
<a id="pl.160.27"></a><var>160.27</var>and community by educating parents on community resources, assisting with problem <br/>
<a id="pl.160.28"></a><var>160.28</var>solving, and educating parents on mental illnesses.<br/>
<a id="pl.160.29"></a><var>160.29</var>    Subd. 3. <b>Eligibility.</b> Family peer support services may be located in inpatient <br/>
<a id="pl.160.30"></a><var>160.30</var>hospitalization, partial hospitalization, residential treatment, treatment foster care, day <br/>
<a id="pl.160.31"></a><var>160.31</var>treatment, children's therapeutic services and supports, or crisis services.<br/>
<a id="pl.160.32"></a><var>160.32</var>    Subd. 4. <b>Peer support specialist program providers.</b> The commissioner shall <br/>
<a id="pl.160.33"></a><var>160.33</var>develop a process to certify family peer support specialist programs, in accordance with <br/>
<a id="pl.160.34"></a><var>160.34</var>the federal guidelines, in order for the program to bill for reimbursable services. Family <br/>
<a id="pl.161.1"></a><var>161.1</var>peer support programs must operate within an existing mental health community provider <br/>
<a id="pl.161.2"></a><var>161.2</var>or center.<br/>
<a id="pl.161.3"></a><var>161.3</var>    Subd. 5. <b>Certified family peer specialist training and certification.</b> The <br/>
<a id="pl.161.4"></a><var>161.4</var>commissioner shall develop a training and certification process for certified family peer <br/>
<a id="pl.161.5"></a><var>161.5</var>specialists who must be at least 21 years of age and have a high school diploma or its <br/>
<a id="pl.161.6"></a><var>161.6</var>equivalent. The candidates must have raised or are currently raising a child with a mental <br/>
<a id="pl.161.7"></a><var>161.7</var>illness, have had experience navigating the children's mental health system, and must <br/>
<a id="pl.161.8"></a><var>161.8</var>demonstrate leadership and advocacy skills and a strong dedication to family-driven and <br/>
<a id="pl.161.9"></a><var>161.9</var>family-focused services. The training curriculum must teach participating family peer <br/>
<a id="pl.161.10"></a><var>161.10</var>specialists specific skills relevant to providing peer support to other parents. In addition <br/>
<a id="pl.161.11"></a><var>161.11</var>to initial training and certification, the commissioner shall develop ongoing continuing <br/>
<a id="pl.161.12"></a><var>161.12</var>educational workshops on pertinent issues related to family peer support counseling.<br/>
<br/>
<a id="bill.4.13.0"></a><a id="pl.161.13"></a><var>161.13</var>    Sec. 13. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:<br/>
<a id="pl.161.14"></a><var>161.14</var>    Subd. 2. <b>Definitions.</b> For purposes of this section, the following terms have the <br/>
<a id="pl.161.15"></a><var>161.15</var>meanings given them.<br/>
<a id="pl.161.16"></a><var>161.16</var>(a) "Adult rehabilitative mental health services" means mental health services <br/>
<a id="pl.161.17"></a><var>161.17</var>which are rehabilitative and enable the recipient to develop and enhance psychiatric <br/>
<a id="pl.161.18"></a><var>161.18</var>stability, social competencies, personal and emotional adjustment, and independent living, <br/>
<a id="pl.161.19"></a><var>161.19</var>parenting skills, and community skills, when these abilities are impaired by the symptoms <br/>
<a id="pl.161.20"></a><var>161.20</var>of mental illness. Adult rehabilitative mental health services are also appropriate when <br/>
<a id="pl.161.21"></a><var>161.21</var>provided to enable a recipient to retain stability and functioning, if the recipient would <br/>
<a id="pl.161.22"></a><var>161.22</var>be at risk of significant functional decompensation or more restrictive service settings <br/>
<a id="pl.161.23"></a><var>161.23</var>without these services.<br/>
<a id="pl.161.24"></a><var>161.24</var>(1) Adult rehabilitative mental health services instruct, assist, and support the <br/>
<a id="pl.161.25"></a><var>161.25</var>recipient in areas such as: interpersonal communication skills, community resource <br/>
<a id="pl.161.26"></a><var>161.26</var>utilization and integration skills, crisis assistance, relapse prevention skills, health care <br/>
<a id="pl.161.27"></a><var>161.27</var>directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking <br/>
<a id="pl.161.28"></a><var>161.28</var>and nutrition skills, transportation skills, medication education and monitoring, mental <br/>
<a id="pl.161.29"></a><var>161.29</var>illness symptom management skills, household management skills, employment-related <br/>
<a id="pl.161.30"></a><var>161.30</var>skills, parenting skills, and transition to community living services.<br/>
<a id="pl.161.31"></a><var>161.31</var>(2) These services shall be provided to the recipient on a one-to-one basis in the <br/>
<a id="pl.161.32"></a><var>161.32</var>recipient's home or another community setting or in groups.<br/>
<a id="pl.161.33"></a><var>161.33</var>(b) "Medication education services" means services provided individually or in <br/>
<a id="pl.161.34"></a><var>161.34</var>groups which focus on educating the recipient about mental illness and symptoms; the role <br/>
<a id="pl.161.35"></a><var>161.35</var>and effects of medications in treating symptoms of mental illness; and the side effects of <br/>
<a id="pl.162.1"></a><var>162.1</var>medications. Medication education is coordinated with medication management services <br/>
<a id="pl.162.2"></a><var>162.2</var>and does not duplicate it. Medication education services are provided by physicians, <br/>
<a id="pl.162.3"></a><var>162.3</var>pharmacists, physician's assistants, or registered nurses.<br/>
<a id="pl.162.4"></a><var>162.4</var>(c) "Transition to community living services" means services which maintain <br/>
<a id="pl.162.5"></a><var>162.5</var>continuity of contact between the rehabilitation services provider and the recipient and <br/>
<a id="pl.162.6"></a><var>162.6</var>which facilitate discharge from a hospital, residential treatment program under Minnesota <br/>
<a id="pl.162.7"></a><var>162.7</var>Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community <br/>
<a id="pl.162.8"></a><var>162.8</var>living services are not intended to provide other areas of adult rehabilitative mental health <br/>
<a id="pl.162.9"></a><var>162.9</var>services.<br/>
<br/>
<a id="bill.4.14.0"></a><a id="pl.162.10"></a><var>162.10</var>    Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to <br/>
<a id="pl.162.11"></a><var>162.11</var>read:<br/>
<a id="pl.162.12"></a><var>162.12</var>    Subd. 48. <b>Psychiatric consultation to primary care practitioners.</b> Effective <br/>
<a id="pl.162.13"></a><var>162.13</var>January 1, 2006, Medical assistance covers consultation provided by a psychiatrist, <br/>
<a id="pl.162.14"></a><var>162.14</var>psychologist, or an advanced practice registered nurse certified in psychiatric mental <br/>
<a id="pl.162.15"></a><var>162.15</var>health via telephone, e-mail, facsimile, or other means of communication to primary care <br/>
<a id="pl.162.16"></a><var>162.16</var>practitioners, including pediatricians. The need for consultation and the receipt of the <br/>
<a id="pl.162.17"></a><var>162.17</var>consultation must be documented in the patient record maintained by the primary care <br/>
<a id="pl.162.18"></a><var>162.18</var>practitioner. If the patient consents, and subject to federal limitations and data privacy <br/>
<a id="pl.162.19"></a><var>162.19</var>provisions, the consultation may be provided without the patient present.<br/>
<br/>
<a id="bill.4.15.0"></a><a id="pl.162.20"></a><var>162.20</var>    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to <br/>
<a id="pl.162.21"></a><var>162.21</var>read:<br/>
<a id="pl.162.22"></a><var>162.22</var>    Subd. 56. <b>Medical service coordination.</b> (a)(1)  Medical assistance covers in-reach <br/>
<a id="pl.162.23"></a><var>162.23</var>community-based service coordination that is performed through a hospital emergency <br/>
<a id="pl.162.24"></a><var>162.24</var>department as an eligible procedure under a state healthcare program for a frequent user. <br/>
<a id="pl.162.25"></a><var>162.25</var>A frequent user is defined as an individual who has frequented the hospital emergency <br/>
<a id="pl.162.26"></a><var>162.26</var>department for services three or more times in the previous four consecutive months. <br/>
<a id="pl.162.27"></a><var>162.27</var>In-reach community-based service coordination includes navigating services to address a <br/>
<a id="pl.162.28"></a><var>162.28</var>client's mental health, chemical health, social, economic, and housing needs, or any other <br/>
<a id="pl.162.29"></a><var>162.29</var>activity targeted at reducing the incidence of emergency room and other nonmedically <br/>
<a id="pl.162.30"></a><var>162.30</var>necessary health care utilization.<br/>
<a id="pl.162.31"></a><var>162.31</var>(2) Medical assistance covers in-reach community-based service coordination that <br/>
<a id="pl.162.32"></a><var>162.32</var>is performed through a hospital emergency department or inpatient psychiatric unit <br/>
<a id="pl.162.33"></a><var>162.33</var>for a child or young adult up to age 21 with a serious emotional disturbance who has <br/>
<a id="pl.162.34"></a><var>162.34</var>frequented the hospital emergency room two or more times in the previous consecutive <br/>
<a id="pl.163.1"></a><var>163.1</var>three months or been admitted to an inpatient psychiatric unit two or more times in the <br/>
<a id="pl.163.2"></a><var>163.2</var>previous consecutive four months, or is being discharged to a shelter. <br/>
<a id="pl.163.3"></a><var>163.3</var>    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60 <br/>
<a id="pl.163.4"></a><var>163.4</var>days posthospital discharge based upon the specific identified emergency department visit <br/>
<a id="pl.163.5"></a><var>163.5</var>or inpatient admitting event. In-reach community-based service coordination shall seek to <br/>
<a id="pl.163.6"></a><var>163.6</var>connect frequent users with existing covered services available to them, including, but not <br/>
<a id="pl.163.7"></a><var>163.7</var>limited to, targeted case management, waiver case management, or care coordination in a <br/>
<a id="pl.163.8"></a><var>163.8</var>health care home. For children and young adults with a serious emotional disturbance, <br/>
<a id="pl.163.9"></a><var>163.9</var>in-reach community-based service coordination includes navigating and arranging for <br/>
<a id="pl.163.10"></a><var>163.10</var>community-based services prior to discharge to address a client's mental health, chemical <br/>
<a id="pl.163.11"></a><var>163.11</var>health, social, educational, family support and housing needs, or any other activity targeted <br/>
<a id="pl.163.12"></a><var>163.12</var>at reducing multiple incidents of emergency room use, inpatient readmissions, and other <br/>
<a id="pl.163.13"></a><var>163.13</var>nonmedically necessary health care utilization. In-reach services shall seek to connect <br/>
<a id="pl.163.14"></a><var>163.14</var>them with existing covered services, including targeted case management, waiver case <br/>
<a id="pl.163.15"></a><var>163.15</var>management, care coordination in a health care home, children's therapeutic services and <br/>
<a id="pl.163.16"></a><var>163.16</var>supports, crisis services, and respite care. Eligible in-reach service coordinators must hold <br/>
<a id="pl.163.17"></a><var>163.17</var>a minimum of a bachelor's degree in social work, public health, corrections, or a related <br/>
<a id="pl.163.18"></a><var>163.18</var>field. The commissioner shall submit any necessary application for waivers to the Centers <br/>
<a id="pl.163.19"></a><var>163.19</var>for Medicare and Medicaid Services to implement this subdivision.<br/>
<a id="pl.163.20"></a><var>163.20</var>    (c)(1) For the purposes of this subdivision, "in-reach community-based service <br/>
<a id="pl.163.21"></a><var>163.21</var>coordination" means the practice of a community-based worker with training, knowledge, <br/>
<a id="pl.163.22"></a><var>163.22</var>skills, and ability to access a continuum of services, including housing, transportation, <br/>
<a id="pl.163.23"></a><var>163.23</var>chemical and mental health treatment, employment, education, and peer support services, <br/>
<a id="pl.163.24"></a><var>163.24</var>by working with an organization's staff to transition an individual back into the individual's <br/>
<a id="pl.163.25"></a><var>163.25</var>living environment. In-reach community-based service coordination includes working <br/>
<a id="pl.163.26"></a><var>163.26</var>with the individual during their discharge and for up to a defined amount of time in the <br/>
<a id="pl.163.27"></a><var>163.27</var>individual's living environment, reducing the individual's need for readmittance.<br/>
<a id="pl.163.28"></a><var>163.28</var>    (2) Hospitals utilizing in-reach service coordinators shall report annually to the <br/>
<a id="pl.163.29"></a><var>163.29</var>commissioner on the number of adults, children, and adolescents served; the postdischarge <br/>
<a id="pl.163.30"></a><var>163.30</var>services which they accessed; and emergency department/psychiatric hospitalization <br/>
<a id="pl.163.31"></a><var>163.31</var>readmissions. The commissioner shall ensure that services and payments provided under <br/>
<a id="pl.163.32"></a><var>163.32</var>in-reach care coordination do not duplicate services or payments provided under section <br/>
<a id="pl.163.33"></a><var>163.33</var>256B.0753, 256B.0755, or 256B.0625, subdivision 20.<br/>
<br/>
<a id="bill.4.16.0"></a><a id="pl.163.34"></a><var>163.34</var>    Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a <br/>
<a id="pl.163.35"></a><var>163.35</var>subdivision to read:<br/>
<a id="pl.164.1"></a><var>164.1</var>    Subd. 61. <b>Family psychoeducation services.</b> Effective July 1, 2013, or upon <br/>
<a id="pl.164.2"></a><var>164.2</var>federal approval, whichever is later, medical assistance covers family psychoeducation <br/>
<a id="pl.164.3"></a><var>164.3</var>services provided to a child up to age 21 with a diagnosed mental health condition when <br/>
<a id="pl.164.4"></a><var>164.4</var>identified in the child's individual treatment plan and provided by a licensed mental health <br/>
<a id="pl.164.5"></a><var>164.5</var>professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a <br/>
<a id="pl.164.6"></a><var>164.6</var>clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who <br/>
<a id="pl.164.7"></a><var>164.7</var>has determined it medically necessary to involve family members in the child's care. For <br/>
<a id="pl.164.8"></a><var>164.8</var>the purposes of this subdivision, "family psychoeducation services" means information <br/>
<a id="pl.164.9"></a><var>164.9</var>or demonstration provided to an individual or family as part of an individual, family, <br/>
<a id="pl.164.10"></a><var>164.10</var>multifamily group, or peer group session to explain, educate, and support the child and <br/>
<a id="pl.164.11"></a><var>164.11</var>family in understanding a child's symptoms of mental illness, the impact on the child's <br/>
<a id="pl.164.12"></a><var>164.12</var>development, and needed components of treatment and skill development so that the <br/>
<a id="pl.164.13"></a><var>164.13</var>individual, family, or group can help the child to prevent relapse, prevent the acquisition <br/>
<a id="pl.164.14"></a><var>164.14</var>of comorbid disorders, and to achieve optimal mental health and long-term resilience.<br/>
<br/>
<a id="bill.4.17.0"></a><a id="pl.164.15"></a><var>164.15</var>    Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a <br/>
<a id="pl.164.16"></a><var>164.16</var>subdivision to read:<br/>
<a id="pl.164.17"></a><var>164.17</var>    Subd. 62. <b>Mental health clinical care consultation.</b> Effective July 1, 2013, or upon <br/>
<a id="pl.164.18"></a><var>164.18</var>federal approval, whichever is later, medical assistance covers clinical care consultation <br/>
<a id="pl.164.19"></a><var>164.19</var>for a person up to age 21 who is diagnosed with a complex mental health condition or a <br/>
<a id="pl.164.20"></a><var>164.20</var>mental health condition that co-occurs with other complex and chronic conditions, when <br/>
<a id="pl.164.21"></a><var>164.21</var>described in the person's individual treatment plan and provided by a licensed mental <br/>
<a id="pl.164.22"></a><var>164.22</var>health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a <br/>
<a id="pl.164.23"></a><var>164.23</var>clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the <br/>
<a id="pl.164.24"></a><var>164.24</var>purposes of this subdivision, "clinical care consultation" means communication from a <br/>
<a id="pl.164.25"></a><var>164.25</var>treating mental health professional to other providers or educators not under the clinical <br/>
<a id="pl.164.26"></a><var>164.26</var>supervision of the treating mental health professional who are working with the same client <br/>
<a id="pl.164.27"></a><var>164.27</var>to inform, inquire, and instruct regarding the client's symptoms; strategies for effective <br/>
<a id="pl.164.28"></a><var>164.28</var>engagement, care, and intervention needs; treatment expectations across service settings; <br/>
<a id="pl.164.29"></a><var>164.29</var>and to direct and coordinate clinical service components provided to the client and family.<br/>
<br/>
<a id="bill.4.18.0"></a><a id="pl.164.30"></a><var>164.30</var>    Sec. 18. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:<br/>
<a id="pl.164.31"></a><var>164.31</var>    Subdivision 1. <b>Definitions.</b> For purposes of this section, the following terms have <br/>
<a id="pl.164.32"></a><var>164.32</var>the meanings given them.<br/>
<a id="pl.164.33"></a><var>164.33</var>(a) "Children's therapeutic services and supports" means the flexible package of <br/>
<a id="pl.164.34"></a><var>164.34</var>mental health services for children who require varying therapeutic and rehabilitative <br/>
<a id="pl.165.1"></a><var>165.1</var>levels of intervention. The services are time-limited interventions that are delivered using <br/>
<a id="pl.165.2"></a><var>165.2</var>various treatment modalities and combinations of services designed to reach treatment <br/>
<a id="pl.165.3"></a><var>165.3</var>outcomes identified in the individual treatment plan.<br/>
<a id="pl.165.4"></a><var>165.4</var>(b) "Clinical supervision" means the overall responsibility of the mental health <br/>
<a id="pl.165.5"></a><var>165.5</var>professional for the control and direction of individualized treatment planning, service <br/>
<a id="pl.165.6"></a><var>165.6</var>delivery, and treatment review for each client. A mental health professional who is an <br/>
<a id="pl.165.7"></a><var>165.7</var>enrolled Minnesota health care program provider accepts full professional responsibility <br/>
<a id="pl.165.8"></a><var>165.8</var>for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, <br/>
<a id="pl.165.9"></a><var>165.9</var>and oversees or directs the supervisee's work.<br/>
<a id="pl.165.10"></a><var>165.10</var>(c) "County board" means the county board of commissioners or board established <br/>
<a id="pl.165.11"></a><var>165.11</var>under sections 
         <statute_ref>402.01</statute_ref> to 
         <statute_ref>402.10</statute_ref> or 
         <statute_ref>471.59</statute_ref>.<br/>
<a id="pl.165.12"></a><var>165.12</var>(d) "Crisis assistance" has the meaning given in section 
         <statute_ref>245.4871, subdivision 9a</statute_ref>.<br/>
<a id="pl.165.13"></a><var>165.13</var>(e) "Culturally competent provider" means a provider who understands and can <br/>
<a id="pl.165.14"></a><var>165.14</var>utilize to a client's benefit the client's culture when providing services to the client. A <br/>
<a id="pl.165.15"></a><var>165.15</var>provider may be culturally competent because the provider is of the same cultural or <br/>
<a id="pl.165.16"></a><var>165.16</var>ethnic group as the client or the provider has developed the knowledge and skills through <br/>
<a id="pl.165.17"></a><var>165.17</var>training and experience to provide services to culturally diverse clients.<br/>
<a id="pl.165.18"></a><var>165.18</var>(f) "Day treatment program" for children means a site-based structured program <br/>
<a id="pl.165.19"></a><var>165.19</var>consisting of group psychotherapy for more than three individuals and other intensive <br/>
<a id="pl.165.20"></a><var>165.20</var>therapeutic services provided by a multidisciplinary team, under the clinical supervision <br/>
<a id="pl.165.21"></a><var>165.21</var>of a mental health professional.<br/>
<a id="pl.165.22"></a><var>165.22</var>(g) "Diagnostic assessment" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.165.23"></a><var>165.23</var>11
         </statute_ref>.<br/>
<a id="pl.165.24"></a><var>165.24</var>(h) "Direct service time" means the time that a mental health professional, mental <br/>
<a id="pl.165.25"></a><var>165.25</var>health practitioner, or mental health behavioral aide spends face-to-face with a client <br/>
<a id="pl.165.26"></a><var>165.26</var>and the client's family. Direct service time includes time in which the provider obtains <br/>
<a id="pl.165.27"></a><var>165.27</var>a client's history or provides service components of children's therapeutic services and <br/>
<a id="pl.165.28"></a><var>165.28</var>supports. Direct service time does not include time doing work before and after providing <br/>
<a id="pl.165.29"></a><var>165.29</var>direct services, including scheduling, maintaining clinical records, consulting with others <br/>
<a id="pl.165.30"></a><var>165.30</var>about the client's mental health status, preparing reports, receiving clinical supervision, <br/>
<a id="pl.165.31"></a><var>165.31</var>and revising the client's individual treatment plan.<br/>
<a id="pl.165.32"></a><var>165.32</var>(i) "Direction of mental health behavioral aide" means the activities of a mental <br/>
<a id="pl.165.33"></a><var>165.33</var>health professional or mental health practitioner in guiding the mental health behavioral <br/>
<a id="pl.165.34"></a><var>165.34</var>aide in providing services to a client. The direction of a mental health behavioral aide <br/>
<a id="pl.165.35"></a><var>165.35</var>must be based on the client's individualized treatment plan and meet the requirements in <br/>
<a id="pl.165.36"></a><var>165.36</var>subdivision 6, paragraph (b), clause (5).<br/>
<a id="pl.166.1"></a><var>166.1</var>(j) "Emotional disturbance" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.166.2"></a><var>166.2</var>15
         </statute_ref>. For persons at least age 18 but under age 21, mental illness has the meaning given in <br/>
<a id="pl.166.3"></a><var>166.3</var>section 
         <statute_ref>245.462, subdivision 20</statute_ref>, paragraph (a).<br/>
<a id="pl.166.4"></a><var>166.4</var>(k) "Individual behavioral plan" means a plan of intervention, treatment, and <br/>
<a id="pl.166.5"></a><var>166.5</var>services for a child written by a mental health professional or mental health practitioner, <br/>
<a id="pl.166.6"></a><var>166.6</var>under the clinical supervision of a mental health professional, to guide the work of the <br/>
<a id="pl.166.7"></a><var>166.7</var>mental health behavioral aide.<br/>
<a id="pl.166.8"></a><var>166.8</var>(l) "Individual treatment plan" has the meaning given in section 
         <statute_ref>245.4871, <br/>
<a id="pl.166.9"></a><var>166.9</var>subdivision 21
         </statute_ref>.<br/>
<a id="pl.166.10"></a><var>166.10</var>(m) "Mental health behavioral aide services" means medically necessary one-on-one <br/>
<a id="pl.166.11"></a><var>166.11</var>activities performed by a trained paraprofessional to assist a child retain or generalize <br/>
<a id="pl.166.12"></a><var>166.12</var>psychosocial skills as taught by a mental health professional or mental health practitioner <br/>
<a id="pl.166.13"></a><var>166.13</var>and as described in the child's individual treatment plan and individual behavior plan. <br/>
<a id="pl.166.14"></a><var>166.14</var>Activities involve working directly with the child or child's family as provided in <br/>
<a id="pl.166.15"></a><var>166.15</var>subdivision 9, paragraph (b), clause (4).<br/>
<a id="pl.166.16"></a><var>166.16</var>(n) "Mental health professional" means an individual as defined in section 
         <statute_ref>245.4871, <br/>
<a id="pl.166.17"></a><var>166.17</var>subdivision 27
         </statute_ref>, clauses (1) to (6), or tribal vendor as defined in section 
         <statute_ref>256B.02, <br/>
<a id="pl.166.18"></a><var>166.18</var>subdivision 7
         </statute_ref>, paragraph (b).<br/>
<a id="pl.166.19"></a><var>166.19</var>    (o) "Mental health service plan development" includes:<br/>
<a id="pl.166.20"></a><var>166.20</var>    (1) the development, review, and revision of a child's individual treatment plan, <br/>
<a id="pl.166.21"></a><var>166.21</var>as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of <br/>
<a id="pl.166.22"></a><var>166.22</var>the client or client's parents, primary caregiver, or other person authorized to consent to <br/>
<a id="pl.166.23"></a><var>166.23</var>mental health services for the client, and including arrangement of treatment and support <br/>
<a id="pl.166.24"></a><var>166.24</var>activities specified in the individual treatment plan; and<br/>
<a id="pl.166.25"></a><var>166.25</var>    (2) administering standardized outcome measurement instruments, determined <br/>
<a id="pl.166.26"></a><var>166.26</var>and updated by the commissioner, as periodically needed to evaluate the effectiveness <br/>
<a id="pl.166.27"></a><var>166.27</var>of treatment for children receiving clinical services and reporting outcome measures, <br/>
<a id="pl.166.28"></a><var>166.28</var>as required by the commissioner.<br/>
<a id="pl.166.29"></a><var>166.29</var>(o) (p) "Preschool program" means a day program licensed under Minnesota Rules, <br/>
<a id="pl.166.30"></a><var>166.30</var>parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and <br/>
<a id="pl.166.31"></a><var>166.31</var>supports provider to provide a structured treatment program to a child who is at least 33 <br/>
<a id="pl.166.32"></a><var>166.32</var>months old but who has not yet attended the first day of kindergarten.<br/>
<a id="pl.166.33"></a><var>166.33</var>(p) (q) "Skills training" means individual, family, or group training, delivered <br/>
<a id="pl.166.34"></a><var>166.34</var>by or under the direction of a mental health professional, designed to facilitate the <br/>
<a id="pl.166.35"></a><var>166.35</var>acquisition of psychosocial skills that are medically necessary to rehabilitate the child <br/>
<a id="pl.166.36"></a><var>166.36</var>to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric <br/>
<a id="pl.167.1"></a><var>167.1</var>illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits <br/>
<a id="pl.167.2"></a><var>167.2</var>or maladaptive skills acquired over the course of a psychiatric illness. Skills training <br/>
<a id="pl.167.3"></a><var>167.3</var>is subject to the following requirements:<br/>
<a id="pl.167.4"></a><var>167.4</var>(1) a mental health professional or a mental health practitioner must provide skills <br/>
<a id="pl.167.5"></a><var>167.5</var>training;<br/>
<a id="pl.167.6"></a><var>167.6</var>(2) the child must always be present during skills training; however, a brief absence <br/>
<a id="pl.167.7"></a><var>167.7</var>of the child for no more than ten percent of the session unit may be allowed to redirect or <br/>
<a id="pl.167.8"></a><var>167.8</var>instruct family members;<br/>
<a id="pl.167.9"></a><var>167.9</var>(3) skills training delivered to children or their families must be targeted to the <br/>
<a id="pl.167.10"></a><var>167.10</var>specific deficits or maladaptations of the child's mental health disorder and must be <br/>
<a id="pl.167.11"></a><var>167.11</var>prescribed in the child's individual treatment plan;<br/>
<a id="pl.167.12"></a><var>167.12</var>(4) skills training delivered to the child's family must teach skills needed by parents <br/>
<a id="pl.167.13"></a><var>167.13</var>to enhance the child's skill development and to help the child use in daily life the skills <br/>
<a id="pl.167.14"></a><var>167.14</var>previously taught by a mental health professional or mental health practitioner and to <br/>
<a id="pl.167.15"></a><var>167.15</var>develop or maintain a home environment that supports the child's progressive use skills;<br/>
<a id="pl.167.16"></a><var>167.16</var>(5) group skills training may be provided to multiple recipients who, because of the <br/>
<a id="pl.167.17"></a><var>167.17</var>nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from <br/>
<a id="pl.167.18"></a><var>167.18</var>interaction in a group setting, which must be staffed as follows:<br/>
<a id="pl.167.19"></a><var>167.19</var>(i) one mental health professional or one mental health practitioner under supervision <br/>
<a id="pl.167.20"></a><var>167.20</var>of a licensed mental health professional must work with a group of four to eight clients; or<br/>
<a id="pl.167.21"></a><var>167.21</var>(ii) two mental health professionals or two mental health practitioners under <br/>
<a id="pl.167.22"></a><var>167.22</var>supervision of a licensed mental health professional, or one professional plus one <br/>
<a id="pl.167.23"></a><var>167.23</var>practitioner must work with a group of nine to 12 clients.<br/>
<br/>
<a id="bill.4.19.0"></a><a id="pl.167.24"></a><var>167.24</var>    Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:<br/>
<a id="pl.167.25"></a><var>167.25</var>    Subd. 2. <b>Covered service components of children's therapeutic services and </b><br/>
<a id="pl.167.26"></a><var>167.26</var><b>supports.</b> (a) Subject to federal approval, medical assistance covers medically necessary <br/>
<a id="pl.167.27"></a><var>167.27</var>children's therapeutic services and supports as defined in this section that an eligible <br/>
<a id="pl.167.28"></a><var>167.28</var>provider entity certified under subdivision 4 provides to a client eligible under subdivision <br/>
<a id="pl.167.29"></a><var>167.29</var>3.<br/>
<a id="pl.167.30"></a><var>167.30</var>(b) The service components of children's therapeutic services and supports are:<br/>
<a id="pl.167.31"></a><var>167.31</var>(1) individual, family, and group psychotherapy;<br/>
<a id="pl.167.32"></a><var>167.32</var>(2) individual, family, or group skills training provided by a mental health <br/>
<a id="pl.167.33"></a><var>167.33</var>professional or mental health practitioner;<br/>
<a id="pl.167.34"></a><var>167.34</var>(3) crisis assistance;<br/>
<a id="pl.167.35"></a><var>167.35</var>(4) mental health behavioral aide services; and<br/>
<a id="pl.168.1"></a><var>168.1</var>(5) direction of a mental health behavioral aide.;<br/>
<a id="pl.168.2"></a><var>168.2</var>(6) mental health service plan development;<br/>
<a id="pl.168.3"></a><var>168.3</var>(7) clinical care consultation provided by a mental health professional under section <br/>
<a id="pl.168.4"></a><var>168.4</var>256B.0625, subdivision 62; <br/>
<a id="pl.168.5"></a><var>168.5</var>(8) family psychoeducation under section 256B.0625, subdivision 61; and<br/>
<a id="pl.168.6"></a><var>168.6</var>(9) services provided by a family peer specialist under section 256B.0616.<br/>
<a id="pl.168.7"></a><var>168.7</var>(c) Service components in paragraph (b) may be combined to constitute therapeutic <br/>
<a id="pl.168.8"></a><var>168.8</var>programs, including day treatment programs and therapeutic preschool programs.<br/>
<br/>
<a id="bill.4.20.0"></a><a id="pl.168.9"></a><var>168.9</var>    Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:<br/>
<a id="pl.168.10"></a><var>168.10</var>    Subd. 7. <b>Qualifications of individual and team providers.</b> (a) An individual <br/>
<a id="pl.168.11"></a><var>168.11</var>or team provider working within the scope of the provider's practice or qualifications <br/>
<a id="pl.168.12"></a><var>168.12</var>may provide service components of children's therapeutic services and supports that are <br/>
<a id="pl.168.13"></a><var>168.13</var>identified as medically necessary in a client's individual treatment plan.<br/>
<a id="pl.168.14"></a><var>168.14</var>(b) An individual provider must be qualified as:<br/>
<a id="pl.168.15"></a><var>168.15</var>(1) a mental health professional as defined in subdivision 1, paragraph (n); or<br/>
<a id="pl.168.16"></a><var>168.16</var>(2) a mental health practitioner as defined in section 
         <statute_ref>245.4871, subdivision 26</statute_ref>. The <br/>
<a id="pl.168.17"></a><var>168.17</var>mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.168.18"></a><var>168.18</var>professional; or<br/>
<a id="pl.168.19"></a><var>168.19</var>(3) a mental health behavioral aide working under the clinical supervision of a <br/>
<a id="pl.168.20"></a><var>168.20</var>mental health professional to implement the rehabilitative mental health services identified <br/>
<a id="pl.168.21"></a><var>168.21</var>in the client's individual treatment plan and individual behavior plan.<br/>
<a id="pl.168.22"></a><var>168.22</var>(A) A level I mental health behavioral aide must:<br/>
<a id="pl.168.23"></a><var>168.23</var>(i) be at least 18 years old;<br/>
<a id="pl.168.24"></a><var>168.24</var>(ii) have a high school diploma or general equivalency diploma (GED) or two years <br/>
<a id="pl.168.25"></a><var>168.25</var>of experience as a primary caregiver to a child with severe emotional disturbance within <br/>
<a id="pl.168.26"></a><var>168.26</var>the previous ten years; and<br/>
<a id="pl.168.27"></a><var>168.27</var>(iii) meet preservice and continuing education requirements under subdivision 8.<br/>
<a id="pl.168.28"></a><var>168.28</var>(B) A level II mental health behavioral aide must:<br/>
<a id="pl.168.29"></a><var>168.29</var>(i) be at least 18 years old;<br/>
<a id="pl.168.30"></a><var>168.30</var>(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering <br/>
<a id="pl.168.31"></a><var>168.31</var>clinical services in the treatment of mental illness concerning children or adolescents or <br/>
<a id="pl.168.32"></a><var>168.32</var>complete a certificate program established under subdivision 8a; and<br/>
<a id="pl.168.33"></a><var>168.33</var>(iii) meet preservice and continuing education requirements in subdivision 8.<br/>
<a id="pl.169.1"></a><var>169.1</var>(c) A preschool program multidisciplinary team must include at least one mental <br/>
<a id="pl.169.2"></a><var>169.2</var>health professional and one or more of the following individuals under the clinical <br/>
<a id="pl.169.3"></a><var>169.3</var>supervision of a mental health professional:<br/>
<a id="pl.169.4"></a><var>169.4</var>(i) a mental health practitioner; or<br/>
<a id="pl.169.5"></a><var>169.5</var>(ii) a program person, including a teacher, assistant teacher, or aide, who meets the <br/>
<a id="pl.169.6"></a><var>169.6</var>qualifications and training standards of a level I mental health behavioral aide.<br/>
<a id="pl.169.7"></a><var>169.7</var>(d) A day treatment multidisciplinary team must include at least one mental health <br/>
<a id="pl.169.8"></a><var>169.8</var>professional and one mental health practitioner.<br/>
<br/>
<a id="bill.4.21.0"></a><a id="pl.169.9"></a><var>169.9</var>    Sec. 21. Minnesota Statutes 2012, section 256B.0943, is amended by adding a <br/>
<a id="pl.169.10"></a><var>169.10</var>subdivision to read:<br/>
<a id="pl.169.11"></a><var>169.11</var>    Subd. 8a. <b>Level II mental health behavioral aide.</b> The commissioner of human <br/>
<a id="pl.169.12"></a><var>169.12</var>services, in collaboration with the Board of Trustees of the Minnesota State Colleges and <br/>
<a id="pl.169.13"></a><var>169.13</var>Universities, shall develop a certificate program of not fewer than 11 credits for level II <br/>
<a id="pl.169.14"></a><var>169.14</var>mental health behavioral aides. The program shall include classroom and field-based <br/>
<a id="pl.169.15"></a><var>169.15</var>learning. The program components must include, but not be limited to, mental illnesses <br/>
<a id="pl.169.16"></a><var>169.16</var>in children, parent and family perspectives, skill training, documentation and reporting, <br/>
<a id="pl.169.17"></a><var>169.17</var>communication skills, and cultural competence.<br/>
<br/>
<a id="bill.4.22.0"></a><a id="pl.169.18"></a><var>169.18</var>    Sec. 22. Minnesota Statutes 2012, section 256B.0946, is amended to read:<br/>
<a id="pl.169.19"></a><var>169.19</var><b>256B.0946 </b><b>INTENSIVE </b><b>TREATMENT</b><b> IN</b><b> FOSTER CARE.</b><br/>
<a id="pl.169.20"></a><var>169.20</var>    Subdivision 1. <b>Required </b><b>covered service</b><b> components</b><b>.</b> (a) Effective July 1, 2006,<br/>
<a id="pl.169.21"></a><var>169.21</var> upon enactment and subject to federal approval, medical assistance covers medically <br/>
<a id="pl.169.22"></a><var>169.22</var>necessary intensive treatment services described under paragraph (b) that are provided <br/>
<a id="pl.169.23"></a><var>169.23</var>by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2 <br/>
<a id="pl.169.24"></a><var>169.24</var>who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000 <br/>
<a id="pl.169.25"></a><var>169.25</var>to 2960.3340.<br/>
<a id="pl.169.26"></a><var>169.26</var>(b) Intensive treatment services to children with severe emotional disturbance mental <br/>
<a id="pl.169.27"></a><var>169.27</var>illness residing in treatment foster care family settings must meet the relevant standards <br/>
<a id="pl.169.28"></a><var>169.28</var>for mental health services under sections 
<statute_ref>245.487</statute_ref> to 
<statute_ref>245.4889</statute_ref>. In addition, that comprise<br/>
<a id="pl.169.29"></a><var>169.29</var> specific required service components provided in clauses (1) to (5), are reimbursed by <br/>
<a id="pl.169.30"></a><var>169.30</var>medical assistance must when they meet the following standards:<br/>
<a id="pl.169.31"></a><var>169.31</var>(1) case management service component must meet the standards in Minnesota <br/>
<a id="pl.169.32"></a><var>169.32</var>Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;<br/>
<a id="pl.170.1"></a><var>170.1</var>(1) psychotherapy provided by a mental health professional as defined in Minnesota <br/>
<a id="pl.170.2"></a><var>170.2</var>Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota <br/>
<a id="pl.170.3"></a><var>170.3</var>Rules, part 9505.0371, subpart 5, item C;<br/>
<a id="pl.170.4"></a><var>170.4</var>(2) psychotherapy, crisis assistance, and skills training components must meet the<br/>
<a id="pl.170.5"></a><var>170.5</var> provided according to standards for children's therapeutic services and supports in section <br/>
<statute_ref><a id="pl.170.6"></a><var>170.6</var>256B.0943
         </statute_ref>; and<br/>
<a id="pl.170.7"></a><var>170.7</var>(3) individual family, and group psychoeducation services under supervision of, <br/>
<a id="pl.170.8"></a><var>170.8</var>defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a <br/>
<a id="pl.170.9"></a><var>170.9</var>clinical trainee;<br/>
<a id="pl.170.10"></a><var>170.10</var>(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental <br/>
<a id="pl.170.11"></a><var>170.11</var>health professional or a clinical trainee; and<br/>
<a id="pl.170.12"></a><var>170.12</var>(5) service delivery payment requirements as provided under subdivision 4.<br/>
<a id="pl.170.13"></a><var>170.13</var>    Subd. 1a. <b>Definitions.</b> For the purposes of this section, the following terms have <br/>
<a id="pl.170.14"></a><var>170.14</var>the meanings given them.<br/>
<a id="pl.170.15"></a><var>170.15</var>(a) "Clinical care consultation" means communication from a treating clinician to <br/>
<a id="pl.170.16"></a><var>170.16</var>other providers working with the same client to inform, inquire, and instruct regarding <br/>
<a id="pl.170.17"></a><var>170.17</var>the client's symptoms, strategies for effective engagement, care and intervention needs, <br/>
<a id="pl.170.18"></a><var>170.18</var>and treatment expectations across service settings, including but not limited to the client's <br/>
<a id="pl.170.19"></a><var>170.19</var>school, social services, day care, probation, home, primary care, medication prescribers, <br/>
<a id="pl.170.20"></a><var>170.20</var>disabilities services, and other mental health providers and to direct and coordinate clinical <br/>
<a id="pl.170.21"></a><var>170.21</var>service components provided to the client and family.<br/>
<a id="pl.170.22"></a><var>170.22</var>(b) "Clinical supervision" means the documented time a clinical supervisor and <br/>
<a id="pl.170.23"></a><var>170.23</var>supervisee spend together to discuss the supervisee's work, to review individual client <br/>
<a id="pl.170.24"></a><var>170.24</var>cases, and for the supervisee's professional development. It includes the documented <br/>
<a id="pl.170.25"></a><var>170.25</var>oversight and supervision responsibility for planning, implementation, and evaluation of <br/>
<a id="pl.170.26"></a><var>170.26</var>services for a client's mental health treatment.<br/>
<a id="pl.170.27"></a><var>170.27</var>(c) "Clinical supervisor" means the mental health professional who is responsible <br/>
<a id="pl.170.28"></a><var>170.28</var>for clinical supervision.<br/>
<a id="pl.170.29"></a><var>170.29</var>(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, <br/>
<a id="pl.170.30"></a><var>170.30</var>subpart 5, item C;<br/>
<a id="pl.170.31"></a><var>170.31</var>(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a, <br/>
<a id="pl.170.32"></a><var>170.32</var>including the development of a plan that addresses prevention and intervention strategies <br/>
<a id="pl.170.33"></a><var>170.33</var>to be used in a potential crisis, but does not include actual crisis intervention.<br/>
<a id="pl.170.34"></a><var>170.34</var>(f) "Culturally appropriate" means providing mental health services in a manner that <br/>
<a id="pl.170.35"></a><var>170.35</var>incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370, <br/>
<a id="pl.171.1"></a><var>171.1</var>subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural <br/>
<a id="pl.171.2"></a><var>171.2</var>strengths and resources to promote overall wellness.<br/>
<a id="pl.171.3"></a><var>171.3</var>(g) "Culture" means the distinct ways of living and understanding the world that <br/>
<a id="pl.171.4"></a><var>171.4</var>are used by a group of people and are transmitted from one generation to another or <br/>
<a id="pl.171.5"></a><var>171.5</var>adopted by an individual.<br/>
<a id="pl.171.6"></a><var>171.6</var>(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part <br/>
<a id="pl.171.7"></a><var>171.7</var>9505.0370, subpart 11.<br/>
<a id="pl.171.8"></a><var>171.8</var>(i) "Family" means a person who is identified by the client or the client's parent or <br/>
<a id="pl.171.9"></a><var>171.9</var>guardian as being important to the client's mental health treatment. Family may include, <br/>
<a id="pl.171.10"></a><var>171.10</var>but is not limited to, parents, foster parents, children, spouse, committed partners, former <br/>
<a id="pl.171.11"></a><var>171.11</var>spouses, persons related by blood or adoption, persons who are a part of the client's <br/>
<a id="pl.171.12"></a><var>171.12</var>permanency plan, or persons who are presently residing together as a family unit.<br/>
<a id="pl.171.13"></a><var>171.13</var>(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.<br/>
<a id="pl.171.14"></a><var>171.14</var>(k) "Foster family setting" means the foster home in which the license holder resides.<br/>
<a id="pl.171.15"></a><var>171.15</var>(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part <br/>
<a id="pl.171.16"></a><var>171.16</var>9505.0370, subpart 15.<br/>
<a id="pl.171.17"></a><var>171.17</var>(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part <br/>
<a id="pl.171.18"></a><var>171.18</var>9505.0370, subpart 17.<br/>
<a id="pl.171.19"></a><var>171.19</var>(n) "Mental health professional" has the meaning given in Minnesota Rules, part <br/>
<a id="pl.171.20"></a><var>171.20</var>9505.0370, subpart 18.<br/>
<a id="pl.171.21"></a><var>171.21</var>(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, <br/>
<a id="pl.171.22"></a><var>171.22</var>subpart 20.<br/>
<a id="pl.171.23"></a><var>171.23</var>(p) "Parent" has the meaning given in section 260C.007, subdivision 25.<br/>
<a id="pl.171.24"></a><var>171.24</var>(q) "Psychoeducation services" means information or demonstration provided to <br/>
<a id="pl.171.25"></a><var>171.25</var>an individual, family, or group to explain, educate, and support the individual, family, or <br/>
<a id="pl.171.26"></a><var>171.26</var>group in understanding a child's symptoms of mental illness, the impact on the child's <br/>
<a id="pl.171.27"></a><var>171.27</var>development, and needed components of treatment and skill development so that the <br/>
<a id="pl.171.28"></a><var>171.28</var>individual, family, or group can help the child to prevent relapse, prevent the acquisition <br/>
<a id="pl.171.29"></a><var>171.29</var>of comorbid disorders, and to achieve optimal mental health and long-term resilience.<br/>
<a id="pl.171.30"></a><var>171.30</var>(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, <br/>
<a id="pl.171.31"></a><var>171.31</var>subpart 27.<br/>
<a id="pl.171.32"></a><var>171.32</var>(s) "Team consultation and treatment planning" means the coordination of treatment <br/>
<a id="pl.171.33"></a><var>171.33</var>plans and consultation among providers in a group concerning the treatment needs of the <br/>
<a id="pl.171.34"></a><var>171.34</var>child, including disseminating the child's treatment service schedule to all members of the <br/>
<a id="pl.171.35"></a><var>171.35</var>service team. Team members must include all mental health professionals working with <br/>
<a id="pl.171.36"></a><var>171.36</var>the child, a parent, the child unless the team lead or parent deem it clinically inappropriate, <br/>
<a id="pl.172.1"></a><var>172.1</var>and at least two of the following: an individualized education program case manager; <br/>
<a id="pl.172.2"></a><var>172.2</var>probation agent; children's mental health case manager; child welfare worker, including <br/>
<a id="pl.172.3"></a><var>172.3</var>adoption or guardianship worker; primary care provider; foster parent; and any other <br/>
<a id="pl.172.4"></a><var>172.4</var>member of the child's service team.<br/>
<a id="pl.172.5"></a><var>172.5</var>    Subd. 2. <b>Determination of client eligibility.</b> A client's eligibility to receive <br/>
<a id="pl.172.6"></a><var>172.6</var>treatment foster care under this section shall be determined by An eligible recipient is an <br/>
<a id="pl.172.7"></a><var>172.7</var>individual, from birth through age 20, who is currently placed in a foster home licensed <br/>
<a id="pl.172.8"></a><var>172.8</var>under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic <br/>
<a id="pl.172.9"></a><var>172.9</var>assessment, and an evaluation of level of care needed, and development of an individual <br/>
<a id="pl.172.10"></a><var>172.10</var>treatment plan, as defined in paragraphs (a) to (c) and (b).<br/>
<a id="pl.172.11"></a><var>172.11</var>(a) The diagnostic assessment must:<br/>
<a id="pl.172.12"></a><var>172.12</var>(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be <br/>
<a id="pl.172.13"></a><var>172.13</var>conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social <br/>
<a id="pl.172.14"></a><var>172.14</var>worker that is mental health professional or a clinical trainee;<br/>
<a id="pl.172.15"></a><var>172.15</var>(2) determine whether or not a child meets the criteria for mental illness, as defined <br/>
<a id="pl.172.16"></a><var>172.16</var>in Minnesota Rules, part 9505.0370, subpart 20;<br/>
<a id="pl.172.17"></a><var>172.17</var>(3) document that intensive treatment services are medically necessary within a <br/>
<a id="pl.172.18"></a><var>172.18</var>foster family setting to ameliorate identified symptoms and functional impairments;<br/>
<a id="pl.172.19"></a><var>172.19</var>(4) be  performed within 180 days prior to before the start of service; and<br/>
<a id="pl.172.20"></a><var>172.20</var>(2) include current diagnoses on all five axes of the client's current mental health <br/>
<a id="pl.172.21"></a><var>172.21</var>status;<br/>
<a id="pl.172.22"></a><var>172.22</var>(3) determine whether or not a child meets the criteria for severe emotional <br/>
<a id="pl.172.23"></a><var>172.23</var>disturbance in section 
<statute_ref>245.4871, subdivision 6</statute_ref>, or for serious and persistent mental illness <br/>
<a id="pl.172.24"></a><var>172.24</var>in section 
<statute_ref>245.462, subdivision 20</statute_ref>; and<br/>
<a id="pl.172.25"></a><var>172.25</var>(4) be completed annually until age 18. For individuals between age 18 and 21, <br/>
<a id="pl.172.26"></a><var>172.26</var>unless a client's mental health condition has changed markedly since the client's most <br/>
<a id="pl.172.27"></a><var>172.27</var>recent diagnostic assessment, annual updating is necessary. For the purpose of this section, <br/>
<a id="pl.172.28"></a><var>172.28</var>"updating" means a written summary, including current diagnoses on all five axes, by a <br/>
<a id="pl.172.29"></a><var>172.29</var>mental health professional of the client's current mental status and service needs.<br/>
<a id="pl.172.30"></a><var>172.30</var>(5) be completed as either a standard or extended diagnostic assessment annually to <br/>
<a id="pl.172.31"></a><var>172.31</var>determine continued eligibility for the service.<br/>
<a id="pl.172.32"></a><var>172.32</var>(b) The evaluation of level of care must be conducted by the placing county with <br/>
<a id="pl.172.33"></a><var>172.33</var>an instrument, tribe, or case manager in conjunction with the diagnostic assessment as <br/>
<a id="pl.172.34"></a><var>172.34</var>described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool<br/>
<a id="pl.172.35"></a><var>172.35</var> approved by the commissioner of human services and not subject to the rulemaking <br/>
<a id="pl.172.36"></a><var>172.36</var>process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which <br/>
<a id="pl.173.1"></a><var>173.1</var>evaluation demonstrates that the child requires intensive intervention without 24-hour <br/>
<a id="pl.173.2"></a><var>173.2</var>medical monitoring. The commissioner shall update the list of approved level of care <br/>
<a id="pl.173.3"></a><var>173.3</var>instruments tools annually and publish on the department's Web site.<br/>
<a id="pl.173.4"></a><var>173.4</var>(c) The individual treatment plan must be:<br/>
<a id="pl.173.5"></a><var>173.5</var>(1) based on the information in the client's diagnostic assessment;<br/>
<a id="pl.173.6"></a><var>173.6</var>(2) developed through a child-centered, family driven planning process that identifies <br/>
<a id="pl.173.7"></a><var>173.7</var>service needs and individualized, planned, and culturally appropriate interventions that <br/>
<a id="pl.173.8"></a><var>173.8</var>contain specific measurable treatment goals and objectives for the client and treatment <br/>
<a id="pl.173.9"></a><var>173.9</var>strategies for the client's family and foster family;<br/>
<a id="pl.173.10"></a><var>173.10</var>(3) reviewed at least once every 90 days and revised; and<br/>
<a id="pl.173.11"></a><var>173.11</var>(4) signed by the client or, if appropriate, by the client's parent or other person <br/>
<a id="pl.173.12"></a><var>173.12</var>authorized by statute to consent to mental health services for the client.<br/>
<a id="pl.173.13"></a><var>173.13</var>    Subd. 3. <b>Eligible </b><b>mental health services </b><b>providers.</b> (a) Eligible providers for <br/>
<a id="pl.173.14"></a><var>173.14</var>intensive children's mental health services in a foster family setting must be certified <br/>
<a id="pl.173.15"></a><var>173.15</var>by the state and have a service provision contract with a county board or a reservation <br/>
<a id="pl.173.16"></a><var>173.16</var>tribal council and must be able to demonstrate the ability to provide all of the services <br/>
<a id="pl.173.17"></a><var>173.17</var>required in this section.<br/>
<a id="pl.173.18"></a><var>173.18</var>(b) For purposes of this section, a provider agency must have an individual <br/>
<a id="pl.173.19"></a><var>173.19</var>placement agreement for each recipient and must be a licensed child placing agency, under <br/>
<a id="pl.173.20"></a><var>173.20</var>Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:<br/>
<a id="pl.173.21"></a><var>173.21</var>(1) a county county-operated entity certified by the state;<br/>
<a id="pl.173.22"></a><var>173.22</var>(2) an Indian Health Services facility operated by a tribe or tribal organization under <br/>
<a id="pl.173.23"></a><var>173.23</var>funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the <br/>
<a id="pl.173.24"></a><var>173.24</var>Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or<br/>
<a id="pl.173.25"></a><var>173.25</var>(3) a noncounty entity under contract with a county board.<br/>
<a id="pl.173.26"></a><var>173.26</var>(c) Certified providers that do not meet the service delivery standards required in <br/>
<a id="pl.173.27"></a><var>173.27</var>this section shall be subject to a decertification process.<br/>
<a id="pl.173.28"></a><var>173.28</var>(d) For the purposes of this section, all services delivered to a client must be <br/>
<a id="pl.173.29"></a><var>173.29</var>provided by a mental health professional or a clinical trainee.<br/>
<a id="pl.173.30"></a><var>173.30</var>    Subd. 4. <b>Eligible provider responsibilities</b><b> </b><b>Service delivery payment </b><br/>
<a id="pl.173.31"></a><var>173.31</var><b>requirements</b><b>.</b> (a) To be an eligible provider for payment under this section, a provider <br/>
<a id="pl.173.32"></a><var>173.32</var>must develop and practice written policies and procedures for treatment foster care services<br/>
<a id="pl.173.33"></a><var>173.33</var> intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1), <br/>
<a id="pl.173.34"></a><var>173.34</var>(2), and (3) and comply with the following requirements in paragraphs (b) to (n).<br/>
<a id="pl.173.35"></a><var>173.35</var>(b) In delivering services under this section, a treatment foster care provider must <br/>
<a id="pl.173.36"></a><var>173.36</var>ensure that staff caseload size reasonably enables the provider to play an active role in <br/>
<a id="pl.174.1"></a><var>174.1</var>service planning, monitoring, delivering, and reviewing for discharge planning to meet <br/>
<a id="pl.174.2"></a><var>174.2</var>the needs of the client, the client's foster family, and the birth family, as specified in each <br/>
<a id="pl.174.3"></a><var>174.3</var>client's individual treatment plan.<br/>
<a id="pl.174.4"></a><var>174.4</var>(b) A qualified clinical supervisor, as defined in and performing in compliance with <br/>
<a id="pl.174.5"></a><var>174.5</var>Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and <br/>
<a id="pl.174.6"></a><var>174.6</var>provision of services described in this section.<br/>
<a id="pl.174.7"></a><var>174.7</var>(c) Each client receiving treatment services must receive an extended diagnostic <br/>
<a id="pl.174.8"></a><var>174.8</var>assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within <br/>
<a id="pl.174.9"></a><var>174.9</var>30 days of enrollment in this service unless the client has a previous extended diagnostic <br/>
<a id="pl.174.10"></a><var>174.10</var>assessment that the client, parent, and mental health professional agree still accurately <br/>
<a id="pl.174.11"></a><var>174.11</var>describes the client's current mental health functioning.<br/>
<a id="pl.174.12"></a><var>174.12</var>(d) Each previous and current mental health, school, and physical health treatment <br/>
<a id="pl.174.13"></a><var>174.13</var>provider must be contacted to request documentation of treatment and assessments that the <br/>
<a id="pl.174.14"></a><var>174.14</var>eligible client has received and this information must be reviewed and incorporated into <br/>
<a id="pl.174.15"></a><var>174.15</var>the diagnostic assessment and team consultation and treatment planning review process.<br/>
<a id="pl.174.16"></a><var>174.16</var>(e) Each client receiving treatment must be assessed for a trauma history and <br/>
<a id="pl.174.17"></a><var>174.17</var>the client's treatment plan must document how the results of the assessment will be <br/>
<a id="pl.174.18"></a><var>174.18</var>incorporated into treatment.<br/>
<a id="pl.174.19"></a><var>174.19</var>(f) Each client receiving treatment services must have an individual treatment plan <br/>
<a id="pl.174.20"></a><var>174.20</var>that is reviewed, evaluated, and signed every 90 days using the team consultation and <br/>
<a id="pl.174.21"></a><var>174.21</var>treatment planning process, as defined in subdivision 1a, paragraph (s).<br/>
<a id="pl.174.22"></a><var>174.22</var>(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided <br/>
<a id="pl.174.23"></a><var>174.23</var>in accordance with the client's individual treatment plan.<br/>
<a id="pl.174.24"></a><var>174.24</var>(h) Each client must have a crisis assistance plan within ten days of initiating <br/>
<a id="pl.174.25"></a><var>174.25</var>services and must have access to clinical phone support 24 hours per day, seven days per <br/>
<a id="pl.174.26"></a><var>174.26</var>week, during the course of treatment, and the crisis plan must demonstrate coordination <br/>
<a id="pl.174.27"></a><var>174.27</var>with the local or regional mobile crisis intervention team.<br/>
<a id="pl.174.28"></a><var>174.28</var>(i) Services must be delivered and documented at least three days per week, equaling <br/>
<a id="pl.174.29"></a><var>174.29</var>at least six hours of treatment per week, unless reduced units of service are specified on <br/>
<a id="pl.174.30"></a><var>174.30</var>the treatment plan as part of transition or on a discharge plan to another service or level of <br/>
<a id="pl.174.31"></a><var>174.31</var>care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.<br/>
<a id="pl.174.32"></a><var>174.32</var>(j) Location of service delivery must be in the client's home, day care setting, <br/>
<a id="pl.174.33"></a><var>174.33</var>school, or other community-based setting that is specified on the client's individualized <br/>
<a id="pl.174.34"></a><var>174.34</var>treatment plan.<br/>
<a id="pl.174.35"></a><var>174.35</var>(k) Treatment must be developmentally and culturally appropriate for the client.<br/>
<a id="pl.175.1"></a><var>175.1</var>(l) Services must be delivered in continual collaboration and consultation with the <br/>
<a id="pl.175.2"></a><var>175.2</var>client's medical providers and, in particular, with prescribers of psychotropic medications, <br/>
<a id="pl.175.3"></a><var>175.3</var>including those prescribed on an off-label basis, and members of the service team must be <br/>
<a id="pl.175.4"></a><var>175.4</var>aware of the medication regimen and potential side effects.<br/>
<a id="pl.175.5"></a><var>175.5</var>(m) Parents, siblings, foster parents, and members of the child's permanency plan <br/>
<a id="pl.175.6"></a><var>175.6</var>must be involved in treatment and service delivery unless otherwise noted in the treatment <br/>
<a id="pl.175.7"></a><var>175.7</var>plan.<br/>
<a id="pl.175.8"></a><var>175.8</var>(n) Transition planning for the child must be conducted starting with the first <br/>
<a id="pl.175.9"></a><var>175.9</var>treatment plan and must be addressed throughout treatment to support the child's <br/>
<a id="pl.175.10"></a><var>175.10</var>permanency plan and postdischarge mental health service needs.<br/>
<a id="pl.175.11"></a><var>175.11</var>    Subd. 5. <b>Service authorization.</b> The commissioner will administer authorizations <br/>
<a id="pl.175.12"></a><var>175.12</var>for services under this section in compliance with section 
         <statute_ref>256B.0625, subdivision 25</statute_ref>.<br/>
<a id="pl.175.13"></a><var>175.13</var>    Subd. 6. <b>Excluded services.</b> (a) Services in clauses (1) to (4) (7) are not covered <br/>
<a id="pl.175.14"></a><var>175.14</var>under this section and are not eligible for medical assistance payment as components of <br/>
<a id="pl.175.15"></a><var>175.15</var>intensive treatment in foster care services, but may be billed separately:<br/>
<a id="pl.175.16"></a><var>175.16</var>(1) treatment foster care services provided in violation of medical assistance policy <br/>
<a id="pl.175.17"></a><var>175.17</var>in Minnesota Rules, part 9505.0220;<br/>
<a id="pl.175.18"></a><var>175.18</var>(2) service components of children's therapeutic services and supports <br/>
<a id="pl.175.19"></a><var>175.19</var>simultaneously provided by more than one treatment foster care provider;<br/>
<a id="pl.175.20"></a><var>175.20</var>(3) home and community-based waiver services; and<br/>
<a id="pl.175.21"></a><var>175.21</var>(4) treatment foster care services provided to a child without a level of care <br/>
<a id="pl.175.22"></a><var>175.22</var>determination according to section 
<statute_ref>245.4885, subdivision 1</statute_ref>.<br/>
<a id="pl.175.23"></a><var>175.23</var>(1) inpatient psychiatric hospital treatment;<br/>
<a id="pl.175.24"></a><var>175.24</var>(2) mental health targeted case management;<br/>
<a id="pl.175.25"></a><var>175.25</var>(3) partial hospitalization;<br/>
<a id="pl.175.26"></a><var>175.26</var>(4) medication management;<br/>
<a id="pl.175.27"></a><var>175.27</var>(5) children's mental health day treatment services;<br/>
<a id="pl.175.28"></a><var>175.28</var>(6) crisis response services under section 256B.0944; and<br/>
<a id="pl.175.29"></a><var>175.29</var>(7) transportation.<br/>
<a id="pl.175.30"></a><var>175.30</var>(b) Children receiving intensive treatment in foster care services are not eligible for <br/>
<a id="pl.175.31"></a><var>175.31</var>medical assistance reimbursement for the following services while receiving intensive <br/>
<a id="pl.175.32"></a><var>175.32</var>treatment in foster care:<br/>
<a id="pl.175.33"></a><var>175.33</var>(1) mental health case management services under section 
<statute_ref>256B.0625, subdivision <br/>
<a id="pl.175.34"></a><var>175.34</var>20
</statute_ref>; and<br/>
<a id="pl.175.35"></a><var>175.35</var>(2) (1) psychotherapy and skill skills training components of children's therapeutic <br/>
<a id="pl.175.36"></a><var>175.36</var>services and supports under section 
         <statute_ref>256B.0625, subdivision 35b</statute_ref>.;<br/>
<a id="pl.176.1"></a><var>176.1</var>(2) mental health behavioral aide services as defined in section 256B.0943, <br/>
<a id="pl.176.2"></a><var>176.2</var>subdivision 1, paragraph (m);<br/>
<a id="pl.176.3"></a><var>176.3</var>(3) home and community-based waiver services;<br/>
<a id="pl.176.4"></a><var>176.4</var>(4) mental health residential treatment; and<br/>
<a id="pl.176.5"></a><var>176.5</var>(5) room and board costs as defined in section 256I.03, subdivision 6.<br/>
<a id="pl.176.6"></a><var>176.6</var>    Subd. 7. <b>Medical assistance payment and rate setting.</b> The commissioner shall <br/>
<a id="pl.176.7"></a><var>176.7</var>establish a single daily per-client encounter rate for intensive treatment in foster care <br/>
<a id="pl.176.8"></a><var>176.8</var>services. The rate must be constructed to cover only eligible services delivered to an <br/>
<a id="pl.176.9"></a><var>176.9</var>eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).<br/>
<br/>
<a id="bill.4.23.0"></a><a id="pl.176.10"></a><var>176.10</var>    Sec. 23. Minnesota Statutes 2012, section 256B.761, is amended to read:<br/>
<a id="pl.176.11"></a><var>176.11</var><b>256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.</b><br/>
<a id="pl.176.12"></a><var>176.12</var>(a) Effective for services rendered on or after July 1, 2001, payment for medication <br/>
<a id="pl.176.13"></a><var>176.13</var>management provided to psychiatric patients, outpatient mental health services, day <br/>
<a id="pl.176.14"></a><var>176.14</var>treatment services, home-based mental health services, and family community support <br/>
<a id="pl.176.15"></a><var>176.15</var>services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the <br/>
<a id="pl.176.16"></a><var>176.16</var>50th percentile of 1999 charges.<br/>
<a id="pl.176.17"></a><var>176.17</var>(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health <br/>
<a id="pl.176.18"></a><var>176.18</var>services provided by an entity that operates: (1) a Medicare-certified comprehensive <br/>
<a id="pl.176.19"></a><var>176.19</var>outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, <br/>
<a id="pl.176.20"></a><var>176.20</var>1993, with at least 33 percent of the clients receiving rehabilitation services in the most <br/>
<a id="pl.176.21"></a><var>176.21</var>recent calendar year who are medical assistance recipients, will be increased by 38 percent, <br/>
<a id="pl.176.22"></a><var>176.22</var>when those services are provided within the comprehensive outpatient rehabilitation <br/>
<a id="pl.176.23"></a><var>176.23</var>facility and provided to residents of nursing facilities owned by the entity.<br/>
<a id="pl.176.24"></a><var>176.24</var>(c) The commissioner shall establish three levels of payment for mental health <br/>
<a id="pl.176.25"></a><var>176.25</var>diagnostic assessment, based on three levels of complexity. The aggregate payment under <br/>
<a id="pl.176.26"></a><var>176.26</var>the tiered rates must not exceed the projected aggregate payments for mental health <br/>
<a id="pl.176.27"></a><var>176.27</var>diagnostic assessment under the previous single rate. The new rate structure is effective <br/>
<a id="pl.176.28"></a><var>176.28</var>January 1, 2011, or upon federal approval, whichever is later.<br/>
<a id="pl.176.29"></a><var>176.29</var>(d) In addition to rate increases otherwise provided, the commissioner may <br/>
<a id="pl.176.30"></a><var>176.30</var>restructure coverage policy and rates to improve access to adult rehabilitative mental <br/>
<a id="pl.176.31"></a><var>176.31</var>health services under section 256B.0623 and related mental health support services under <br/>
<a id="pl.176.32"></a><var>176.32</var>section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and <br/>
<a id="pl.176.33"></a><var>176.33</var>2016, the projected state share of increased costs due to this paragraph is transferred <br/>
<a id="pl.176.34"></a><var>176.34</var>from adult mental health grants under sections 245.4661 and 256E.12. The transfer for <br/>
<a id="pl.176.35"></a><var>176.35</var>fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments <br/>
<a id="pl.177.1"></a><var>177.1</var>made to managed care plans and county-based purchasing plans under sections 256B.69, <br/>
<a id="pl.177.2"></a><var>177.2</var>256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.<br/>
<br/>
<a id="bill.4.24.0"></a><a id="pl.177.3"></a><var>177.3</var>    Sec. 24. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:<br/>
<a id="pl.177.4"></a><var>177.4</var>    Subd. 1e. <b>Supplementary rate for certain facilities.</b> (a) Notwithstanding the <br/>
<a id="pl.177.5"></a><var>177.5</var>provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall <br/>
<a id="pl.177.6"></a><var>177.6</var>negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to <br/>
<a id="pl.177.7"></a><var>177.7</var>exceed $700 per month, including any legislatively authorized inflationary adjustments, <br/>
<a id="pl.177.8"></a><var>177.8</var>for a group residential housing provider that:<br/>
<a id="pl.177.9"></a><var>177.9</var>(1) is located in Hennepin County and has had a group residential housing contract <br/>
<a id="pl.177.10"></a><var>177.10</var>with the county since June 1996;<br/>
<a id="pl.177.11"></a><var>177.11</var>(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a <br/>
<a id="pl.177.12"></a><var>177.12</var>26-bed facility; and<br/>
<a id="pl.177.13"></a><var>177.13</var>(3) serves a chemically dependent clientele, providing 24 hours per day supervision <br/>
<a id="pl.177.14"></a><var>177.14</var>and limiting a resident's maximum length of stay to 13 months out of a consecutive <br/>
<a id="pl.177.15"></a><var>177.15</var>24-month period.<br/>
<a id="pl.177.16"></a><var>177.16</var>(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a <br/>
<a id="pl.177.17"></a><var>177.17</var>supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 <br/>
<a id="pl.177.18"></a><var>177.18</var>per month, including any legislatively authorized inflationary adjustments, of a group <br/>
<a id="pl.177.19"></a><var>177.19</var>residential provider that:<br/>
<a id="pl.177.20"></a><var>177.20</var>(1) is located in St. Louis County and has had a group residential housing contract <br/>
<a id="pl.177.21"></a><var>177.21</var>with the county since 2006;<br/>
<a id="pl.177.22"></a><var>177.22</var>(2) operates a 62-bed facility; and<br/>
<a id="pl.177.23"></a><var>177.23</var>(3) serves a chemically dependent adult male clientele, providing 24 hours per <br/>
<a id="pl.177.24"></a><var>177.24</var>day supervision and limiting a resident's maximum length of stay to 13 months out of <br/>
<a id="pl.177.25"></a><var>177.25</var>a consecutive 24-month period.<br/>
<a id="pl.177.26"></a><var>177.26</var>(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency <br/>
<a id="pl.177.27"></a><var>177.27</var>shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not <br/>
<a id="pl.177.28"></a><var>177.28</var>to exceed $700 per month, including any legislatively authorized inflationary adjustments, <br/>
<a id="pl.177.29"></a><var>177.29</var>for the group residential provider described under paragraphs (a) and (b), not to exceed <br/>
<a id="pl.177.30"></a><var>177.30</var>an additional 115 beds.<br/>
<br/>
<a id="bill.4.25.0"></a><a id="pl.177.31"></a><var>177.31</var>    Sec. 25. <b>CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.</b><br/>
<a id="pl.177.32"></a><var>177.32</var>The commissioner of human services shall, in consultation with children's mental <br/>
<a id="pl.177.33"></a><var>177.33</var>health community providers, hospitals providing care to children, children's mental health <br/>
<a id="pl.177.34"></a><var>177.34</var>advocates, and other interested parties, develop recommendations and legislation, if <br/>
<a id="pl.178.1"></a><var>178.1</var>necessary, for the state-operated child and adolescent behavioral health services facility <br/>
<a id="pl.178.2"></a><var>178.2</var>to ensure that:<br/>
<a id="pl.178.3"></a><var>178.3</var>(1) the facility and the services provided meet the needs of children with serious <br/>
<a id="pl.178.4"></a><var>178.4</var>emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD, <br/>
<a id="pl.178.5"></a><var>178.5</var>serious emotional disturbance co-occurring with a developmental disability, borderline <br/>
<a id="pl.178.6"></a><var>178.6</var>personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries, <br/>
<a id="pl.178.7"></a><var>178.7</var>violent tendencies, and complex medical issues;<br/>
<a id="pl.178.8"></a><var>178.8</var>(2) qualified personnel and staff can be recruited who have specific expertise and <br/>
<a id="pl.178.9"></a><var>178.9</var>training to treat the children in the facility; and<br/>
<a id="pl.178.10"></a><var>178.10</var>(3) the treatment provided at the facility is high-quality, effective treatment.<br/>
<br/>
<a id="bill.4.26.0"></a><a id="pl.178.11"></a><var>178.11</var>    Sec. 26. <b>PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND </b><br/>
<a id="pl.178.12"></a><var>178.12</var><b>CHILDREN'S MENTAL HEALTH SERVICES.</b><br/>
<a id="pl.178.13"></a><var>178.13</var>(a) To assess the efficiency and other operational issues in the management of the <br/>
<a id="pl.178.14"></a><var>178.14</var>health care delivery system, the commissioner of human services shall initiate a provider <br/>
<a id="pl.178.15"></a><var>178.15</var>survey. The pilot survey shall consist of an electronic survey of providers of pediatric <br/>
<a id="pl.178.16"></a><var>178.16</var>home health care services and children's mental health services to identify and measure <br/>
<a id="pl.178.17"></a><var>178.17</var>issues that arise in dealing with the management of medical assistance. To the maximum <br/>
<a id="pl.178.18"></a><var>178.18</var>degree possible, existing technology shall be used and interns sought to analyze the results.<br/>
<a id="pl.178.19"></a><var>178.19</var>(b) The survey questions must focus on seven key business functions provided <br/>
<a id="pl.178.20"></a><var>178.20</var>by medical assistance contractors: provider inquiries; provider outreach and education; <br/>
<a id="pl.178.21"></a><var>178.21</var>claims processing; appeals; provider enrollment; medical review; and provider audit and <br/>
<a id="pl.178.22"></a><var>178.22</var>reimbursement. The commissioner must consider the results of the survey in evaluating <br/>
<a id="pl.178.23"></a><var>178.23</var>and renewing managed care and fee-for-service management contracts.<br/>
<a id="pl.178.24"></a><var>178.24</var>(c) The commissioner shall report by January 15, 2014, the results of the survey to <br/>
<a id="pl.178.25"></a><var>178.25</var>the chairs of the health and human services policy and finance committees and shall <br/>
<a id="pl.178.26"></a><var>178.26</var>make recommendations on the value of implementing an annual survey with a rotating <br/>
<a id="pl.178.27"></a><var>178.27</var>list of provider groups as a component of the continuous quality improvement system for <br/>
<a id="pl.178.28"></a><var>178.28</var>medical assistance.<br/>
<br/>
<a id="bill.4.27.0"></a><a id="pl.178.29"></a><var>178.29</var>    Sec. 27. <b>MENTALLY ILL AND DANGEROUS COMMITMENTS </b><br/>
<a id="pl.178.30"></a><var>178.30</var><b>STAKEHOLDERS GROUP.</b><br/>
<a id="pl.178.31"></a><var>178.31</var>(a) The commissioner of human services, in consultation with the state court <br/>
<a id="pl.178.32"></a><var>178.32</var>administrator, shall convene a stakeholder group to develop recommendations for the <br/>
<a id="pl.178.33"></a><var>178.33</var>legislature that address issues raised in the February 2013 Office of the Legislative <br/>
<a id="pl.178.34"></a><var>178.34</var>Auditor report on State-Operated Services for persons committed to the commissioner as <br/>
<a id="pl.179.1"></a><var>179.1</var>mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must <br/>
<a id="pl.179.2"></a><var>179.2</var>include representatives from the Department of Human Services, county human services, <br/>
<a id="pl.179.3"></a><var>179.3</var>county attorneys, commitment defense attorneys, the ombudsman for mental health and <br/>
<a id="pl.179.4"></a><var>179.4</var>developmental disabilities, the federal protection and advocacy system, and consumers <br/>
<a id="pl.179.5"></a><var>179.5</var>and advocates for persons with mental illnesses.<br/>
<a id="pl.179.6"></a><var>179.6</var>(b) The stakeholder group shall provide recommendations in the following areas:<br/>
<a id="pl.179.7"></a><var>179.7</var>(1) the role of the special review board, including the scope of authority of the <br/>
<a id="pl.179.8"></a><var>179.8</var>special review board and the authority of the commissioner to accept or reject special <br/>
<a id="pl.179.9"></a><var>179.9</var>review board recommendations;<br/>
<a id="pl.179.10"></a><var>179.10</var>(2) review of special review board decisions by the district court;<br/>
<a id="pl.179.11"></a><var>179.11</var>(3) annual district court review of commitment, scope of court authority, and <br/>
<a id="pl.179.12"></a><var>179.12</var>appropriate review criteria;<br/>
<a id="pl.179.13"></a><var>179.13</var>(4) options, including annual court hearing and review, as alternatives to <br/>
<a id="pl.179.14"></a><var>179.14</var>indeterminate commitment under Minnesota Statutes, section 253B.18; and <br/>
<a id="pl.179.15"></a><var>179.15</var>(5) extension of the right to petition the court under Minnesota Statutes, <br/>
<a id="pl.179.16"></a><var>179.16</var>section 253B.17, to those committed under Minnesota Statutes, section 253B.18. <br/>
<a id="pl.179.17"></a><var>179.17</var>The commissioner of human services and the state court administrator shall provide <br/>
<a id="pl.179.18"></a><var>179.18</var>relevant data for the group's consideration in developing these recommendations, <br/>
<a id="pl.179.19"></a><var>179.19</var>including numbers of proceedings in each category and costs associated with court and <br/>
<a id="pl.179.20"></a><var>179.20</var>administrative proceedings under Minnesota Statutes, section 253B.18.<br/>
<a id="pl.179.21"></a><var>179.21</var>(c) By January 15, 2014, the commissioner of human services shall submit the <br/>
<a id="pl.179.22"></a><var>179.22</var>recommendations of the stakeholder group to the chairs and ranking minority members <br/>
<a id="pl.179.23"></a><var>179.23</var>of the committees of the legislature with jurisdiction over civil commitment and human <br/>
<a id="pl.179.24"></a><var>179.24</var>services issues.<br/>
<br/>
<a id="bill.5.0.0"></a>

<a id="pl.179.27"></a><var>179.27</var><b>OFFICE OF INSPECTOR GENERAL</b><br/>

<a id="bill.5.1.0"></a><a id="pl.179.28"></a><var>179.28</var>    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a <br/>
<a id="pl.179.29"></a><var>179.29</var>subdivision to read:<br/>
<a id="pl.179.30"></a><var>179.30</var>    Subd. 7b. <b>Child care provider and recipient fraud investigations.</b> Data related <br/>
<a id="pl.179.31"></a><var>179.31</var>to child care fraud and recipient fraud investigations are governed by section 245E.01, <br/>
<a id="pl.179.32"></a><var>179.32</var>subdivision 15.<br/>
<br/>
<a id="bill.5.2.0"></a><a id="pl.179.33"></a><var>179.33</var>    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:<br/>
<a id="pl.180.1"></a><var>180.1</var>    Subd. 7. <b>Use of data.</b> (a) Except as otherwise provided in subdivision 7a or sections <br/>
<statute_ref><a id="pl.180.2"></a><var>180.2</var>244.052
         </statute_ref> and 
         <statute_ref>299C.093</statute_ref>, the data provided under this section is private data on individuals <br/>
<a id="pl.180.3"></a><var>180.3</var>under section 
         <statute_ref>13.02, subdivision 12</statute_ref>.<br/>
<a id="pl.180.4"></a><var>180.4</var>(b)  The data may be used only for by law enforcement and corrections agencies for<br/>
<a id="pl.180.5"></a><var>180.5</var> law enforcement and corrections purposes.<br/>
<a id="pl.180.6"></a><var>180.6</var>(c) The commissioner of human services is authorized to have access to the data for:<br/>
<a id="pl.180.7"></a><var>180.7</var>(1) state-operated services, as defined in section 
         <statute_ref>246.014</statute_ref>, are also authorized to <br/>
<a id="pl.180.8"></a><var>180.8</var>have access to the data for the purposes described in section 
         <statute_ref>246.13, subdivision 2</statute_ref>, <br/>
<a id="pl.180.9"></a><var>180.9</var>paragraph (b); and<br/>
<a id="pl.180.10"></a><var>180.10</var>(2) purposes of completing background studies under chapter 245C.<br/>
<br/>
<a id="bill.5.3.0"></a><a id="pl.180.11"></a><var>180.11</var>    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision <br/>
<a id="pl.180.12"></a><var>180.12</var>to read:<br/>
<a id="pl.180.13"></a><var>180.13</var>    Subd. 4a. <b>Agency background studies.</b> (a) The commissioner shall develop and <br/>
<a id="pl.180.14"></a><var>180.14</var>implement an electronic process for the regular transfer of new criminal case information <br/>
<a id="pl.180.15"></a><var>180.15</var>that is added to the Minnesota court information system. The commissioner's system <br/>
<a id="pl.180.16"></a><var>180.16</var>must include for review only information that relates to individuals who have been the <br/>
<a id="pl.180.17"></a><var>180.17</var>subject of a background study under this chapter that remain affiliated with the agency <br/>
<a id="pl.180.18"></a><var>180.18</var>that initiated the background study. For purposes of this paragraph, an individual remains <br/>
<a id="pl.180.19"></a><var>180.19</var>affiliated with an agency that initiated the background study until the agency informs the <br/>
<a id="pl.180.20"></a><var>180.20</var>commissioner that the individual is no longer affiliated. When any individual no longer <br/>
<a id="pl.180.21"></a><var>180.21</var>affiliated according to this paragraph returns to a position requiring a background study <br/>
<a id="pl.180.22"></a><var>180.22</var>under this chapter, the agency with whom the individual is again affiliated shall initiate <br/>
<a id="pl.180.23"></a><var>180.23</var>a new background study regardless of the length of time the individual was no longer <br/>
<a id="pl.180.24"></a><var>180.24</var>affiliated with the agency.<br/>
<a id="pl.180.25"></a><var>180.25</var>(b) The commissioner shall develop and implement an online system for agencies that <br/>
<a id="pl.180.26"></a><var>180.26</var>initiate background studies under this chapter to access and maintain records of background <br/>
<a id="pl.180.27"></a><var>180.27</var>studies initiated by that agency. The system must show all active background study subjects <br/>
<a id="pl.180.28"></a><var>180.28</var>affiliated with that agency and the status of each individual's background study. Each <br/>
<a id="pl.180.29"></a><var>180.29</var>agency that initiates background studies must use this system to notify the commissioner <br/>
<a id="pl.180.30"></a><var>180.30</var>of discontinued affiliation for purposes of the processes required under paragraph (a).<br/>
<br/>
<a id="bill.5.4.0"></a><a id="pl.180.31"></a><var>180.31</var>    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:<br/>
<a id="pl.180.32"></a><var>180.32</var>    Subdivision 1. <b>Background studies conducted by Department of Human </b><br/>
<a id="pl.180.33"></a><var>180.33</var><b>Services.</b> (a) For a background study conducted by the Department of Human Services, <br/>
<a id="pl.180.34"></a><var>180.34</var>the commissioner shall review:<br/>
<a id="pl.181.1"></a><var>181.1</var>    (1) information related to names of substantiated perpetrators of maltreatment of <br/>
<a id="pl.181.2"></a><var>181.2</var>vulnerable adults that has been received by the commissioner as required under section <br/>
<statute_ref><a id="pl.181.3"></a><var>181.3</var>626.557, subdivision 9c
         </statute_ref>, paragraph (j);<br/>
<a id="pl.181.4"></a><var>181.4</var>    (2) the commissioner's records relating to the maltreatment of minors in licensed <br/>
<a id="pl.181.5"></a><var>181.5</var>programs, and from findings of maltreatment of minors as indicated through the social <br/>
<a id="pl.181.6"></a><var>181.6</var>service information system;<br/>
<a id="pl.181.7"></a><var>181.7</var>    (3) information from juvenile courts as required in subdivision 4 for individuals <br/>
<a id="pl.181.8"></a><var>181.8</var>listed in section 
         <statute_ref>245C.03, subdivision 1</statute_ref>, paragraph (a), when there is reasonable cause;<br/>
<a id="pl.181.9"></a><var>181.9</var>    (4) information from the Bureau of Criminal Apprehension, including information <br/>
<a id="pl.181.10"></a><var>181.10</var>regarding a background study subject's registration in Minnesota as a predatory offender <br/>
<a id="pl.181.11"></a><var>181.11</var>under section 243.166;<br/>
<a id="pl.181.12"></a><var>181.12</var>    (5) except as provided in clause (6), information from the national crime information <br/>
<a id="pl.181.13"></a><var>181.13</var>system when the commissioner has reasonable cause as defined under section 
         <statute_ref>245C.05</statute_ref>, <br/>
<a id="pl.181.14"></a><var>181.14</var>subdivision 5; and<br/>
<a id="pl.181.15"></a><var>181.15</var>    (6) for a background study related to a child foster care application for licensure or <br/>
<a id="pl.181.16"></a><var>181.16</var>adoptions, the commissioner shall also review:<br/>
<a id="pl.181.17"></a><var>181.17</var>    (i) information from the child abuse and neglect registry for any state in which the <br/>
<a id="pl.181.18"></a><var>181.18</var>background study subject has resided for the past five years; and<br/>
<a id="pl.181.19"></a><var>181.19</var>    (ii) information from national crime information databases, when the background <br/>
<a id="pl.181.20"></a><var>181.20</var>study subject is 18 years of age or older.<br/>
<a id="pl.181.21"></a><var>181.21</var>    (b) Notwithstanding expungement by a court, the commissioner may consider <br/>
<a id="pl.181.22"></a><var>181.22</var>information obtained under paragraph (a), clauses (3) and (4), unless the commissioner <br/>
<a id="pl.181.23"></a><var>181.23</var>received notice of the petition for expungement and the court order for expungement is <br/>
<a id="pl.181.24"></a><var>181.24</var>directed specifically to the commissioner.<br/>
<a id="pl.181.25"></a><var>181.25</var>    (c) The commissioner shall also review criminal case information received according <br/>
<a id="pl.181.26"></a><var>181.26</var>to section 245C.04, subdivision 4a, from the Minnesota court information system that <br/>
<a id="pl.181.27"></a><var>181.27</var>relates to individuals who have already been studied under this chapter and who remain <br/>
<a id="pl.181.28"></a><var>181.28</var>affiliated with the agency that initiated the background study.<br/>
<br/>
<a id="bill.5.5.0"></a><a id="pl.181.29"></a><var>181.29</var>    Sec. 5. Minnesota Statutes 2012, section 245C.32, subdivision 2, is amended to read:<br/>
<a id="pl.181.30"></a><var>181.30</var>    Subd. 2. <b>Use.</b> (a) The commissioner may also use these systems and records to <br/>
<a id="pl.181.31"></a><var>181.31</var>obtain and provide criminal history data from the Bureau of Criminal Apprehension, <br/>
<a id="pl.181.32"></a><var>181.32</var>criminal history data held by the commissioner, and data about substantiated maltreatment <br/>
<a id="pl.181.33"></a><var>181.33</var>under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref>, for other purposes, provided that:<br/>
<a id="pl.181.34"></a><var>181.34</var>(1) the background study is specifically authorized in statute; or<br/>
<a id="pl.182.1"></a><var>182.1</var>(2) the request is made with the informed consent of the subject of the study as <br/>
<a id="pl.182.2"></a><var>182.2</var>provided in section 
         <statute_ref>13.05, subdivision 4</statute_ref>.<br/>
<a id="pl.182.3"></a><var>182.3</var>(b) An individual making a request under paragraph (a), clause (2), must agree in <br/>
<a id="pl.182.4"></a><var>182.4</var>writing not to disclose the data to any other individual without the consent of the subject <br/>
<a id="pl.182.5"></a><var>182.5</var>of the data.<br/>
<a id="pl.182.6"></a><var>182.6</var>(c) The commissioner may recover the cost of obtaining and providing background <br/>
<a id="pl.182.7"></a><var>182.7</var>study data by charging the individual or entity requesting the study a fee of no more <br/>
<a id="pl.182.8"></a><var>182.8</var>than $20 per study. The fees collected under this paragraph are appropriated to the <br/>
<a id="pl.182.9"></a><var>182.9</var>commissioner for the purpose of conducting background studies.<br/>
<a id="pl.182.10"></a><var>182.10</var>(d) The commissioner shall recover the cost of obtaining background study data <br/>
<a id="pl.182.11"></a><var>182.11</var>required under section 524.5-118 through a fee of $50 per study for an individual who <br/>
<a id="pl.182.12"></a><var>182.12</var>has not lived outside Minnesota for the past ten years, and a fee of $100 for an individual <br/>
<a id="pl.182.13"></a><var>182.13</var>who has resided outside of Minnesota for any period during the ten years preceding the <br/>
<a id="pl.182.14"></a><var>182.14</var>background study. The commissioner shall recover, from the individual, any additional <br/>
<a id="pl.182.15"></a><var>182.15</var>fees charged by other states' licensing agencies that are associated with these data requests. <br/>
<a id="pl.182.16"></a><var>182.16</var>Fees under subdivision 3 also apply when criminal history data from the National Criminal <br/>
<a id="pl.182.17"></a><var>182.17</var>Records Repository is required.<br/>
<br/>
<a id="bill.5.6.0"></a><a id="pl.182.18"></a><var>182.18</var>    Sec. 6. <b>[245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD </b><br/>
<a id="pl.182.19"></a><var>182.19</var><b>INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.</b><br/>
<a id="pl.182.20"></a><var>182.20</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the terms defined in this <br/>
<a id="pl.182.21"></a><var>182.21</var>subdivision have the meanings given them.<br/>
<a id="pl.182.22"></a><var>182.22</var>(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.<br/>
<a id="pl.182.23"></a><var>182.23</var>(c) "Child care assistance program" means any of the assistance programs under <br/>
<a id="pl.182.24"></a><var>182.24</var>chapter 119B.<br/>
<a id="pl.182.25"></a><var>182.25</var>(d) "Commissioner" means the commissioner of human services.<br/>
<a id="pl.182.26"></a><var>182.26</var>(e) "Controlling individual" has the meaning given in section 245A.02, subdivision <br/>
<a id="pl.182.27"></a><var>182.27</var>5a.<br/>
<a id="pl.182.28"></a><var>182.28</var>(f) "County" means a local county child care assistance program staff or <br/>
<a id="pl.182.29"></a><var>182.29</var>subcontracted staff, or a county investigator acting on behalf of the commissioner.<br/>
<a id="pl.182.30"></a><var>182.30</var>(g) "Department" means the Department of Human Services.<br/>
<a id="pl.182.31"></a><var>182.31</var>(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or <br/>
<a id="pl.182.32"></a><var>182.32</var>omissions that result in fraud and abuse or error against the Department of Human Services.<br/>
<a id="pl.182.33"></a><var>182.33</var>(i) "Identify" means to furnish the full name, current or last known address, phone <br/>
<a id="pl.182.34"></a><var>182.34</var>number, and e-mail address of the individual or business entity.<br/>
<a id="pl.182.35"></a><var>182.35</var>(j) "License holder" has the meaning given in section 245A.02, subdivision 9.<br/>
<a id="pl.183.1"></a><var>183.1</var>(k) "Mail" means the use of any mail service with proof of delivery and receipt.<br/>
<a id="pl.183.2"></a><var>183.2</var>(l) "Provider" means either a provider as defined in section 119B.011, subdivision <br/>
<a id="pl.183.3"></a><var>183.3</var>19, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.<br/>
<a id="pl.183.4"></a><var>183.4</var>(m) "Recipient" means a family receiving assistance as defined under section <br/>
<a id="pl.183.5"></a><var>183.5</var>119B.011, subdivision 13.<br/>
<a id="pl.183.6"></a><var>183.6</var>(n) "Terminate" means revocation of participation in the child care assistance <br/>
<a id="pl.183.7"></a><var>183.7</var>program.<br/>
<a id="pl.183.8"></a><var>183.8</var>    Subd. 2. <b>Investigating provider or recipient financial misconduct.</b> The <br/>
<a id="pl.183.9"></a><var>183.9</var>department shall investigate alleged or suspected financial misconduct by providers and <br/>
<a id="pl.183.10"></a><var>183.10</var>errors related to payments issued by the child care assistance program under this chapter. <br/>
<a id="pl.183.11"></a><var>183.11</var>Recipients, employees, and staff may be investigated when the evidence shows that their <br/>
<a id="pl.183.12"></a><var>183.12</var>conduct is related to the financial misconduct of a provider, license holder, or controlling <br/>
<a id="pl.183.13"></a><var>183.13</var>individual.<br/>
<a id="pl.183.14"></a><var>183.14</var>    Subd. 3. <b>Scope of investigations.</b> (a) The department may contact any person, <br/>
<a id="pl.183.15"></a><var>183.15</var>agency, organization, or other entity that is necessary to an investigation.<br/>
<a id="pl.183.16"></a><var>183.16</var>(b) The department may examine or interview any individual, document, or piece of <br/>
<a id="pl.183.17"></a><var>183.17</var>evidence that may lead to information that is relevant to child care assistance program <br/>
<a id="pl.183.18"></a><var>183.18</var>benefits, payments, and child care provider authorizations. This includes, but is not <br/>
<a id="pl.183.19"></a><var>183.19</var>limited to:<br/>
<a id="pl.183.20"></a><var>183.20</var>(1) child care assistance program payments;<br/>
<a id="pl.183.21"></a><var>183.21</var>(2) services provided by the program or related to child care assistance program <br/>
<a id="pl.183.22"></a><var>183.22</var>recipients;<br/>
<a id="pl.183.23"></a><var>183.23</var>(3) services provided to a provider;<br/>
<a id="pl.183.24"></a><var>183.24</var>(4) provider financial records of any type;<br/>
<a id="pl.183.25"></a><var>183.25</var>(5) daily attendance records of the children receiving services from the provider;<br/>
<a id="pl.183.26"></a><var>183.26</var>(6) billings; and<br/>
<a id="pl.183.27"></a><var>183.27</var>(7) verification of the credentials of a license holder, controlling individual, <br/>
<a id="pl.183.28"></a><var>183.28</var>employee, staff person, contractor, subcontractor, and entities under contract with the <br/>
<a id="pl.183.29"></a><var>183.29</var>provider to provide services or maintain service and the provider's financial records <br/>
<a id="pl.183.30"></a><var>183.30</var>related to those services.<br/>
<a id="pl.183.31"></a><var>183.31</var>    Subd. 4. <b>Determination of investigation.</b> After completing its investigation, the <br/>
<a id="pl.183.32"></a><var>183.32</var>department shall issue one of the following determinations:<br/>
<a id="pl.183.33"></a><var>183.33</var>(1) no violation of child care assistance requirements occurred;<br/>
<a id="pl.183.34"></a><var>183.34</var>(2) there is insufficient evidence to show that a violation of child care assistance <br/>
<a id="pl.183.35"></a><var>183.35</var>requirements occurred;<br/>
<a id="pl.184.1"></a><var>184.1</var>(3) a preponderance of evidence shows a violation of child care assistance program <br/>
<a id="pl.184.2"></a><var>184.2</var>law, rule, or policy; or<br/>
<a id="pl.184.3"></a><var>184.3</var>(4) there exists a credible allegation of fraud.<br/>
<a id="pl.184.4"></a><var>184.4</var>    Subd. 5. <b>Actions or administrative sanctions.</b> (a) In addition to section 256.98, <br/>
<a id="pl.184.5"></a><var>184.5</var>after completing the determination under subdivision 4, the department may take one or <br/>
<a id="pl.184.6"></a><var>184.6</var>more of the actions or sanctions specified in this subdivision.<br/>
<a id="pl.184.7"></a><var>184.7</var>(b) The department may take the following actions:<br/>
<a id="pl.184.8"></a><var>184.8</var>(1) refer the investigation to law enforcement or a county attorney for possible <br/>
<a id="pl.184.9"></a><var>184.9</var>criminal prosecution;<br/>
<a id="pl.184.10"></a><var>184.10</var>(2) refer relevant information to the department's licensing division, the child care <br/>
<a id="pl.184.11"></a><var>184.11</var>assistance program, the Department of Education, the federal child and adult care food <br/>
<a id="pl.184.12"></a><var>184.12</var>program, or appropriate child or adult protection agency;<br/>
<a id="pl.184.13"></a><var>184.13</var>(3) enter into a settlement agreement with a provider, license holder, controlling <br/>
<a id="pl.184.14"></a><var>184.14</var>individual, or recipient; or<br/>
<a id="pl.184.15"></a><var>184.15</var>(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction <br/>
<a id="pl.184.16"></a><var>184.16</var>for possible civil action under the Minnesota False Claims Act, chapter 15C.<br/>
<a id="pl.184.17"></a><var>184.17</var>(c) The department may impose sanctions by:<br/>
<a id="pl.184.18"></a><var>184.18</var>(1) pursuing administrative disqualification through hearings or waivers;<br/>
<a id="pl.184.19"></a><var>184.19</var>(2) establishing and seeking monetary recovery or recoupment; or <br/>
<a id="pl.184.20"></a><var>184.20</var>(3) issuing an order of corrective action that states the practices that are violations of <br/>
<a id="pl.184.21"></a><var>184.21</var>child care assistance program policies, laws, or regulations, and that they must be corrected.<br/>
<a id="pl.184.22"></a><var>184.22</var>    Subd. 6. <b>Duty to provide access.</b> (a) A provider, license holder, controlling <br/>
<a id="pl.184.23"></a><var>184.23</var>individual, employee, staff person, or recipient has an affirmative duty to provide access <br/>
<a id="pl.184.24"></a><var>184.24</var>upon request to information specified under subdivision 8 or the program facility.<br/>
<a id="pl.184.25"></a><var>184.25</var>(b) Failure to provide access may result in denial or termination of authorizations for <br/>
<a id="pl.184.26"></a><var>184.26</var>or payments to a recipient, provider, license holder, or controlling individual in the child <br/>
<a id="pl.184.27"></a><var>184.27</var>care assistance program.<br/>
<a id="pl.184.28"></a><var>184.28</var>(c) When a provider fails to provide access, a 15-day notice of denial or termination <br/>
<a id="pl.184.29"></a><var>184.29</var>must be issued to the provider, which prohibits the provider from participating in the child <br/>
<a id="pl.184.30"></a><var>184.30</var>care assistance program. Notice must be sent to recipients whose children are under the <br/>
<a id="pl.184.31"></a><var>184.31</var>provider's care pursuant to Minnesota Rules, part 3400.0185.<br/>
<a id="pl.184.32"></a><var>184.32</var>(d) If the provider continues to fail to provide access at the expiration of the 15-day <br/>
<a id="pl.184.33"></a><var>184.33</var>notice period, child care assistance program payments to the provider must be denied <br/>
<a id="pl.184.34"></a><var>184.34</var>beginning the 16th day following notice of the initial failure or refusal to provide access. <br/>
<a id="pl.184.35"></a><var>184.35</var>The department may rescind the denial based upon good cause if the provider submits in <br/>
<a id="pl.184.36"></a><var>184.36</var>writing a good cause basis for having failed or refused to provide access. The writing must <br/>
<a id="pl.185.1"></a><var>185.1</var>be postmarked no later than the 15th day following the provider's notice of initial failure <br/>
<a id="pl.185.2"></a><var>185.2</var>to provide access. Additionally, the provider, license holder, or controlling individual <br/>
<a id="pl.185.3"></a><var>185.3</var>must immediately provide complete, ongoing access to the department. Repeated failures <br/>
<a id="pl.185.4"></a><var>185.4</var>to provide access must, after the initial failure or for any subsequent failure, result in <br/>
<a id="pl.185.5"></a><var>185.5</var>termination from participation in the child care assistance program.<br/>
<a id="pl.185.6"></a><var>185.6</var>(e) The department, at its own expense, may photocopy or otherwise duplicate <br/>
<a id="pl.185.7"></a><var>185.7</var>records referenced in subdivision 8. Photocopying must be done on the provider's <br/>
<a id="pl.185.8"></a><var>185.8</var>premises on the day of the request or other mutually agreeable time, unless removal of <br/>
<a id="pl.185.9"></a><var>185.9</var>records is specifically permitted by the provider. If requested, a provider, license holder, <br/>
<a id="pl.185.10"></a><var>185.10</var>or controlling individual, or a designee, must assist the investigator in duplicating any <br/>
<a id="pl.185.11"></a><var>185.11</var>record, including a hard copy or electronically stored data, on the day of the request.<br/>
<a id="pl.185.12"></a><var>185.12</var>(f) A provider, license holder, controlling individual, employee, or staff person must <br/>
<a id="pl.185.13"></a><var>185.13</var>grant the department access during the department's normal business hours, and any hours <br/>
<a id="pl.185.14"></a><var>185.14</var>that the program is operated, to examine the provider's program or the records listed in <br/>
<a id="pl.185.15"></a><var>185.15</var>subdivision 8. A provider shall make records available at the provider's place of business <br/>
<a id="pl.185.16"></a><var>185.16</var>on the day for which access is requested, unless the provider and the department both agree <br/>
<a id="pl.185.17"></a><var>185.17</var>otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday <br/>
<a id="pl.185.18"></a><var>185.18</var>through Friday, excluding state holidays as defined in section 645.44, subdivision 5.<br/>
<a id="pl.185.19"></a><var>185.19</var>    Subd. 7. <b>Honest and truthful statements.</b> It shall be unlawful for a provider, <br/>
<a id="pl.185.20"></a><var>185.20</var>license holder, controlling individual, or recipient to:<br/>
<a id="pl.185.21"></a><var>185.21</var>(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;<br/>
<a id="pl.185.22"></a><var>185.22</var>(2) make any materially false, fictitious, or fraudulent statement or representation; or<br/>
<a id="pl.185.23"></a><var>185.23</var>(3) make or use any false writing or document knowing the same to contain any <br/>
<a id="pl.185.24"></a><var>185.24</var>materially false, fictitious, or fraudulent statement or entry related to any child care <br/>
<a id="pl.185.25"></a><var>185.25</var>assistance program services that the provider, license holder, or controlling individual <br/>
<a id="pl.185.26"></a><var>185.26</var>supplies or in relation to any child care assistance payments received by a provider, license <br/>
<a id="pl.185.27"></a><var>185.27</var>holder, or controlling individual or to any fraud investigator or law enforcement officer <br/>
<a id="pl.185.28"></a><var>185.28</var>conducting a financial misconduct investigation.<br/>
<a id="pl.185.29"></a><var>185.29</var>    Subd. 8. <b>Record retention.</b> (a) The following records must be maintained, <br/>
<a id="pl.185.30"></a><var>185.30</var>controlled, and made immediately accessible to license holders, providers, and controlling <br/>
<a id="pl.185.31"></a><var>185.31</var>individuals. The records must be organized and labeled to correspond to categories that <br/>
<a id="pl.185.32"></a><var>185.32</var>make them easy to identify so that they can be made available immediately upon request <br/>
<a id="pl.185.33"></a><var>185.33</var>to an investigator acting on behalf of the commissioner at the provider's place of business:<br/>
<a id="pl.185.34"></a><var>185.34</var>(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting <br/>
<a id="pl.185.35"></a><var>185.35</var>records;<br/>
<a id="pl.186.1"></a><var>186.1</var>(2) daily attendance records required by and that comply with section 119B.125, <br/>
<a id="pl.186.2"></a><var>186.2</var>subdivision 6;<br/>
<a id="pl.186.3"></a><var>186.3</var>(3) billing transmittal forms requesting payments from the child care assistance <br/>
<a id="pl.186.4"></a><var>186.4</var>program and billing adjustments related to child care assistance program payments;<br/>
<a id="pl.186.5"></a><var>186.5</var>(4) records identifying all persons, corporations, partnerships, and entities with an <br/>
<a id="pl.186.6"></a><var>186.6</var>ownership or controlling interest in the provider's child care business;<br/>
<a id="pl.186.7"></a><var>186.7</var>(5) employee records identifying those persons currently employed by the provider's <br/>
<a id="pl.186.8"></a><var>186.8</var>child care business or who have been employed by the business at any time within the <br/>
<a id="pl.186.9"></a><var>186.9</var>previous five years. The records must include each employee's name, hourly and annual <br/>
<a id="pl.186.10"></a><var>186.10</var>salary, qualifications, position description, job title, and dates of employment. In addition, <br/>
<a id="pl.186.11"></a><var>186.11</var>employee records that must be made available include the employee's time sheets, current <br/>
<a id="pl.186.12"></a><var>186.12</var>home address of the employee or last known address of any former employee, and <br/>
<a id="pl.186.13"></a><var>186.13</var>documentation of background studies required under chapter 119B or 245C;<br/>
<a id="pl.186.14"></a><var>186.14</var>(6) records related to transportation of children in care, including but not limited to:<br/>
<a id="pl.186.15"></a><var>186.15</var>(i) the dates and times that transportation is provided to children for transportation to <br/>
<a id="pl.186.16"></a><var>186.16</var>and from the provider's business location for any purpose. For transportation related to <br/>
<a id="pl.186.17"></a><var>186.17</var>field trips or locations away from the provider's business location, the names and addresses <br/>
<a id="pl.186.18"></a><var>186.18</var>of those field trips and locations must also be provided;<br/>
<a id="pl.186.19"></a><var>186.19</var>(ii) the name, business address, phone number, and Web site address, if any, of the <br/>
<a id="pl.186.20"></a><var>186.20</var>transportation service utilized; and<br/>
<a id="pl.186.21"></a><var>186.21</var>(iii) all billing or transportation records related to the transportation.<br/>
<a id="pl.186.22"></a><var>186.22</var>(b) A provider, license holder, or controlling individual must retain all records <br/>
<a id="pl.186.23"></a><var>186.23</var>in paragraph (a) for at least six years after the date the record is created. Microfilm or <br/>
<a id="pl.186.24"></a><var>186.24</var>electronically stored records satisfy the record keeping requirements of this subdivision.<br/>
<a id="pl.186.25"></a><var>186.25</var>(c) A provider, license holder, or controlling individual who withdraws or is <br/>
<a id="pl.186.26"></a><var>186.26</var>terminated from the child care assistance program must retain the records required under <br/>
<a id="pl.186.27"></a><var>186.27</var>this subdivision and make them available to the department on demand.<br/>
<a id="pl.186.28"></a><var>186.28</var>(d) If the ownership of a provider changes, the transferor, unless otherwise provided <br/>
<a id="pl.186.29"></a><var>186.29</var>by law or by written agreement with the transferee, is responsible for maintaining, <br/>
<a id="pl.186.30"></a><var>186.30</var>preserving, and upon request from the department, making available the records related to <br/>
<a id="pl.186.31"></a><var>186.31</var>the provider that were generated before the date of the transfer. Any written agreement <br/>
<a id="pl.186.32"></a><var>186.32</var>affecting this provision must be held in the possession of the transferor and transferee. <br/>
<a id="pl.186.33"></a><var>186.33</var>The written agreement must be provided to the department or county immediately upon <br/>
<a id="pl.186.34"></a><var>186.34</var>request, and the written agreement must be retained by the transferor and transferee for six <br/>
<a id="pl.186.35"></a><var>186.35</var>years after the agreement is fully executed.<br/>
<a id="pl.187.1"></a><var>187.1</var>(e) In the event of an appealed case, the provider must retain all records required in <br/>
<a id="pl.187.2"></a><var>187.2</var>this subdivision for the duration of the appeal or six years, whichever is longer.<br/>
<a id="pl.187.3"></a><var>187.3</var>(f) A provider's use of electronic record keeping or electronic signatures is governed <br/>
<a id="pl.187.4"></a><var>187.4</var>by chapter 325L.<br/>
<a id="pl.187.5"></a><var>187.5</var>    Subd. 9. <b>Factors regarding imposition of administrative sanctions.</b> (a) The <br/>
<a id="pl.187.6"></a><var>187.6</var>department shall consider the following factors in determining the administrative sanctions <br/>
<a id="pl.187.7"></a><var>187.7</var>to be imposed:<br/>
<a id="pl.187.8"></a><var>187.8</var>(1) nature and extent of financial misconduct;<br/>
<a id="pl.187.9"></a><var>187.9</var>(2) history of financial misconduct;<br/>
<a id="pl.187.10"></a><var>187.10</var>(3) actions taken or recommended by other state agencies, other divisions of the <br/>
<a id="pl.187.11"></a><var>187.11</var>department, and court and administrative decisions;<br/>
<a id="pl.187.12"></a><var>187.12</var>(4) prior imposition of sanctions;<br/>
<a id="pl.187.13"></a><var>187.13</var>(5) size and type of provider;<br/>
<a id="pl.187.14"></a><var>187.14</var>(6) information obtained through an investigation from any source;<br/>
<a id="pl.187.15"></a><var>187.15</var>(7) convictions or pending criminal charges; and<br/>
<a id="pl.187.16"></a><var>187.16</var>(8) any other information relevant to the acts or omissions related to the financial <br/>
<a id="pl.187.17"></a><var>187.17</var>misconduct.<br/>
<a id="pl.187.18"></a><var>187.18</var>(b) Any single factor under paragraph (a) may be determinative of the department's <br/>
<a id="pl.187.19"></a><var>187.19</var>decision of whether and what sanctions are imposed.<br/>
<a id="pl.187.20"></a><var>187.20</var>    Subd. 10. <b>Written notice of department sanction.</b> (a) The department shall give <br/>
<a id="pl.187.21"></a><var>187.21</var>notice in writing to a person of an administrative sanction that is to be imposed. The notice <br/>
<a id="pl.187.22"></a><var>187.22</var>shall be sent by mail as defined in subdivision 1, paragraph (k).<br/>
<a id="pl.187.23"></a><var>187.23</var>(b) The notice shall state:<br/>
<a id="pl.187.24"></a><var>187.24</var>(1) the factual basis for the department's determination;<br/>
<a id="pl.187.25"></a><var>187.25</var>(2) the sanction the department intends to take;<br/>
<a id="pl.187.26"></a><var>187.26</var>(3) the dollar amount of the monetary recovery or recoupment, if any;<br/>
<a id="pl.187.27"></a><var>187.27</var>(4) how the dollar amount was computed;<br/>
<a id="pl.187.28"></a><var>187.28</var>(5) the right to dispute the department's determination and to provide evidence;<br/>
<a id="pl.187.29"></a><var>187.29</var>(6) the right to appeal the department's proposed sanction; and<br/>
<a id="pl.187.30"></a><var>187.30</var>(7) the option to meet informally with department staff, and to bring additional <br/>
<a id="pl.187.31"></a><var>187.31</var>documentation or information, to resolve the issues.<br/>
<a id="pl.187.32"></a><var>187.32</var>(c) In cases of determinations resulting in denial or termination of payments, in <br/>
<a id="pl.187.33"></a><var>187.33</var>addition to the requirements of paragraph (b), the notice must state:<br/>
<a id="pl.187.34"></a><var>187.34</var>(1) the length of the denial or termination;<br/>
<a id="pl.187.35"></a><var>187.35</var>(2) the requirements and procedures for reinstatement; and<br/>
<a id="pl.188.1"></a><var>188.1</var>(3) the provider's right to submit documents and written arguments against the <br/>
<a id="pl.188.2"></a><var>188.2</var>denial or termination of payments for review by the department before the effective date <br/>
<a id="pl.188.3"></a><var>188.3</var>of denial or termination.<br/>
<a id="pl.188.4"></a><var>188.4</var>(d) The submission of documents and written argument for review by the department <br/>
<a id="pl.188.5"></a><var>188.5</var>under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the <br/>
<a id="pl.188.6"></a><var>188.6</var>deadline for filing an appeal.<br/>
<a id="pl.188.7"></a><var>188.7</var>(e) Unless timely appealed, the effective date of the proposed sanction shall be 30 <br/>
<a id="pl.188.8"></a><var>188.8</var>days after the license holder's, provider's, controlling individual's, or recipient's receipt of <br/>
<a id="pl.188.9"></a><var>188.9</var>the notice. If a timely appeal is made, the proposed sanction shall be delayed pending <br/>
<a id="pl.188.10"></a><var>188.10</var>the final outcome of the appeal. Implementation of a proposed sanction following the <br/>
<a id="pl.188.11"></a><var>188.11</var>resolution of a timely appeal may be postponed if, in the opinion of the department, the <br/>
<a id="pl.188.12"></a><var>188.12</var>delay of sanction is necessary to protect the health or safety of children in care. The <br/>
<a id="pl.188.13"></a><var>188.13</var>department may consider the economic hardship of a person in implementing the proposed <br/>
<a id="pl.188.14"></a><var>188.14</var>sanction, but economic hardship shall not be a determinative factor in implementing the <br/>
<a id="pl.188.15"></a><var>188.15</var>proposed sanction.<br/>
<a id="pl.188.16"></a><var>188.16</var>(f) Requests for an informal meeting to attempt to resolve issues and requests <br/>
<a id="pl.188.17"></a><var>188.17</var>for appeals must be sent or delivered to the department's Office of Inspector General, <br/>
<a id="pl.188.18"></a><var>188.18</var>Financial Fraud and Abuse Division.<br/>
<a id="pl.188.19"></a><var>188.19</var>    Subd. 11. <b>Appeal of department sanction under this section.</b> (a) If the department <br/>
<a id="pl.188.20"></a><var>188.20</var>does not pursue a criminal action against a provider, license holder, controlling individual, <br/>
<a id="pl.188.21"></a><var>188.21</var>or recipient for financial misconduct, but the department imposes an administrative <br/>
<a id="pl.188.22"></a><var>188.22</var>sanction, any individual or entity against whom the sanction was imposed may appeal the <br/>
<a id="pl.188.23"></a><var>188.23</var>department's administrative sanction under this section pursuant to section 119B.16 or <br/>
<a id="pl.188.24"></a><var>188.24</var>256.045 with the additional requirements in clauses (1) to (4). An appeal must specify:<br/>
<a id="pl.188.25"></a><var>188.25</var>(1) each disputed item, the reason for the dispute, and an estimate of the dollar <br/>
<a id="pl.188.26"></a><var>188.26</var>amount involved for each disputed item, if appropriate;<br/>
<a id="pl.188.27"></a><var>188.27</var>(2) the computation that is believed to be correct, if appropriate;<br/>
<a id="pl.188.28"></a><var>188.28</var>(3) the authority in the statute or rule relied upon for each disputed item; and<br/>
<a id="pl.188.29"></a><var>188.29</var>(4) the name, address, and phone number of the person at the provider's place of <br/>
<a id="pl.188.30"></a><var>188.30</var>business with whom contact may be made regarding the appeal.<br/>
<a id="pl.188.31"></a><var>188.31</var>(b) An appeal is considered timely only if postmarked or received by the <br/>
<a id="pl.188.32"></a><var>188.32</var>department's Office of Inspector General, Financial Fraud and Abuse Division within 30 <br/>
<a id="pl.188.33"></a><var>188.33</var>days after receiving a notice of department sanction.<br/>
<a id="pl.188.34"></a><var>188.34</var>(c) Before the appeal hearing, the department may deny or terminate authorizations <br/>
<a id="pl.188.35"></a><var>188.35</var>or payment to the entity or individual if the department determines that the action is <br/>
<a id="pl.188.36"></a><var>188.36</var>necessary to protect the public welfare or the interests of the child care assistance program.<br/>
<a id="pl.189.1"></a><var>189.1</var>    Subd. 12. <b>Consolidated hearings with licensing sanction.</b> If a financial <br/>
<a id="pl.189.2"></a><var>189.2</var>misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing <br/>
<a id="pl.189.3"></a><var>189.3</var>sanction exists for which there is an appeal hearing right and the sanction is timely <br/>
<a id="pl.189.4"></a><var>189.4</var>appealed, and the overpayment recovery action and licensing sanction involve the same <br/>
<a id="pl.189.5"></a><var>189.5</var>set of facts, the overpayment recovery action and licensing sanction must be consolidated <br/>
<a id="pl.189.6"></a><var>189.6</var>in the contested case hearing related to the licensing sanction.<br/>
<a id="pl.189.7"></a><var>189.7</var>    Subd. 13. <b>Grounds for and methods of monetary recovery.</b> (a) The department <br/>
<a id="pl.189.8"></a><var>189.8</var>may obtain monetary recovery from a provider who has been improperly paid by the <br/>
<a id="pl.189.9"></a><var>189.9</var>child care assistance program, regardless of whether the error was intentional or county <br/>
<a id="pl.189.10"></a><var>189.10</var>error. The department does not need to establish a pattern as a precondition of monetary <br/>
<a id="pl.189.11"></a><var>189.11</var>recovery of erroneous or false billing claims, duplicate billing claims, or billing claims <br/>
<a id="pl.189.12"></a><var>189.12</var>based on false statements or financial misconduct.<br/>
<a id="pl.189.13"></a><var>189.13</var>(b) The department shall obtain monetary recovery from providers by the following <br/>
<a id="pl.189.14"></a><var>189.14</var>means:<br/>
<a id="pl.189.15"></a><var>189.15</var>(1) permitting voluntary repayment of money, either in lump-sum payment or <br/>
<a id="pl.189.16"></a><var>189.16</var>installment payments;<br/>
<a id="pl.189.17"></a><var>189.17</var>(2) using any legal collection process;<br/>
<a id="pl.189.18"></a><var>189.18</var>(3) deducting or withholding program payments; or<br/>
<a id="pl.189.19"></a><var>189.19</var>(4) utilizing the means set forth in chapter 16D.<br/>
<a id="pl.189.20"></a><var>189.20</var>    Subd. 14. <b>Reporting of suspected fraudulent activity.</b> (a) A person who, in <br/>
<a id="pl.189.21"></a><var>189.21</var>good faith, makes a report of or testifies in any action or proceeding in which financial <br/>
<a id="pl.189.22"></a><var>189.22</var>misconduct is alleged, and who is not involved in, has not participated in, or has not aided <br/>
<a id="pl.189.23"></a><var>189.23</var>and abetted, conspired, or colluded in the financial misconduct, shall have immunity from <br/>
<a id="pl.189.24"></a><var>189.24</var>any liability, civil or criminal, that results by reason of the person's report or testimony. <br/>
<a id="pl.189.25"></a><var>189.25</var>For the purpose of any proceeding, the good faith of any person reporting or testifying <br/>
<a id="pl.189.26"></a><var>189.26</var>under this provision shall be presumed.<br/>
<a id="pl.189.27"></a><var>189.27</var>(b) If a person that is or has been involved in, participated in, aided and abetted, <br/>
<a id="pl.189.28"></a><var>189.28</var>conspired, or colluded in the financial misconduct reports the financial misconduct, <br/>
<a id="pl.189.29"></a><var>189.29</var>the department may consider that person's report and assistance in investigating the <br/>
<a id="pl.189.30"></a><var>189.30</var>misconduct as a mitigating factor in the department's pursuit of civil, criminal, or <br/>
<a id="pl.189.31"></a><var>189.31</var>administrative remedies.<br/>
<a id="pl.189.32"></a><var>189.32</var>    Subd. 15. <b>Data privacy.</b> Data of any kind obtained or created in relation to a provider <br/>
<a id="pl.189.33"></a><var>189.33</var>or recipient investigation under this section is defined, classified, and protected the same as <br/>
<a id="pl.189.34"></a><var>189.34</var>all other data under section 13.46, and this data has the same classification as licensing data.<br/>
<a id="pl.189.35"></a><var>189.35</var>    Subd. 16. <b>Monetary recovery; random sample extrapolation.</b> The department is <br/>
<a id="pl.189.36"></a><var>189.36</var>authorized to calculate the amount of monetary recovery from a provider, license holder, or <br/>
<a id="pl.190.1"></a><var>190.1</var>controlling individual based upon extrapolation from a statistical random sample of claims <br/>
<a id="pl.190.2"></a><var>190.2</var>submitted by the provider, license holder, or controlling individual and paid by the child <br/>
<a id="pl.190.3"></a><var>190.3</var>care assistance program. The department's random sample extrapolation shall constitute a <br/>
<a id="pl.190.4"></a><var>190.4</var>rebuttable presumption of the accuracy of the calculation of monetary recovery. If the <br/>
<a id="pl.190.5"></a><var>190.5</var>presumption is not rebutted by the provider, license holder, or controlling individual in the <br/>
<a id="pl.190.6"></a><var>190.6</var>appeal process, the department shall use the extrapolation as the monetary recovery figure. <br/>
<a id="pl.190.7"></a><var>190.7</var>The department may use sampling and extrapolation to calculate the amount of monetary <br/>
<a id="pl.190.8"></a><var>190.8</var>recovery if the claims to be reviewed represent services to 50 or more children in care.<br/>
<a id="pl.190.9"></a><var>190.9</var>    Subd. 17. <b>Effect of department's monetary penalty determination.</b> Unless <br/>
<a id="pl.190.10"></a><var>190.10</var>a timely and proper appeal is received by the department's Office of Inspector General, <br/>
<a id="pl.190.11"></a><var>190.11</var>Financial Fraud and Abuse Division, the department's administrative determination or <br/>
<a id="pl.190.12"></a><var>190.12</var>sanction shall be considered a final department determination.<br/>
<a id="pl.190.13"></a><var>190.13</var>    Subd. 18. <b>Office of Inspector General recoveries.</b> Overpayment recoveries <br/>
<a id="pl.190.14"></a><var>190.14</var>resulting from child care provider fraud investigations initiated by the department's Office <br/>
<a id="pl.190.15"></a><var>190.15</var>of Inspector General's fraud investigations staff are excluded from the county recovery <br/>
<a id="pl.190.16"></a><var>190.16</var>provision in section 119B.11, subdivision 3.<br/>
<br/>
<a id="bill.5.7.0"></a><a id="pl.190.17"></a><var>190.17</var>    Sec. 7. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:<br/>
<a id="pl.190.18"></a><var>190.18</var>    Subd. 21. <b>Provider enrollment.</b> (a) If the commissioner or the Centers for <br/>
<a id="pl.190.19"></a><var>190.19</var>Medicare and Medicaid Services determines that a provider is designated "high-risk," the <br/>
<a id="pl.190.20"></a><var>190.20</var>commissioner may withhold payment from providers within that category upon initial <br/>
<a id="pl.190.21"></a><var>190.21</var>enrollment for a 90-day period. The withholding for each provider must begin on the date <br/>
<a id="pl.190.22"></a><var>190.22</var>of the first submission of a claim.<br/>
<a id="pl.190.23"></a><var>190.23</var>(b) An enrolled provider that is also licensed by the commissioner under chapter <br/>
<a id="pl.190.24"></a><var>190.24</var>245A must designate an individual as the entity's compliance officer. The compliance <br/>
<a id="pl.190.25"></a><var>190.25</var>officer must:<br/>
<a id="pl.190.26"></a><var>190.26</var>(1) develop policies and procedures to assure adherence to medical assistance laws <br/>
<a id="pl.190.27"></a><var>190.27</var>and regulations and to prevent inappropriate claims submissions;<br/>
<a id="pl.190.28"></a><var>190.28</var>(2) train the employees of the provider entity, and any agents or subcontractors of <br/>
<a id="pl.190.29"></a><var>190.29</var>the provider entity including billers, on the policies and procedures under clause (1);<br/>
<a id="pl.190.30"></a><var>190.30</var>(3) respond to allegations of improper conduct related to the provision or billing of <br/>
<a id="pl.190.31"></a><var>190.31</var>medical assistance services, and implement action to remediate any resulting problems;<br/>
<a id="pl.190.32"></a><var>190.32</var>(4) use evaluation techniques to monitor compliance with medical assistance laws <br/>
<a id="pl.190.33"></a><var>190.33</var>and regulations;<br/>
<a id="pl.190.34"></a><var>190.34</var>(5) promptly report to the commissioner any identified violations of medical <br/>
<a id="pl.190.35"></a><var>190.35</var>assistance laws or regulations; and<br/>
<a id="pl.191.1"></a><var>191.1</var>    (6) within 60 days of discovery by the provider of a medical assistance <br/>
<a id="pl.191.2"></a><var>191.2</var>reimbursement overpayment, report the overpayment to the commissioner and make <br/>
<a id="pl.191.3"></a><var>191.3</var>arrangements with the commissioner for the commissioner's recovery of the overpayment.<br/>
<a id="pl.191.4"></a><var>191.4</var>The commissioner may require, as a condition of enrollment in medical assistance, that a <br/>
<a id="pl.191.5"></a><var>191.5</var>provider within a particular industry sector or category establish a compliance program that <br/>
<a id="pl.191.6"></a><var>191.6</var>contains the core elements established by the Centers for Medicare and Medicaid Services.<br/>
<a id="pl.191.7"></a><var>191.7</var>(c) The commissioner may revoke the enrollment of an ordering or rendering <br/>
<a id="pl.191.8"></a><var>191.8</var>provider for a period of not more than one year, if the provider fails to maintain and, upon <br/>
<a id="pl.191.9"></a><var>191.9</var>request from the commissioner, provide access to documentation relating to written orders <br/>
<a id="pl.191.10"></a><var>191.10</var>or requests for payment for durable medical equipment, certifications for home health <br/>
<a id="pl.191.11"></a><var>191.11</var>services, or referrals for other items or services written or ordered by such provider, when <br/>
<a id="pl.191.12"></a><var>191.12</var>the commissioner has identified a pattern of a lack of documentation. A pattern means a <br/>
<a id="pl.191.13"></a><var>191.13</var>failure to maintain documentation or provide access to documentation on more than one <br/>
<a id="pl.191.14"></a><var>191.14</var>occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a <br/>
<a id="pl.191.15"></a><var>191.15</var>provider under the provisions of section 
         <statute_ref>256B.064</statute_ref>.<br/>
<a id="pl.191.16"></a><var>191.16</var>(d) The commissioner shall terminate or deny the enrollment of any individual or <br/>
<a id="pl.191.17"></a><var>191.17</var>entity if the individual or entity has been terminated from participation in Medicare or <br/>
<a id="pl.191.18"></a><var>191.18</var>under the Medicaid program or Children's Health Insurance Program of any other state.<br/>
<a id="pl.191.19"></a><var>191.19</var>(e) As a condition of enrollment in medical assistance, the commissioner shall <br/>
<a id="pl.191.20"></a><var>191.20</var>require that a provider designated "moderate" or "high-risk" by the Centers for Medicare <br/>
<a id="pl.191.21"></a><var>191.21</var>and Medicaid Services or the Minnesota Department of Human Services commissioner<br/>
<a id="pl.191.22"></a><var>191.22</var> permit the Centers for Medicare and Medicaid Services, its agents, or its designated <br/>
<a id="pl.191.23"></a><var>191.23</var>contractors and the state agency, its agents, or its designated contractors to conduct <br/>
<a id="pl.191.24"></a><var>191.24</var>unannounced on-site inspections of any provider location. The commissioner shall publish <br/>
<a id="pl.191.25"></a><var>191.25</var>in the Minnesota Health Care Program Provider Manual a list of provider types designated <br/>
<a id="pl.191.26"></a><var>191.26</var>"limited," "moderate," or "high-risk," based on the criteria and standards used to designate <br/>
<a id="pl.191.27"></a><var>191.27</var>Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and <br/>
<a id="pl.191.28"></a><var>191.28</var>criteria are not subject to the requirements of chapter 14. The commissioner's designations <br/>
<a id="pl.191.29"></a><var>191.29</var>are not subject to administrative appeal.<br/>
<a id="pl.191.30"></a><var>191.30</var>(f) As a condition of enrollment in medical assistance, the commissioner shall <br/>
<a id="pl.191.31"></a><var>191.31</var>require that a high-risk provider, or a person with a direct or indirect ownership interest in <br/>
<a id="pl.191.32"></a><var>191.32</var>the provider of five percent or higher, consent to criminal background checks, including <br/>
<a id="pl.191.33"></a><var>191.33</var>fingerprinting, when required to do so under state law or by a determination by the <br/>
<a id="pl.191.34"></a><var>191.34</var>commissioner or the Centers for Medicare and Medicaid Services that a provider is <br/>
<a id="pl.191.35"></a><var>191.35</var>designated high-risk for fraud, waste, or abuse.<br/>
<a id="pl.192.1"></a><var>192.1</var>(g) As a condition of enrollment, all durable medical equipment, prosthetics, <br/>
<a id="pl.192.2"></a><var>192.2</var>orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name <br/>
<a id="pl.192.3"></a><var>192.3</var>the Department of Human Services, in addition to the Centers for Medicare and Medicaid <br/>
<a id="pl.192.4"></a><var>192.4</var>Services, as an obligee on all surety performance bonds required pursuant to section <br/>
<a id="pl.192.5"></a><var>192.5</var>4312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social <br/>
<a id="pl.192.6"></a><var>192.6</var>Security Act, section 1834(a). The performance bond must also allow for recovery of <br/>
<a id="pl.192.7"></a><var>192.7</var>costs and fees in pursuing a claim on the bond.<br/>
<a id="pl.192.8"></a><var>192.8</var>(h) The Department of Human Services may require a provider to purchase a <br/>
<a id="pl.192.9"></a><var>192.9</var>performance surety bond as a condition of initial enrollment, reenrollment, reinstatement, <br/>
<a id="pl.192.10"></a><var>192.10</var>or continued enrollment if: (1) the provider fails to demonstrate financial viability; (2) the <br/>
<a id="pl.192.11"></a><var>192.11</var>department determines there is significant evidence of or potential for fraud and abuse <br/>
<a id="pl.192.12"></a><var>192.12</var>by the provider; or (3) the provider or category of providers is designated high-risk <br/>
<a id="pl.192.13"></a><var>192.13</var>pursuant to paragraph (a) and Code of Federal Regulations, title 42, section 455.450, or <br/>
<a id="pl.192.14"></a><var>192.14</var>the department otherwise finds it is in the best interest of the Medicaid program to do so. <br/>
<a id="pl.192.15"></a><var>192.15</var>The performance bond must be in an amount of $100,000 or ten percent of the provider's <br/>
<a id="pl.192.16"></a><var>192.16</var>payments from Medicaid during the immediately preceding 12 months, whichever is <br/>
<a id="pl.192.17"></a><var>192.17</var>greater. The performance bond must name the Department of Human Services as an <br/>
<a id="pl.192.18"></a><var>192.18</var>obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.<br/>
<a id="pl.192.19"></a><var>192.19</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.8.0"></a><a id="pl.192.20"></a><var>192.20</var>    Sec. 8. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision <br/>
<a id="pl.192.21"></a><var>192.21</var>to read:<br/>
<a id="pl.192.22"></a><var>192.22</var>    Subd. 22. <b>Application fee.</b> (a) The commissioner must collect and retain federally <br/>
<a id="pl.192.23"></a><var>192.23</var>required nonrefundable application fees to pay for provider screening activities in <br/>
<a id="pl.192.24"></a><var>192.24</var>accordance with Code of Federal Regulations, title 42, section 455, subpart E. The <br/>
<a id="pl.192.25"></a><var>192.25</var>enrollment application must be made under the procedures specified by the commissioner, <br/>
<a id="pl.192.26"></a><var>192.26</var>in the form specified by the commissioner, and accompanied by an application fee <br/>
<a id="pl.192.27"></a><var>192.27</var>described in paragraph (b), or a request for a hardship exception as described in the <br/>
<a id="pl.192.28"></a><var>192.28</var>specified procedures. Application fees must be deposited in the provider screening account <br/>
<a id="pl.192.29"></a><var>192.29</var>in the special revenue fund. Amounts in the provider screening account are appropriated <br/>
<a id="pl.192.30"></a><var>192.30</var>to the commissioner for costs associated with the provider screening activities required <br/>
<a id="pl.192.31"></a><var>192.31</var>in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner <br/>
<a id="pl.192.32"></a><var>192.32</var>shall conduct screening activities as required by Code of Federal Regulations, title 42, <br/>
<a id="pl.192.33"></a><var>192.33</var>section 455, subpart E, and as otherwise provided by law, to include database checks, <br/>
<a id="pl.192.34"></a><var>192.34</var>unannounced pre- and postenrollment site visits, fingerprinting, and criminal background <br/>
<a id="pl.193.1"></a><var>193.1</var>studies. The commissioner must revalidate all providers under this subdivision at least <br/>
<a id="pl.193.2"></a><var>193.2</var>once every five years.<br/>
<a id="pl.193.3"></a><var>193.3</var>(b) The application fee under this subdivision is $532 for the calendar year 2013. <br/>
<a id="pl.193.4"></a><var>193.4</var>For calendar year 2014 and subsequent years, the fee:<br/>
<a id="pl.193.5"></a><var>193.5</var>(1) is adjusted by the percentage change to the consumer price index for all urban <br/>
<a id="pl.193.6"></a><var>193.6</var>consumers, United States city average, for the 12-month period ending with June of the <br/>
<a id="pl.193.7"></a><var>193.7</var>previous year. The resulting fee must be announced in the Federal Register;<br/>
<a id="pl.193.8"></a><var>193.8</var>(2) is effective from January 1 to December 31 of a calendar year;<br/>
<a id="pl.193.9"></a><var>193.9</var>(3) is required on the submission of an initial application, an application to establish <br/>
<a id="pl.193.10"></a><var>193.10</var>a new practice location, an application for reenrollment when the provider is not enrolled <br/>
<a id="pl.193.11"></a><var>193.11</var>at the time of application of reenrollment, or at revalidation when required by federal <br/>
<a id="pl.193.12"></a><var>193.12</var>regulation; and<br/>
<a id="pl.193.13"></a><var>193.13</var>(4) must be in the amount in effect for the calendar year during which the application <br/>
<a id="pl.193.14"></a><var>193.14</var>for enrollment, new practice location, or reenrollment is being submitted.<br/>
<a id="pl.193.15"></a><var>193.15</var>(c) The application fee under this subdivision cannot be charged to:<br/>
<a id="pl.193.16"></a><var>193.16</var>(1) providers who are enrolled in Medicare or who provide documentation of <br/>
<a id="pl.193.17"></a><var>193.17</var>payment of the fee to, and enrollment with, another state;<br/>
<a id="pl.193.18"></a><var>193.18</var>(2) providers who are enrolled but are required to submit new applications for <br/>
<a id="pl.193.19"></a><var>193.19</var>purposes of reenrollment; or<br/>
<a id="pl.193.20"></a><var>193.20</var>(3) a provider who enrolls as an individual.<br/>
<a id="pl.193.21"></a><var>193.21</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.9.0"></a><a id="pl.193.22"></a><var>193.22</var>    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:<br/>
<a id="pl.193.23"></a><var>193.23</var>    Subd. 1a. <b>Grounds for sanctions against vendors.</b> The commissioner may <br/>
<a id="pl.193.24"></a><var>193.24</var>impose sanctions against a vendor of medical care for any of the following: (1) fraud, <br/>
<a id="pl.193.25"></a><var>193.25</var>theft, or abuse in connection with the provision of medical care to recipients of public <br/>
<a id="pl.193.26"></a><var>193.26</var>assistance; (2) a pattern of presentment of false or duplicate claims or claims for services <br/>
<a id="pl.193.27"></a><var>193.27</var>not medically necessary; (3) a pattern of making false statements of material facts for <br/>
<a id="pl.193.28"></a><var>193.28</var>the purpose of obtaining greater compensation than that to which the vendor is legally <br/>
<a id="pl.193.29"></a><var>193.29</var>entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state <br/>
<a id="pl.193.30"></a><var>193.30</var>agency access during regular business hours to examine all records necessary to disclose <br/>
<a id="pl.193.31"></a><var>193.31</var>the extent of services provided to program recipients and appropriateness of claims for <br/>
<a id="pl.193.32"></a><var>193.32</var>payment; (6) failure to repay an overpayment or a fine finally established under this <br/>
<a id="pl.193.33"></a><var>193.33</var>section; and (7) failure to correct errors in the maintenance of health service or financial <br/>
<a id="pl.193.34"></a><var>193.34</var>records for which a fine was imposed or after issuance of a warning by the commissioner; <br/>
<a id="pl.193.35"></a><var>193.35</var>and (8) any reason for which a vendor could be excluded from participation in the <br/>
<a id="pl.194.1"></a><var>194.1</var>Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act. <br/>
<a id="pl.194.2"></a><var>194.2</var>The determination of services not medically necessary may be made by the commissioner <br/>
<a id="pl.194.3"></a><var>194.3</var>in consultation with a peer advisory task force appointed by the commissioner on the <br/>
<a id="pl.194.4"></a><var>194.4</var>recommendation of appropriate professional organizations. The task force expires as <br/>
<a id="pl.194.5"></a><var>194.5</var>provided in section 
         <statute_ref>15.059, subdivision 5</statute_ref>.<br/>
<br/>
<a id="bill.5.10.0"></a><a id="pl.194.6"></a><var>194.6</var>    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:<br/>
<a id="pl.194.7"></a><var>194.7</var>    Subd. 1b. <b>Sanctions available.</b> The commissioner may impose the following <br/>
<a id="pl.194.8"></a><var>194.8</var>sanctions for the conduct described in subdivision 1a: suspension or withholding of <br/>
<a id="pl.194.9"></a><var>194.9</var>payments to a vendor and suspending or terminating participation in the program, or <br/>
<a id="pl.194.10"></a><var>194.10</var>imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under <br/>
<a id="pl.194.11"></a><var>194.11</var>this section, the commissioner shall consider the nature, chronicity, or severity of the <br/>
<a id="pl.194.12"></a><var>194.12</var>conduct and the effect of the conduct on the health and safety of persons served by the <br/>
<a id="pl.194.13"></a><var>194.13</var>vendor. Regardless of imposition of sanctions, the commissioner may make a referral <br/>
<a id="pl.194.14"></a><var>194.14</var>to the appropriate state licensing board.<br/>
<br/>
<a id="bill.5.11.0"></a><a id="pl.194.15"></a><var>194.15</var>    Sec. 11. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:<br/>
<a id="pl.194.16"></a><var>194.16</var>    Subd. 2. <b>Imposition of monetary recovery and sanctions.</b> (a) The commissioner <br/>
<a id="pl.194.17"></a><var>194.17</var>shall determine any monetary amounts to be recovered and sanctions to be imposed upon <br/>
<a id="pl.194.18"></a><var>194.18</var>a vendor of medical care under this section. Except as provided in paragraphs (b) and <br/>
<a id="pl.194.19"></a><var>194.19</var>(d), neither a monetary recovery nor a sanction will be imposed by the commissioner <br/>
<a id="pl.194.20"></a><var>194.20</var>without prior notice and an opportunity for a hearing, according to chapter 14, on the <br/>
<a id="pl.194.21"></a><var>194.21</var>commissioner's proposed action, provided that the commissioner may suspend or reduce <br/>
<a id="pl.194.22"></a><var>194.22</var>payment to a vendor of medical care, except a nursing home or convalescent care facility, <br/>
<a id="pl.194.23"></a><var>194.23</var>after notice and prior to the hearing if in the commissioner's opinion that action is <br/>
<a id="pl.194.24"></a><var>194.24</var>necessary to protect the public welfare and the interests of the program.<br/>
<a id="pl.194.25"></a><var>194.25</var>(b) Except when the commissioner finds good cause not to suspend payments under <br/>
<a id="pl.194.26"></a><var>194.26</var>Code of Federal Regulations, title 42, section 
         <statute_ref>455.23 </statute_ref>(e) or (f), the commissioner shall <br/>
<a id="pl.194.27"></a><var>194.27</var>withhold or reduce payments to a vendor of medical care without providing advance <br/>
<a id="pl.194.28"></a><var>194.28</var>notice of such withholding or reduction if either of the following occurs:<br/>
<a id="pl.194.29"></a><var>194.29</var>(1) the vendor is convicted of a crime involving the conduct described in subdivision <br/>
<a id="pl.194.30"></a><var>194.30</var>1a; or<br/>
<a id="pl.194.31"></a><var>194.31</var>(2) the commissioner determines there is a credible allegation of fraud for which an <br/>
<a id="pl.194.32"></a><var>194.32</var>investigation is pending under the program. A credible allegation of fraud is an allegation <br/>
<a id="pl.194.33"></a><var>194.33</var>which has been verified by the state, from any source, including but not limited to:<br/>
<a id="pl.194.34"></a><var>194.34</var>(i) fraud hotline complaints;<br/>
<a id="pl.195.1"></a><var>195.1</var>(ii) claims data mining; and<br/>
<a id="pl.195.2"></a><var>195.2</var>(iii) patterns identified through provider audits, civil false claims cases, and law <br/>
<a id="pl.195.3"></a><var>195.3</var>enforcement investigations.<br/>
<a id="pl.195.4"></a><var>195.4</var>Allegations are considered to be credible when they have an indicia of reliability <br/>
<a id="pl.195.5"></a><var>195.5</var>and the state agency has reviewed all allegations, facts, and evidence carefully and acts <br/>
<a id="pl.195.6"></a><var>195.6</var>judiciously on a case-by-case basis.<br/>
<a id="pl.195.7"></a><var>195.7</var>(c) The commissioner must send notice of the withholding or reduction of payments <br/>
<a id="pl.195.8"></a><var>195.8</var>under paragraph (b) within five days of taking such action unless requested in writing by a <br/>
<a id="pl.195.9"></a><var>195.9</var>law enforcement agency to temporarily withhold the notice. The notice must:<br/>
<a id="pl.195.10"></a><var>195.10</var>(1) state that payments are being withheld according to paragraph (b);<br/>
<a id="pl.195.11"></a><var>195.11</var>(2) set forth the general allegations as to the nature of the withholding action, but <br/>
<a id="pl.195.12"></a><var>195.12</var>need not disclose any specific information concerning an ongoing investigation;<br/>
<a id="pl.195.13"></a><var>195.13</var>(3) except in the case of a conviction for conduct described in subdivision 1a, state <br/>
<a id="pl.195.14"></a><var>195.14</var>that the withholding is for a temporary period and cite the circumstances under which <br/>
<a id="pl.195.15"></a><var>195.15</var>withholding will be terminated;<br/>
<a id="pl.195.16"></a><var>195.16</var>(4) identify the types of claims to which the withholding applies; and<br/>
<a id="pl.195.17"></a><var>195.17</var>(5) inform the vendor of the right to submit written evidence for consideration by <br/>
<a id="pl.195.18"></a><var>195.18</var>the commissioner.<br/>
<a id="pl.195.19"></a><var>195.19</var>The withholding or reduction of payments will not continue after the commissioner <br/>
<a id="pl.195.20"></a><var>195.20</var>determines there is insufficient evidence of fraud by the vendor, or after legal proceedings <br/>
<a id="pl.195.21"></a><var>195.21</var>relating to the alleged fraud are completed, unless the commissioner has sent notice of <br/>
<a id="pl.195.22"></a><var>195.22</var>intention to impose monetary recovery or sanctions under paragraph (a).<br/>
<a id="pl.195.23"></a><var>195.23</var>(d) The commissioner shall suspend or terminate a vendor's participation in the <br/>
<a id="pl.195.24"></a><var>195.24</var>program without providing advance notice and an opportunity for a hearing when the <br/>
<a id="pl.195.25"></a><var>195.25</var>suspension or termination is required because of the vendor's exclusion from participation <br/>
<a id="pl.195.26"></a><var>195.26</var>in Medicare. Within five days of taking such action, the commissioner must send notice of <br/>
<a id="pl.195.27"></a><var>195.27</var>the suspension or termination. The notice must:<br/>
<a id="pl.195.28"></a><var>195.28</var>(1) state that suspension or termination is the result of the vendor's exclusion from <br/>
<a id="pl.195.29"></a><var>195.29</var>Medicare;<br/>
<a id="pl.195.30"></a><var>195.30</var>(2) identify the effective date of the suspension or termination; and<br/>
<a id="pl.195.31"></a><var>195.31</var>(3) inform the vendor of the need to be reinstated to Medicare before reapplying <br/>
<a id="pl.195.32"></a><var>195.32</var>for participation in the program.<br/>
<a id="pl.195.33"></a><var>195.33</var>(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or <br/>
<a id="pl.195.34"></a><var>195.34</var>sanction is to be imposed, a vendor may request a contested case, as defined in section <br/>
<statute_ref><a id="pl.195.35"></a><var>195.35</var>14.02, subdivision 3
         </statute_ref>, by filing with the commissioner a written request of appeal. The <br/>
<a id="pl.195.36"></a><var>195.36</var>appeal request must be received by the commissioner no later than 30 days after the date <br/>
<a id="pl.196.1"></a><var>196.1</var>the notification of monetary recovery or sanction was mailed to the vendor. The appeal <br/>
<a id="pl.196.2"></a><var>196.2</var>request must specify:<br/>
<a id="pl.196.3"></a><var>196.3</var>(1) each disputed item, the reason for the dispute, and an estimate of the dollar <br/>
<a id="pl.196.4"></a><var>196.4</var>amount involved for each disputed item;<br/>
<a id="pl.196.5"></a><var>196.5</var>(2) the computation that the vendor believes is correct;<br/>
<a id="pl.196.6"></a><var>196.6</var>(3) the authority in statute or rule upon which the vendor relies for each disputed item;<br/>
<a id="pl.196.7"></a><var>196.7</var>(4) the name and address of the person or entity with whom contacts may be made <br/>
<a id="pl.196.8"></a><var>196.8</var>regarding the appeal; and<br/>
<a id="pl.196.9"></a><var>196.9</var>(5) other information required by the commissioner.<br/>
<a id="pl.196.10"></a><var>196.10</var>(f) The commissioner may order a vendor to forfeit a fine for failure to fully document <br/>
<a id="pl.196.11"></a><var>196.11</var>services according to standards in this chapter and Minnesota Rules, chapter 9505. The <br/>
<a id="pl.196.12"></a><var>196.12</var>commissioner may assess fines if specific required components of documentation are <br/>
<a id="pl.196.13"></a><var>196.13</var>missing. The fine for incomplete documentation shall equal 20 percent of the amount paid <br/>
<a id="pl.196.14"></a><var>196.14</var>on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.<br/>
<a id="pl.196.15"></a><var>196.15</var>(g) The vendor shall pay the fine assessed on or before the payment date specified. If <br/>
<a id="pl.196.16"></a><var>196.16</var>the vendor fails to pay the fine, the commissioner may withhold or reduce payments and <br/>
<a id="pl.196.17"></a><var>196.17</var>recover the amount of the fine. A timely appeal shall stay payment of the fine until the <br/>
<a id="pl.196.18"></a><var>196.18</var>commissioner issues a final order.<br/>
<br/>
<a id="bill.5.12.0"></a><a id="pl.196.19"></a><var>196.19</var>    Sec. 12. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to <br/>
<a id="pl.196.20"></a><var>196.20</var>read:<br/>
<a id="pl.196.21"></a><var>196.21</var>    Subd. 21. <b>Requirements for initial enrollment of personal care assistance </b><br/>
<a id="pl.196.22"></a><var>196.22</var><b>provider agencies.</b> (a) All personal care assistance provider agencies must provide, at the <br/>
<a id="pl.196.23"></a><var>196.23</var>time of enrollment as a personal care assistance provider agency in a format determined <br/>
<a id="pl.196.24"></a><var>196.24</var>by the commissioner, information and documentation that includes, but is not limited to, <br/>
<a id="pl.196.25"></a><var>196.25</var>the following:<br/>
<a id="pl.196.26"></a><var>196.26</var>    (1) the personal care assistance provider agency's current contact information <br/>
<a id="pl.196.27"></a><var>196.27</var>including address, telephone number, and e-mail address;<br/>
<a id="pl.196.28"></a><var>196.28</var>    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent <br/>
<a id="pl.196.29"></a><var>196.29</var>of the provider's payments from Medicaid in the previous year, whichever is less more. <br/>
<a id="pl.196.30"></a><var>196.30</var>The performance bond must be in a form approved by the commissioner, must be renewed <br/>
<a id="pl.196.31"></a><var>196.31</var>annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;<br/>
<a id="pl.196.32"></a><var>196.32</var>    (3) proof of fidelity bond coverage in the amount of $20,000;<br/>
<a id="pl.196.33"></a><var>196.33</var>    (4) proof of workers' compensation insurance coverage;<br/>
<a id="pl.196.34"></a><var>196.34</var>    (5) proof of liability insurance;<br/>
<a id="pl.197.1"></a><var>197.1</var>    (6) a description of the personal care assistance provider agency's organization <br/>
<a id="pl.197.2"></a><var>197.2</var>identifying the names of all owners, managing employees, staff, board of directors, and <br/>
<a id="pl.197.3"></a><var>197.3</var>the affiliations of the directors, owners, or staff to other service providers;<br/>
<a id="pl.197.4"></a><var>197.4</var>    (7) a copy of the personal care assistance provider agency's written policies and <br/>
<a id="pl.197.5"></a><var>197.5</var>procedures including: hiring of employees; training requirements; service delivery; <br/>
<a id="pl.197.6"></a><var>197.6</var>and employee and consumer safety including process for notification and resolution <br/>
<a id="pl.197.7"></a><var>197.7</var>of consumer grievances, identification and prevention of communicable diseases, and <br/>
<a id="pl.197.8"></a><var>197.8</var>employee misconduct;<br/>
<a id="pl.197.9"></a><var>197.9</var>    (8) copies of all other forms the personal care assistance provider agency uses in <br/>
<a id="pl.197.10"></a><var>197.10</var>the course of daily business including, but not limited to:<br/>
<a id="pl.197.11"></a><var>197.11</var>    (i) a copy of the personal care assistance provider agency's time sheet if the time <br/>
<a id="pl.197.12"></a><var>197.12</var>sheet varies from the standard time sheet for personal care assistance services approved <br/>
<a id="pl.197.13"></a><var>197.13</var>by the commissioner, and a letter requesting approval of the personal care assistance <br/>
<a id="pl.197.14"></a><var>197.14</var>provider agency's nonstandard time sheet;<br/>
<a id="pl.197.15"></a><var>197.15</var>    (ii) the personal care assistance provider agency's template for the personal care <br/>
<a id="pl.197.16"></a><var>197.16</var>assistance care plan; and<br/>
<a id="pl.197.17"></a><var>197.17</var>    (iii) the personal care assistance provider agency's template for the written <br/>
<a id="pl.197.18"></a><var>197.18</var>agreement in subdivision 20 for recipients using the personal care assistance choice <br/>
<a id="pl.197.19"></a><var>197.19</var>option, if applicable;<br/>
<a id="pl.197.20"></a><var>197.20</var>    (9) a list of all training and classes that the personal care assistance provider agency <br/>
<a id="pl.197.21"></a><var>197.21</var>requires of its staff providing personal care assistance services;<br/>
<a id="pl.197.22"></a><var>197.22</var>    (10) documentation that the personal care assistance provider agency and staff have <br/>
<a id="pl.197.23"></a><var>197.23</var>successfully completed all the training required by this section;<br/>
<a id="pl.197.24"></a><var>197.24</var>    (11) documentation of the agency's marketing practices;<br/>
<a id="pl.197.25"></a><var>197.25</var>    (12) disclosure of ownership, leasing, or management of all residential properties <br/>
<a id="pl.197.26"></a><var>197.26</var>that is used or could be used for providing home care services;<br/>
<a id="pl.197.27"></a><var>197.27</var>    (13) documentation that the agency will use the following percentages of revenue <br/>
<a id="pl.197.28"></a><var>197.28</var>generated from the medical assistance rate paid for personal care assistance services <br/>
<a id="pl.197.29"></a><var>197.29</var>for employee personal care assistant wages and benefits: 72.5 percent of revenue in the <br/>
<a id="pl.197.30"></a><var>197.30</var>personal care assistance choice option and 72.5 percent of revenue from other personal <br/>
<a id="pl.197.31"></a><var>197.31</var>care assistance providers. The revenue generated by the qualified professional and the <br/>
<a id="pl.197.32"></a><var>197.32</var>reasonable costs associated with the qualified professional shall not be used in making <br/>
<a id="pl.197.33"></a><var>197.33</var>this calculation; and<br/>
<a id="pl.197.34"></a><var>197.34</var>    (14) effective May 15, 2010, documentation that the agency does not burden <br/>
<a id="pl.197.35"></a><var>197.35</var>recipients' free exercise of their right to choose service providers by requiring personal <br/>
<a id="pl.197.36"></a><var>197.36</var>care assistants to sign an agreement not to work with any particular personal care <br/>
<a id="pl.198.1"></a><var>198.1</var>assistance recipient or for another personal care assistance provider agency after leaving <br/>
<a id="pl.198.2"></a><var>198.2</var>the agency and that the agency is not taking action on any such agreements or requirements <br/>
<a id="pl.198.3"></a><var>198.3</var>regardless of the date signed.<br/>
<a id="pl.198.4"></a><var>198.4</var>    (b) Personal care assistance provider agencies shall provide the information specified <br/>
<a id="pl.198.5"></a><var>198.5</var>in paragraph (a) to the commissioner at the time the personal care assistance provider <br/>
<a id="pl.198.6"></a><var>198.6</var>agency enrolls as a vendor or upon request from the commissioner. The commissioner <br/>
<a id="pl.198.7"></a><var>198.7</var>shall collect the information specified in paragraph (a) from all personal care assistance <br/>
<a id="pl.198.8"></a><var>198.8</var>providers beginning July 1, 2009.<br/>
<a id="pl.198.9"></a><var>198.9</var>    (c) All personal care assistance provider agencies shall require all employees in <br/>
<a id="pl.198.10"></a><var>198.10</var>management and supervisory positions and owners of the agency who are active in the <br/>
<a id="pl.198.11"></a><var>198.11</var>day-to-day management and operations of the agency to complete mandatory training <br/>
<a id="pl.198.12"></a><var>198.12</var>as determined by the commissioner before enrollment of the agency as a provider. <br/>
<a id="pl.198.13"></a><var>198.13</var>Employees in management and supervisory positions and owners who are active in <br/>
<a id="pl.198.14"></a><var>198.14</var>the day-to-day operations of an agency who have completed the required training as <br/>
<a id="pl.198.15"></a><var>198.15</var>an employee with a personal care assistance provider agency do not need to repeat <br/>
<a id="pl.198.16"></a><var>198.16</var>the required training if they are hired by another agency, if they have completed the <br/>
<a id="pl.198.17"></a><var>198.17</var>training within the past three years. By September 1, 2010, the required training must <br/>
<a id="pl.198.18"></a><var>198.18</var>be available with meaningful access according to title VI of the Civil Rights Act and <br/>
<a id="pl.198.19"></a><var>198.19</var>federal regulations adopted under that law or any guidance from the United States Health <br/>
<a id="pl.198.20"></a><var>198.20</var>and Human Services Department. The required training must be available online or by <br/>
<a id="pl.198.21"></a><var>198.21</var>electronic remote connection. The required training must provide for competency testing. <br/>
<a id="pl.198.22"></a><var>198.22</var>Personal care assistance provider agency billing staff shall complete training about <br/>
<a id="pl.198.23"></a><var>198.23</var>personal care assistance program financial management. This training is effective July 1, <br/>
<a id="pl.198.24"></a><var>198.24</var>2009. Any personal care assistance provider agency enrolled before that date shall, if it <br/>
<a id="pl.198.25"></a><var>198.25</var>has not already, complete the provider training within 18 months of July 1, 2009. Any new <br/>
<a id="pl.198.26"></a><var>198.26</var>owners or employees in management and supervisory positions involved in the day-to-day <br/>
<a id="pl.198.27"></a><var>198.27</var>operations are required to complete mandatory training as a requisite of working for the <br/>
<a id="pl.198.28"></a><var>198.28</var>agency. Personal care assistance provider agencies certified for participation in Medicare <br/>
<a id="pl.198.29"></a><var>198.29</var>as home health agencies are exempt from the training required in this subdivision. When <br/>
<a id="pl.198.30"></a><var>198.30</var>available, Medicare-certified home health agency owners, supervisors, or managers must <br/>
<a id="pl.198.31"></a><var>198.31</var>successfully complete the competency test.<br/>
<a id="pl.198.32"></a><var>198.32</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.5.13.0"></a><a id="pl.198.33"></a><var>198.33</var>    Sec. 13. Minnesota Statutes 2012, section 299C.093, is amended to read:<br/>
<a id="pl.198.34"></a><var>198.34</var><b>299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.</b><br/>
<a id="pl.199.1"></a><var>199.1</var>The superintendent of the Bureau of Criminal Apprehension shall maintain a <br/>
<a id="pl.199.2"></a><var>199.2</var>computerized data system relating to individuals required to register as predatory offenders <br/>
<a id="pl.199.3"></a><var>199.3</var>under section 
         <statute_ref>243.166</statute_ref>. To the degree feasible, the system must include the data required <br/>
<a id="pl.199.4"></a><var>199.4</var>to be provided under section 
         <statute_ref>243.166</statute_ref>, subdivisions 4 and 4a, and indicate the time period <br/>
<a id="pl.199.5"></a><var>199.5</var>that the person is required to register. The superintendent shall maintain this data in a <br/>
<a id="pl.199.6"></a><var>199.6</var>manner that ensures that it is readily available to law enforcement agencies. This data is <br/>
<a id="pl.199.7"></a><var>199.7</var>private data on individuals under section 
         <statute_ref>13.02, subdivision 12</statute_ref>, but may be used for law <br/>
<a id="pl.199.8"></a><var>199.8</var>enforcement and corrections purposes. The commissioner of human services has access <br/>
<a id="pl.199.9"></a><var>199.9</var>to the data for state-operated services, as defined in section 
         <statute_ref>246.014</statute_ref>, are also authorized <br/>
<a id="pl.199.10"></a><var>199.10</var>to have access to the data for the purposes described in section 
         <statute_ref>246.13, subdivision 2</statute_ref>, <br/>
<a id="pl.199.11"></a><var>199.11</var>paragraph (b), and for purposes of conducting background studies under chapter 245C.<br/>
<br/>
<a id="bill.5.14.0"></a><a id="pl.199.12"></a><var>199.12</var>    Sec. 14. Minnesota Statutes 2012, section 524.5-118, subdivision 1, is amended to read:<br/>
<a id="pl.199.13"></a><var>199.13</var>    Subdivision 1. <b>When required; exception.</b> (a) The court shall require a background <br/>
<a id="pl.199.14"></a><var>199.14</var>study under this section:<br/>
<a id="pl.199.15"></a><var>199.15</var>(1) before the appointment of a guardian or conservator, unless a background study <br/>
<a id="pl.199.16"></a><var>199.16</var>has been done on the person under this section within the previous five two years; and<br/>
<a id="pl.199.17"></a><var>199.17</var>(2) once every five two years after the appointment, if the person continues to serve <br/>
<a id="pl.199.18"></a><var>199.18</var>as a guardian or conservator.<br/>
<a id="pl.199.19"></a><var>199.19</var>(b) The background study must include:<br/>
<a id="pl.199.20"></a><var>199.20</var>(1) criminal history data from the Bureau of Criminal Apprehension, other criminal <br/>
<a id="pl.199.21"></a><var>199.21</var>history data held by the commissioner of human services, and data regarding whether the <br/>
<a id="pl.199.22"></a><var>199.22</var>person has been a perpetrator of substantiated maltreatment of a vulnerable adult and a<br/>
<a id="pl.199.23"></a><var>199.23</var> or minor.;<br/>
<a id="pl.199.24"></a><var>199.24</var>(c) The court shall request a search of the (2) criminal history data from the National <br/>
<a id="pl.199.25"></a><var>199.25</var>Criminal Records Repository if the proposed guardian or conservator has not resided in <br/>
<a id="pl.199.26"></a><var>199.26</var>Minnesota for the previous five ten years or if the Bureau of Criminal Apprehension <br/>
<a id="pl.199.27"></a><var>199.27</var>information received from the commissioner of human services under subdivision 2, <br/>
<a id="pl.199.28"></a><var>199.28</var>paragraph (b), indicates that the subject is a multistate offender or that the individual's <br/>
<a id="pl.199.29"></a><var>199.29</var>multistate offender status is undetermined.; and<br/>
<a id="pl.199.30"></a><var>199.30</var>(3) state licensing agency data if a search of the database or databases of the agencies <br/>
<a id="pl.199.31"></a><var>199.31</var>listed in subdivision 2a shows that the proposed guardian or conservator has ever held a <br/>
<a id="pl.199.32"></a><var>199.32</var>professional license directly related to the responsibilities of a professional fiduciary from <br/>
<a id="pl.199.33"></a><var>199.33</var>an agency listed in subdivision 2a that was conditioned, suspended, revoked, or canceled.<br/>
<a id="pl.199.34"></a><var>199.34</var>(d) (c) If the guardian or conservator is not an individual, the background study must <br/>
<a id="pl.199.35"></a><var>199.35</var>be done on all individuals currently employed by the proposed guardian or conservator <br/>
<a id="pl.200.1"></a><var>200.1</var>who will be responsible for exercising powers and duties under the guardianship or <br/>
<a id="pl.200.2"></a><var>200.2</var>conservatorship.<br/>
<a id="pl.200.3"></a><var>200.3</var>(e) (d) If the court determines that it would be in the best interests of the ward or <br/>
<a id="pl.200.4"></a><var>200.4</var>protected person to appoint a guardian or conservator before the background study can <br/>
<a id="pl.200.5"></a><var>200.5</var>be completed, the court may make the appointment pending the results of the study, <br/>
<a id="pl.200.6"></a><var>200.6</var>however, the background study must then be completed as soon as reasonably possible <br/>
<a id="pl.200.7"></a><var>200.7</var>after appointment, no later than 30 days after appointment.<br/>
<a id="pl.200.8"></a><var>200.8</var>(f) (e) The fee for conducting a background study for appointment of a professional <br/>
<a id="pl.200.9"></a><var>200.9</var>guardian or conservator must be paid by the guardian or conservator. In other cases, <br/>
<a id="pl.200.10"></a><var>200.10</var>the fee must be paid as follows:<br/>
<a id="pl.200.11"></a><var>200.11</var>(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes <br/>
<a id="pl.200.12"></a><var>200.12</var>of section 
         <statute_ref>524.5-502, paragraph (a)</statute_ref>;<br/>
<a id="pl.200.13"></a><var>200.13</var>(2) if there is an estate of the ward or protected person, the fee must be paid from <br/>
<a id="pl.200.14"></a><var>200.14</var>the estate; or<br/>
<a id="pl.200.15"></a><var>200.15</var>(3) in the case of a guardianship or conservatorship of the person that is not <br/>
<a id="pl.200.16"></a><var>200.16</var>proceeding in forma pauperis, the court may order that the fee be paid by the guardian or <br/>
<a id="pl.200.17"></a><var>200.17</var>conservator or by the court.<br/>
<a id="pl.200.18"></a><var>200.18</var>(g) (f) The requirements of this subdivision do not apply if the guardian or <br/>
<a id="pl.200.19"></a><var>200.19</var>conservator is:<br/>
<a id="pl.200.20"></a><var>200.20</var>(1) a state agency or county;<br/>
<a id="pl.200.21"></a><var>200.21</var>(2) a parent or guardian of a proposed ward or protected person who has a <br/>
<a id="pl.200.22"></a><var>200.22</var>developmental disability, if the parent or guardian has raised the proposed ward or <br/>
<a id="pl.200.23"></a><var>200.23</var>protected person in the family home until the time the petition is filed, unless counsel <br/>
<a id="pl.200.24"></a><var>200.24</var>appointed for the proposed ward or protected person under section 
         <statute_ref>524.5-205, paragraph <br/>
<a id="pl.200.25"></a><var>200.25</var>(d)
         </statute_ref>; 
         <statute_ref>524.5-304, paragraph (b)</statute_ref>; 
         <statute_ref>524.5-405, paragraph (a)</statute_ref>; or 
         <statute_ref>524.5-406, paragraph (b)</statute_ref>, <br/>
<a id="pl.200.26"></a><var>200.26</var>recommends a background study; or<br/>
<a id="pl.200.27"></a><var>200.27</var>(3) a bank with trust powers, bank and trust company, or trust company, organized <br/>
<a id="pl.200.28"></a><var>200.28</var>under the laws of any state or of the United States and which is regulated by the <br/>
<a id="pl.200.29"></a><var>200.29</var>commissioner of commerce or a federal regulator.<br/>
<br/>
<a id="bill.5.15.0"></a><a id="pl.200.30"></a><var>200.30</var>    Sec. 15. Minnesota Statutes 2012, section 524.5-118, is amended by adding a <br/>
<a id="pl.200.31"></a><var>200.31</var>subdivision to read:<br/>
<a id="pl.200.32"></a><var>200.32</var>    Subd. 2a. <b>Procedure; state licensing agency data.</b> (a) The court shall request the <br/>
<a id="pl.200.33"></a><var>200.33</var>commissioner of human services to provide the court within 25 working days of receipt of <br/>
<a id="pl.200.34"></a><var>200.34</var>the request with licensing agency data for licenses directly related to the responsibilities of <br/>
<a id="pl.200.35"></a><var>200.35</var>a professional fiduciary from the following agencies in Minnesota:<br/>
<a id="pl.201.1"></a><var>201.1</var>(1) Lawyers Responsibility Board;<br/>
<a id="pl.201.2"></a><var>201.2</var>(2) State Board of Accountancy;<br/>
<a id="pl.201.3"></a><var>201.3</var>(3) Board of Social Work;<br/>
<a id="pl.201.4"></a><var>201.4</var>(4) Board of Psychology;<br/>
<a id="pl.201.5"></a><var>201.5</var>(5) Board of Nursing;<br/>
<a id="pl.201.6"></a><var>201.6</var>(6) Board of Medical Practice;<br/>
<a id="pl.201.7"></a><var>201.7</var>(7) Department of Education;<br/>
<a id="pl.201.8"></a><var>201.8</var>(8) Department of Commerce;<br/>
<a id="pl.201.9"></a><var>201.9</var>(9) Board of Chiropractic Examiners;<br/>
<a id="pl.201.10"></a><var>201.10</var>(10) Board of Dentistry;<br/>
<a id="pl.201.11"></a><var>201.11</var>(11) Board of Marriage and Family Therapy;<br/>
<a id="pl.201.12"></a><var>201.12</var>(12) Department of Human Services; and<br/>
<a id="pl.201.13"></a><var>201.13</var>(13) Peace Officer Standards and Training (POST) Board.<br/>
<a id="pl.201.14"></a><var>201.14</var>(b) The commissioner shall enter into agreements with these agencies to provide for <br/>
<a id="pl.201.15"></a><var>201.15</var>electronic access to the relevant licensing data by the commissioner.<br/>
<a id="pl.201.16"></a><var>201.16</var>(c) The commissioner shall provide to the court the electronically available data <br/>
<a id="pl.201.17"></a><var>201.17</var>maintained in the agency's database, including whether the proposed guardian or <br/>
<a id="pl.201.18"></a><var>201.18</var>conservator is or has been licensed by the agency, and if the licensing agency database <br/>
<a id="pl.201.19"></a><var>201.19</var>indicates a disciplinary action or a sanction against the individual's license, including a <br/>
<a id="pl.201.20"></a><var>201.20</var>condition, suspension, revocation, or cancellation.<br/>
<a id="pl.201.21"></a><var>201.21</var>(d) If the proposed guardian or conservator has resided in a state other than <br/>
<a id="pl.201.22"></a><var>201.22</var>Minnesota in the previous ten years, licensing agency data under this section shall also <br/>
<a id="pl.201.23"></a><var>201.23</var>include the licensing agency data from any other state where the proposed guardian or <br/>
<a id="pl.201.24"></a><var>201.24</var>conservator reported to have resided during the previous ten years. If the proposed <br/>
<a id="pl.201.25"></a><var>201.25</var>guardian or conservator has or has had a professional license in another state that is <br/>
<a id="pl.201.26"></a><var>201.26</var>directly related to the responsibilities of a professional fiduciary from one of the agencies <br/>
<a id="pl.201.27"></a><var>201.27</var>listed under paragraph (a), state licensing agency data shall also include data from the <br/>
<a id="pl.201.28"></a><var>201.28</var>relevant licensing agency of that state.<br/>
<a id="pl.201.29"></a><var>201.29</var>(e) The commissioner is not required to repeat a search for Minnesota or out-of-state <br/>
<a id="pl.201.30"></a><var>201.30</var>licensing data on an individual if the commissioner has provided this information to the <br/>
<a id="pl.201.31"></a><var>201.31</var>court within the prior two years.<br/>
<a id="pl.201.32"></a><var>201.32</var>(f) If an individual has continuously resided in Minnesota since a previous <br/>
<a id="pl.201.33"></a><var>201.33</var>background study under this section was completed, the commissioner is not required to <br/>
<a id="pl.201.34"></a><var>201.34</var>repeat a search for records in another state.<br/>
<br/>
<a id="bill.5.16.0"></a><a id="pl.202.1"></a><var>202.1</var>    Sec. 16. Minnesota Statutes 2012, section 524.5-303, is amended to read:<br/>
<a id="pl.202.2"></a><var>202.2</var><b>524.5-303 JUDICIAL APPOINTMENT OF GUARDIAN: PETITION.</b><br/>
<a id="pl.202.3"></a><var>202.3</var>(a) An individual or a person interested in the individual's welfare may petition for <br/>
<a id="pl.202.4"></a><var>202.4</var>a determination of incapacity, in whole or in part, and for the appointment of a limited <br/>
<a id="pl.202.5"></a><var>202.5</var>or unlimited guardian for the individual.<br/>
<a id="pl.202.6"></a><var>202.6</var>(b) The petition must set forth the petitioner's name, residence, current address if <br/>
<a id="pl.202.7"></a><var>202.7</var>different, relationship to the respondent, and interest in the appointment and, to the extent <br/>
<a id="pl.202.8"></a><var>202.8</var>known, state or contain the following with respect to the respondent and the relief requested:<br/>
<a id="pl.202.9"></a><var>202.9</var>(1) the respondent's name, age, principal residence, current street address, and, if <br/>
<a id="pl.202.10"></a><var>202.10</var>different, the address of the dwelling in which it is proposed that the respondent will <br/>
<a id="pl.202.11"></a><var>202.11</var>reside if the appointment is made;<br/>
<a id="pl.202.12"></a><var>202.12</var>(2) the name and address of the respondent's:<br/>
<a id="pl.202.13"></a><var>202.13</var>(i) spouse, or if the respondent has none, an adult with whom the respondent has <br/>
<a id="pl.202.14"></a><var>202.14</var>resided for more than six months before the filing of the petition; and<br/>
<a id="pl.202.15"></a><var>202.15</var>(ii) adult children or, if the respondent has none, the respondent's parents and adult <br/>
<a id="pl.202.16"></a><var>202.16</var>brothers and sisters, or if the respondent has none, at least one of the adults nearest in <br/>
<a id="pl.202.17"></a><var>202.17</var>kinship to the respondent who can be found;<br/>
<a id="pl.202.18"></a><var>202.18</var>(3) the name of the administrative head and address of the institution where the <br/>
<a id="pl.202.19"></a><var>202.19</var>respondent is a patient, resident, or client of any hospital, nursing home, home care <br/>
<a id="pl.202.20"></a><var>202.20</var>agency, or other institution;<br/>
<a id="pl.202.21"></a><var>202.21</var>(4) the name and address of any legal representative for the respondent;<br/>
<a id="pl.202.22"></a><var>202.22</var>(5) the name, address, and telephone number of any person nominated as guardian <br/>
<a id="pl.202.23"></a><var>202.23</var>by the respondent in any manner permitted by law, including a health care agent nominated <br/>
<a id="pl.202.24"></a><var>202.24</var>in a health care directive;<br/>
<a id="pl.202.25"></a><var>202.25</var>(6) the name, address, and telephone number of any proposed guardian and the <br/>
<a id="pl.202.26"></a><var>202.26</var>reason why the proposed guardian should be selected;<br/>
<a id="pl.202.27"></a><var>202.27</var>(7) the name and address of any health care agent or proxy appointed pursuant to <br/>
<a id="pl.202.28"></a><var>202.28</var>a health care directive as defined in section 
         <statute_ref>145C.01</statute_ref>, a living will under chapter 145B, <br/>
<a id="pl.202.29"></a><var>202.29</var>or other similar document executed in another state and enforceable under the laws of <br/>
<a id="pl.202.30"></a><var>202.30</var>this state;<br/>
<a id="pl.202.31"></a><var>202.31</var>(8) the reason why guardianship is necessary, including a brief description of the <br/>
<a id="pl.202.32"></a><var>202.32</var>nature and extent of the respondent's alleged incapacity;<br/>
<a id="pl.202.33"></a><var>202.33</var>(9) if an unlimited guardianship is requested, the reason why limited guardianship <br/>
<a id="pl.202.34"></a><var>202.34</var>is inappropriate and, if a limited guardianship is requested, the powers to be granted to <br/>
<a id="pl.202.35"></a><var>202.35</var>the limited guardian; and<br/>
<a id="pl.203.1"></a><var>203.1</var>(10) a general statement of the respondent's property with an estimate of its value, <br/>
<a id="pl.203.2"></a><var>203.2</var>including any insurance or pension, and the source and amount of any other anticipated <br/>
<a id="pl.203.3"></a><var>203.3</var>income or receipts.<br/>
<a id="pl.203.4"></a><var>203.4</var>(c) The petition must also set forth the following information regarding the proposed <br/>
<a id="pl.203.5"></a><var>203.5</var>guardian or any employee of the guardian responsible for exercising powers and duties <br/>
<a id="pl.203.6"></a><var>203.6</var>under the guardianship:<br/>
<a id="pl.203.7"></a><var>203.7</var>(1) whether the proposed guardian has ever been removed for cause from serving as <br/>
<a id="pl.203.8"></a><var>203.8</var>a guardian or conservator and, if so, the case number and court location; and<br/>
<a id="pl.203.9"></a><var>203.9</var>(2) if the proposed guardian is a professional guardian or conservator, a summary of <br/>
<a id="pl.203.10"></a><var>203.10</var>the proposed guardian's educational background and relevant work and other experience.;<br/>
<a id="pl.203.11"></a><var>203.11</var>(3) whether the proposed guardian has ever applied for or held, at any time, any <br/>
<a id="pl.203.12"></a><var>203.12</var>professional license from an agency listed under section 524.5-118, subdivision 2a, and if <br/>
<a id="pl.203.13"></a><var>203.13</var>so, the name of the licensing agency, and as applicable, the license number and status; <br/>
<a id="pl.203.14"></a><var>203.14</var>whether the license is active or has been denied, conditioned, suspended, revoked, or <br/>
<a id="pl.203.15"></a><var>203.15</var>canceled; and the basis for the denial, condition, suspension, revocation, or cancellation <br/>
<a id="pl.203.16"></a><var>203.16</var>of the license;<br/>
<a id="pl.203.17"></a><var>203.17</var>(4) whether the proposed guardian has ever been found civilly liable in an action <br/>
<a id="pl.203.18"></a><var>203.18</var>that involved fraud, misrepresentation, material omission, misappropriation, theft, or <br/>
<a id="pl.203.19"></a><var>203.19</var>conversion, and if so, the case number and court location;<br/>
<a id="pl.203.20"></a><var>203.20</var>(5) whether the proposed guardian has ever filed for or received protection under the <br/>
<a id="pl.203.21"></a><var>203.21</var>bankruptcy laws, and if so, the case number and court location;<br/>
<a id="pl.203.22"></a><var>203.22</var>(6) whether the proposed guardian has any outstanding civil monetary judgments <br/>
<a id="pl.203.23"></a><var>203.23</var>against the proposed guardian, and if so, the case number, court location, and outstanding <br/>
<a id="pl.203.24"></a><var>203.24</var>amount owed;<br/>
<a id="pl.203.25"></a><var>203.25</var>(7) whether an order for protection or harassment restraining order has ever been <br/>
<a id="pl.203.26"></a><var>203.26</var>issued against the proposed guardian, and if so, the case number and court location; and<br/>
<a id="pl.203.27"></a><var>203.27</var>(8) whether the proposed guardian has ever been convicted of a crime other than a <br/>
<a id="pl.203.28"></a><var>203.28</var>petty misdemeanor or traffic offense, and if so, the case number and the crime of which <br/>
<a id="pl.203.29"></a><var>203.29</var>the guardian was convicted.<br/>
<br/>
<a id="bill.5.17.0"></a><a id="pl.203.30"></a><var>203.30</var>    Sec. 17. Minnesota Statutes 2012, section 524.5-316, is amended to read:<br/>
<a id="pl.203.31"></a><var>203.31</var><b>524.5-316 REPORTS; MONITORING OF GUARDIANSHIP; COURT </b><br/>
<a id="pl.203.32"></a><var>203.32</var><b>ORDERS.</b><br/>
<a id="pl.203.33"></a><var>203.33</var>(a) A guardian shall report to the court in writing on the condition of the ward at least <br/>
<a id="pl.203.34"></a><var>203.34</var>annually and whenever ordered by the court. A copy of the report must be provided to the <br/>
<a id="pl.203.35"></a><var>203.35</var>ward and to interested persons of record with the court. A report must state or contain:<br/>
<a id="pl.204.1"></a><var>204.1</var>(1) the current mental, physical, and social condition of the ward;<br/>
<a id="pl.204.2"></a><var>204.2</var>(2) the living arrangements for all addresses of the ward during the reporting period;<br/>
<a id="pl.204.3"></a><var>204.3</var>(3) any restrictions placed on the ward's right to communication and visitation with <br/>
<a id="pl.204.4"></a><var>204.4</var>persons of the ward's choice and the factual bases for those restrictions;<br/>
<a id="pl.204.5"></a><var>204.5</var>(4) the medical, educational, vocational, and other services provided to the ward and <br/>
<a id="pl.204.6"></a><var>204.6</var>the guardian's opinion as to the adequacy of the ward's care;<br/>
<a id="pl.204.7"></a><var>204.7</var>(5) a recommendation as to the need for continued guardianship and any <br/>
<a id="pl.204.8"></a><var>204.8</var>recommended changes in the scope of the guardianship;<br/>
<a id="pl.204.9"></a><var>204.9</var>(6) an address and telephone number where the guardian can be contacted; and<br/>
<a id="pl.204.10"></a><var>204.10</var>(7) whether the guardian has ever been removed for cause from serving as a guardian <br/>
<a id="pl.204.11"></a><var>204.11</var>or conservator and, if so, the case number and court location;<br/>
<a id="pl.204.12"></a><var>204.12</var>(8) any changes occurring that would affect the accuracy of information contained <br/>
<a id="pl.204.13"></a><var>204.13</var>in the most recent criminal background study of the guardian conducted under section <br/>
<a id="pl.204.14"></a><var>204.14</var><statute_ref>524.5-118</statute_ref>; and<br/>
<a id="pl.204.15"></a><var>204.15</var>(9) (7) if applicable, the amount of reimbursement for services rendered to the ward <br/>
<a id="pl.204.16"></a><var>204.16</var>that the guardian received during the previous year that were not reimbursed by county <br/>
<a id="pl.204.17"></a><var>204.17</var>contract.<br/>
<a id="pl.204.18"></a><var>204.18</var>(b) A guardian shall report to the court in writing within 30 days of the occurrence of <br/>
<a id="pl.204.19"></a><var>204.19</var>any of the events listed in this paragraph. The guardian must report any of the occurrences <br/>
<a id="pl.204.20"></a><var>204.20</var>in this paragraph and follow the same reporting requirements in this paragraph for <br/>
<a id="pl.204.21"></a><var>204.21</var>any employee of the guardian responsible for exercising powers and duties under the <br/>
<a id="pl.204.22"></a><var>204.22</var>guardianship. A copy of the report must be provided to the ward and to interested persons <br/>
<a id="pl.204.23"></a><var>204.23</var>of record with the court. A guardian shall report when:<br/>
<a id="pl.204.24"></a><var>204.24</var>(1) the guardian is removed for cause from serving as a guardian or conservator, and <br/>
<a id="pl.204.25"></a><var>204.25</var>if so, the case number and court location;<br/>
<a id="pl.204.26"></a><var>204.26</var>(2) the guardian has a professional license from an agency listed under section <br/>
<a id="pl.204.27"></a><var>204.27</var>524.5-118, subdivision 2a, denied, conditioned, suspended, revoked, or canceled, and <br/>
<a id="pl.204.28"></a><var>204.28</var>if so, the licensing agency and license number, and the basis for denial, condition, <br/>
<a id="pl.204.29"></a><var>204.29</var>suspension, revocation, or cancellation of the license;<br/>
<a id="pl.204.30"></a><var>204.30</var>(3) the guardian is found civilly liable in an action that involves fraud, <br/>
<a id="pl.204.31"></a><var>204.31</var>misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the <br/>
<a id="pl.204.32"></a><var>204.32</var>case number and court location;<br/>
<a id="pl.204.33"></a><var>204.33</var>(4) the guardian files for or receives protection under the bankruptcy laws, and <br/>
<a id="pl.204.34"></a><var>204.34</var>if so, the case number and court location;<br/>
<a id="pl.204.35"></a><var>204.35</var>(5) a civil monetary judgment is entered against the guardian, and if so, the case <br/>
<a id="pl.204.36"></a><var>204.36</var>number, court location, and outstanding amount owed;<br/>
<a id="pl.205.1"></a><var>205.1</var>(6) the guardian is convicted of a crime other than a petty misdemeanor or traffic <br/>
<a id="pl.205.2"></a><var>205.2</var>offense, and if so, the case number and court location; or<br/>
<a id="pl.205.3"></a><var>205.3</var>(7) an order for protection or harassment restraining order is issued against the <br/>
<a id="pl.205.4"></a><var>205.4</var>guardian, and if so, the case number and court location.<br/>
<a id="pl.205.5"></a><var>205.5</var>(b) (c) A ward or interested person of record with the court may submit to the court a <br/>
<a id="pl.205.6"></a><var>205.6</var>written statement disputing statements or conclusions regarding the condition of the ward <br/>
<a id="pl.205.7"></a><var>205.7</var>or addressing any disciplinary or legal action that are is contained in the report guardian's <br/>
<a id="pl.205.8"></a><var>205.8</var>reports and may petition the court for an order that is in the best interests of the ward or <br/>
<a id="pl.205.9"></a><var>205.9</var>for other appropriate relief.<br/>
<a id="pl.205.10"></a><var>205.10</var>(c) (d) An interested person may notify the court in writing that the interested person <br/>
<a id="pl.205.11"></a><var>205.11</var>does not wish to receive copies of reports required under this section.<br/>
<a id="pl.205.12"></a><var>205.12</var>(d) (e) The court may appoint a visitor to review a report, interview the ward or <br/>
<a id="pl.205.13"></a><var>205.13</var>guardian, and make any other investigation the court directs.<br/>
<a id="pl.205.14"></a><var>205.14</var>(e) (f) The court shall establish a system for monitoring guardianships, including the <br/>
<a id="pl.205.15"></a><var>205.15</var>filing and review of annual reports. If an annual report is not filed within 60 days of the <br/>
<a id="pl.205.16"></a><var>205.16</var>required date, the court shall issue an order to show cause.<br/>
<a id="pl.205.17"></a><var>205.17</var>(g) If a guardian fails to comply with this section, the court may decline to appoint that <br/>
<a id="pl.205.18"></a><var>205.18</var>person as a guardian or conservator, or may remove a person as guardian or conservator.<br/>
<br/>
<a id="bill.5.18.0"></a><a id="pl.205.19"></a><var>205.19</var>    Sec. 18. Minnesota Statutes 2012, section 524.5-403, is amended to read:<br/>
<a id="pl.205.20"></a><var>205.20</var><b>524.5-403 ORIGINAL PETITION FOR APPOINTMENT OR PROTECTIVE </b><br/>
<a id="pl.205.21"></a><var>205.21</var><b>ORDER.</b><br/>
<a id="pl.205.22"></a><var>205.22</var>(a) The following may petition for the appointment of a conservator or for any <br/>
<a id="pl.205.23"></a><var>205.23</var>other appropriate protective order:<br/>
<a id="pl.205.24"></a><var>205.24</var>(1) the person to be protected;<br/>
<a id="pl.205.25"></a><var>205.25</var>(2) an individual interested in the estate, affairs, or welfare of the person to be <br/>
<a id="pl.205.26"></a><var>205.26</var>protected; or<br/>
<a id="pl.205.27"></a><var>205.27</var>(3) a person who would be adversely affected by lack of effective management of <br/>
<a id="pl.205.28"></a><var>205.28</var>the property and business affairs of the person to be protected.<br/>
<a id="pl.205.29"></a><var>205.29</var>(b) The petition must set forth the petitioner's name, residence, current address <br/>
<a id="pl.205.30"></a><var>205.30</var>if different, relationship to the respondent, and interest in the appointment or other <br/>
<a id="pl.205.31"></a><var>205.31</var>protective order, and, to the extent known, state or contain the following with respect to <br/>
<a id="pl.205.32"></a><var>205.32</var>the respondent and the relief requested:<br/>
<a id="pl.205.33"></a><var>205.33</var>(1) the respondent's name, age, principal residence, current street address, and, if <br/>
<a id="pl.205.34"></a><var>205.34</var>different, the address of the dwelling where it is proposed that the respondent will reside if <br/>
<a id="pl.205.35"></a><var>205.35</var>the appointment is made;<br/>
<a id="pl.206.1"></a><var>206.1</var>(2) if the petition alleges impairment in the respondent's ability to receive and <br/>
<a id="pl.206.2"></a><var>206.2</var>evaluate information, a brief description of the nature and extent of the respondent's <br/>
<a id="pl.206.3"></a><var>206.3</var>alleged impairment;<br/>
<a id="pl.206.4"></a><var>206.4</var>(3) if the petition alleges that the respondent is missing, detained, or unable to <br/>
<a id="pl.206.5"></a><var>206.5</var>return to the United States, a statement of the relevant circumstances, including the time <br/>
<a id="pl.206.6"></a><var>206.6</var>and nature of the disappearance or detention and a description of any search or inquiry <br/>
<a id="pl.206.7"></a><var>206.7</var>concerning the respondent's whereabouts;<br/>
<a id="pl.206.8"></a><var>206.8</var>(4) the name and address of the respondent's:<br/>
<a id="pl.206.9"></a><var>206.9</var>(i) spouse, or if the respondent has none, an adult with whom the respondent has <br/>
<a id="pl.206.10"></a><var>206.10</var>resided for more than six months before the filing of the petition; and<br/>
<a id="pl.206.11"></a><var>206.11</var>(ii) adult children or, if the respondent has none, the respondent's parents and adult <br/>
<a id="pl.206.12"></a><var>206.12</var>brothers and sisters or, if the respondent has none, at least one of the adults nearest in <br/>
<a id="pl.206.13"></a><var>206.13</var>kinship to the respondent who can be found;<br/>
<a id="pl.206.14"></a><var>206.14</var>(5) the name of the administrative head and address of the institution where the <br/>
<a id="pl.206.15"></a><var>206.15</var>respondent is a patient, resident, or client of any hospital, nursing home, home care <br/>
<a id="pl.206.16"></a><var>206.16</var>agency, or other institution;<br/>
<a id="pl.206.17"></a><var>206.17</var>(6) the name and address of any legal representative for the respondent;<br/>
<a id="pl.206.18"></a><var>206.18</var>(7) the name and address of any health care agent or proxy appointed pursuant to <br/>
<a id="pl.206.19"></a><var>206.19</var>a health care directive as defined in section 
         <statute_ref>145C.01</statute_ref>, a living will under chapter 145B, <br/>
<a id="pl.206.20"></a><var>206.20</var>or other similar document executed in another state and enforceable under the laws of <br/>
<a id="pl.206.21"></a><var>206.21</var>this state;<br/>
<a id="pl.206.22"></a><var>206.22</var>(8) a general statement of the respondent's property with an estimate of its value, <br/>
<a id="pl.206.23"></a><var>206.23</var>including any insurance or pension, and the source and amount of other anticipated <br/>
<a id="pl.206.24"></a><var>206.24</var>income or receipts; and<br/>
<a id="pl.206.25"></a><var>206.25</var>(9) the reason why a conservatorship or other protective order is in the best interest <br/>
<a id="pl.206.26"></a><var>206.26</var>of the respondent.<br/>
<a id="pl.206.27"></a><var>206.27</var>(c) If a conservatorship is requested, the petition must also set forth to the extent <br/>
<a id="pl.206.28"></a><var>206.28</var>known:<br/>
<a id="pl.206.29"></a><var>206.29</var>(1) the name, address, and telephone number of any proposed conservator and the <br/>
<a id="pl.206.30"></a><var>206.30</var>reason why the proposed conservator should be selected;<br/>
<a id="pl.206.31"></a><var>206.31</var>(2) the name, address, and telephone number of any person nominated as conservator <br/>
<a id="pl.206.32"></a><var>206.32</var>by the respondent if the respondent has attained 14 years of age; and<br/>
<a id="pl.206.33"></a><var>206.33</var>(3) the type of conservatorship requested and, if an unlimited conservatorship, <br/>
<a id="pl.206.34"></a><var>206.34</var>the reason why limited conservatorship is inappropriate or, if a limited conservatorship, <br/>
<a id="pl.206.35"></a><var>206.35</var>the property to be placed under the conservator's control and any limitation on the <br/>
<a id="pl.206.36"></a><var>206.36</var>conservator's powers and duties.<br/>
<a id="pl.207.1"></a><var>207.1</var>(d) The petition must also set forth the following information regarding the proposed <br/>
<a id="pl.207.2"></a><var>207.2</var>conservator or any employee of the conservator responsible for exercising powers and <br/>
<a id="pl.207.3"></a><var>207.3</var>duties under the conservatorship:<br/>
<a id="pl.207.4"></a><var>207.4</var>(1) whether the proposed conservator has ever been removed for cause from serving <br/>
<a id="pl.207.5"></a><var>207.5</var>as a guardian or conservator and, if so, the case number and court location; and<br/>
<a id="pl.207.6"></a><var>207.6</var>(2) if the proposed conservator is a professional guardian or conservator, a summary <br/>
<a id="pl.207.7"></a><var>207.7</var>of the proposed conservator's educational background and relevant work and other <br/>
<a id="pl.207.8"></a><var>207.8</var>experience.;<br/>
<a id="pl.207.9"></a><var>207.9</var>(3) whether the proposed conservator has ever applied for or held, at any time, any <br/>
<a id="pl.207.10"></a><var>207.10</var>professional license from an agency listed under section 524.5-118, subdivision 2a, and if <br/>
<a id="pl.207.11"></a><var>207.11</var>so, the name of the licensing agency, and as applicable, the license number and status; <br/>
<a id="pl.207.12"></a><var>207.12</var>whether the license is active or has been denied, conditioned, suspended, revoked, or <br/>
<a id="pl.207.13"></a><var>207.13</var>canceled; and the basis for the denial, condition, suspension, revocation, or cancellation <br/>
<a id="pl.207.14"></a><var>207.14</var>of the license;<br/>
<a id="pl.207.15"></a><var>207.15</var>(4) whether the proposed conservator has ever been found civilly liable in an action <br/>
<a id="pl.207.16"></a><var>207.16</var>that involved fraud, misrepresentation, material omission, misappropriation, theft, or <br/>
<a id="pl.207.17"></a><var>207.17</var>conversion, and if so, the case number and court location;<br/>
<a id="pl.207.18"></a><var>207.18</var>(5) whether the proposed conservator has ever filed for or received protection under <br/>
<a id="pl.207.19"></a><var>207.19</var>the bankruptcy laws, and if so, the case number and court location;<br/>
<a id="pl.207.20"></a><var>207.20</var>(6) whether the proposed conservator has any outstanding civil monetary judgments <br/>
<a id="pl.207.21"></a><var>207.21</var>against the proposed conservator, and if so, the case number, court location, and <br/>
<a id="pl.207.22"></a><var>207.22</var>outstanding amount owed;<br/>
<a id="pl.207.23"></a><var>207.23</var>(7) whether an order for protection or harassment restraining order has ever been <br/>
<a id="pl.207.24"></a><var>207.24</var>issued against the proposed conservator, and if so, the case number and court location; and<br/>
<a id="pl.207.25"></a><var>207.25</var>(8) whether the proposed conservator has ever been convicted of a crime other than <br/>
<a id="pl.207.26"></a><var>207.26</var>a petty misdemeanor or traffic offense, and if so, the case number and the crime of which <br/>
<a id="pl.207.27"></a><var>207.27</var>the conservator was convicted.<br/>
<br/>
<a id="bill.5.19.0"></a><a id="pl.207.28"></a><var>207.28</var>    Sec. 19. Minnesota Statutes 2012, section 524.5-420, is amended to read:<br/>
<a id="pl.207.29"></a><var>207.29</var><b>524.5-420 REPORTS; APPOINTMENT OF VISITOR; MONITORING; </b><br/>
<a id="pl.207.30"></a><var>207.30</var><b>COURT ORDERS.</b><br/>
<a id="pl.207.31"></a><var>207.31</var>(a) A conservator shall report to the court for administration of the estate annually <br/>
<a id="pl.207.32"></a><var>207.32</var>unless the court otherwise directs, upon resignation or removal, upon termination of the <br/>
<a id="pl.207.33"></a><var>207.33</var>conservatorship, and at other times as the court directs. An order, after notice and hearing, <br/>
<a id="pl.207.34"></a><var>207.34</var>allowing an intermediate report of a conservator adjudicates liabilities concerning the <br/>
<a id="pl.208.1"></a><var>208.1</var>matters adequately disclosed in the accounting. An order, after notice and hearing, allowing <br/>
<a id="pl.208.2"></a><var>208.2</var>a final report adjudicates all previously unsettled liabilities relating to the conservatorship.<br/>
<a id="pl.208.3"></a><var>208.3</var>(b) A report must state or contain a listing of the assets of the estate under the <br/>
<a id="pl.208.4"></a><var>208.4</var>conservator's control and a listing of the receipts, disbursements, and distributions during <br/>
<a id="pl.208.5"></a><var>208.5</var>the reporting period.<br/>
<a id="pl.208.6"></a><var>208.6</var>(c) The report must also state:<br/>
<a id="pl.208.7"></a><var>208.7</var>(1) an address and telephone number where the conservator can be contacted;.<br/>
<a id="pl.208.8"></a><var>208.8</var>(2) whether the conservator has ever been removed for cause from serving as a <br/>
<a id="pl.208.9"></a><var>208.9</var>guardian or conservator and, if so, the case number and court locations; and<br/>
<a id="pl.208.10"></a><var>208.10</var>(3) any changes occurring that would affect the accuracy of information contained in <br/>
<a id="pl.208.11"></a><var>208.11</var>the most recent criminal background study of the conservator conducted under section <br/>
<a id="pl.208.12"></a><var>208.12</var><statute_ref>524.5-118</statute_ref>.<br/>
<a id="pl.208.13"></a><var>208.13</var>(d) A conservator shall report to the court in writing within 30 days of the occurrence <br/>
<a id="pl.208.14"></a><var>208.14</var>of any of the events listed in this paragraph. The conservator must report any of the <br/>
<a id="pl.208.15"></a><var>208.15</var>occurrences in this paragraph and follow the same reporting requirements in this paragraph <br/>
<a id="pl.208.16"></a><var>208.16</var>for any employee of the conservator responsible for exercising powers and duties under <br/>
<a id="pl.208.17"></a><var>208.17</var>the conservatorship. A copy of the report must be provided to the protected person and to <br/>
<a id="pl.208.18"></a><var>208.18</var>interested persons of record with the court. A conservator shall report when:<br/>
<a id="pl.208.19"></a><var>208.19</var>(1) the conservator is removed for cause from serving as a guardian or conservator, <br/>
<a id="pl.208.20"></a><var>208.20</var>and if so, the case number and court location;<br/>
<a id="pl.208.21"></a><var>208.21</var>(2) the conservator has a professional license from an agency listed under section <br/>
<a id="pl.208.22"></a><var>208.22</var>524.5-118, subdivision 2a, denied, conditioned, suspended, revoked, or canceled, and <br/>
<a id="pl.208.23"></a><var>208.23</var>if so, the licensing agency and license number, and the basis for denial, condition, <br/>
<a id="pl.208.24"></a><var>208.24</var>suspension, revocation, or cancellation of the license;<br/>
<a id="pl.208.25"></a><var>208.25</var>(3) the conservator is found civilly liable in an action that involves fraud, <br/>
<a id="pl.208.26"></a><var>208.26</var>misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the <br/>
<a id="pl.208.27"></a><var>208.27</var>case number and court location;<br/>
<a id="pl.208.28"></a><var>208.28</var>(4) the conservator files for or receives protection under the bankruptcy laws, and <br/>
<a id="pl.208.29"></a><var>208.29</var>if so, the case number and court location;<br/>
<a id="pl.208.30"></a><var>208.30</var>(5) a civil monetary judgment is entered against the conservator, and if so, the case <br/>
<a id="pl.208.31"></a><var>208.31</var>number, court location, and outstanding amount owed;<br/>
<a id="pl.208.32"></a><var>208.32</var>(6) the conservator is convicted of a crime other than a petty misdemeanor or traffic <br/>
<a id="pl.208.33"></a><var>208.33</var>offense, and if so, the case number and court location; or<br/>
<a id="pl.208.34"></a><var>208.34</var>(7) an order for protection or harassment restraining order is issued against the <br/>
<a id="pl.208.35"></a><var>208.35</var>conservator, and if so, the case number and court location.<br/>
<a id="pl.209.1"></a><var>209.1</var>(d) (e) A protected person or an interested person of record with the court may <br/>
<a id="pl.209.2"></a><var>209.2</var>submit to the court a written statement disputing account statements regarding the <br/>
<a id="pl.209.3"></a><var>209.3</var>administration of the estate or addressing any disciplinary or legal action that are is<br/>
<a id="pl.209.4"></a><var>209.4</var> contained in the report reports and may petition the court for any order that is in the best <br/>
<a id="pl.209.5"></a><var>209.5</var>interests of the protected person and the estate or for other appropriate relief.<br/>
<a id="pl.209.6"></a><var>209.6</var>(e) (f) An interested person may notify the court in writing that the interested person <br/>
<a id="pl.209.7"></a><var>209.7</var>does not wish to receive copies of reports required under this section.<br/>
<a id="pl.209.8"></a><var>209.8</var>(f) (g) The court may appoint a visitor to review a report or plan, interview the <br/>
<a id="pl.209.9"></a><var>209.9</var>protected person or conservator, and make any other investigation the court directs. In <br/>
<a id="pl.209.10"></a><var>209.10</var>connection with a report, the court may order a conservator to submit the assets of the <br/>
<a id="pl.209.11"></a><var>209.11</var>estate to an appropriate examination to be made in a manner the court directs.<br/>
<a id="pl.209.12"></a><var>209.12</var>(g) (h) The court shall establish a system for monitoring of conservatorships, <br/>
<a id="pl.209.13"></a><var>209.13</var>including the filing and review of conservators' reports and plans. If an annual report is <br/>
<a id="pl.209.14"></a><var>209.14</var>not filed within 60 days of the required date, the court shall issue an order to show cause.<br/>
<a id="pl.209.15"></a><var>209.15</var>(i) If a conservator fails to comply with this section, the court may decline to appoint <br/>
<a id="pl.209.16"></a><var>209.16</var>that person as a guardian or conservator, or may remove a person as guardian or conservator.<br/>
<br/>
<a id="bill.5.20.0"></a><a id="pl.209.17"></a><var>209.17</var>    Sec. 20. <b>INSTRUCTIONS TO THE COMMISSIONER.</b><br/>
<a id="pl.209.18"></a><var>209.18</var>    In collaboration with labor organizations, the commissioner of human services shall <br/>
<a id="pl.209.19"></a><var>209.19</var>develop clear and consistent standards for state-operated services programs to:<br/>
<a id="pl.209.20"></a><var>209.20</var>    (1) address direct service staffing shortages;<br/>
<a id="pl.209.21"></a><var>209.21</var>    (2) identify and help resolve workplace safety issues; and<br/>
<a id="pl.209.22"></a><var>209.22</var>    (3) elevate the use and visibility of performance measures and objectives related to <br/>
<a id="pl.209.23"></a><var>209.23</var>overtime use.<br/>
<br/>
<a id="bill.6.0.0"></a>

<a id="bill.6.1.0"></a><a id="pl.209.26"></a><var>209.26</var>    Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:<br/>
<a id="pl.209.27"></a><var>209.27</var>    Subdivision 1. <b>Establishment.</b> There is created a Department of Human Services. <br/>
<a id="pl.209.28"></a><var>209.28</var>A commissioner of human services shall be appointed by the governor under the <br/>
<a id="pl.209.29"></a><var>209.29</var>provisions of section 
         <statute_ref>15.06</statute_ref>. The commissioner shall be selected on the basis of ability and <br/>
<a id="pl.209.30"></a><var>209.30</var>experience in welfare and without regard to political affiliations. The commissioner shall<br/>
<a id="pl.209.31"></a><var>209.31</var> may appoint a up to two deputy commissioner commissioners.<br/>
<br/>
<a id="bill.6.2.0"></a><a id="pl.209.32"></a><var>209.32</var>    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:<br/>
<a id="pl.210.1"></a><var>210.1</var>    Subd. 3. <b>Surcharge on HMOs and community integrated service networks.</b> (a) <br/>
<a id="pl.210.2"></a><var>210.2</var>Effective October 1, 1992, each health maintenance organization with a certificate of <br/>
<a id="pl.210.3"></a><var>210.3</var>authority issued by the commissioner of health under chapter 62D and each community <br/>
<a id="pl.210.4"></a><var>210.4</var>integrated service network licensed by the commissioner under chapter 62N shall pay to <br/>
<a id="pl.210.5"></a><var>210.5</var>the commissioner of human services a surcharge equal to six-tenths of one percent of the <br/>
<a id="pl.210.6"></a><var>210.6</var>total premium revenues of the health maintenance organization or community integrated <br/>
<a id="pl.210.7"></a><var>210.7</var>service network as reported to the commissioner of health according to the schedule in <br/>
<a id="pl.210.8"></a><var>210.8</var>subdivision 4.<br/>
<a id="pl.210.9"></a><var>210.9</var>(b) Effective July 1, 2013, to June 30, 2015, the surcharge under paragraph (a) is <br/>
<a id="pl.210.10"></a><var>210.10</var>increased to 1.48 percent.<br/>
<a id="pl.210.11"></a><var>210.11</var>(c) For purposes of this subdivision, total premium revenue means:<br/>
<a id="pl.210.12"></a><var>210.12</var>(1) premium revenue recognized on a prepaid basis from individuals and groups <br/>
<a id="pl.210.13"></a><var>210.13</var>for provision of a specified range of health services over a defined period of time which <br/>
<a id="pl.210.14"></a><var>210.14</var>is normally one month, excluding premiums paid to a health maintenance organization <br/>
<a id="pl.210.15"></a><var>210.15</var>or community integrated service network from the Federal Employees Health Benefit <br/>
<a id="pl.210.16"></a><var>210.16</var>Program;<br/>
<a id="pl.210.17"></a><var>210.17</var>(2) premiums from Medicare wraparound subscribers for health benefits which <br/>
<a id="pl.210.18"></a><var>210.18</var>supplement Medicare coverage;<br/>
<a id="pl.210.19"></a><var>210.19</var>(3) Medicare revenue, as a result of an arrangement between a health maintenance <br/>
<a id="pl.210.20"></a><var>210.20</var>organization or a community integrated service network and the Centers for Medicare <br/>
<a id="pl.210.21"></a><var>210.21</var>and Medicaid Services of the federal Department of Health and Human Services, for <br/>
<a id="pl.210.22"></a><var>210.22</var>services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited <br/>
<a id="pl.210.23"></a><var>210.23</var>from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social <br/>
<a id="pl.210.24"></a><var>210.24</var>Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and <br/>
<a id="pl.210.25"></a><var>210.25</var>1395w-24, respectively, as they may be amended from time to time; and<br/>
<a id="pl.210.26"></a><var>210.26</var>(4) medical assistance revenue, as a result of an arrangement between a health <br/>
<a id="pl.210.27"></a><var>210.27</var>maintenance organization or community integrated service network and a Medicaid state <br/>
<a id="pl.210.28"></a><var>210.28</var>agency, for services to a medical assistance beneficiary.<br/>
<a id="pl.210.29"></a><var>210.29</var>If advance payments are made under clause (1) or (2) to the health maintenance <br/>
<a id="pl.210.30"></a><var>210.30</var>organization or community integrated service network for more than one reporting period, <br/>
<a id="pl.210.31"></a><var>210.31</var>the portion of the payment that has not yet been earned must be treated as a liability.<br/>
<a id="pl.210.32"></a><var>210.32</var>(c) (d)  When a health maintenance organization or community integrated service <br/>
<a id="pl.210.33"></a><var>210.33</var>network merges or consolidates with or is acquired by another health maintenance <br/>
<a id="pl.210.34"></a><var>210.34</var>organization or community integrated service network, the surviving corporation or the <br/>
<a id="pl.210.35"></a><var>210.35</var>new corporation shall be responsible for the annual surcharge originally imposed on <br/>
<a id="pl.210.36"></a><var>210.36</var>each of the entities or corporations subject to the merger, consolidation, or acquisition, <br/>
<a id="pl.211.1"></a><var>211.1</var>regardless of whether one of the entities or corporations does not retain a certificate of <br/>
<a id="pl.211.2"></a><var>211.2</var>authority under chapter 62D or a license under chapter 62N.<br/>
<a id="pl.211.3"></a><var>211.3</var>(d) (e)  Effective July 1 of each year, the surviving corporation's or the new <br/>
<a id="pl.211.4"></a><var>211.4</var>corporation's surcharge shall be based on the revenues earned in the second previous <br/>
<a id="pl.211.5"></a><var>211.5</var>calendar year by all of the entities or corporations subject to the merger, consolidation, <br/>
<a id="pl.211.6"></a><var>211.6</var>or acquisition regardless of whether one of the entities or corporations does not retain a <br/>
<a id="pl.211.7"></a><var>211.7</var>certificate of authority under chapter 62D or a license under chapter 62N until the total <br/>
<a id="pl.211.8"></a><var>211.8</var>premium revenues of the surviving corporation include the total premium revenues of all <br/>
<a id="pl.211.9"></a><var>211.9</var>the merged entities as reported to the commissioner of health.<br/>
<a id="pl.211.10"></a><var>211.10</var>(e) (f)  When a health maintenance organization or community integrated service <br/>
<a id="pl.211.11"></a><var>211.11</var>network, which is subject to liability for the surcharge under this chapter, transfers, <br/>
<a id="pl.211.12"></a><var>211.12</var>assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability <br/>
<a id="pl.211.13"></a><var>211.13</var>for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer <br/>
<a id="pl.211.14"></a><var>211.14</var>of the health maintenance organization or community integrated service network.<br/>
<a id="pl.211.15"></a><var>211.15</var>(f) (g)  In the event a health maintenance organization or community integrated <br/>
<a id="pl.211.16"></a><var>211.16</var>service network converts its licensure to a different type of entity subject to liability <br/>
<a id="pl.211.17"></a><var>211.17</var>for the surcharge under this chapter, but survives in the same or substantially similar <br/>
<a id="pl.211.18"></a><var>211.18</var>form, the surviving entity remains liable for the surcharge regardless of whether one of <br/>
<a id="pl.211.19"></a><var>211.19</var>the entities or corporations does not retain a certificate of authority under chapter 62D <br/>
<a id="pl.211.20"></a><var>211.20</var>or a license under chapter 62N.<br/>
<a id="pl.211.21"></a><var>211.21</var>(g) (h)  The surcharge assessed to a health maintenance organization or community <br/>
<a id="pl.211.22"></a><var>211.22</var>integrated service network ends when the entity ceases providing services for premiums <br/>
<a id="pl.211.23"></a><var>211.23</var>and the cessation is not connected with a merger, consolidation, acquisition, or conversion.<br/>
<br/>
<a id="bill.6.3.0"></a><a id="pl.211.24"></a><var>211.24</var>    Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:<br/>
<a id="pl.211.25"></a><var>211.25</var>    Subd. 3a. <b>Payments.</b> (a) Acute care hospital billings under the medical <br/>
<a id="pl.211.26"></a><var>211.26</var>assistance program must not be submitted until the recipient is discharged. However, <br/>
<a id="pl.211.27"></a><var>211.27</var>the commissioner shall establish monthly interim payments for inpatient hospitals that <br/>
<a id="pl.211.28"></a><var>211.28</var>have individual patient lengths of stay over 30 days regardless of diagnostic category. <br/>
<a id="pl.211.29"></a><var>211.29</var>Except as provided in section 
         <statute_ref>256.9693</statute_ref>, medical assistance reimbursement for treatment <br/>
<a id="pl.211.30"></a><var>211.30</var>of mental illness shall be reimbursed based on diagnostic classifications. Individual <br/>
<a id="pl.211.31"></a><var>211.31</var>hospital payments established under this section and sections 
         <statute_ref>256.9685</statute_ref>, 
         <statute_ref>256.9686</statute_ref>, and <br/>
<statute_ref><a id="pl.211.32"></a><var>211.32</var>256.9695
         </statute_ref>, in addition to third-party and recipient liability, for discharges occurring during <br/>
<a id="pl.211.33"></a><var>211.33</var>the rate year shall not exceed, in aggregate, the charges for the medical assistance covered <br/>
<a id="pl.211.34"></a><var>211.34</var>inpatient services paid for the same period of time to the hospital. This payment limitation <br/>
<a id="pl.211.35"></a><var>211.35</var>shall be calculated separately for medical assistance and general assistance medical <br/>
<a id="pl.212.1"></a><var>212.1</var>care services. The limitation on general assistance medical care shall be effective for <br/>
<a id="pl.212.2"></a><var>212.2</var>admissions occurring on or after July 1, 1991. Services that have rates established under <br/>
<a id="pl.212.3"></a><var>212.3</var>subdivision 11 or 12, must be limited separately from other services. After consulting with <br/>
<a id="pl.212.4"></a><var>212.4</var>the affected hospitals, the commissioner may consider related hospitals one entity and <br/>
<a id="pl.212.5"></a><var>212.5</var>may merge the payment rates while maintaining separate provider numbers. The operating <br/>
<a id="pl.212.6"></a><var>212.6</var>and property base rates per admission or per day shall be derived from the best Medicare <br/>
<a id="pl.212.7"></a><var>212.7</var>and claims data available when rates are established. The commissioner shall determine <br/>
<a id="pl.212.8"></a><var>212.8</var>the best Medicare and claims data, taking into consideration variables of recency of the <br/>
<a id="pl.212.9"></a><var>212.9</var>data, audit disposition, settlement status, and the ability to set rates in a timely manner. <br/>
<a id="pl.212.10"></a><var>212.10</var>The commissioner shall notify hospitals of payment rates by December 1 of the year <br/>
<a id="pl.212.11"></a><var>212.11</var>preceding the rate year. The rate setting data must reflect the admissions data used to <br/>
<a id="pl.212.12"></a><var>212.12</var>establish relative values. Base year changes from 1981 to the base year established for the <br/>
<a id="pl.212.13"></a><var>212.13</var>rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited <br/>
<a id="pl.212.14"></a><var>212.14</var>to the limits ending June 30, 1987, on the maximum rate of increase under subdivision <br/>
<a id="pl.212.15"></a><var>212.15</var>1. The commissioner may adjust base year cost, relative value, and case mix index data <br/>
<a id="pl.212.16"></a><var>212.16</var>to exclude the costs of services that have been discontinued by the October 1 of the year <br/>
<a id="pl.212.17"></a><var>212.17</var>preceding the rate year or that are paid separately from inpatient services. Inpatient stays <br/>
<a id="pl.212.18"></a><var>212.18</var>that encompass portions of two or more rate years shall have payments established based <br/>
<a id="pl.212.19"></a><var>212.19</var>on payment rates in effect at the time of admission unless the date of admission preceded <br/>
<a id="pl.212.20"></a><var>212.20</var>the rate year in effect by six months or more. In this case, operating payment rates for <br/>
<a id="pl.212.21"></a><var>212.21</var>services rendered during the rate year in effect and established based on the date of <br/>
<a id="pl.212.22"></a><var>212.22</var>admission shall be adjusted to the rate year in effect by the hospital cost index.<br/>
<a id="pl.212.23"></a><var>212.23</var>    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total <br/>
<a id="pl.212.24"></a><var>212.24</var>payment, before third-party liability and spenddown, made to hospitals for inpatient <br/>
<a id="pl.212.25"></a><var>212.25</var>services is reduced by .5 percent from the current statutory rates.<br/>
<a id="pl.212.26"></a><var>212.26</var>    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service <br/>
<a id="pl.212.27"></a><var>212.27</var>admissions occurring on or after July 1, 2003, made to hospitals for inpatient services <br/>
<a id="pl.212.28"></a><var>212.28</var>before third-party liability and spenddown, is reduced five percent from the current <br/>
<a id="pl.212.29"></a><var>212.29</var>statutory rates. Mental health services within diagnosis related groups 424 to 432, and <br/>
<a id="pl.212.30"></a><var>212.30</var>facilities defined under subdivision 16 are excluded from this paragraph.<br/>
<a id="pl.212.31"></a><var>212.31</var>    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for <br/>
<a id="pl.212.32"></a><var>212.32</var>fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for <br/>
<a id="pl.212.33"></a><var>212.33</var>inpatient services before third-party liability and spenddown, is reduced 6.0 percent <br/>
<a id="pl.212.34"></a><var>212.34</var>from the current statutory rates. Mental health services within diagnosis related groups <br/>
<a id="pl.212.35"></a><var>212.35</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.212.36"></a><var>212.36</var>Notwithstanding section 
         <statute_ref>256.9686, subdivision 7</statute_ref>, for purposes of this paragraph, medical <br/>
<a id="pl.213.1"></a><var>213.1</var>assistance does not include general assistance medical care. Payments made to managed <br/>
<a id="pl.213.2"></a><var>213.2</var>care plans shall be reduced for services provided on or after January 1, 2006, to reflect <br/>
<a id="pl.213.3"></a><var>213.3</var>this reduction.<br/>
<a id="pl.213.4"></a><var>213.4</var>    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.213.5"></a><var>213.5</var>fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made <br/>
<a id="pl.213.6"></a><var>213.6</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.213.7"></a><var>213.7</var>3.46 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.213.8"></a><var>213.8</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.213.9"></a><var>213.9</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.213.10"></a><var>213.10</var>on or after January 1, 2009, through June 30, 2009, to reflect this reduction.<br/>
<a id="pl.213.11"></a><var>213.11</var>    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for <br/>
<a id="pl.213.12"></a><var>213.12</var>fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made <br/>
<a id="pl.213.13"></a><var>213.13</var>to hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.213.14"></a><var>213.14</var>1.9 percent from the current statutory rates. Mental health services with diagnosis related <br/>
<a id="pl.213.15"></a><var>213.15</var>groups 424 to 432 and facilities defined under subdivision 16 are excluded from this <br/>
<a id="pl.213.16"></a><var>213.16</var>paragraph. Payments made to managed care plans shall be reduced for services provided <br/>
<a id="pl.213.17"></a><var>213.17</var>on or after July 1, 2009, through June 30, 2011, to reflect this reduction.<br/>
<a id="pl.213.18"></a><var>213.18</var>    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment <br/>
<a id="pl.213.19"></a><var>213.19</var>for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for <br/>
<a id="pl.213.20"></a><var>213.20</var>inpatient services before third-party liability and spenddown, is reduced 1.79 percent <br/>
<a id="pl.213.21"></a><var>213.21</var>from the current statutory rates. Mental health services with diagnosis related groups <br/>
<a id="pl.213.22"></a><var>213.22</var>424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. <br/>
<a id="pl.213.23"></a><var>213.23</var>Payments made to managed care plans shall be reduced for services provided on or after <br/>
<a id="pl.213.24"></a><var>213.24</var>July 1, 2011, to reflect this reduction.<br/>
<a id="pl.213.25"></a><var>213.25</var>(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total <br/>
<a id="pl.213.26"></a><var>213.26</var>payment for fee-for-service admissions occurring on or after July 1, 2009, made to <br/>
<a id="pl.213.27"></a><var>213.27</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.213.28"></a><var>213.28</var>one percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.213.29"></a><var>213.29</var>excluded from this paragraph. Payments made to managed care plans shall be reduced for <br/>
<a id="pl.213.30"></a><var>213.30</var>services provided on or after October 1, 2009, to reflect this reduction.<br/>
<a id="pl.213.31"></a><var>213.31</var>(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total <br/>
<a id="pl.213.32"></a><var>213.32</var>payment for fee-for-service admissions occurring on or after July 1, 2011, made to <br/>
<a id="pl.213.33"></a><var>213.33</var>hospitals for inpatient services before third-party liability and spenddown, is reduced <br/>
<a id="pl.213.34"></a><var>213.34</var>1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are <br/>
<a id="pl.213.35"></a><var>213.35</var>excluded from this paragraph. Payments made to managed care plans shall be reduced for <br/>
<a id="pl.213.36"></a><var>213.36</var>services provided on or after January 1, 2011, to reflect this reduction.<br/>
<a id="pl.214.1"></a><var>214.1</var>(j) For admissions occurring on or after January 1, 2015, the rate for inpatient <br/>
<a id="pl.214.2"></a><var>214.2</var>hospital services must be increased 1.4 percent from the rate in effect on December 31, <br/>
<a id="pl.214.3"></a><var>214.3</var>2014. Payments made to managed care plans and county-based purchasing plans shall <br/>
<a id="pl.214.4"></a><var>214.4</var>not be adjusted to reflect payments under this paragraph.<br/>
<br/>
<a id="bill.6.4.0"></a><a id="pl.214.5"></a><var>214.5</var>    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:<br/>
<a id="pl.214.6"></a><var>214.6</var>    Subd. 29. <b>Reimbursement for the fee increase for the early hearing detection </b><br/>
<a id="pl.214.7"></a><var>214.7</var><b>and intervention program.</b> (a) For admissions occurring on or after July 1, 2010, <br/>
<a id="pl.214.8"></a><var>214.8</var>payment rates shall be adjusted to include the increase to the fee that is effective on July 1, <br/>
<a id="pl.214.9"></a><var>214.9</var>2010, for the early hearing detection and intervention program recipients under section <br/>
<statute_ref><a id="pl.214.10"></a><var>214.10</var>144.125, subdivision 1
         </statute_ref>, that is paid by the hospital for public program recipients. This <br/>
<a id="pl.214.11"></a><var>214.11</var>payment increase shall be in effect until the increase is fully recognized in the base year <br/>
<a id="pl.214.12"></a><var>214.12</var>cost under subdivision 2b. This payment shall be included in payments to contracted <br/>
<a id="pl.214.13"></a><var>214.13</var>managed care organizations.<br/>
<a id="pl.214.14"></a><var>214.14</var>    (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted <br/>
<a id="pl.214.15"></a><var>214.15</var>to include the increase to the fee that is effective July 1, 2013, for the early hearing <br/>
<a id="pl.214.16"></a><var>214.16</var>detection and intervention program under section 144.125, subdivision 1, paragraph (d), <br/>
<a id="pl.214.17"></a><var>214.17</var>that is paid by the hospital for medical assistance and MinnesotaCare program enrollees. <br/>
<a id="pl.214.18"></a><var>214.18</var>This payment increase shall be in effect until the increase is fully recognized in the <br/>
<a id="pl.214.19"></a><var>214.19</var>base-year cost under subdivision 2b. This payment shall be included in payments to <br/>
<a id="pl.214.20"></a><var>214.20</var>managed care plans and county-based purchasing plans.<br/>
<br/>
<a id="bill.6.5.0"></a><a id="pl.214.21"></a><var>214.21</var>    Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:<br/>
<a id="pl.214.22"></a><var>214.22</var>    Subd. 14. <b>Persons detained by law.</b> (a) Medical assistance may be paid for an <br/>
<a id="pl.214.23"></a><var>214.23</var>inmate of a correctional facility who is conditionally released as authorized under section <br/>
<statute_ref><a id="pl.214.24"></a><var>214.24</var>241.26
         </statute_ref>, 
         <statute_ref>244.065</statute_ref>, or 
         <statute_ref>631.425</statute_ref>, if the individual does not require the security of a public <br/>
<a id="pl.214.25"></a><var>214.25</var>detention facility and is housed in a halfway house or community correction center, or <br/>
<a id="pl.214.26"></a><var>214.26</var>under house arrest and monitored by electronic surveillance in a residence approved <br/>
<a id="pl.214.27"></a><var>214.27</var>by the commissioner of corrections, and if the individual meets the other eligibility <br/>
<a id="pl.214.28"></a><var>214.28</var>requirements of this chapter.<br/>
<a id="pl.214.29"></a><var>214.29</var>    (b) An individual who is enrolled in medical assistance, and who is charged with a <br/>
<a id="pl.214.30"></a><var>214.30</var>crime and incarcerated for less than 12 months shall be suspended from eligibility at the <br/>
<a id="pl.214.31"></a><var>214.31</var>time of incarceration until the individual is released. Upon release, medical assistance <br/>
<a id="pl.214.32"></a><var>214.32</var>eligibility is reinstated without reapplication using a reinstatement process and form, if the <br/>
<a id="pl.214.33"></a><var>214.33</var>individual is otherwise eligible.<br/>
<a id="pl.215.1"></a><var>215.1</var>    (c) An individual, regardless of age, who is considered an inmate of a public <br/>
<a id="pl.215.2"></a><var>215.2</var>institution as defined in Code of Federal Regulations, title 42, section 435.1010, and <br/>
<a id="pl.215.3"></a><var>215.3</var>who meets the eligibility requirements in section 256B.056, is not eligible for medical <br/>
<a id="pl.215.4"></a><var>215.4</var>assistance, except for covered services received while an inpatient in a medical institution <br/>
<a id="pl.215.5"></a><var>215.5</var>as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues, <br/>
<a id="pl.215.6"></a><var>215.6</var>including costs, related to the inpatient treatment of an inmate are the responsibility of the <br/>
<a id="pl.215.7"></a><var>215.7</var>entity with jurisdiction over the inmate.<br/>
<a id="pl.215.8"></a><var>215.8</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.6.6.0"></a><a id="pl.215.9"></a><var>215.9</var>    Sec. 6. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:<br/>
<a id="pl.215.10"></a><var>215.10</var>    Subd. 4. <b>Citizenship requirements.</b> (a) Eligibility for medical assistance is limited <br/>
<a id="pl.215.11"></a><var>215.11</var>to citizens of the United States, qualified noncitizens as defined in this subdivision, and <br/>
<a id="pl.215.12"></a><var>215.12</var>other persons residing lawfully in the United States. Citizens or nationals of the United <br/>
<a id="pl.215.13"></a><var>215.13</var>States must cooperate in obtaining satisfactory documentary evidence of citizenship or <br/>
<a id="pl.215.14"></a><var>215.14</var>nationality according to the requirements of the federal Deficit Reduction Act of 2005, <br/>
<a id="pl.215.15"></a><var>215.15</var>Public Law 109-171.<br/>
<a id="pl.215.16"></a><var>215.16</var>(b) "Qualified noncitizen" means a person who meets one of the following <br/>
<a id="pl.215.17"></a><var>215.17</var>immigration criteria:<br/>
<a id="pl.215.18"></a><var>215.18</var>(1) admitted for lawful permanent residence according to United States Code, title 8;<br/>
<a id="pl.215.19"></a><var>215.19</var>(2) admitted to the United States as a refugee according to United States Code, <br/>
<a id="pl.215.20"></a><var>215.20</var>title 8, section 1157;<br/>
<a id="pl.215.21"></a><var>215.21</var>(3) granted asylum according to United States Code, title 8, section 1158;<br/>
<a id="pl.215.22"></a><var>215.22</var>(4) granted withholding of deportation according to United States Code, title 8, <br/>
<a id="pl.215.23"></a><var>215.23</var>section 1253(h);<br/>
<a id="pl.215.24"></a><var>215.24</var>(5) paroled for a period of at least one year according to United States Code, title 8, <br/>
<a id="pl.215.25"></a><var>215.25</var>section 1182(d)(5);<br/>
<a id="pl.215.26"></a><var>215.26</var>(6) granted conditional entrant status according to United States Code, title 8, <br/>
<a id="pl.215.27"></a><var>215.27</var>section 1153(a)(7);<br/>
<a id="pl.215.28"></a><var>215.28</var>(7) determined to be a battered noncitizen by the United States Attorney General <br/>
<a id="pl.215.29"></a><var>215.29</var>according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, <br/>
<a id="pl.215.30"></a><var>215.30</var>title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;<br/>
<a id="pl.215.31"></a><var>215.31</var>(8) is a child of a noncitizen determined to be a battered noncitizen by the United <br/>
<a id="pl.215.32"></a><var>215.32</var>States Attorney General according to the Illegal Immigration Reform and Immigrant <br/>
<a id="pl.215.33"></a><var>215.33</var>Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, <br/>
<a id="pl.215.34"></a><var>215.34</var>Public Law 104-200; or<br/>
<a id="pl.216.1"></a><var>216.1</var>(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public <br/>
<a id="pl.216.2"></a><var>216.2</var>Law 96-422, the Refugee Education Assistance Act of 1980.<br/>
<a id="pl.216.3"></a><var>216.3</var>(c) All qualified noncitizens who were residing in the United States before August <br/>
<a id="pl.216.4"></a><var>216.4</var>22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for <br/>
<a id="pl.216.5"></a><var>216.5</var>medical assistance with federal financial participation.<br/>
<a id="pl.216.6"></a><var>216.6</var>(d) Beginning December 1, 1996, qualified noncitizens who entered the United <br/>
<a id="pl.216.7"></a><var>216.7</var>States on or after August 22, 1996, and who otherwise meet the eligibility requirements <br/>
<a id="pl.216.8"></a><var>216.8</var>of this chapter are eligible for medical assistance with federal participation for five years <br/>
<a id="pl.216.9"></a><var>216.9</var>if they meet one of the following criteria:<br/>
<a id="pl.216.10"></a><var>216.10</var>(1) refugees admitted to the United States according to United States Code, title 8, <br/>
<a id="pl.216.11"></a><var>216.11</var>section 1157;<br/>
<a id="pl.216.12"></a><var>216.12</var>(2) persons granted asylum according to United States Code, title 8, section 1158;<br/>
<a id="pl.216.13"></a><var>216.13</var>(3) persons granted withholding of deportation according to United States Code, <br/>
<a id="pl.216.14"></a><var>216.14</var>title 8, section 1253(h);<br/>
<a id="pl.216.15"></a><var>216.15</var>(4) veterans of the United States armed forces with an honorable discharge for <br/>
<a id="pl.216.16"></a><var>216.16</var>a reason other than noncitizen status, their spouses and unmarried minor dependent <br/>
<a id="pl.216.17"></a><var>216.17</var>children; or<br/>
<a id="pl.216.18"></a><var>216.18</var>(5) persons on active duty in the United States armed forces, other than for training, <br/>
<a id="pl.216.19"></a><var>216.19</var>their spouses and unmarried minor dependent children.<br/>
<a id="pl.216.20"></a><var>216.20</var> Beginning July 1, 2010, children and pregnant women who are noncitizens <br/>
<a id="pl.216.21"></a><var>216.21</var>described in paragraph (b) or who are lawfully present in the United States as defined <br/>
<a id="pl.216.22"></a><var>216.22</var>in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet <br/>
<a id="pl.216.23"></a><var>216.23</var>eligibility requirements of this chapter, are eligible for medical assistance with federal <br/>
<a id="pl.216.24"></a><var>216.24</var>financial participation as provided by the federal Children's Health Insurance Program <br/>
<a id="pl.216.25"></a><var>216.25</var>Reauthorization Act of 2009, Public Law 111-3.<br/>
<a id="pl.216.26"></a><var>216.26</var>(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter <br/>
<a id="pl.216.27"></a><var>216.27</var>are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this <br/>
<a id="pl.216.28"></a><var>216.28</var>subdivision, a "nonimmigrant" is a person in one of the classes listed in United States <br/>
<a id="pl.216.29"></a><var>216.29</var>Code, title 8, section 1101(a)(15).<br/>
<a id="pl.216.30"></a><var>216.30</var>(f) Payment shall also be made for care and services that are furnished to noncitizens, <br/>
<a id="pl.216.31"></a><var>216.31</var>regardless of immigration status, who otherwise meet the eligibility requirements of <br/>
<a id="pl.216.32"></a><var>216.32</var>this chapter, if such care and services are necessary for the treatment of an emergency <br/>
<a id="pl.216.33"></a><var>216.33</var>medical condition.<br/>
<a id="pl.216.34"></a><var>216.34</var>(g) For purposes of this subdivision, the term "emergency medical condition" means <br/>
<a id="pl.216.35"></a><var>216.35</var>a medical condition that meets the requirements of United States Code, title 42, section <br/>
<a id="pl.216.36"></a><var>216.36</var>1396b(v).<br/>
<a id="pl.217.1"></a><var>217.1</var>(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment <br/>
<a id="pl.217.2"></a><var>217.2</var>of an emergency medical condition are limited to the following:<br/>
<a id="pl.217.3"></a><var>217.3</var>(i) services delivered in an emergency room or by an ambulance service licensed <br/>
<a id="pl.217.4"></a><var>217.4</var>under chapter 144E that are directly related to the treatment of an emergency medical <br/>
<a id="pl.217.5"></a><var>217.5</var>condition;<br/>
<a id="pl.217.6"></a><var>217.6</var>(ii) services delivered in an inpatient hospital setting following admission from an <br/>
<a id="pl.217.7"></a><var>217.7</var>emergency room or clinic for an acute emergency condition; and<br/>
<a id="pl.217.8"></a><var>217.8</var>(iii) follow-up services that are directly related to the original service provided <br/>
<a id="pl.217.9"></a><var>217.9</var>to treat the emergency medical condition and are covered by the global payment made <br/>
<a id="pl.217.10"></a><var>217.10</var>to the provider.<br/>
<a id="pl.217.11"></a><var>217.11</var>    (2) Services for the treatment of emergency medical conditions do not include:<br/>
<a id="pl.217.12"></a><var>217.12</var>(i) services delivered in an emergency room or inpatient setting to treat a <br/>
<a id="pl.217.13"></a><var>217.13</var>nonemergency condition;<br/>
<a id="pl.217.14"></a><var>217.14</var>(ii) organ transplants, stem cell transplants, and related care;<br/>
<a id="pl.217.15"></a><var>217.15</var>(iii) services for routine prenatal care;<br/>
<a id="pl.217.16"></a><var>217.16</var>(iv) continuing care, including long-term care, nursing facility services, home health <br/>
<a id="pl.217.17"></a><var>217.17</var>care, adult day care, day training, or supportive living services;<br/>
<a id="pl.217.18"></a><var>217.18</var>(v) elective surgery;<br/>
<a id="pl.217.19"></a><var>217.19</var>(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as <br/>
<a id="pl.217.20"></a><var>217.20</var>part of an emergency room visit;<br/>
<a id="pl.217.21"></a><var>217.21</var>(vii) preventative health care and family planning services;<br/>
<a id="pl.217.22"></a><var>217.22</var>(viii) dialysis;<br/>
<a id="pl.217.23"></a><var>217.23</var>(ix) chemotherapy or therapeutic radiation services;<br/>
<a id="pl.217.24"></a><var>217.24</var>(x) (viii) rehabilitation services;<br/>
<a id="pl.217.25"></a><var>217.25</var>(xi) (ix) physical, occupational, or speech therapy;<br/>
<a id="pl.217.26"></a><var>217.26</var>(xii) (x) transportation services;<br/>
<a id="pl.217.27"></a><var>217.27</var>(xiii) (xi) case management;<br/>
<a id="pl.217.28"></a><var>217.28</var>(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;<br/>
<a id="pl.217.29"></a><var>217.29</var>(xv) (xiii) dental services;<br/>
<a id="pl.217.30"></a><var>217.30</var>(xvi) (xiv) hospice care;<br/>
<a id="pl.217.31"></a><var>217.31</var>(xvii) (xv) audiology services and hearing aids;<br/>
<a id="pl.217.32"></a><var>217.32</var>(xviii) (xvi) podiatry services;<br/>
<a id="pl.217.33"></a><var>217.33</var>(xix) (xvii) chiropractic services;<br/>
<a id="pl.217.34"></a><var>217.34</var>(xx) (xviii) immunizations;<br/>
<a id="pl.217.35"></a><var>217.35</var>(xxi) (xix) vision services and eyeglasses;<br/>
<a id="pl.217.36"></a><var>217.36</var>(xxii) (xx) waiver services;<br/>
<a id="pl.218.1"></a><var>218.1</var>(xxiii) (xxi) individualized education programs; or<br/>
<a id="pl.218.2"></a><var>218.2</var>(xxiv) (xxii) chemical dependency treatment.<br/>
<a id="pl.218.3"></a><var>218.3</var>(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, <br/>
<a id="pl.218.4"></a><var>218.4</var>nonimmigrants, or lawfully present in the United States as defined in Code of Federal <br/>
<a id="pl.218.5"></a><var>218.5</var>Regulations, title 8, section 103.12, are not covered by a group health plan or health <br/>
<a id="pl.218.6"></a><var>218.6</var>insurance coverage according to Code of Federal Regulations, title 42, section 457.310, <br/>
<a id="pl.218.7"></a><var>218.7</var>and who otherwise meet the eligibility requirements of this chapter, are eligible for <br/>
<a id="pl.218.8"></a><var>218.8</var>medical assistance through the period of pregnancy, including labor and delivery, and 60 <br/>
<a id="pl.218.9"></a><var>218.9</var>days postpartum, to the extent federal funds are available under title XXI of the Social <br/>
<a id="pl.218.10"></a><var>218.10</var>Security Act, and the state children's health insurance program.<br/>
<a id="pl.218.11"></a><var>218.11</var>(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation <br/>
<a id="pl.218.12"></a><var>218.12</var>services from a nonprofit center established to serve victims of torture and are otherwise <br/>
<a id="pl.218.13"></a><var>218.13</var>ineligible for medical assistance under this chapter are eligible for medical assistance <br/>
<a id="pl.218.14"></a><var>218.14</var>without federal financial participation. These individuals are eligible only for the period <br/>
<a id="pl.218.15"></a><var>218.15</var>during which they are receiving services from the center. Individuals eligible under this <br/>
<a id="pl.218.16"></a><var>218.16</var>paragraph shall not be required to participate in prepaid medical assistance.<br/>
<a id="pl.218.17"></a><var>218.17</var>(k) Notwithstanding paragraph (h), clause (2), the following services are covered as <br/>
<a id="pl.218.18"></a><var>218.18</var>emergency medical conditions under paragraph (f) except where coverage is prohibited <br/>
<a id="pl.218.19"></a><var>218.19</var>under federal law:<br/>
<a id="pl.218.20"></a><var>218.20</var>(1) dialysis services provided in a hospital or freestanding dialysis facility; and<br/>
<a id="pl.218.21"></a><var>218.21</var>(2) surgery and the administration of chemotherapy, radiation, and related services <br/>
<a id="pl.218.22"></a><var>218.22</var>necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission <br/>
<a id="pl.218.23"></a><var>218.23</var>and requires surgery, chemotherapy, or radiation treatment.<br/>
<a id="pl.218.24"></a><var>218.24</var>    (l) The commissioner or its third party medical review agent may authorize payment <br/>
<a id="pl.218.25"></a><var>218.25</var>for follow-up care and alternative services, including, but not limited to, long-term care <br/>
<a id="pl.218.26"></a><var>218.26</var>services that would not otherwise be paid for under this subdivision if the commissioner <br/>
<a id="pl.218.27"></a><var>218.27</var>determines that the services, if provided, will directly prevent a medical emergency from <br/>
<a id="pl.218.28"></a><var>218.28</var>immediately occurring.<br/>
<br/>
<a id="bill.6.7.0"></a><a id="pl.218.29"></a><var>218.29</var>    Sec. 7. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to <br/>
<a id="pl.218.30"></a><var>218.30</var>read:<br/>
<a id="pl.218.31"></a><var>218.31</var>    Subd. 13e. <b>Payment rates.</b> (a) The basis for determining the amount of payment <br/>
<a id="pl.218.32"></a><var>218.32</var>shall be the lower of the actual acquisition costs of the drugs or the maximum allowable <br/>
<a id="pl.218.33"></a><var>218.33</var>cost by the commissioner plus the fixed dispensing fee; or the usual and customary price <br/>
<a id="pl.218.34"></a><var>218.34</var>charged to the public. The amount of payment basis must be reduced to reflect all discount <br/>
<a id="pl.218.35"></a><var>218.35</var>amounts applied to the charge by any provider/insurer agreement or contract for submitted <br/>
<a id="pl.219.1"></a><var>219.1</var>charges to medical assistance programs. The net submitted charge may not be greater <br/>
<a id="pl.219.2"></a><var>219.2</var>than the patient liability for the service. The pharmacy dispensing fee shall be $3.65, <br/>
<a id="pl.219.3"></a><var>219.3</var>except that the dispensing fee for intravenous solutions which must be compounded by the <br/>
<a id="pl.219.4"></a><var>219.4</var>pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 <br/>
<a id="pl.219.5"></a><var>219.5</var>per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per <br/>
<a id="pl.219.6"></a><var>219.6</var>bag for total parenteral nutritional products dispensed in quantities greater than one liter. <br/>
<a id="pl.219.7"></a><var>219.7</var>Actual acquisition cost includes quantity and other special discounts except time and cash <br/>
<a id="pl.219.8"></a><var>219.8</var>discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at <br/>
<a id="pl.219.9"></a><var>219.9</var>wholesale acquisition cost plus four percent for independently owned pharmacies located <br/>
<a id="pl.219.10"></a><var>219.10</var>in a designated rural area within Minnesota, and at wholesale acquisition cost plus two <br/>
<a id="pl.219.11"></a><var>219.11</var>percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four <br/>
<a id="pl.219.12"></a><var>219.12</var>or fewer pharmacies under the same ownership nationally. A "designated rural area" means <br/>
<a id="pl.219.13"></a><var>219.13</var>an area defined as a small rural area or isolated rural area according to the four-category <br/>
<a id="pl.219.14"></a><var>219.14</var>classification of the Rural Urban Commuting Area system developed for the United States <br/>
<a id="pl.219.15"></a><var>219.15</var>Health Resources and Services Administration. Wholesale acquisition cost is defined as the <br/>
<a id="pl.219.16"></a><var>219.16</var>manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the <br/>
<a id="pl.219.17"></a><var>219.17</var>United States, not including prompt pay or other discounts, rebates, or reductions in price, <br/>
<a id="pl.219.18"></a><var>219.18</var>for the most recent month for which information is available, as reported in wholesale price <br/>
<a id="pl.219.19"></a><var>219.19</var>guides or other publications of drug or biological pricing data. The maximum allowable <br/>
<a id="pl.219.20"></a><var>219.20</var>cost of a multisource drug may be set by the commissioner and it shall be comparable to, <br/>
<a id="pl.219.21"></a><var>219.21</var>but no higher than, the maximum amount paid by other third-party payors in this state who <br/>
<a id="pl.219.22"></a><var>219.22</var>have maximum allowable cost programs. Establishment of the amount of payment for <br/>
<a id="pl.219.23"></a><var>219.23</var>drugs shall not be subject to the requirements of the Administrative Procedure Act.<br/>
<a id="pl.219.24"></a><var>219.24</var>    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid <br/>
<a id="pl.219.25"></a><var>219.25</var>to pharmacists for legend drug prescriptions dispensed to residents of long-term care <br/>
<a id="pl.219.26"></a><var>219.26</var>facilities when a unit dose blister card system, approved by the department, is used. Under <br/>
<a id="pl.219.27"></a><var>219.27</var>this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The <br/>
<a id="pl.219.28"></a><var>219.28</var>National Drug Code (NDC) from the drug container used to fill the blister card must be <br/>
<a id="pl.219.29"></a><var>219.29</var>identified on the claim to the department. The unit dose blister card containing the drug <br/>
<a id="pl.219.30"></a><var>219.30</var>must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that <br/>
<a id="pl.219.31"></a><var>219.31</var>govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will <br/>
<a id="pl.219.32"></a><var>219.32</var>be required to credit the department for the actual acquisition cost of all unused drugs that <br/>
<a id="pl.219.33"></a><var>219.33</var>are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in <br/>
<a id="pl.219.34"></a><var>219.34</var>a quantity that is less than a 30-day supply.<br/>
<a id="pl.219.35"></a><var>219.35</var>    (c) Whenever a maximum allowable cost has been set for a multisource drug, <br/>
<a id="pl.219.36"></a><var>219.36</var>payment shall be the lower of the usual and customary price charged to the public or the <br/>
<a id="pl.220.1"></a><var>220.1</var>maximum allowable cost established by the commissioner unless prior authorization <br/>
<a id="pl.220.2"></a><var>220.2</var>for the brand name product has been granted according to the criteria established by <br/>
<a id="pl.220.3"></a><var>220.3</var>the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the <br/>
<a id="pl.220.4"></a><var>220.4</var>prescriber has indicated "dispense as written" on the prescription in a manner consistent <br/>
<a id="pl.220.5"></a><var>220.5</var>with section 
         <statute_ref>151.21, subdivision 2</statute_ref>.<br/>
<a id="pl.220.6"></a><var>220.6</var>    (d) The basis for determining the amount of payment for drugs administered in an <br/>
<a id="pl.220.7"></a><var>220.7</var>outpatient setting shall be the lower of the usual and customary cost submitted by the <br/>
<a id="pl.220.8"></a><var>220.8</var>provider or, 106 percent of the average sales price as determined by the United States <br/>
<a id="pl.220.9"></a><var>220.9</var>Department of Health and Human Services pursuant to title XVIII, section 1847a of the <br/>
<a id="pl.220.10"></a><var>220.10</var>federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost <br/>
<a id="pl.220.11"></a><var>220.11</var>set by the commissioner. If average sales price is unavailable, the amount of payment <br/>
<a id="pl.220.12"></a><var>220.12</var>must be lower of the usual and customary cost submitted by the provider or, the wholesale <br/>
<a id="pl.220.13"></a><var>220.13</var>acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the <br/>
<a id="pl.220.14"></a><var>220.14</var>commissioner. The payment for drugs administered in an outpatient setting shall be made <br/>
<a id="pl.220.15"></a><var>220.15</var>to the administering facility or practitioner. A retail or specialty pharmacy dispensing a <br/>
<a id="pl.220.16"></a><var>220.16</var>drug for administration in an outpatient setting is not eligible for direct reimbursement.<br/>
<a id="pl.220.17"></a><var>220.17</var>    (e) The commissioner may negotiate lower reimbursement rates for specialty <br/>
<a id="pl.220.18"></a><var>220.18</var>pharmacy products than the rates specified in paragraph (a). The commissioner may <br/>
<a id="pl.220.19"></a><var>220.19</var>require individuals enrolled in the health care programs administered by the department <br/>
<a id="pl.220.20"></a><var>220.20</var>to obtain specialty pharmacy products from providers with whom the commissioner has <br/>
<a id="pl.220.21"></a><var>220.21</var>negotiated lower reimbursement rates. Specialty pharmacy products are defined as those <br/>
<a id="pl.220.22"></a><var>220.22</var>used by a small number of recipients or recipients with complex and chronic diseases <br/>
<a id="pl.220.23"></a><var>220.23</var>that require expensive and challenging drug regimens. Examples of these conditions <br/>
<a id="pl.220.24"></a><var>220.24</var>include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis <br/>
<a id="pl.220.25"></a><var>220.25</var>C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms <br/>
<a id="pl.220.26"></a><var>220.26</var>of cancer. Specialty pharmaceutical products include injectable and infusion therapies, <br/>
<a id="pl.220.27"></a><var>220.27</var>biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies <br/>
<a id="pl.220.28"></a><var>220.28</var>that require complex care. The commissioner shall consult with the formulary committee <br/>
<a id="pl.220.29"></a><var>220.29</var>to develop a list of specialty pharmacy products subject to this paragraph. In consulting <br/>
<a id="pl.220.30"></a><var>220.30</var>with the formulary committee in developing this list, the commissioner shall take into <br/>
<a id="pl.220.31"></a><var>220.31</var>consideration the population served by specialty pharmacy products, the current delivery <br/>
<a id="pl.220.32"></a><var>220.32</var>system and standard of care in the state, and access to care issues. The commissioner shall <br/>
<a id="pl.220.33"></a><var>220.33</var>have the discretion to adjust the reimbursement rate to prevent access to care issues.<br/>
<a id="pl.220.34"></a><var>220.34</var>(f) Home infusion therapy services provided by home infusion therapy pharmacies <br/>
<a id="pl.220.35"></a><var>220.35</var>must be paid at rates according to subdivision 8d.<br/>
<a id="pl.220.36"></a><var>220.36</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.6.8.0"></a><a id="pl.221.1"></a><var>221.1</var>    Sec. 8. Minnesota Statutes 2012, section 256B.0625, is amended by adding a <br/>
<a id="pl.221.2"></a><var>221.2</var>subdivision to read:<br/>
<a id="pl.221.3"></a><var>221.3</var>    Subd. 28b. <b>Doula services.</b> Medical assistance covers doula services provided by a <br/>
<a id="pl.221.4"></a><var>221.4</var>certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For <br/>
<a id="pl.221.5"></a><var>221.5</var>purposes of this section, "doula services" means childbirth education and support services, <br/>
<a id="pl.221.6"></a><var>221.6</var>including emotional and physical support provided during pregnancy, labor, birth, and <br/>
<a id="pl.221.7"></a><var>221.7</var>postpartum.<br/>
<a id="pl.221.8"></a><var>221.8</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2014, or upon federal <br/>
<a id="pl.221.9"></a><var>221.9</var>approval, whichever is later, and applies to services provided on or after the effective date.<br/>
<br/>
<a id="bill.6.9.0"></a><a id="pl.221.10"></a><var>221.10</var>    Sec. 9. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:<br/>
<a id="pl.221.11"></a><var>221.11</var>    Subd. 31. <b>Medical supplies and equipment.</b> (a) Medical assistance covers medical <br/>
<a id="pl.221.12"></a><var>221.12</var>supplies and equipment. Separate payment outside of the facility's payment rate shall <br/>
<a id="pl.221.13"></a><var>221.13</var>be made for wheelchairs and wheelchair accessories for recipients who are residents <br/>
<a id="pl.221.14"></a><var>221.14</var>of intermediate care facilities for the developmentally disabled. Reimbursement for <br/>
<a id="pl.221.15"></a><var>221.15</var>wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same <br/>
<a id="pl.221.16"></a><var>221.16</var>conditions and limitations as coverage for recipients who do not reside in institutions. A <br/>
<a id="pl.221.17"></a><var>221.17</var>wheelchair purchased outside of the facility's payment rate is the property of the recipient. <br/>
<a id="pl.221.18"></a><var>221.18</var>The commissioner may set reimbursement rates for specified categories of medical <br/>
<a id="pl.221.19"></a><var>221.19</var>supplies at levels below the Medicare payment rate.<br/>
<a id="pl.221.20"></a><var>221.20</var>(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies <br/>
<a id="pl.221.21"></a><var>221.21</var>must enroll as a Medicare provider.<br/>
<a id="pl.221.22"></a><var>221.22</var>(c) When necessary to ensure access to durable medical equipment, prosthetics, <br/>
<a id="pl.221.23"></a><var>221.23</var>orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare <br/>
<a id="pl.221.24"></a><var>221.24</var>enrollment requirement if:<br/>
<a id="pl.221.25"></a><var>221.25</var>(1) the vendor supplies only one type of durable medical equipment, prosthetic, <br/>
<a id="pl.221.26"></a><var>221.26</var>orthotic, or medical supply;<br/>
<a id="pl.221.27"></a><var>221.27</var>(2) the vendor serves ten or fewer medical assistance recipients per year;<br/>
<a id="pl.221.28"></a><var>221.28</var>(3) the commissioner finds that other vendors are not available to provide same or <br/>
<a id="pl.221.29"></a><var>221.29</var>similar durable medical equipment, prosthetics, orthotics, or medical supplies; and<br/>
<a id="pl.221.30"></a><var>221.30</var>(4) the vendor complies with all screening requirements in this chapter and Code of <br/>
<a id="pl.221.31"></a><var>221.31</var>Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from <br/>
<a id="pl.221.32"></a><var>221.32</var>the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare <br/>
<a id="pl.221.33"></a><var>221.33</var>and Medicaid Services approved national accreditation organization as complying with <br/>
<a id="pl.221.34"></a><var>221.34</var>the Medicare program's supplier and quality standards and the vendor serves primarily <br/>
<a id="pl.221.35"></a><var>221.35</var>pediatric patients.<br/>
<a id="pl.222.1"></a><var>222.1</var>(d) Durable medical equipment means a device or equipment that:<br/>
<a id="pl.222.2"></a><var>222.2</var>(1) can withstand repeated use;<br/>
<a id="pl.222.3"></a><var>222.3</var>(2) is generally not useful in the absence of an illness, injury, or disability; and<br/>
<a id="pl.222.4"></a><var>222.4</var>(3) is provided to correct or accommodate a physiological disorder or physical <br/>
<a id="pl.222.5"></a><var>222.5</var>condition or is generally used primarily for a medical purpose.<br/>
<a id="pl.222.6"></a><var>222.6</var>(e) Electronic tablets may be considered durable medical equipment if the electronic <br/>
<a id="pl.222.7"></a><var>222.7</var>tablet will be used as an augmentative and alternative communication system as defined <br/>
<a id="pl.222.8"></a><var>222.8</var>under subdivision 31a, paragraph (a). To be covered by medical assistance, the device <br/>
<a id="pl.222.9"></a><var>222.9</var>must be locked in order to prevent use not related to communication.<br/>
<br/>
<a id="bill.6.10.0"></a><a id="pl.222.10"></a><var>222.10</var>    Sec. 10. Minnesota Statutes 2012, section 256B.0625, is amended by adding a <br/>
<a id="pl.222.11"></a><var>222.11</var>subdivision to read:<br/>
<a id="pl.222.12"></a><var>222.12</var>    Subd. 31b. <b>Preferred diabetic testing supply program.</b> (a) The commissioner <br/>
<a id="pl.222.13"></a><var>222.13</var>shall implement a point-of-sale preferred diabetic testing supply program by January 1, <br/>
<a id="pl.222.14"></a><var>222.14</var>2014. Medical assistance coverage for diabetic testing supplies shall conform to the <br/>
<a id="pl.222.15"></a><var>222.15</var>limitations established under the program. The commissioner may enter into a contract <br/>
<a id="pl.222.16"></a><var>222.16</var>with a vendor for the purpose of participating in a preferred diabetic testing supply list and <br/>
<a id="pl.222.17"></a><var>222.17</var>supplemental rebate program. The commissioner shall ensure that any contract meets all <br/>
<a id="pl.222.18"></a><var>222.18</var>federal requirements and maximizes federal financial participation. The commissioner <br/>
<a id="pl.222.19"></a><var>222.19</var>shall maintain an accurate and up-to-date list on the department's Web site.<br/>
<a id="pl.222.20"></a><var>222.20</var>(b) The commissioner may add to, delete from, and otherwise modify the preferred <br/>
<a id="pl.222.21"></a><var>222.21</var>diabetic testing supply program drug list after consulting with the Drug Formulary <br/>
<a id="pl.222.22"></a><var>222.22</var>Committee and appropriate medial specialists and providing public notice and the <br/>
<a id="pl.222.23"></a><var>222.23</var>opportunity for public comment.<br/>
<a id="pl.222.24"></a><var>222.24</var>(c) The commissioner shall adopt and administer the preferred diabetic testing <br/>
<a id="pl.222.25"></a><var>222.25</var>supply program as part of the administration of the diabetic testing supply rebate program. <br/>
<a id="pl.222.26"></a><var>222.26</var>Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply <br/>
<a id="pl.222.27"></a><var>222.27</var>list may be subject to prior authorization.<br/>
<a id="pl.222.28"></a><var>222.28</var>(d) All claims for diabetic testing supplies in categories on the preferred diabetic <br/>
<a id="pl.222.29"></a><var>222.29</var>testing supply list must be submitted by enrolled pharmacy providers using the most <br/>
<a id="pl.222.30"></a><var>222.30</var>current National Council of Prescription Drug Providers electronic claims standard.<br/>
<a id="pl.222.31"></a><var>222.31</var>(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a <br/>
<a id="pl.222.32"></a><var>222.32</var>list of diabetic testing supplies selected by the commissioner, for which prior authorization <br/>
<a id="pl.222.33"></a><var>222.33</var>is not required.<br/>
<a id="pl.222.34"></a><var>222.34</var>(f) The commissioner shall seek any federal waivers or approvals necessary to <br/>
<a id="pl.222.35"></a><var>222.35</var>implement this subdivision.<br/>
<br/>
<a id="bill.6.11.0"></a><a id="pl.223.1"></a><var>223.1</var>    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to <br/>
<a id="pl.223.2"></a><var>223.2</var>read:<br/>
<a id="pl.223.3"></a><var>223.3</var>    Subd. 39. <b>Childhood immunizations.</b> Providers who administer pediatric vaccines <br/>
<a id="pl.223.4"></a><var>223.4</var>within the scope of their licensure, and who are enrolled as a medical assistance provider, <br/>
<a id="pl.223.5"></a><var>223.5</var>must enroll in the pediatric vaccine administration program established by section 13631 <br/>
<a id="pl.223.6"></a><var>223.6</var>of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an <br/>
<a id="pl.223.7"></a><var>223.7</var>$8.50 fee per dose for administration of the vaccine to children eligible for medical <br/>
<a id="pl.223.8"></a><var>223.8</var>assistance. Medical assistance does not pay for vaccines that are available at no cost from <br/>
<a id="pl.223.9"></a><var>223.9</var>the pediatric vaccine administration program.<br/>
<br/>
<a id="bill.6.12.0"></a><a id="pl.223.10"></a><var>223.10</var>    Sec. 12. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to <br/>
<a id="pl.223.11"></a><var>223.11</var>read:<br/>
<a id="pl.223.12"></a><var>223.12</var>    Subd. 58. <b>Early and periodic screening, diagnosis, and treatment services.</b><br/>
<a id="pl.223.13"></a><var>223.13</var>Medical assistance covers early and periodic screening, diagnosis, and treatment services <br/>
<a id="pl.223.14"></a><var>223.14</var>(EPSDT). The payment amount for a complete EPSDT screening shall not include charges <br/>
<a id="pl.223.15"></a><var>223.15</var>for vaccines that are available at no cost to the provider and shall not exceed the rate <br/>
<a id="pl.223.16"></a><var>223.16</var>established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.<br/>
<br/>
<a id="bill.6.13.0"></a><a id="pl.223.17"></a><var>223.17</var>    Sec. 13. Minnesota Statutes 2012, section 256B.0625, is amended by adding a <br/>
<a id="pl.223.18"></a><var>223.18</var>subdivision to read:<br/>
<a id="pl.223.19"></a><var>223.19</var>    Subd. 61. <b>Payment for multiple services provided on the same day.</b> The <br/>
<a id="pl.223.20"></a><var>223.20</var>commissioner shall not prohibit payment, including supplemental payments, for mental <br/>
<a id="pl.223.21"></a><var>223.21</var>health services or dental services provided to a patient by a clinic or health care <br/>
<a id="pl.223.22"></a><var>223.22</var>professional solely because the mental health or dental services were provided on the same <br/>
<a id="pl.223.23"></a><var>223.23</var>day as other covered health services furnished by the same provider.<br/>
<br/>
<a id="bill.6.14.0"></a><a id="pl.223.24"></a><var>223.24</var>    Sec. 14. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:<br/>
<a id="pl.223.25"></a><var>223.25</var>    Subdivision 1. <b>Cost-sharing.</b> (a) Except as provided in subdivision 2, the medical <br/>
<a id="pl.223.26"></a><var>223.26</var>assistance benefit plan shall include the following cost-sharing for all recipients, effective <br/>
<a id="pl.223.27"></a><var>223.27</var>for services provided on or after September 1, 2011:<br/>
<a id="pl.223.28"></a><var>223.28</var>    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes <br/>
<a id="pl.223.29"></a><var>223.29</var>of this subdivision, a visit means an episode of service which is required because of <br/>
<a id="pl.223.30"></a><var>223.30</var>a recipient's symptoms, diagnosis, or established illness, and which is delivered in an <br/>
<a id="pl.223.31"></a><var>223.31</var>ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse <br/>
<a id="pl.223.32"></a><var>223.32</var>midwife, advanced practice nurse, audiologist, optician, or optometrist;<br/>
<a id="pl.224.1"></a><var>224.1</var>    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that <br/>
<a id="pl.224.2"></a><var>224.2</var>this co-payment shall be increased to $20 upon federal approval;<br/>
<a id="pl.224.3"></a><var>224.3</var>    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, <br/>
<a id="pl.224.4"></a><var>224.4</var>subject to a $12 per month maximum for prescription drug co-payments. No co-payments <br/>
<a id="pl.224.5"></a><var>224.5</var>shall apply to antipsychotic drugs when used for the treatment of mental illness;<br/>
<a id="pl.224.6"></a><var>224.6</var>(4) effective January 1, 2012, a family deductible equal to the maximum amount <br/>
<a id="pl.224.7"></a><var>224.7</var>allowed under Code of Federal Regulations, title 42, part 447.54; and<br/>
<a id="pl.224.8"></a><var>224.8</var>    (5) for individuals identified by the commissioner with income at or below 100 <br/>
<a id="pl.224.9"></a><var>224.9</var>percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five <br/>
<a id="pl.224.10"></a><var>224.10</var>percent of family income. For purposes of this paragraph, family income is the total <br/>
<a id="pl.224.11"></a><var>224.11</var>earned and unearned income of the individual and the individual's spouse, if the spouse is <br/>
<a id="pl.224.12"></a><var>224.12</var>enrolled in medical assistance and also subject to the five percent limit on cost-sharing.<br/>
<a id="pl.224.13"></a><var>224.13</var>    (b) Recipients of medical assistance are responsible for all co-payments and <br/>
<a id="pl.224.14"></a><var>224.14</var>deductibles in this subdivision.<br/>
<a id="pl.224.15"></a><var>224.15</var>(c) Notwithstanding paragraph (b), the commissioner, through the contracting <br/>
<a id="pl.224.16"></a><var>224.16</var>process under sections 
         <statute_ref>256B.69</statute_ref> and 
         <statute_ref>256B.692</statute_ref>, may allow managed care plans and <br/>
<a id="pl.224.17"></a><var>224.17</var>county-based purchasing plans to waive the family deductible under paragraph (a), <br/>
<a id="pl.224.18"></a><var>224.18</var>clause (4). The value of the family deductible shall not be included in the capitation <br/>
<a id="pl.224.19"></a><var>224.19</var>payment to managed care plans and county-based purchasing plans. Managed care plans <br/>
<a id="pl.224.20"></a><var>224.20</var>and county-based purchasing plans shall certify annually to the commissioner the dollar <br/>
<a id="pl.224.21"></a><var>224.21</var>value of the family deductible.<br/>
<a id="pl.224.22"></a><var>224.22</var>(d) Notwithstanding paragraph (b), the commissioner may shall waive the collection <br/>
<a id="pl.224.23"></a><var>224.23</var>of the family deductible described under paragraph (a), clause (4), from individuals and <br/>
<a id="pl.224.24"></a><var>224.24</var>allow long-term care and waivered service providers to assume responsibility for payment.<br/>
<a id="pl.224.25"></a><var>224.25</var>(e) Notwithstanding paragraph (b), the commissioner, through the contracting <br/>
<a id="pl.224.26"></a><var>224.26</var>process under section 256B.0756 shall allow the pilot program in Hennepin County to <br/>
<a id="pl.224.27"></a><var>224.27</var>waive co-payments. The value of the co-payments shall not be included as part of the <br/>
<a id="pl.224.28"></a><var>224.28</var>payment system for the integrated health care delivery networks under the pilot program.<br/>
<br/>
<a id="bill.6.15.0"></a><a id="pl.224.29"></a><var>224.29</var>    Sec. 15. Minnesota Statutes 2012, section 256B.0756, is amended to read:<br/>
<a id="pl.224.30"></a><var>224.30</var><b>256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.</b><br/>
<a id="pl.224.31"></a><var>224.31</var>(a) The commissioner, upon federal approval of a new waiver request or amendment <br/>
<a id="pl.224.32"></a><var>224.32</var>of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey <br/>
<a id="pl.224.33"></a><var>224.33</var>County, or both, to test alternative and innovative integrated health care delivery networks.<br/>
<a id="pl.224.34"></a><var>224.34</var>(b) Individuals eligible for the pilot program shall be individuals who are eligible for <br/>
<a id="pl.224.35"></a><var>224.35</var>medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin <br/>
<a id="pl.225.1"></a><var>225.1</var>County or Ramsey County. The commissioner may identify individuals to be enrolled <br/>
<a id="pl.225.2"></a><var>225.2</var>in the Hennepin County pilot program by zip code or by whether the individuals would <br/>
<a id="pl.225.3"></a><var>225.3</var>benefit from an integrated health care delivery network.<br/>
<a id="pl.225.4"></a><var>225.4</var>(c) Individuals enrolled in the pilot program shall be enrolled in an integrated <br/>
<a id="pl.225.5"></a><var>225.5</var>health care delivery network in their county of residence. The integrated health care <br/>
<a id="pl.225.6"></a><var>225.6</var>delivery network in Hennepin County shall be a network, such as an accountable care <br/>
<a id="pl.225.7"></a><var>225.7</var>organization or a community-based collaborative care network, created by or including <br/>
<a id="pl.225.8"></a><var>225.8</var>Hennepin County Medical Center. The integrated health care delivery network in Ramsey <br/>
<a id="pl.225.9"></a><var>225.9</var>County shall be a network, such as an accountable care organization or community-based <br/>
<a id="pl.225.10"></a><var>225.10</var>collaborative care network, created by or including Regions Hospital.<br/>
<a id="pl.225.11"></a><var>225.11</var>(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for <br/>
<a id="pl.225.12"></a><var>225.12</var>Hennepin County and 3,500 enrollees for Ramsey County.<br/>
<a id="pl.225.13"></a><var>225.13</var>(e) (d) In developing a payment system for the pilot programs, the commissioner <br/>
<a id="pl.225.14"></a><var>225.14</var>shall establish a total cost of care for the recipients enrolled in the pilot programs that <br/>
<a id="pl.225.15"></a><var>225.15</var>equals the cost of care that would otherwise be spent for these enrollees in the prepaid <br/>
<a id="pl.225.16"></a><var>225.16</var>medical assistance program.<br/>
<a id="pl.225.17"></a><var>225.17</var>(f) Counties may transfer funds necessary to support the nonfederal share of <br/>
<a id="pl.225.18"></a><var>225.18</var>payments for integrated health care delivery networks in their county. Such transfers per <br/>
<a id="pl.225.19"></a><var>225.19</var>county shall not exceed 15 percent of the expected expenses for county enrollees.<br/>
<a id="pl.225.20"></a><var>225.20</var>(g) (e) The commissioner shall apply to the federal government for, or as appropriate, <br/>
<a id="pl.225.21"></a><var>225.21</var>cooperate with counties, providers, or other entities that are applying for any applicable <br/>
<a id="pl.225.22"></a><var>225.22</var>grant or demonstration under the Patient Protection and Affordable Health Care Act, Public <br/>
<a id="pl.225.23"></a><var>225.23</var>Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law <br/>
<a id="pl.225.24"></a><var>225.24</var>111-152, that would further the purposes of or assist in the creation of an integrated health <br/>
<a id="pl.225.25"></a><var>225.25</var>care delivery network for the purposes of this subdivision, including, but not limited to, a <br/>
<a id="pl.225.26"></a><var>225.26</var>global payment demonstration or the community-based collaborative care network grants.<br/>
<br/>
<a id="bill.6.16.0"></a><a id="pl.225.27"></a><var>225.27</var>    Sec. 16. Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:<br/>
<a id="pl.225.28"></a><var>225.28</var>    Subd. 2. <b>Commissioner's duties.</b> (a) For the purposes of this subdivision and <br/>
<a id="pl.225.29"></a><var>225.29</var>subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital <br/>
<a id="pl.225.30"></a><var>225.30</var>services upper payment limit for nonstate government hospitals. The commissioner shall <br/>
<a id="pl.225.31"></a><var>225.31</var>then determine the amount of a supplemental payment to Hennepin County Medical <br/>
<a id="pl.225.32"></a><var>225.32</var>Center and Regions Hospital for these services that would increase medical assistance <br/>
<a id="pl.225.33"></a><var>225.33</var>spending in this category to the aggregate upper payment limit for all nonstate government <br/>
<a id="pl.225.34"></a><var>225.34</var>hospitals in Minnesota. In making this determination, the commissioner shall allot the <br/>
<a id="pl.225.35"></a><var>225.35</var>available increases between Hennepin County Medical Center and Regions Hospital <br/>
<a id="pl.226.1"></a><var>226.1</var>based on the ratio of medical assistance fee-for-service outpatient hospital payments to <br/>
<a id="pl.226.2"></a><var>226.2</var>the two facilities. The commissioner shall adjust this allotment as necessary based on <br/>
<a id="pl.226.3"></a><var>226.3</var>federal approvals, the amount of intergovernmental transfers received from Hennepin and <br/>
<a id="pl.226.4"></a><var>226.4</var>Ramsey Counties, and other factors, in order to maximize the additional total payments. <br/>
<a id="pl.226.5"></a><var>226.5</var>The commissioner shall inform Hennepin County and Ramsey County of the periodic <br/>
<a id="pl.226.6"></a><var>226.6</var>intergovernmental transfers necessary to match federal Medicaid payments available <br/>
<a id="pl.226.7"></a><var>226.7</var>under this subdivision in order to make supplementary medical assistance payments to <br/>
<a id="pl.226.8"></a><var>226.8</var>Hennepin County Medical Center and Regions Hospital equal to an amount that when <br/>
<a id="pl.226.9"></a><var>226.9</var>combined with existing medical assistance payments to nonstate governmental hospitals <br/>
<a id="pl.226.10"></a><var>226.10</var>would increase total payments to hospitals in this category for outpatient services to <br/>
<a id="pl.226.11"></a><var>226.11</var>the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon <br/>
<a id="pl.226.12"></a><var>226.12</var>receipt of these periodic transfers, the commissioner shall make supplementary payments <br/>
<a id="pl.226.13"></a><var>226.13</var>to Hennepin County Medical Center and Regions Hospital.<br/>
<a id="pl.226.14"></a><var>226.14</var>    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall <br/>
<a id="pl.226.15"></a><var>226.15</var>determine an upper payment limit for physicians and other billing professionals affiliated <br/>
<a id="pl.226.16"></a><var>226.16</var>with Hennepin County Medical Center and with Regions Hospital. The upper payment <br/>
<a id="pl.226.17"></a><var>226.17</var>limit shall be based on the average commercial rate or be determined using another method <br/>
<a id="pl.226.18"></a><var>226.18</var>acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall <br/>
<a id="pl.226.19"></a><var>226.19</var>inform Hennepin County and Ramsey County of the periodic intergovernmental transfers <br/>
<a id="pl.226.20"></a><var>226.20</var>necessary to match the federal Medicaid payments available under this subdivision in order <br/>
<a id="pl.226.21"></a><var>226.21</var>to make supplementary payments to physicians and other billing professionals affiliated <br/>
<a id="pl.226.22"></a><var>226.22</var>with Hennepin County Medical Center and to make supplementary payments to physicians <br/>
<a id="pl.226.23"></a><var>226.23</var>and other billing professionals affiliated with Regions Hospital through HealthPartners <br/>
<a id="pl.226.24"></a><var>226.24</var>Medical Group equal to the difference between the established medical assistance <br/>
<a id="pl.226.25"></a><var>226.25</var>payment for physician and other billing professional services and the upper payment limit. <br/>
<a id="pl.226.26"></a><var>226.26</var>Upon receipt of these periodic transfers, the commissioner shall make supplementary <br/>
<a id="pl.226.27"></a><var>226.27</var>payments to physicians and other billing professionals affiliated with Hennepin County <br/>
<a id="pl.226.28"></a><var>226.28</var>Medical Center and shall make supplementary payments to physicians and other billing <br/>
<a id="pl.226.29"></a><var>226.29</var>professionals affiliated with Regions Hospital through HealthPartners Medical Group.<br/>
<a id="pl.226.30"></a><var>226.30</var>    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make <br/>
<a id="pl.226.31"></a><var>226.31</var>monthly voluntary intergovernmental transfers to the commissioner in amounts not to <br/>
<a id="pl.226.32"></a><var>226.32</var>exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from <br/>
<a id="pl.226.33"></a><var>226.33</var>Ramsey County. The commissioner shall increase the medical assistance capitation <br/>
<a id="pl.226.34"></a><var>226.34</var>payments to any licensed health plan under contract with the medical assistance program <br/>
<a id="pl.226.35"></a><var>226.35</var>that agrees to make enhanced payments to Hennepin County Medical Center or Regions <br/>
<a id="pl.226.36"></a><var>226.36</var>Hospital. The increase shall be in an amount equal to the annual value of the monthly <br/>
<a id="pl.227.1"></a><var>227.1</var>transfers plus federal financial participation, with each health plan receiving its pro rata <br/>
<a id="pl.227.2"></a><var>227.2</var>share of the increase based on the pro rata share of medical assistance admissions to <br/>
<a id="pl.227.3"></a><var>227.3</var>Hennepin County Medical Center and Regions Hospital by those plans. Upon the request <br/>
<a id="pl.227.4"></a><var>227.4</var>of the commissioner, health plans shall submit individual-level cost data for verification <br/>
<a id="pl.227.5"></a><var>227.5</var>purposes. The commissioner may ratably reduce these payments on a pro rata basis in <br/>
<a id="pl.227.6"></a><var>227.6</var>order to satisfy federal requirements for actuarial soundness. If payments are reduced, <br/>
<a id="pl.227.7"></a><var>227.7</var>transfers shall be reduced accordingly. Any licensed health plan that receives increased <br/>
<a id="pl.227.8"></a><var>227.8</var>medical assistance capitation payments under the intergovernmental transfer described in <br/>
<a id="pl.227.9"></a><var>227.9</var>this paragraph shall increase its medical assistance payments to Hennepin County Medical <br/>
<a id="pl.227.10"></a><var>227.10</var>Center and Regions Hospital by the same amount as the increased payments received in <br/>
<a id="pl.227.11"></a><var>227.11</var>the capitation payment described in this paragraph.<br/>
<a id="pl.227.12"></a><var>227.12</var>    (d) For the purposes of this subdivision and subdivision 3, the commissioner shall <br/>
<a id="pl.227.13"></a><var>227.13</var>determine an upper payment limit for ambulance services affiliated with Hennepin County <br/>
<a id="pl.227.14"></a><var>227.14</var>Medical Center. The upper payment limit shall be based on the average commercial <br/>
<a id="pl.227.15"></a><var>227.15</var>rate or be determined using another method acceptable to the Centers for Medicare and <br/>
<a id="pl.227.16"></a><var>227.16</var>Medicaid Services. The commissioner shall inform Hennepin County of the periodic <br/>
<a id="pl.227.17"></a><var>227.17</var>intergovernmental transfers necessary to match the federal Medicaid payments available <br/>
<a id="pl.227.18"></a><var>227.18</var>under this subdivision in order to make supplementary payments to Hennepin County <br/>
<a id="pl.227.19"></a><var>227.19</var>Medical Center equal to the difference between the established medical assistance <br/>
<a id="pl.227.20"></a><var>227.20</var>payment for ambulance services and the upper payment limit. Upon receipt of these <br/>
<a id="pl.227.21"></a><var>227.21</var>periodic transfers, the commissioner shall make supplementary payments to Hennepin <br/>
<a id="pl.227.22"></a><var>227.22</var>County Medical Center.<br/>
<a id="pl.227.23"></a><var>227.23</var>    (e) The commissioner shall inform the transferring governmental entities on an <br/>
<a id="pl.227.24"></a><var>227.24</var>ongoing basis of the need for any changes needed in the intergovernmental transfers in <br/>
<a id="pl.227.25"></a><var>227.25</var>order to continue the payments under paragraphs (a) to (c) (d), at their maximum level, <br/>
<a id="pl.227.26"></a><var>227.26</var>including increases in upper payment limits, changes in the federal Medicaid match, and <br/>
<a id="pl.227.27"></a><var>227.27</var>other factors.<br/>
<a id="pl.227.28"></a><var>227.28</var>    (e) (f)  The payments in paragraphs (a) to (c) (d)  shall be implemented independently <br/>
<a id="pl.227.29"></a><var>227.29</var>of each other, subject to federal approval and to the receipt of transfers under subdivision 3.<br/>
<br/>
<a id="bill.6.17.0"></a><a id="pl.227.30"></a><var>227.30</var>    Sec. 17. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:<br/>
<a id="pl.227.31"></a><var>227.31</var>    Subd. 5c. <b>Medical education and research fund.</b> (a) The commissioner of human <br/>
<a id="pl.227.32"></a><var>227.32</var>services shall transfer each year to the medical education and research fund established <br/>
<a id="pl.227.33"></a><var>227.33</var>under section 
         <statute_ref>62J.692</statute_ref>, an amount specified in this subdivision. The commissioner shall <br/>
<a id="pl.227.34"></a><var>227.34</var>calculate the following:<br/>
<a id="pl.228.1"></a><var>228.1</var>(1) an amount equal to the reduction in the prepaid medical assistance payments as <br/>
<a id="pl.228.2"></a><var>228.2</var>specified in this clause. Until January 1, 2002, the county medical assistance capitation <br/>
<a id="pl.228.3"></a><var>228.3</var>base rate prior to plan specific adjustments and after the regional rate adjustments under <br/>
<a id="pl.228.4"></a><var>228.4</var>subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining <br/>
<a id="pl.228.5"></a><var>228.5</var>metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after <br/>
<a id="pl.228.6"></a><var>228.6</var>January 1, 2002, the county medical assistance capitation base rate prior to plan specific <br/>
<a id="pl.228.7"></a><var>228.7</var>adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining <br/>
<a id="pl.228.8"></a><var>228.8</var>metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing <br/>
<a id="pl.228.9"></a><var>228.9</var>facility and elderly waiver payments and demonstration project payments operating <br/>
<a id="pl.228.10"></a><var>228.10</var>under subdivision 23 are excluded from this reduction. The amount calculated under <br/>
<a id="pl.228.11"></a><var>228.11</var>this clause shall not be adjusted for periods already paid due to subsequent changes to <br/>
<a id="pl.228.12"></a><var>228.12</var>the capitation payments;<br/>
<a id="pl.228.13"></a><var>228.13</var>(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this <br/>
<a id="pl.228.14"></a><var>228.14</var>section;<br/>
<a id="pl.228.15"></a><var>228.15</var>(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates <br/>
<a id="pl.228.16"></a><var>228.16</var>paid under this section; and<br/>
<a id="pl.228.17"></a><var>228.17</var>(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid <br/>
<a id="pl.228.18"></a><var>228.18</var>under this section.<br/>
<a id="pl.228.19"></a><var>228.19</var>(b) This subdivision shall be effective upon approval of a federal waiver which <br/>
<a id="pl.228.20"></a><var>228.20</var>allows federal financial participation in the medical education and research fund. The <br/>
<a id="pl.228.21"></a><var>228.21</var>amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount <br/>
<a id="pl.228.22"></a><var>228.22</var>transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under <br/>
<a id="pl.228.23"></a><var>228.23</var>paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally <br/>
<a id="pl.228.24"></a><var>228.24</var>reduce the amount specified under paragraph (a), clause (1).<br/>
<a id="pl.228.25"></a><var>228.25</var>(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner <br/>
<a id="pl.228.26"></a><var>228.26</var>shall transfer $21,714,000 each fiscal year to the medical education and research fund.<br/>
<a id="pl.228.27"></a><var>228.27</var>(d) Beginning September 1, 2011, of the amount in paragraph (a), following the <br/>
<a id="pl.228.28"></a><var>228.28</var>transfer under paragraph (c), the commissioner shall transfer to the medical education <br/>
<a id="pl.228.29"></a><var>228.29</var>research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $43,148,000 in <br/>
<a id="pl.228.30"></a><var>228.30</var>fiscal year 2014 and thereafter.<br/>
<br/>
<a id="bill.6.18.0"></a><a id="pl.228.31"></a><var>228.31</var>    Sec. 18. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:<br/>
<a id="pl.228.32"></a><var>228.32</var>    Subd. 31. <b>Payment reduction.</b> (a) Beginning September 1, 2011, the commissioner <br/>
<a id="pl.228.33"></a><var>228.33</var>shall reduce payments and limit future rate increases paid to managed care plans and <br/>
<a id="pl.228.34"></a><var>228.34</var>county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved <br/>
<a id="pl.228.35"></a><var>228.35</var>on a statewide aggregate basis by program. The commissioner may use competitive <br/>
<a id="pl.229.1"></a><var>229.1</var>bidding, payment reductions, or other reductions to achieve the reductions and limits <br/>
<a id="pl.229.2"></a><var>229.2</var>in this subdivision.<br/>
<a id="pl.229.3"></a><var>229.3</var>(b) Beginning September 1, 2011, the commissioner shall reduce payments to <br/>
<a id="pl.229.4"></a><var>229.4</var>managed care plans and county-based purchasing plans as follows:<br/>
<a id="pl.229.5"></a><var>229.5</var>(1) 2.0 percent for medical assistance elderly basic care. This shall not apply <br/>
<a id="pl.229.6"></a><var>229.6</var>to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver <br/>
<a id="pl.229.7"></a><var>229.7</var>services;<br/>
<a id="pl.229.8"></a><var>229.8</var>(2) 2.82 percent for medical assistance families and children;<br/>
<a id="pl.229.9"></a><var>229.9</var>(3) 10.1 percent for medical assistance adults without children; and<br/>
<a id="pl.229.10"></a><var>229.10</var>(4) 6.0 percent for MinnesotaCare families and children.<br/>
<a id="pl.229.11"></a><var>229.11</var>(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed <br/>
<a id="pl.229.12"></a><var>229.12</var>care plans and county-based purchasing plans for calendar year 2012 to a percentage of <br/>
<a id="pl.229.13"></a><var>229.13</var>the rates in effect on August 31, 2011, as follows:<br/>
<a id="pl.229.14"></a><var>229.14</var>(1) 98 percent for medical assistance elderly basic care. This shall not apply to <br/>
<a id="pl.229.15"></a><var>229.15</var>Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver <br/>
<a id="pl.229.16"></a><var>229.16</var>services;<br/>
<a id="pl.229.17"></a><var>229.17</var>(2) 97.18 percent for medical assistance families and children;<br/>
<a id="pl.229.18"></a><var>229.18</var>(3) 89.9 percent for medical assistance adults without children; and<br/>
<a id="pl.229.19"></a><var>229.19</var>(4) 94 percent for MinnesotaCare families and children.<br/>
<a id="pl.229.20"></a><var>229.20</var>(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit <br/>
<a id="pl.229.21"></a><var>229.21</var>the maximum annual trend increases to rates paid to managed care plans and county-based <br/>
<a id="pl.229.22"></a><var>229.22</var>purchasing plans as follows:<br/>
<a id="pl.229.23"></a><var>229.23</var>(1) 7.5 percent for medical assistance elderly basic care. This shall not apply <br/>
<a id="pl.229.24"></a><var>229.24</var>to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver <br/>
<a id="pl.229.25"></a><var>229.25</var>services;<br/>
<a id="pl.229.26"></a><var>229.26</var>(2) 5.0 percent for medical assistance special needs basic care;<br/>
<a id="pl.229.27"></a><var>229.27</var>(3) 2.0 percent for medical assistance families and children;<br/>
<a id="pl.229.28"></a><var>229.28</var>(4) 3.0 percent for medical assistance adults without children;<br/>
<a id="pl.229.29"></a><var>229.29</var>(5) 3.0 percent for MinnesotaCare families and children; and<br/>
<a id="pl.229.30"></a><var>229.30</var>(6) 3.0 percent for MinnesotaCare adults without children.<br/>
<a id="pl.229.31"></a><var>229.31</var>(e) The commissioner may limit trend increases to less than the maximum. <br/>
<a id="pl.229.32"></a><var>229.32</var>Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend <br/>
<a id="pl.229.33"></a><var>229.33</var>increases to rates paid to managed care plans and county-based purchasing plans as <br/>
<a id="pl.229.34"></a><var>229.34</var>follows for calendar years 2014 and, 2015, 2016, and 2017:<br/>
<a id="pl.230.1"></a><var>230.1</var>(1) 7.5 6.0  percent for medical assistance elderly basic care. This shall not apply <br/>
<a id="pl.230.2"></a><var>230.2</var>to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver <br/>
<a id="pl.230.3"></a><var>230.3</var>services;<br/>
<a id="pl.230.4"></a><var>230.4</var>(2) 5.0 0.5  percent for medical assistance special needs basic care;<br/>
<a id="pl.230.5"></a><var>230.5</var>(3) 2.0 0.5 percent for medical assistance families and children;<br/>
<a id="pl.230.6"></a><var>230.6</var>(4) 3.0 0  percent for medical assistance adults without children;<br/>
<a id="pl.230.7"></a><var>230.7</var>(5) 3.0 percent for MinnesotaCare families and children; and<br/>
<a id="pl.230.8"></a><var>230.8</var>(6) 4.0 percent for MinnesotaCare adults without children.<br/>
<a id="pl.230.9"></a><var>230.9</var>The commissioner may limit trend increases to less than the maximum.<br/>
<br/>
<a id="bill.6.19.0"></a><a id="pl.230.10"></a><var>230.10</var>    Sec. 19. Minnesota Statutes 2012, section 256B.69, is amended by adding a <br/>
<a id="pl.230.11"></a><var>230.11</var>subdivision to read:<br/>
<a id="pl.230.12"></a><var>230.12</var>    Subd. 34. <b>Risk corridors.</b> (a) Effective for services rendered on or after January 1, <br/>
<a id="pl.230.13"></a><var>230.13</var>2014, the commissioner shall establish risk corridors that are actuarially sound for each <br/>
<a id="pl.230.14"></a><var>230.14</var>managed care plan and each county-based purchasing plan providing services under this <br/>
<a id="pl.230.15"></a><var>230.15</var>section and section 256B.692. The risk corridors shall be calculated annually based on the <br/>
<a id="pl.230.16"></a><var>230.16</var>calendar year's net underwriting gain or loss. If the managed care plan or county-based <br/>
<a id="pl.230.17"></a><var>230.17</var>purchasing plan achieved a net underwriting gain of greater than three percent of <br/>
<a id="pl.230.18"></a><var>230.18</var>revenue, any excess must be repaid to the commissioner by July 31 of the year following <br/>
<a id="pl.230.19"></a><var>230.19</var>calculation of the risk corridor year. If the managed care plan or county-based purchasing <br/>
<a id="pl.230.20"></a><var>230.20</var>plan has incurred a net underwriting loss greater than three percent of total revenue, any <br/>
<a id="pl.230.21"></a><var>230.21</var>excess must be repaid to the managed care plan or county-based purchasing plan by <br/>
<a id="pl.230.22"></a><var>230.22</var>the commissioner by July 31 of the year following calculation of the risk corridor year. <br/>
<a id="pl.230.23"></a><var>230.23</var>Determination of total revenues and net underwriting gain or loss must be based on the <br/>
<a id="pl.230.24"></a><var>230.24</var>Minnesota supplement report #1 that is filed on April 1 of the year following calculation <br/>
<a id="pl.230.25"></a><var>230.25</var>of the risk corridor and adjusted for the actual withhold calculation under subdivision 5a <br/>
<a id="pl.230.26"></a><var>230.26</var>and section 256L.12, subdivision 9. The report must be filed with the commissioner of <br/>
<a id="pl.230.27"></a><var>230.27</var>health and must be made available on the Department of Health's Web site.<br/>
<a id="pl.230.28"></a><var>230.28</var>(b) This subdivision shall not apply to the special demonstration projects under <br/>
<a id="pl.230.29"></a><var>230.29</var>subdivisions 23 and 28.<br/>
<br/>
<a id="bill.6.20.0"></a><a id="pl.230.30"></a><var>230.30</var>    Sec. 20. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:<br/>
<a id="pl.230.31"></a><var>230.31</var>    Subdivision 1. <b>Physician reimbursement. </b> (a) Effective for services rendered on <br/>
<a id="pl.230.32"></a><var>230.32</var>or after October 1, 1992, the commissioner shall make payments for physician services <br/>
<a id="pl.230.33"></a><var>230.33</var>as follows:<br/>
<a id="pl.231.1"></a><var>231.1</var>    (1) payment for level one Centers for Medicare and Medicaid Services' common <br/>
<a id="pl.231.2"></a><var>231.2</var>procedural coding system codes titled "office and other outpatient services," "preventive <br/>
<a id="pl.231.3"></a><var>231.3</var>medicine new and established patient," "delivery, antepartum, and postpartum care," <br/>
<a id="pl.231.4"></a><var>231.4</var>"critical care," cesarean delivery and pharmacologic management provided to psychiatric <br/>
<a id="pl.231.5"></a><var>231.5</var>patients, and level three codes for enhanced services for prenatal high risk, shall be paid <br/>
<a id="pl.231.6"></a><var>231.6</var>at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June <br/>
<a id="pl.231.7"></a><var>231.7</var>30, 1992. If the rate on any procedure code within these categories is different than the <br/>
<a id="pl.231.8"></a><var>231.8</var>rate that would have been paid under the methodology in section 
         <statute_ref>256B.74, subdivision 2</statute_ref>, <br/>
<a id="pl.231.9"></a><var>231.9</var>then the larger rate shall be paid;<br/>
<a id="pl.231.10"></a><var>231.10</var>    (2) payments for all other services shall be paid at the lower of (i) submitted charges, <br/>
<a id="pl.231.11"></a><var>231.11</var>or (ii) 15.4 percent above the rate in effect on June 30, 1992; and<br/>
<a id="pl.231.12"></a><var>231.12</var>    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th <br/>
<a id="pl.231.13"></a><var>231.13</var>percentile of 1989, less the percent in aggregate necessary to equal the above increases <br/>
<a id="pl.231.14"></a><var>231.14</var>except that payment rates for home health agency services shall be the rates in effect <br/>
<a id="pl.231.15"></a><var>231.15</var>on September 30, 1992.<br/>
<a id="pl.231.16"></a><var>231.16</var>    (b) Effective for services rendered on or after January 1, 2000, payment rates for <br/>
<a id="pl.231.17"></a><var>231.17</var>physician and professional services shall be increased by three percent over the rates <br/>
<a id="pl.231.18"></a><var>231.18</var>in effect on December 31, 1999, except for home health agency and family planning <br/>
<a id="pl.231.19"></a><var>231.19</var>agency services. The increases in this paragraph shall be implemented January 1, 2000, <br/>
<a id="pl.231.20"></a><var>231.20</var>for managed care.<br/>
<a id="pl.231.21"></a><var>231.21</var>(c) Effective for services rendered on or after July 1, 2009, payment rates for <br/>
<a id="pl.231.22"></a><var>231.22</var>physician and professional services shall be reduced by five percent, except that for the <br/>
<a id="pl.231.23"></a><var>231.23</var>period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent <br/>
<a id="pl.231.24"></a><var>231.24</var>for the medical assistance and general assistance medical care programs, over the rates in <br/>
<a id="pl.231.25"></a><var>231.25</var>effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply <br/>
<a id="pl.231.26"></a><var>231.26</var>to office or other outpatient visits, preventive medicine visits and family planning visits <br/>
<a id="pl.231.27"></a><var>231.27</var>billed by physicians, advanced practice nurses, or physician assistants in a family planning <br/>
<a id="pl.231.28"></a><var>231.28</var>agency or in one of the following primary care practices: general practice, general internal <br/>
<a id="pl.231.29"></a><var>231.29</var>medicine, general pediatrics, general geriatrics, and family medicine. This reduction <br/>
<a id="pl.231.30"></a><var>231.30</var>and the reductions in paragraph (d) do not apply to federally qualified health centers, <br/>
<a id="pl.231.31"></a><var>231.31</var>rural health centers, and Indian health services. Effective October 1, 2009, payments <br/>
<a id="pl.231.32"></a><var>231.32</var>made to managed care plans and county-based purchasing plans under sections 
         <statute_ref>256B.69</statute_ref>, <br/>
<statute_ref><a id="pl.231.33"></a><var>231.33</var>256B.692
         </statute_ref>, and 
         <statute_ref>256L.12</statute_ref> shall reflect the payment reduction described in this paragraph.<br/>
<a id="pl.231.34"></a><var>231.34</var>(d) Effective for services rendered on or after July 1, 2010, payment rates for <br/>
<a id="pl.231.35"></a><var>231.35</var>physician and professional services shall be reduced an additional seven percent over <br/>
<a id="pl.231.36"></a><var>231.36</var>the five percent reduction in rates described in paragraph (c). This additional reduction <br/>
<a id="pl.232.1"></a><var>232.1</var>does not apply to physical therapy services, occupational therapy services, and speech <br/>
<a id="pl.232.2"></a><var>232.2</var>pathology and related services provided on or after July 1, 2010. This additional reduction <br/>
<a id="pl.232.3"></a><var>232.3</var>does not apply to physician services billed by a psychiatrist or an advanced practice nurse <br/>
<a id="pl.232.4"></a><var>232.4</var>with a specialty in mental health. Effective October 1, 2010, payments made to managed <br/>
<a id="pl.232.5"></a><var>232.5</var>care plans and county-based purchasing plans under sections 
         <statute_ref>256B.69</statute_ref>, 
         <statute_ref>256B.692</statute_ref>, and <br/>
<statute_ref><a id="pl.232.6"></a><var>232.6</var>256L.12
         </statute_ref> shall reflect the payment reduction described in this paragraph.<br/>
<a id="pl.232.7"></a><var>232.7</var>(e) Effective for services rendered on or after September 1, 2011, through June 30, <br/>
<a id="pl.232.8"></a><var>232.8</var>2013, payment rates for physician and professional services shall be reduced three percent <br/>
<a id="pl.232.9"></a><var>232.9</var>from the rates in effect on August 31, 2011. This reduction does not apply to physical <br/>
<a id="pl.232.10"></a><var>232.10</var>therapy services, occupational therapy services, and speech pathology and related services.<br/>
<a id="pl.232.11"></a><var>232.11</var>(f) Effective for services rendered on or after January 1, 2015, payment rates for <br/>
<a id="pl.232.12"></a><var>232.12</var>physician and professional services, including physical therapy, occupational therapy, <br/>
<a id="pl.232.13"></a><var>232.13</var>speech pathology, and mental health services shall be increased by five percent from <br/>
<a id="pl.232.14"></a><var>232.14</var>the rates in effect on December 31, 2014. This increase does not apply to federally <br/>
<a id="pl.232.15"></a><var>232.15</var>qualified health centers, rural health centers, and Indian health services. Payments made to <br/>
<a id="pl.232.16"></a><var>232.16</var>managed care plans and county-based purchasing plans shall not be adjusted to reflect <br/>
<a id="pl.232.17"></a><var>232.17</var>payments under this paragraph.<br/>
<br/>
<a id="bill.6.21.0"></a><a id="pl.232.18"></a><var>232.18</var>    Sec. 21. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:<br/>
<a id="pl.232.19"></a><var>232.19</var>    Subd. 2. <b>Dental reimbursement. </b> (a) Effective for services rendered on or after <br/>
<a id="pl.232.20"></a><var>232.20</var>October 1, 1992, the commissioner shall make payments for dental services as follows:<br/>
<a id="pl.232.21"></a><var>232.21</var>    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 <br/>
<a id="pl.232.22"></a><var>232.22</var>percent above the rate in effect on June 30, 1992; and<br/>
<a id="pl.232.23"></a><var>232.23</var>    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th <br/>
<a id="pl.232.24"></a><var>232.24</var>percentile of 1989, less the percent in aggregate necessary to equal the above increases.<br/>
<a id="pl.232.25"></a><var>232.25</var>    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments <br/>
<a id="pl.232.26"></a><var>232.26</var>shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.<br/>
<a id="pl.232.27"></a><var>232.27</var>    (c) Effective for services rendered on or after January 1, 2000, payment rates for <br/>
<a id="pl.232.28"></a><var>232.28</var>dental services shall be increased by three percent over the rates in effect on December <br/>
<a id="pl.232.29"></a><var>232.29</var>31, 1999.<br/>
<a id="pl.232.30"></a><var>232.30</var>    (d) Effective for services provided on or after January 1, 2002, payment for <br/>
<a id="pl.232.31"></a><var>232.31</var>diagnostic examinations and dental x-rays provided to children under age 21 shall be the <br/>
<a id="pl.232.32"></a><var>232.32</var>lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.<br/>
<a id="pl.232.33"></a><var>232.33</var>    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, <br/>
<a id="pl.232.34"></a><var>232.34</var>2000, for managed care.<br/>
<a id="pl.233.1"></a><var>233.1</var>(f) Effective for dental services rendered on or after October 1, 2010, by a <br/>
<a id="pl.233.2"></a><var>233.2</var>state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based <br/>
<a id="pl.233.3"></a><var>233.3</var>on the Medicare principles of reimbursement. This payment shall be effective for services <br/>
<a id="pl.233.4"></a><var>233.4</var>rendered on or after January 1, 2011, to recipients enrolled in managed care plans or <br/>
<a id="pl.233.5"></a><var>233.5</var>county-based purchasing plans.<br/>
<a id="pl.233.6"></a><var>233.6</var>(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics <br/>
<a id="pl.233.7"></a><var>233.7</var>in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal <br/>
<a id="pl.233.8"></a><var>233.8</var>year, a supplemental state payment equal to the difference between the total payments <br/>
<a id="pl.233.9"></a><var>233.9</var>in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated <br/>
<a id="pl.233.10"></a><var>233.10</var>services for the operation of the dental clinics.<br/>
<a id="pl.233.11"></a><var>233.11</var>(h) If the cost-based payment system for state-operated dental clinics described in <br/>
<a id="pl.233.12"></a><var>233.12</var>paragraph (f) does not receive federal approval, then state-operated dental clinics shall be <br/>
<a id="pl.233.13"></a><var>233.13</var>designated as critical access dental providers under subdivision 4, paragraph (b), and shall <br/>
<a id="pl.233.14"></a><var>233.14</var>receive the critical access dental reimbursement rate as described under subdivision 4, <br/>
<a id="pl.233.15"></a><var>233.15</var>paragraph (a).<br/>
<a id="pl.233.16"></a><var>233.16</var>(i) Effective for services rendered on or after September 1, 2011, through June 30, <br/>
<a id="pl.233.17"></a><var>233.17</var>2013, payment rates for dental services shall be reduced by three percent. This reduction <br/>
<a id="pl.233.18"></a><var>233.18</var>does not apply to state-operated dental clinics in paragraph (f).<br/>
<a id="pl.233.19"></a><var>233.19</var>(j) Effective for services rendered on or after January 1, 2015, payment rates for <br/>
<a id="pl.233.20"></a><var>233.20</var>dental services shall be increased by five percent from the rates in effect on December <br/>
<a id="pl.233.21"></a><var>233.21</var>31, 2014. This increase does not apply to state-operated dental clinics in paragraph <br/>
<a id="pl.233.22"></a><var>233.22</var>(f), federally qualified health centers, rural health centers, and Indian health services. <br/>
<a id="pl.233.23"></a><var>233.23</var>Effective January 1, 2015, payments made to managed care plans and county-based <br/>
<a id="pl.233.24"></a><var>233.24</var>purchasing plans under sections 256B.69, 256B.692, and chapter 256L shall reflect the <br/>
<a id="pl.233.25"></a><var>233.25</var>payment increase described in this paragraph.<br/>
<br/>
<a id="bill.6.22.0"></a><a id="pl.233.26"></a><var>233.26</var>    Sec. 22. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:<br/>
<a id="pl.233.27"></a><var>233.27</var>    Subd. 4. <b>Critical access dental providers. </b> (a) Effective for dental services rendered <br/>
<a id="pl.233.28"></a><var>233.28</var>on or after January 1, 2002, the commissioner shall increase reimbursements to dentists <br/>
<a id="pl.233.29"></a><var>233.29</var>and dental clinics deemed by the commissioner to be critical access dental providers. <br/>
<a id="pl.233.30"></a><var>233.30</var>For dental services rendered on or after July 1, 2007, the commissioner shall increase <br/>
<a id="pl.233.31"></a><var>233.31</var>reimbursement by 30 35 percent above the reimbursement rate that would otherwise be <br/>
<a id="pl.233.32"></a><var>233.32</var>paid to the critical access dental provider. The commissioner shall pay the managed <br/>
<a id="pl.233.33"></a><var>233.33</var>care plans and county-based purchasing plans in amounts sufficient to reflect increased <br/>
<a id="pl.233.34"></a><var>233.34</var>reimbursements to critical access dental providers as approved by the commissioner.<br/>
<a id="pl.234.1"></a><var>234.1</var>(b) The commissioner shall designate the following dentists and dental clinics as <br/>
<a id="pl.234.2"></a><var>234.2</var>critical access dental providers:<br/>
<a id="pl.234.3"></a><var>234.3</var>    (1) nonprofit community clinics that:<br/>
<a id="pl.234.4"></a><var>234.4</var>(i) have nonprofit status in accordance with chapter 317A;<br/>
<a id="pl.234.5"></a><var>234.5</var>(ii) have tax exempt status in accordance with the Internal Revenue Code, section <br/>
<a id="pl.234.6"></a><var>234.6</var>501(c)(3);<br/>
<a id="pl.234.7"></a><var>234.7</var>(iii) are established to provide oral health services to patients who are low income, <br/>
<a id="pl.234.8"></a><var>234.8</var>uninsured, have special needs, and are underserved;<br/>
<a id="pl.234.9"></a><var>234.9</var>(iv) have professional staff familiar with the cultural background of the clinic's <br/>
<a id="pl.234.10"></a><var>234.10</var>patients;<br/>
<a id="pl.234.11"></a><var>234.11</var>(v) charge for services on a sliding fee scale designed to provide assistance to <br/>
<a id="pl.234.12"></a><var>234.12</var>low-income patients based on current poverty income guidelines and family size;<br/>
<a id="pl.234.13"></a><var>234.13</var>(vi) do not restrict access or services because of a patient's financial limitations <br/>
<a id="pl.234.14"></a><var>234.14</var>or public assistance status; and<br/>
<a id="pl.234.15"></a><var>234.15</var>(vii) have free care available as needed;<br/>
<a id="pl.234.16"></a><var>234.16</var>    (2) federally qualified health centers, rural health clinics, and public health clinics;<br/>
<a id="pl.234.17"></a><var>234.17</var>    (3) city or county owned and operated hospital-based dental clinics;<br/>
<a id="pl.234.18"></a><var>234.18</var>(4) a dental clinic or dental group owned and operated by a nonprofit corporation in <br/>
<a id="pl.234.19"></a><var>234.19</var>accordance with chapter 317A with more than 10,000 patient encounters per year with <br/>
<a id="pl.234.20"></a><var>234.20</var>patients who are uninsured or covered by medical assistance, general assistance medical <br/>
<a id="pl.234.21"></a><var>234.21</var>care, or MinnesotaCare; and<br/>
<a id="pl.234.22"></a><var>234.22</var>(5) a dental clinic owned and operated by the University of Minnesota or the <br/>
<a id="pl.234.23"></a><var>234.23</var>Minnesota State Colleges and Universities system.; and<br/>
<a id="pl.234.24"></a><var>234.24</var>(6) private practicing dentists if:<br/>
<a id="pl.234.25"></a><var>234.25</var>(i) the dentist's office is located within a health professional shortage area as defined <br/>
<a id="pl.234.26"></a><var>234.26</var>under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, <br/>
<a id="pl.234.27"></a><var>234.27</var>section 254E;<br/>
<a id="pl.234.28"></a><var>234.28</var>(ii) more than 50 percent of the dentist's patient encounters per year are with patients <br/>
<a id="pl.234.29"></a><var>234.29</var>who are uninsured or covered by medical assistance or MinnesotaCare;<br/>
<a id="pl.234.30"></a><var>234.30</var>(iii) the dentist does not restrict access or services because of a patient's financial <br/>
<a id="pl.234.31"></a><var>234.31</var>limitations or public assistance status; and<br/>
<a id="pl.234.32"></a><var>234.32</var>(iv) the level of service provided by the dentist is critical to maintaining adequate <br/>
<a id="pl.234.33"></a><var>234.33</var>levels of patient access within the service area in which the dentist operates.<br/>
<a id="pl.234.34"></a><var>234.34</var>    (c) The commissioner may designate a dentist or dental clinic as a critical access <br/>
<a id="pl.234.35"></a><var>234.35</var>dental provider if the dentist or dental clinic is willing to provide care to patients covered <br/>
<a id="pl.235.1"></a><var>235.1</var>by medical assistance, general assistance medical care, or MinnesotaCare at a level which <br/>
<a id="pl.235.2"></a><var>235.2</var>significantly increases access to dental care in the service area.<br/>
<a id="pl.235.3"></a><var>235.3</var>(d) (c) A designated critical access clinic shall receive the reimbursement rate <br/>
<a id="pl.235.4"></a><var>235.4</var>specified in paragraph (a) for dental services provided off site at a private dental office if <br/>
<a id="pl.235.5"></a><var>235.5</var>the following requirements are met:<br/>
<a id="pl.235.6"></a><var>235.6</var>(1) the designated critical access dental clinic is located within a health professional <br/>
<a id="pl.235.7"></a><var>235.7</var>shortage area as defined under Code of Federal Regulations, title 42, part 5, and United <br/>
<a id="pl.235.8"></a><var>235.8</var>States Code, title 42, section 254E, and is located outside the seven-county metropolitan <br/>
<a id="pl.235.9"></a><var>235.9</var>area;<br/>
<a id="pl.235.10"></a><var>235.10</var>(2) the designated critical access dental clinic is not able to provide the service <br/>
<a id="pl.235.11"></a><var>235.11</var>and refers the patient to the off-site dentist;<br/>
<a id="pl.235.12"></a><var>235.12</var>(3) the service, if provided at the critical access dental clinic, would be reimbursed <br/>
<a id="pl.235.13"></a><var>235.13</var>at the critical access reimbursement rate;<br/>
<a id="pl.235.14"></a><var>235.14</var>(4) the dentist and allied dental professionals providing the services off site are <br/>
<a id="pl.235.15"></a><var>235.15</var>licensed and in good standing under chapter 150A;<br/>
<a id="pl.235.16"></a><var>235.16</var>(5) the dentist providing the services is enrolled as a medical assistance provider;<br/>
<a id="pl.235.17"></a><var>235.17</var>(6) the critical access dental clinic submits the claim for services provided off site <br/>
<a id="pl.235.18"></a><var>235.18</var>and receives the payment for the services; and<br/>
<a id="pl.235.19"></a><var>235.19</var>(7) the critical access dental clinic maintains dental records for each claim submitted <br/>
<a id="pl.235.20"></a><var>235.20</var>under this paragraph, including the name of the dentist, the off-site location, and the <br/>
<a id="pl.235.21"></a><var>235.21</var>license number of the dentist and allied dental professionals providing the services.<br/>
<br/>
<a id="bill.6.23.0"></a><a id="pl.235.22"></a><var>235.22</var>    Sec. 23. Minnesota Statutes 2012, section 256B.76, is amended by adding a <br/>
<a id="pl.235.23"></a><var>235.23</var>subdivision to read:<br/>
<a id="pl.235.24"></a><var>235.24</var>    Subd. 7. <b>Payment for certain primary care services and immunization </b><br/>
<a id="pl.235.25"></a><var>235.25</var><b>administration.</b> Payment for certain primary care services and immunization <br/>
<a id="pl.235.26"></a><var>235.26</var>administration services rendered on or after January 1, 2013, through December 31, 2014, <br/>
<a id="pl.235.27"></a><var>235.27</var>shall be made in accordance with section 1902(a)(13) of the Social Security Act.<br/>
<br/>
<a id="bill.6.24.0"></a><a id="pl.235.28"></a><var>235.28</var>    Sec. 24. Minnesota Statutes 2012, section 256B.764, is amended to read:<br/>
<a id="pl.235.29"></a><var>235.29</var><b>256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.</b><br/>
<a id="pl.235.30"></a><var>235.30</var>    (a) Effective for services rendered on or after July 1, 2007, payment rates for family <br/>
<a id="pl.235.31"></a><var>235.31</var>planning services shall be increased by 25 percent over the rates in effect June 30, 2007, <br/>
<a id="pl.235.32"></a><var>235.32</var>when these services are provided by a community clinic as defined in section 
         <statute_ref>145.9268</statute_ref>, <br/>
<a id="pl.235.33"></a><var>235.33</var>subdivision 1.<br/>
<a id="pl.236.1"></a><var>236.1</var>    (b) Effective for services rendered on or after July 1, 2014, payment rates for <br/>
<a id="pl.236.2"></a><var>236.2</var>family planning services shall be increased by 20 percent over the rates in effect June <br/>
<a id="pl.236.3"></a><var>236.3</var>30, 2014, when these services are provided by a community clinic as defined in section <br/>
<a id="pl.236.4"></a><var>236.4</var>145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care <br/>
<a id="pl.236.5"></a><var>236.5</var>and county-based purchasing plans to reflect this increase, and shall require plans to pass <br/>
<a id="pl.236.6"></a><var>236.6</var>on the full amount of the rate increase to eligible community clinics, in the form of higher <br/>
<a id="pl.236.7"></a><var>236.7</var>payment rates for family planning services.<br/>
<br/>
<a id="bill.6.25.0"></a><a id="pl.236.8"></a><var>236.8</var>    Sec. 25. Minnesota Statutes 2012, section 256B.766, is amended to read:<br/>
<a id="pl.236.9"></a><var>236.9</var><b>256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.</b><br/>
<a id="pl.236.10"></a><var>236.10</var>(a) Effective for services provided on or after July 1, 2009, total payments for basic <br/>
<a id="pl.236.11"></a><var>236.11</var>care services, shall be reduced by three percent, except that for the period July 1, 2009, <br/>
<a id="pl.236.12"></a><var>236.12</var>through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical <br/>
<a id="pl.236.13"></a><var>236.13</var>assistance and general assistance medical care programs, prior to third-party liability and <br/>
<a id="pl.236.14"></a><var>236.14</var>spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical <br/>
<a id="pl.236.15"></a><var>236.15</var>therapy services, occupational therapy services, and speech-language pathology and <br/>
<a id="pl.236.16"></a><var>236.16</var>related services as basic care services. The reduction in this paragraph shall apply to <br/>
<a id="pl.236.17"></a><var>236.17</var>physical therapy services, occupational therapy services, and speech-language pathology <br/>
<a id="pl.236.18"></a><var>236.18</var>and related services provided on or after July 1, 2010.<br/>
<a id="pl.236.19"></a><var>236.19</var>(b) Payments made to managed care plans and county-based purchasing plans shall <br/>
<a id="pl.236.20"></a><var>236.20</var>be reduced for services provided on or after October 1, 2009, to reflect the reduction <br/>
<a id="pl.236.21"></a><var>236.21</var>effective July 1, 2009, and payments made to the plans shall be reduced effective October <br/>
<a id="pl.236.22"></a><var>236.22</var>1, 2010, to reflect the reduction effective July 1, 2010.<br/>
<a id="pl.236.23"></a><var>236.23</var>(c) Effective for services provided on or after September 1, 2011, through June 30, <br/>
<a id="pl.236.24"></a><var>236.24</var>2013, total payments for outpatient hospital facility fees shall be reduced by five percent <br/>
<a id="pl.236.25"></a><var>236.25</var>from the rates in effect on August 31, 2011.<br/>
<a id="pl.236.26"></a><var>236.26</var>(d) Effective for services provided on or after September 1, 2011, through June <br/>
<a id="pl.236.27"></a><var>236.27</var>30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies <br/>
<a id="pl.236.28"></a><var>236.28</var>and durable medical equipment not subject to a volume purchase contract, prosthetics <br/>
<a id="pl.236.29"></a><var>236.29</var>and orthotics, renal dialysis services, laboratory services, public health nursing services, <br/>
<a id="pl.236.30"></a><var>236.30</var>physical therapy services, occupational therapy services, speech therapy services, <br/>
<a id="pl.236.31"></a><var>236.31</var>eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume <br/>
<a id="pl.236.32"></a><var>236.32</var>purchase contract, and  anesthesia services, and hospice services shall be reduced by three <br/>
<a id="pl.236.33"></a><var>236.33</var>percent from the rates in effect on August 31, 2011.<br/>
<a id="pl.236.34"></a><var>236.34</var>(e) Effective for services provided on or after January 1, 2015, payments for <br/>
<a id="pl.236.35"></a><var>236.35</var>ambulatory surgery centers facility fees, medical supplies and durable medical equipment <br/>
<a id="pl.237.1"></a><var>237.1</var>not subject to a volume purchase contract, prosthetics and orthotics, hospice services, <br/>
<a id="pl.237.2"></a><var>237.2</var>renal dialysis services, laboratory services, public health nursing services, eyeglasses <br/>
<a id="pl.237.3"></a><var>237.3</var>not subject to a volume purchase contract, and hearing aids not subject to a volume <br/>
<a id="pl.237.4"></a><var>237.4</var>purchase contract shall be increased by three percent. Payments made to managed care <br/>
<a id="pl.237.5"></a><var>237.5</var>plans and county-based purchasing plans shall not be adjusted to reflect payments under <br/>
<a id="pl.237.6"></a><var>237.6</var>this paragraph.<br/>
<a id="pl.237.7"></a><var>237.7</var>(e) (f) This section does not apply to physician and professional services, inpatient <br/>
<a id="pl.237.8"></a><var>237.8</var>hospital services, family planning services, mental health services, dental services, <br/>
<a id="pl.237.9"></a><var>237.9</var>prescription drugs, medical transportation, federally qualified health centers, rural health <br/>
<a id="pl.237.10"></a><var>237.10</var>centers, Indian health services, and Medicare cost-sharing.<br/>
<br/>
<a id="bill.6.26.0"></a><a id="pl.237.11"></a><var>237.11</var>    Sec. 26. Laws 2012, chapter 247, article 1, section 28, is amended to read:<br/>
<a id="pl.237.12"></a><var>237.12</var>    Sec. 28. <b>EMERGENCY MEDICAL ASSISTANCE STUDY.</b><br/>
<a id="pl.237.13"></a><var>237.13</var>(a) The commissioner of human services shall convene a work group to develop a <br/>
<a id="pl.237.14"></a><var>237.14</var>plan to provide coordinated and cost-effective health care and coverage for individuals <br/>
<a id="pl.237.15"></a><var>237.15</var>who meet eligibility standards for emergency medical assistance and who are ineligible <br/>
<a id="pl.237.16"></a><var>237.16</var>for other state public programs. The commissioner shall consult with work group shall <br/>
<a id="pl.237.17"></a><var>237.17</var>consist of representatives of  relevant stakeholders in the development of the plan, <br/>
<a id="pl.237.18"></a><var>237.18</var>including but not limited to safety net hospitals, nonprofit health care coverage programs, <br/>
<a id="pl.237.19"></a><var>237.19</var>nonprofit community clinics, and counties. The commissioner work group shall consider <br/>
<a id="pl.237.20"></a><var>237.20</var>the following elements:<br/>
<a id="pl.237.21"></a><var>237.21</var>(1) strategies to provide individuals with the most appropriate care in the appropriate <br/>
<a id="pl.237.22"></a><var>237.22</var>setting, utilizing higher quality and lower cost providers;<br/>
<a id="pl.237.23"></a><var>237.23</var>(2) payment mechanisms to encourage providers to manage the care of these <br/>
<a id="pl.237.24"></a><var>237.24</var>populations, and to produce lower cost of care and better patient outcomes;<br/>
<a id="pl.237.25"></a><var>237.25</var>(3) ensure coverage and payment options that address the unique needs of those <br/>
<a id="pl.237.26"></a><var>237.26</var>needing episodic care, chronic care, and long-term care services;<br/>
<a id="pl.237.27"></a><var>237.27</var>(4) strategies for coordinating health care and nonhealth care services, and <br/>
<a id="pl.237.28"></a><var>237.28</var>integrating with existing coverage; and<br/>
<a id="pl.237.29"></a><var>237.29</var>(5) other issues and strategies to ensure cost-effective and coordinated delivery <br/>
<a id="pl.237.30"></a><var>237.30</var>of coverage and services.<br/>
<a id="pl.237.31"></a><var>237.31</var>(b) The commissioner shall submit the plan of the work group to the chairs and <br/>
<a id="pl.237.32"></a><var>237.32</var>ranking minority members of the legislative committees with jurisdiction over health and <br/>
<a id="pl.237.33"></a><var>237.33</var>human services policy and financing by January 15 July 15, 2013.<br/>
<a id="pl.237.34"></a><var>237.34</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.6.27.0"></a><a id="pl.238.1"></a><var>238.1</var>    Sec. 27. Laws 2013, chapter 1, section 6, is amended to read:<br/>
<a id="pl.238.2"></a><var>238.2</var>    Sec. 6. <b>TRANSFER.</b><br/>
<a id="pl.238.3"></a><var>238.3</var>(a) The commissioner of management and budget shall transfer from the health care <br/>
<a id="pl.238.4"></a><var>238.4</var>access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000 <br/>
<a id="pl.238.5"></a><var>238.5</var>in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal <br/>
<a id="pl.238.6"></a><var>238.6</var>year 2017.<br/>
<a id="pl.238.7"></a><var>238.7</var>(b) The commissioner of human services shall determine the difference between the <br/>
<a id="pl.238.8"></a><var>238.8</var>actual cost to the medical assistance program of adding 19- and 20-year-olds and parents <br/>
<a id="pl.238.9"></a><var>238.9</var>and relative caretaker populations with income between 100 and 138 percent of the federal <br/>
<a id="pl.238.10"></a><var>238.10</var>poverty guidelines and the cost of adding those populations that was estimated during the <br/>
<a id="pl.238.11"></a><var>238.11</var>2013 legislative session based on the data from the February 2013 forecast.<br/>
<a id="pl.238.12"></a><var>238.12</var>(c) For each fiscal year from 2014 to 2017, the commissioner of human services <br/>
<a id="pl.238.13"></a><var>238.13</var>shall certify and report to the commissioner of management and budget the actual cost <br/>
<a id="pl.238.14"></a><var>238.14</var>difference of adding 19- and 20-year-olds and parents and relative caretaker populations <br/>
<a id="pl.238.15"></a><var>238.15</var>with income between 100 and 138 percent of the federal poverty guidelines, as determined <br/>
<a id="pl.238.16"></a><var>238.16</var>under paragraph (b), by June 30 of each fiscal year. In each fiscal year, the commissioner <br/>
<a id="pl.238.17"></a><var>238.17</var>of management and budget shall reduce the transfer under paragraph (a) by the amount <br/>
<a id="pl.238.18"></a><var>238.18</var>of the costs certified under paragraph (b). If, for any fiscal year, the amount of the cost <br/>
<a id="pl.238.19"></a><var>238.19</var>difference determined under paragraph (b) exceeds the amount of the transfer, the transfer <br/>
<a id="pl.238.20"></a><var>238.20</var>for that year must be zero.<br/>
<br/>
<a id="bill.6.28.0"></a><a id="pl.238.21"></a><var>238.21</var>    Sec. 28. <b>340B PROVIDER PRESCRIPTION DRUGS REIMBURSEMENT </b><br/>
<a id="pl.238.22"></a><var>238.22</var><b>STUDY.</b><br/>
<a id="pl.238.23"></a><var>238.23</var>(a) The commissioner of human services shall study and make recommendations on <br/>
<a id="pl.238.24"></a><var>238.24</var>changes to standardize the medical assistance reimbursement rates for prescription drugs <br/>
<a id="pl.238.25"></a><var>238.25</var>obtained through the federal 340B Program and dispensed to medical assistance enrollees. <br/>
<a id="pl.238.26"></a><var>238.26</var>The study must examine the current medical assistance rate 340B providers are receiving <br/>
<a id="pl.238.27"></a><var>238.27</var>through claims submissions and make recommendations on an overall reimbursement <br/>
<a id="pl.238.28"></a><var>238.28</var>discount that will pay the same for drugs dispensed through the 340B Program as is paid <br/>
<a id="pl.238.29"></a><var>238.29</var>for drugs dispensed by non340B providers, taking into consideration any federal rebate.<br/>
<a id="pl.238.30"></a><var>238.30</var>(b) The commissioner shall consult with 340B providers that would be most <br/>
<a id="pl.238.31"></a><var>238.31</var>affected by a change in the reimbursement formula, including but not limited to safety net <br/>
<a id="pl.238.32"></a><var>238.32</var>hospitals, children's hospitals, community health centers, and family planning clinics.<br/>
<a id="pl.238.33"></a><var>238.33</var>(c) The commissioner shall submit recommendations to the chairs and ranking <br/>
<a id="pl.238.34"></a><var>238.34</var>minority members of the legislative committees and divisions with jurisdiction over health <br/>
<a id="pl.238.35"></a><var>238.35</var>and human services policy and finance by January 15, 2014.<br/>
<br/>
<a id="bill.6.29.0"></a><a id="pl.239.1"></a><var>239.1</var>    Sec. 29. <b>DENTAL ACCESS AND REIMBURSEMENT REPORT.</b><br/>
<a id="pl.239.2"></a><var>239.2</var>    Subdivision 1. <b>Study.</b> (a) The commissioner of human services shall study <br/>
<a id="pl.239.3"></a><var>239.3</var>the current oral health and dental services delivery system for state public health <br/>
<a id="pl.239.4"></a><var>239.4</var>care programs to improve access and ensure cost-effective delivery of services. The <br/>
<a id="pl.239.5"></a><var>239.5</var>commissioner shall make recommendations on modifying the delivery of services and <br/>
<a id="pl.239.6"></a><var>239.6</var>reimbursement methods, including modifications to the critical access dental provider <br/>
<a id="pl.239.7"></a><var>239.7</var>payments under Minnesota Statutes, section 256B.76, subdivision 4.<br/>
<a id="pl.239.8"></a><var>239.8</var>(b) The commissioner shall consult with dental providers enrolled in Minnesota <br/>
<a id="pl.239.9"></a><var>239.9</var>health care programs, including providers who serve substantial numbers of low-income <br/>
<a id="pl.239.10"></a><var>239.10</var>and uninsured patients and are currently receiving enhanced critical access dental provider <br/>
<a id="pl.239.11"></a><var>239.11</var>payments.<br/>
<a id="pl.239.12"></a><var>239.12</var>    Subd. 2. <b>Service delivery and reimbursement methods.</b> The recommendations <br/>
<a id="pl.239.13"></a><var>239.13</var>must address:<br/>
<a id="pl.239.14"></a><var>239.14</var>(1) targeting state funding and critical access dental payments to improve access <br/>
<a id="pl.239.15"></a><var>239.15</var>to oral health services for individuals enrolled in Minnesota health care programs who <br/>
<a id="pl.239.16"></a><var>239.16</var>are not receiving timely and appropriate dental services;<br/>
<a id="pl.239.17"></a><var>239.17</var>(2) encouraging the use of cost-effective service delivery methods, workforce <br/>
<a id="pl.239.18"></a><var>239.18</var>innovations, and the delivery of preventive services, including, but not limited to, dental <br/>
<a id="pl.239.19"></a><var>239.19</var>sealants that will reduce dental disease and future costs of treatment;<br/>
<a id="pl.239.20"></a><var>239.20</var>(3) improving access in all geographic areas of the state;<br/>
<a id="pl.239.21"></a><var>239.21</var>(4) encouraging the use of tele-dentistry and mobile dental equipment to serve <br/>
<a id="pl.239.22"></a><var>239.22</var>underserved patients and communities;<br/>
<a id="pl.239.23"></a><var>239.23</var>(5) evaluating the use of a single administrator delivery model;<br/>
<a id="pl.239.24"></a><var>239.24</var>(6) compensating providers for the added costs to providers of serving low-income <br/>
<a id="pl.239.25"></a><var>239.25</var>and underserved patients and populations who experience the greatest oral health <br/>
<a id="pl.239.26"></a><var>239.26</var>disparities in terms of incidence of oral health disease and access to and utilization of <br/>
<a id="pl.239.27"></a><var>239.27</var>needed oral health services;<br/>
<a id="pl.239.28"></a><var>239.28</var>(7) encouraging coordination of oral health care with other health care services;<br/>
<a id="pl.239.29"></a><var>239.29</var>(8) preventing overtreatment, fraud, and abuse; and<br/>
<a id="pl.239.30"></a><var>239.30</var>(9) reducing administrative costs for the state and for dental providers.<br/>
<a id="pl.239.31"></a><var>239.31</var>    Subd. 3. <b>Report.</b> The commissioner shall submit a report on the recommendations to <br/>
<a id="pl.239.32"></a><var>239.32</var>the chairs and ranking minority members of the of the legislative committees and divisions <br/>
<a id="pl.239.33"></a><var>239.33</var>with jurisdiction over health and human services policy and finance by December 15, 2013.<br/>
<br/>
<a id="bill.6.30.0"></a><a id="pl.239.34"></a><var>239.34</var>    Sec. 30. <b>TAX FORM POSTING.</b><br/>
<a id="pl.240.1"></a><var>240.1</var>Any nonprofit organization that receives state grant funds from the commissioner of <br/>
<a id="pl.240.2"></a><var>240.2</var>human services or the commissioner of health shall annually post the organization's 990 <br/>
<a id="pl.240.3"></a><var>240.3</var>tax form on its Web site, if the organization has a Web site.<br/>
<br/>
<a id="bill.7.0.0"></a>

<a id="bill.7.1.0"></a><a id="pl.240.6"></a><var>240.6</var>    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:<br/>
<a id="pl.240.7"></a><var>240.7</var>    Subd. 6. <b>Penalties for late or nonsubmission.</b> (a) A facility that fails to complete <br/>
<a id="pl.240.8"></a><var>240.8</var>or submit an assessment for a RUG-III or RUG-IV classification within seven days of the <br/>
<a id="pl.240.9"></a><var>240.9</var>time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident. <br/>
<a id="pl.240.10"></a><var>240.10</var>The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on <br/>
<a id="pl.240.11"></a><var>240.11</var>the day of admission for new admission assessments or on the day that the assessment <br/>
<a id="pl.240.12"></a><var>240.12</var>was due for all other assessments and continues in effect until the first day of the month <br/>
<a id="pl.240.13"></a><var>240.13</var>following the date of submission of the resident's assessment.<br/>
<a id="pl.240.14"></a><var>240.14</var>    (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days <br/>
<a id="pl.240.15"></a><var>240.15</var>are equal to or greater than 1.0 percent of the total operating costs on the facility's most <br/>
<a id="pl.240.16"></a><var>240.16</var>recent annual statistical and cost report, a facility may apply to the commissioner of <br/>
<a id="pl.240.17"></a><var>240.17</var>human services for a reduction in the total penalty amount. The commissioner of human <br/>
<a id="pl.240.18"></a><var>240.18</var>services, in consultation with the commissioner of health, may, at the sole discretion of <br/>
<a id="pl.240.19"></a><var>240.19</var>the commissioner of human services, limit the penalty for residents covered by medical <br/>
<a id="pl.240.20"></a><var>240.20</var>assistance to 15 days.<br/>
<br/>
<a id="bill.7.2.0"></a><a id="pl.240.21"></a><var>240.21</var>    Sec. 2. Minnesota Statutes 2012, section 144A.071, subdivision 4b, is amended to read:<br/>
<a id="pl.240.22"></a><var>240.22</var>    Subd. 4b. <b>Licensed beds on layaway status.</b> A licensed and certified nursing <br/>
<a id="pl.240.23"></a><var>240.23</var>facility may lay away, upon prior written notice to the commissioner of health, licensed <br/>
<a id="pl.240.24"></a><var>240.24</var>and certified beds. A nursing facility may not discharge a resident in order to lay away <br/>
<a id="pl.240.25"></a><var>240.25</var>a bed. Notice to the commissioner shall be given 60 days prior to the effective date of <br/>
<a id="pl.240.26"></a><var>240.26</var>the layaway. Beds on layaway shall have the same status as voluntarily delicensed and <br/>
<a id="pl.240.27"></a><var>240.27</var>decertified beds and shall not be subject to license fees and license surcharge fees. In <br/>
<a id="pl.240.28"></a><var>240.28</var>addition, beds on layaway may be removed from layaway at any time on or after one year<br/>
<a id="pl.240.29"></a><var>240.29</var> six months  after the effective date of layaway in the facility of origin, with a 60-day notice <br/>
<a id="pl.240.30"></a><var>240.30</var>to the commissioner. A nursing facility that removes beds from layaway may not place <br/>
<a id="pl.240.31"></a><var>240.31</var>beds on layaway status for one year six months  after the effective date of the removal from <br/>
<a id="pl.240.32"></a><var>240.32</var>layaway. The commissioner may approve the immediate removal of beds from layaway if <br/>
<a id="pl.240.33"></a><var>240.33</var>necessary to provide access to those nursing home beds to residents relocated from other <br/>
<a id="pl.240.34"></a><var>240.34</var>nursing homes due to emergency situations or closure. In the event approval is granted, <br/>
<a id="pl.241.1"></a><var>241.1</var>the one-year six-month  restriction on placing beds on layaway after a removal of beds <br/>
<a id="pl.241.2"></a><var>241.2</var>from layaway shall not apply. Beds may remain on layaway for up to ten years. The <br/>
<a id="pl.241.3"></a><var>241.3</var>commissioner may approve placing and removing beds on layaway at any time during <br/>
<a id="pl.241.4"></a><var>241.4</var>renovation or construction related to a moratorium project approved under this section <br/>
<a id="pl.241.5"></a><var>241.5</var>or section 
         <statute_ref>144A.073</statute_ref>. Nursing facilities are not required to comply with any licensure or <br/>
<a id="pl.241.6"></a><var>241.6</var>certification requirements for beds on layaway status.<br/>
<br/>
<a id="bill.7.3.0"></a><a id="pl.241.7"></a><var>241.7</var>    Sec. 3. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:<br/>
<a id="pl.241.8"></a><var>241.8</var>    Subd. 7. <b>Licensing moratorium.</b> (a) The commissioner shall not issue an <br/>
<a id="pl.241.9"></a><var>241.9</var>initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to <br/>
<a id="pl.241.10"></a><var>241.10</var>2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to <br/>
<a id="pl.241.11"></a><var>241.11</var>9555.6265, under this chapter for a physical location that will not be the primary residence <br/>
<a id="pl.241.12"></a><var>241.12</var>of the license holder for the entire period of licensure. If a license is issued during this <br/>
<a id="pl.241.13"></a><var>241.13</var>moratorium, and the license holder changes the license holder's primary residence away <br/>
<a id="pl.241.14"></a><var>241.14</var>from the physical location of the foster care license, the commissioner shall revoke the <br/>
<a id="pl.241.15"></a><var>241.15</var>license according to section 
         <statute_ref>245A.07</statute_ref>. Exceptions to the moratorium include:<br/>
<a id="pl.241.16"></a><var>241.16</var>(1) foster care settings that are required to be registered under chapter 144D;<br/>
<a id="pl.241.17"></a><var>241.17</var>(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, <br/>
<a id="pl.241.18"></a><var>241.18</var>and determined to be needed by the commissioner under paragraph (b);<br/>
<a id="pl.241.19"></a><var>241.19</var>(3) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.241.20"></a><var>241.20</var>paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or;<br/>
<a id="pl.241.21"></a><var>241.21</var> restructuring of state-operated services that limits the capacity of state-operated facilities;<br/>
<a id="pl.241.22"></a><var>241.22</var>(4) new foster care licenses determined to be needed by the commissioner under <br/>
<a id="pl.241.23"></a><var>241.23</var>paragraph (b) for persons requiring hospital level care; or<br/>
<a id="pl.241.24"></a><var>241.24</var>(5) new foster care licenses determined to be needed by the commissioner for the <br/>
<a id="pl.241.25"></a><var>241.25</var>transition of people from personal care assistance to the home and community-based <br/>
<a id="pl.241.26"></a><var>241.26</var>services.<br/>
<a id="pl.241.27"></a><var>241.27</var>(b) The commissioner shall determine the need for newly licensed foster care homes <br/>
<a id="pl.241.28"></a><var>241.28</var>as defined under this subdivision. As part of the determination, the commissioner shall <br/>
<a id="pl.241.29"></a><var>241.29</var>consider the availability of foster care capacity in the area in which the licensee seeks to <br/>
<a id="pl.241.30"></a><var>241.30</var>operate, and the recommendation of the local county board. The determination by the <br/>
<a id="pl.241.31"></a><var>241.31</var>commissioner must be final. A determination of need is not required for a change in <br/>
<a id="pl.241.32"></a><var>241.32</var>ownership at the same address.<br/>
<a id="pl.241.33"></a><var>241.33</var>(c) The commissioner shall study the effects of the license moratorium under this <br/>
<a id="pl.241.34"></a><var>241.34</var>subdivision and shall report back to the legislature by January 15, 2011. This study shall <br/>
<a id="pl.241.35"></a><var>241.35</var>include, but is not limited to the following:<br/>
<a id="pl.242.1"></a><var>242.1</var>(1) the overall capacity and utilization of foster care beds where the physical location <br/>
<a id="pl.242.2"></a><var>242.2</var>is not the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.242.3"></a><var>242.3</var>of the moratorium;<br/>
<a id="pl.242.4"></a><var>242.4</var>(2) the overall capacity and utilization of foster care beds where the physical <br/>
<a id="pl.242.5"></a><var>242.5</var>location is the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.242.6"></a><var>242.6</var>of the moratorium; and<br/>
<a id="pl.242.7"></a><var>242.7</var>(3) the number of licensed and occupied ICF/MR beds prior to and after <br/>
<a id="pl.242.8"></a><var>242.8</var>implementation of the moratorium.<br/>
<a id="pl.242.9"></a><var>242.9</var>(d) (c) When a foster care recipient moves out of a foster home that is not the primary <br/>
<a id="pl.242.10"></a><var>242.10</var>residence of the license holder according to section 
         <statute_ref>256B.49, subdivision 15</statute_ref>, paragraph <br/>
<a id="pl.242.11"></a><var>242.11</var>(f), the county shall immediately inform the Department of Human Services Licensing <br/>
<a id="pl.242.12"></a><var>242.12</var>Division. The department shall decrease the statewide licensed capacity for foster care <br/>
<a id="pl.242.13"></a><var>242.13</var>settings where the physical location is not the primary residence of the license holder, if <br/>
<a id="pl.242.14"></a><var>242.14</var>the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings <br/>
<a id="pl.242.15"></a><var>242.15</var>required by reductions in licensed bed capacity under Laws 2011, First Special Session <br/>
<a id="pl.242.16"></a><var>242.16</var>chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term <br/>
<a id="pl.242.17"></a><var>242.17</var>care residential services capacity within budgetary limits. Implementation of the statewide <br/>
<a id="pl.242.18"></a><var>242.18</var>licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense <br/>
<a id="pl.242.19"></a><var>242.19</var>up to 128 beds by June 30, 2014, using the needs determination process. Under this <br/>
<a id="pl.242.20"></a><var>242.20</var>paragraph, the commissioner has the authority to reduce unused licensed capacity of a <br/>
<a id="pl.242.21"></a><var>242.21</var>current foster care program to accomplish the consolidation or closure of settings. Under <br/>
<a id="pl.242.22"></a><var>242.22</var>this paragraph, the commissioner has the authority to manage statewide capacity, including <br/>
<a id="pl.242.23"></a><var>242.23</var>adjusting the capacity available to each county and adjusting statewide available capacity, <br/>
<a id="pl.242.24"></a><var>242.24</var>to meet the statewide needs identified through the process in paragraph (e). A decreased <br/>
<a id="pl.242.25"></a><var>242.25</var>licensed capacity according to this paragraph is not subject to appeal under this chapter.<br/>
<a id="pl.242.26"></a><var>242.26</var>(e) (d) Residential settings that would otherwise be subject to the decreased license <br/>
<a id="pl.242.27"></a><var>242.27</var>capacity established in paragraph (d) (c) shall be exempt under the following circumstances:<br/>
<a id="pl.242.28"></a><var>242.28</var>(1) until August 1, 2013, the license holder's beds occupied by residents whose <br/>
<a id="pl.242.29"></a><var>242.29</var>primary diagnosis is mental illness and the license holder is:<br/>
<a id="pl.242.30"></a><var>242.30</var>(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental <br/>
<a id="pl.242.31"></a><var>242.31</var>health services (ARMHS) as defined in section 
         <statute_ref>256B.0623</statute_ref>;<br/>
<a id="pl.242.32"></a><var>242.32</var>(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to <br/>
<a id="pl.242.33"></a><var>242.33</var>9520.0870;<br/>
<a id="pl.242.34"></a><var>242.34</var>(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to <br/>
<a id="pl.242.35"></a><var>242.35</var>9520.0870; or<br/>
<a id="pl.243.1"></a><var>243.1</var>(iv) a provider of intensive residential treatment services (IRTS) licensed under <br/>
<a id="pl.243.2"></a><var>243.2</var>Minnesota Rules, parts 9520.0500 to 9520.0670; or<br/>
<a id="pl.243.3"></a><var>243.3</var>(2) the license holder's beds occupied by residents whose primary diagnosis is <br/>
<a id="pl.243.4"></a><var>243.4</var>mental illness and the license holder is certified under the requirements in subdivision 6a.<br/>
<a id="pl.243.5"></a><var>243.5</var>(f) (e) A resource need determination process, managed at the state level, using the <br/>
<a id="pl.243.6"></a><var>243.6</var>available reports required by section 
         <statute_ref>144A.351</statute_ref>, and other data and information shall <br/>
<a id="pl.243.7"></a><var>243.7</var>be used to determine where the reduced capacity required under paragraph (d) (c) will <br/>
<a id="pl.243.8"></a><var>243.8</var>be implemented. The commissioner shall consult with the stakeholders described in <br/>
<a id="pl.243.9"></a><var>243.9</var>section 
         <statute_ref>144A.351</statute_ref>, and employ a variety of methods to improve the state's capacity to <br/>
<a id="pl.243.10"></a><var>243.10</var>meet long-term care service needs within budgetary limits, including seeking proposals <br/>
<a id="pl.243.11"></a><var>243.11</var>from service providers or lead agencies to change service type, capacity, or location to <br/>
<a id="pl.243.12"></a><var>243.12</var>improve services, increase the independence of residents, and better meet needs identified <br/>
<a id="pl.243.13"></a><var>243.13</var>by the long-term care services reports and statewide data and information. By February <br/>
<a id="pl.243.14"></a><var>243.14</var>1 of each, 2013, and August 1, 2014, and each following year, the commissioner shall <br/>
<a id="pl.243.15"></a><var>243.15</var>provide information and data on the overall capacity of licensed long-term care services, <br/>
<a id="pl.243.16"></a><var>243.16</var>actions taken under this subdivision to manage statewide long-term care services and <br/>
<a id="pl.243.17"></a><var>243.17</var>supports resources, and any recommendations for change to the legislative committees <br/>
<a id="pl.243.18"></a><var>243.18</var>with jurisdiction over health and human services budget.<br/>
<a id="pl.243.19"></a><var>243.19</var>    (g) (f) At the time of application and reapplication for licensure, the applicant and the <br/>
<a id="pl.243.20"></a><var>243.20</var>license holder that are subject to the moratorium or an exclusion established in paragraph <br/>
<a id="pl.243.21"></a><var>243.21</var>(a) are required to inform the commissioner whether the physical location where the foster <br/>
<a id="pl.243.22"></a><var>243.22</var>care will be provided is or will be the primary residence of the license holder for the entire <br/>
<a id="pl.243.23"></a><var>243.23</var>period of licensure. If the primary residence of the applicant or license holder changes, the <br/>
<a id="pl.243.24"></a><var>243.24</var>applicant or license holder must notify the commissioner immediately. The commissioner <br/>
<a id="pl.243.25"></a><var>243.25</var>shall print on the foster care license certificate whether or not the physical location is the <br/>
<a id="pl.243.26"></a><var>243.26</var>primary residence of the license holder.<br/>
<a id="pl.243.27"></a><var>243.27</var>    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that <br/>
<a id="pl.243.28"></a><var>243.28</var>are not the primary residence of the license holder and that also provide services in the <br/>
<a id="pl.243.29"></a><var>243.29</var>foster care home that are covered by a federally approved home and community-based <br/>
<a id="pl.243.30"></a><var>243.30</var>services waiver, as authorized under section 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, or 
         <statute_ref>256B.49</statute_ref>, must <br/>
<a id="pl.243.31"></a><var>243.31</var>inform the human services licensing division that the license holder provides or intends to <br/>
<a id="pl.243.32"></a><var>243.32</var>provide these waiver-funded services. These license holders must be considered registered <br/>
<a id="pl.243.33"></a><var>243.33</var>under section 
         <statute_ref>256B.092, subdivision 11</statute_ref>, paragraph (c), and this registration status must <br/>
<a id="pl.243.34"></a><var>243.34</var>be identified on their license certificates.<br/>
<br/>
<a id="bill.7.4.0"></a><a id="pl.244.1"></a><var>244.1</var>    Sec. 4. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision <br/>
<a id="pl.244.2"></a><var>244.2</var>to read:<br/>
<a id="pl.244.3"></a><var>244.3</var>    Subd. 2b. <b> Nicollet County facility project.</b> The commissioner of health shall <br/>
<a id="pl.244.4"></a><var>244.4</var>certify one additional bed in an intermediate care facility for persons with developmental <br/>
<a id="pl.244.5"></a><var>244.5</var>disabilities in Nicollet County.<br/>
<br/>
<a id="bill.7.5.0"></a><a id="pl.244.6"></a><var>244.6</var>    Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:<br/>
<a id="pl.244.7"></a><var>244.7</var>    Subd. 3a. <b>Elderly waiver cost limits.</b> (a) The monthly limit for the cost of <br/>
<a id="pl.244.8"></a><var>244.8</var>waivered services to an individual elderly waiver client except for individuals described in <br/>
<a id="pl.244.9"></a><var>244.9</var>paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility <br/>
<a id="pl.244.10"></a><var>244.10</var>rate of the case mix resident class to which the elderly waiver client would be assigned <br/>
<a id="pl.244.11"></a><var>244.11</var>under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance <br/>
<a id="pl.244.12"></a><var>244.12</var>needs allowance as described in subdivision 1d, paragraph (a), until the first day of the <br/>
<a id="pl.244.13"></a><var>244.13</var>state fiscal year in which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> <br/>
<a id="pl.244.14"></a><var>244.14</var>for nursing home rate determination is implemented. Effective on the first day of the state <br/>
<a id="pl.244.15"></a><var>244.15</var>fiscal year in which the resident assessment system as described in section 
         <statute_ref>256B.438</statute_ref> for <br/>
<a id="pl.244.16"></a><var>244.16</var>nursing home rate determination is implemented and the first day of each subsequent state <br/>
<a id="pl.244.17"></a><var>244.17</var>fiscal year, the monthly limit for the cost of waivered services to an individual elderly <br/>
<a id="pl.244.18"></a><var>244.18</var>waiver client shall be the rate of the case mix resident class to which the waiver client <br/>
<a id="pl.244.19"></a><var>244.19</var>would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on <br/>
<a id="pl.244.20"></a><var>244.20</var>the last day of the previous state fiscal year, adjusted by any legislatively adopted home <br/>
<a id="pl.244.21"></a><var>244.21</var>and community-based services percentage rate adjustment.<br/>
<a id="pl.244.22"></a><var>244.22</var>    (b) The monthly limit for the cost of waivered services to an individual elderly <br/>
<a id="pl.244.23"></a><var>244.23</var>waiver client assigned to a case mix classification A under paragraph (a) with:<br/>
<a id="pl.244.24"></a><var>244.24</var>(1) no dependencies in activities of daily living; or<br/>
<a id="pl.244.25"></a><var>244.25</var>(2) up to two dependencies in bathing, dressing, grooming, walking, and eating <br/>
<a id="pl.244.26"></a><var>244.26</var>when the dependency score in eating is three or greater as determined by an assessment <br/>
<a id="pl.244.27"></a><var>244.27</var>performed under section 
         <statute_ref>256B.0911</statute_ref> shall be $1,750 per month effective on July 1, 2011, <br/>
<a id="pl.244.28"></a><var>244.28</var>for all new participants enrolled in the program on or after July 1, 2011. This monthly <br/>
<a id="pl.244.29"></a><var>244.29</var>limit shall be applied to all other participants who meet this criteria at reassessment. This <br/>
<a id="pl.244.30"></a><var>244.30</var>monthly limit shall be increased annually as described in paragraph (a).<br/>
<a id="pl.244.31"></a><var>244.31</var>(c) If extended medical supplies and equipment or environmental modifications are <br/>
<a id="pl.244.32"></a><var>244.32</var>or will be purchased for an elderly waiver client, the costs may be prorated for up to <br/>
<a id="pl.244.33"></a><var>244.33</var>12 consecutive months beginning with the month of purchase. If the monthly cost of a <br/>
<a id="pl.244.34"></a><var>244.34</var>recipient's waivered services exceeds the monthly limit established in paragraph (a) or <br/>
<a id="pl.244.35"></a><var>244.35</var>(b), the annual cost of all waivered services shall be determined. In this event, the annual <br/>
<a id="pl.245.1"></a><var>245.1</var>cost of all waivered services shall not exceed 12 times the monthly limit of waivered <br/>
<a id="pl.245.2"></a><var>245.2</var>services as described in paragraph (a) or (b).<br/>
<a id="pl.245.3"></a><var>245.3</var>(d) Effective July 1, 2013, the monthly cost limit of waiver services, including <br/>
<a id="pl.245.4"></a><var>245.4</var>any necessary home care services described in section 256B.0651, subdivision 2, for <br/>
<a id="pl.245.5"></a><var>245.5</var>individuals who meet the criteria as ventilator-dependent given in section 256B.0651, <br/>
<a id="pl.245.6"></a><var>245.6</var>subdivision 1, paragraph (g), shall be the average of the monthly medical assistance <br/>
<a id="pl.245.7"></a><var>245.7</var>amount established for home care services as described in section 256B.0652, subdivision <br/>
<a id="pl.245.8"></a><var>245.8</var>7, and the annual average contracted amount established by the commissioner for nursing <br/>
<a id="pl.245.9"></a><var>245.9</var>facility services for ventilator-dependent individuals. This monthly limit shall be increased <br/>
<a id="pl.245.10"></a><var>245.10</var>annually as described in paragraph (a).<br/>
<br/>
<a id="bill.7.6.0"></a><a id="pl.245.11"></a><var>245.11</var>    Sec. 6. Minnesota Statutes 2012, section 256B.0915, is amended by adding a <br/>
<a id="pl.245.12"></a><var>245.12</var>subdivision to read:<br/>
<a id="pl.245.13"></a><var>245.13</var>    Subd. 3j. <b>Individual community living support.</b> Upon federal approval, there <br/>
<a id="pl.245.14"></a><var>245.14</var>is established a new service called individual community living support (ICLS) that is <br/>
<a id="pl.245.15"></a><var>245.15</var>available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor <br/>
<a id="pl.245.16"></a><var>245.16</var>have any interest in the recipient's housing. ICLS must be delivered in a single-family <br/>
<a id="pl.245.17"></a><var>245.17</var>home or apartment where the service recipient or their family owns or rents, as <br/>
<a id="pl.245.18"></a><var>245.18</var>demonstrated by a lease agreement, and maintains control over the individual unit. Case <br/>
<a id="pl.245.19"></a><var>245.19</var>managers or care coordinators must develop individual ICLS plans in consultation with <br/>
<a id="pl.245.20"></a><var>245.20</var>the client using a tool developed by the commissioner. The commissioner shall establish <br/>
<a id="pl.245.21"></a><var>245.21</var>payment rates and mechanisms to align payments with the type and amount of service <br/>
<a id="pl.245.22"></a><var>245.22</var>provided, assure statewide uniformity for payment rates, and assure cost-effectiveness. <br/>
<a id="pl.245.23"></a><var>245.23</var>Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and <br/>
<a id="pl.245.24"></a><var>245.24</var>Human Services to avoid conflict with provider regulatory standards pursuant to section <br/>
<a id="pl.245.25"></a><var>245.25</var>144A.43 and chapter 245D. <br/>
<br/>
<a id="bill.7.7.0"></a><a id="pl.245.26"></a><var>245.26</var>    Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a <br/>
<a id="pl.245.27"></a><var>245.27</var>subdivision to read:<br/>
<a id="pl.245.28"></a><var>245.28</var>    Subd. 11. <b>Excess spending.</b> County and tribal agencies are responsible for spending <br/>
<a id="pl.245.29"></a><var>245.29</var>in excess of the allocation made by the commissioner. In the event a county or tribal <br/>
<a id="pl.245.30"></a><var>245.30</var>agency spends in excess of the allocation made by the commissioner for a given allocation <br/>
<a id="pl.245.31"></a><var>245.31</var>period, they must submit a corrective action plan to the commissioner. The plan must state <br/>
<a id="pl.245.32"></a><var>245.32</var>the actions the agency will take to correct their overspending for the year following the <br/>
<a id="pl.245.33"></a><var>245.33</var>period when the overspending occurred. Failure to correct overspending shall result in <br/>
<a id="pl.245.34"></a><var>245.34</var>recoupment of spending in excess of the allocation. Nothing in this subdivision shall be <br/>
<a id="pl.246.1"></a><var>246.1</var>construed as reducing the county's responsibility to offer and make available feasible <br/>
<a id="pl.246.2"></a><var>246.2</var>home and community-based options to eligible waiver recipients within the resources <br/>
<a id="pl.246.3"></a><var>246.3</var>allocated to them for that purpose.<br/>
<br/>
<a id="bill.7.8.0"></a><a id="pl.246.4"></a><var>246.4</var>    Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:<br/>
<a id="pl.246.5"></a><var>246.5</var>    Subd. 11. <b>Residential support services.</b> (a) Upon federal approval, there is <br/>
<a id="pl.246.6"></a><var>246.6</var>established a new service called residential support that is available on the community <br/>
<a id="pl.246.7"></a><var>246.7</var>alternative care, community alternatives for disabled individuals, developmental <br/>
<a id="pl.246.8"></a><var>246.8</var>disabilities, and brain injury waivers. Existing waiver service descriptions must be <br/>
<a id="pl.246.9"></a><var>246.9</var>modified to the extent necessary to ensure there is no duplication between other services. <br/>
<a id="pl.246.10"></a><var>246.10</var>Residential support services must be provided by vendors licensed as a community <br/>
<a id="pl.246.11"></a><var>246.11</var>residential setting as defined in section 
         <statute_ref>245A.11, subdivision 8</statute_ref>.<br/>
<a id="pl.246.12"></a><var>246.12</var>    (b) Residential support services must meet the following criteria:<br/>
<a id="pl.246.13"></a><var>246.13</var>    (1) providers of residential support services must own or control the residential site;<br/>
<a id="pl.246.14"></a><var>246.14</var>    (2) the residential site must not be the primary residence of the license holder;<br/>
<a id="pl.246.15"></a><var>246.15</var>    (3) the residential site must have a designated program supervisor responsible for <br/>
<a id="pl.246.16"></a><var>246.16</var>program oversight, development, and implementation of policies and procedures;<br/>
<a id="pl.246.17"></a><var>246.17</var>    (4) the provider of residential support services must provide supervision, training, <br/>
<a id="pl.246.18"></a><var>246.18</var>and assistance as described in the person's coordinated service and support plan; and<br/>
<a id="pl.246.19"></a><var>246.19</var>    (5) the provider of residential support services must meet the requirements of <br/>
<a id="pl.246.20"></a><var>246.20</var>licensure and additional requirements of the person's coordinated service and support plan.<br/>
<a id="pl.246.21"></a><var>246.21</var>    (c) Providers of residential support services that meet the definition in paragraph <br/>
<a id="pl.246.22"></a><var>246.22</var>(a) must be registered using a process determined by the commissioner beginning July <br/>
<a id="pl.246.23"></a><var>246.23</var>1, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts <br/>
<a id="pl.246.24"></a><var>246.24</var>2960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts <br/>
<a id="pl.246.25"></a><var>246.25</var>9555.5105 to 9555.6265, and that meet the requirements in section 
         <statute_ref>245A.03, subdivision <br/>
<a id="pl.246.26"></a><var>246.26</var>7
         </statute_ref>, paragraph (g) (f), are considered registered under this section.<br/>
<br/>
<a id="bill.7.9.0"></a><a id="pl.246.27"></a><var>246.27</var>    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:<br/>
<a id="pl.246.28"></a><var>246.28</var>    Subd. 12. <b>Waivered services statewide priorities.</b> (a) The commissioner shall <br/>
<a id="pl.246.29"></a><var>246.29</var>establish statewide priorities for individuals on the waiting list for developmental <br/>
<a id="pl.246.30"></a><var>246.30</var>disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must <br/>
<a id="pl.246.31"></a><var>246.31</var>include, but are not limited to, individuals who continue to have a need for waiver services <br/>
<a id="pl.246.32"></a><var>246.32</var>after they have maximized the use of state plan services and other funding resources, <br/>
<a id="pl.246.33"></a><var>246.33</var>including natural supports, prior to accessing waiver services, and who meet at least one <br/>
<a id="pl.246.34"></a><var>246.34</var>of the following criteria:<br/>
<a id="pl.247.1"></a><var>247.1</var>(1) no longer require the intensity of services provided where they are currently <br/>
<a id="pl.247.2"></a><var>247.2</var>living; or<br/>
<a id="pl.247.3"></a><var>247.3</var>(2) make a request to move from an institutional setting.<br/>
<a id="pl.247.4"></a><var>247.4</var>(b) After the priorities in paragraph (a) are met, priority must also be given to <br/>
<a id="pl.247.5"></a><var>247.5</var>individuals who meet at least one of the following criteria:<br/>
<a id="pl.247.6"></a><var>247.6</var>(1) have unstable living situations due to the age, incapacity, or sudden loss of <br/>
<a id="pl.247.7"></a><var>247.7</var>the primary caregivers;<br/>
<a id="pl.247.8"></a><var>247.8</var>(2) are moving from an institution due to bed closures;<br/>
<a id="pl.247.9"></a><var>247.9</var>(3) experience a sudden closure of their current living arrangement;<br/>
<a id="pl.247.10"></a><var>247.10</var>(4) require protection from confirmed abuse, neglect, or exploitation;<br/>
<a id="pl.247.11"></a><var>247.11</var>(5) experience a sudden change in need that can no longer be met through state plan <br/>
<a id="pl.247.12"></a><var>247.12</var>services or other funding resources alone; or<br/>
<a id="pl.247.13"></a><var>247.13</var>(6) meet other priorities established by the department.<br/>
<a id="pl.247.14"></a><var>247.14</var>(b) (c) When allocating resources to lead agencies, the commissioner must take into <br/>
<a id="pl.247.15"></a><var>247.15</var>consideration the number of individuals waiting who meet statewide priorities and the <br/>
<a id="pl.247.16"></a><var>247.16</var>lead agencies' current use of waiver funds and existing service options. The commissioner <br/>
<a id="pl.247.17"></a><var>247.17</var>has the authority to transfer funds between counties, groups of counties, and tribes to <br/>
<a id="pl.247.18"></a><var>247.18</var>accommodate statewide priorities and resource needs while accounting for a necessary <br/>
<a id="pl.247.19"></a><var>247.19</var>base level reserve amount for each county, group of counties, and tribe.<br/>
<a id="pl.247.20"></a><var>247.20</var>(c) The commissioner shall evaluate the impact of the use of statewide priorities and <br/>
<a id="pl.247.21"></a><var>247.21</var>provide recommendations to the legislature on whether to continue the use of statewide <br/>
<a id="pl.247.22"></a><var>247.22</var>priorities in the November 1, 2011, annual report required by the commissioner in sections <br/>
<a id="pl.247.23"></a><var>247.23</var><statute_ref>256B.0916, subdivision 7</statute_ref>, and 
<statute_ref>256B.49, subdivision 21</statute_ref>.<br/>
<br/>
<a id="bill.7.10.0"></a><a id="pl.247.24"></a><var>247.24</var>    Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a <br/>
<a id="pl.247.25"></a><var>247.25</var>subdivision to read:<br/>
<a id="pl.247.26"></a><var>247.26</var>    Subd. 14. <b>Reduce avoidable behavioral crisis emergency room admissions, </b><br/>
<a id="pl.247.27"></a><var>247.27</var><b>psychiatric inpatient hospitalizations, and commitments to institutions.</b> (a) Persons <br/>
<a id="pl.247.28"></a><var>247.28</var>receiving home and community-based services authorized under this section who have <br/>
<a id="pl.247.29"></a><var>247.29</var>had two or more admissions within a calendar year to an emergency room, psychiatric <br/>
<a id="pl.247.30"></a><var>247.30</var>unit, or institution must receive consultation from a mental health professional as defined <br/>
<a id="pl.247.31"></a><var>247.31</var>in section 245.462, subdivision 18, or a behavioral professional as defined in the home <br/>
<a id="pl.247.32"></a><var>247.32</var>and community-based services state plan within 30 days of discharge. The mental health <br/>
<a id="pl.247.33"></a><var>247.33</var>professional or behavioral professional must:<br/>
<a id="pl.247.34"></a><var>247.34</var>(1) conduct a functional assessment of the crisis incident as defined in section <br/>
<a id="pl.247.35"></a><var>247.35</var>245D.02, subdivision 11, which led to the hospitalization with the goal of developing <br/>
<a id="pl.248.1"></a><var>248.1</var>proactive strategies as well as necessary reactive strategies to reduce the likelihood of <br/>
<a id="pl.248.2"></a><var>248.2</var>future avoidable hospitalizations due to a behavioral crisis;<br/>
<a id="pl.248.3"></a><var>248.3</var>(2) use the results of the functional assessment to amend the coordinated service and <br/>
<a id="pl.248.4"></a><var>248.4</var>support plan set forth in section 245D.02, subdivision 4b, to address the potential need <br/>
<a id="pl.248.5"></a><var>248.5</var>for additional staff training, increased staffing, access to crisis mobility services, mental <br/>
<a id="pl.248.6"></a><var>248.6</var>health services, use of technology, and crisis stabilization services in section 256B.0624, <br/>
<a id="pl.248.7"></a><var>248.7</var>subdivision 7; and <br/>
<a id="pl.248.8"></a><var>248.8</var>(3) identify the need for additional consultation, testing, and mental health crisis <br/>
<a id="pl.248.9"></a><var>248.9</var>intervention team services as defined in section 245D.02, subdivision 20, psychotropic <br/>
<a id="pl.248.10"></a><var>248.10</var>medication use and monitoring under section 245D.051, and the frequency and duration <br/>
<a id="pl.248.11"></a><var>248.11</var>of ongoing consultation. <br/>
<a id="pl.248.12"></a><var>248.12</var>(b) For the purposes of this subdivision, "institution" includes, but is not limited to, <br/>
<a id="pl.248.13"></a><var>248.13</var>the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.<br/>
<br/>
<a id="bill.7.11.0"></a><a id="pl.248.14"></a><var>248.14</var>    Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:<br/>
<a id="pl.248.15"></a><var>248.15</var><b>256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.</b><br/>
<a id="pl.248.16"></a><var>248.16</var>    (a) Effective July 1, 1998, a quality assurance system for persons with developmental <br/>
<a id="pl.248.17"></a><var>248.17</var>disabilities, which includes an alternative quality assurance licensing system for programs, <br/>
<a id="pl.248.18"></a><var>248.18</var>is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, <br/>
<a id="pl.248.19"></a><var>248.19</var>Steele, Wabasha, and Winona Counties for the purpose of improving the quality of <br/>
<a id="pl.248.20"></a><var>248.20</var>services provided to persons with developmental disabilities. A county, at its option, may <br/>
<a id="pl.248.21"></a><var>248.21</var>choose to have all programs for persons with developmental disabilities located within <br/>
<a id="pl.248.22"></a><var>248.22</var>the county licensed under chapter 245A using standards determined under the alternative <br/>
<a id="pl.248.23"></a><var>248.23</var>quality assurance licensing system or may continue regulation of these programs under the <br/>
<a id="pl.248.24"></a><var>248.24</var>licensing system operated by the commissioner. The project expires on June 30, 2014.<br/>
<a id="pl.248.25"></a><var>248.25</var>    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to <br/>
<a id="pl.248.26"></a><var>248.26</var>participate in the quality assurance system established under paragraph (a). The <br/>
<a id="pl.248.27"></a><var>248.27</var>commission established under section 
         <statute_ref>256B.0951</statute_ref> may, at its option, allow additional <br/>
<a id="pl.248.28"></a><var>248.28</var>counties to participate in the system.<br/>
<a id="pl.248.29"></a><var>248.29</var>    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) <br/>
<a id="pl.248.30"></a><var>248.30</var>may establish a quality assurance system under this section. A new system established <br/>
<a id="pl.248.31"></a><var>248.31</var>under this section shall have the same rights and duties as the system established <br/>
<a id="pl.248.32"></a><var>248.32</var>under paragraph (a). A new system shall be governed by a commission under section <br/>
<statute_ref><a id="pl.248.33"></a><var>248.33</var>256B.0951
         </statute_ref>. The commissioner shall appoint the initial commission members based <br/>
<a id="pl.248.34"></a><var>248.34</var>on recommendations from advocates, families, service providers, and counties in the <br/>
<a id="pl.248.35"></a><var>248.35</var>geographic area included in the new system. Counties that choose to participate in a <br/>
<a id="pl.249.1"></a><var>249.1</var>new system shall have the duties assigned under section 
         <statute_ref>256B.0952</statute_ref>. The new system <br/>
<a id="pl.249.2"></a><var>249.2</var>shall establish a quality assurance process under section 
         <statute_ref>256B.0953</statute_ref>. The provisions of <br/>
<a id="pl.249.3"></a><var>249.3</var>section 
         <statute_ref>256B.0954</statute_ref> shall apply to a new system established under this paragraph. The <br/>
<a id="pl.249.4"></a><var>249.4</var>commissioner shall delegate authority to a new system established under this paragraph <br/>
<a id="pl.249.5"></a><var>249.5</var>according to section 
         <statute_ref>256B.0955</statute_ref>.<br/>
<a id="pl.249.6"></a><var>249.6</var>    (d) Effective July 1, 2007, the quality assurance system may be expanded to include <br/>
<a id="pl.249.7"></a><var>249.7</var>programs for persons with disabilities and older adults.<br/>
<a id="pl.249.8"></a><var>249.8</var>(e) Effective July 1, 2013, a provider of service located in a county listed in <br/>
<a id="pl.249.9"></a><var>249.9</var>paragraph (a) that is a non-opted-in county may opt in to the quality assurance system <br/>
<a id="pl.249.10"></a><var>249.10</var>provided the county where services are provided indicates its agreement with a county <br/>
<a id="pl.249.11"></a><var>249.11</var>with a delegation agreement with the Department of Human Services.<br/>
<a id="pl.249.12"></a><var>249.12</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2013.<br/>
<br/>
<a id="bill.7.12.0"></a><a id="pl.249.13"></a><var>249.13</var>    Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:<br/>
<a id="pl.249.14"></a><var>249.14</var>    Subdivision 1. <b>Membership.</b> The Quality Assurance Commission is established. <br/>
<a id="pl.249.15"></a><var>249.15</var>The commission consists of at least 14 but not more than 21 members as follows: at <br/>
<a id="pl.249.16"></a><var>249.16</var>least three but not more than five members representing advocacy organizations; at <br/>
<a id="pl.249.17"></a><var>249.17</var>least three but not more than five members representing consumers, families, and their <br/>
<a id="pl.249.18"></a><var>249.18</var>legal representatives; at least three but not more than five members representing service <br/>
<a id="pl.249.19"></a><var>249.19</var>providers; at least three but not more than five members representing counties; and the <br/>
<a id="pl.249.20"></a><var>249.20</var>commissioner of human services or the commissioner's designee. The first commission <br/>
<a id="pl.249.21"></a><var>249.21</var>shall establish membership guidelines for the transition and recruitment of membership for <br/>
<a id="pl.249.22"></a><var>249.22</var>the commission's ongoing existence. Members of the commission who do not receive a <br/>
<a id="pl.249.23"></a><var>249.23</var>salary or wages from an employer for time spent on commission duties may receive a per <br/>
<a id="pl.249.24"></a><var>249.24</var>diem payment when performing commission duties and functions. All members may be <br/>
<a id="pl.249.25"></a><var>249.25</var>reimbursed for expenses related to commission activities. Notwithstanding the provisions <br/>
<a id="pl.249.26"></a><var>249.26</var>of section 
<statute_ref>15.059, subdivision 5</statute_ref>, the commission expires on June 30, 2014.<br/>
<br/>
<a id="bill.7.13.0"></a><a id="pl.249.27"></a><var>249.27</var>    Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:<br/>
<a id="pl.249.28"></a><var>249.28</var>    Subd. 4. <b>Commission's authority to recommend variances of licensing </b><br/>
<a id="pl.249.29"></a><var>249.29</var><b>standards.</b> The commission may recommend to the commissioners of human services <br/>
<a id="pl.249.30"></a><var>249.30</var>and health variances from the standards governing licensure of programs for persons with <br/>
<a id="pl.249.31"></a><var>249.31</var>developmental disabilities in order to improve the quality of services by implementing <br/>
<a id="pl.249.32"></a><var>249.32</var>an alternative developmental disabilities licensing system if the commission determines <br/>
<a id="pl.249.33"></a><var>249.33</var>that the alternative licensing system does not adversely affect the health or safety of <br/>
<a id="pl.250.1"></a><var>250.1</var>persons being served by the licensed program nor compromise the qualifications of staff <br/>
<a id="pl.250.2"></a><var>250.2</var>to provide services.<br/>
<br/>
<a id="bill.7.14.0"></a><a id="pl.250.3"></a><var>250.3</var>    Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:<br/>
<a id="pl.250.4"></a><var>250.4</var>    Subdivision 1. <b>Notification.</b> Counties or providers shall give notice to the <br/>
<a id="pl.250.5"></a><var>250.5</var>commission and commissioners of human services and health of intent to join the <br/>
<a id="pl.250.6"></a><var>250.6</var>alternative quality assurance licensing system. A county or provider choosing to participate <br/>
<a id="pl.250.7"></a><var>250.7</var>in the alternative quality assurance licensing system commits to participate for three years.<br/>
<br/>
<a id="bill.7.15.0"></a><a id="pl.250.8"></a><var>250.8</var>    Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:<br/>
<a id="pl.250.9"></a><var>250.9</var>    Subd. 5. <b>Quality assurance teams.</b> Quality assurance teams shall be comprised <br/>
<a id="pl.250.10"></a><var>250.10</var>of county staff; providers; consumers, families, and their legal representatives; members <br/>
<a id="pl.250.11"></a><var>250.11</var>of advocacy organizations; and other involved community members. Team members <br/>
<a id="pl.250.12"></a><var>250.12</var>must satisfactorily complete the training program approved by the commission and must <br/>
<a id="pl.250.13"></a><var>250.13</var>demonstrate performance-based competency. Team members are not considered to be <br/>
<a id="pl.250.14"></a><var>250.14</var>county employees for purposes of workers' compensation, unemployment insurance, or <br/>
<a id="pl.250.15"></a><var>250.15</var>state retirement laws solely on the basis of participation on a quality assurance team. The <br/>
<a id="pl.250.16"></a><var>250.16</var>county may pay A per diem may be paid to team members for time spent on alternative <br/>
<a id="pl.250.17"></a><var>250.17</var>quality assurance process matters. All team members may be reimbursed for expenses <br/>
<a id="pl.250.18"></a><var>250.18</var>related to their participation in the alternative process.<br/>
<br/>
<a id="bill.7.16.0"></a><a id="pl.250.19"></a><var>250.19</var>    Sec. 16. Minnesota Statutes 2012, section 256B.0955, is amended to read:<br/>
<a id="pl.250.20"></a><var>250.20</var><b>256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.</b><br/>
<a id="pl.250.21"></a><var>250.21</var>(a) Effective July 1, 1998, the commissioner of human services shall delegate <br/>
<a id="pl.250.22"></a><var>250.22</var>authority to perform licensing functions and activities, in accordance with section <br/>
<statute_ref><a id="pl.250.23"></a><var>250.23</var>245A.16
         </statute_ref>, to counties participating in the alternative quality assurance licensing system. <br/>
<a id="pl.250.24"></a><var>250.24</var>The commissioner shall not license or reimburse a facility, program, or service for persons <br/>
<a id="pl.250.25"></a><var>250.25</var>with developmental disabilities in a county that participates in the alternative quality <br/>
<a id="pl.250.26"></a><var>250.26</var>assurance licensing system if the commissioner has received from the appropriate county <br/>
<a id="pl.250.27"></a><var>250.27</var>notification that the facility, program, or service has been reviewed by a quality assurance <br/>
<a id="pl.250.28"></a><var>250.28</var>team and has failed to qualify for licensure.<br/>
<a id="pl.250.29"></a><var>250.29</var>(b) The commissioner may conduct random licensing inspections based on outcomes <br/>
<a id="pl.250.30"></a><var>250.30</var>adopted under section 
         <statute_ref>256B.0951</statute_ref> at facilities, programs, and services governed by the <br/>
<a id="pl.250.31"></a><var>250.31</var>alternative quality assurance licensing system. The role of such random inspections shall <br/>
<a id="pl.250.32"></a><var>250.32</var>be to verify that the alternative quality assurance licensing system protects the safety <br/>
<a id="pl.251.1"></a><var>251.1</var>and well-being of consumers and maintains the availability of high-quality services for <br/>
<a id="pl.251.2"></a><var>251.2</var>persons with developmental disabilities.<br/>
<a id="pl.251.3"></a><var>251.3</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2013.<br/>
<br/>
<a id="bill.7.17.0"></a><a id="pl.251.4"></a><var>251.4</var>    Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:<br/>
<a id="pl.251.5"></a><var>251.5</var>    Subdivision 1. <b>Scope.</b> (a) In order to improve the quality of services provided to <br/>
<a id="pl.251.6"></a><var>251.6</var>Minnesotans with disabilities and to meet the requirements of the federally approved home <br/>
<a id="pl.251.7"></a><var>251.7</var>and community-based waivers under section 1915c of the Social Security Act, a State <br/>
<a id="pl.251.8"></a><var>251.8</var>Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving <br/>
<a id="pl.251.9"></a><var>251.9</var>disability services is enacted. This system is a partnership between the Department of <br/>
<a id="pl.251.10"></a><var>251.10</var>Human Services and the State Quality Council established under subdivision 3.<br/>
<a id="pl.251.11"></a><var>251.11</var>    (b) This system is a result of the recommendations from the Department of Human <br/>
<a id="pl.251.12"></a><var>251.12</var>Services' licensing and alternative quality assurance study mandated under Laws 2005, <br/>
<a id="pl.251.13"></a><var>251.13</var>First Special Session chapter 4, article 7, section 57, and presented to the legislature <br/>
<a id="pl.251.14"></a><var>251.14</var>in February 2007.<br/>
<a id="pl.251.15"></a><var>251.15</var>    (c) The disability services eligible under this section include:<br/>
<a id="pl.251.16"></a><var>251.16</var>    (1) the home and community-based services waiver programs for persons with <br/>
<a id="pl.251.17"></a><var>251.17</var>developmental disabilities under section 
         <statute_ref>256B.092, subdivision 4</statute_ref>, or section 
         <statute_ref>256B.49</statute_ref>, <br/>
<a id="pl.251.18"></a><var>251.18</var>including brain injuries and services for those who qualify for nursing facility level of care <br/>
<a id="pl.251.19"></a><var>251.19</var>or hospital facility level of care and any other services licensed under chapter 245D;<br/>
<a id="pl.251.20"></a><var>251.20</var>    (2) home care services under section 
         <statute_ref>256B.0651</statute_ref>;<br/>
<a id="pl.251.21"></a><var>251.21</var>    (3) family support grants under section 
         <statute_ref>252.32</statute_ref>;<br/>
<a id="pl.251.22"></a><var>251.22</var>    (4) consumer support grants under section 
         <statute_ref>256.476</statute_ref>;<br/>
<a id="pl.251.23"></a><var>251.23</var>    (5) semi-independent living services under section 
         <statute_ref>252.275</statute_ref>; and<br/>
<a id="pl.251.24"></a><var>251.24</var>    (6) services provided through an intermediate care facility for the developmentally <br/>
<a id="pl.251.25"></a><var>251.25</var>disabled.<br/>
<a id="pl.251.26"></a><var>251.26</var>    (d) For purposes of this section, the following definitions apply:<br/>
<a id="pl.251.27"></a><var>251.27</var>    (1) "commissioner" means the commissioner of human services;<br/>
<a id="pl.251.28"></a><var>251.28</var>    (2) "council" means the State Quality Council under subdivision 3;<br/>
<a id="pl.251.29"></a><var>251.29</var>    (3) "Quality Assurance Commission" means the commission under section <br/>
<statute_ref><a id="pl.251.30"></a><var>251.30</var>256B.0951
         </statute_ref>; and<br/>
<a id="pl.251.31"></a><var>251.31</var>    (4) "system" means the State Quality Assurance, Quality Improvement and <br/>
<a id="pl.251.32"></a><var>251.32</var>Licensing System under this section.<br/>
<br/>
<a id="bill.7.18.0"></a><a id="pl.251.33"></a><var>251.33</var>    Sec. 18. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:<br/>
<a id="pl.252.1"></a><var>252.1</var>    Subd. 3. <b>State Quality Council.</b> (a) There is hereby created a State Quality <br/>
<a id="pl.252.2"></a><var>252.2</var>Council which must define regional quality councils, and carry out a community-based, <br/>
<a id="pl.252.3"></a><var>252.3</var>person-directed quality review component, and a comprehensive system for effective <br/>
<a id="pl.252.4"></a><var>252.4</var>incident reporting, investigation, analysis, and follow-up.<br/>
<a id="pl.252.5"></a><var>252.5</var>    (b) By August 1, 2011, the commissioner of human services shall appoint the <br/>
<a id="pl.252.6"></a><var>252.6</var>members of the initial State Quality Council. Members shall include representatives <br/>
<a id="pl.252.7"></a><var>252.7</var>from the following groups:<br/>
<a id="pl.252.8"></a><var>252.8</var>    (1) disability service recipients and their family members;<br/>
<a id="pl.252.9"></a><var>252.9</var>    (2) during the first two four years of the State Quality Council, there must be at least <br/>
<a id="pl.252.10"></a><var>252.10</var>three members from the Region 10 stakeholders. As regional quality councils are formed <br/>
<a id="pl.252.11"></a><var>252.11</var>under subdivision 4, each regional quality council shall appoint one member;<br/>
<a id="pl.252.12"></a><var>252.12</var>    (3) disability service providers;<br/>
<a id="pl.252.13"></a><var>252.13</var>    (4) disability advocacy groups; and<br/>
<a id="pl.252.14"></a><var>252.14</var>    (5) county human services agencies and staff from the Department of Human <br/>
<a id="pl.252.15"></a><var>252.15</var>Services and Ombudsman for Mental Health and Developmental Disabilities.<br/>
<a id="pl.252.16"></a><var>252.16</var>    (c) Members of the council who do not receive a salary or wages from an employer <br/>
<a id="pl.252.17"></a><var>252.17</var>for time spent on council duties may receive a per diem payment when performing council <br/>
<a id="pl.252.18"></a><var>252.18</var>duties and functions.<br/>
<a id="pl.252.19"></a><var>252.19</var>    (d) The State Quality Council shall:<br/>
<a id="pl.252.20"></a><var>252.20</var>    (1) assist the Department of Human Services in fulfilling federally mandated <br/>
<a id="pl.252.21"></a><var>252.21</var>obligations by monitoring disability service quality and quality assurance and <br/>
<a id="pl.252.22"></a><var>252.22</var>improvement practices in Minnesota;<br/>
<a id="pl.252.23"></a><var>252.23</var>    (2) establish state quality improvement priorities with methods for achieving results <br/>
<a id="pl.252.24"></a><var>252.24</var>and provide an annual report to the legislative committees with jurisdiction over policy <br/>
<a id="pl.252.25"></a><var>252.25</var>and funding of disability services on the outcomes, improvement priorities, and activities <br/>
<a id="pl.252.26"></a><var>252.26</var>undertaken by the commission during the previous state fiscal year;<br/>
<a id="pl.252.27"></a><var>252.27</var>(3) identify issues pertaining to financial and personal risk that impede Minnesotans <br/>
<a id="pl.252.28"></a><var>252.28</var>with disabilities from optimizing choice of community-based services; and<br/>
<a id="pl.252.29"></a><var>252.29</var>(4) recommend to the chairs and ranking minority members of the legislative <br/>
<a id="pl.252.30"></a><var>252.30</var>committees with jurisdiction over human services and civil law by January 15, 2013<br/>
<a id="pl.252.31"></a><var>252.31</var> 2014, statutory and rule changes related to the findings under clause (3) that promote <br/>
<a id="pl.252.32"></a><var>252.32</var>individualized service and housing choices balanced with appropriate individualized <br/>
<a id="pl.252.33"></a><var>252.33</var>protection.<br/>
<a id="pl.252.34"></a><var>252.34</var>    (e) The State Quality Council, in partnership with the commissioner, shall:<br/>
<a id="pl.252.35"></a><var>252.35</var>    (1) approve and direct implementation of the community-based, person-directed <br/>
<a id="pl.252.36"></a><var>252.36</var>system established in this section;<br/>
<a id="pl.253.1"></a><var>253.1</var>    (2) recommend an appropriate method of funding this system, and determine the <br/>
<a id="pl.253.2"></a><var>253.2</var>feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;<br/>
<a id="pl.253.3"></a><var>253.3</var>    (3) approve measurable outcomes in the areas of health and safety, consumer <br/>
<a id="pl.253.4"></a><var>253.4</var>evaluation, education and training, providers, and systems;<br/>
<a id="pl.253.5"></a><var>253.5</var>    (4) establish variable licensure periods not to exceed three years based on outcomes <br/>
<a id="pl.253.6"></a><var>253.6</var>achieved; and<br/>
<a id="pl.253.7"></a><var>253.7</var>    (5) in cooperation with the Quality Assurance Commission, design a transition plan <br/>
<a id="pl.253.8"></a><var>253.8</var>for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.<br/>
<a id="pl.253.9"></a><var>253.9</var>    (f) The State Quality Council shall notify the commissioner of human services that a <br/>
<a id="pl.253.10"></a><var>253.10</var>facility, program, or service has been reviewed by quality assurance team members under <br/>
<a id="pl.253.11"></a><var>253.11</var>subdivision 4, paragraph (b), clause (13), and qualifies for a license.<br/>
<a id="pl.253.12"></a><var>253.12</var>    (g) The State Quality Council, in partnership with the commissioner, shall establish <br/>
<a id="pl.253.13"></a><var>253.13</var>an ongoing review process for the system. The review shall take into account the <br/>
<a id="pl.253.14"></a><var>253.14</var>comprehensive nature of the system which is designed to evaluate the broad spectrum of <br/>
<a id="pl.253.15"></a><var>253.15</var>licensed and unlicensed entities that provide services to persons with disabilities. The <br/>
<a id="pl.253.16"></a><var>253.16</var>review shall address efficiencies and effectiveness of the system.<br/>
<a id="pl.253.17"></a><var>253.17</var>    (h) The State Quality Council may recommend to the commissioner certain <br/>
<a id="pl.253.18"></a><var>253.18</var>variances from the standards governing licensure of programs for persons with disabilities <br/>
<a id="pl.253.19"></a><var>253.19</var>in order to improve the quality of services so long as the recommended variances do <br/>
<a id="pl.253.20"></a><var>253.20</var>not adversely affect the health or safety of persons being served or compromise the <br/>
<a id="pl.253.21"></a><var>253.21</var>qualifications of staff to provide services.<br/>
<a id="pl.253.22"></a><var>253.22</var>    (i) The safety standards, rights, or procedural protections referenced under <br/>
<a id="pl.253.23"></a><var>253.23</var>subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make <br/>
<a id="pl.253.24"></a><var>253.24</var>recommendations to the commissioner or to the legislature in the report required under <br/>
<a id="pl.253.25"></a><var>253.25</var>paragraph (c) regarding alternatives or modifications to the safety standards, rights, or <br/>
<a id="pl.253.26"></a><var>253.26</var>procedural protections referenced under subdivision 2, paragraph (c).<br/>
<a id="pl.253.27"></a><var>253.27</var>    (j) The State Quality Council may hire staff to perform the duties assigned in this <br/>
<a id="pl.253.28"></a><var>253.28</var>subdivision.<br/>
<br/>
<a id="bill.7.19.0"></a><a id="pl.253.29"></a><var>253.29</var>    Sec. 19. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:<br/>
<a id="pl.253.30"></a><var>253.30</var>    Subd. 44. <b>Property rate </b><b>increase</b><b> increases</b><b> for </b><b>a facility in Bloomington effective </b><br/>
<a id="pl.253.31"></a><var>253.31</var><b>November 1, 2010</b><b> certain nursing facilities</b><b>.</b> (a) Notwithstanding any other law to the <br/>
<a id="pl.253.32"></a><var>253.32</var>contrary, money available for moratorium projects under section 
         <statute_ref>144A.073, subdivision <br/>
<a id="pl.253.33"></a><var>253.33</var>11
         </statute_ref>, shall be used, effective November 1, 2010, to fund an approved moratorium exception <br/>
<a id="pl.253.34"></a><var>253.34</var>project for a nursing facility in Bloomington licensed for 137 beds as of November 1, <br/>
<a id="pl.253.35"></a><var>253.35</var>2010, up to a total property rate adjustment of $19.33.<br/>
<a id="pl.254.1"></a><var>254.1</var>(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110 <br/>
<a id="pl.254.2"></a><var>254.2</var>beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow <br/>
<a id="pl.254.3"></a><var>254.3</var>$1,129,463 of a completed construction project to increase the property payment rate. <br/>
<a id="pl.254.4"></a><var>254.4</var>Notwithstanding any other law to the contrary, money available under section 144A.073, <br/>
<a id="pl.254.5"></a><var>254.5</var>subdivision 11, after the completion of the moratorium exception approval process in 2013 <br/>
<a id="pl.254.6"></a><var>254.6</var>under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the <br/>
<a id="pl.254.7"></a><var>254.7</var>medical assistance budget for the increase in the replacement-cost-new limit.<br/>
<a id="pl.254.8"></a><var>254.8</var>(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for <br/>
<a id="pl.254.9"></a><var>254.9</var>61 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to <br/>
<a id="pl.254.10"></a><var>254.10</var>allow $1,407,624 of a completed construction project to increase their property payment <br/>
<a id="pl.254.11"></a><var>254.11</var>rate. Effective September 1, 2013, or later, their replacement-cost-new limit under <br/>
<a id="pl.254.12"></a><var>254.12</var>subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project <br/>
<a id="pl.254.13"></a><var>254.13</var>to increase the property payment rate. Notwithstanding any other law to the contrary, <br/>
<a id="pl.254.14"></a><var>254.14</var>money available under section 144A.073, subdivision 11, after the completion of the <br/>
<a id="pl.254.15"></a><var>254.15</var>moratorium exception approval process in 2013 under section 144A.073, subdivision 3, <br/>
<a id="pl.254.16"></a><var>254.16</var>shall be used to reduce the fiscal impact to the medical assistance budget for the increase <br/>
<a id="pl.254.17"></a><var>254.17</var>in the replacement-cost-new limit.<br/>
<a id="pl.254.18"></a><var>254.18</var><b>EFFECTIVE DATE.</b>Paragraph (b) is effective retroactively from June 1, 2012. <br/>
<a id="pl.254.19"></a><var>254.19</var>Paragraph (c) is effective retroactively from July 1, 2012.<br/>
<br/>
<a id="bill.7.20.0"></a><a id="pl.254.20"></a><var>254.20</var>    Sec. 20. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:<br/>
<a id="pl.254.21"></a><var>254.21</var>    Subd. 4. <b>Alternate rates for nursing facilities.</b> (a) For nursing facilities which <br/>
<a id="pl.254.22"></a><var>254.22</var>have their payment rates determined under this section rather than section 
         <statute_ref>256B.431</statute_ref>, the <br/>
<a id="pl.254.23"></a><var>254.23</var>commissioner shall establish a rate under this subdivision. The nursing facility must enter <br/>
<a id="pl.254.24"></a><var>254.24</var>into a written contract with the commissioner.<br/>
<a id="pl.254.25"></a><var>254.25</var>    (b) A nursing facility's case mix payment rate for the first rate year of a facility's <br/>
<a id="pl.254.26"></a><var>254.26</var>contract under this section is the payment rate the facility would have received under <br/>
<a id="pl.254.27"></a><var>254.27</var>section 
         <statute_ref>256B.431</statute_ref>.<br/>
<a id="pl.254.28"></a><var>254.28</var>    (c) A nursing facility's case mix payment rates for the second and subsequent years <br/>
<a id="pl.254.29"></a><var>254.29</var>of a facility's contract under this section are the previous rate year's contract payment <br/>
<a id="pl.254.30"></a><var>254.30</var>rates plus an inflation adjustment and, for facilities reimbursed under this section or <br/>
<a id="pl.254.31"></a><var>254.31</var>section 
         <statute_ref>256B.431</statute_ref>, an adjustment to include the cost of any increase in Health Department <br/>
<a id="pl.254.32"></a><var>254.32</var>licensing fees for the facility taking effect on or after July 1, 2001. The index for the <br/>
<a id="pl.254.33"></a><var>254.33</var>inflation adjustment must be based on the change in the Consumer Price Index-All Items <br/>
<a id="pl.254.34"></a><var>254.34</var>(United States City average) (CPI-U) forecasted by the commissioner of management and <br/>
<a id="pl.254.35"></a><var>254.35</var>budget's national economic consultant, as forecasted in the fourth quarter of the calendar <br/>
<a id="pl.255.1"></a><var>255.1</var>year preceding the rate year. The inflation adjustment must be based on the 12-month <br/>
<a id="pl.255.2"></a><var>255.2</var>period from the midpoint of the previous rate year to the midpoint of the rate year for <br/>
<a id="pl.255.3"></a><var>255.3</var>which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, <br/>
<a id="pl.255.4"></a><var>255.4</var>2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, <br/>
<a id="pl.255.5"></a><var>255.5</var>July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall <br/>
<a id="pl.255.6"></a><var>255.6</var>apply only to the property-related payment rate. For the rate years beginning on October <br/>
<a id="pl.255.7"></a><var>255.7</var>1, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and <br/>
<a id="pl.255.8"></a><var>255.8</var>October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning <br/>
<a id="pl.255.9"></a><var>255.9</var>in 2005, adjustment to the property payment rate under this section and section 
         <statute_ref>256B.431</statute_ref> <br/>
<a id="pl.255.10"></a><var>255.10</var>shall be effective on October 1. In determining the amount of the property-related payment <br/>
<a id="pl.255.11"></a><var>255.11</var>rate adjustment under this paragraph, the commissioner shall determine the proportion of <br/>
<a id="pl.255.12"></a><var>255.12</var>the facility's rates that are property-related based on the facility's most recent cost report.<br/>
<a id="pl.255.13"></a><var>255.13</var>    (d) The commissioner shall develop additional incentive-based payments of up to <br/>
<a id="pl.255.14"></a><var>255.14</var>five percent above a facility's operating payment rate for achieving outcomes specified <br/>
<a id="pl.255.15"></a><var>255.15</var>in a contract. The commissioner may solicit contract amendments and implement those <br/>
<a id="pl.255.16"></a><var>255.16</var>which, on a competitive basis, best meet the state's policy objectives. The commissioner <br/>
<a id="pl.255.17"></a><var>255.17</var>shall limit the amount of any incentive payment and the number of contract amendments <br/>
<a id="pl.255.18"></a><var>255.18</var>under this paragraph to operate the incentive payments within funds appropriated for this <br/>
<a id="pl.255.19"></a><var>255.19</var>purpose. The contract amendments may specify various levels of payment for various <br/>
<a id="pl.255.20"></a><var>255.20</var>levels of performance. Incentive payments to facilities under this paragraph may be in the <br/>
<a id="pl.255.21"></a><var>255.21</var>form of time-limited rate adjustments or onetime supplemental payments. In establishing <br/>
<a id="pl.255.22"></a><var>255.22</var>the specified outcomes and related criteria, the commissioner shall consider the following <br/>
<a id="pl.255.23"></a><var>255.23</var>state policy objectives:<br/>
<a id="pl.255.24"></a><var>255.24</var>    (1) successful diversion or discharge of residents to the residents' prior home or other <br/>
<a id="pl.255.25"></a><var>255.25</var>community-based alternatives;<br/>
<a id="pl.255.26"></a><var>255.26</var>    (2) adoption of new technology to improve quality or efficiency;<br/>
<a id="pl.255.27"></a><var>255.27</var>    (3) improved quality as measured in the Nursing Home Report Card;<br/>
<a id="pl.255.28"></a><var>255.28</var>    (4) reduced acute care costs; and<br/>
<a id="pl.255.29"></a><var>255.29</var>    (5) any additional outcomes proposed by a nursing facility that the commissioner <br/>
<a id="pl.255.30"></a><var>255.30</var>finds desirable.<br/>
<a id="pl.255.31"></a><var>255.31</var>    (e) Notwithstanding the threshold in section 
         <statute_ref>256B.431, subdivision 16</statute_ref>, facilities that <br/>
<a id="pl.255.32"></a><var>255.32</var>take action to come into compliance with existing or pending requirements of the life <br/>
<a id="pl.255.33"></a><var>255.33</var>safety code provisions or federal regulations governing sprinkler systems must receive <br/>
<a id="pl.255.34"></a><var>255.34</var>reimbursement for the costs associated with compliance if all of the following conditions <br/>
<a id="pl.255.35"></a><var>255.35</var>are met:<br/>
<a id="pl.256.1"></a><var>256.1</var>    (1) the expenses associated with compliance occurred on or after January 1, 2005, <br/>
<a id="pl.256.2"></a><var>256.2</var>and before December 31, 2008;<br/>
<a id="pl.256.3"></a><var>256.3</var>    (2) the costs were not otherwise reimbursed under subdivision 4f or section <br/>
<statute_ref><a id="pl.256.4"></a><var>256.4</var>144A.071
         </statute_ref> or 
         <statute_ref>144A.073</statute_ref>; and<br/>
<a id="pl.256.5"></a><var>256.5</var>    (3) the total allowable costs reported under this paragraph are less than the minimum <br/>
<a id="pl.256.6"></a><var>256.6</var>threshold established under section 
         <statute_ref>256B.431, subdivision 15</statute_ref>, paragraph (e), and <br/>
<a id="pl.256.7"></a><var>256.7</var>subdivision 16.<br/>
<a id="pl.256.8"></a><var>256.8</var>The commissioner shall use money appropriated for this purpose to provide to qualifying <br/>
<a id="pl.256.9"></a><var>256.9</var>nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, <br/>
<a id="pl.256.10"></a><var>256.10</var>2008. Nursing facilities that have spent money or anticipate the need to spend money <br/>
<a id="pl.256.11"></a><var>256.11</var>to satisfy the most recent life safety code requirements by (1) installing a sprinkler <br/>
<a id="pl.256.12"></a><var>256.12</var>system or (2) replacing all or portions of an existing sprinkler system may submit to the <br/>
<a id="pl.256.13"></a><var>256.13</var>commissioner by June 30, 2007, on a form provided by the commissioner the actual <br/>
<a id="pl.256.14"></a><var>256.14</var>costs of a completed project or the estimated costs, based on a project bid, of a planned <br/>
<a id="pl.256.15"></a><var>256.15</var>project. The commissioner shall calculate a rate adjustment equal to the allowable <br/>
<a id="pl.256.16"></a><var>256.16</var>costs of the project divided by the resident days reported for the report year ending <br/>
<a id="pl.256.17"></a><var>256.17</var>September 30, 2006. If the costs from all projects exceed the appropriation for this <br/>
<a id="pl.256.18"></a><var>256.18</var>purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the <br/>
<a id="pl.256.19"></a><var>256.19</var>qualifying facilities by reducing the rate adjustment determined for each facility by an <br/>
<a id="pl.256.20"></a><var>256.20</var>equal percentage. Facilities that used estimated costs when requesting the rate adjustment <br/>
<a id="pl.256.21"></a><var>256.21</var>shall report to the commissioner by January 31, 2009, on the use of this money on a <br/>
<a id="pl.256.22"></a><var>256.22</var>form provided by the commissioner. If the nursing facility fails to provide the report, the <br/>
<a id="pl.256.23"></a><var>256.23</var>commissioner shall recoup the money paid to the facility for this purpose. If the facility <br/>
<a id="pl.256.24"></a><var>256.24</var>reports expenditures allowable under this subdivision that are less than the amount received <br/>
<a id="pl.256.25"></a><var>256.25</var>in the facility's annualized rate adjustment, the commissioner shall recoup the difference.<br/>
<br/>
<a id="bill.7.21.0"></a><a id="pl.256.26"></a><var>256.26</var>    Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:<br/>
<a id="pl.256.27"></a><var>256.27</var>    Subd. 6. <b>Planned closure rate adjustment.</b> (a) The commissioner of human <br/>
<a id="pl.256.28"></a><var>256.28</var>services shall calculate the amount of the planned closure rate adjustment available under <br/>
<a id="pl.256.29"></a><var>256.29</var>subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):<br/>
<a id="pl.256.30"></a><var>256.30</var>(1) the amount available is the net reduction of nursing facility beds multiplied <br/>
<a id="pl.256.31"></a><var>256.31</var>by $2,080;<br/>
<a id="pl.256.32"></a><var>256.32</var>(2) the total number of beds in the nursing facility or facilities receiving the planned <br/>
<a id="pl.256.33"></a><var>256.33</var>closure rate adjustment must be identified;<br/>
<a id="pl.256.34"></a><var>256.34</var>(3) capacity days are determined by multiplying the number determined under <br/>
<a id="pl.256.35"></a><var>256.35</var>clause (2) by 365; and<br/>
<a id="pl.257.1"></a><var>257.1</var>(4) the planned closure rate adjustment is the amount available in clause (1), divided <br/>
<a id="pl.257.2"></a><var>257.2</var>by capacity days determined under clause (3).<br/>
<a id="pl.257.3"></a><var>257.3</var>(b) A planned closure rate adjustment under this section is effective on the first day <br/>
<a id="pl.257.4"></a><var>257.4</var>of the month following completion of closure of the facility designated for closure in <br/>
<a id="pl.257.5"></a><var>257.5</var>the application and becomes part of the nursing facility's total operating external fixed<br/>
<a id="pl.257.6"></a><var>257.6</var> payment rate.<br/>
<a id="pl.257.7"></a><var>257.7</var>(c) Applicants may use the planned closure rate adjustment to allow for a property <br/>
<a id="pl.257.8"></a><var>257.8</var>payment for a new nursing facility or an addition to an existing nursing facility or as <br/>
<a id="pl.257.9"></a><var>257.9</var>an operating payment external fixed rate adjustment. Applications approved under this <br/>
<a id="pl.257.10"></a><var>257.10</var>subdivision are exempt from other requirements for moratorium exceptions under section <br/>
<statute_ref><a id="pl.257.11"></a><var>257.11</var>144A.073
         </statute_ref>, subdivisions 2 and 3.<br/>
<a id="pl.257.12"></a><var>257.12</var>(d) Upon the request of a closing facility, the commissioner must allow the facility a <br/>
<a id="pl.257.13"></a><var>257.13</var>closure rate adjustment as provided under section 
         <statute_ref>144A.161, subdivision 10</statute_ref>.<br/>
<a id="pl.257.14"></a><var>257.14</var>(e) A facility that has received a planned closure rate adjustment may reassign it <br/>
<a id="pl.257.15"></a><var>257.15</var>to another facility that is under the same ownership at any time within three years of its <br/>
<a id="pl.257.16"></a><var>257.16</var>effective date. The amount of the adjustment shall be computed according to paragraph (a).<br/>
<a id="pl.257.17"></a><var>257.17</var>(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, <br/>
<a id="pl.257.18"></a><var>257.18</var>the commissioner shall recalculate planned closure rate adjustments for facilities that <br/>
<a id="pl.257.19"></a><var>257.19</var>delicense beds under this section on or after July 1, 2001, to reflect the increase in the per <br/>
<a id="pl.257.20"></a><var>257.20</var>bed dollar amount. The recalculated planned closure rate adjustment shall be effective <br/>
<a id="pl.257.21"></a><var>257.21</var>from the date the per bed dollar amount is increased.<br/>
<a id="pl.257.22"></a><var>257.22</var>(g) For planned closures approved after June 30, 2009, the commissioner of human <br/>
<a id="pl.257.23"></a><var>257.23</var>services shall calculate the amount of the planned closure rate adjustment available under <br/>
<a id="pl.257.24"></a><var>257.24</var>subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).<br/>
<a id="pl.257.25"></a><var>257.25</var>(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no <br/>
<a id="pl.257.26"></a><var>257.26</var>longer not accept applications for planned closure rate adjustments under subdivision 3.<br/>
<br/>
<a id="bill.7.22.0"></a><a id="pl.257.27"></a><var>257.27</var>    Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 55, is amended to read:<br/>
<a id="pl.257.28"></a><var>257.28</var>    Subd. 55. <b>Phase-in of rebased operating payment rates.</b>  (a) For the rate years <br/>
<a id="pl.257.29"></a><var>257.29</var>beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated <br/>
<a id="pl.257.30"></a><var>257.30</var>under this section shall be phased in by blending the operating rate with the operating <br/>
<a id="pl.257.31"></a><var>257.31</var>payment rate determined under section 
         <statute_ref>256B.434</statute_ref>. For purposes of this subdivision, the <br/>
<a id="pl.257.32"></a><var>257.32</var>rate to be used that is determined under section 
         <statute_ref>256B.434</statute_ref> shall not include the portion of <br/>
<a id="pl.257.33"></a><var>257.33</var>the operating payment rate related to performance-based incentive payments under section <br/>
<statute_ref><a id="pl.257.34"></a><var>257.34</var>256B.434, subdivision 4
         </statute_ref>, paragraph (d).:<br/>
<a id="pl.258.1"></a><var>258.1</var>    (1)  for the rate year beginning October 1, 2008, the operating payment rate for each <br/>
<a id="pl.258.2"></a><var>258.2</var>facility shall be 13 percent of the operating payment rate from this section, and 87 percent <br/>
<a id="pl.258.3"></a><var>258.3</var>of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>.; <br/>
<a id="pl.258.4"></a><var>258.4</var>    (2) for the rate period from October 1, 2009, to September 30, 2013, no rate <br/>
<a id="pl.258.5"></a><var>258.5</var>adjustments shall be implemented under this section, but shall be determined under <br/>
<a id="pl.258.6"></a><var>258.6</var>section 
         <statute_ref>256B.434</statute_ref>.; <br/>
<a id="pl.258.7"></a><var>258.7</var>    (3) for the rate year beginning October 1, 2013, the operating payment rate for each <br/>
<a id="pl.258.8"></a><var>258.8</var>facility shall be 65 15.4 percent of the operating payment rate from this section, and 35<br/>
<a id="pl.258.9"></a><var>258.9</var> 84.6 percent of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>.; and<br/>
<a id="pl.258.10"></a><var>258.10</var>    (4) for the rate year beginning October 1, 2014 2015, the operating payment rate for <br/>
<a id="pl.258.11"></a><var>258.11</var>each facility shall be 82 24.3 percent of the operating payment rate from this section, and <br/>
<a id="pl.258.12"></a><var>258.12</var>18 75.7  percent of the operating payment rate from section 
         <statute_ref>256B.434</statute_ref>.<br/>
<a id="pl.258.13"></a><var>258.13</var>     for the rate year beginning October 1, 2015, the operating payment rate for each <br/>
<a id="pl.258.14"></a><var>258.14</var>facility shall be the operating payment rate determined under this section. The blending <br/>
<a id="pl.258.15"></a><var>258.15</var>of operating payment rates under this section shall be performed separately for each <br/>
<a id="pl.258.16"></a><var>258.16</var>RUG's class.<br/>
<a id="pl.258.17"></a><var>258.17</var>    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits <br/>
<a id="pl.258.18"></a><var>258.18</var>to the operating payment rate increases under paragraph (a) by creating a minimum <br/>
<a id="pl.258.19"></a><var>258.19</var>percentage increase and a maximum percentage increase.:<br/>
<a id="pl.258.20"></a><var>258.20</var>    (1) each nursing facility that receives a blended October 1, 2008, operating payment <br/>
<a id="pl.258.21"></a><var>258.21</var>rate increase under paragraph (a) of less than one percent, when compared to its operating <br/>
<a id="pl.258.22"></a><var>258.22</var>payment rate on September 30, 2008, computed using rates with RUG's weight of 
         <statute_ref>1.00</statute_ref>, <br/>
<a id="pl.258.23"></a><var>258.23</var>shall receive a rate adjustment of one percent.;<br/>
<a id="pl.258.24"></a><var>258.24</var>    (2) the commissioner shall determine a maximum percentage increase that will <br/>
<a id="pl.258.25"></a><var>258.25</var>result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing <br/>
<a id="pl.258.26"></a><var>258.26</var>facilities with a blended October 1, 2008, operating payment rate increase under paragraph <br/>
<a id="pl.258.27"></a><var>258.27</var>(a) greater than the maximum percentage increase determined by the commissioner, when <br/>
<a id="pl.258.28"></a><var>258.28</var>compared to its operating payment rate on September 30, 2008, computed using rates with <br/>
<a id="pl.258.29"></a><var>258.29</var>a RUG's weight of 
         <statute_ref>1.00</statute_ref>, shall receive the maximum percentage increase.;<br/>
<a id="pl.258.30"></a><var>258.30</var>    (3) nursing facilities with a blended October 1, 2008, operating payment rate <br/>
<a id="pl.258.31"></a><var>258.31</var>increase under paragraph (a) greater than one percent and less than the maximum <br/>
<a id="pl.258.32"></a><var>258.32</var>percentage increase determined by the commissioner, when compared to its operating <br/>
<a id="pl.258.33"></a><var>258.33</var>payment rate on September 30, 2008, computed using rates with a RUG's weight of 
         <statute_ref>1.00</statute_ref>, <br/>
<a id="pl.258.34"></a><var>258.34</var>shall receive the blended October 1, 2008, operating payment rate increase determined <br/>
<a id="pl.258.35"></a><var>258.35</var>under paragraph (a).; and<br/>
<a id="pl.259.1"></a><var>259.1</var>    (4) the October 1, 2009, through October 1, 2015, operating payment rate for <br/>
<a id="pl.259.2"></a><var>259.2</var>facilities receiving the maximum percentage increase determined in clause (2) shall be <br/>
<a id="pl.259.3"></a><var>259.3</var>the amount determined under paragraph (a) less the difference between the amount <br/>
<a id="pl.259.4"></a><var>259.4</var>determined under paragraph (a) for October 1, 2008, and the amount allowed under clause <br/>
<a id="pl.259.5"></a><var>259.5</var>(2). This rate restriction does not apply to rate increases provided in any other section.<br/>
<a id="pl.259.6"></a><var>259.6</var>    (c) A portion of the funds received under this subdivision that are in excess of <br/>
<a id="pl.259.7"></a><var>259.7</var>operating payment rates that a facility would have received under section 
         <statute_ref>256B.434</statute_ref>, as <br/>
<a id="pl.259.8"></a><var>259.8</var>determined in accordance with clauses (1) to (3), shall be subject to the requirements in <br/>
<a id="pl.259.9"></a><var>259.9</var>section 
         <statute_ref>256B.434, subdivision 19</statute_ref>, paragraphs (b) to (h).:<br/>
<a id="pl.259.10"></a><var>259.10</var>    (1) determine the amount of additional funding available to a facility, which shall be <br/>
<a id="pl.259.11"></a><var>259.11</var>equal to total medical assistance resident days from the most recent reporting year times <br/>
<a id="pl.259.12"></a><var>259.12</var>the difference between the blended rate determined in paragraph (a) for the rate year being <br/>
<a id="pl.259.13"></a><var>259.13</var>computed and the blended rate for the prior year.;<br/>
<a id="pl.259.14"></a><var>259.14</var>    (2) determine the portion of all operating costs, for the most recent reporting year, <br/>
<a id="pl.259.15"></a><var>259.15</var>that are compensation related. If this value exceeds 75 percent, use 75 percent.;<br/>
<a id="pl.259.16"></a><var>259.16</var>    (3) subtract the amount determined in clause (2) from 75 percent.; and<br/>
<a id="pl.259.17"></a><var>259.17</var>    (4) the portion of the fund received under this subdivision that shall be subject to the <br/>
<a id="pl.259.18"></a><var>259.18</var>requirements in section 
         <statute_ref>256B.434, subdivision 19</statute_ref>, paragraphs (b) to (h), shall equal the <br/>
<a id="pl.259.19"></a><var>259.19</var>amount determined in clause (1) times the amount determined in clause (3).<br/>
<br/>
<a id="bill.7.23.0"></a><a id="pl.259.20"></a><var>259.20</var>    Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 56, is amended to read:<br/>
<a id="pl.259.21"></a><var>259.21</var>    Subd. 56. <b>Hold harmless.</b> For the rate years beginning October 1, 2008, to October <br/>
<a id="pl.259.22"></a><var>259.22</var>1, 2016, no nursing facility shall receive an operating cost payment rate less than its <br/>
<a id="pl.259.23"></a><var>259.23</var>operating cost payment rate under section 
         <statute_ref>256B.434</statute_ref>. For rate years beginning between <br/>
<a id="pl.259.24"></a><var>259.24</var>October 1, 2009, and October 1, 2015, no nursing facility shall receive an operating <br/>
<a id="pl.259.25"></a><var>259.25</var>payment rate less than its operating payment rate in effect on September 30, 2009. The <br/>
<a id="pl.259.26"></a><var>259.26</var>comparison of operating payment rates under this section shall be made for a RUG's <br/>
<a id="pl.259.27"></a><var>259.27</var>rate with a weight of 1.00.<br/>
<br/>
<a id="bill.7.24.0"></a><a id="pl.259.28"></a><var>259.28</var>    Sec. 24. Minnesota Statutes 2012, section 256B.441, subdivision 62, is amended to read:<br/>
<a id="pl.259.29"></a><var>259.29</var>    Subd. 62. <b>Repeal of rebased operating payment rates.</b> Notwithstanding <br/>
<a id="pl.259.30"></a><var>259.30</var>subdivision 54 or 55, no further steps toward phase-in of rebased operating payment rates <br/>
<a id="pl.259.31"></a><var>259.31</var>shall be taken, except for subdivision 55, paragraph (a), clauses (3) and (4).<br/>
<br/>
<a id="bill.7.25.0"></a><a id="pl.259.32"></a><var>259.32</var>    Sec. 25. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:<br/>
<a id="pl.260.1"></a><var>260.1</var>    Subd. 11a. <b>Waivered services statewide priorities.</b> (a) The commissioner shall <br/>
<a id="pl.260.2"></a><var>260.2</var>establish statewide priorities for individuals on the waiting list for community alternative <br/>
<a id="pl.260.3"></a><var>260.3</var>care, community alternatives for disabled individuals, and brain injury waiver services, <br/>
<a id="pl.260.4"></a><var>260.4</var>as of January 1, 2010. The statewide priorities must include, but are not limited to, <br/>
<a id="pl.260.5"></a><var>260.5</var>individuals who continue to have a need for waiver services after they have maximized the <br/>
<a id="pl.260.6"></a><var>260.6</var>use of state plan services and other funding resources, including natural supports, prior to <br/>
<a id="pl.260.7"></a><var>260.7</var>accessing waiver services, and who meet at least one of the following criteria:<br/>
<a id="pl.260.8"></a><var>260.8</var>(1) no longer require the intensity of services provided where they are currently <br/>
<a id="pl.260.9"></a><var>260.9</var>living; or<br/>
<a id="pl.260.10"></a><var>260.10</var>(2) make a request to move from an institutional setting.<br/>
<a id="pl.260.11"></a><var>260.11</var>(b) After the priorities in paragraph (a) are met, priority must also be given to <br/>
<a id="pl.260.12"></a><var>260.12</var>individuals who meet at least one of the following criteria:<br/>
<a id="pl.260.13"></a><var>260.13</var>(1) have unstable living situations due to the age, incapacity, or sudden loss of <br/>
<a id="pl.260.14"></a><var>260.14</var>the primary caregivers;<br/>
<a id="pl.260.15"></a><var>260.15</var>(2) are moving from an institution due to bed closures;<br/>
<a id="pl.260.16"></a><var>260.16</var>(3) experience a sudden closure of their current living arrangement;<br/>
<a id="pl.260.17"></a><var>260.17</var>(4) require protection from confirmed abuse, neglect, or exploitation;<br/>
<a id="pl.260.18"></a><var>260.18</var>(5) experience a sudden change in need that can no longer be met through state plan <br/>
<a id="pl.260.19"></a><var>260.19</var>services or other funding resources alone; or<br/>
<a id="pl.260.20"></a><var>260.20</var>(6) meet other priorities established by the department.<br/>
<a id="pl.260.21"></a><var>260.21</var>(b) (c) When allocating resources to lead agencies, the commissioner must take into <br/>
<a id="pl.260.22"></a><var>260.22</var>consideration the number of individuals waiting who meet statewide priorities and the <br/>
<a id="pl.260.23"></a><var>260.23</var>lead agencies' current use of waiver funds and existing service options. The commissioner <br/>
<a id="pl.260.24"></a><var>260.24</var>has the authority to transfer funds between counties, groups of counties, and tribes to <br/>
<a id="pl.260.25"></a><var>260.25</var>accommodate statewide priorities and resource needs while accounting for a necessary <br/>
<a id="pl.260.26"></a><var>260.26</var>base level reserve amount for each county, group of counties, and tribe.<br/>
<a id="pl.260.27"></a><var>260.27</var>(c) The commissioner shall evaluate the impact of the use of statewide priorities and <br/>
<a id="pl.260.28"></a><var>260.28</var>provide recommendations to the legislature on whether to continue the use of statewide <br/>
<a id="pl.260.29"></a><var>260.29</var>priorities in the November 1, 2011, annual report required by the commissioner in sections <br/>
<a id="pl.260.30"></a><var>260.30</var><statute_ref>256B.0916, subdivision 7</statute_ref>, and 
<statute_ref>256B.49, subdivision 21</statute_ref>.<br/>
<br/>
<a id="bill.7.26.0"></a><a id="pl.260.31"></a><var>260.31</var>    Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:<br/>
<a id="pl.260.32"></a><var>260.32</var>    Subd. 15. <b>Coordinated service and support plan; comprehensive transitional </b><br/>
<a id="pl.260.33"></a><var>260.33</var><b>service plan; maintenance service plan.</b> (a) Each recipient of home and community-based <br/>
<a id="pl.260.34"></a><var>260.34</var>waivered services shall be provided a copy of the written coordinated service and support <br/>
<a id="pl.260.35"></a><var>260.35</var>plan which meets the requirements in section 
         <statute_ref>256B.092</statute_ref>, subdivision 1b.<br/>
<a id="pl.261.1"></a><var>261.1</var>(b) In developing the comprehensive transitional service plan, the individual <br/>
<a id="pl.261.2"></a><var>261.2</var>receiving services, the case manager, and the guardian, if applicable, will identify the <br/>
<a id="pl.261.3"></a><var>261.3</var>transitional service plan fundamental service outcome and anticipated timeline to achieve <br/>
<a id="pl.261.4"></a><var>261.4</var>this outcome. Within the first 20 days following a recipient's request for an assessment or <br/>
<a id="pl.261.5"></a><var>261.5</var>reassessment, the transitional service planning team must be identified. A team leader must <br/>
<a id="pl.261.6"></a><var>261.6</var>be identified who will be responsible for assigning responsibility and communicating with <br/>
<a id="pl.261.7"></a><var>261.7</var>team members to ensure implementation of the transition plan and ongoing assessment and <br/>
<a id="pl.261.8"></a><var>261.8</var>communication process. The team leader should be an individual, such as the case manager <br/>
<a id="pl.261.9"></a><var>261.9</var>or guardian, who has the opportunity to follow the recipient to the next level of service.<br/>
<a id="pl.261.10"></a><var>261.10</var>Within ten days following an assessment, a comprehensive transitional service plan <br/>
<a id="pl.261.11"></a><var>261.11</var>must be developed incorporating elements of a comprehensive functional assessment and <br/>
<a id="pl.261.12"></a><var>261.12</var>including short-term measurable outcomes and timelines for achievement of and reporting <br/>
<a id="pl.261.13"></a><var>261.13</var>on these outcomes. Functional milestones must also be identified and reported according <br/>
<a id="pl.261.14"></a><var>261.14</var>to the timelines agreed upon by the transitional service planning team. In addition, the <br/>
<a id="pl.261.15"></a><var>261.15</var>comprehensive transitional service plan must identify additional supports that may assist <br/>
<a id="pl.261.16"></a><var>261.16</var>in the achievement of the fundamental service outcome such as the development of greater <br/>
<a id="pl.261.17"></a><var>261.17</var>natural community support, increased collaboration among agencies, and technological <br/>
<a id="pl.261.18"></a><var>261.18</var>supports.<br/>
<a id="pl.261.19"></a><var>261.19</var>The timelines for reporting on functional milestones will prompt a reassessment of <br/>
<a id="pl.261.20"></a><var>261.20</var>services provided, the units of services, rates, and appropriate service providers. It is <br/>
<a id="pl.261.21"></a><var>261.21</var>the responsibility of the transitional service planning team leader to review functional <br/>
<a id="pl.261.22"></a><var>261.22</var>milestone reporting to determine if the milestones are consistent with observable skills <br/>
<a id="pl.261.23"></a><var>261.23</var>and that milestone achievement prompts any needed changes to the comprehensive <br/>
<a id="pl.261.24"></a><var>261.24</var>transitional service plan.<br/>
<a id="pl.261.25"></a><var>261.25</var>For those whose fundamental transitional service outcome involves the need to <br/>
<a id="pl.261.26"></a><var>261.26</var>procure housing, a plan for the recipient to seek the resources necessary to secure the least <br/>
<a id="pl.261.27"></a><var>261.27</var>restrictive housing possible should be incorporated into the plan, including employment <br/>
<a id="pl.261.28"></a><var>261.28</var>and public supports such as housing access and shelter needy funding.<br/>
<a id="pl.261.29"></a><var>261.29</var>(c) Counties and other agencies responsible for funding community placement and <br/>
<a id="pl.261.30"></a><var>261.30</var>ongoing community supportive services are responsible for the implementation of the <br/>
<a id="pl.261.31"></a><var>261.31</var>comprehensive transitional service plans. Oversight responsibilities include both ensuring <br/>
<a id="pl.261.32"></a><var>261.32</var>effective transitional service delivery and efficient utilization of funding resources.<br/>
<a id="pl.261.33"></a><var>261.33</var>(d) Following one year of transitional services, the transitional services planning team <br/>
<a id="pl.261.34"></a><var>261.34</var>will make a determination as to whether or not the individual receiving services requires <br/>
<a id="pl.261.35"></a><var>261.35</var>the current level of continuous and consistent support in order to maintain the recipient's <br/>
<a id="pl.261.36"></a><var>261.36</var>current level of functioning. Recipients who are determined to have not had a significant <br/>
<a id="pl.262.1"></a><var>262.1</var>change in functioning for 12 months must move from a transitional to a maintenance <br/>
<a id="pl.262.2"></a><var>262.2</var>service plan. Recipients on a maintenance service plan must be reassessed to determine if <br/>
<a id="pl.262.3"></a><var>262.3</var>the recipient would benefit from a transitional service plan at least every 12 months and at <br/>
<a id="pl.262.4"></a><var>262.4</var>other times when there has been a significant change in the recipient's functioning. This <br/>
<a id="pl.262.5"></a><var>262.5</var>assessment should consider any changes to technological or natural community supports.<br/>
<a id="pl.262.6"></a><var>262.6</var>(e) When a county is evaluating denials, reductions, or terminations of home and <br/>
<a id="pl.262.7"></a><var>262.7</var>community-based services under section 
         <statute_ref>256B.49</statute_ref> for an individual, the case manager <br/>
<a id="pl.262.8"></a><var>262.8</var>shall offer to meet with the individual or the individual's guardian in order to discuss <br/>
<a id="pl.262.9"></a><var>262.9</var>the prioritization of service needs within the coordinated service and support plan, <br/>
<a id="pl.262.10"></a><var>262.10</var>comprehensive transitional service plan, or maintenance service plan. The reduction in <br/>
<a id="pl.262.11"></a><var>262.11</var>the authorized services for an individual due to changes in funding for waivered services <br/>
<a id="pl.262.12"></a><var>262.12</var>may not exceed the amount needed to ensure medically necessary services to meet the <br/>
<a id="pl.262.13"></a><var>262.13</var>individual's health, safety, and welfare.<br/>
<a id="pl.262.14"></a><var>262.14</var>(f) At the time of reassessment, local agency case managers shall assess each recipient <br/>
<a id="pl.262.15"></a><var>262.15</var>of community alternatives for disabled individuals or brain injury waivered services <br/>
<a id="pl.262.16"></a><var>262.16</var>currently residing in a licensed adult foster home that is not the primary residence of the <br/>
<a id="pl.262.17"></a><var>262.17</var>license holder, or in which the license holder is not the primary caregiver, to determine if <br/>
<a id="pl.262.18"></a><var>262.18</var>that recipient could appropriately be served in a community-living setting. If appropriate <br/>
<a id="pl.262.19"></a><var>262.19</var>for the recipient, the case manager shall offer the recipient, through a person-centered <br/>
<a id="pl.262.20"></a><var>262.20</var>planning process, the option to receive alternative housing and service options. In the <br/>
<a id="pl.262.21"></a><var>262.21</var>event that the recipient chooses to transfer from the adult foster home, the vacated bed <br/>
<a id="pl.262.22"></a><var>262.22</var>shall not be filled with another recipient of waiver services and group residential housing <br/>
<a id="pl.262.23"></a><var>262.23</var>and the licensed capacity shall be reduced accordingly, unless the savings required by the <br/>
<a id="pl.262.24"></a><var>262.24</var>licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7, <br/>
<a id="pl.262.25"></a><var>262.25</var>sections 1 and 40, paragraph (f), for foster care settings where the physical location is not <br/>
<a id="pl.262.26"></a><var>262.26</var>the primary residence of the license holder are met through voluntary changes described <br/>
<a id="pl.262.27"></a><var>262.27</var>in section 
         <statute_ref>245A.03, subdivision 7</statute_ref>, paragraph (f) (e), or as provided under paragraph (a), <br/>
<a id="pl.262.28"></a><var>262.28</var>clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers, <br/>
<a id="pl.262.29"></a><var>262.29</var>the county agency, with the assistance of the department, shall facilitate a consolidation of <br/>
<a id="pl.262.30"></a><var>262.30</var>settings or closure. This reassessment process shall be completed by July 1, 2013.<br/>
<br/>
<a id="bill.7.27.0"></a><a id="pl.262.31"></a><var>262.31</var>    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a <br/>
<a id="pl.262.32"></a><var>262.32</var>subdivision to read:<br/>
<a id="pl.262.33"></a><var>262.33</var>    Subd. 25. <b>Reduce avoidable behavioral crisis emergency room admissions, </b><br/>
<a id="pl.262.34"></a><var>262.34</var><b>psychiatric inpatient hospitalizations, and commitments to institutions.</b> (a) Persons <br/>
<a id="pl.262.35"></a><var>262.35</var>receiving home and community-based services authorized under this section who have <br/>
<a id="pl.263.1"></a><var>263.1</var>two or more admissions within a calendar year to an emergency room, psychiatric unit, <br/>
<a id="pl.263.2"></a><var>263.2</var>or institution must receive consultation from a mental health professional as defined in <br/>
<a id="pl.263.3"></a><var>263.3</var>section 245.462, subdivision 18, or a behavioral professional as defined in the home and <br/>
<a id="pl.263.4"></a><var>263.4</var>community-based services state plan within 30 days of discharge. The mental health <br/>
<a id="pl.263.5"></a><var>263.5</var>professional or behavioral professional must:<br/>
<a id="pl.263.6"></a><var>263.6</var>(1) conduct a functional assessment of the crisis incident as defined in section <br/>
<a id="pl.263.7"></a><var>263.7</var>245D.02, subdivision 11, which led to the hospitalization with the goal of developing <br/>
<a id="pl.263.8"></a><var>263.8</var>proactive strategies as well as necessary reactive strategies to reduce the likelihood of <br/>
<a id="pl.263.9"></a><var>263.9</var>future avoidable hospitalizations due to a behavioral crisis;<br/>
<a id="pl.263.10"></a><var>263.10</var>(2) use the results of the functional assessment to amend the coordinated service and <br/>
<a id="pl.263.11"></a><var>263.11</var>support plan in section 245D.02, subdivision 4b, to address the potential need for additional <br/>
<a id="pl.263.12"></a><var>263.12</var>staff training, increased staffing, access to crisis mobility services, mental health services, <br/>
<a id="pl.263.13"></a><var>263.13</var>use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and<br/>
<a id="pl.263.14"></a><var>263.14</var>(3) identify the need for additional consultation, testing, mental health crisis <br/>
<a id="pl.263.15"></a><var>263.15</var>intervention team services as defined in section 245D.02, subdivision 20, psychotropic <br/>
<a id="pl.263.16"></a><var>263.16</var>medication use and monitoring under section 245D.051, and the frequency and duration <br/>
<a id="pl.263.17"></a><var>263.17</var>of ongoing consultation. <br/>
<a id="pl.263.18"></a><var>263.18</var>(b) For the purposes of this subdivision, "institution" includes, but is not limited to, <br/>
<a id="pl.263.19"></a><var>263.19</var>the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.<br/>
<br/>
<a id="bill.7.28.0"></a><a id="pl.263.20"></a><var>263.20</var>    Sec. 28. Minnesota Statutes 2012, section 256B.49, is amended by adding a <br/>
<a id="pl.263.21"></a><var>263.21</var>subdivision to read:<br/>
<a id="pl.263.22"></a><var>263.22</var>    Subd. 26. <b>Excess allocations.</b> County and tribal agencies will be responsible for <br/>
<a id="pl.263.23"></a><var>263.23</var>authorizations in excess of the allocation made by the commissioner. In the event a county <br/>
<a id="pl.263.24"></a><var>263.24</var>or tribal agency authorizes in excess of the allocation made by the commissioner for a <br/>
<a id="pl.263.25"></a><var>263.25</var>given allocation period, the county or tribal agency must submit a corrective action plan to <br/>
<a id="pl.263.26"></a><var>263.26</var>the commissioner. The plan must state the actions the agency will take to correct their <br/>
<a id="pl.263.27"></a><var>263.27</var>overauthorization for the year following the period when the overspending occurred. <br/>
<a id="pl.263.28"></a><var>263.28</var>Failure to correct overauthorizations shall result in recoupment of authorizations in excess <br/>
<a id="pl.263.29"></a><var>263.29</var>of the allocation. Nothing in this subdivision shall be construed as reducing the county's <br/>
<a id="pl.263.30"></a><var>263.30</var>responsibility to offer and make available feasible home and community-based options to <br/>
<a id="pl.263.31"></a><var>263.31</var>eligible waiver recipients within the resources allocated to them for that purpose.<br/>
<br/>
<a id="bill.7.29.0"></a><a id="pl.263.32"></a><var>263.32</var>    Sec. 29. Minnesota Statutes 2012, section 256B.492, is amended to read:<br/>
<a id="pl.263.33"></a><var>263.33</var><b>256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE </b><br/>
<a id="pl.263.34"></a><var>263.34</var><b>WITH DISABILITIES.</b><br/>
<a id="pl.264.1"></a><var>264.1</var>(a) Individuals receiving services under a home and community-based waiver under <br/>
<a id="pl.264.2"></a><var>264.2</var>section 
         <statute_ref>256B.092</statute_ref> or 
         <statute_ref>256B.49</statute_ref> may receive services in the following settings:<br/>
<a id="pl.264.3"></a><var>264.3</var>(1) an individual's own home or family home;<br/>
<a id="pl.264.4"></a><var>264.4</var>(2) a licensed adult foster care setting of up to five people; and<br/>
<a id="pl.264.5"></a><var>264.5</var>(3) community living settings as defined in section 
         <statute_ref>256B.49</statute_ref>, subdivision 23, where <br/>
<a id="pl.264.6"></a><var>264.6</var>individuals with disabilities may reside in all of the units in a building of four or fewer <br/>
<a id="pl.264.7"></a><var>264.7</var>units, and no more than the greater of four or 25 percent of the units in a multifamily <br/>
<a id="pl.264.8"></a><var>264.8</var>building of more than four units, unless required by the Housing Opportunities for Persons <br/>
<a id="pl.264.9"></a><var>264.9</var>with AIDS Program.<br/>
<a id="pl.264.10"></a><var>264.10</var>(b) The settings in paragraph (a) must not:<br/>
<a id="pl.264.11"></a><var>264.11</var>(1) be located in a building that is a publicly or privately operated facility that <br/>
<a id="pl.264.12"></a><var>264.12</var>provides institutional treatment or custodial care;<br/>
<a id="pl.264.13"></a><var>264.13</var>(2) be located in a building on the grounds of or adjacent to a public or private <br/>
<a id="pl.264.14"></a><var>264.14</var>institution;<br/>
<a id="pl.264.15"></a><var>264.15</var>(3) be a housing complex designed expressly around an individual's diagnosis or <br/>
<a id="pl.264.16"></a><var>264.16</var>disability, unless required by the Housing Opportunities for Persons with AIDS Program;<br/>
<a id="pl.264.17"></a><var>264.17</var>(4) be segregated based on a disability, either physically or because of setting <br/>
<a id="pl.264.18"></a><var>264.18</var>characteristics, from the larger community; and<br/>
<a id="pl.264.19"></a><var>264.19</var>(5) have the qualities of an institution which include, but are not limited to: <br/>
<a id="pl.264.20"></a><var>264.20</var>regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions <br/>
<a id="pl.264.21"></a><var>264.21</var>agreed to and documented in the person's individual service plan shall not result in a <br/>
<a id="pl.264.22"></a><var>264.22</var>residence having the qualities of an institution as long as the restrictions for the person are <br/>
<a id="pl.264.23"></a><var>264.23</var>not imposed upon others in the same residence and are the least restrictive alternative, <br/>
<a id="pl.264.24"></a><var>264.24</var>imposed for the shortest possible time to meet the person's needs.<br/>
<a id="pl.264.25"></a><var>264.25</var>(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which <br/>
<a id="pl.264.26"></a><var>264.26</var>individuals receive services under a home and community-based waiver as of July 1, <br/>
<a id="pl.264.27"></a><var>264.27</var>2012, and the setting does not meet the criteria of this section.<br/>
<a id="pl.264.28"></a><var>264.28</var>(d) Notwithstanding paragraph (c), a program in Hennepin County established as <br/>
<a id="pl.264.29"></a><var>264.29</var>part of a Hennepin County demonstration project is qualified for the exception allowed <br/>
<a id="pl.264.30"></a><var>264.30</var>under paragraph (c).<br/>
<a id="pl.264.31"></a><var>264.31</var>(e) The commissioner shall submit an amendment to the waiver plan no later than <br/>
<a id="pl.264.32"></a><var>264.32</var>December 31, 2012.<br/>
<br/>
<a id="bill.7.30.0"></a><a id="pl.264.33"></a><var>264.33</var>    Sec. 30. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:<br/>
<a id="pl.264.34"></a><var>264.34</var>    Subd. 2. <b>Planned closure process needs determination.</b> The commissioner shall <br/>
<a id="pl.264.35"></a><var>264.35</var>announce and implement a program for planned closure of adult foster care homes. Planned <br/>
<a id="pl.265.1"></a><var>265.1</var>closure shall be the preferred method for achieving necessary budgetary savings required by <br/>
<a id="pl.265.2"></a><var>265.2</var>the licensed bed closure budget reduction in section 
         <statute_ref>245A.03, subdivision 7</statute_ref>, paragraph (d)<br/>
<a id="pl.265.3"></a><var>265.3</var> (c). If additional closures are required to achieve the necessary savings, the commissioner <br/>
<a id="pl.265.4"></a><var>265.4</var>shall use the process and priorities in section 
         <statute_ref>245A.03, subdivision 7</statute_ref>, paragraph (d) (c).<br/>
<br/>
<a id="bill.7.31.0"></a><a id="pl.265.5"></a><var>265.5</var>    Sec. 31. Minnesota Statutes 2012, section 256B.501, is amended by adding a <br/>
<a id="pl.265.6"></a><var>265.6</var>subdivision to read:<br/>
<a id="pl.265.7"></a><var>265.7</var>    Subd. 14. <b>Rate adjustment for ICF/DD in Cottonwood County.</b> The <br/>
<a id="pl.265.8"></a><var>265.8</var>commissioner of health shall decertify three beds in an intermediate care facility for <br/>
<a id="pl.265.9"></a><var>265.9</var>persons with developmental disabilities with 21 certified beds located in Cottonwood <br/>
<a id="pl.265.10"></a><var>265.10</var>County. The total payment rate shall be $282.62 per bed, per day.<br/>
<br/>
<a id="bill.7.32.0"></a><a id="pl.265.11"></a><var>265.11</var>    Sec. 32. Minnesota Statutes 2012, section 256B.5012, is amended by adding a <br/>
<a id="pl.265.12"></a><var>265.12</var>subdivision to read:<br/>
<a id="pl.265.13"></a><var>265.13</var>    Subd. 15. <b>ICF/DD rate increases effective January 1, 2015, and July 1, 2015.</b> (a) <br/>
<a id="pl.265.14"></a><var>265.14</var>Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate <br/>
<a id="pl.265.15"></a><var>265.15</var>period beginning January 1, 2015, the commissioner shall increase operating payments <br/>
<a id="pl.265.16"></a><var>265.16</var>equal to one percent of the operating payment rates in effect on December 31, 2014. <br/>
<a id="pl.265.17"></a><var>265.17</var>For the rate period beginning July 1, 2015, the commissioner shall increase operating <br/>
<a id="pl.265.18"></a><var>265.18</var>payments equal to one percent of the operating payment rates in effect on June 30, 2015.<br/>
<a id="pl.265.19"></a><var>265.19</var>(b) For each facility, the commissioner shall apply the rate increase based on <br/>
<a id="pl.265.20"></a><var>265.20</var>occupied beds, using the percentage specified in this subdivision multiplied by the total <br/>
<a id="pl.265.21"></a><var>265.21</var>payment rate, including the variable rate, but excluding the property-related payment <br/>
<a id="pl.265.22"></a><var>265.22</var>rate in effect on the preceding date. The total rate increase shall include the adjustment <br/>
<a id="pl.265.23"></a><var>265.23</var>provided in section 256B.501, subdivision 12.<br/>
<br/>
<a id="bill.7.33.0"></a><a id="pl.265.24"></a><var>265.24</var>    Sec. 33. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:<br/>
<a id="pl.265.25"></a><var>265.25</var>    Subd. 5. <b>Special needs.</b> In addition to the state standards of assistance established in <br/>
<a id="pl.265.26"></a><var>265.26</var>subdivisions 1 to 4, payments are allowed for the following special needs of recipients of <br/>
<a id="pl.265.27"></a><var>265.27</var>Minnesota supplemental aid who are not residents of a nursing home, a regional treatment <br/>
<a id="pl.265.28"></a><var>265.28</var>center, or a group residential housing facility.<br/>
<a id="pl.265.29"></a><var>265.29</var>    (a) The county agency shall pay a monthly allowance for medically prescribed <br/>
<a id="pl.265.30"></a><var>265.30</var>diets if the cost of those additional dietary needs cannot be met through some other <br/>
<a id="pl.265.31"></a><var>265.31</var>maintenance benefit. The need for special diets or dietary items must be prescribed by <br/>
<a id="pl.265.32"></a><var>265.32</var>a licensed physician. Costs for special diets shall be determined as percentages of the <br/>
<a id="pl.265.33"></a><var>265.33</var>allotment for a one-person household under the thrifty food plan as defined by the United <br/>
<a id="pl.266.1"></a><var>266.1</var>States Department of Agriculture. The types of diets and the percentages of the thrifty <br/>
<a id="pl.266.2"></a><var>266.2</var>food plan that are covered are as follows:<br/>
<a id="pl.266.3"></a><var>266.3</var>    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;<br/>
<a id="pl.266.4"></a><var>266.4</var>    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent <br/>
<a id="pl.266.5"></a><var>266.5</var>of thrifty food plan;<br/>
<a id="pl.266.6"></a><var>266.6</var>    (3) controlled protein diet, less than 40 grams and requires special products, 125 <br/>
<a id="pl.266.7"></a><var>266.7</var>percent of thrifty food plan;<br/>
<a id="pl.266.8"></a><var>266.8</var>    (4) low cholesterol diet, 25 percent of thrifty food plan;<br/>
<a id="pl.266.9"></a><var>266.9</var>    (5) high residue diet, 20 percent of thrifty food plan;<br/>
<a id="pl.266.10"></a><var>266.10</var>    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;<br/>
<a id="pl.266.11"></a><var>266.11</var>    (7) gluten-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.266.12"></a><var>266.12</var>    (8) lactose-free diet, 25 percent of thrifty food plan;<br/>
<a id="pl.266.13"></a><var>266.13</var>    (9) antidumping diet, 15 percent of thrifty food plan;<br/>
<a id="pl.266.14"></a><var>266.14</var>    (10) hypoglycemic diet, 15 percent of thrifty food plan; or<br/>
<a id="pl.266.15"></a><var>266.15</var>    (11) ketogenic diet, 25 percent of thrifty food plan.<br/>
<a id="pl.266.16"></a><var>266.16</var>    (b) Payment for nonrecurring special needs must be allowed for necessary home <br/>
<a id="pl.266.17"></a><var>266.17</var>repairs or necessary repairs or replacement of household furniture and appliances using <br/>
<a id="pl.266.18"></a><var>266.18</var>the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, <br/>
<a id="pl.266.19"></a><var>266.19</var>as long as other funding sources are not available.<br/>
<a id="pl.266.20"></a><var>266.20</var>    (c) A fee for guardian or conservator service is allowed at a reasonable rate <br/>
<a id="pl.266.21"></a><var>266.21</var>negotiated by the county or approved by the court. This rate shall not exceed five percent <br/>
<a id="pl.266.22"></a><var>266.22</var>of the assistance unit's gross monthly income up to a maximum of $100 per month. If the <br/>
<a id="pl.266.23"></a><var>266.23</var>guardian or conservator is a member of the county agency staff, no fee is allowed.<br/>
<a id="pl.266.24"></a><var>266.24</var>    (d) The county agency shall continue to pay a monthly allowance of $68 for <br/>
<a id="pl.266.25"></a><var>266.25</var>restaurant meals for a person who was receiving a restaurant meal allowance on June 1, <br/>
<a id="pl.266.26"></a><var>266.26</var>1990, and who eats two or more meals in a restaurant daily. The allowance must continue <br/>
<a id="pl.266.27"></a><var>266.27</var>until the person has not received Minnesota supplemental aid for one full calendar month <br/>
<a id="pl.266.28"></a><var>266.28</var>or until the person's living arrangement changes and the person no longer meets the criteria <br/>
<a id="pl.266.29"></a><var>266.29</var>for the restaurant meal allowance, whichever occurs first.<br/>
<a id="pl.266.30"></a><var>266.30</var>    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, <br/>
<a id="pl.266.31"></a><var>266.31</var>is allowed for representative payee services provided by an agency that meets the <br/>
<a id="pl.266.32"></a><var>266.32</var>requirements under SSI regulations to charge a fee for representative payee services. This <br/>
<a id="pl.266.33"></a><var>266.33</var>special need is available to all recipients of Minnesota supplemental aid regardless of <br/>
<a id="pl.266.34"></a><var>266.34</var>their living arrangement.<br/>
<a id="pl.266.35"></a><var>266.35</var>    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the <br/>
<a id="pl.266.36"></a><var>266.36</var>maximum allotment authorized by the federal Food Stamp Program for a single individual <br/>
<a id="pl.267.1"></a><var>267.1</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.267.2"></a><var>267.2</var>assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify <br/>
<a id="pl.267.3"></a><var>267.3</var>as shelter needy and are: (i) relocating from an institution, or an adult mental health <br/>
<a id="pl.267.4"></a><var>267.4</var>residential treatment program under section 
         <statute_ref>256B.0622</statute_ref>; (ii) eligible for the self-directed <br/>
<a id="pl.267.5"></a><var>267.5</var>supports option as defined under section 
         <statute_ref>256B.0657, subdivision 2</statute_ref>; or (iii) home and <br/>
<a id="pl.267.6"></a><var>267.6</var>community-based waiver recipients living in their own home or rented or leased apartment <br/>
<a id="pl.267.7"></a><var>267.7</var>which is not owned, operated, or controlled by a provider of service not related by blood <br/>
<a id="pl.267.8"></a><var>267.8</var>or marriage, unless allowed under paragraph (g).<br/>
<a id="pl.267.9"></a><var>267.9</var>    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the <br/>
<a id="pl.267.10"></a><var>267.10</var>shelter needy benefit under this paragraph is considered a household of one. An eligible <br/>
<a id="pl.267.11"></a><var>267.11</var>individual who receives this benefit prior to age 65 may continue to receive the benefit <br/>
<a id="pl.267.12"></a><var>267.12</var>after the age of 65.<br/>
<a id="pl.267.13"></a><var>267.13</var>    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that <br/>
<a id="pl.267.14"></a><var>267.14</var>exceed 40 percent of the assistance unit's gross income before the application of this <br/>
<a id="pl.267.15"></a><var>267.15</var>special needs standard. "Gross income" for the purposes of this section is the applicant's or <br/>
<a id="pl.267.16"></a><var>267.16</var>recipient's income as defined in section 
         <statute_ref>256D.35, subdivision 10</statute_ref>, or the standard specified <br/>
<a id="pl.267.17"></a><var>267.17</var>in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or <br/>
<a id="pl.267.18"></a><var>267.18</var>state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be <br/>
<a id="pl.267.19"></a><var>267.19</var>considered shelter needy for purposes of this paragraph.<br/>
<a id="pl.267.20"></a><var>267.20</var>(g) Notwithstanding this subdivision, to access housing and services as provided <br/>
<a id="pl.267.21"></a><var>267.21</var>in paragraph (f), the recipient may choose housing that may be owned, operated, or <br/>
<a id="pl.267.22"></a><var>267.22</var>controlled by the recipient's service provider. In a multifamily building of more than four <br/>
<a id="pl.267.23"></a><var>267.23</var>units, the maximum number of units that may be used by recipients of this program shall <br/>
<a id="pl.267.24"></a><var>267.24</var>be the greater of four units or 25 percent of the units in the building, unless required by the <br/>
<a id="pl.267.25"></a><var>267.25</var>Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four <br/>
<a id="pl.267.26"></a><var>267.26</var>or fewer units, all of the units may be used by recipients of this program. When housing is <br/>
<a id="pl.267.27"></a><var>267.27</var>controlled by the service provider, the individual may choose the individual's own service <br/>
<a id="pl.267.28"></a><var>267.28</var>provider as provided in section 
         <statute_ref>256B.49, subdivision 23</statute_ref>, clause (3). When the housing is <br/>
<a id="pl.267.29"></a><var>267.29</var>controlled by the service provider, the service provider shall implement a plan with the <br/>
<a id="pl.267.30"></a><var>267.30</var>recipient to transition the lease to the recipient's name. Within two years of signing the <br/>
<a id="pl.267.31"></a><var>267.31</var>initial lease, the service provider shall transfer the lease entered into under this subdivision <br/>
<a id="pl.267.32"></a><var>267.32</var>to the recipient. In the event the landlord denies this transfer, the commissioner may <br/>
<a id="pl.267.33"></a><var>267.33</var>approve an exception within sufficient time to ensure the continued occupancy by the <br/>
<a id="pl.267.34"></a><var>267.34</var>recipient. This paragraph expires June 30, 2016.<br/>
<br/>
<a id="bill.7.34.0"></a><a id="pl.268.1"></a><var>268.1</var>    Sec. 34. Laws 2011, First Special Session chapter 9, article 7, section 39, subdivision <br/>
<a id="pl.268.2"></a><var>268.2</var>14, is amended to read:<br/>
<a id="pl.268.3"></a><var>268.3</var>    Subd. 14. <b>Assessment and reassessment.</b> (a) Assessments of each recipient's <br/>
<a id="pl.268.4"></a><var>268.4</var>strengths, informal support systems, and need for services shall be completed within 20 <br/>
<a id="pl.268.5"></a><var>268.5</var>working days of the recipient's request as provided in section 
         <statute_ref>256B.0911</statute_ref>. Reassessment <br/>
<a id="pl.268.6"></a><var>268.6</var>of each recipient's strengths, support systems, and need for services shall be conducted <br/>
<a id="pl.268.7"></a><var>268.7</var>at least every 12 months and at other times when there has been a significant change in <br/>
<a id="pl.268.8"></a><var>268.8</var>the recipient's functioning.<br/>
<a id="pl.268.9"></a><var>268.9</var>(b) There must be a determination that the client requires a hospital level of care or a <br/>
<a id="pl.268.10"></a><var>268.10</var>nursing facility level of care as defined in section 
         <statute_ref>256B.0911, subdivision 4a</statute_ref>, paragraph <br/>
<a id="pl.268.11"></a><var>268.11</var>(d), at initial and subsequent assessments to initiate and maintain participation in the <br/>
<a id="pl.268.12"></a><var>268.12</var>waiver program.<br/>
<a id="pl.268.13"></a><var>268.13</var>(c) Regardless of other assessments identified in section 
         <statute_ref>144.0724, subdivision 4</statute_ref>, as <br/>
<a id="pl.268.14"></a><var>268.14</var>appropriate to determine nursing facility level of care for purposes of medical assistance <br/>
<a id="pl.268.15"></a><var>268.15</var>payment for nursing facility services, only face-to-face assessments conducted according <br/>
<a id="pl.268.16"></a><var>268.16</var>to section 
         <statute_ref>256B.0911, subdivisions 3a</statute_ref>, 3b, and 4d, that result in a hospital level of care <br/>
<a id="pl.268.17"></a><var>268.17</var>determination or a nursing facility level of care determination must be accepted for <br/>
<a id="pl.268.18"></a><var>268.18</var>purposes of initial and ongoing access to waiver services payment.<br/>
<a id="pl.268.19"></a><var>268.19</var>(d) Persons with developmental disabilities who apply for services under the nursing <br/>
<a id="pl.268.20"></a><var>268.20</var>facility level waiver programs shall be screened for the appropriate level of care according <br/>
<a id="pl.268.21"></a><var>268.21</var>to section 
         <statute_ref>256B.092</statute_ref>.<br/>
<a id="pl.268.22"></a><var>268.22</var>(e) Recipients who are found eligible for home and community-based services under <br/>
<a id="pl.268.23"></a><var>268.23</var>this section before their 65th birthday may remain eligible for these services after their <br/>
<a id="pl.268.24"></a><var>268.24</var>65th birthday if they continue to meet all other eligibility factors.<br/>
<a id="pl.268.25"></a><var>268.25</var>(f) The commissioner shall develop criteria to identify recipients whose level of <br/>
<a id="pl.268.26"></a><var>268.26</var>functioning is reasonably expected to improve and reassess these recipients to establish <br/>
<a id="pl.268.27"></a><var>268.27</var>a baseline assessment. Recipients who meet these criteria must have a comprehensive <br/>
<a id="pl.268.28"></a><var>268.28</var>transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be <br/>
<a id="pl.268.29"></a><var>268.29</var>reassessed every six months until there has been no significant change in the recipient's <br/>
<a id="pl.268.30"></a><var>268.30</var>functioning for at least 12 months. After there has been no significant change in the <br/>
<a id="pl.268.31"></a><var>268.31</var>recipient's functioning for at least 12 months, reassessments of the recipient's strengths, <br/>
<a id="pl.268.32"></a><var>268.32</var>informal support systems, and need for services shall be conducted at least every 12 <br/>
<a id="pl.268.33"></a><var>268.33</var>months and at other times when there has been a significant change in the recipient's <br/>
<a id="pl.268.34"></a><var>268.34</var>functioning. Counties, case managers, and service providers are responsible for <br/>
<a id="pl.268.35"></a><var>268.35</var>conducting these reassessments and shall complete the reassessments out of existing funds.<br/>
<br/>
<a id="bill.7.35.0"></a><a id="pl.269.1"></a><var>269.1</var>    Sec. 35. Laws 2012, chapter 247, article 6, section 4, is amended to read:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.269.2"></a><var>269.2</var><br/>
<a id="pl.269.3"></a><var>269.3</var><br/>
</td>
<td colspan="3">Sec. 4. <b>BOARD OF NURSING HOME </b><br/>
<b>ADMINISTRATORS</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>-0-</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>10,000</b><br/>
</td>
</tr>
</table><a id="pl.269.4"></a><var>269.4</var><b>Administrative Services Unit.</b> This <br/>
<a id="pl.269.5"></a><var>269.5</var>appropriation is to provide a grant to the <br/>
<a id="pl.269.6"></a><var>269.6</var>Minnesota Ambulance Association to <br/>
<a id="pl.269.7"></a><var>269.7</var>coordinate and prepare an assessment of <br/>
<a id="pl.269.8"></a><var>269.8</var>the extent and costs of uncompensated care <br/>
<a id="pl.269.9"></a><var>269.9</var>as a direct result of emergency responses <br/>
<a id="pl.269.10"></a><var>269.10</var>on interstate highways in Minnesota. <br/>
<a id="pl.269.11"></a><var>269.11</var>The study will collect appropriate <br/>
<a id="pl.269.12"></a><var>269.12</var>information from medical response units <br/>
<a id="pl.269.13"></a><var>269.13</var>and ambulance services regulated under <br/>
<a id="pl.269.14"></a><var>269.14</var>Minnesota Statutes, chapter 144E, and to <br/>
<a id="pl.269.15"></a><var>269.15</var>the extent possible, firefighting agencies. <br/>
<a id="pl.269.16"></a><var>269.16</var>In preparing the assessment, the Minnesota <br/>
<a id="pl.269.17"></a><var>269.17</var>Ambulance Association shall consult with <br/>
<a id="pl.269.18"></a><var>269.18</var>its membership, the Minnesota Fire Chiefs <br/>
<a id="pl.269.19"></a><var>269.19</var>Association, the Office of the State Fire <br/>
<a id="pl.269.20"></a><var>269.20</var>Marshal, and the Emergency Medical <br/>
<a id="pl.269.21"></a><var>269.21</var>Services Regulatory Board. The findings <br/>
<a id="pl.269.22"></a><var>269.22</var>of the assessment will be reported to the <br/>
<a id="pl.269.23"></a><var>269.23</var>chairs and ranking minority members of the <br/>
<a id="pl.269.24"></a><var>269.24</var>legislative committees with jurisdiction over <br/>
<a id="pl.269.25"></a><var>269.25</var>health and public safety by January 1, 2013.<br/>
<a id="pl.269.26"></a><var>269.26</var> This is a onetime appropriation.<br/>
<br/>
<a id="bill.7.36.0"></a><a id="pl.269.27"></a><var>269.27</var>    Sec. 36. <b>DIRECTION TO COMMISSIONER.</b><br/>
<a id="pl.269.28"></a><var>269.28</var>    The commissioner of human services shall request authority, in whatever form is <br/>
<a id="pl.269.29"></a><var>269.29</var>necessary, from the federal Centers for Medicare and Medicaid Services to allow persons <br/>
<a id="pl.269.30"></a><var>269.30</var>under age 65 participating in the home and community-based services waivers to continue <br/>
<a id="pl.269.31"></a><var>269.31</var>to use the disregard of the nonassisted spouse's income and assets instead of the spousal <br/>
<a id="pl.269.32"></a><var>269.32</var>impoverishment provisions under the federal Patient Protection and Affordable Care Act, <br/>
<a id="pl.269.33"></a><var>269.33</var>Public Law 111-148, section 2404, as amended by the federal Health Care and Education <br/>
<a id="pl.269.34"></a><var>269.34</var>Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations <br/>
<a id="pl.269.35"></a><var>269.35</var>or guidance issued under, those acts.<br/>
<br/>
<a id="bill.7.37.0"></a><a id="pl.270.1"></a><var>270.1</var>    Sec. 37. <b>RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR </b><br/>
<a id="pl.270.2"></a><var>270.2</var><b>SENIORS AND PERSONS WITH DISABILITIES.</b><br/>
<a id="pl.270.3"></a><var>270.3</var>    The commissioner of human services shall consult with interested stakeholders to <br/>
<a id="pl.270.4"></a><var>270.4</var>develop recommendations and a request for a federal 1115 demonstration waiver in order <br/>
<a id="pl.270.5"></a><var>270.5</var>to increase the asset limit for individuals eligible for medical assistance due to disability <br/>
<a id="pl.270.6"></a><var>270.6</var>or age who are not residing in a nursing facility, intermediate care facility for persons <br/>
<a id="pl.270.7"></a><var>270.7</var>with developmental disabilities, or other institution whose costs for room and board are <br/>
<a id="pl.270.8"></a><var>270.8</var>covered by medical assistance or state funds. The recommendations must be provided to <br/>
<a id="pl.270.9"></a><var>270.9</var>the legislative committees and divisions with jurisdiction over health and human services <br/>
<a id="pl.270.10"></a><var>270.10</var>policy and finance by February 1, 2014.<br/>
<br/>
<a id="bill.7.38.0"></a><a id="pl.270.11"></a><var>270.11</var>    Sec. 38. <b>NURSING HOME LEVEL OF CARE REPORT.</b><br/>
<a id="pl.270.12"></a><var>270.12</var>    (a) The commissioner of human services shall report on the impact of the <br/>
<a id="pl.270.13"></a><var>270.13</var>modification to the nursing facility level of care to be implemented January 1, 2014, <br/>
<a id="pl.270.14"></a><var>270.14</var>including the following:<br/>
<a id="pl.270.15"></a><var>270.15</var>    (1) the number of individuals who lose eligibility for home and community-based <br/>
<a id="pl.270.16"></a><var>270.16</var>services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and <br/>
<a id="pl.270.17"></a><var>270.17</var>alternative care under Minnesota Statutes, section 256B.0913;<br/>
<a id="pl.270.18"></a><var>270.18</var>    (2) the number of individuals who lose eligibility for medical assistance; and <br/>
<a id="pl.270.19"></a><var>270.19</var>    (3) for individuals reported under clauses (1) and (2), and to the extent possible:<br/>
<a id="pl.270.20"></a><var>270.20</var>    (i) their living situation before and after nursing facility level of care implementation; <br/>
<a id="pl.270.21"></a><var>270.21</var>and<br/>
<a id="pl.270.22"></a><var>270.22</var>    (ii) the programs or services they received before and after nursing facility level of <br/>
<a id="pl.270.23"></a><var>270.23</var>care implementation, including, but not limited to, personal care assistant services and <br/>
<a id="pl.270.24"></a><var>270.24</var>essential community supports.<br/>
<a id="pl.270.25"></a><var>270.25</var>    (b) The commissioner of human services shall report to the chairs and ranking <br/>
<a id="pl.270.26"></a><var>270.26</var>minority members of the legislative committees and divisions with jurisdiction over health <br/>
<a id="pl.270.27"></a><var>270.27</var>and human services policy and finance with the information required under paragraph <br/>
<a id="pl.270.28"></a><var>270.28</var>(a). A preliminary report shall be submitted on October 1, 2014, and a final report shall <br/>
<a id="pl.270.29"></a><var>270.29</var>be submitted February 15, 2015.<br/>
<br/>
<a id="bill.7.39.0"></a><a id="pl.270.30"></a><var>270.30</var>    Sec. 39. <b>ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND </b><br/>
<a id="pl.270.31"></a><var>270.31</var><b>COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT.</b><br/>
<a id="pl.270.32"></a><var>270.32</var>(a) For the purposes of this section, "assistive technology equipment" includes <br/>
<a id="pl.270.33"></a><var>270.33</var>computer tablets, passive sensors, and other forms of technology allowing increased <br/>
<a id="pl.270.34"></a><var>270.34</var>safety and independence, and used by those receiving services through a home and <br/>
<a id="pl.271.1"></a><var>271.1</var>community-based services waiver under Minnesota Statutes, sections 256B.0915, <br/>
<a id="pl.271.2"></a><var>271.2</var>256B.092, and 256B.49.<br/>
<a id="pl.271.3"></a><var>271.3</var>(b) The commissioner of human services shall develop recommendations for <br/>
<a id="pl.271.4"></a><var>271.4</var>assistive technology equipment funding to enable individuals receiving services identified <br/>
<a id="pl.271.5"></a><var>271.5</var>in paragraph (a) to live in the least restrictive setting possible. In developing the funding, <br/>
<a id="pl.271.6"></a><var>271.6</var>the commissioner shall examine funding for the following:<br/>
<a id="pl.271.7"></a><var>271.7</var>(1) an assessment process to match the appropriate assistive technology equipment <br/>
<a id="pl.271.8"></a><var>271.8</var>with the waiver recipient, including when the recipient's condition changes or progresses;<br/>
<a id="pl.271.9"></a><var>271.9</var>(2) the use of monitoring services, if applicable, to the assistive technology <br/>
<a id="pl.271.10"></a><var>271.10</var>equipment identified in clause (1);<br/>
<a id="pl.271.11"></a><var>271.11</var>(3) the leasing of assistive technology equipment as a possible alternative to <br/>
<a id="pl.271.12"></a><var>271.12</var>purchasing the equipment; and<br/>
<a id="pl.271.13"></a><var>271.13</var>(4) ongoing support services, such as technological support.<br/>
<a id="pl.271.14"></a><var>271.14</var>(c) The commissioner shall provide the chairs and ranking minority members of the <br/>
<a id="pl.271.15"></a><var>271.15</var>legislative committees and divisions with jurisdiction over health and human services <br/>
<a id="pl.271.16"></a><var>271.16</var>policy and finance a recommendation for implementing an assistive technology equipment <br/>
<a id="pl.271.17"></a><var>271.17</var>program as developed in paragraph (b) by February 1, 2014.<br/>
<br/>
<a id="bill.7.40.0"></a><a id="pl.271.18"></a><var>271.18</var>    Sec. 40. <b>PROVIDER RATE AND GRANT INCREASES EFFECTIVE JANUARY </b><br/>
<a id="pl.271.19"></a><var>271.19</var><b>1, 2015, AND JULY 1, 2015.</b><br/>
<a id="pl.271.20"></a><var>271.20</var>(a) The commissioner of human services shall increase reimbursement rates, grants, <br/>
<a id="pl.271.21"></a><var>271.21</var>allocations, individual limits, and rate limits, as applicable, by one percent for the rate <br/>
<a id="pl.271.22"></a><var>271.22</var>period beginning January 1, 2015, and by one percent for the rate period beginning July 1, <br/>
<a id="pl.271.23"></a><var>271.23</var>2015, for services rendered on or after those dates. County or tribal contracts for services <br/>
<a id="pl.271.24"></a><var>271.24</var>specified in this section must be amended to pass through these rate increases within 60 <br/>
<a id="pl.271.25"></a><var>271.25</var>days of the effective date.<br/>
<a id="pl.271.26"></a><var>271.26</var>(b) The rate changes described in this section must be provided to:<br/>
<a id="pl.271.27"></a><var>271.27</var>(1) home and community-based waivered services for persons with developmental <br/>
<a id="pl.271.28"></a><var>271.28</var>disabilities or related conditions, including consumer-directed community supports, under <br/>
<a id="pl.271.29"></a><var>271.29</var>Minnesota Statutes, section 256B.501;<br/>
<a id="pl.271.30"></a><var>271.30</var>(2) waivered services under community alternatives for disabled individuals, <br/>
<a id="pl.271.31"></a><var>271.31</var>including consumer-directed community supports, under Minnesota Statutes, section <br/>
<a id="pl.271.32"></a><var>271.32</var>256B.49;<br/>
<a id="pl.271.33"></a><var>271.33</var>(3) community alternative care waivered services, including consumer-directed <br/>
<a id="pl.271.34"></a><var>271.34</var>community supports, under Minnesota Statutes, section 256B.49;<br/>
<a id="pl.272.1"></a><var>272.1</var>(4) brain injury waivered services, including consumer-directed community <br/>
<a id="pl.272.2"></a><var>272.2</var>supports, under Minnesota Statutes, section 256B.49;<br/>
<a id="pl.272.3"></a><var>272.3</var>(5) home and community-based waivered services for the elderly under Minnesota <br/>
<a id="pl.272.4"></a><var>272.4</var>Statutes, section 256B.0915;<br/>
<a id="pl.272.5"></a><var>272.5</var>(6) nursing services and home health services under Minnesota Statutes, section <br/>
<a id="pl.272.6"></a><var>272.6</var>256B.0625, subdivision 6a;<br/>
<a id="pl.272.7"></a><var>272.7</var>(7) personal care services and qualified professional supervision of personal care <br/>
<a id="pl.272.8"></a><var>272.8</var>services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;<br/>
<a id="pl.272.9"></a><var>272.9</var>(8) private duty nursing services under Minnesota Statutes, section 256B.0625, <br/>
<a id="pl.272.10"></a><var>272.10</var>subdivision 7;<br/>
<a id="pl.272.11"></a><var>272.11</var>(9) day training and habilitation services for adults with developmental disabilities <br/>
<a id="pl.272.12"></a><var>272.12</var>or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the <br/>
<a id="pl.272.13"></a><var>272.13</var>additional cost of rate adjustments on day training and habilitation services, provided as a <br/>
<a id="pl.272.14"></a><var>272.14</var>social service, under Minnesota Statutes, section 256M.60;<br/>
<a id="pl.272.15"></a><var>272.15</var>(10) alternative care services under Minnesota Statutes, section 256B.0913;<br/>
<a id="pl.272.16"></a><var>272.16</var>(11) living skills training programs for persons with intractable epilepsy who need <br/>
<a id="pl.272.17"></a><var>272.17</var>assistance in the transition to independent living under Laws 1988, chapter 689;<br/>
<a id="pl.272.18"></a><var>272.18</var>(12) semi-independent living services (SILS) under Minnesota Statutes, section <br/>
<a id="pl.272.19"></a><var>272.19</var>252.275, including SILS funding under county social services grants formerly funded <br/>
<a id="pl.272.20"></a><var>272.20</var>under Minnesota Statutes, chapter 256I;<br/>
<a id="pl.272.21"></a><var>272.21</var>(13) consumer support grants under Minnesota Statutes, section 256.476;<br/>
<a id="pl.272.22"></a><var>272.22</var>(14) family support grants under Minnesota Statutes, section 252.32;<br/>
<a id="pl.272.23"></a><var>272.23</var>(15) housing access grants under Minnesota Statutes, section 256B.0658;<br/>
<a id="pl.272.24"></a><var>272.24</var>(16) self-advocacy grants under Laws 2009, chapter 101; and<br/>
<a id="pl.272.25"></a><var>272.25</var>(17) technology grants under Laws 2009, chapter 79.<br/>
<a id="pl.272.26"></a><var>272.26</var>(c) A managed care plan receiving state payments for the services in this section <br/>
<a id="pl.272.27"></a><var>272.27</var>must include these increases in their payments to providers. To implement the rate increase <br/>
<a id="pl.272.28"></a><var>272.28</var>in this section, capitation rates paid by the commissioner to managed care organizations <br/>
<a id="pl.272.29"></a><var>272.29</var>under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the <br/>
<a id="pl.272.30"></a><var>272.30</var>specified services for the period beginning January 1, 2015.<br/>
<a id="pl.272.31"></a><var>272.31</var>(d) Counties shall increase the budget for each recipient of consumer-directed <br/>
<a id="pl.272.32"></a><var>272.32</var>community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).<br/>
<br/>
<a id="bill.7.41.0"></a><a id="pl.272.33"></a><var>272.33</var>    Sec. 41. <b>SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES </b><br/>
<a id="pl.272.34"></a><var>272.34</var><b>WAIVERS.</b><br/>
<a id="pl.273.1"></a><var>273.1</var>The commissioner of human services shall submit a request by December 31, 2013, <br/>
<a id="pl.273.2"></a><var>273.2</var>to the federal government to amend the home and community-based services waivers for <br/>
<a id="pl.273.3"></a><var>273.3</var>individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to <br/>
<a id="pl.273.4"></a><var>273.4</var>modify the financial management of the home and community-based services waivers <br/>
<a id="pl.273.5"></a><var>273.5</var>to provide a state-administered safety net when costs for an individual increase above <br/>
<a id="pl.273.6"></a><var>273.6</var>an identified threshold. The implementation of the safety net may result in a decreased <br/>
<a id="pl.273.7"></a><var>273.7</var>allocation for individual counties, tribes, or collaboratives of counties or tribes, but must <br/>
<a id="pl.273.8"></a><var>273.8</var>not result in a net decreased statewide allocation.<br/>
<br/>
<a id="bill.7.42.0"></a><a id="pl.273.9"></a><var>273.9</var>    Sec. 42. <b>SHARED LIVING MODEL.</b><br/>
<a id="pl.273.10"></a><var>273.10</var>The commissioner of human services shall develop and promote a shared living model <br/>
<a id="pl.273.11"></a><var>273.11</var>option for individuals receiving services through the home and community-based services <br/>
<a id="pl.273.12"></a><var>273.12</var>waivers for individuals with disabilities, authorized under Minnesota Statutes, section <br/>
<a id="pl.273.13"></a><var>273.13</var>256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The <br/>
<a id="pl.273.14"></a><var>273.14</var>option must be a companion model with a limit of one or two individuals receiving support <br/>
<a id="pl.273.15"></a><var>273.15</var>in the home, planned respite for the caregiver, and the availability of intensive training <br/>
<a id="pl.273.16"></a><var>273.16</var>and support on the needs of the individual or individuals. Any necessary amendments to <br/>
<a id="pl.273.17"></a><var>273.17</var>implement the model must be submitted to the federal government by December 31, 2013.<br/>
<br/>
<a id="bill.7.43.0"></a><a id="pl.273.18"></a><var>273.18</var>    Sec. 43. <b>MONEY FOLLOWS THE PERSON GRANT.</b><br/>
<a id="pl.273.19"></a><var>273.19</var>The commissioner of human services shall submit to the federal government all <br/>
<a id="pl.273.20"></a><var>273.20</var>necessary waiver amendments to implement the Money Follows the Person federal grant <br/>
<a id="pl.273.21"></a><var>273.21</var>by December 31, 2013.<br/>
<br/>
<a id="bill.7.44.0"></a><a id="pl.273.22"></a><var>273.22</var>    Sec. 44. <b> REPEALER.</b><br/>
<a id="pl.273.23"></a><var>273.23</var>Minnesota Statutes 2012, sections 256B.096, subdivisions 1, 2, 3, and 4; and <br/>
<a id="pl.273.24"></a><var>273.24</var>256B.5012, subdivision 13; and Laws 2011, First Special Session chapter 9, article 7, <br/>
<a id="pl.273.25"></a><var>273.25</var>section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012, <br/>
<a id="pl.273.26"></a><var>273.26</var>chapter 298, section 3,  are repealed.<br/>
<br/>
<a id="bill.8.0.0"></a>

<a id="bill.8.1.0"></a><a id="pl.273.29"></a><var>273.29</var>    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a <br/>
<a id="pl.273.30"></a><var>273.30</var>subdivision to read:<br/>
<a id="pl.274.1"></a><var>274.1</var>    Subd. 7c. <b>Human services license holders.</b> Section 245D.095, subdivision 3, <br/>
<a id="pl.274.2"></a><var>274.2</var>requires certain license holders to protect service recipient records in accordance with <br/>
<a id="pl.274.3"></a><var>274.3</var>specified provisions of this chapter.<br/>
<br/>
<a id="bill.8.2.0"></a><a id="pl.274.4"></a><var>274.4</var>    Sec. 2. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:<br/>
<a id="pl.274.5"></a><var>274.5</var>    Subd. 7. <b>Health care facility.</b> "Health care facility" means a hospital or other entity <br/>
<a id="pl.274.6"></a><var>274.6</var>licensed under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>, a nursing home licensed to serve adults under <br/>
<a id="pl.274.7"></a><var>274.7</var>section 
         <statute_ref>144A.02</statute_ref>, a home care provider licensed under sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47</statute_ref>, <br/>
<a id="pl.274.8"></a><var>274.8</var>an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts <br/>
<a id="pl.274.9"></a><var>274.9</var>9555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or <br/>
<a id="pl.274.10"></a><var>274.10</var>a hospice provider licensed under sections 
         <statute_ref>144A.75</statute_ref> to 
         <statute_ref>144A.755</statute_ref>.<br/>
<br/>
<a id="bill.8.3.0"></a><a id="pl.274.11"></a><var>274.11</var>    Sec. 3. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:<br/>
<a id="pl.274.12"></a><var>274.12</var>    Subd. 4b. <b>Health care facility; notice of status.</b> (a) For the purposes of this <br/>
<a id="pl.274.13"></a><var>274.13</var>subdivision, "health care facility" means a facility:<br/>
<a id="pl.274.14"></a><var>274.14</var>(1) licensed by the commissioner of health as a hospital, boarding care home or <br/>
<a id="pl.274.15"></a><var>274.15</var>supervised living facility under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>, or a nursing home under <br/>
<a id="pl.274.16"></a><var>274.16</var>chapter 144A;<br/>
<a id="pl.274.17"></a><var>274.17</var>(2) registered by the commissioner of health as a housing with services establishment <br/>
<a id="pl.274.18"></a><var>274.18</var>as defined in section 
         <statute_ref>144D.01</statute_ref>; or<br/>
<a id="pl.274.19"></a><var>274.19</var>(3) licensed by the commissioner of human services as a residential facility under <br/>
<a id="pl.274.20"></a><var>274.20</var>chapter 245A to provide adult foster care, adult mental health treatment, chemical <br/>
<a id="pl.274.21"></a><var>274.21</var>dependency treatment to adults, or residential services to persons with developmental<br/>
<a id="pl.274.22"></a><var>274.22</var> disabilities.<br/>
<a id="pl.274.23"></a><var>274.23</var>(b) Prior to admission to a health care facility, a person required to register under <br/>
<a id="pl.274.24"></a><var>274.24</var>this section shall disclose to:<br/>
<a id="pl.274.25"></a><var>274.25</var>(1) the health care facility employee processing the admission the person's status <br/>
<a id="pl.274.26"></a><var>274.26</var>as a registered predatory offender under this section; and<br/>
<a id="pl.274.27"></a><var>274.27</var>(2) the person's corrections agent, or if the person does not have an assigned <br/>
<a id="pl.274.28"></a><var>274.28</var>corrections agent, the law enforcement authority with whom the person is currently <br/>
<a id="pl.274.29"></a><var>274.29</var>required to register, that inpatient admission will occur.<br/>
<a id="pl.274.30"></a><var>274.30</var>(c) A law enforcement authority or corrections agent who receives notice under <br/>
<a id="pl.274.31"></a><var>274.31</var>paragraph (b) or who knows that a person required to register under this section is <br/>
<a id="pl.274.32"></a><var>274.32</var>planning to be admitted and receive, or has been admitted and is receiving health care <br/>
<a id="pl.274.33"></a><var>274.33</var>at a health care facility shall notify the administrator of the facility and deliver a fact <br/>
<a id="pl.274.34"></a><var>274.34</var>sheet to the administrator containing the following information: (1) name and physical <br/>
<a id="pl.275.1"></a><var>275.1</var>description of the offender; (2) the offender's conviction history, including the dates of <br/>
<a id="pl.275.2"></a><var>275.2</var>conviction; (3) the risk level classification assigned to the offender under section 
         <statute_ref>244.052</statute_ref>, <br/>
<a id="pl.275.3"></a><var>275.3</var>if any; and (4) the profile of likely victims.<br/>
<a id="pl.275.4"></a><var>275.4</var>(d) Except for a hospital licensed under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>, if a health care <br/>
<a id="pl.275.5"></a><var>275.5</var>facility receives a fact sheet under paragraph (c) that includes a risk level classification for <br/>
<a id="pl.275.6"></a><var>275.6</var>the offender, and if the facility admits the offender, the facility shall distribute the fact <br/>
<a id="pl.275.7"></a><var>275.7</var>sheet to all residents at the facility. If the facility determines that distribution to a resident <br/>
<a id="pl.275.8"></a><var>275.8</var>is not appropriate given the resident's medical, emotional, or mental status, the facility <br/>
<a id="pl.275.9"></a><var>275.9</var>shall distribute the fact sheet to the patient's next of kin or emergency contact.<br/>
<br/>
<a id="bill.8.4.0"></a><a id="pl.275.10"></a><var>275.10</var>    Sec. 4. <b>[245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY </b><br/>
<a id="pl.275.11"></a><var>275.11</var><b>MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.</b><br/>
<a id="pl.275.12"></a><var>275.12</var>    Subdivision 1. <b>Rules.</b> The commissioner of human services shall, within 24 months <br/>
<a id="pl.275.13"></a><var>275.13</var>of enactment of this section, adopt rules governing the use of positive support strategies, <br/>
<a id="pl.275.14"></a><var>275.14</var>safety interventions, and emergency use of manual restraint in facilities and services <br/>
<a id="pl.275.15"></a><var>275.15</var>licensed under chapter 245D.<br/>
<a id="pl.275.16"></a><var>275.16</var>    Subd. 2. <b>Data collection.</b> (a) The commissioner shall, with stakeholder input, <br/>
<a id="pl.275.17"></a><var>275.17</var>develop data collection elements specific to incidents on the use of controlled procedures <br/>
<a id="pl.275.18"></a><var>275.18</var>with persons receiving services from providers regulated under Minnesota Rules, parts <br/>
<a id="pl.275.19"></a><var>275.19</var>9525.2700 to 9525.2810, and incidents involving persons receiving services from <br/>
<a id="pl.275.20"></a><var>275.20</var>providers identified to be licensed under chapter 245D effective January 1, 2014. Providers <br/>
<a id="pl.275.21"></a><var>275.21</var>shall report the data in a format and at a frequency provided by the commissioner of <br/>
<a id="pl.275.22"></a><var>275.22</var>human services.<br/>
<a id="pl.275.23"></a><var>275.23</var>(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts <br/>
<a id="pl.275.24"></a><var>275.24</var>9525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures <br/>
<a id="pl.275.25"></a><var>275.25</var>in a format and at a frequency provided by the commissioner.<br/>
<br/>
<a id="bill.8.5.0"></a><a id="pl.275.26"></a><var>275.26</var>    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:<br/>
<a id="pl.275.27"></a><var>275.27</var>    Subd. 10. <b>Nonresidential program.</b> "Nonresidential program" means care, <br/>
<a id="pl.275.28"></a><var>275.28</var>supervision, rehabilitation, training or habilitation of a person provided outside the <br/>
<a id="pl.275.29"></a><var>275.29</var>person's own home and provided for fewer than 24 hours a day, including adult day <br/>
<a id="pl.275.30"></a><var>275.30</var>care programs; and chemical dependency or chemical abuse programs that are located <br/>
<a id="pl.275.31"></a><var>275.31</var>in a nursing home or hospital and receive public funds for providing chemical abuse or <br/>
<a id="pl.275.32"></a><var>275.32</var>chemical dependency treatment services under chapter 254B. Nonresidential programs <br/>
<a id="pl.275.33"></a><var>275.33</var>include home and community-based services and semi-independent living services for <br/>
<a id="pl.276.1"></a><var>276.1</var>persons with developmental disabilities or persons age 65 and older that are provided in <br/>
<a id="pl.276.2"></a><var>276.2</var>or outside of a person's own home under chapter 245D.<br/>
<br/>
<a id="bill.8.6.0"></a><a id="pl.276.3"></a><var>276.3</var>    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:<br/>
<a id="pl.276.4"></a><var>276.4</var>    Subd. 14. <b>Residential program.</b> "Residential program" means a program <br/>
<a id="pl.276.5"></a><var>276.5</var>that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training, <br/>
<a id="pl.276.6"></a><var>276.6</var>education, habilitation, or treatment outside a person's own home, including a program <br/>
<a id="pl.276.7"></a><var>276.7</var>in an intermediate care facility for four or more persons with developmental disabilities; <br/>
<a id="pl.276.8"></a><var>276.8</var>and chemical dependency or chemical abuse programs that are located in a hospital <br/>
<a id="pl.276.9"></a><var>276.9</var>or nursing home and receive public funds for providing chemical abuse or chemical <br/>
<a id="pl.276.10"></a><var>276.10</var>dependency treatment services under chapter 254B. Residential programs include home <br/>
<a id="pl.276.11"></a><var>276.11</var>and community-based services for persons with developmental disabilities or persons age <br/>
<a id="pl.276.12"></a><var>276.12</var>65 and older that are provided in or outside of a person's own home under chapter 245D.<br/>
<br/>
<a id="bill.8.7.0"></a><a id="pl.276.13"></a><var>276.13</var>    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:<br/>
<a id="pl.276.14"></a><var>276.14</var>    Subd. 7. <b>Licensing moratorium.</b> (a) The commissioner shall not issue an initial <br/>
<a id="pl.276.15"></a><var>276.15</var>license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, <br/>
<a id="pl.276.16"></a><var>276.16</var>or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under <br/>
<a id="pl.276.17"></a><var>276.17</var>this chapter for a physical location that will not be the primary residence of the license <br/>
<a id="pl.276.18"></a><var>276.18</var>holder for the entire period of licensure. If a license is issued during this moratorium, and <br/>
<a id="pl.276.19"></a><var>276.19</var>the license holder changes the license holder's primary residence away from the physical <br/>
<a id="pl.276.20"></a><var>276.20</var>location of the foster care license, the commissioner shall revoke the license according <br/>
<a id="pl.276.21"></a><var>276.21</var>to section 
         <statute_ref>245A.07</statute_ref>. The commissioner shall not issue an initial license for a community <br/>
<a id="pl.276.22"></a><var>276.22</var>residential setting licensed under chapter 245D. Exceptions to the moratorium include:<br/>
<a id="pl.276.23"></a><var>276.23</var>(1) foster care settings that are required to be registered under chapter 144D;<br/>
<a id="pl.276.24"></a><var>276.24</var>(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or <br/>
<a id="pl.276.25"></a><var>276.25</var>community residential setting licenses replacing adult foster care licenses in existence on <br/>
<a id="pl.276.26"></a><var>276.26</var>December 31, 2013, and determined to be needed by the commissioner under paragraph (b);<br/>
<a id="pl.276.27"></a><var>276.27</var>(3) new foster care licenses or community residential setting licenses determined to <br/>
<a id="pl.276.28"></a><var>276.28</var>be needed by the commissioner under paragraph (b) for the closure of a nursing facility, <br/>
<a id="pl.276.29"></a><var>276.29</var>ICF/MR, or regional treatment center, or restructuring of state-operated services that <br/>
<a id="pl.276.30"></a><var>276.30</var>limits the capacity of state-operated facilities;<br/>
<a id="pl.276.31"></a><var>276.31</var>(4) new foster care licenses or community residential setting licenses determined <br/>
<a id="pl.276.32"></a><var>276.32</var>to be needed by the commissioner under paragraph (b) for persons requiring hospital <br/>
<a id="pl.276.33"></a><var>276.33</var>level care; or<br/>
<a id="pl.277.1"></a><var>277.1</var>(5) new foster care licenses or community residential setting licenses determined to <br/>
<a id="pl.277.2"></a><var>277.2</var>be needed by the commissioner for the transition of people from personal care assistance <br/>
<a id="pl.277.3"></a><var>277.3</var>to the home and community-based services.<br/>
<a id="pl.277.4"></a><var>277.4</var>(b) The commissioner shall determine the need for newly licensed foster care <br/>
<a id="pl.277.5"></a><var>277.5</var>homes or community residential settings as defined under this subdivision. As part of the <br/>
<a id="pl.277.6"></a><var>277.6</var>determination, the commissioner shall consider the availability of foster care capacity in <br/>
<a id="pl.277.7"></a><var>277.7</var>the area in which the licensee seeks to operate, and the recommendation of the local <br/>
<a id="pl.277.8"></a><var>277.8</var>county board. The determination by the commissioner must be final. A determination of <br/>
<a id="pl.277.9"></a><var>277.9</var>need is not required for a change in ownership at the same address.<br/>
<a id="pl.277.10"></a><var>277.10</var>(c) The commissioner shall study the effects of the license moratorium under this <br/>
<a id="pl.277.11"></a><var>277.11</var>subdivision and shall report back to the legislature by January 15, 2011. This study shall <br/>
<a id="pl.277.12"></a><var>277.12</var>include, but is not limited to the following:<br/>
<a id="pl.277.13"></a><var>277.13</var>(1) the overall capacity and utilization of foster care beds where the physical location <br/>
<a id="pl.277.14"></a><var>277.14</var>is not the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.277.15"></a><var>277.15</var>of the moratorium;<br/>
<a id="pl.277.16"></a><var>277.16</var>(2) the overall capacity and utilization of foster care beds where the physical <br/>
<a id="pl.277.17"></a><var>277.17</var>location is the primary residence of the license holder prior to and after implementation <br/>
<a id="pl.277.18"></a><var>277.18</var>of the moratorium; and<br/>
<a id="pl.277.19"></a><var>277.19</var>(3) the number of licensed and occupied ICF/MR beds prior to and after <br/>
<a id="pl.277.20"></a><var>277.20</var>implementation of the moratorium.<br/>
<a id="pl.277.21"></a><var>277.21</var>(d) When a foster care recipient resident served by the program moves out of a <br/>
<a id="pl.277.22"></a><var>277.22</var>foster home that is not the primary residence of the license holder according to section <br/>
<statute_ref><a id="pl.277.23"></a><var>277.23</var>256B.49, subdivision 15
         </statute_ref>, paragraph (f), or the community residential setting, the county <br/>
<a id="pl.277.24"></a><var>277.24</var>shall immediately inform the Department of Human Services Licensing Division. <br/>
<a id="pl.277.25"></a><var>277.25</var>The department shall decrease the statewide licensed capacity for foster care settings <br/>
<a id="pl.277.26"></a><var>277.26</var>where the physical location is not the primary residence of the license holder, or for <br/>
<a id="pl.277.27"></a><var>277.27</var>community residential settings, if the voluntary changes described in paragraph (f) are <br/>
<a id="pl.277.28"></a><var>277.28</var>not sufficient to meet the savings required by reductions in licensed bed capacity under <br/>
<a id="pl.277.29"></a><var>277.29</var>Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), <br/>
<a id="pl.277.30"></a><var>277.30</var>and maintain statewide long-term care residential services capacity within budgetary <br/>
<a id="pl.277.31"></a><var>277.31</var>limits. Implementation of the statewide licensed capacity reduction shall begin on July <br/>
<a id="pl.277.32"></a><var>277.32</var>1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the <br/>
<a id="pl.277.33"></a><var>277.33</var>needs determination process. Under this paragraph, the commissioner has the authority <br/>
<a id="pl.277.34"></a><var>277.34</var>to reduce unused licensed capacity of a current foster care program, or the community <br/>
<a id="pl.277.35"></a><var>277.35</var>residential settings, to accomplish the consolidation or closure of settings. A decreased <br/>
<a id="pl.277.36"></a><var>277.36</var>licensed capacity according to this paragraph is not subject to appeal under this chapter.<br/>
<a id="pl.278.1"></a><var>278.1</var>(e) Residential settings that would otherwise be subject to the decreased license <br/>
<a id="pl.278.2"></a><var>278.2</var>capacity established in paragraph (d) shall be exempt under the following circumstances:<br/>
<a id="pl.278.3"></a><var>278.3</var>(1) until August 1, 2013, the license holder's beds occupied by residents whose <br/>
<a id="pl.278.4"></a><var>278.4</var>primary diagnosis is mental illness and the license holder is:<br/>
<a id="pl.278.5"></a><var>278.5</var>(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental <br/>
<a id="pl.278.6"></a><var>278.6</var>health services (ARMHS) as defined in section 
         <statute_ref>256B.0623</statute_ref>;<br/>
<a id="pl.278.7"></a><var>278.7</var>(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to <br/>
<a id="pl.278.8"></a><var>278.8</var>9520.0870;<br/>
<a id="pl.278.9"></a><var>278.9</var>(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to <br/>
<a id="pl.278.10"></a><var>278.10</var>9520.0870; or<br/>
<a id="pl.278.11"></a><var>278.11</var>(iv) a provider of intensive residential treatment services (IRTS) licensed under <br/>
<a id="pl.278.12"></a><var>278.12</var>Minnesota Rules, parts 9520.0500 to 9520.0670; or<br/>
<a id="pl.278.13"></a><var>278.13</var>(2) the license holder is certified under the requirements in subdivision 6a or section <br/>
<a id="pl.278.14"></a><var>278.14</var>245D.33.<br/>
<a id="pl.278.15"></a><var>278.15</var>(f) A resource need determination process, managed at the state level, using the <br/>
<a id="pl.278.16"></a><var>278.16</var>available reports required by section 
         <statute_ref>144A.351</statute_ref>, and other data and information shall <br/>
<a id="pl.278.17"></a><var>278.17</var>be used to determine where the reduced capacity required under paragraph (d) will be <br/>
<a id="pl.278.18"></a><var>278.18</var>implemented. The commissioner shall consult with the stakeholders described in section <br/>
<statute_ref><a id="pl.278.19"></a><var>278.19</var>144A.351
         </statute_ref>, and employ a variety of methods to improve the state's capacity to meet <br/>
<a id="pl.278.20"></a><var>278.20</var>long-term care service needs within budgetary limits, including seeking proposals from <br/>
<a id="pl.278.21"></a><var>278.21</var>service providers or lead agencies to change service type, capacity, or location to improve <br/>
<a id="pl.278.22"></a><var>278.22</var>services, increase the independence of residents, and better meet needs identified by the <br/>
<a id="pl.278.23"></a><var>278.23</var>long-term care services reports and statewide data and information. By February 1 of each <br/>
<a id="pl.278.24"></a><var>278.24</var>year, the commissioner shall provide information and data on the overall capacity of <br/>
<a id="pl.278.25"></a><var>278.25</var>licensed long-term care services, actions taken under this subdivision to manage statewide <br/>
<a id="pl.278.26"></a><var>278.26</var>long-term care services and supports resources, and any recommendations for change to <br/>
<a id="pl.278.27"></a><var>278.27</var>the legislative committees with jurisdiction over health and human services budget.<br/>
<a id="pl.278.28"></a><var>278.28</var>    (g) At the time of application and reapplication for licensure, the applicant and the <br/>
<a id="pl.278.29"></a><var>278.29</var>license holder that are subject to the moratorium or an exclusion established in paragraph <br/>
<a id="pl.278.30"></a><var>278.30</var>(a) are required to inform the commissioner whether the physical location where the foster <br/>
<a id="pl.278.31"></a><var>278.31</var>care will be provided is or will be the primary residence of the license holder for the entire <br/>
<a id="pl.278.32"></a><var>278.32</var>period of licensure. If the primary residence of the applicant or license holder changes, the <br/>
<a id="pl.278.33"></a><var>278.33</var>applicant or license holder must notify the commissioner immediately. The commissioner <br/>
<a id="pl.278.34"></a><var>278.34</var>shall print on the foster care license certificate whether or not the physical location is the <br/>
<a id="pl.278.35"></a><var>278.35</var>primary residence of the license holder.<br/>
<a id="pl.279.1"></a><var>279.1</var>    (h) License holders of foster care homes identified under paragraph (g) that are not <br/>
<a id="pl.279.2"></a><var>279.2</var>the primary residence of the license holder and that also provide services in the foster care <br/>
<a id="pl.279.3"></a><var>279.3</var>home that are covered by a federally approved home and community-based services <br/>
<a id="pl.279.4"></a><var>279.4</var>waiver, as authorized under section 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, or 
         <statute_ref>256B.49</statute_ref>, must inform the <br/>
<a id="pl.279.5"></a><var>279.5</var>human services licensing division that the license holder provides or intends to provide <br/>
<a id="pl.279.6"></a><var>279.6</var>these waiver-funded services. These license holders must be considered registered under <br/>
<a id="pl.279.7"></a><var>279.7</var>section 
<statute_ref>256B.092, subdivision 11</statute_ref>, paragraph (c), and this registration status must be <br/>
<a id="pl.279.8"></a><var>279.8</var>identified on their license certificates.<br/>
<br/>
<a id="bill.8.8.0"></a><a id="pl.279.9"></a><var>279.9</var>    Sec. 8. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:<br/>
<a id="pl.279.10"></a><var>279.10</var>    Subd. 8. <b>Excluded providers seeking licensure.</b> Nothing in this section shall <br/>
<a id="pl.279.11"></a><var>279.11</var>prohibit a program that is excluded from licensure under subdivision 2, paragraph <br/>
<a id="pl.279.12"></a><var>279.12</var>(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any <br/>
<a id="pl.279.13"></a><var>279.13</var>application received from such an excluded provider is processed in the same manner as <br/>
<a id="pl.279.14"></a><var>279.14</var>all other applications for child care center licensure.<br/>
<br/>
<a id="bill.8.9.0"></a><a id="pl.279.15"></a><var>279.15</var>    Sec. 9. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:<br/>
<a id="pl.279.16"></a><var>279.16</var>    Subd. 3. <b>Implementation.</b> (a) The commissioner shall implement the <br/>
<a id="pl.279.17"></a><var>279.17</var>responsibilities of this chapter according to the timelines in paragraphs (b) and (c) <br/>
<a id="pl.279.18"></a><var>279.18</var>only within the limits of available appropriations or other administrative cost recovery <br/>
<a id="pl.279.19"></a><var>279.19</var>methodology.<br/>
<a id="pl.279.20"></a><var>279.20</var>(b) The licensure of home and community-based services according to this section <br/>
<a id="pl.279.21"></a><var>279.21</var>shall be implemented January 1, 2014. License applications shall be received and <br/>
<a id="pl.279.22"></a><var>279.22</var>processed on a phased-in schedule as determined by the commissioner beginning July <br/>
<a id="pl.279.23"></a><var>279.23</var>1, 2013. Licenses will be issued thereafter upon the commissioner's determination that <br/>
<a id="pl.279.24"></a><var>279.24</var>the application is complete according to section 
         <statute_ref>245A.04</statute_ref>.<br/>
<a id="pl.279.25"></a><var>279.25</var>(c) Within the limits of available appropriations or other administrative cost recovery <br/>
<a id="pl.279.26"></a><var>279.26</var>methodology, implementation of compliance monitoring must be phased in after January <br/>
<a id="pl.279.27"></a><var>279.27</var>1, 2014.<br/>
<a id="pl.279.28"></a><var>279.28</var>(1) Applicants who do not currently hold a license issued under this chapter 245B<br/>
<a id="pl.279.29"></a><var>279.29</var> must receive an initial compliance monitoring visit after 12 months of the effective date of <br/>
<a id="pl.279.30"></a><var>279.30</var>the initial license for the purpose of providing technical assistance on how to achieve and <br/>
<a id="pl.279.31"></a><var>279.31</var>maintain compliance with the applicable law or rules governing the provision of home and <br/>
<a id="pl.279.32"></a><var>279.32</var>community-based services under chapter 245D. If during the review the commissioner <br/>
<a id="pl.279.33"></a><var>279.33</var>finds that the license holder has failed to achieve compliance with an applicable law or <br/>
<a id="pl.279.34"></a><var>279.34</var>rule and this failure does not imminently endanger the health, safety, or rights of the <br/>
<a id="pl.280.1"></a><var>280.1</var>persons served by the program, the commissioner may issue a licensing review report with <br/>
<a id="pl.280.2"></a><var>280.2</var>recommendations for achieving and maintaining compliance.<br/>
<a id="pl.280.3"></a><var>280.3</var>(2) Applicants who do currently hold a license issued under this chapter must receive <br/>
<a id="pl.280.4"></a><var>280.4</var>a compliance monitoring visit after 24 months of the effective date of the initial license.<br/>
<a id="pl.280.5"></a><var>280.5</var>(d) Nothing in this subdivision shall be construed to limit the commissioner's <br/>
<a id="pl.280.6"></a><var>280.6</var>authority to suspend or revoke a license or issue a fine at any time under section 
         <statute_ref>245A.07</statute_ref>, <br/>
<a id="pl.280.7"></a><var>280.7</var>or make issue correction orders and make a license conditional for failure to comply with <br/>
<a id="pl.280.8"></a><var>280.8</var>applicable laws or rules under section 
         <statute_ref>245A.06</statute_ref>, based on the nature, chronicity, or severity <br/>
<a id="pl.280.9"></a><var>280.9</var>of the violation of law or rule and the effect of the violation on the health, safety, or <br/>
<a id="pl.280.10"></a><var>280.10</var>rights of persons served by the program.<br/>
<br/>
<a id="bill.8.10.0"></a><a id="pl.280.11"></a><var>280.11</var>    Sec. 10. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:<br/>
<a id="pl.280.12"></a><var>280.12</var>    Subd. 2a. <b>Consolidated contested case hearings.</b> (a) When a denial of a license <br/>
<a id="pl.280.13"></a><var>280.13</var>under section 
         <statute_ref>245A.05</statute_ref> or a licensing sanction under section 
         <statute_ref>245A.07, subdivision 3</statute_ref>, is <br/>
<a id="pl.280.14"></a><var>280.14</var>based on a disqualification for which reconsideration was requested and which was not <br/>
<a id="pl.280.15"></a><var>280.15</var>set aside under section 
         <statute_ref>245C.22</statute_ref>, the scope of the contested case hearing shall include the <br/>
<a id="pl.280.16"></a><var>280.16</var>disqualification and the licensing sanction or denial of a license, unless otherwise specified <br/>
<a id="pl.280.17"></a><var>280.17</var>in this subdivision. When the licensing sanction or denial of a license is based on a <br/>
<a id="pl.280.18"></a><var>280.18</var>determination of maltreatment under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref>, or a disqualification for <br/>
<a id="pl.280.19"></a><var>280.19</var>serious or recurring maltreatment which was not set aside, the scope of the contested case <br/>
<a id="pl.280.20"></a><var>280.20</var>hearing shall include the maltreatment determination, disqualification, and the licensing <br/>
<a id="pl.280.21"></a><var>280.21</var>sanction or denial of a license, unless otherwise specified in this subdivision. In such <br/>
<a id="pl.280.22"></a><var>280.22</var>cases, a fair hearing under section 
         <statute_ref>256.045</statute_ref> shall not be conducted as provided for in <br/>
<a id="pl.280.23"></a><var>280.23</var>sections 
         <statute_ref>245C.27, 626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557, subdivision 9d</statute_ref>.<br/>
<a id="pl.280.24"></a><var>280.24</var>    (b) Except for family child care and child foster care, reconsideration of a <br/>
<a id="pl.280.25"></a><var>280.25</var>maltreatment determination under sections 
         <statute_ref>626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557</statute_ref>, <br/>
<a id="pl.280.26"></a><var>280.26</var>subdivision 9d, and reconsideration of a disqualification under section 
         <statute_ref>245C.22</statute_ref>, shall <br/>
<a id="pl.280.27"></a><var>280.27</var>not be conducted when:<br/>
<a id="pl.280.28"></a><var>280.28</var>    (1) a denial of a license under section 
         <statute_ref>245A.05</statute_ref>, or a licensing sanction under section <br/>
<statute_ref><a id="pl.280.29"></a><var>280.29</var>245A.07
         </statute_ref>, is based on a determination that the license holder is responsible for maltreatment <br/>
<a id="pl.280.30"></a><var>280.30</var>or the disqualification of a license holder is based on serious or recurring maltreatment;<br/>
<a id="pl.280.31"></a><var>280.31</var>    (2) the denial of a license or licensing sanction is issued at the same time as the <br/>
<a id="pl.280.32"></a><var>280.32</var>maltreatment determination or disqualification; and<br/>
<a id="pl.280.33"></a><var>280.33</var>    (3) the license holder appeals the maltreatment determination or disqualification, <br/>
<a id="pl.280.34"></a><var>280.34</var>and denial of a license or licensing sanction. In these cases, a fair hearing shall not be <br/>
<a id="pl.280.35"></a><var>280.35</var>conducted under sections 
         <statute_ref>245C.27</statute_ref>, 
         <statute_ref>626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557</statute_ref>, subdivision <br/>
<a id="pl.281.1"></a><var>281.1</var>9d. The scope of the contested case hearing must include the maltreatment determination, <br/>
<a id="pl.281.2"></a><var>281.2</var>disqualification, and denial of a license or licensing sanction.<br/>
<a id="pl.281.3"></a><var>281.3</var>    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment <br/>
<a id="pl.281.4"></a><var>281.4</var>determination or disqualification, but does not appeal the denial of a license or a licensing <br/>
<a id="pl.281.5"></a><var>281.5</var>sanction, reconsideration of the maltreatment determination shall be conducted under <br/>
<a id="pl.281.6"></a><var>281.6</var>sections 
         <statute_ref>626.556, subdivision 10i</statute_ref>, and 
         <statute_ref>626.557, subdivision 9d</statute_ref>, and reconsideration of the <br/>
<a id="pl.281.7"></a><var>281.7</var>disqualification shall be conducted under section 
         <statute_ref>245C.22</statute_ref>. In such cases, a fair hearing <br/>
<a id="pl.281.8"></a><var>281.8</var>shall also be conducted as provided under sections 
         <statute_ref>245C.27</statute_ref>, 
         <statute_ref>626.556</statute_ref>, subdivision 10i, and <br/>
<statute_ref><a id="pl.281.9"></a><var>281.9</var>626.557, subdivision 9d
         </statute_ref>.<br/>
<a id="pl.281.10"></a><var>281.10</var>    (c) In consolidated contested case hearings regarding sanctions issued in family child <br/>
<a id="pl.281.11"></a><var>281.11</var>care, child foster care, family adult day services, and adult foster care, and community <br/>
<a id="pl.281.12"></a><var>281.12</var>residential settings, the county attorney shall defend the commissioner's orders in <br/>
<a id="pl.281.13"></a><var>281.13</var>accordance with section 
         <statute_ref>245A.16, subdivision 4</statute_ref>.<br/>
<a id="pl.281.14"></a><var>281.14</var>    (d) The commissioner's final order under subdivision 5 is the final agency action <br/>
<a id="pl.281.15"></a><var>281.15</var>on the issue of maltreatment and disqualification, including for purposes of subsequent <br/>
<a id="pl.281.16"></a><var>281.16</var>background studies under chapter 245C and is the only administrative appeal of the final <br/>
<a id="pl.281.17"></a><var>281.17</var>agency determination, specifically, including a challenge to the accuracy and completeness <br/>
<a id="pl.281.18"></a><var>281.18</var>of data under section 
         <statute_ref>13.04</statute_ref>.<br/>
<a id="pl.281.19"></a><var>281.19</var>    (e) When consolidated hearings under this subdivision involve a licensing sanction <br/>
<a id="pl.281.20"></a><var>281.20</var>based on a previous maltreatment determination for which the commissioner has issued <br/>
<a id="pl.281.21"></a><var>281.21</var>a final order in an appeal of that determination under section 
         <statute_ref>256.045</statute_ref>, or the individual <br/>
<a id="pl.281.22"></a><var>281.22</var>failed to exercise the right to appeal the previous maltreatment determination under <br/>
<a id="pl.281.23"></a><var>281.23</var>section 
         <statute_ref>626.556, subdivision 10i</statute_ref>, or 
         <statute_ref>626.557, subdivision 9d</statute_ref>, the commissioner's order is <br/>
<a id="pl.281.24"></a><var>281.24</var>conclusive on the issue of maltreatment. In such cases, the scope of the administrative <br/>
<a id="pl.281.25"></a><var>281.25</var>law judge's review shall be limited to the disqualification and the licensing sanction or <br/>
<a id="pl.281.26"></a><var>281.26</var>denial of a license. In the case of a denial of a license or a licensing sanction issued to <br/>
<a id="pl.281.27"></a><var>281.27</var>a facility based on a maltreatment determination regarding an individual who is not the <br/>
<a id="pl.281.28"></a><var>281.28</var>license holder or a household member, the scope of the administrative law judge's review <br/>
<a id="pl.281.29"></a><var>281.29</var>includes the maltreatment determination.<br/>
<a id="pl.281.30"></a><var>281.30</var>    (f) The hearings of all parties may be consolidated into a single contested case <br/>
<a id="pl.281.31"></a><var>281.31</var>hearing upon consent of all parties and the administrative law judge, if:<br/>
<a id="pl.281.32"></a><var>281.32</var>    (1) a maltreatment determination or disqualification, which was not set aside under <br/>
<a id="pl.281.33"></a><var>281.33</var>section 
         <statute_ref>245C.22</statute_ref>, is the basis for a denial of a license under section 
         <statute_ref>245A.05</statute_ref> or a licensing <br/>
<a id="pl.281.34"></a><var>281.34</var>sanction under section 
         <statute_ref>245A.07</statute_ref>;<br/>
<a id="pl.281.35"></a><var>281.35</var>    (2) the disqualified subject is an individual other than the license holder and upon <br/>
<a id="pl.281.36"></a><var>281.36</var>whom a background study must be conducted under section 
         <statute_ref>245C.03</statute_ref>; and<br/>
<a id="pl.282.1"></a><var>282.1</var>    (3) the individual has a hearing right under section 
         <statute_ref>245C.27</statute_ref>.<br/>
<a id="pl.282.2"></a><var>282.2</var>    (g) When a denial of a license under section 
         <statute_ref>245A.05</statute_ref> or a licensing sanction under <br/>
<a id="pl.282.3"></a><var>282.3</var>section 
         <statute_ref>245A.07</statute_ref> is based on a disqualification for which reconsideration was requested <br/>
<a id="pl.282.4"></a><var>282.4</var>and was not set aside under section 
         <statute_ref>245C.22</statute_ref>, and the individual otherwise has no hearing <br/>
<a id="pl.282.5"></a><var>282.5</var>right under section 
         <statute_ref>245C.27</statute_ref>, the scope of the administrative law judge's review shall <br/>
<a id="pl.282.6"></a><var>282.6</var>include the denial or sanction and a determination whether the disqualification should <br/>
<a id="pl.282.7"></a><var>282.7</var>be set aside, unless section 
         <statute_ref>245C.24</statute_ref> prohibits the set-aside of the disqualification. In <br/>
<a id="pl.282.8"></a><var>282.8</var>determining whether the disqualification should be set aside, the administrative law judge <br/>
<a id="pl.282.9"></a><var>282.9</var>shall consider the factors under section 
         <statute_ref>245C.22, subdivision 4</statute_ref>, to determine whether the <br/>
<a id="pl.282.10"></a><var>282.10</var>individual poses a risk of harm to any person receiving services from the license holder.<br/>
<a id="pl.282.11"></a><var>282.11</var>    (h) Notwithstanding section 
         <statute_ref>245C.30, subdivision 5</statute_ref>, when a licensing sanction <br/>
<a id="pl.282.12"></a><var>282.12</var>under section 
         <statute_ref>245A.07</statute_ref> is based on the termination of a variance under section 
         <statute_ref>245C.30, <br/>
<a id="pl.282.13"></a><var>282.13</var>subdivision 4
         </statute_ref>, the scope of the administrative law judge's review shall include the sanction <br/>
<a id="pl.282.14"></a><var>282.14</var>and a determination whether the disqualification should be set aside, unless section <br/>
<statute_ref><a id="pl.282.15"></a><var>282.15</var>245C.24
         </statute_ref> prohibits the set-aside of the disqualification. In determining whether the <br/>
<a id="pl.282.16"></a><var>282.16</var>disqualification should be set aside, the administrative law judge shall consider the factors <br/>
<a id="pl.282.17"></a><var>282.17</var>under section 
         <statute_ref>245C.22, subdivision 4</statute_ref>, to determine whether the individual poses a risk of <br/>
<a id="pl.282.18"></a><var>282.18</var>harm to any person receiving services from the license holder.<br/>
<br/>
<a id="bill.8.11.0"></a><a id="pl.282.19"></a><var>282.19</var>    Sec. 11. Minnesota Statutes 2012, section 245A.10, is amended to read:<br/>
<a id="pl.282.20"></a><var>282.20</var><b>245A.10 FEES.</b><br/>
<a id="pl.282.21"></a><var>282.21</var>    Subdivision 1. <b>Application or license fee required, programs exempt from fee.</b><br/>
<a id="pl.282.22"></a><var>282.22</var>(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation <br/>
<a id="pl.282.23"></a><var>282.23</var>of applications and inspection of programs which are licensed under this chapter.<br/>
<a id="pl.282.24"></a><var>282.24</var>(b) Except as provided under subdivision 2, no application or license fee shall be <br/>
<a id="pl.282.25"></a><var>282.25</var>charged for child foster care, adult foster care, or family and group family child care, or <br/>
<a id="pl.282.26"></a><var>282.26</var>a community residential setting.<br/>
<a id="pl.282.27"></a><var>282.27</var>    Subd. 2. <b>County fees for background studies and licensing inspections.</b> (a) For <br/>
<a id="pl.282.28"></a><var>282.28</var>purposes of family and group family child care licensing under this chapter, a county <br/>
<a id="pl.282.29"></a><var>282.29</var>agency may charge a fee to an applicant or license holder to recover the actual cost of <br/>
<a id="pl.282.30"></a><var>282.30</var>background studies, but in any case not to exceed $100 annually. A county agency may <br/>
<a id="pl.282.31"></a><var>282.31</var>also charge a license fee to an applicant or license holder not to exceed $50 for a one-year <br/>
<a id="pl.282.32"></a><var>282.32</var>license or $100 for a two-year license.<br/>
<a id="pl.282.33"></a><var>282.33</var>    (b) A county agency may charge a fee to a legal nonlicensed child care provider or <br/>
<a id="pl.282.34"></a><var>282.34</var>applicant for authorization to recover the actual cost of background studies completed <br/>
<a id="pl.282.35"></a><var>282.35</var>under section 
         <statute_ref>119B.125</statute_ref>, but in any case not to exceed $100 annually.<br/>
<a id="pl.283.1"></a><var>283.1</var>    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):<br/>
<a id="pl.283.2"></a><var>283.2</var>    (1) in cases of financial hardship;<br/>
<a id="pl.283.3"></a><var>283.3</var>    (2) if the county has a shortage of providers in the county's area;<br/>
<a id="pl.283.4"></a><var>283.4</var>    (3) for new providers; or<br/>
<a id="pl.283.5"></a><var>283.5</var>    (4) for providers who have attained at least 16 hours of training before seeking <br/>
<a id="pl.283.6"></a><var>283.6</var>initial licensure.<br/>
<a id="pl.283.7"></a><var>283.7</var>    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on <br/>
<a id="pl.283.8"></a><var>283.8</var>an installment basis for up to one year. If the provider is receiving child care assistance <br/>
<a id="pl.283.9"></a><var>283.9</var>payments from the state, the provider may have the fees under paragraph (a) or (b) <br/>
<a id="pl.283.10"></a><var>283.10</var>deducted from the child care assistance payments for up to one year and the state shall <br/>
<a id="pl.283.11"></a><var>283.11</var>reimburse the county for the county fees collected in this manner.<br/>
<a id="pl.283.12"></a><var>283.12</var>    (e) For purposes of adult foster care and child foster care licensing, and licensing <br/>
<a id="pl.283.13"></a><var>283.13</var>the physical plant of a community residential setting, under this chapter, a county agency <br/>
<a id="pl.283.14"></a><var>283.14</var>may charge a fee to a corporate applicant or corporate license holder to recover the actual <br/>
<a id="pl.283.15"></a><var>283.15</var>cost of licensing inspections, not to exceed $500 annually.<br/>
<a id="pl.283.16"></a><var>283.16</var>    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the <br/>
<a id="pl.283.17"></a><var>283.17</var>following circumstances:<br/>
<a id="pl.283.18"></a><var>283.18</var>(1) in cases of financial hardship;<br/>
<a id="pl.283.19"></a><var>283.19</var>(2) if the county has a shortage of providers in the county's area; or<br/>
<a id="pl.283.20"></a><var>283.20</var>(3) for new providers.<br/>
<a id="pl.283.21"></a><var>283.21</var>    Subd. 3. <b>Application fee for initial license or certification.</b> (a) For fees required <br/>
<a id="pl.283.22"></a><var>283.22</var>under subdivision 1, an applicant for an initial license or certification issued by the <br/>
<a id="pl.283.23"></a><var>283.23</var>commissioner shall submit a $500 application fee with each new application required <br/>
<a id="pl.283.24"></a><var>283.24</var>under this subdivision. An applicant for an initial day services facility license under <br/>
<a id="pl.283.25"></a><var>283.25</var>chapter 245D shall submit a $250 application fee with each new application. The <br/>
<a id="pl.283.26"></a><var>283.26</var>application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license <br/>
<a id="pl.283.27"></a><var>283.27</var>or certification fee that expires on December 31. The commissioner shall not process an <br/>
<a id="pl.283.28"></a><var>283.28</var>application until the application fee is paid.<br/>
<a id="pl.283.29"></a><var>283.29</var>(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license <br/>
<a id="pl.283.30"></a><var>283.30</var>to provide services at a specific location.<br/>
<a id="pl.283.31"></a><var>283.31</var>(1) For a license to provide residential-based habilitation services to persons with <br/>
<a id="pl.283.32"></a><var>283.32</var>developmental disabilities under chapter 245B, an applicant shall submit an application <br/>
<a id="pl.283.33"></a><var>283.33</var>for each county in which the services will be provided. Upon licensure, the license <br/>
<a id="pl.283.34"></a><var>283.34</var>holder may provide services to persons in that county plus no more than three persons <br/>
<a id="pl.283.35"></a><var>283.35</var>at any one time in each of up to ten additional counties. A license holder in one county <br/>
<a id="pl.283.36"></a><var>283.36</var>may not provide services under the home and community-based waiver for persons with <br/>
<a id="pl.284.1"></a><var>284.1</var>developmental disabilities to more than three people in a second county without holding <br/>
<a id="pl.284.2"></a><var>284.2</var>a separate license for that second county. Applicants or licensees providing services <br/>
<a id="pl.284.3"></a><var>284.3</var>under this clause to not more than three persons remain subject to the inspection fees <br/>
<a id="pl.284.4"></a><var>284.4</var>established in section 
<statute_ref>245A.10, subdivision 2</statute_ref>, for each location. The license issued by <br/>
<a id="pl.284.5"></a><var>284.5</var>the commissioner must state the name of each additional county where services are being <br/>
<a id="pl.284.6"></a><var>284.6</var>provided to persons with developmental disabilities. A license holder must notify the <br/>
<a id="pl.284.7"></a><var>284.7</var>commissioner before making any changes that would alter the license information listed <br/>
<a id="pl.284.8"></a><var>284.8</var>under section 
<statute_ref>245A.04, subdivision 7</statute_ref>, paragraph (a), including any additional counties <br/>
<a id="pl.284.9"></a><var>284.9</var>where persons with developmental disabilities are being served. For a license to provide <br/>
<a id="pl.284.10"></a><var>284.10</var>home and community-based services to persons with disabilities or age 65 and older under <br/>
<a id="pl.284.11"></a><var>284.11</var>chapter 245D, an applicant shall submit an application to provide services statewide.<br/>
<a id="pl.284.12"></a><var>284.12</var>(2) For a license to provide supported employment, crisis respite, or <br/>
<a id="pl.284.13"></a><var>284.13</var>semi-independent living services to persons with developmental disabilities under chapter <br/>
<a id="pl.284.14"></a><var>284.14</var>245B, an applicant shall submit a single application to provide services statewide.<br/>
<a id="pl.284.15"></a><var>284.15</var>(3) For a license to provide independent living assistance for youth under section <br/>
<statute_ref><a id="pl.284.16"></a><var>284.16</var>245A.22
         </statute_ref>, an applicant shall submit a single application to provide services statewide.<br/>
<a id="pl.284.17"></a><var>284.17</var>(4) (3) For a license for a private agency to provide foster care or adoption services <br/>
<a id="pl.284.18"></a><var>284.18</var>under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single <br/>
<a id="pl.284.19"></a><var>284.19</var>application to provide services statewide.<br/>
<a id="pl.284.20"></a><var>284.20</var>(c) The initial application fee charged under this subdivision does not include the <br/>
<a id="pl.284.21"></a><var>284.21</var>temporary license surcharge under section 16E.22.<br/>
<a id="pl.284.22"></a><var>284.22</var>    Subd. 4. <b>License or certification fee for certain programs.</b> (a) Child care centers <br/>
<a id="pl.284.23"></a><var>284.23</var>shall pay an annual nonrefundable license fee based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="5"/>
<col width="30"/>
<col width="30"/>
<tr>
<td><a id="pl.284.24"></a><var>284.24</var><br/>
<a id="pl.284.25"></a><var>284.25</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>Child Care Center<br/>
                  		License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.26"></a><var>284.26</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$200<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.27"></a><var>284.27</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$300<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.28"></a><var>284.28</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$400<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.29"></a><var>284.29</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$500<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.30"></a><var>284.30</var><br/>
</td>
<td></td>
<td>100 to 124 persons<br/>
</td>
<td>$600<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.31"></a><var>284.31</var><br/>
</td>
<td></td>
<td>125 to 149 persons<br/>
</td>
<td>$700<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.32"></a><var>284.32</var><br/>
</td>
<td></td>
<td>150 to 174 persons<br/>
</td>
<td>$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.33"></a><var>284.33</var><br/>
</td>
<td></td>
<td>175 to 199 persons<br/>
</td>
<td>$900<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.34"></a><var>284.34</var><br/>
</td>
<td></td>
<td>200 to 224 persons<br/>
</td>
<td>$1,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.284.35"></a><var>284.35</var><br/>
</td>
<td></td>
<td>225 or more persons<br/>
</td>
<td>$1,100<br/>
</td>
</tr>
</table><a id="pl.284.36"></a><var>284.36</var>    (b) A day training and habilitation program serving persons with developmental <br/>
<a id="pl.284.37"></a><var>284.37</var>disabilities or related conditions shall pay an annual nonrefundable license fee based on <br/>
<a id="pl.284.38"></a><var>284.38</var>the following schedule:<br/>
<table>
<col width="50px"/>
<col width="5"/>
<col width="30"/>
<col width="30"/>
<tr>
<td><a id="pl.285.1"></a><var>285.1</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.2"></a><var>285.2</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.3"></a><var>285.3</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$1,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.4"></a><var>285.4</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.5"></a><var>285.5</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$1,400<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.6"></a><var>285.6</var><br/>
</td>
<td></td>
<td>100 to 124 persons<br/>
</td>
<td>$1,600<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.7"></a><var>285.7</var><br/>
</td>
<td></td>
<td>125 to 149 persons<br/>
</td>
<td>$1,800<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.8"></a><var>285.8</var><br/>
</td>
<td></td>
<td>150 or more persons<br/>
</td>
<td>$2,000<br/>
</td>
</tr>
</table><a id="pl.285.9"></a><var>285.9</var>Except as provided in paragraph (c), when a day training and habilitation program <br/>
<a id="pl.285.10"></a><var>285.10</var>serves more than 50 percent of the same persons in two or more locations in a community, <br/>
<a id="pl.285.11"></a><var>285.11</var>the day training and habilitation program shall pay a license fee based on the licensed <br/>
<a id="pl.285.12"></a><var>285.12</var>capacity of the largest facility and the other facility or facilities shall be charged a license <br/>
<a id="pl.285.13"></a><var>285.13</var>fee based on a licensed capacity of a residential program serving one to 24 persons.<br/>
<a id="pl.285.14"></a><var>285.14</var>    (c) When a day training and habilitation program serving persons with developmental <br/>
<a id="pl.285.15"></a><var>285.15</var>disabilities or related conditions seeks a single license allowed under section 
<statute_ref>245B.07</statute_ref>, <br/>
<a id="pl.285.16"></a><var>285.16</var>subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed <br/>
<a id="pl.285.17"></a><var>285.17</var>capacity for each location.<br/>
<a id="pl.285.18"></a><var>285.18</var>(d) A program licensed to provide supported employment services to persons <br/>
<a id="pl.285.19"></a><var>285.19</var>with developmental disabilities under chapter 245B shall pay an annual nonrefundable <br/>
<a id="pl.285.20"></a><var>285.20</var>license fee of $650.<br/>
<a id="pl.285.21"></a><var>285.21</var>(e) A program licensed to provide crisis respite services to persons with <br/>
<a id="pl.285.22"></a><var>285.22</var>developmental disabilities under chapter 245B shall pay an annual nonrefundable license <br/>
<a id="pl.285.23"></a><var>285.23</var>fee of $700.<br/>
<a id="pl.285.24"></a><var>285.24</var>(f) A program licensed to provide semi-independent living services to persons <br/>
<a id="pl.285.25"></a><var>285.25</var>with developmental disabilities under chapter 245B shall pay an annual nonrefundable <br/>
<a id="pl.285.26"></a><var>285.26</var>license fee of $700.<br/>
<a id="pl.285.27"></a><var>285.27</var>(g) A program licensed to provide residential-based habilitation services under the <br/>
<a id="pl.285.28"></a><var>285.28</var>home and community-based waiver for persons with developmental disabilities shall pay <br/>
<a id="pl.285.29"></a><var>285.29</var>an annual license fee that includes a base rate of $690 plus $60 times the number of clients <br/>
<a id="pl.285.30"></a><var>285.30</var>served on the first day of July of the current license year.<br/>
<a id="pl.285.31"></a><var>285.31</var>(h) A residential program certified by the Department of Health as an intermediate <br/>
<a id="pl.285.32"></a><var>285.32</var>care facility for persons with developmental disabilities (ICF/MR) and a noncertified <br/>
<a id="pl.285.33"></a><var>285.33</var>residential program licensed to provide health or rehabilitative services for persons <br/>
<a id="pl.285.34"></a><var>285.34</var>with developmental disabilities shall pay an annual nonrefundable license fee based on <br/>
<a id="pl.285.35"></a><var>285.35</var>the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.285.36"></a><var>285.36</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.285.37"></a><var>285.37</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$535<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.1"></a><var>286.1</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$735<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.2"></a><var>286.2</var><br/>
</td>
<td></td>
<td>50 or more persons<br/>
</td>
<td>$935<br/>
</td>
</tr>
</table><a id="pl.286.3"></a><var>286.3</var>(b) A program licensed to provide one or more of the home and community-based <br/>
<a id="pl.286.4"></a><var>286.4</var>services and supports identified under chapter 245D to persons with disabilities or age <br/>
<a id="pl.286.5"></a><var>286.5</var>65 and older, shall pay an annual nonrefundable license fee that includes a base rate of <br/>
<a id="pl.286.6"></a><var>286.6</var>$563, plus $46 times the number of persons served on the last day of June of the current <br/>
<a id="pl.286.7"></a><var>286.7</var>license year for programs serving ten or more persons. The fee is limited to a maximum of <br/>
<a id="pl.286.8"></a><var>286.8</var>200 persons, regardless of the actual number of persons served. Programs serving nine <br/>
<a id="pl.286.9"></a><var>286.9</var>or fewer persons pay only the base rate.<br/>
<a id="pl.286.10"></a><var>286.10</var>(c) A facility licensed under chapter 245D to provide day services shall pay an <br/>
<a id="pl.286.11"></a><var>286.11</var>annual nonrefundable license fee of $100.<br/>
<a id="pl.286.12"></a><var>286.12</var>(i) (d) A chemical dependency treatment program licensed under Minnesota Rules, <br/>
<a id="pl.286.13"></a><var>286.13</var>parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an <br/>
<a id="pl.286.14"></a><var>286.14</var>annual nonrefundable license fee based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.286.15"></a><var>286.15</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.16"></a><var>286.16</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$600<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.17"></a><var>286.17</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$800<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.18"></a><var>286.18</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$1,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.19"></a><var>286.19</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.20"></a><var>286.20</var><br/>
</td>
<td></td>
<td>100 or more persons<br/>
</td>
<td>$1,400<br/>
</td>
</tr>
</table><a id="pl.286.21"></a><var>286.21</var>(j) (e) A chemical dependency program licensed under Minnesota Rules, parts <br/>
<a id="pl.286.22"></a><var>286.22</var>9530.6510 to 9530.6590, to provide detoxification services shall pay an annual <br/>
<a id="pl.286.23"></a><var>286.23</var>nonrefundable license fee based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.286.24"></a><var>286.24</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.25"></a><var>286.25</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$760<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.26"></a><var>286.26</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$960<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.27"></a><var>286.27</var><br/>
</td>
<td></td>
<td>50 or more persons<br/>
</td>
<td>$1,160<br/>
</td>
</tr>
</table><a id="pl.286.28"></a><var>286.28</var>(k) (f) Except for child foster care, a residential facility licensed under Minnesota <br/>
<a id="pl.286.29"></a><var>286.29</var>Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee <br/>
<a id="pl.286.30"></a><var>286.30</var>based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.286.31"></a><var>286.31</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.32"></a><var>286.32</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$1,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.33"></a><var>286.33</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$1,100<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.34"></a><var>286.34</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.35"></a><var>286.35</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$1,300<br/>
</td>
</tr>
<tr>
<td><a id="pl.286.36"></a><var>286.36</var><br/>
</td>
<td></td>
<td>100 or more persons<br/>
</td>
<td>$1,400<br/>
</td>
</tr>
</table><a id="pl.287.1"></a><var>287.1</var>(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to <br/>
<a id="pl.287.2"></a><var>287.2</var>9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license <br/>
<a id="pl.287.3"></a><var>287.3</var>fee based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.287.4"></a><var>287.4</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.5"></a><var>287.5</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$2,525<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.6"></a><var>287.6</var><br/>
</td>
<td></td>
<td>25 or more persons<br/>
</td>
<td>$2,725<br/>
</td>
</tr>
</table><a id="pl.287.7"></a><var>287.7</var>(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to <br/>
<a id="pl.287.8"></a><var>287.8</var>9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable <br/>
<a id="pl.287.9"></a><var>287.9</var>license fee based on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.287.10"></a><var>287.10</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.11"></a><var>287.11</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$450<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.12"></a><var>287.12</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$650<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.13"></a><var>287.13</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$850<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.14"></a><var>287.14</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$1,050<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.15"></a><var>287.15</var><br/>
</td>
<td></td>
<td>100 or more persons<br/>
</td>
<td>$1,250<br/>
</td>
</tr>
</table><a id="pl.287.16"></a><var>287.16</var>(n) (i) A program licensed to provide independent living assistance for youth under <br/>
<a id="pl.287.17"></a><var>287.17</var>section 
         <statute_ref>245A.22</statute_ref> shall pay an annual nonrefundable license fee of $1,500.<br/>
<a id="pl.287.18"></a><var>287.18</var>(o) (j) A private agency licensed to provide foster care and adoption services under <br/>
<a id="pl.287.19"></a><var>287.19</var>Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable <br/>
<a id="pl.287.20"></a><var>287.20</var>license fee of $875.<br/>
<a id="pl.287.21"></a><var>287.21</var>(p) (k) A program licensed as an adult day care center licensed under Minnesota <br/>
<a id="pl.287.22"></a><var>287.22</var>Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based <br/>
<a id="pl.287.23"></a><var>287.23</var>on the following schedule:<br/>
<table>
<col width="50px"/>
<col width="10"/>
<col width="27.5"/>
<col width="27.5"/>
<tr>
<td><a id="pl.287.24"></a><var>287.24</var><br/>
</td>
<td></td>
<td>Licensed Capacity<br/>
</td>
<td>License Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.25"></a><var>287.25</var><br/>
</td>
<td></td>
<td>1 to 24 persons<br/>
</td>
<td>$500<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.26"></a><var>287.26</var><br/>
</td>
<td></td>
<td>25 to 49 persons<br/>
</td>
<td>$700<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.27"></a><var>287.27</var><br/>
</td>
<td></td>
<td>50 to 74 persons<br/>
</td>
<td>$900<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.28"></a><var>287.28</var><br/>
</td>
<td></td>
<td>75 to 99 persons<br/>
</td>
<td>$1,100<br/>
</td>
</tr>
<tr>
<td><a id="pl.287.29"></a><var>287.29</var><br/>
</td>
<td></td>
<td>100 or more persons<br/>
</td>
<td>$1,300<br/>
</td>
</tr>
</table><a id="pl.287.30"></a><var>287.30</var>(q) (l) A program licensed to provide treatment services to persons with sexual <br/>
<a id="pl.287.31"></a><var>287.31</var>psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts <br/>
<a id="pl.287.32"></a><var>287.32</var>9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.<br/>
<a id="pl.287.33"></a><var>287.33</var>(r) (m) A mental health center or mental health clinic requesting certification for <br/>
<a id="pl.287.34"></a><var>287.34</var>purposes of insurance and subscriber contract reimbursement under Minnesota Rules, <br/>
<a id="pl.287.35"></a><var>287.35</var>parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the <br/>
<a id="pl.287.36"></a><var>287.36</var>mental health center or mental health clinic provides services at a primary location with <br/>
<a id="pl.288.1"></a><var>288.1</var>satellite facilities, the satellite facilities shall be certified with the primary location without <br/>
<a id="pl.288.2"></a><var>288.2</var>an additional charge.<br/>
<a id="pl.288.3"></a><var>288.3</var>    Subd. 6. <b>License not issued until license or certification fee is paid.</b> The <br/>
<a id="pl.288.4"></a><var>288.4</var>commissioner shall not issue a license or certification until the license or certification fee <br/>
<a id="pl.288.5"></a><var>288.5</var>is paid. The commissioner shall send a bill for the license or certification fee to the billing <br/>
<a id="pl.288.6"></a><var>288.6</var>address identified by the license holder. If the license holder does not submit the license or <br/>
<a id="pl.288.7"></a><var>288.7</var>certification fee payment by the due date, the commissioner shall send the license holder <br/>
<a id="pl.288.8"></a><var>288.8</var>a past due notice. If the license holder fails to pay the license or certification fee by the <br/>
<a id="pl.288.9"></a><var>288.9</var>due date on the past due notice, the commissioner shall send a final notice to the license <br/>
<a id="pl.288.10"></a><var>288.10</var>holder informing the license holder that the program license will expire on December 31 <br/>
<a id="pl.288.11"></a><var>288.11</var>unless the license fee is paid before December 31. If a license expires, the program is no <br/>
<a id="pl.288.12"></a><var>288.12</var>longer licensed and, unless exempt from licensure under section 
         <statute_ref>245A.03, subdivision 2</statute_ref>, <br/>
<a id="pl.288.13"></a><var>288.13</var>must not operate after the expiration date. After a license expires, if the former license <br/>
<a id="pl.288.14"></a><var>288.14</var>holder wishes to provide licensed services, the former license holder must submit a new <br/>
<a id="pl.288.15"></a><var>288.15</var>license application and application fee under subdivision 3.<br/>
<a id="pl.288.16"></a><var>288.16</var>    Subd. 7. <b>Human services licensing fees to recover expenditures.</b> Notwithstanding <br/>
<a id="pl.288.17"></a><var>288.17</var>section 
         <statute_ref>16A.1285, subdivision 2</statute_ref>, related to activities for which the commissioner charges <br/>
<a id="pl.288.18"></a><var>288.18</var>a fee, the commissioner must plan to fully recover direct expenditures for licensing <br/>
<a id="pl.288.19"></a><var>288.19</var>activities under this chapter over a five-year period. The commissioner may have <br/>
<a id="pl.288.20"></a><var>288.20</var>anticipated expenditures in excess of anticipated revenues in a biennium by using surplus <br/>
<a id="pl.288.21"></a><var>288.21</var>revenues accumulated in previous bienniums.<br/>
<a id="pl.288.22"></a><var>288.22</var>    Subd. 8. <b>Deposit of license fees.</b> A human services licensing account is created in <br/>
<a id="pl.288.23"></a><var>288.23</var>the state government special revenue fund. Fees collected under subdivisions 3 and 4 must <br/>
<a id="pl.288.24"></a><var>288.24</var>be deposited in the human services licensing account and are annually appropriated to the <br/>
<a id="pl.288.25"></a><var>288.25</var>commissioner for licensing activities authorized under this chapter.<br/>
<a id="pl.288.26"></a><var>288.26</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2013.<br/>
<br/>
<a id="bill.8.12.0"></a><a id="pl.288.27"></a><var>288.27</var>    Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:<br/>
<a id="pl.288.28"></a><var>288.28</var>    Subd. 2a. <b>Adult foster care</b><b> and community residential setting</b><b> license capacity.</b><br/>
<a id="pl.288.29"></a><var>288.29</var>(a) The commissioner shall issue adult foster care and community residential setting<br/>
<a id="pl.288.30"></a><var>288.30</var> licenses with a maximum licensed capacity of four beds, including nonstaff roomers and <br/>
<a id="pl.288.31"></a><var>288.31</var>boarders, except that the commissioner may issue a license with a capacity of five beds, <br/>
<a id="pl.288.32"></a><var>288.32</var>including roomers and boarders, according to paragraphs (b) to (f).<br/>
<a id="pl.288.33"></a><var>288.33</var>(b) An adult foster care The license holder may have a maximum license capacity <br/>
<a id="pl.288.34"></a><var>288.34</var>of five if all persons in care are age 55 or over and do not have a serious and persistent <br/>
<a id="pl.288.35"></a><var>288.35</var>mental illness or a developmental disability.<br/>
<a id="pl.289.1"></a><var>289.1</var>(c) The commissioner may grant variances to paragraph (b) to allow a foster care <br/>
<a id="pl.289.2"></a><var>289.2</var>provider facility with a licensed capacity of five persons to admit an individual under the <br/>
<a id="pl.289.3"></a><var>289.3</var>age of 55 if the variance complies with section 
         <statute_ref>245A.04, subdivision 9</statute_ref>, and approval of <br/>
<a id="pl.289.4"></a><var>289.4</var>the variance is recommended by the county in which the licensed foster care provider<br/>
<a id="pl.289.5"></a><var>289.5</var> facility is located.<br/>
<a id="pl.289.6"></a><var>289.6</var>(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth <br/>
<a id="pl.289.7"></a><var>289.7</var>bed for emergency crisis services for a person with serious and persistent mental illness <br/>
<a id="pl.289.8"></a><var>289.8</var>or a developmental disability, regardless of age, if the variance complies with section <br/>
<statute_ref><a id="pl.289.9"></a><var>289.9</var>245A.04, subdivision 9
         </statute_ref>, and approval of the variance is recommended by the county in <br/>
<a id="pl.289.10"></a><var>289.10</var>which the licensed foster care provider facility is located.<br/>
<a id="pl.289.11"></a><var>289.11</var>(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a <br/>
<a id="pl.289.12"></a><var>289.12</var>fifth bed for respite services, as defined in section 
         <statute_ref>245A.02</statute_ref>, for persons with disabilities, <br/>
<a id="pl.289.13"></a><var>289.13</var>regardless of age, if the variance complies with sections 
         <statute_ref>245A.03, subdivision 7</statute_ref>, and <br/>
<statute_ref><a id="pl.289.14"></a><var>289.14</var>245A.04, subdivision 9
         </statute_ref>, and approval of the variance is recommended by the county in <br/>
<a id="pl.289.15"></a><var>289.15</var>which the licensed foster care provider facility is licensed located. Respite care may be <br/>
<a id="pl.289.16"></a><var>289.16</var>provided under the following conditions:<br/>
<a id="pl.289.17"></a><var>289.17</var>(1) staffing ratios cannot be reduced below the approved level for the individuals <br/>
<a id="pl.289.18"></a><var>289.18</var>being served in the home on a permanent basis;<br/>
<a id="pl.289.19"></a><var>289.19</var>(2) no more than two different individuals can be accepted for respite services in <br/>
<a id="pl.289.20"></a><var>289.20</var>any calendar month and the total respite days may not exceed 120 days per program in <br/>
<a id="pl.289.21"></a><var>289.21</var>any calendar year;<br/>
<a id="pl.289.22"></a><var>289.22</var>(3) the person receiving respite services must have his or her own bedroom, which <br/>
<a id="pl.289.23"></a><var>289.23</var>could be used for alternative purposes when not used as a respite bedroom, and cannot be <br/>
<a id="pl.289.24"></a><var>289.24</var>the room of another person who lives in the foster care home facility; and<br/>
<a id="pl.289.25"></a><var>289.25</var>(4) individuals living in the foster care home facility must be notified when the <br/>
<a id="pl.289.26"></a><var>289.26</var>variance is approved. The provider must give 60 days' notice in writing to the residents <br/>
<a id="pl.289.27"></a><var>289.27</var>and their legal representatives prior to accepting the first respite placement. Notice must <br/>
<a id="pl.289.28"></a><var>289.28</var>be given to residents at least two days prior to service initiation, or as soon as the license <br/>
<a id="pl.289.29"></a><var>289.29</var>holder is able if they receive notice of the need for respite less than two days prior to <br/>
<a id="pl.289.30"></a><var>289.30</var>initiation, each time a respite client will be served, unless the requirement for this notice is <br/>
<a id="pl.289.31"></a><var>289.31</var>waived by the resident or legal guardian.<br/>
<a id="pl.289.32"></a><var>289.32</var>(f) The commissioner may issue an adult foster care or community residential setting<br/>
<a id="pl.289.33"></a><var>289.33</var> license with a capacity of five adults if the fifth bed does not increase the overall statewide <br/>
<a id="pl.289.34"></a><var>289.34</var>capacity of licensed adult foster care or community residential setting beds in homes that <br/>
<a id="pl.289.35"></a><var>289.35</var>are not the primary residence of the license holder, as identified in a plan submitted to the <br/>
<a id="pl.290.1"></a><var>290.1</var>commissioner by the county, when the capacity is recommended by the county licensing <br/>
<a id="pl.290.2"></a><var>290.2</var>agency of the county in which the facility is located and if the recommendation verifies that:<br/>
<a id="pl.290.3"></a><var>290.3</var>(1) the facility meets the physical environment requirements in the adult foster <br/>
<a id="pl.290.4"></a><var>290.4</var>care licensing rule;<br/>
<a id="pl.290.5"></a><var>290.5</var>(2) the five-bed living arrangement is specified for each resident in the resident's:<br/>
<a id="pl.290.6"></a><var>290.6</var>(i) individualized plan of care;<br/>
<a id="pl.290.7"></a><var>290.7</var>(ii) individual service plan under section 
         <statute_ref>256B.092, subdivision 1b</statute_ref>, if required; or<br/>
<a id="pl.290.8"></a><var>290.8</var>(iii) individual resident placement agreement under Minnesota Rules, part <br/>
<a id="pl.290.9"></a><var>290.9</var>9555.5105, subpart 19, if required;<br/>
<a id="pl.290.10"></a><var>290.10</var>(3) the license holder obtains written and signed informed consent from each <br/>
<a id="pl.290.11"></a><var>290.11</var>resident or resident's legal representative documenting the resident's informed choice <br/>
<a id="pl.290.12"></a><var>290.12</var>to remain living in the home and that the resident's refusal to consent would not have <br/>
<a id="pl.290.13"></a><var>290.13</var>resulted in service termination; and<br/>
<a id="pl.290.14"></a><var>290.14</var>(4) the facility was licensed for adult foster care before March 1, 2011.<br/>
<a id="pl.290.15"></a><var>290.15</var>(g) The commissioner shall not issue a new adult foster care license under paragraph <br/>
<a id="pl.290.16"></a><var>290.16</var>(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care <br/>
<a id="pl.290.17"></a><var>290.17</var>license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five <br/>
<a id="pl.290.18"></a><var>290.18</var>adults if the license holder continues to comply with the requirements in paragraph (f).<br/>
<br/>
<a id="bill.8.13.0"></a><a id="pl.290.19"></a><var>290.19</var>    Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:<br/>
<a id="pl.290.20"></a><var>290.20</var>    Subd. 7. <b>Adult foster care; variance for alternate overnight supervision.</b> (a) The <br/>
<a id="pl.290.21"></a><var>290.21</var>commissioner may grant a variance under section 
         <statute_ref>245A.04, subdivision 9</statute_ref>, to rule parts <br/>
<a id="pl.290.22"></a><var>290.22</var>requiring a caregiver to be present in an adult foster care home during normal sleeping <br/>
<a id="pl.290.23"></a><var>290.23</var>hours to allow for alternative methods of overnight supervision. The commissioner may <br/>
<a id="pl.290.24"></a><var>290.24</var>grant the variance if the local county licensing agency recommends the variance and the <br/>
<a id="pl.290.25"></a><var>290.25</var>county recommendation includes documentation verifying that:<br/>
<a id="pl.290.26"></a><var>290.26</var>    (1) the county has approved the license holder's plan for alternative methods of <br/>
<a id="pl.290.27"></a><var>290.27</var>providing overnight supervision and determined the plan protects the residents' health, <br/>
<a id="pl.290.28"></a><var>290.28</var>safety, and rights;<br/>
<a id="pl.290.29"></a><var>290.29</var>    (2) the license holder has obtained written and signed informed consent from <br/>
<a id="pl.290.30"></a><var>290.30</var>each resident or each resident's legal representative documenting the resident's or legal <br/>
<a id="pl.290.31"></a><var>290.31</var>representative's agreement with the alternative method of overnight supervision; and<br/>
<a id="pl.290.32"></a><var>290.32</var>    (3) the alternative method of providing overnight supervision, which may include <br/>
<a id="pl.290.33"></a><var>290.33</var>the use of technology, is specified for each resident in the resident's: (i) individualized <br/>
<a id="pl.290.34"></a><var>290.34</var>plan of care; (ii) individual service plan under section 
         <statute_ref>256B.092, subdivision 1b</statute_ref>, if <br/>
<a id="pl.291.1"></a><var>291.1</var>required; or (iii) individual resident placement agreement under Minnesota Rules, part <br/>
<a id="pl.291.2"></a><var>291.2</var>9555.5105, subpart 19, if required.<br/>
<a id="pl.291.3"></a><var>291.3</var>    (b) To be eligible for a variance under paragraph (a), the adult foster care license <br/>
<a id="pl.291.4"></a><var>291.4</var>holder must not have had a conditional license issued under section 
         <statute_ref>245A.06</statute_ref>, or any <br/>
<a id="pl.291.5"></a><var>291.5</var>other licensing sanction issued under section 
         <statute_ref>245A.07</statute_ref> during the prior 24 months based <br/>
<a id="pl.291.6"></a><var>291.6</var>on failure to provide adequate supervision, health care services, or resident safety in <br/>
<a id="pl.291.7"></a><var>291.7</var>the adult foster care home.<br/>
<a id="pl.291.8"></a><var>291.8</var>    (c) A license holder requesting a variance under this subdivision to utilize <br/>
<a id="pl.291.9"></a><var>291.9</var>technology as a component of a plan for alternative overnight supervision may request <br/>
<a id="pl.291.10"></a><var>291.10</var>the commissioner's review in the absence of a county recommendation. Upon receipt of <br/>
<a id="pl.291.11"></a><var>291.11</var>such a request from a license holder, the commissioner shall review the variance request <br/>
<a id="pl.291.12"></a><var>291.12</var>with the county.<br/>
<a id="pl.291.13"></a><var>291.13</var>(d) A variance granted by the commissioner according to this subdivision before <br/>
<a id="pl.291.14"></a><var>291.14</var>January 1, 2014, to a license holder for an adult foster care home must transfer with the <br/>
<a id="pl.291.15"></a><var>291.15</var>license when the license converts to a community residential setting license under chapter <br/>
<a id="pl.291.16"></a><var>291.16</var>245D. The terms and conditions of the variance remain in effect as approved at the time <br/>
<a id="pl.291.17"></a><var>291.17</var>the variance was granted.<br/>
<br/>
<a id="bill.8.14.0"></a><a id="pl.291.18"></a><var>291.18</var>    Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:<br/>
<a id="pl.291.19"></a><var>291.19</var>    Subd. 7a. <b>Alternate overnight supervision technology; adult foster care </b><b>license</b><br/>
<a id="pl.291.20"></a><var>291.20</var><b> and community residential setting licenses</b><b>.</b> (a) The commissioner may grant an <br/>
<a id="pl.291.21"></a><var>291.21</var>applicant or license holder an adult foster care or community residential setting license <br/>
<a id="pl.291.22"></a><var>291.22</var>for a residence that does not have a caregiver in the residence during normal sleeping <br/>
<a id="pl.291.23"></a><var>291.23</var>hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section <br/>
<a id="pl.291.24"></a><var>291.24</var>245D.02, subdivision 33b, but uses monitoring technology to alert the license holder <br/>
<a id="pl.291.25"></a><var>291.25</var>when an incident occurs that may jeopardize the health, safety, or rights of a foster <br/>
<a id="pl.291.26"></a><var>291.26</var>care recipient. The applicant or license holder must comply with all other requirements <br/>
<a id="pl.291.27"></a><var>291.27</var>under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under <br/>
<a id="pl.291.28"></a><var>291.28</var>chapter 245D, and the requirements under this subdivision. The license printed by the <br/>
<a id="pl.291.29"></a><var>291.29</var>commissioner must state in bold and large font:<br/>
<a id="pl.291.30"></a><var>291.30</var>    (1) that the facility is under electronic monitoring; and<br/>
<a id="pl.291.31"></a><var>291.31</var>    (2) the telephone number of the county's common entry point for making reports of <br/>
<a id="pl.291.32"></a><var>291.32</var>suspected maltreatment of vulnerable adults under section 
         <statute_ref>626.557, subdivision 9</statute_ref>.<br/>
<a id="pl.291.33"></a><var>291.33</var>(b) Applications for a license under this section must be submitted directly to <br/>
<a id="pl.291.34"></a><var>291.34</var>the Department of Human Services licensing division. The licensing division must <br/>
<a id="pl.291.35"></a><var>291.35</var>immediately notify the host county and lead county contract agency and the host county <br/>
<a id="pl.292.1"></a><var>292.1</var>licensing agency. The licensing division must collaborate with the county licensing <br/>
<a id="pl.292.2"></a><var>292.2</var>agency in the review of the application and the licensing of the program.<br/>
<a id="pl.292.3"></a><var>292.3</var>    (c) Before a license is issued by the commissioner, and for the duration of the <br/>
<a id="pl.292.4"></a><var>292.4</var>license, the applicant or license holder must establish, maintain, and document the <br/>
<a id="pl.292.5"></a><var>292.5</var>implementation of written policies and procedures addressing the requirements in <br/>
<a id="pl.292.6"></a><var>292.6</var>paragraphs (d) through (f).<br/>
<a id="pl.292.7"></a><var>292.7</var>    (d) The applicant or license holder must have policies and procedures that:<br/>
<a id="pl.292.8"></a><var>292.8</var>    (1) establish characteristics of target populations that will be admitted into the home, <br/>
<a id="pl.292.9"></a><var>292.9</var>and characteristics of populations that will not be accepted into the home;<br/>
<a id="pl.292.10"></a><var>292.10</var>    (2) explain the discharge process when a foster care recipient resident served by the <br/>
<a id="pl.292.11"></a><var>292.11</var>program requires overnight supervision or other services that cannot be provided by the <br/>
<a id="pl.292.12"></a><var>292.12</var>license holder due to the limited hours that the license holder is on site;<br/>
<a id="pl.292.13"></a><var>292.13</var>    (3) describe the types of events to which the program will respond with a physical <br/>
<a id="pl.292.14"></a><var>292.14</var>presence when those events occur in the home during time when staff are not on site, and <br/>
<a id="pl.292.15"></a><var>292.15</var>how the license holder's response plan meets the requirements in paragraph (e), clause <br/>
<a id="pl.292.16"></a><var>292.16</var>(1) or (2);<br/>
<a id="pl.292.17"></a><var>292.17</var>    (4) establish a process for documenting a review of the implementation and <br/>
<a id="pl.292.18"></a><var>292.18</var>effectiveness of the response protocol for the response required under paragraph (e), <br/>
<a id="pl.292.19"></a><var>292.19</var>clause (1) or (2). The documentation must include:<br/>
<a id="pl.292.20"></a><var>292.20</var>    (i) a description of the triggering incident;<br/>
<a id="pl.292.21"></a><var>292.21</var>    (ii) the date and time of the triggering incident;<br/>
<a id="pl.292.22"></a><var>292.22</var>    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);<br/>
<a id="pl.292.23"></a><var>292.23</var>    (iv) whether the response met the resident's needs;<br/>
<a id="pl.292.24"></a><var>292.24</var>    (v) whether the existing policies and response protocols were followed; and<br/>
<a id="pl.292.25"></a><var>292.25</var>    (vi) whether the existing policies and protocols are adequate or need modification.<br/>
<a id="pl.292.26"></a><var>292.26</var>    When no physical presence response is completed for a three-month period, the <br/>
<a id="pl.292.27"></a><var>292.27</var>license holder's written policies and procedures must require a physical presence response <br/>
<a id="pl.292.28"></a><var>292.28</var>drill to be conducted for which the effectiveness of the response protocol under paragraph <br/>
<a id="pl.292.29"></a><var>292.29</var>(e), clause (1) or (2), will be reviewed and documented as required under this clause; and<br/>
<a id="pl.292.30"></a><var>292.30</var>    (5) establish that emergency and nonemergency phone numbers are posted in a <br/>
<a id="pl.292.31"></a><var>292.31</var>prominent location in a common area of the home where they can be easily observed by a <br/>
<a id="pl.292.32"></a><var>292.32</var>person responding to an incident who is not otherwise affiliated with the home.<br/>
<a id="pl.292.33"></a><var>292.33</var>    (e) The license holder must document and include in the license application which <br/>
<a id="pl.292.34"></a><var>292.34</var>response alternative under clause (1) or (2) is in place for responding to situations that <br/>
<a id="pl.292.35"></a><var>292.35</var>present a serious risk to the health, safety, or rights of people receiving foster care services <br/>
<a id="pl.292.36"></a><var>292.36</var>in the home residents served by the program:<br/>
<a id="pl.293.1"></a><var>293.1</var>    (1) response alternative (1) requires only the technology to provide an electronic <br/>
<a id="pl.293.2"></a><var>293.2</var>notification or alert to the license holder that an event is underway that requires a response. <br/>
<a id="pl.293.3"></a><var>293.3</var>Under this alternative, no more than ten minutes will pass before the license holder will be <br/>
<a id="pl.293.4"></a><var>293.4</var>physically present on site to respond to the situation; or<br/>
<a id="pl.293.5"></a><var>293.5</var>    (2) response alternative (2) requires the electronic notification and alert system under <br/>
<a id="pl.293.6"></a><var>293.6</var>alternative (1), but more than ten minutes may pass before the license holder is present on <br/>
<a id="pl.293.7"></a><var>293.7</var>site to respond to the situation. Under alternative (2), all of the following conditions are met:<br/>
<a id="pl.293.8"></a><var>293.8</var>    (i) the license holder has a written description of the interactive technological <br/>
<a id="pl.293.9"></a><var>293.9</var>applications that will assist the license holder in communicating with and assessing the <br/>
<a id="pl.293.10"></a><var>293.10</var>needs related to the care, health, and safety of the foster care recipients. This interactive <br/>
<a id="pl.293.11"></a><var>293.11</var>technology must permit the license holder to remotely assess the well being of the foster <br/>
<a id="pl.293.12"></a><var>293.12</var>care recipient resident served by the program without requiring the initiation of the <br/>
<a id="pl.293.13"></a><var>293.13</var>foster care recipient. Requiring the foster care recipient to initiate a telephone call does <br/>
<a id="pl.293.14"></a><var>293.14</var>not meet this requirement;<br/>
<a id="pl.293.15"></a><var>293.15</var>(ii) the license holder documents how the remote license holder is qualified and <br/>
<a id="pl.293.16"></a><var>293.16</var>capable of meeting the needs of the foster care recipients and assessing foster care <br/>
<a id="pl.293.17"></a><var>293.17</var>recipients' needs under item (i) during the absence of the license holder on site;<br/>
<a id="pl.293.18"></a><var>293.18</var>(iii) the license holder maintains written procedures to dispatch emergency response <br/>
<a id="pl.293.19"></a><var>293.19</var>personnel to the site in the event of an identified emergency; and<br/>
<a id="pl.293.20"></a><var>293.20</var>    (iv) each foster care recipient's resident's individualized plan of care, individual <br/>
<a id="pl.293.21"></a><var>293.21</var>service plan coordinated service and support plan under section sections 256B.0913, <br/>
<a id="pl.293.22"></a><var>293.22</var>subdivision 8; 256B.0915, subdivision 6; 
<statute_ref>256B.092, subdivision 1b</statute_ref>; and 256B.49, <br/>
<a id="pl.293.23"></a><var>293.23</var>subdivision 15, if required, or individual resident placement agreement under Minnesota <br/>
<a id="pl.293.24"></a><var>293.24</var>Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time, <br/>
<a id="pl.293.25"></a><var>293.25</var>which may be greater than ten minutes, for the license holder to be on site for that foster <br/>
<a id="pl.293.26"></a><var>293.26</var>care recipient resident.<br/>
<a id="pl.293.27"></a><var>293.27</var>    (f) Each foster care recipient's resident's placement agreement, individual service <br/>
<a id="pl.293.28"></a><var>293.28</var>agreement, and plan must clearly state that the adult foster care or community residential <br/>
<a id="pl.293.29"></a><var>293.29</var>setting license category is a program without the presence of a caregiver in the residence <br/>
<a id="pl.293.30"></a><var>293.30</var>during normal sleeping hours; the protocols in place for responding to situations that <br/>
<a id="pl.293.31"></a><var>293.31</var>present a serious risk to the health, safety, or rights of foster care recipients residents <br/>
<a id="pl.293.32"></a><var>293.32</var>served by the program under paragraph (e), clause (1) or (2); and a signed informed <br/>
<a id="pl.293.33"></a><var>293.33</var>consent from each foster care recipient resident served by the program or the person's <br/>
<a id="pl.293.34"></a><var>293.34</var>legal representative documenting the person's or legal representative's agreement with <br/>
<a id="pl.293.35"></a><var>293.35</var>placement in the program. If electronic monitoring technology is used in the home, the <br/>
<a id="pl.293.36"></a><var>293.36</var>informed consent form must also explain the following:<br/>
<a id="pl.294.1"></a><var>294.1</var>    (1) how any electronic monitoring is incorporated into the alternative supervision <br/>
<a id="pl.294.2"></a><var>294.2</var>system;<br/>
<a id="pl.294.3"></a><var>294.3</var>    (2) the backup system for any electronic monitoring in times of electrical outages or <br/>
<a id="pl.294.4"></a><var>294.4</var>other equipment malfunctions;<br/>
<a id="pl.294.5"></a><var>294.5</var>    (3) how the caregivers or direct support staff are trained on the use of the technology;<br/>
<a id="pl.294.6"></a><var>294.6</var>    (4) the event types and license holder response times established under paragraph (e);<br/>
<a id="pl.294.7"></a><var>294.7</var>    (5) how the license holder protects the foster care recipient's each resident's privacy <br/>
<a id="pl.294.8"></a><var>294.8</var>related to electronic monitoring and related to any electronically recorded data generated <br/>
<a id="pl.294.9"></a><var>294.9</var>by the monitoring system. A foster care recipient resident served by the program may <br/>
<a id="pl.294.10"></a><var>294.10</var>not be removed from a program under this subdivision for failure to consent to electronic <br/>
<a id="pl.294.11"></a><var>294.11</var>monitoring. The consent form must explain where and how the electronically recorded <br/>
<a id="pl.294.12"></a><var>294.12</var>data is stored, with whom it will be shared, and how long it is retained; and<br/>
<a id="pl.294.13"></a><var>294.13</var>    (6) the risks and benefits of the alternative overnight supervision system.<br/>
<a id="pl.294.14"></a><var>294.14</var>    The written explanations under clauses (1) to (6) may be accomplished through <br/>
<a id="pl.294.15"></a><var>294.15</var>cross-references to other policies and procedures as long as they are explained to the <br/>
<a id="pl.294.16"></a><var>294.16</var>person giving consent, and the person giving consent is offered a copy.<br/>
<a id="pl.294.17"></a><var>294.17</var>(g) Nothing in this section requires the applicant or license holder to develop or <br/>
<a id="pl.294.18"></a><var>294.18</var>maintain separate or duplicative policies, procedures, documentation, consent forms, or <br/>
<a id="pl.294.19"></a><var>294.19</var>individual plans that may be required for other licensing standards, if the requirements of <br/>
<a id="pl.294.20"></a><var>294.20</var>this section are incorporated into those documents.<br/>
<a id="pl.294.21"></a><var>294.21</var>(h) The commissioner may grant variances to the requirements of this section <br/>
<a id="pl.294.22"></a><var>294.22</var>according to section 
         <statute_ref>245A.04, subdivision 9</statute_ref>.<br/>
<a id="pl.294.23"></a><var>294.23</var>(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning <br/>
<a id="pl.294.24"></a><var>294.24</var>under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and <br/>
<a id="pl.294.25"></a><var>294.25</var>contractors affiliated with the license holder.<br/>
<a id="pl.294.26"></a><var>294.26</var>(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to <br/>
<a id="pl.294.27"></a><var>294.27</var>remotely determine what action the license holder needs to take to protect the well-being <br/>
<a id="pl.294.28"></a><var>294.28</var>of the foster care recipient.<br/>
<a id="pl.294.29"></a><var>294.29</var>(k) The commissioner shall evaluate license applications using the requirements <br/>
<a id="pl.294.30"></a><var>294.30</var>in paragraphs (d) to (f). The commissioner shall provide detailed application forms, <br/>
<a id="pl.294.31"></a><var>294.31</var>including a checklist of criteria needed for approval.<br/>
<a id="pl.294.32"></a><var>294.32</var>(l) To be eligible for a license under paragraph (a), the adult foster care or community <br/>
<a id="pl.294.33"></a><var>294.33</var>residential setting license holder must not have had a conditional license issued under <br/>
<a id="pl.294.34"></a><var>294.34</var>section 
         <statute_ref>245A.06</statute_ref> or any licensing sanction under section 
         <statute_ref>245A.07</statute_ref> during the prior 24 <br/>
<a id="pl.294.35"></a><var>294.35</var>months based on failure to provide adequate supervision, health care services, or resident <br/>
<a id="pl.294.36"></a><var>294.36</var>safety in the adult foster care home or community residential setting.<br/>
<a id="pl.295.1"></a><var>295.1</var>(m) The commissioner shall review an application for an alternative overnight <br/>
<a id="pl.295.2"></a><var>295.2</var>supervision license within 60 days of receipt of the application. When the commissioner <br/>
<a id="pl.295.3"></a><var>295.3</var>receives an application that is incomplete because the applicant failed to submit required <br/>
<a id="pl.295.4"></a><var>295.4</var>documents or that is substantially deficient because the documents submitted do not meet <br/>
<a id="pl.295.5"></a><var>295.5</var>licensing requirements, the commissioner shall provide the applicant written notice <br/>
<a id="pl.295.6"></a><var>295.6</var>that the application is incomplete or substantially deficient. In the written notice to the <br/>
<a id="pl.295.7"></a><var>295.7</var>applicant, the commissioner shall identify documents that are missing or deficient and <br/>
<a id="pl.295.8"></a><var>295.8</var>give the applicant 45 days to resubmit a second application that is substantially complete. <br/>
<a id="pl.295.9"></a><var>295.9</var>An applicant's failure to submit a substantially complete application after receiving <br/>
<a id="pl.295.10"></a><var>295.10</var>notice from the commissioner is a basis for license denial under section 
         <statute_ref>245A.05</statute_ref>. The <br/>
<a id="pl.295.11"></a><var>295.11</var>commissioner shall complete subsequent review within 30 days.<br/>
<a id="pl.295.12"></a><var>295.12</var>(n) Once the application is considered complete under paragraph (m), the <br/>
<a id="pl.295.13"></a><var>295.13</var>commissioner will approve or deny an application for an alternative overnight supervision <br/>
<a id="pl.295.14"></a><var>295.14</var>license within 60 days.<br/>
<a id="pl.295.15"></a><var>295.15</var>(o) For the purposes of this subdivision, "supervision" means:<br/>
<a id="pl.295.16"></a><var>295.16</var>(1) oversight by a caregiver or direct support staff as specified in the individual <br/>
<a id="pl.295.17"></a><var>295.17</var>resident's place agreement or coordinated service and support plan and awareness of the <br/>
<a id="pl.295.18"></a><var>295.18</var>resident's needs and activities; and<br/>
<a id="pl.295.19"></a><var>295.19</var>(2) the presence of a caregiver or direct support staff in a residence during normal <br/>
<a id="pl.295.20"></a><var>295.20</var>sleeping hours, unless a determination has been made and documented in the individual's<br/>
<a id="pl.295.21"></a><var>295.21</var> coordinated service and support plan that the individual does not require the presence of a <br/>
<a id="pl.295.22"></a><var>295.22</var>caregiver or direct support staff during normal sleeping hours.<br/>
<br/>
<a id="bill.8.15.0"></a><a id="pl.295.23"></a><var>295.23</var>    Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:<br/>
<a id="pl.295.24"></a><var>295.24</var>    Subd. 7b. <b>Adult foster care data privacy and security.</b> (a) An adult foster care<br/>
<a id="pl.295.25"></a><var>295.25</var> or community residential setting license holder who creates, collects, records, maintains, <br/>
<a id="pl.295.26"></a><var>295.26</var>stores, or discloses any individually identifiable recipient data, whether in an electronic <br/>
<a id="pl.295.27"></a><var>295.27</var>or any other format, must comply with the privacy and security provisions of applicable <br/>
<a id="pl.295.28"></a><var>295.28</var>privacy laws and regulations, including:<br/>
<a id="pl.295.29"></a><var>295.29</var>(1) the federal Health Insurance Portability and Accountability Act of 1996 <br/>
<a id="pl.295.30"></a><var>295.30</var>(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, <br/>
<a id="pl.295.31"></a><var>295.31</var>title 45, part 160, and subparts A and E of part 164; and<br/>
<a id="pl.295.32"></a><var>295.32</var>(2) the Minnesota Government Data Practices Act as codified in chapter 13.<br/>
<a id="pl.295.33"></a><var>295.33</var>(b) For purposes of licensure, the license holder shall be monitored for compliance <br/>
<a id="pl.295.34"></a><var>295.34</var>with the following data privacy and security provisions:<br/>
<a id="pl.296.1"></a><var>296.1</var>(1) the license holder must control access to data on foster care recipients residents <br/>
<a id="pl.296.2"></a><var>296.2</var>served by the program according to the definitions of public and private data on individuals <br/>
<a id="pl.296.3"></a><var>296.3</var>under section 
         <statute_ref>13.02</statute_ref>; classification of the data on individuals as private under section <br/>
<statute_ref><a id="pl.296.4"></a><var>296.4</var>13.46, subdivision 2
         </statute_ref>; and control over the collection, storage, use, access, protection, <br/>
<a id="pl.296.5"></a><var>296.5</var>and contracting related to data according to section 
         <statute_ref>13.05</statute_ref>, in which the license holder is <br/>
<a id="pl.296.6"></a><var>296.6</var>assigned the duties of a government entity;<br/>
<a id="pl.296.7"></a><var>296.7</var>(2) the license holder must provide each foster care recipient resident served by <br/>
<a id="pl.296.8"></a><var>296.8</var>the program with a notice that meets the requirements under section 
         <statute_ref>13.04</statute_ref>, in which <br/>
<a id="pl.296.9"></a><var>296.9</var>the license holder is assigned the duties of the government entity, and that meets the <br/>
<a id="pl.296.10"></a><var>296.10</var>requirements of Code of Federal Regulations, title 45, part 
         <statute_ref>164.52</statute_ref>. The notice shall <br/>
<a id="pl.296.11"></a><var>296.11</var>describe the purpose for collection of the data, and to whom and why it may be disclosed <br/>
<a id="pl.296.12"></a><var>296.12</var>pursuant to law. The notice must inform the recipient individual that the license holder <br/>
<a id="pl.296.13"></a><var>296.13</var>uses electronic monitoring and, if applicable, that recording technology is used;<br/>
<a id="pl.296.14"></a><var>296.14</var>(3) the license holder must not install monitoring cameras in bathrooms;<br/>
<a id="pl.296.15"></a><var>296.15</var>(4) electronic monitoring cameras must not be concealed from the foster care <br/>
<a id="pl.296.16"></a><var>296.16</var>recipients residents served by the program; and<br/>
<a id="pl.296.17"></a><var>296.17</var>(5) electronic video and audio recordings of foster care recipients residents served <br/>
<a id="pl.296.18"></a><var>296.18</var>by the program shall be stored by the license holder for five days unless: (i) a foster care <br/>
<a id="pl.296.19"></a><var>296.19</var>recipient resident served by the program or legal representative requests that the recording <br/>
<a id="pl.296.20"></a><var>296.20</var>be held longer based on a specific report of alleged maltreatment; or (ii) the recording <br/>
<a id="pl.296.21"></a><var>296.21</var>captures an incident or event of alleged maltreatment under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref> or <br/>
<a id="pl.296.22"></a><var>296.22</var>a crime under chapter 609. When requested by a recipient resident served by the program<br/>
<a id="pl.296.23"></a><var>296.23</var> or when a recording captures an incident or event of alleged maltreatment or a crime, the <br/>
<a id="pl.296.24"></a><var>296.24</var>license holder must maintain the recording in a secured area for no longer than 30 days <br/>
<a id="pl.296.25"></a><var>296.25</var>to give the investigating agency an opportunity to make a copy of the recording. The <br/>
<a id="pl.296.26"></a><var>296.26</var>investigating agency will maintain the electronic video or audio recordings as required in <br/>
<a id="pl.296.27"></a><var>296.27</var>section 
         <statute_ref>626.557, subdivision 12b</statute_ref>.<br/>
<a id="pl.296.28"></a><var>296.28</var>(c) The commissioner shall develop, and make available to license holders and <br/>
<a id="pl.296.29"></a><var>296.29</var>county licensing workers, a checklist of the data privacy provisions to be monitored <br/>
<a id="pl.296.30"></a><var>296.30</var>for purposes of licensure.<br/>
<br/>
<a id="bill.8.16.0"></a><a id="pl.296.31"></a><var>296.31</var>    Sec. 16. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:<br/>
<a id="pl.296.32"></a><var>296.32</var>    Subd. 8. <b>Community residential setting license.</b> (a) The commissioner shall <br/>
<a id="pl.296.33"></a><var>296.33</var>establish provider standards for residential support services that integrate service standards <br/>
<a id="pl.296.34"></a><var>296.34</var>and the residential setting under one license. The commissioner shall propose statutory <br/>
<a id="pl.296.35"></a><var>296.35</var>language and an implementation plan for licensing requirements for residential support <br/>
<a id="pl.297.1"></a><var>297.1</var>services to the legislature by January 15, 2012, as a component of the quality outcome <br/>
<a id="pl.297.2"></a><var>297.2</var>standards recommendations required by Laws 2010, chapter 352, article 1, section 24.<br/>
<a id="pl.297.3"></a><var>297.3</var>(b) Providers licensed under chapter 245B, and providing, contracting, or arranging <br/>
<a id="pl.297.4"></a><var>297.4</var>for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105 <br/>
<a id="pl.297.5"></a><var>297.5</var>to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340; <br/>
<a id="pl.297.6"></a><var>297.6</var>and meeting the provisions of section 
<statute_ref>256B.092, subdivision 11</statute_ref>, paragraph (b) section <br/>
<a id="pl.297.7"></a><var>297.7</var>245D.02, subdivision 4a, must be required to obtain a community residential setting license.<br/>
<br/>
<a id="bill.8.17.0"></a><a id="pl.297.8"></a><var>297.8</var>    Sec. 17. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:<br/>
<a id="pl.297.9"></a><var>297.9</var>    Subdivision 1. <b>Delegation of authority to agencies.</b> (a) County agencies and <br/>
<a id="pl.297.10"></a><var>297.10</var>private agencies that have been designated or licensed by the commissioner to perform <br/>
<a id="pl.297.11"></a><var>297.11</var>licensing functions and activities under section 
         <statute_ref>245A.04</statute_ref> and background studies for family <br/>
<a id="pl.297.12"></a><var>297.12</var>child care under chapter 245C; to recommend denial of applicants under section 
         <statute_ref>245A.05</statute_ref>; <br/>
<a id="pl.297.13"></a><var>297.13</var>to issue correction orders, to issue variances, and recommend a conditional license under <br/>
<a id="pl.297.14"></a><var>297.14</var>section 
         <statute_ref>245A.06</statute_ref>, or to recommend suspending or revoking a license or issuing a fine under <br/>
<a id="pl.297.15"></a><var>297.15</var>section 
         <statute_ref>245A.07</statute_ref>, shall comply with rules and directives of the commissioner governing <br/>
<a id="pl.297.16"></a><var>297.16</var>those functions and with this section. The following variances are excluded from the <br/>
<a id="pl.297.17"></a><var>297.17</var>delegation of variance authority and may be issued only by the commissioner:<br/>
<a id="pl.297.18"></a><var>297.18</var>    (1) dual licensure of family child care and child foster care, dual licensure of child <br/>
<a id="pl.297.19"></a><var>297.19</var>and adult foster care, and adult foster care and family child care;<br/>
<a id="pl.297.20"></a><var>297.20</var>    (2) adult foster care maximum capacity;<br/>
<a id="pl.297.21"></a><var>297.21</var>    (3) adult foster care minimum age requirement;<br/>
<a id="pl.297.22"></a><var>297.22</var>    (4) child foster care maximum age requirement;<br/>
<a id="pl.297.23"></a><var>297.23</var>    (5) variances regarding disqualified individuals except that county agencies may <br/>
<a id="pl.297.24"></a><var>297.24</var>issue variances under section 
         <statute_ref>245C.30</statute_ref> regarding disqualified individuals when the county <br/>
<a id="pl.297.25"></a><var>297.25</var>is responsible for conducting a consolidated reconsideration according to sections 
         <statute_ref>245C.25 <br/>
</statute_ref><a id="pl.297.26"></a><var>297.26</var>and 
         <statute_ref>245C.27, subdivision 2</statute_ref>, clauses (a) and (b), of a county maltreatment determination <br/>
<a id="pl.297.27"></a><var>297.27</var>and a disqualification based on serious or recurring maltreatment; and<br/>
<a id="pl.297.28"></a><var>297.28</var>    (6) the required presence of a caregiver in the adult foster care residence during <br/>
<a id="pl.297.29"></a><var>297.29</var>normal sleeping hours; and<br/>
<a id="pl.297.30"></a><var>297.30</var>    (7) variances for community residential setting licenses under chapter 245D.<br/>
<a id="pl.297.31"></a><var>297.31</var>Except as provided in section 
         <statute_ref>245A.14, subdivision 4</statute_ref>, paragraph (e), a county agency <br/>
<a id="pl.297.32"></a><var>297.32</var>must not grant a license holder a variance to exceed the maximum allowable family child <br/>
<a id="pl.297.33"></a><var>297.33</var>care license capacity of 14 children.<br/>
<a id="pl.297.34"></a><var>297.34</var>    (b) County agencies must report information about disqualification reconsiderations <br/>
<a id="pl.297.35"></a><var>297.35</var>under sections 
         <statute_ref>245C.25</statute_ref> and 
         <statute_ref>245C.27, subdivision 2</statute_ref>, paragraphs (a) and (b), and variances <br/>
<a id="pl.298.1"></a><var>298.1</var>granted under paragraph (a), clause (5), to the commissioner at least monthly in a format <br/>
<a id="pl.298.2"></a><var>298.2</var>prescribed by the commissioner.<br/>
<a id="pl.298.3"></a><var>298.3</var>    (c) For family day care programs, the commissioner may authorize licensing reviews <br/>
<a id="pl.298.4"></a><var>298.4</var>every two years after a licensee has had at least one annual review.<br/>
<a id="pl.298.5"></a><var>298.5</var>    (d) For family adult day services programs, the commissioner may authorize <br/>
<a id="pl.298.6"></a><var>298.6</var>licensing reviews every two years after a licensee has had at least one annual review.<br/>
<a id="pl.298.7"></a><var>298.7</var>    (e) A license issued under this section may be issued for up to two years.<br/>
<br/>
<a id="bill.8.18.0"></a><a id="pl.298.8"></a><var>298.8</var>    Sec. 18. Minnesota Statutes 2012, section 245D.02, is amended to read:<br/>
<a id="pl.298.9"></a><var>298.9</var><b>245D.02 DEFINITIONS.</b><br/>
<a id="pl.298.10"></a><var>298.10</var>    Subdivision 1. <b>Scope.</b> The terms used in this chapter have the meanings given <br/>
<a id="pl.298.11"></a><var>298.11</var>them in this section.<br/>
<a id="pl.298.12"></a><var>298.12</var>    Subd. 2. <b>Annual and annually.</b> "Annual" and "annually" have the meaning given <br/>
<a id="pl.298.13"></a><var>298.13</var>in section 
         <statute_ref>245A.02, subdivision 2b</statute_ref>.<br/>
<a id="pl.298.14"></a><var>298.14</var>    Subd. 2a. <b>Authorized representative.</b> "Authorized representative" means a parent, <br/>
<a id="pl.298.15"></a><var>298.15</var>family member, advocate, or other adult authorized by the person or the person's legal <br/>
<a id="pl.298.16"></a><var>298.16</var>representative, to serve as a representative in connection with the provision of services <br/>
<a id="pl.298.17"></a><var>298.17</var>licensed under this chapter. This authorization must be in writing or by another method <br/>
<a id="pl.298.18"></a><var>298.18</var>that clearly indicates the person's free choice. The authorized representative must have no <br/>
<a id="pl.298.19"></a><var>298.19</var>financial interest in the provision of any services included in the person's service delivery <br/>
<a id="pl.298.20"></a><var>298.20</var>plan and must be capable of providing the support necessary to assist the person in the use <br/>
<a id="pl.298.21"></a><var>298.21</var>of home and community-based services licensed under this chapter.<br/>
<a id="pl.298.22"></a><var>298.22</var>    Subd. 3. <b>Case manager.</b> "Case manager" means the individual designated <br/>
<a id="pl.298.23"></a><var>298.23</var>to provide waiver case management services, care coordination, or long-term care <br/>
<a id="pl.298.24"></a><var>298.24</var>consultation, as specified in sections 
         <statute_ref>256B.0913</statute_ref>, 
         <statute_ref>256B.0915</statute_ref>, 
         <statute_ref>256B.092</statute_ref>, and 
         <statute_ref>256B.49</statute_ref>, <br/>
<a id="pl.298.25"></a><var>298.25</var>or successor provisions.<br/>
<a id="pl.298.26"></a><var>298.26</var>    Subd. 3a. <b>Certification.</b> "Certification" means the commissioner's written <br/>
<a id="pl.298.27"></a><var>298.27</var>authorization for a license holder to provide specialized services based on certification <br/>
<a id="pl.298.28"></a><var>298.28</var>standards in section 245D.33. The term certification and its derivatives have the same <br/>
<a id="pl.298.29"></a><var>298.29</var>meaning and may be substituted for the term licensure and its derivatives in this chapter <br/>
<a id="pl.298.30"></a><var>298.30</var>and chapter 245A.<br/>
<a id="pl.298.31"></a><var>298.31</var>    Subd. 4. <b>Commissioner.</b> "Commissioner" means the commissioner of the <br/>
<a id="pl.298.32"></a><var>298.32</var>Department of Human Services or the commissioner's designated representative.<br/>
<a id="pl.298.33"></a><var>298.33</var>    Subd. 4a. <b>Community residential setting.</b> "Community residential setting" means <br/>
<a id="pl.298.34"></a><var>298.34</var>a residential program as identified in section 245A.11, subdivision 8, where residential <br/>
<a id="pl.298.35"></a><var>298.35</var>supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause <br/>
<a id="pl.299.1"></a><var>299.1</var>(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant <br/>
<a id="pl.299.2"></a><var>299.2</var>of the facility licensed according to this chapter, and the license holder does not reside <br/>
<a id="pl.299.3"></a><var>299.3</var>in the facility.<br/>
<a id="pl.299.4"></a><var>299.4</var>    Subd. 4b. <b>Coordinated service and support plan.</b> "Coordinated service and support <br/>
<a id="pl.299.5"></a><var>299.5</var>plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision <br/>
<a id="pl.299.6"></a><var>299.6</var>6; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.<br/>
<a id="pl.299.7"></a><var>299.7</var>    Subd. 4c. <b>Coordinated service and support plan addendum.</b> "Coordinated <br/>
<a id="pl.299.8"></a><var>299.8</var>service and support plan addendum" means the documentation that this chapter requires <br/>
<a id="pl.299.9"></a><var>299.9</var>of the license holder for each person receiving services.<br/>
<a id="pl.299.10"></a><var>299.10</var>    Subd. 4d. <b>Corporate foster care.</b> "Corporate foster care" means a child foster <br/>
<a id="pl.299.11"></a><var>299.11</var>residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, <br/>
<a id="pl.299.12"></a><var>299.12</var>or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to <br/>
<a id="pl.299.13"></a><var>299.13</var>9555.6265, where the license holder does not live in the home.<br/>
<a id="pl.299.14"></a><var>299.14</var>    Subd. 4e. <b>Cultural competence or culturally competent.</b> "Cultural competence" <br/>
<a id="pl.299.15"></a><var>299.15</var>or "culturally competent" means the ability and the will to respond to the unique needs of <br/>
<a id="pl.299.16"></a><var>299.16</var>a person that arise from the person's culture and the ability to use the person's culture as a <br/>
<a id="pl.299.17"></a><var>299.17</var>resource or tool to assist with the intervention and help meet the person's needs.<br/>
<a id="pl.299.18"></a><var>299.18</var>    Subd. 4f. <b>Day services facility.</b> "Day services facility" means a facility licensed <br/>
<a id="pl.299.19"></a><var>299.19</var>according to this chapter at which persons receive day services licensed under this chapter <br/>
<a id="pl.299.20"></a><var>299.20</var>from the license holder's direct support staff for a cumulative total of more than 30 days <br/>
<a id="pl.299.21"></a><var>299.21</var>within any 12-month period and the license holder is the owner, lessor, or tenant of the <br/>
<a id="pl.299.22"></a><var>299.22</var>facility.<br/>
<a id="pl.299.23"></a><var>299.23</var>    Subd. 5. <b>Department.</b> "Department" means the Department of Human Services.<br/>
<a id="pl.299.24"></a><var>299.24</var>    Subd. 6. <b>Direct contact.</b> "Direct contact" has the meaning given in section 
         <statute_ref>245C.02, <br/>
<a id="pl.299.25"></a><var>299.25</var>subdivision 11
         </statute_ref>, and is used interchangeably with the term "direct support service."<br/>
<a id="pl.299.26"></a><var>299.26</var>    Subd. 6a. <b>Direct support staff or staff.</b> "Direct support staff" or "staff" means <br/>
<a id="pl.299.27"></a><var>299.27</var>employees of the license holder who have direct contact with persons served by the <br/>
<a id="pl.299.28"></a><var>299.28</var>program and includes temporary staff or subcontractors, regardless of employer, providing <br/>
<a id="pl.299.29"></a><var>299.29</var>program services for hire under the control of the license holder who have direct contact <br/>
<a id="pl.299.30"></a><var>299.30</var>with persons served by the program.<br/>
<a id="pl.299.31"></a><var>299.31</var>    Subd. 7. <b>Drug.</b> "Drug" has the meaning given in section 
         <statute_ref>151.01, subdivision 5</statute_ref>.<br/>
<a id="pl.299.32"></a><var>299.32</var>    Subd. 8. <b>Emergency.</b> "Emergency" means any event that affects the ordinary <br/>
<a id="pl.299.33"></a><var>299.33</var>daily operation of the program including, but not limited to, fires, severe weather, natural <br/>
<a id="pl.299.34"></a><var>299.34</var>disasters, power failures, or other events that threaten the immediate health and safety of <br/>
<a id="pl.299.35"></a><var>299.35</var>a person receiving services and that require calling 911, emergency evacuation, moving <br/>
<a id="pl.300.1"></a><var>300.1</var>to an emergency shelter, or temporary closure or relocation of the program to another <br/>
<a id="pl.300.2"></a><var>300.2</var>facility or service site for more than 24 hours.<br/>
<a id="pl.300.3"></a><var>300.3</var>    Subd. 8a. <b>Emergency use of manual restraint.</b> "Emergency use of manual <br/>
<a id="pl.300.4"></a><var>300.4</var>restraint" means using a manual restraint when a person poses an imminent risk of <br/>
<a id="pl.300.5"></a><var>300.5</var>physical harm to self or others and is the least restrictive intervention that would achieve <br/>
<a id="pl.300.6"></a><var>300.6</var>safety. Property damage, verbal aggression, or a person's refusal to receive or participate <br/>
<a id="pl.300.7"></a><var>300.7</var>in treatment or programming on their own, do not constitute an emergency.<br/>
<a id="pl.300.8"></a><var>300.8</var>    Subd. 8b. <b>Expanded support team.</b> "Expanded support team" means the members <br/>
<a id="pl.300.9"></a><var>300.9</var>of the support team defined in subdivision 46, and a licensed health or mental health <br/>
<a id="pl.300.10"></a><var>300.10</var>professional or other licensed, certified, or qualified professionals or consultants working <br/>
<a id="pl.300.11"></a><var>300.11</var>with the person and included in the team at the request of the person or the person's legal <br/>
<a id="pl.300.12"></a><var>300.12</var>representative.<br/>
<a id="pl.300.13"></a><var>300.13</var>    Subd. 8c. <b>Family foster care.</b> "Family foster care" means a child foster family <br/>
<a id="pl.300.14"></a><var>300.14</var>setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult <br/>
<a id="pl.300.15"></a><var>300.15</var>foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265, <br/>
<a id="pl.300.16"></a><var>300.16</var>where the license holder lives in the home.<br/>
<a id="pl.300.17"></a><var>300.17</var>    Subd. 9. <b>Health services.</b> "Health services" means any service or treatment <br/>
<a id="pl.300.18"></a><var>300.18</var>consistent with the physical and mental health needs of the person, such as medication <br/>
<a id="pl.300.19"></a><var>300.19</var>administration and monitoring, medical, dental, nutritional, health monitoring, wellness <br/>
<a id="pl.300.20"></a><var>300.20</var>education, and exercise.<br/>
<a id="pl.300.21"></a><var>300.21</var>    Subd. 10. <b>Home and community-based services.</b> "Home and community-based <br/>
<a id="pl.300.22"></a><var>300.22</var>services" means the services subject to the provisions of this chapter identified in section <br/>
<a id="pl.300.23"></a><var>300.23</var>245D.03, subdivision 1, and as defined in:<br/>
<a id="pl.300.24"></a><var>300.24</var>(1) the federal federally approved waiver plans governed by United States Code, <br/>
<a id="pl.300.25"></a><var>300.25</var>title 42, sections 1396 et seq., or the state's alternative care program according to section <br/>
<a id="pl.300.26"></a><var>300.26</var><statute_ref>256B.0913</statute_ref>, including the waivers for persons with disabilities under section 256B.49, <br/>
<a id="pl.300.27"></a><var>300.27</var>subdivision 11, including the brain injury (BI) waiver, plan; the community alternative <br/>
<a id="pl.300.28"></a><var>300.28</var>care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI) <br/>
<a id="pl.300.29"></a><var>300.29</var>waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092, <br/>
<a id="pl.300.30"></a><var>300.30</var>subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1; <br/>
<a id="pl.300.31"></a><var>300.31</var>or successor plans respective to each waiver; or<br/>
<a id="pl.300.32"></a><var>300.32</var>(2) the alternative care (AC) program under section 256B.0913.<br/>
<a id="pl.300.33"></a><var>300.33</var>    Subd. 11. <b>Incident.</b> "Incident" means an occurrence that affects the which involves <br/>
<a id="pl.300.34"></a><var>300.34</var>a person and requires the program to make a response that is not a part of the program's <br/>
<a id="pl.300.35"></a><var>300.35</var> ordinary provision of services to a that person, and includes any of the following:<br/>
<a id="pl.300.36"></a><var>300.36</var>(1) serious injury of a person as determined by section 
         <statute_ref>245.91, subdivision 6</statute_ref>;<br/>
<a id="pl.301.1"></a><var>301.1</var>(2) a person's death;<br/>
<a id="pl.301.2"></a><var>301.2</var>(3) any medical emergency, unexpected serious illness, or significant unexpected <br/>
<a id="pl.301.3"></a><var>301.3</var>change in an illness or medical condition, or the mental health status of a person that <br/>
<a id="pl.301.4"></a><var>301.4</var>requires calling the program to call 911 or a mental health crisis intervention team, <br/>
<a id="pl.301.5"></a><var>301.5</var>physician treatment, or hospitalization;<br/>
<a id="pl.301.6"></a><var>301.6</var>(4) any mental health crisis that requires the program to call 911 or a mental health <br/>
<a id="pl.301.7"></a><var>301.7</var>crisis intervention team;<br/>
<a id="pl.301.8"></a><var>301.8</var>(5) an act or situation involving a person that requires the program to call 911, <br/>
<a id="pl.301.9"></a><var>301.9</var>law enforcement, or the fire department;<br/>
<a id="pl.301.10"></a><var>301.10</var>(4) (6) a person's unauthorized or unexplained absence from a program;<br/>
<a id="pl.301.11"></a><var>301.11</var>(5) (7) physical aggression conduct by a person receiving services against another <br/>
<a id="pl.301.12"></a><var>301.12</var>person receiving services that causes physical pain, injury, or persistent emotional distress, <br/>
<a id="pl.301.13"></a><var>301.13</var>including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting, <br/>
<a id="pl.301.14"></a><var>301.14</var>pushing, and spitting;:<br/>
<a id="pl.301.15"></a><var>301.15</var>(i) is so severe, pervasive, or objectively offensive that it substantially interferes with <br/>
<a id="pl.301.16"></a><var>301.16</var>a person's opportunities to participate in or receive service or support;<br/>
<a id="pl.301.17"></a><var>301.17</var>(ii) places the person in actual and reasonable fear of harm;<br/>
<a id="pl.301.18"></a><var>301.18</var>(iii) places the person in actual and reasonable fear of damage to property of the <br/>
<a id="pl.301.19"></a><var>301.19</var>person; or<br/>
<a id="pl.301.20"></a><var>301.20</var>(iv) substantially disrupts the orderly operation of the program;<br/>
<a id="pl.301.21"></a><var>301.21</var>(6) (8) any sexual activity between persons receiving services involving force or <br/>
<a id="pl.301.22"></a><var>301.22</var>coercion as defined under section 
         <statute_ref>609.341, subdivisions 3</statute_ref> and 14; or<br/>
<a id="pl.301.23"></a><var>301.23</var>(9) any emergency use of manual restraint as identified in section 245D.061; or<br/>
<a id="pl.301.24"></a><var>301.24</var>(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment <br/>
<a id="pl.301.25"></a><var>301.25</var>under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref>.<br/>
<a id="pl.301.26"></a><var>301.26</var>    Subd. 11a. <b>Intermediate care facility for persons with developmental disabilities </b><br/>
<a id="pl.301.27"></a><var>301.27</var><b>or ICF/DD.</b> "Intermediate care facility for persons with developmental disabilities" or <br/>
<a id="pl.301.28"></a><var>301.28</var>"ICF/DD" means a residential program licensed to serve four or more persons with <br/>
<a id="pl.301.29"></a><var>301.29</var>developmental disabilities under section 252.28 and chapter 245A and licensed as a <br/>
<a id="pl.301.30"></a><var>301.30</var>supervised living facility under chapter 144, which together are certified by the Department <br/>
<a id="pl.301.31"></a><var>301.31</var>of Health as an intermediate care facility for persons with developmental disabilities.<br/>
<a id="pl.301.32"></a><var>301.32</var>    Subd. 11b. <b>Least restrictive alternative.</b> "Least restrictive alternative" means <br/>
<a id="pl.301.33"></a><var>301.33</var>the alternative method for providing supports and services that is the least intrusive and <br/>
<a id="pl.301.34"></a><var>301.34</var>most normalized given the level of supervision and protection required for the person. <br/>
<a id="pl.301.35"></a><var>301.35</var>This level of supervision and protection allows risk taking to the extent that there is no <br/>
<a id="pl.301.36"></a><var>301.36</var>reasonable likelihood that serious harm will happen to the person or others.<br/>
<a id="pl.302.1"></a><var>302.1</var>    Subd. 12. <b>Legal representative.</b> "Legal representative" means the parent of a <br/>
<a id="pl.302.2"></a><var>302.2</var>person who is under 18 years of age, a court-appointed guardian, or other representative <br/>
<a id="pl.302.3"></a><var>302.3</var>with legal authority to make decisions about services for a person. Other representatives <br/>
<a id="pl.302.4"></a><var>302.4</var>with legal authority to make decisions include but are not limited to a health care agent or <br/>
<a id="pl.302.5"></a><var>302.5</var>an attorney-in-fact authorized through a health care directive or power of attorney.<br/>
<a id="pl.302.6"></a><var>302.6</var>    Subd. 13. <b>License.</b> "License" has the meaning given in section 
         <statute_ref>245A.02, <br/>
<a id="pl.302.7"></a><var>302.7</var>subdivision 8
         </statute_ref>.<br/>
<a id="pl.302.8"></a><var>302.8</var>    Subd. 14. <b>Licensed health professional.</b> "Licensed health professional" means a <br/>
<a id="pl.302.9"></a><var>302.9</var>person licensed in Minnesota to practice those professions described in section 
         <statute_ref>214.01, <br/>
<a id="pl.302.10"></a><var>302.10</var>subdivision 2
         </statute_ref>.<br/>
<a id="pl.302.11"></a><var>302.11</var>    Subd. 15. <b>License holder.</b> "License holder" has the meaning given in section <br/>
<statute_ref><a id="pl.302.12"></a><var>302.12</var>245A.02, subdivision 9
         </statute_ref>.<br/>
<a id="pl.302.13"></a><var>302.13</var>    Subd. 16. <b>Medication.</b> "Medication" means a prescription drug or over-the-counter <br/>
<a id="pl.302.14"></a><var>302.14</var>drug. For purposes of this chapter, "medication" includes dietary supplements.<br/>
<a id="pl.302.15"></a><var>302.15</var>    Subd. 17. <b>Medication administration.</b> "Medication administration" means <br/>
<a id="pl.302.16"></a><var>302.16</var>performing the following set of tasks to ensure a person takes both prescription and <br/>
<a id="pl.302.17"></a><var>302.17</var>over-the-counter medications and treatments according to orders issued by appropriately <br/>
<a id="pl.302.18"></a><var>302.18</var>licensed professionals, and includes the following:<br/>
<a id="pl.302.19"></a><var>302.19</var>(1) checking the person's medication record;<br/>
<a id="pl.302.20"></a><var>302.20</var>(2) preparing the medication for administration;<br/>
<a id="pl.302.21"></a><var>302.21</var>(3) administering the medication to the person;<br/>
<a id="pl.302.22"></a><var>302.22</var>(4) documenting the administration of the medication or the reason for not <br/>
<a id="pl.302.23"></a><var>302.23</var>administering the medication; and<br/>
<a id="pl.302.24"></a><var>302.24</var>(5) reporting to the prescriber or a nurse any concerns about the medication, <br/>
<a id="pl.302.25"></a><var>302.25</var>including side effects, adverse reactions, effectiveness, or the person's refusal to take the <br/>
<a id="pl.302.26"></a><var>302.26</var>medication or the person's self-administration of the medication.<br/>
<a id="pl.302.27"></a><var>302.27</var>    Subd. 18. <b>Medication assistance.</b> "Medication assistance" means providing verbal <br/>
<a id="pl.302.28"></a><var>302.28</var>or visual reminders to take regularly scheduled medication, which includes either of <br/>
<a id="pl.302.29"></a><var>302.29</var>the following:<br/>
<a id="pl.302.30"></a><var>302.30</var>(1) bringing to the person and opening a container of previously set up medications <br/>
<a id="pl.302.31"></a><var>302.31</var>and emptying the container into the person's hand or opening and giving the medications <br/>
<a id="pl.302.32"></a><var>302.32</var>in the original container to the person, or bringing to the person liquids or food to <br/>
<a id="pl.302.33"></a><var>302.33</var>accompany the medication; or<br/>
<a id="pl.302.34"></a><var>302.34</var>(2) providing verbal or visual reminders to perform regularly scheduled treatments <br/>
<a id="pl.302.35"></a><var>302.35</var>and exercises.<br/>
<a id="pl.303.1"></a><var>303.1</var>    Subd. 19. <b>Medication management.</b> "Medication management" means the <br/>
<a id="pl.303.2"></a><var>303.2</var>provision of any of the following:<br/>
<a id="pl.303.3"></a><var>303.3</var>(1) medication-related services to a person;<br/>
<a id="pl.303.4"></a><var>303.4</var>(2) medication setup;<br/>
<a id="pl.303.5"></a><var>303.5</var>(3) medication administration;<br/>
<a id="pl.303.6"></a><var>303.6</var>(4) medication storage and security;<br/>
<a id="pl.303.7"></a><var>303.7</var>(5) medication documentation and charting;<br/>
<a id="pl.303.8"></a><var>303.8</var>(6) verification and monitoring of effectiveness of systems to ensure safe medication <br/>
<a id="pl.303.9"></a><var>303.9</var>handling and administration;<br/>
<a id="pl.303.10"></a><var>303.10</var>(7) coordination of medication refills;<br/>
<a id="pl.303.11"></a><var>303.11</var>(8) handling changes to prescriptions and implementation of those changes;<br/>
<a id="pl.303.12"></a><var>303.12</var>(9) communicating with the pharmacy; or<br/>
<a id="pl.303.13"></a><var>303.13</var>(10) coordination and communication with prescriber.<br/>
<a id="pl.303.14"></a><var>303.14</var>For the purposes of this chapter, medication management does not mean "medication <br/>
<a id="pl.303.15"></a><var>303.15</var>therapy management services" as identified in section 
<statute_ref>256B.0625, subdivision 13h</statute_ref>.<br/>
<a id="pl.303.16"></a><var>303.16</var>    Subd. 20. <b>Mental health crisis intervention team.</b> "Mental health crisis <br/>
<a id="pl.303.17"></a><var>303.17</var>intervention team" means a mental health crisis response providers provider as identified <br/>
<a id="pl.303.18"></a><var>303.18</var>in section 
         <statute_ref>256B.0624, subdivision 2</statute_ref>, paragraph (d), for adults, and in section 
         <statute_ref>256B.0944, <br/>
<a id="pl.303.19"></a><var>303.19</var>subdivision 1
         </statute_ref>, paragraph (d), for children.<br/>
<a id="pl.303.20"></a><var>303.20</var>    Subd. 20a. <b>Most integrated setting.</b> "Most integrated setting" means a setting that <br/>
<a id="pl.303.21"></a><var>303.21</var>enables individuals with disabilities to interact with nondisabled persons to the fullest <br/>
<a id="pl.303.22"></a><var>303.22</var>extent possible.<br/>
<a id="pl.303.23"></a><var>303.23</var>    Subd. 21. <b>Over-the-counter drug.</b> "Over-the-counter drug" means a drug that <br/>
<a id="pl.303.24"></a><var>303.24</var>is not required by federal law to bear the statement "Caution: Federal law prohibits <br/>
<a id="pl.303.25"></a><var>303.25</var>dispensing without prescription."<br/>
<a id="pl.303.26"></a><var>303.26</var>    Subd. 21a. <b>Outcome.</b> "Outcome" means the behavior, action, or status attained by <br/>
<a id="pl.303.27"></a><var>303.27</var>the person that can be observed, measured, and determined reliable and valid.<br/>
<a id="pl.303.28"></a><var>303.28</var>    Subd. 22. <b>Person.</b> "Person" has the meaning given in section 
         <statute_ref>245A.02, subdivision <br/>
<a id="pl.303.29"></a><var>303.29</var>11
         </statute_ref>.<br/>
<a id="pl.303.30"></a><var>303.30</var>    Subd. 23. <b>Person with a disability.</b> "Person with a disability" means a person <br/>
<a id="pl.303.31"></a><var>303.31</var>determined to have a disability by the commissioner's state medical review team as <br/>
<a id="pl.303.32"></a><var>303.32</var>identified in section 
         <statute_ref>256B.055, subdivision 7</statute_ref>, the Social Security Administration, or <br/>
<a id="pl.303.33"></a><var>303.33</var>the person is determined to have a developmental disability as defined in Minnesota <br/>
<a id="pl.303.34"></a><var>303.34</var>Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section <br/>
<statute_ref><a id="pl.303.35"></a><var>303.35</var>252.27, subdivision 1a
         </statute_ref>.<br/>
<a id="pl.304.1"></a><var>304.1</var>    Subd. 23a. <b>Physician.</b> "Physician" means a person who is licensed under chapter <br/>
<a id="pl.304.2"></a><var>304.2</var>147.<br/>
<a id="pl.304.3"></a><var>304.3</var>    Subd. 24. <b>Prescriber.</b> "Prescriber" means a licensed practitioner as defined in <br/>
<a id="pl.304.4"></a><var>304.4</var>section 
<statute_ref>151.01, subdivision 23</statute_ref>, person who is authorized under section 148.235; 151.01, <br/>
<a id="pl.304.5"></a><var>304.5</var>subdivision 23; or
<statute_ref>151.37</statute_ref> to prescribe drugs. For the purposes of this chapter, the term <br/>
<a id="pl.304.6"></a><var>304.6</var>"prescriber" is used interchangeably with "physician."<br/>
<a id="pl.304.7"></a><var>304.7</var>    Subd. 25. <b>Prescription drug.</b> "Prescription drug" has the meaning given in section <br/>
<statute_ref><a id="pl.304.8"></a><var>304.8</var>151.01, subdivision 17 16
</statute_ref>.<br/>
<a id="pl.304.9"></a><var>304.9</var>    Subd. 26. <b>Program.</b> "Program" means either the nonresidential or residential <br/>
<a id="pl.304.10"></a><var>304.10</var>program as defined in section 
         <statute_ref>245A.02, subdivisions 10</statute_ref> and 14.<br/>
<a id="pl.304.11"></a><var>304.11</var>    Subd. 27. <b>Psychotropic medication.</b> "Psychotropic medication" means any <br/>
<a id="pl.304.12"></a><var>304.12</var>medication prescribed to treat the symptoms of mental illness that affect thought processes, <br/>
<a id="pl.304.13"></a><var>304.13</var>mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic <br/>
<a id="pl.304.14"></a><var>304.14</var>(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and <br/>
<a id="pl.304.15"></a><var>304.15</var>stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder. <br/>
<a id="pl.304.16"></a><var>304.16</var>Other miscellaneous medications are considered to be a psychotropic medication when <br/>
<a id="pl.304.17"></a><var>304.17</var>they are specifically prescribed to treat a mental illness or to control or alter behavior.<br/>
<a id="pl.304.18"></a><var>304.18</var>    Subd. 28. <b>Restraint.</b> "Restraint" means physical or mechanical limiting of the free <br/>
<a id="pl.304.19"></a><var>304.19</var>and normal movement of body or limbs.<br/>
<a id="pl.304.20"></a><var>304.20</var>    Subd. 29. <b>Seclusion.</b> "Seclusion" means separating a person from others in a way <br/>
<a id="pl.304.21"></a><var>304.21</var>that prevents social contact and prevents the person from leaving the situation if he or she <br/>
<a id="pl.304.22"></a><var>304.22</var>chooses the placement of a person alone in a room from which exit is prohibited by a staff <br/>
<a id="pl.304.23"></a><var>304.23</var>person or a mechanism such as a lock, a device, or an object positioned to hold the door <br/>
<a id="pl.304.24"></a><var>304.24</var>closed or otherwise prevent the person from leaving the room.<br/>
<a id="pl.304.25"></a><var>304.25</var>    Subd. 29a. <b>Self-determination.</b> "Self-determination" means the person makes <br/>
<a id="pl.304.26"></a><var>304.26</var>decisions independently, plans for the person's own future, determines how money is spent <br/>
<a id="pl.304.27"></a><var>304.27</var>for the person's supports, and takes responsibility for making these decisions. If a person <br/>
<a id="pl.304.28"></a><var>304.28</var>has a legal representative, the legal representative's decision-making authority is limited to <br/>
<a id="pl.304.29"></a><var>304.29</var>the scope of authority granted by the court or allowed in the document authorizing the <br/>
<a id="pl.304.30"></a><var>304.30</var>legal representative to act.<br/>
<a id="pl.304.31"></a><var>304.31</var>    Subd. 29b. <b>Semi-independent living services.</b> "Semi-independent living services" <br/>
<a id="pl.304.32"></a><var>304.32</var>has the meaning given in section 252.275.<br/>
<a id="pl.304.33"></a><var>304.33</var>    Subd. 30. <b>Service.</b> "Service" means care, training, supervision, counseling, <br/>
<a id="pl.304.34"></a><var>304.34</var>consultation, or medication assistance assigned to the license holder in the coordinated <br/>
<a id="pl.304.35"></a><var>304.35</var>service and support plan.<br/>
<a id="pl.305.1"></a><var>305.1</var>    Subd. 31. <b>Service plan.</b> "Service plan" means the individual service plan or <br/>
<a id="pl.305.2"></a><var>305.2</var>individual care plan identified in sections 
<statute_ref>256B.0913</statute_ref>, 
<statute_ref>256B.0915</statute_ref>, 
<statute_ref>256B.092</statute_ref>, and 
<statute_ref>256B.49</statute_ref>, <br/>
<a id="pl.305.3"></a><var>305.3</var>or successor provisions, and includes any support plans or service needs identified as <br/>
<a id="pl.305.4"></a><var>305.4</var>a result of long-term care consultation, or a support team meeting that includes the <br/>
<a id="pl.305.5"></a><var>305.5</var>participation of the person, the person's legal representative, and case manager, or assigned <br/>
<a id="pl.305.6"></a><var>305.6</var>to a license holder through an authorized service agreement.<br/>
<a id="pl.305.7"></a><var>305.7</var>    Subd. 32. <b>Service site.</b> "Service site" means the location where the service is <br/>
<a id="pl.305.8"></a><var>305.8</var>provided to the person, including, but not limited to, a facility licensed according to <br/>
<a id="pl.305.9"></a><var>305.9</var>chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's <br/>
<a id="pl.305.10"></a><var>305.10</var>own home; or a community-based location.<br/>
<a id="pl.305.11"></a><var>305.11</var>    Subd. 33. <b>Staff.</b> "Staff" means an employee who will have direct contact with a <br/>
<a id="pl.305.12"></a><var>305.12</var>person served by the facility, agency, or program.<br/>
<a id="pl.305.13"></a><var>305.13</var>    Subd. 33a. <b>Supervised living facility.</b> "Supervised living facility" has the meaning <br/>
<a id="pl.305.14"></a><var>305.14</var>given in Minnesota Rules, part 4665.0100, subpart 10.<br/>
<a id="pl.305.15"></a><var>305.15</var>    Subd. 33b. <b>Supervision.</b> (a) "Supervision" means:<br/>
<a id="pl.305.16"></a><var>305.16</var>(1) oversight by direct support staff as specified in the person's coordinated service <br/>
<a id="pl.305.17"></a><var>305.17</var>and support plan or coordinated service and support plan addendum and awareness of <br/>
<a id="pl.305.18"></a><var>305.18</var>the person's needs and activities;<br/>
<a id="pl.305.19"></a><var>305.19</var>(2) responding to situations that present a serious risk to the health, safety, or rights <br/>
<a id="pl.305.20"></a><var>305.20</var>of the person while services are being provided; and<br/>
<a id="pl.305.21"></a><var>305.21</var>(3) the presence of direct support staff at a service site while services are being <br/>
<a id="pl.305.22"></a><var>305.22</var>provided, unless a determination has been made and documented in the person's coordinated <br/>
<a id="pl.305.23"></a><var>305.23</var>service and support plan or coordinated service and support plan addendum that the person <br/>
<a id="pl.305.24"></a><var>305.24</var>does not require the presence of direct support staff while services are being provided.<br/>
<a id="pl.305.25"></a><var>305.25</var>(b) For the purposes of this definition, "while services are being provided," means <br/>
<a id="pl.305.26"></a><var>305.26</var>any period of time during which the license holder will seek reimbursement for services.<br/>
<a id="pl.305.27"></a><var>305.27</var>    Subd. 34. <b>Support team.</b> "Support team" means the service planning team <br/>
<a id="pl.305.28"></a><var>305.28</var>identified in section 
         <statute_ref>256B.49, subdivision 15</statute_ref>, or the interdisciplinary team identified in <br/>
<a id="pl.305.29"></a><var>305.29</var>Minnesota Rules, part 9525.0004, subpart 14.<br/>
<a id="pl.305.30"></a><var>305.30</var>    Subd. 34a. <b>Time out.</b> "Time out" means removing a person involuntarily from an <br/>
<a id="pl.305.31"></a><var>305.31</var>ongoing activity to a room, either locked or unlocked, or otherwise separating a person <br/>
<a id="pl.305.32"></a><var>305.32</var>from others in a way that prevents social contact and prevents the person from leaving <br/>
<a id="pl.305.33"></a><var>305.33</var>the situation if the person chooses. For the purpose of chapter 245D, "time out" does <br/>
<a id="pl.305.34"></a><var>305.34</var>not mean voluntary removal or self-removal for the purpose of calming, prevention of <br/>
<a id="pl.305.35"></a><var>305.35</var>escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out" <br/>
<a id="pl.305.36"></a><var>305.36</var>does not include a person voluntarily moving from an ongoing activity to an unlocked <br/>
<a id="pl.306.1"></a><var>306.1</var>room or otherwise separating from a situation or social contact with others if the person <br/>
<a id="pl.306.2"></a><var>306.2</var>chooses. For the purposes of this definition, "voluntarily" means without being forced, <br/>
<a id="pl.306.3"></a><var>306.3</var>compelled, or coerced.<br/>
<a id="pl.306.4"></a><var>306.4</var>    Subd. 35. <b>Unit of government.</b> "Unit of government" means every city, county, <br/>
<a id="pl.306.5"></a><var>306.5</var>town, school district, other political subdivisions of the state, and any agency of the state <br/>
<a id="pl.306.6"></a><var>306.6</var>or the United States, and includes any instrumentality of a unit of government.<br/>
<a id="pl.306.7"></a><var>306.7</var>    Subd. 35a. <b>Treatment.</b> "Treatment" means the provision of care, other than <br/>
<a id="pl.306.8"></a><var>306.8</var>medications, ordered or prescribed by a licensed health or mental health professional, <br/>
<a id="pl.306.9"></a><var>306.9</var>provided to a person to cure, rehabilitate, or ease symptoms.<br/>
<a id="pl.306.10"></a><var>306.10</var>    Subd. 36. <b>Volunteer.</b> "Volunteer" means an individual who, under the direction of the <br/>
<a id="pl.306.11"></a><var>306.11</var>license holder, provides direct services without pay to a person served by the license holder.<br/>
<a id="pl.306.12"></a><var>306.12</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.19.0"></a><a id="pl.306.13"></a><var>306.13</var>    Sec. 19. Minnesota Statutes 2012, section 245D.03, is amended to read:<br/>
<a id="pl.306.14"></a><var>306.14</var><b>245D.03 APPLICABILITY AND EFFECT.</b><br/>
<a id="pl.306.15"></a><var>306.15</var>    Subdivision 1. <b>Applicability. </b> (a) The commissioner shall regulate the provision of <br/>
<a id="pl.306.16"></a><var>306.16</var>home and community-based services to persons with disabilities and persons age 65 and <br/>
<a id="pl.306.17"></a><var>306.17</var>older pursuant to this chapter. The licensing standards in this chapter govern the provision <br/>
<a id="pl.306.18"></a><var>306.18</var>of the following basic support services: and intensive support services.<br/>
<a id="pl.306.19"></a><var>306.19</var>(1) housing access coordination as defined under the current BI, CADI, and DD <br/>
<a id="pl.306.20"></a><var>306.20</var>waiver plans or successor plans;<br/>
<a id="pl.306.21"></a><var>306.21</var>(2) respite services as defined under the current CADI, BI, CAC, DD, and EW <br/>
<a id="pl.306.22"></a><var>306.22</var>waiver plans or successor plans when the provider is an individual who is not an employee <br/>
<a id="pl.306.23"></a><var>306.23</var>of a residential or nonresidential program licensed by the Department of Human Services <br/>
<a id="pl.306.24"></a><var>306.24</var>or the Department of Health that is otherwise providing the respite service;<br/>
<a id="pl.306.25"></a><var>306.25</var>(3) behavioral programming as defined under the current BI and CADI waiver <br/>
<a id="pl.306.26"></a><var>306.26</var>plans or successor plans;<br/>
<a id="pl.306.27"></a><var>306.27</var>(4) specialist services as defined under the current DD waiver plan or successor plans;<br/>
<a id="pl.306.28"></a><var>306.28</var>(5) companion services as defined under the current BI, CADI, and EW waiver <br/>
<a id="pl.306.29"></a><var>306.29</var>plans or successor plans, excluding companion services provided under the Corporation <br/>
<a id="pl.306.30"></a><var>306.30</var>for National and Community Services Senior Companion Program established under the <br/>
<a id="pl.306.31"></a><var>306.31</var>Domestic Volunteer Service Act of 1973, Public Law 98-288;<br/>
<a id="pl.306.32"></a><var>306.32</var>(6) personal support as defined under the current DD waiver plan or successor plans;<br/>
<a id="pl.306.33"></a><var>306.33</var>(7) 24-hour emergency assistance, on-call and personal emergency response as <br/>
<a id="pl.306.34"></a><var>306.34</var>defined under the current CADI and DD waiver plans or successor plans;<br/>
<a id="pl.307.1"></a><var>307.1</var>(8) night supervision services as defined under the current BI waiver plan or <br/>
<a id="pl.307.2"></a><var>307.2</var>successor plans;<br/>
<a id="pl.307.3"></a><var>307.3</var>(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW <br/>
<a id="pl.307.4"></a><var>307.4</var>waiver plans or successor plans, excluding providers licensed by the Department of Health <br/>
<a id="pl.307.5"></a><var>307.5</var>under chapter 144A and those providers providing cleaning services only;<br/>
<a id="pl.307.6"></a><var>307.6</var>(10) independent living skills training as defined under the current BI and CADI <br/>
<a id="pl.307.7"></a><var>307.7</var>waiver plans or successor plans;<br/>
<a id="pl.307.8"></a><var>307.8</var>(11) prevocational services as defined under the current BI and CADI waiver plans <br/>
<a id="pl.307.9"></a><var>307.9</var>or successor plans;<br/>
<a id="pl.307.10"></a><var>307.10</var>(12) structured day services as defined under the current BI waiver plan or successor <br/>
<a id="pl.307.11"></a><var>307.11</var>plans; or<br/>
<a id="pl.307.12"></a><var>307.12</var>(13) supported employment as defined under the current BI and CADI waiver plans <br/>
<a id="pl.307.13"></a><var>307.13</var>or successor plans.<br/>
<a id="pl.307.14"></a><var>307.14</var>(b) Basic support services provide the level of assistance, supervision, and care that <br/>
<a id="pl.307.15"></a><var>307.15</var>is necessary to ensure the health and safety of the person and do not include services that <br/>
<a id="pl.307.16"></a><var>307.16</var>are specifically directed toward the training, treatment, habilitation, or rehabilitation of <br/>
<a id="pl.307.17"></a><var>307.17</var>the person. Basic support services include:<br/>
<a id="pl.307.18"></a><var>307.18</var>(1) in-home and out-of-home respite care services as defined in section 245A.02, <br/>
<a id="pl.307.19"></a><var>307.19</var>subdivision 15, and under the brain injury, community alternative care, community <br/>
<a id="pl.307.20"></a><var>307.20</var>alternatives for disabled individuals, developmental disability, and elderly waiver plans;<br/>
<a id="pl.307.21"></a><var>307.21</var>(2) companion services as defined under the brain injury, community alternatives for <br/>
<a id="pl.307.22"></a><var>307.22</var>disabled individuals, and elderly waiver plans, excluding companion services provided <br/>
<a id="pl.307.23"></a><var>307.23</var>under the Corporation for National and Community Services Senior Companion Program <br/>
<a id="pl.307.24"></a><var>307.24</var>established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;<br/>
<a id="pl.307.25"></a><var>307.25</var>(3) personal support as defined under the developmental disability waiver plan;<br/>
<a id="pl.307.26"></a><var>307.26</var>(4) 24-hour emergency assistance, personal emergency response as defined under the <br/>
<a id="pl.307.27"></a><var>307.27</var>community alternatives for disabled individuals and developmental disability waiver plans;<br/>
<a id="pl.307.28"></a><var>307.28</var>(5) night supervision services as defined under the brain injury waiver plan; and<br/>
<a id="pl.307.29"></a><var>307.29</var>(6) homemaker services as defined under the community alternatives for disabled <br/>
<a id="pl.307.30"></a><var>307.30</var>individuals, brain injury, community alternative care, developmental disability, and elderly <br/>
<a id="pl.307.31"></a><var>307.31</var>waiver plans, excluding providers licensed by the Department of Health under chapter <br/>
<a id="pl.307.32"></a><var>307.32</var>144A and those providers providing cleaning services only.<br/>
<a id="pl.307.33"></a><var>307.33</var>(c) Intensive support services provide assistance, supervision, and care that is <br/>
<a id="pl.307.34"></a><var>307.34</var>necessary to ensure the health and safety of the person and services specifically directed <br/>
<a id="pl.307.35"></a><var>307.35</var>toward the training, habilitation, or rehabilitation of the person. Intensive support services <br/>
<a id="pl.307.36"></a><var>307.36</var>include:<br/>
<a id="pl.308.1"></a><var>308.1</var>(1) intervention services, including:<br/>
<a id="pl.308.2"></a><var>308.2</var>(i) behavioral support services as defined under the brain injury and community <br/>
<a id="pl.308.3"></a><var>308.3</var>alternatives for disabled individuals waiver plans;<br/>
<a id="pl.308.4"></a><var>308.4</var>(ii) in-home or out-of-home crisis respite services as defined under the developmental <br/>
<a id="pl.308.5"></a><var>308.5</var>disability waiver plan; and<br/>
<a id="pl.308.6"></a><var>308.6</var>(iii) specialist services as defined under the current developmental disability waiver <br/>
<a id="pl.308.7"></a><var>308.7</var>plan;<br/>
<a id="pl.308.8"></a><var>308.8</var>(2) in-home support services, including:<br/>
<a id="pl.308.9"></a><var>308.9</var>(i) in-home family support and supported living services as defined under the <br/>
<a id="pl.308.10"></a><var>308.10</var>developmental disability waiver plan;<br/>
<a id="pl.308.11"></a><var>308.11</var>(ii) independent living services training as defined under the brain injury and <br/>
<a id="pl.308.12"></a><var>308.12</var>community alternatives for disabled individuals waiver plans; and<br/>
<a id="pl.308.13"></a><var>308.13</var>(iii) semi-independent living services;<br/>
<a id="pl.308.14"></a><var>308.14</var>(3) residential supports and services, including:<br/>
<a id="pl.308.15"></a><var>308.15</var>(i) supported living services as defined under the developmental disability waiver <br/>
<a id="pl.308.16"></a><var>308.16</var>plan provided in a family or corporate child foster care residence, a family adult foster <br/>
<a id="pl.308.17"></a><var>308.17</var>care residence, a community residential setting, or a supervised living facility;<br/>
<a id="pl.308.18"></a><var>308.18</var>(ii) foster care services as defined in the brain injury, community alternative care, <br/>
<a id="pl.308.19"></a><var>308.19</var>and community alternatives for disabled individuals waiver plans provided in a family or <br/>
<a id="pl.308.20"></a><var>308.20</var>corporate child foster care residence, a family adult foster care residence, or a community <br/>
<a id="pl.308.21"></a><var>308.21</var>residential setting; and<br/>
<a id="pl.308.22"></a><var>308.22</var>(iii) residential services provided in a supervised living facility that is certified by <br/>
<a id="pl.308.23"></a><var>308.23</var>the Department of Health as an ICF/DD;<br/>
<a id="pl.308.24"></a><var>308.24</var>(4) day services, including:<br/>
<a id="pl.308.25"></a><var>308.25</var>(i) structured day services as defined under the brain injury waiver plan;<br/>
<a id="pl.308.26"></a><var>308.26</var>(ii) day training and habilitation services under sections 252.40 to 252.46, and as <br/>
<a id="pl.308.27"></a><var>308.27</var>defined under the developmental disability waiver plan; and<br/>
<a id="pl.308.28"></a><var>308.28</var>(iii) prevocational services as defined under the brain injury and community <br/>
<a id="pl.308.29"></a><var>308.29</var>alternatives for disabled individuals waiver plans; and<br/>
<a id="pl.308.30"></a><var>308.30</var>(5) supported employment as defined under the brain injury, developmental <br/>
<a id="pl.308.31"></a><var>308.31</var>disability, and community alternatives for disabled individuals waiver plans.<br/>
<a id="pl.308.32"></a><var>308.32</var>    Subd. 2. <b>Relationship to other standards governing home and community-based </b><br/>
<a id="pl.308.33"></a><var>308.33</var><b>services.</b> (a) A license holder governed by this chapter is also subject to the licensure <br/>
<a id="pl.308.34"></a><var>308.34</var>requirements under chapter 245A.<br/>
<a id="pl.308.35"></a><var>308.35</var>(b) A license holder concurrently providing child foster care services licensed <br/>
<a id="pl.308.36"></a><var>308.36</var>according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed <br/>
<a id="pl.309.1"></a><var>309.1</var>under this chapter is exempt from section 
<statute_ref>245D.04</statute_ref> as it applies to the person. A corporate <br/>
<a id="pl.309.2"></a><var>309.2</var>or family child foster care site controlled by a license holder and providing services <br/>
<a id="pl.309.3"></a><var>309.3</var>governed by this chapter is exempt from compliance with section 245D.04. This exemption <br/>
<a id="pl.309.4"></a><var>309.4</var>applies to foster care homes where at least one resident is receiving residential supports <br/>
<a id="pl.309.5"></a><var>309.5</var>and services licensed according to this chapter. This chapter does not apply to corporate or <br/>
<a id="pl.309.6"></a><var>309.6</var>family child foster care homes that do not provide services licensed under this chapter.<br/>
<a id="pl.309.7"></a><var>309.7</var>(c) A family adult foster care site controlled by a license holder and providing <br/>
<a id="pl.309.8"></a><var>309.8</var>services governed by this chapter is exempt from compliance with Minnesota Rules, parts <br/>
<a id="pl.309.9"></a><var>309.9</var>9555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart <br/>
<a id="pl.309.10"></a><var>309.10</var>2; and 9555.6265. These exemptions apply to family adult foster care homes where at <br/>
<a id="pl.309.11"></a><var>309.11</var>least one resident is receiving residential supports and services licensed according to this <br/>
<a id="pl.309.12"></a><var>309.12</var>chapter. This chapter does not apply to family adult foster care homes that do not provide <br/>
<a id="pl.309.13"></a><var>309.13</var>services licensed under this chapter.<br/>
<a id="pl.309.14"></a><var>309.14</var>(d) A license holder providing services licensed according to this chapter in a <br/>
<a id="pl.309.15"></a><var>309.15</var>supervised living facility is exempt from compliance with sections 245D.04; 245D.05, <br/>
<a id="pl.309.16"></a><var>309.16</var>subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).<br/>
<a id="pl.309.17"></a><var>309.17</var>(e) A license holder providing residential services to persons in an ICF/DD is exempt <br/>
<a id="pl.309.18"></a><var>309.18</var>from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision <br/>
<a id="pl.309.19"></a><var>309.19</var>2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, <br/>
<a id="pl.309.20"></a><var>309.20</var>subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.<br/>
<a id="pl.309.21"></a><var>309.21</var>(c) (f) A license holder concurrently providing home care homemaker services <br/>
<a id="pl.309.22"></a><var>309.22</var>registered licensed according to sections 
<statute_ref>144A.43</statute_ref> to 
<statute_ref>144A.49</statute_ref> to the same person receiving <br/>
<a id="pl.309.23"></a><var>309.23</var>home management services licensed under this chapter and registered according to chapter <br/>
<a id="pl.309.24"></a><var>309.24</var>144A is exempt from compliance with section 
         <statute_ref>245D.04</statute_ref> as it applies to the person.<br/>
<a id="pl.309.25"></a><var>309.25</var>(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt <br/>
<a id="pl.309.26"></a><var>309.26</var>from compliance with sections 
<statute_ref>245A.65, subdivision 2</statute_ref>, paragraph (a), and 
<statute_ref>626.557, <br/>
<a id="pl.309.27"></a><var>309.27</var>subdivision 14
</statute_ref>, paragraph (b).<br/>
<a id="pl.309.28"></a><var>309.28</var>(e) Notwithstanding section 
<statute_ref>245D.06, subdivision 5</statute_ref>, a license holder providing <br/>
<a id="pl.309.29"></a><var>309.29</var>structured day, prevocational, or supported employment services under this chapter <br/>
<a id="pl.309.30"></a><var>309.30</var>and day training and habilitation or supported employment services licensed under <br/>
<a id="pl.309.31"></a><var>309.31</var>chapter 245B within the same program is exempt from compliance with this chapter <br/>
<a id="pl.309.32"></a><var>309.32</var>when the license holder notifies the commissioner in writing that the requirements under <br/>
<a id="pl.309.33"></a><var>309.33</var>chapter 245B will be met for all persons receiving these services from the program. For <br/>
<a id="pl.309.34"></a><var>309.34</var>the purposes of this paragraph, if the license holder has obtained approval from the <br/>
<a id="pl.309.35"></a><var>309.35</var>commissioner for an alternative inspection status according to section 
<statute_ref>245B.031</statute_ref>, that <br/>
<a id="pl.309.36"></a><var>309.36</var>approval will apply to all persons receiving services in the program.<br/>
<a id="pl.310.1"></a><var>310.1</var>(g) Nothing in this chapter prohibits a license holder from concurrently serving <br/>
<a id="pl.310.2"></a><var>310.2</var>persons without disabilities or people who are or are not age 65 and older, provided this <br/>
<a id="pl.310.3"></a><var>310.3</var>chapter's standards are met as well as other relevant standards.<br/>
<a id="pl.310.4"></a><var>310.4</var>(h) The documentation required under sections 245D.07 and 245D.071 must meet <br/>
<a id="pl.310.5"></a><var>310.5</var>the individual program plan requirements identified in section 256B.092 or successor <br/>
<a id="pl.310.6"></a><var>310.6</var>provisions.<br/>
<a id="pl.310.7"></a><var>310.7</var>    Subd. 3. <b>Variance.</b> If the conditions in section 
         <statute_ref>245A.04, subdivision 9</statute_ref>, are met, <br/>
<a id="pl.310.8"></a><var>310.8</var>the commissioner may grant a variance to any of the requirements in this chapter, except <br/>
<a id="pl.310.9"></a><var>310.9</var>sections 
         <statute_ref>245D.04</statute_ref>, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4, <br/>
<a id="pl.310.10"></a><var>310.10</var>paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and <br/>
<a id="pl.310.11"></a><var>310.11</var>information rights of persons.<br/>
<a id="pl.310.12"></a><var>310.12</var>    Subd. 4. <b>License holders with multiple 245D licenses.</b> (a) When a person changes <br/>
<a id="pl.310.13"></a><var>310.13</var>service from one license to a different license held by the same license holder, the license <br/>
<a id="pl.310.14"></a><var>310.14</var>holder is exempt from the requirements in section 
<statute_ref>245D.10, subdivision 4</statute_ref>, paragraph (b).<br/>
<a id="pl.310.15"></a><var>310.15</var>(b) When a staff person begins providing direct service under one or more licenses <br/>
<a id="pl.310.16"></a><var>310.16</var>held by the same license holder, other than the license for which staff orientation was <br/>
<a id="pl.310.17"></a><var>310.17</var>initially provided according to section 
<statute_ref>245D.09, subdivision 4</statute_ref>, the license holder is <br/>
<a id="pl.310.18"></a><var>310.18</var>exempt from those staff orientation requirements, except the staff person must review each <br/>
<a id="pl.310.19"></a><var>310.19</var>person's service plan and medication administration procedures in accordance with section <br/>
<a id="pl.310.20"></a><var>310.20</var><statute_ref>245D.09, subdivision 4</statute_ref>, paragraph (c), if not previously reviewed by the staff person.<br/>
<a id="pl.310.21"></a><var>310.21</var>    Subd. 5. <b>Program certification.</b> An applicant or a license holder may apply for <br/>
<a id="pl.310.22"></a><var>310.22</var>program certification as identified in section 245D.33.<br/>
<a id="pl.310.23"></a><var>310.23</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.20.0"></a><a id="pl.310.24"></a><var>310.24</var>    Sec. 20. Minnesota Statutes 2012, section 245D.04, is amended to read:<br/>
<a id="pl.310.25"></a><var>310.25</var><b>245D.04 SERVICE RECIPIENT RIGHTS.</b><br/>
<a id="pl.310.26"></a><var>310.26</var>    Subdivision 1. <b>License holder responsibility for individual rights of persons </b><br/>
<a id="pl.310.27"></a><var>310.27</var><b>served by the program. </b> The license holder must:<br/>
<a id="pl.310.28"></a><var>310.28</var>(1) provide each person or each person's legal representative with a written notice <br/>
<a id="pl.310.29"></a><var>310.29</var>that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of <br/>
<a id="pl.310.30"></a><var>310.30</var>those rights within five working days of service initiation and annually thereafter;<br/>
<a id="pl.310.31"></a><var>310.31</var>(2) make reasonable accommodations to provide this information in other formats <br/>
<a id="pl.310.32"></a><var>310.32</var>or languages as needed to facilitate understanding of the rights by the person and the <br/>
<a id="pl.310.33"></a><var>310.33</var>person's legal representative, if any;<br/>
<a id="pl.311.1"></a><var>311.1</var>(3) maintain documentation of the person's or the person's legal representative's <br/>
<a id="pl.311.2"></a><var>311.2</var>receipt of a copy and an explanation of the rights; and<br/>
<a id="pl.311.3"></a><var>311.3</var>(4) ensure the exercise and protection of the person's rights in the services provided <br/>
<a id="pl.311.4"></a><var>311.4</var>by the license holder and as authorized in the coordinated service and support plan.<br/>
<a id="pl.311.5"></a><var>311.5</var>    Subd. 2. <b>Service-related rights.</b> A person's service-related rights include the right to:<br/>
<a id="pl.311.6"></a><var>311.6</var>(1) participate in the development and evaluation of the services provided to the <br/>
<a id="pl.311.7"></a><var>311.7</var>person;<br/>
<a id="pl.311.8"></a><var>311.8</var>(2) have services and supports identified in the coordinated service and support plan <br/>
<a id="pl.311.9"></a><var>311.9</var>and the coordinated service and support plan addendum provided in a manner that respects <br/>
<a id="pl.311.10"></a><var>311.10</var>and takes into consideration the person's preferences according to the requirements in <br/>
<a id="pl.311.11"></a><var>311.11</var>sections 245D.07 and 245D.071;<br/>
<a id="pl.311.12"></a><var>311.12</var>(3) refuse or terminate services and be informed of the consequences of refusing <br/>
<a id="pl.311.13"></a><var>311.13</var>or terminating services;<br/>
<a id="pl.311.14"></a><var>311.14</var>(4) know, in advance, limits to the services available from the license holder, <br/>
<a id="pl.311.15"></a><var>311.15</var>including the license holder's knowledge, skill, and ability to meet the person's service and <br/>
<a id="pl.311.16"></a><var>311.16</var>support needs based on the information required in section 245D.031, subdivision 2;<br/>
<a id="pl.311.17"></a><var>311.17</var>(5) know conditions and terms governing the provision of services, including the <br/>
<a id="pl.311.18"></a><var>311.18</var>license holder's admission criteria and policies and procedures related to temporary <br/>
<a id="pl.311.19"></a><var>311.19</var>service suspension and service termination;<br/>
<a id="pl.311.20"></a><var>311.20</var>(6) a coordinated transfer to ensure continuity of care when there will be a change <br/>
<a id="pl.311.21"></a><var>311.21</var>in the provider;<br/>
<a id="pl.311.22"></a><var>311.22</var>(7) know what the charges are for services, regardless of who will be paying for the <br/>
<a id="pl.311.23"></a><var>311.23</var>services, and be notified of changes in those charges;<br/>
<a id="pl.311.24"></a><var>311.24</var>(7) (8) know, in advance, whether services are covered by insurance, government <br/>
<a id="pl.311.25"></a><var>311.25</var>funding, or other sources, and be told of any charges the person or other private party <br/>
<a id="pl.311.26"></a><var>311.26</var>may have to pay; and<br/>
<a id="pl.311.27"></a><var>311.27</var>(8) (9) receive services from an individual who is competent and trained, who has <br/>
<a id="pl.311.28"></a><var>311.28</var>professional certification or licensure, as required, and who meets additional qualifications <br/>
<a id="pl.311.29"></a><var>311.29</var>identified in the person's coordinated service and support plan. or coordinated service and <br/>
<a id="pl.311.30"></a><var>311.30</var>support plan addendum.<br/>
<a id="pl.311.31"></a><var>311.31</var>    Subd. 3. <b>Protection-related rights.</b> (a) A person's protection-related rights include <br/>
<a id="pl.311.32"></a><var>311.32</var>the right to:<br/>
<a id="pl.311.33"></a><var>311.33</var>(1) have personal, financial, service, health, and medical information kept private, <br/>
<a id="pl.311.34"></a><var>311.34</var>and be advised of disclosure of this information by the license holder;<br/>
<a id="pl.311.35"></a><var>311.35</var>(2) access records and recorded information about the person in accordance with <br/>
<a id="pl.311.36"></a><var>311.36</var>applicable state and federal law, regulation, or rule;<br/>
<a id="pl.312.1"></a><var>312.1</var>(3) be free from maltreatment;<br/>
<a id="pl.312.2"></a><var>312.2</var>(4) be free from restraint, time out, or seclusion used for a purpose other than except <br/>
<a id="pl.312.3"></a><var>312.3</var>for emergency use of manual restraint to protect the person from imminent danger to self <br/>
<a id="pl.312.4"></a><var>312.4</var>or others according to the requirements in section 245D.06;<br/>
<a id="pl.312.5"></a><var>312.5</var>(5) receive services in a clean and safe environment when the license holder is the <br/>
<a id="pl.312.6"></a><var>312.6</var>owner, lessor, or tenant of the service site;<br/>
<a id="pl.312.7"></a><var>312.7</var>(6) be treated with courtesy and respect and receive respectful treatment of the <br/>
<a id="pl.312.8"></a><var>312.8</var>person's property;<br/>
<a id="pl.312.9"></a><var>312.9</var>(7) reasonable observance of cultural and ethnic practice and religion;<br/>
<a id="pl.312.10"></a><var>312.10</var>(8) be free from bias and harassment regarding race, gender, age, disability, <br/>
<a id="pl.312.11"></a><var>312.11</var>spirituality, and sexual orientation;<br/>
<a id="pl.312.12"></a><var>312.12</var>(9) be informed of and use the license holder's grievance policy and procedures, <br/>
<a id="pl.312.13"></a><var>312.13</var>including knowing how to contact persons responsible for addressing problems and to <br/>
<a id="pl.312.14"></a><var>312.14</var>appeal under section 
         <statute_ref>256.045</statute_ref>;<br/>
<a id="pl.312.15"></a><var>312.15</var>(10) know the name, telephone number, and the Web site, e-mail, and street <br/>
<a id="pl.312.16"></a><var>312.16</var>addresses of protection and advocacy services, including the appropriate state-appointed <br/>
<a id="pl.312.17"></a><var>312.17</var>ombudsman, and a brief description of how to file a complaint with these offices;<br/>
<a id="pl.312.18"></a><var>312.18</var>(11) assert these rights personally, or have them asserted by the person's family, <br/>
<a id="pl.312.19"></a><var>312.19</var>authorized representative, or legal representative, without retaliation;<br/>
<a id="pl.312.20"></a><var>312.20</var>(12) give or withhold written informed consent to participate in any research or <br/>
<a id="pl.312.21"></a><var>312.21</var>experimental treatment;<br/>
<a id="pl.312.22"></a><var>312.22</var>(13) associate with other persons of the person's choice;<br/>
<a id="pl.312.23"></a><var>312.23</var>(14) personal privacy; and<br/>
<a id="pl.312.24"></a><var>312.24</var>(15) engage in chosen activities.<br/>
<a id="pl.312.25"></a><var>312.25</var>(b) For a person residing in a residential site licensed according to chapter 245A, <br/>
<a id="pl.312.26"></a><var>312.26</var>or where the license holder is the owner, lessor, or tenant of the residential service site, <br/>
<a id="pl.312.27"></a><var>312.27</var>protection-related rights also include the right to:<br/>
<a id="pl.312.28"></a><var>312.28</var>(1) have daily, private access to and use of a non-coin-operated telephone for local <br/>
<a id="pl.312.29"></a><var>312.29</var>calls and long-distance calls made collect or paid for by the person;<br/>
<a id="pl.312.30"></a><var>312.30</var>(2) receive and send, without interference, uncensored, unopened mail or electronic <br/>
<a id="pl.312.31"></a><var>312.31</var>correspondence or communication; and<br/>
<a id="pl.312.32"></a><var>312.32</var>(3) have use of and free access to common areas in the residence; and <br/>
<a id="pl.312.33"></a><var>312.33</var>(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious <br/>
<a id="pl.312.34"></a><var>312.34</var>advisor, or others, in accordance with section 
         <statute_ref>363A.09</statute_ref> of the Human Rights Act, including <br/>
<a id="pl.312.35"></a><var>312.35</var>privacy in the person's bedroom.<br/>
<a id="pl.313.1"></a><var>313.1</var>(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a), <br/>
<a id="pl.313.2"></a><var>313.2</var>clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure <br/>
<a id="pl.313.3"></a><var>313.3</var>the health, safety, and well-being of the person. Any restriction of those rights must be <br/>
<a id="pl.313.4"></a><var>313.4</var>documented in the person's coordinated service and support plan for the person and or <br/>
<a id="pl.313.5"></a><var>313.5</var>coordinated service and support plan addendum. The restriction must be implemented <br/>
<a id="pl.313.6"></a><var>313.6</var>in the least restrictive alternative manner necessary to protect the person and provide <br/>
<a id="pl.313.7"></a><var>313.7</var>support to reduce or eliminate the need for the restriction in the most integrated setting <br/>
<a id="pl.313.8"></a><var>313.8</var>and inclusive manner. The documentation must include the following information:<br/>
<a id="pl.313.9"></a><var>313.9</var>(1) the justification for the restriction based on an assessment of the person's <br/>
<a id="pl.313.10"></a><var>313.10</var>vulnerability related to exercising the right without restriction;<br/>
<a id="pl.313.11"></a><var>313.11</var>(2) the objective measures set as conditions for ending the restriction;<br/>
<a id="pl.313.12"></a><var>313.12</var>(3) a schedule for reviewing the need for the restriction based on the conditions for <br/>
<a id="pl.313.13"></a><var>313.13</var>ending the restriction to occur, at a minimum, every three months for persons who do not <br/>
<a id="pl.313.14"></a><var>313.14</var>have a legal representative and annually for persons who do have a legal representative<br/>
<a id="pl.313.15"></a><var>313.15</var> semiannually from the date of initial approval, at a minimum, or more frequently if <br/>
<a id="pl.313.16"></a><var>313.16</var>requested by the person, the person's legal representative, if any, and case manager; and<br/>
<a id="pl.313.17"></a><var>313.17</var>(4) signed and dated approval for the restriction from the person, or the person's <br/>
<a id="pl.313.18"></a><var>313.18</var>legal representative, if any. A restriction may be implemented only when the required <br/>
<a id="pl.313.19"></a><var>313.19</var>approval has been obtained. Approval may be withdrawn at any time. If approval is <br/>
<a id="pl.313.20"></a><var>313.20</var>withdrawn, the right must be immediately and fully restored.<br/>
<a id="pl.313.21"></a><var>313.21</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.21.0"></a><a id="pl.313.22"></a><var>313.22</var>    Sec. 21. Minnesota Statutes 2012, section 245D.05, is amended to read:<br/>
<a id="pl.313.23"></a><var>313.23</var><b>245D.05 HEALTH SERVICES.</b><br/>
<a id="pl.313.24"></a><var>313.24</var>    Subdivision 1. <b>Health needs.</b> (a) The license holder is responsible for providing<br/>
<a id="pl.313.25"></a><var>313.25</var> meeting health services service needs assigned in the coordinated service and support plan <br/>
<a id="pl.313.26"></a><var>313.26</var>and or the coordinated service and support plan addendum, consistent with the person's <br/>
<a id="pl.313.27"></a><var>313.27</var>health needs. The license holder is responsible for promptly notifying the person or<br/>
<a id="pl.313.28"></a><var>313.28</var> the person's legal representative, if any, and the case manager of changes in a person's <br/>
<a id="pl.313.29"></a><var>313.29</var>physical and mental health needs affecting assigned health services service needs assigned <br/>
<a id="pl.313.30"></a><var>313.30</var>to the license holder in the coordinated service and support plan or the coordinated service <br/>
<a id="pl.313.31"></a><var>313.31</var>and support plan addendum, when discovered by the license holder, unless the license <br/>
<a id="pl.313.32"></a><var>313.32</var>holder has reason to know the change has already been reported. The license holder <br/>
<a id="pl.313.33"></a><var>313.33</var>must document when the notice is provided.<br/>
<a id="pl.314.1"></a><var>314.1</var>(b) When assigned in the service plan, If responsibility for meeting the person's <br/>
<a id="pl.314.2"></a><var>314.2</var>health service needs has been assigned to the license holder in the coordinated service and <br/>
<a id="pl.314.3"></a><var>314.3</var>support plan or the coordinated service and support plan addendum, the license holder is <br/>
<a id="pl.314.4"></a><var>314.4</var>required to must maintain documentation on how the person's health needs will be met, <br/>
<a id="pl.314.5"></a><var>314.5</var>including a description of the procedures the license holder will follow in order to:<br/>
<a id="pl.314.6"></a><var>314.6</var>(1) provide medication administration, assistance or medication assistance, or <br/>
<a id="pl.314.7"></a><var>314.7</var>medication management administration according to this chapter;<br/>
<a id="pl.314.8"></a><var>314.8</var>(2) monitor health conditions according to written instructions from the person's <br/>
<a id="pl.314.9"></a><var>314.9</var>physician or a licensed health professional;<br/>
<a id="pl.314.10"></a><var>314.10</var>(3) assist with or coordinate medical, dental, and other health service appointments; or<br/>
<a id="pl.314.11"></a><var>314.11</var>(4) use medical equipment, devices, or adaptive aides or technology safely and <br/>
<a id="pl.314.12"></a><var>314.12</var>correctly according to written instructions from the person's physician or a licensed <br/>
<a id="pl.314.13"></a><var>314.13</var>health professional.<br/>
<a id="pl.314.14"></a><var>314.14</var>    Subd. 1a. <b>Medication setup.</b> For the purposes of this subdivision, "medication <br/>
<a id="pl.314.15"></a><var>314.15</var>setup" means the arranging of medications according to instructions from the pharmacy, <br/>
<a id="pl.314.16"></a><var>314.16</var>the prescriber, or a licensed nurse, for later administration when the license holder <br/>
<a id="pl.314.17"></a><var>314.17</var>is assigned responsibility for medication assistance or medication administration in <br/>
<a id="pl.314.18"></a><var>314.18</var>the coordinated service and support plan or the coordinated service and support plan <br/>
<a id="pl.314.19"></a><var>314.19</var>addendum. A prescription label or the prescriber's written or electronically recorded order <br/>
<a id="pl.314.20"></a><var>314.20</var>for the prescription is sufficient to constitute written instructions from the prescriber. The <br/>
<a id="pl.314.21"></a><var>314.21</var>license holder must document in the person's medication administration record: dates <br/>
<a id="pl.314.22"></a><var>314.22</var>of setup, name of medication, quantity of dose, times to be administered, and route of <br/>
<a id="pl.314.23"></a><var>314.23</var>administration at time of setup; and, when the person will be away from home, to whom <br/>
<a id="pl.314.24"></a><var>314.24</var>the medications were given.<br/>
<a id="pl.314.25"></a><var>314.25</var>    Subd. 1b. <b>Medication assistance.</b> If responsibility for medication assistance <br/>
<a id="pl.314.26"></a><var>314.26</var>is assigned to the license holder in the coordinated service and support plan or the <br/>
<a id="pl.314.27"></a><var>314.27</var>coordinated service and support plan addendum, the license holder must ensure that <br/>
<a id="pl.314.28"></a><var>314.28</var>the requirements of subdivision 2, paragraph (b), have been met when staff provides <br/>
<a id="pl.314.29"></a><var>314.29</var>medication assistance to enable a person to self-administer medication or treatment when <br/>
<a id="pl.314.30"></a><var>314.30</var>the person is capable of directing the person's own care, or when the person's legal <br/>
<a id="pl.314.31"></a><var>314.31</var>representative is present and able to direct care for the person. For the purposes of this <br/>
<a id="pl.314.32"></a><var>314.32</var>subdivision, "medication assistance" means any of the following:<br/>
<a id="pl.314.33"></a><var>314.33</var>(1) bringing to the person and opening a container of previously set up medications, <br/>
<a id="pl.314.34"></a><var>314.34</var>emptying the container into the person's hand, or opening and giving the medications in <br/>
<a id="pl.314.35"></a><var>314.35</var>the original container to the person;<br/>
<a id="pl.314.36"></a><var>314.36</var>(2) bringing to the person liquids or food to accompany the medication; or<br/>
<a id="pl.315.1"></a><var>315.1</var>(3) providing reminders to take regularly scheduled medication or perform regularly <br/>
<a id="pl.315.2"></a><var>315.2</var>scheduled treatments and exercises.<br/>
<a id="pl.315.3"></a><var>315.3</var>    Subd. 2. <b>Medication administration.</b> (a) If responsibility for medication <br/>
<a id="pl.315.4"></a><var>315.4</var>administration is assigned to the license holder in the coordinated service and support plan <br/>
<a id="pl.315.5"></a><var>315.5</var>or the coordinated service and support plan addendum, the license holder must implement <br/>
<a id="pl.315.6"></a><var>315.6</var>the following medication administration procedures to ensure a person takes medications <br/>
<a id="pl.315.7"></a><var>315.7</var>and treatments as prescribed:<br/>
<a id="pl.315.8"></a><var>315.8</var>(1) checking the person's medication record;<br/>
<a id="pl.315.9"></a><var>315.9</var>(2) preparing the medication as necessary;<br/>
<a id="pl.315.10"></a><var>315.10</var>(3) administering the medication or treatment to the person;<br/>
<a id="pl.315.11"></a><var>315.11</var>(4) documenting the administration of the medication or treatment or the reason for <br/>
<a id="pl.315.12"></a><var>315.12</var>not administering the medication or treatment; and<br/>
<a id="pl.315.13"></a><var>315.13</var>(5) reporting to the prescriber or a nurse any concerns about the medication or <br/>
<a id="pl.315.14"></a><var>315.14</var>treatment, including side effects, effectiveness, or a pattern of the person refusing to <br/>
<a id="pl.315.15"></a><var>315.15</var>take the medication or treatment as prescribed. Adverse reactions must be immediately <br/>
<a id="pl.315.16"></a><var>315.16</var>reported to the prescriber or a nurse.<br/>
<a id="pl.315.17"></a><var>315.17</var>(b)(1) The license holder must ensure that the following criteria requirements in <br/>
<a id="pl.315.18"></a><var>315.18</var>clauses (2) to (4) have been met before staff that is not a licensed health professional <br/>
<a id="pl.315.19"></a><var>315.19</var>administers administering medication or treatment:.<br/>
<a id="pl.315.20"></a><var>315.20</var>(1) (2) The license holder must obtain written authorization has been obtained from <br/>
<a id="pl.315.21"></a><var>315.21</var>the person or the person's legal representative to administer medication or treatment <br/>
<a id="pl.315.22"></a><var>315.22</var>orders; and must obtain reauthorization annually as needed. If the person or the person's <br/>
<a id="pl.315.23"></a><var>315.23</var>legal representative refuses to authorize the license holder to administer medication, the <br/>
<a id="pl.315.24"></a><var>315.24</var>medication must not be administered. The refusal to authorize medication administration <br/>
<a id="pl.315.25"></a><var>315.25</var>must be reported to the prescriber as expediently as possible.<br/>
<a id="pl.315.26"></a><var>315.26</var>(2) (3) The staff person has completed responsible for administering the medication <br/>
<a id="pl.315.27"></a><var>315.27</var>or treatment must complete medication administration training according to section <br/>
<statute_ref><a id="pl.315.28"></a><var>315.28</var>245D.09, subdivision 4
</statute_ref>, paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable <br/>
<a id="pl.315.29"></a><var>315.29</var>to the person, paragraph (d).<br/>
<a id="pl.315.30"></a><var>315.30</var>(3) The medication or treatment will be administered under administration <br/>
<a id="pl.315.31"></a><var>315.31</var>procedures established for the person in consultation with a licensed health professional. <br/>
<a id="pl.315.32"></a><var>315.32</var>written instruction from the person's physician may constitute the medication <br/>
<a id="pl.315.33"></a><var>315.33</var>administration procedures. A prescription label or the prescriber's order for the <br/>
<a id="pl.315.34"></a><var>315.34</var>prescription is sufficient to constitute written instructions from the prescriber. A licensed <br/>
<a id="pl.315.35"></a><var>315.35</var>health professional may delegate medication administration procedures.<br/>
<a id="pl.316.1"></a><var>316.1</var>(4) For a license holder providing intensive support services, the medication or <br/>
<a id="pl.316.2"></a><var>316.2</var>treatment must be administered according to the license holder's medication administration <br/>
<a id="pl.316.3"></a><var>316.3</var>policy and procedures as required under section 245D.11, subdivision 2, clause (3).<br/>
<a id="pl.316.4"></a><var>316.4</var>(b) (c) The license holder must ensure the following information is documented in <br/>
<a id="pl.316.5"></a><var>316.5</var>the person's medication administration record:<br/>
<a id="pl.316.6"></a><var>316.6</var>(1) the information on the current prescription label or the prescriber's current written <br/>
<a id="pl.316.7"></a><var>316.7</var>or electronically recorded order or prescription that includes directions for the person's <br/>
<a id="pl.316.8"></a><var>316.8</var>name, description of the medication or treatment to be provided, and the frequency and <br/>
<a id="pl.316.9"></a><var>316.9</var>other information needed to safely and correctly administering administer the medication <br/>
<a id="pl.316.10"></a><var>316.10</var>or treatment to ensure effectiveness;<br/>
<a id="pl.316.11"></a><var>316.11</var>(2) information on any discomforts, risks, or other side effects that are reasonable to <br/>
<a id="pl.316.12"></a><var>316.12</var>expect, and any contraindications to its use. This information must be readily available <br/>
<a id="pl.316.13"></a><var>316.13</var>to all staff administering the medication;<br/>
<a id="pl.316.14"></a><var>316.14</var>(3) the possible consequences if the medication or treatment is not taken or <br/>
<a id="pl.316.15"></a><var>316.15</var>administered as directed;<br/>
<a id="pl.316.16"></a><var>316.16</var>(4) instruction from the prescriber on when and to whom to report the following:<br/>
<a id="pl.316.17"></a><var>316.17</var>(i) if the a dose of medication or treatment is not administered or treatment is not <br/>
<a id="pl.316.18"></a><var>316.18</var>performed as prescribed, whether by error by the staff or the person or by refusal by <br/>
<a id="pl.316.19"></a><var>316.19</var>the person; and<br/>
<a id="pl.316.20"></a><var>316.20</var>(ii) the occurrence of possible adverse reactions to the medication or treatment;<br/>
<a id="pl.316.21"></a><var>316.21</var>(5) notation of any occurrence of a dose of medication not being administered or <br/>
<a id="pl.316.22"></a><var>316.22</var>treatment not performed as prescribed, whether by error by the staff or the person or by <br/>
<a id="pl.316.23"></a><var>316.23</var>refusal by the person, or of adverse reactions, and when and to whom the report was <br/>
<a id="pl.316.24"></a><var>316.24</var>made; and<br/>
<a id="pl.316.25"></a><var>316.25</var>(6) notation of when a medication or treatment is started, administered, changed, or <br/>
<a id="pl.316.26"></a><var>316.26</var>discontinued.<br/>
<a id="pl.316.27"></a><var>316.27</var>(c) The license holder must ensure that the information maintained in the medication <br/>
<a id="pl.316.28"></a><var>316.28</var>administration record is current and is regularly reviewed with the person or the person's <br/>
<a id="pl.316.29"></a><var>316.29</var>legal representative and the staff administering the medication to identify medication <br/>
<a id="pl.316.30"></a><var>316.30</var>administration issues or errors. At a minimum, the review must be conducted every three <br/>
<a id="pl.316.31"></a><var>316.31</var>months or more often if requested by the person or the person's legal representative. <br/>
<a id="pl.316.32"></a><var>316.32</var>Based on the review, the license holder must develop and implement a plan to correct <br/>
<a id="pl.316.33"></a><var>316.33</var>medication administration issues or errors. If issues or concerns are identified related to <br/>
<a id="pl.316.34"></a><var>316.34</var>the medication itself, the license holder must report those as required under subdivision 4.<br/>
<a id="pl.316.35"></a><var>316.35</var>    Subd. 3. <b>Medication assistance.</b> The license holder must ensure that the <br/>
<a id="pl.316.36"></a><var>316.36</var>requirements of subdivision 2, paragraph (a), have been met when staff provides assistance <br/>
<a id="pl.317.1"></a><var>317.1</var>to enable a person to self-administer medication when the person is capable of directing <br/>
<a id="pl.317.2"></a><var>317.2</var>the person's own care, or when the person's legal representative is present and able to <br/>
<a id="pl.317.3"></a><var>317.3</var>direct care for the person.<br/>
<a id="pl.317.4"></a><var>317.4</var>    Subd. 4. <b>Reviewing and </b><b>reporting medication and treatment issues.</b> The <br/>
<a id="pl.317.5"></a><var>317.5</var>following medication administration issues must be reported to the person or the person's <br/>
<a id="pl.317.6"></a><var>317.6</var>legal representative and case manager as they occur or following timelines established <br/>
<a id="pl.317.7"></a><var>317.7</var>in the person's service plan or as requested in writing by the person or the person's legal <br/>
<a id="pl.317.8"></a><var>317.8</var>representative, or the case manager: (a) When assigned responsibility for medication <br/>
<a id="pl.317.9"></a><var>317.9</var>administration, the license holder must ensure that the information maintained in <br/>
<a id="pl.317.10"></a><var>317.10</var>the medication administration record is current and is regularly reviewed to identify <br/>
<a id="pl.317.11"></a><var>317.11</var>medication administration errors. At a minimum, the review must be conducted every <br/>
<a id="pl.317.12"></a><var>317.12</var>three months, or more frequently as directed in the coordinated service and support plan <br/>
<a id="pl.317.13"></a><var>317.13</var>or coordinated service and support plan addendum or as requested by the person or the <br/>
<a id="pl.317.14"></a><var>317.14</var>person's legal representative. Based on the review, the license holder must develop and <br/>
<a id="pl.317.15"></a><var>317.15</var>implement a plan to correct patterns of medication administration errors when identified.<br/>
<a id="pl.317.16"></a><var>317.16</var>(b) If assigned responsibility for medication assistance or medication administration, <br/>
<a id="pl.317.17"></a><var>317.17</var>the license holder must report the following to the person's legal representative and case <br/>
<a id="pl.317.18"></a><var>317.18</var>manager as they occur or as otherwise directed in the coordinated service and support plan <br/>
<a id="pl.317.19"></a><var>317.19</var>or the coordinated service and support plan addendum:<br/>
<a id="pl.317.20"></a><var>317.20</var>(1) any reports made to the person's physician or prescriber required under <br/>
<a id="pl.317.21"></a><var>317.21</var>subdivision 2, paragraph (b) (c), clause (4);<br/>
<a id="pl.317.22"></a><var>317.22</var>(2) a person's refusal or failure to take or receive medication or treatment as <br/>
<a id="pl.317.23"></a><var>317.23</var>prescribed; or<br/>
<a id="pl.317.24"></a><var>317.24</var>(3) concerns about a person's self-administration of medication or treatment.<br/>
<a id="pl.317.25"></a><var>317.25</var>    Subd. 5. <b>Injectable medications.</b> Injectable medications may be administered <br/>
<a id="pl.317.26"></a><var>317.26</var>according to a prescriber's order and written instructions when one of the following <br/>
<a id="pl.317.27"></a><var>317.27</var>conditions has been met:<br/>
<a id="pl.317.28"></a><var>317.28</var>(1) a registered nurse or licensed practical nurse will administer the subcutaneous or <br/>
<a id="pl.317.29"></a><var>317.29</var>intramuscular injection;<br/>
<a id="pl.317.30"></a><var>317.30</var>(2) a supervising registered nurse with a physician's order has delegated the <br/>
<a id="pl.317.31"></a><var>317.31</var>administration of subcutaneous injectable medication to an unlicensed staff member <br/>
<a id="pl.317.32"></a><var>317.32</var>and has provided the necessary training; or<br/>
<a id="pl.317.33"></a><var>317.33</var>(3) there is an agreement signed by the license holder, the prescriber, and the <br/>
<a id="pl.317.34"></a><var>317.34</var>person or the person's legal representative specifying what subcutaneous injections may <br/>
<a id="pl.317.35"></a><var>317.35</var>be given, when, how, and that the prescriber must retain responsibility for the license <br/>
<a id="pl.318.1"></a><var>318.1</var>holder's giving the injections. A copy of the agreement must be placed in the person's <br/>
<a id="pl.318.2"></a><var>318.2</var>service recipient record.<br/>
<a id="pl.318.3"></a><var>318.3</var>Only licensed health professionals are allowed to administer psychotropic <br/>
<a id="pl.318.4"></a><var>318.4</var>medications by injection.<br/>
<a id="pl.318.5"></a><var>318.5</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.22.0"></a><a id="pl.318.6"></a><var>318.6</var>    Sec. 22. <b>[245D.051] PSYCHOTROPIC MEDICATION USE AND </b><br/>
<a id="pl.318.7"></a><var>318.7</var><b>MONITORING.</b><br/>
<a id="pl.318.8"></a><var>318.8</var>    Subdivision 1. <b>Conditions for psychotropic medication administration.</b> (a) <br/>
<a id="pl.318.9"></a><var>318.9</var>When a person is prescribed a psychotropic medication and the license holder is assigned <br/>
<a id="pl.318.10"></a><var>318.10</var>responsibility for administration of the medication in the person's coordinated service <br/>
<a id="pl.318.11"></a><var>318.11</var>and support plan or the coordinated service and support plan addendum, the license <br/>
<a id="pl.318.12"></a><var>318.12</var>holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05, <br/>
<a id="pl.318.13"></a><var>318.13</var>subdivision 2, are met.<br/>
<a id="pl.318.14"></a><var>318.14</var>(b) Use of the medication must be included in the person's coordinated service and <br/>
<a id="pl.318.15"></a><var>318.15</var>support plan or in the coordinated service and support plan addendum and based on a <br/>
<a id="pl.318.16"></a><var>318.16</var>prescriber's current written or electronically recorded prescription.<br/>
<a id="pl.318.17"></a><var>318.17</var>(c) The license holder must develop, implement, and maintain the following <br/>
<a id="pl.318.18"></a><var>318.18</var>documentation in the person's coordinated service and support plan addendum according <br/>
<a id="pl.318.19"></a><var>318.19</var>to the requirements in sections 245D.07 and 245D.071:<br/>
<a id="pl.318.20"></a><var>318.20</var>(1) a description of the target symptoms that the psychotropic medication is to <br/>
<a id="pl.318.21"></a><var>318.21</var>alleviate; and<br/>
<a id="pl.318.22"></a><var>318.22</var>(2) documentation methods the license holder will use to monitor and measure <br/>
<a id="pl.318.23"></a><var>318.23</var>changes in the target symptoms that are to be alleviated by the psychotropic medication if <br/>
<a id="pl.318.24"></a><var>318.24</var>required by the prescriber. The license holder must collect and report on medication and <br/>
<a id="pl.318.25"></a><var>318.25</var>symptom-related data as instructed by the prescriber. The license holder must provide <br/>
<a id="pl.318.26"></a><var>318.26</var>the monitoring data to the expanded support team for review every three months, or as <br/>
<a id="pl.318.27"></a><var>318.27</var>otherwise requested by the person or the person's legal representative.<br/>
<a id="pl.318.28"></a><var>318.28</var>For the purposes of this section, "target symptom" refers to any perceptible <br/>
<a id="pl.318.29"></a><var>318.29</var>diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic <br/>
<a id="pl.318.30"></a><var>318.30</var>and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or <br/>
<a id="pl.318.31"></a><var>318.31</var>successive editions that has been identified for alleviation.<br/>
<a id="pl.318.32"></a><var>318.32</var>(d) If a person is prescribed a psychotropic medication, monitoring the use of the <br/>
<a id="pl.318.33"></a><var>318.33</var>psychotropic medication must be assigned to the license holder in the coordinated service <br/>
<a id="pl.318.34"></a><var>318.34</var>and support plan or the coordinated service and support plan addendum. The assigned <br/>
<a id="pl.318.35"></a><var>318.35</var>license holder must monitor the psychotropic medication as required by this section.<br/>
<a id="pl.319.1"></a><var>319.1</var>    Subd. 2. <b>Refusal to authorize psychotropic medication.</b> If the person or the <br/>
<a id="pl.319.2"></a><var>319.2</var>person's legal representative refuses to authorize the administration of a psychotropic <br/>
<a id="pl.319.3"></a><var>319.3</var>medication as ordered by the prescriber, the license holder must follow the requirement <br/>
<a id="pl.319.4"></a><var>319.4</var>in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal <br/>
<a id="pl.319.5"></a><var>319.5</var>to the prescriber, the license holder must follow any directives or orders given by the <br/>
<a id="pl.319.6"></a><var>319.6</var>prescriber. A court order must be obtained to override the refusal. Refusal to authorize <br/>
<a id="pl.319.7"></a><var>319.7</var>administration of a specific psychotropic medication is not grounds for service termination <br/>
<a id="pl.319.8"></a><var>319.8</var>and does not constitute an emergency. A decision to terminate services must be reached in <br/>
<a id="pl.319.9"></a><var>319.9</var>compliance with section 245D.10, subdivision 3.<br/>
<a id="pl.319.10"></a><var>319.10</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.23.0"></a><a id="pl.319.11"></a><var>319.11</var>    Sec. 23. Minnesota Statutes 2012, section 245D.06, is amended to read:<br/>
<a id="pl.319.12"></a><var>319.12</var><b>245D.06 PROTECTION STANDARDS.</b><br/>
<a id="pl.319.13"></a><var>319.13</var>    Subdivision 1. <b>Incident response and reporting. </b> (a) The license holder must <br/>
<a id="pl.319.14"></a><var>319.14</var>respond to all incidents under section 
         <statute_ref>245D.02, subdivision 11</statute_ref>, that occur while providing <br/>
<a id="pl.319.15"></a><var>319.15</var>services to protect the health and safety of and minimize risk of harm to the person.<br/>
<a id="pl.319.16"></a><var>319.16</var>(b) The license holder must maintain information about and report incidents to the <br/>
<a id="pl.319.17"></a><var>319.17</var>person's legal representative or designated emergency contact and case manager within 24 <br/>
<a id="pl.319.18"></a><var>319.18</var>hours of an incident occurring while services are being provided, or within 24 hours of <br/>
<a id="pl.319.19"></a><var>319.19</var>discovery or receipt of information that an incident occurred, unless the license holder <br/>
<a id="pl.319.20"></a><var>319.20</var>has reason to know that the incident has already been reported, or as otherwise directed <br/>
<a id="pl.319.21"></a><var>319.21</var>in a person's coordinated service and support plan or coordinated service and support <br/>
<a id="pl.319.22"></a><var>319.22</var>plan addendum. An incident of suspected or alleged maltreatment must be reported as <br/>
<a id="pl.319.23"></a><var>319.23</var>required under paragraph (d), and an incident of serious injury or death must be reported <br/>
<a id="pl.319.24"></a><var>319.24</var>as required under paragraph (e).<br/>
<a id="pl.319.25"></a><var>319.25</var>(c) When the incident involves more than one person, the license holder must not <br/>
<a id="pl.319.26"></a><var>319.26</var>disclose personally identifiable information about any other person when making the report <br/>
<a id="pl.319.27"></a><var>319.27</var>to each person and case manager unless the license holder has the consent of the person.<br/>
<a id="pl.319.28"></a><var>319.28</var>(d) Within 24 hours of reporting maltreatment as required under section 
         <statute_ref>626.556</statute_ref> <br/>
<a id="pl.319.29"></a><var>319.29</var>or 
         <statute_ref>626.557</statute_ref>, the license holder must inform the case manager of the report unless there is <br/>
<a id="pl.319.30"></a><var>319.30</var>reason to believe that the case manager is involved in the suspected maltreatment. The <br/>
<a id="pl.319.31"></a><var>319.31</var>license holder must disclose the nature of the activity or occurrence reported and the <br/>
<a id="pl.319.32"></a><var>319.32</var>agency that received the report.<br/>
<a id="pl.319.33"></a><var>319.33</var>(e) The license holder must report the death or serious injury of the person to the legal <br/>
<a id="pl.319.34"></a><var>319.34</var>representative, if any, and case manager, as required in paragraph (b) and to  the Department <br/>
<a id="pl.320.1"></a><var>320.1</var>of Human Services Licensing Division, and the Office of Ombudsman for Mental Health <br/>
<a id="pl.320.2"></a><var>320.2</var>and Developmental Disabilities as required under section 
         <statute_ref>245.94, subdivision 2a</statute_ref>, within <br/>
<a id="pl.320.3"></a><var>320.3</var>24 hours of the death, or receipt of information that the death occurred, unless the license <br/>
<a id="pl.320.4"></a><var>320.4</var>holder has reason to know that the death has already been reported.<br/>
<a id="pl.320.5"></a><var>320.5</var>(f) When a death or serious injury occurs in a facility certified as an intermediate <br/>
<a id="pl.320.6"></a><var>320.6</var>care facility for persons with developmental disabilities, the death or serious injury must <br/>
<a id="pl.320.7"></a><var>320.7</var>be reported to the Department of Health, Office of Health Facility Complaints, and the <br/>
<a id="pl.320.8"></a><var>320.8</var>Office of Ombudsman for Mental Health and Developmental Disabilities, as required <br/>
<a id="pl.320.9"></a><var>320.9</var>under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to <br/>
<a id="pl.320.10"></a><var>320.10</var>know that the death has already been reported.<br/>
<a id="pl.320.11"></a><var>320.11</var>(f) (g) The license holder must conduct a an internal review of incident reports of <br/>
<a id="pl.320.12"></a><var>320.12</var>deaths and serious injuries that occurred while services were being provided and that <br/>
<a id="pl.320.13"></a><var>320.13</var>were not reported by the program as alleged or suspected maltreatment, for identification <br/>
<a id="pl.320.14"></a><var>320.14</var>of incident patterns, and implementation of corrective action as necessary to reduce <br/>
<a id="pl.320.15"></a><var>320.15</var>occurrences. The review must include an evaluation of whether related policies and <br/>
<a id="pl.320.16"></a><var>320.16</var>procedures were followed, whether the policies and procedures were adequate, whether <br/>
<a id="pl.320.17"></a><var>320.17</var>there is a need for additional staff training, whether the reported event is similar to past <br/>
<a id="pl.320.18"></a><var>320.18</var>events with the persons or the services involved, and whether there is a need for corrective <br/>
<a id="pl.320.19"></a><var>320.19</var>action by the license holder to protect the health and safety of persons receiving services. <br/>
<a id="pl.320.20"></a><var>320.20</var>Based on the results of this review, the license holder must develop, document, and <br/>
<a id="pl.320.21"></a><var>320.21</var>implement a corrective action plan designed to correct current lapses and prevent future <br/>
<a id="pl.320.22"></a><var>320.22</var>lapses in performance by staff or the license holder, if any.<br/>
<a id="pl.320.23"></a><var>320.23</var>(h) The license holder must verbally report the emergency use of manual restraint of <br/>
<a id="pl.320.24"></a><var>320.24</var>a person as required in paragraph (b), within 24 hours of the occurrence. The license holder <br/>
<a id="pl.320.25"></a><var>320.25</var>must ensure the written report and internal review of all incident reports of the emergency <br/>
<a id="pl.320.26"></a><var>320.26</var>use of manual restraints are completed according to the requirements in section 245D.061.<br/>
<a id="pl.320.27"></a><var>320.27</var>    Subd. 2. <b>Environment and safety.</b> The license holder must:<br/>
<a id="pl.320.28"></a><var>320.28</var>(1) ensure the following when the license holder is the owner, lessor, or tenant <br/>
<a id="pl.320.29"></a><var>320.29</var>of the an unlicensed service site:<br/>
<a id="pl.320.30"></a><var>320.30</var>(i) the service site is a safe and hazard-free environment;<br/>
<a id="pl.320.31"></a><var>320.31</var>(ii) doors are locked or toxic substances or dangerous items normally accessible are <br/>
<a id="pl.320.32"></a><var>320.32</var>inaccessible to persons served by the program are stored in locked cabinets, drawers, or <br/>
<a id="pl.320.33"></a><var>320.33</var>containers only to protect the safety of a person receiving services and not as a substitute <br/>
<a id="pl.320.34"></a><var>320.34</var>for staff supervision or interactions with a person who is receiving services. If doors are <br/>
<a id="pl.320.35"></a><var>320.35</var>locked or toxic substances or dangerous items normally accessible to persons served by the <br/>
<a id="pl.320.36"></a><var>320.36</var>program are stored in locked cabinets, drawers, or containers are made inaccessible, the <br/>
<a id="pl.321.1"></a><var>321.1</var>license holder must justify and document how this determination was made in consultation <br/>
<a id="pl.321.2"></a><var>321.2</var>with the person or person's legal representative, and how access will otherwise be provided <br/>
<a id="pl.321.3"></a><var>321.3</var>to the person and all other affected persons receiving services; and document an assessment <br/>
<a id="pl.321.4"></a><var>321.4</var>of the physical plant, its environment, and its population identifying the risk factors which <br/>
<a id="pl.321.5"></a><var>321.5</var>require toxic substances or dangerous items to be inaccessible and a statement of specific <br/>
<a id="pl.321.6"></a><var>321.6</var>measures to be taken to minimize the safety risk to persons receiving services;<br/>
<a id="pl.321.7"></a><var>321.7</var>(iii) doors are locked from the inside to prevent a person from exiting only when <br/>
<a id="pl.321.8"></a><var>321.8</var>necessary to protect the safety of a person receiving services and not as a substitute for <br/>
<a id="pl.321.9"></a><var>321.9</var>staff supervision or interactions with the person. If doors are locked from the inside, the <br/>
<a id="pl.321.10"></a><var>321.10</var>license holder must document an assessment of the physical plant, the environment and <br/>
<a id="pl.321.11"></a><var>321.11</var>the population served, identifying the risk factors which require the use of locked doors, <br/>
<a id="pl.321.12"></a><var>321.12</var>and a statement of specific measures to be taken to minimize the safety risk to persons <br/>
<a id="pl.321.13"></a><var>321.13</var>receiving services at the service site; and<br/>
<a id="pl.321.14"></a><var>321.14</var>(iii) (iv) a staff person is available on site who is trained in basic first aid and, when <br/>
<a id="pl.321.15"></a><var>321.15</var>required in a person's coordinated service and support plan or coordinated service and <br/>
<a id="pl.321.16"></a><var>321.16</var>support plan addendum, cardiopulmonary resuscitation, "CPR," whenever persons are <br/>
<a id="pl.321.17"></a><var>321.17</var>present and staff are required to be at the site to provide direct service. The CPR training <br/>
<a id="pl.321.18"></a><var>321.18</var>must include in-person instruction, hands-on practice, and an observed skills assessment <br/>
<a id="pl.321.19"></a><var>321.19</var>under the direct supervision of a CPR instructor;<br/>
<a id="pl.321.20"></a><var>321.20</var>(2) maintain equipment, vehicles, supplies, and materials owned or leased by the <br/>
<a id="pl.321.21"></a><var>321.21</var>license holder in good condition when used to provide services;<br/>
<a id="pl.321.22"></a><var>321.22</var>(3) follow procedures to ensure safe transportation, handling, and transfers of the <br/>
<a id="pl.321.23"></a><var>321.23</var>person and any equipment used by the person, when the license holder is responsible for <br/>
<a id="pl.321.24"></a><var>321.24</var>transportation of a person or a person's equipment;<br/>
<a id="pl.321.25"></a><var>321.25</var>(4) be prepared for emergencies and follow emergency response procedures to <br/>
<a id="pl.321.26"></a><var>321.26</var>ensure the person's safety in an emergency; and<br/>
<a id="pl.321.27"></a><var>321.27</var>(5) follow universal precautions and sanitary practices, including hand washing, for <br/>
<a id="pl.321.28"></a><var>321.28</var>infection prevention and control, and to prevent communicable diseases.<br/>
<a id="pl.321.29"></a><var>321.29</var>    Subd. 3. <b>Compliance with fire and safety codes.</b> When services are provided at a<br/>
<a id="pl.321.30"></a><var>321.30</var> service site licensed according to chapter 245A or where the license holder is the owner, <br/>
<a id="pl.321.31"></a><var>321.31</var>lessor, or tenant of the service site, the license holder must document compliance with <br/>
<a id="pl.321.32"></a><var>321.32</var>applicable building codes, fire and safety codes, health rules, and zoning ordinances, or <br/>
<a id="pl.321.33"></a><var>321.33</var>document that an appropriate waiver has been granted.<br/>
<a id="pl.321.34"></a><var>321.34</var>    Subd. 4. <b>Funds and property.</b> (a) Whenever the license holder assists a person <br/>
<a id="pl.321.35"></a><var>321.35</var>with the safekeeping of funds or other property according to section 
         <statute_ref>245A.04, subdivision <br/>
<a id="pl.321.36"></a><var>321.36</var>13
         </statute_ref>, the license holder must have obtain written authorization to do so from the person or <br/>
<a id="pl.322.1"></a><var>322.1</var>the person's legal representative and the case manager. Authorization must be obtained <br/>
<a id="pl.322.2"></a><var>322.2</var>within five working days of service initiation and renewed annually thereafter. At the time <br/>
<a id="pl.322.3"></a><var>322.3</var>initial authorization is obtained, the license holder must survey, document, and implement <br/>
<a id="pl.322.4"></a><var>322.4</var>the preferences of the person or the person's legal representative and the case manager <br/>
<a id="pl.322.5"></a><var>322.5</var>for frequency of receiving a statement that itemizes receipts and disbursements of funds <br/>
<a id="pl.322.6"></a><var>322.6</var>or other property. The license holder must document changes to these preferences when <br/>
<a id="pl.322.7"></a><var>322.7</var>they are requested.<br/>
<a id="pl.322.8"></a><var>322.8</var>(b) A license holder or staff person may not accept powers-of-attorney from a <br/>
<a id="pl.322.9"></a><var>322.9</var>person receiving services from the license holder for any purpose, and may not accept an <br/>
<a id="pl.322.10"></a><var>322.10</var>appointment as guardian or conservator of a person receiving services from the license <br/>
<a id="pl.322.11"></a><var>322.11</var>holder. This does not apply to license holders that are Minnesota counties or other <br/>
<a id="pl.322.12"></a><var>322.12</var>units of government or to staff persons employed by license holders who were acting <br/>
<a id="pl.322.13"></a><var>322.13</var>as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals <br/>
<a id="pl.322.14"></a><var>322.14</var>prior to April 23, 2012  implementation of this chapter. The license holder must maintain <br/>
<a id="pl.322.15"></a><var>322.15</var>documentation of the power-of-attorney, guardianship, or conservatorship in the service <br/>
<a id="pl.322.16"></a><var>322.16</var>recipient record.<br/>
<a id="pl.322.17"></a><var>322.17</var>(c) Upon the transfer or death of a person, any funds or other property of the person <br/>
<a id="pl.322.18"></a><var>322.18</var>must be surrendered to the person or the person's legal representative, or given to the <br/>
<a id="pl.322.19"></a><var>322.19</var>executor or administrator of the estate in exchange for an itemized receipt.<br/>
<a id="pl.322.20"></a><var>322.20</var>    Subd. 5. <b>Prohibitions.</b> (a) The license holder is prohibited from using psychotropic <br/>
<a id="pl.322.21"></a><var>322.21</var>medication chemical restraints, mechanical restraint practices, manual restraints, time out, <br/>
<a id="pl.322.22"></a><var>322.22</var>or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program <br/>
<a id="pl.322.23"></a><var>322.23</var>to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason <br/>
<a id="pl.322.24"></a><var>322.24</var>other than as prescribed.<br/>
<a id="pl.322.25"></a><var>322.25</var>(b) The license holder is prohibited from using restraints or seclusion under any <br/>
<a id="pl.322.26"></a><var>322.26</var>circumstance, unless the commissioner has approved a variance request from the license <br/>
<a id="pl.322.27"></a><var>322.27</var>holder that allows for the emergency use of restraints and seclusion according to terms <br/>
<a id="pl.322.28"></a><var>322.28</var>and conditions approved in the variance. Applicants and license holders who have <br/>
<a id="pl.322.29"></a><var>322.29</var>reason to believe they may be serving an individual who will need emergency use of <br/>
<a id="pl.322.30"></a><var>322.30</var>restraints or seclusion may request a variance on the application or reapplication, and <br/>
<a id="pl.322.31"></a><var>322.31</var>the commissioner shall automatically review the request for a variance as part of the <br/>
<a id="pl.322.32"></a><var>322.32</var>application or reapplication process. License holders may also request the variance any <br/>
<a id="pl.322.33"></a><var>322.33</var>time after issuance of a license. In the event a license holder uses restraint or seclusion for <br/>
<a id="pl.322.34"></a><var>322.34</var>any reason without first obtaining a variance as required, the license holder must report <br/>
<a id="pl.322.35"></a><var>322.35</var>the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the <br/>
<a id="pl.322.36"></a><var>322.36</var>occurrence and request the required variance.<br/>
<a id="pl.323.1"></a><var>323.1</var>(b) For the purposes of this subdivision, "chemical restraint" means the <br/>
<a id="pl.323.2"></a><var>323.2</var>administration of a drug or medication to control the person's behavior or restrict the <br/>
<a id="pl.323.3"></a><var>323.3</var>person's freedom of movement and is not a standard treatment of dosage for the person's <br/>
<a id="pl.323.4"></a><var>323.4</var>medical or psychological condition.<br/>
<a id="pl.323.5"></a><var>323.5</var>(c) For the purposes of this subdivision, "mechanical restraint practice" means the <br/>
<a id="pl.323.6"></a><var>323.6</var>use of any adaptive equipment or safety device to control the person's behavior or restrict <br/>
<a id="pl.323.7"></a><var>323.7</var>the person's freedom of movement and not as ordered by a licensed health professional. <br/>
<a id="pl.323.8"></a><var>323.8</var>Mechanical restraint practices include, but are not limited to, the use of bed rails or similar <br/>
<a id="pl.323.9"></a><var>323.9</var>devices on a bed to prevent the person from getting out of bed, chairs that prevent a person <br/>
<a id="pl.323.10"></a><var>323.10</var>from rising, or placing a person in a wheelchair so close to a wall that the wall prevents <br/>
<a id="pl.323.11"></a><var>323.11</var>the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to <br/>
<a id="pl.323.12"></a><var>323.12</var>warn staff that a person is leaving a room or area do not, in and of themselves, restrict <br/>
<a id="pl.323.13"></a><var>323.13</var>freedom of movement and should not be considered restraints.<br/>
<a id="pl.323.14"></a><var>323.14</var>(d) A license holder must not use manual restraints, time out, or seclusion under any <br/>
<a id="pl.323.15"></a><var>323.15</var>circumstance, except for emergency use of manual restraints according to the requirements <br/>
<a id="pl.323.16"></a><var>323.16</var>in section 245D.061 or the use of controlled procedures with a person with a developmental <br/>
<a id="pl.323.17"></a><var>323.17</var>disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor <br/>
<a id="pl.323.18"></a><var>323.18</var>provisions. License holders implementing nonemergency use of manual restraint, or any <br/>
<a id="pl.323.19"></a><var>323.19</var>other programmatic use of mechanical restraint, time out, or seclusion with persons who <br/>
<a id="pl.323.20"></a><var>323.20</var>do not have a developmental disability that is not subject to the requirements of Minnesota <br/>
<a id="pl.323.21"></a><var>323.21</var>Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner <br/>
<a id="pl.323.22"></a><var>323.22</var>for continued use of the procedure within three months of implementation of this chapter.<br/>
<a id="pl.323.23"></a><var>323.23</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.24.0"></a><a id="pl.323.24"></a><var>323.24</var>    Sec. 24. <b>[245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.</b><br/>
<a id="pl.323.25"></a><var>323.25</var>    Subdivision 1. <b>Standards for emergency use of manual restraints.</b> Except <br/>
<a id="pl.323.26"></a><var>323.26</var>for the emergency use of controlled procedures with a person with a developmental <br/>
<a id="pl.323.27"></a><var>323.27</var>disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions, <br/>
<a id="pl.323.28"></a><var>323.28</var>the license holder must ensure that emergency use of manual restraints complies with the <br/>
<a id="pl.323.29"></a><var>323.29</var>requirements of this chapter and the license holder's policy and procedures as required <br/>
<a id="pl.323.30"></a><var>323.30</var>under subdivision 10.<br/>
<a id="pl.323.31"></a><var>323.31</var>    Subd. 2. <b>Definitions.</b> (a) The terms used in this section have the meaning given <br/>
<a id="pl.323.32"></a><var>323.32</var>them in this subdivision.<br/>
<a id="pl.323.33"></a><var>323.33</var>(b) "Manual restraint" means physical intervention intended to hold a person <br/>
<a id="pl.323.34"></a><var>323.34</var>immobile or limit a person's voluntary movement by using body contact as the only source <br/>
<a id="pl.323.35"></a><var>323.35</var>of physical restraint.<br/>
<a id="pl.324.1"></a><var>324.1</var>(c) "Mechanical restraint" means the use of devices, materials, or equipment attached <br/>
<a id="pl.324.2"></a><var>324.2</var>or adjacent to the person's body, or the use of practices which restrict freedom of movement <br/>
<a id="pl.324.3"></a><var>324.3</var>or normal access to one's body or body parts, or limits a person's voluntary movement <br/>
<a id="pl.324.4"></a><var>324.4</var>or holds a person immobile as an intervention precipitated by a person's behavior. The <br/>
<a id="pl.324.5"></a><var>324.5</var>term does apply to mechanical restraint used to prevent injury with persons who engage in <br/>
<a id="pl.324.6"></a><var>324.6</var>self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue <br/>
<a id="pl.324.7"></a><var>324.7</var>damage that have caused or could cause medical problems resulting from the self-injury.<br/>
<a id="pl.324.8"></a><var>324.8</var>    Subd. 3. <b>Conditions for emergency use of manual restraint.</b> Emergency use of <br/>
<a id="pl.324.9"></a><var>324.9</var>manual restraint must meet the following conditions:<br/>
<a id="pl.324.10"></a><var>324.10</var>(1) immediate intervention must be needed to protect the person or others from <br/>
<a id="pl.324.11"></a><var>324.11</var>imminent risk of physical harm; and<br/>
<a id="pl.324.12"></a><var>324.12</var>(2) the type of manual restraint used must be the least restrictive intervention to <br/>
<a id="pl.324.13"></a><var>324.13</var>eliminate the immediate risk of harm and effectively achieve safety. The manual restraint <br/>
<a id="pl.324.14"></a><var>324.14</var>must end when the threat of harm ends.<br/>
<a id="pl.324.15"></a><var>324.15</var>    Subd. 4. <b>Permitted instructional techniques and therapeutic conduct.</b> (a) Use of <br/>
<a id="pl.324.16"></a><var>324.16</var>physical contact as therapeutic conduct or as an instructional technique as identified in <br/>
<a id="pl.324.17"></a><var>324.17</var>paragraphs (b) and (c), is permitted and is not subject to the requirements of this section <br/>
<a id="pl.324.18"></a><var>324.18</var>when such use is addressed in a person's coordinated service and support plan addendum <br/>
<a id="pl.324.19"></a><var>324.19</var>and the required conditions have been met. For the purposes of this subdivision, <br/>
<a id="pl.324.20"></a><var>324.20</var>"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.<br/>
<a id="pl.324.21"></a><var>324.21</var>(b) Physical contact or instructional techniques must use the least restrictive <br/>
<a id="pl.324.22"></a><var>324.22</var>alternative possible to meet the needs of the person and may be used:<br/>
<a id="pl.324.23"></a><var>324.23</var>(1) to calm or comfort a person by holding that person with no resistance from <br/>
<a id="pl.324.24"></a><var>324.24</var>that person; <br/>
<a id="pl.324.25"></a><var>324.25</var>(2) to protect a person known to be at risk of injury due to frequent falls as a result of <br/>
<a id="pl.324.26"></a><var>324.26</var>a medical condition; or<br/>
<a id="pl.324.27"></a><var>324.27</var>(3) to position a person with physical disabilities in a manner specified in the <br/>
<a id="pl.324.28"></a><var>324.28</var>person's coordinated service and support plan addendum.<br/>
<a id="pl.324.29"></a><var>324.29</var>(c) Restraint may be used as therapeutic conduct:<br/>
<a id="pl.324.30"></a><var>324.30</var>(1) to allow a licensed health care professional to safely conduct a medical <br/>
<a id="pl.324.31"></a><var>324.31</var>examination or to provide medical treatment ordered by a licensed health care professional <br/>
<a id="pl.324.32"></a><var>324.32</var>to a person necessary to promote healing or recovery from an acute, meaning short-term, <br/>
<a id="pl.324.33"></a><var>324.33</var>medical condition;<br/>
<a id="pl.324.34"></a><var>324.34</var>(2) to facilitate the person's completion of a task or response when the person does <br/>
<a id="pl.324.35"></a><var>324.35</var>not resist or the person's resistance is minimal in intensity and duration;<br/>
<a id="pl.325.1"></a><var>325.1</var>(3) to briefly block or redirect a person's limbs or body without holding the person <br/>
<a id="pl.325.2"></a><var>325.2</var>or limiting the person's movement to interrupt the person's behavior that may result in <br/>
<a id="pl.325.3"></a><var>325.3</var>injury to self or others; or<br/>
<a id="pl.325.4"></a><var>325.4</var>(4) to assist in the safe evacuation of a person in the event of an emergency or to <br/>
<a id="pl.325.5"></a><var>325.5</var>redirect a person who is at imminent risk of harm in a dangerous situation.<br/>
<a id="pl.325.6"></a><var>325.6</var>(d) A plan for using restraint as therapeutic conduct must be developed according to <br/>
<a id="pl.325.7"></a><var>325.7</var>the requirements in sections 245D.07 and 245D.071, and must include methods to reduce <br/>
<a id="pl.325.8"></a><var>325.8</var>or eliminate the use of and need for restraint.<br/>
<a id="pl.325.9"></a><var>325.9</var>    Subd. 5. <b>Restrictions when implementing emergency use of manual restraint.</b><br/>
<a id="pl.325.10"></a><var>325.10</var>(a) Emergency use of manual restraint procedures must not:<br/>
<a id="pl.325.11"></a><var>325.11</var>(1) be implemented with a child in a manner that constitutes sexual abuse, neglect, <br/>
<a id="pl.325.12"></a><var>325.12</var>physical abuse, or mental injury, as defined in section 626.556, subdivision 2;<br/>
<a id="pl.325.13"></a><var>325.13</var>(2) be implemented with an adult in a manner that constitutes abuse or neglect as <br/>
<a id="pl.325.14"></a><var>325.14</var>defined in section 626.5572, subdivisions 2 and 17;<br/>
<a id="pl.325.15"></a><var>325.15</var>(3) be implemented in a manner that violates a person's rights and protections <br/>
<a id="pl.325.16"></a><var>325.16</var>identified in section 245D.04;<br/>
<a id="pl.325.17"></a><var>325.17</var>(4) restrict a person's normal access to a nutritious diet, drinking water, adequate <br/>
<a id="pl.325.18"></a><var>325.18</var>ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping <br/>
<a id="pl.325.19"></a><var>325.19</var>conditions, or necessary clothing, or to any protection required by state licensing standards <br/>
<a id="pl.325.20"></a><var>325.20</var>and federal regulations governing the program;<br/>
<a id="pl.325.21"></a><var>325.21</var>(5) deny the person visitation or ordinary contact with legal counsel, a legal <br/>
<a id="pl.325.22"></a><var>325.22</var>representative, or next of kin;<br/>
<a id="pl.325.23"></a><var>325.23</var>(6) be used as a substitute for adequate staffing, for the convenience of staff, as <br/>
<a id="pl.325.24"></a><var>325.24</var>punishment, or as a consequence if the person refuses to participate in the treatment <br/>
<a id="pl.325.25"></a><var>325.25</var>or services provided by the program; or<br/>
<a id="pl.325.26"></a><var>325.26</var>(7) use prone restraint. For the purposes of this section, "prone restraint" means use <br/>
<a id="pl.325.27"></a><var>325.27</var>of manual restraint that places a person in a face-down position. This does not include <br/>
<a id="pl.325.28"></a><var>325.28</var>brief physical holding of a person who, during an emergency use of manual restraint, rolls <br/>
<a id="pl.325.29"></a><var>325.29</var>into a prone position, and the person is restored to a standing, sitting, or side-lying position <br/>
<a id="pl.325.30"></a><var>325.30</var>as quickly as possible. Applying back or chest pressure while a person is in the prone or <br/>
<a id="pl.325.31"></a><var>325.31</var>supine position or face-up is prohibited.<br/>
<a id="pl.325.32"></a><var>325.32</var>    Subd. 6. <b>Monitoring emergency use of manual restraint.</b> The license holder shall <br/>
<a id="pl.325.33"></a><var>325.33</var>monitor a person's health and safety during an emergency use of a manual restraint. Staff <br/>
<a id="pl.325.34"></a><var>325.34</var>monitoring the procedure must not be the staff implementing the procedure when possible. <br/>
<a id="pl.325.35"></a><var>325.35</var>The license holder shall complete a monitoring form, approved by the commissioner, for <br/>
<a id="pl.325.36"></a><var>325.36</var>each incident involving the emergency use of a manual restraint.<br/>
<a id="pl.326.1"></a><var>326.1</var>    Subd. 7. <b>Reporting emergency use of manual restraint incident.</b> (a) Within <br/>
<a id="pl.326.2"></a><var>326.2</var>three calendar days after an emergency use of a manual restraint, the staff person who <br/>
<a id="pl.326.3"></a><var>326.3</var>implemented the emergency use must report in writing to the designated coordinator the <br/>
<a id="pl.326.4"></a><var>326.4</var>following information about the emergency use: <br/>
<a id="pl.326.5"></a><var>326.5</var>(1) the staff and persons receiving services who were involved in the incident <br/>
<a id="pl.326.6"></a><var>326.6</var>leading up to the emergency use of manual restraint;<br/>
<a id="pl.326.7"></a><var>326.7</var>(2) a description of the physical and social environment, including who was present <br/>
<a id="pl.326.8"></a><var>326.8</var>before and during the incident leading up to the emergency use of manual restraint;<br/>
<a id="pl.326.9"></a><var>326.9</var>(3) a description of what less restrictive alternative measures were attempted to <br/>
<a id="pl.326.10"></a><var>326.10</var>de-escalate the incident and maintain safety before the manual restraint was implemented <br/>
<a id="pl.326.11"></a><var>326.11</var>that identifies when, how, and how long the alternative measures were attempted before <br/>
<a id="pl.326.12"></a><var>326.12</var>manual restraint was implemented;<br/>
<a id="pl.326.13"></a><var>326.13</var>(4) a description of the mental, physical, and emotional condition of the person who <br/>
<a id="pl.326.14"></a><var>326.14</var>was restrained, and other persons involved in the incident leading up to, during, and <br/>
<a id="pl.326.15"></a><var>326.15</var>following the manual restraint;<br/>
<a id="pl.326.16"></a><var>326.16</var>(5) whether there was any injury to the person who was restrained or other persons <br/>
<a id="pl.326.17"></a><var>326.17</var>involved in the incident, including staff, before or as a result of the use of manual <br/>
<a id="pl.326.18"></a><var>326.18</var>restraint; and<br/>
<a id="pl.326.19"></a><var>326.19</var>(6) whether there was an attempt to debrief with the staff, and, if not contraindicated, <br/>
<a id="pl.326.20"></a><var>326.20</var>with the person who was restrained and other persons who were involved in or who <br/>
<a id="pl.326.21"></a><var>326.21</var>witnessed the restraint, following the incident and the outcome of the debriefing. If the <br/>
<a id="pl.326.22"></a><var>326.22</var>debriefing was not conducted at the time the incident report was made, the report should <br/>
<a id="pl.326.23"></a><var>326.23</var>identify whether a debriefing is planned.<br/>
<a id="pl.326.24"></a><var>326.24</var>(b) Each single incident of emergency use of manual restraint must be reported <br/>
<a id="pl.326.25"></a><var>326.25</var>separately. For the purposes of this subdivision, an incident of emergency use of manual <br/>
<a id="pl.326.26"></a><var>326.26</var>restraint is a single incident when the following conditions have been met:<br/>
<a id="pl.326.27"></a><var>326.27</var>(1) after implementing the manual restraint, staff attempt to release the person at the <br/>
<a id="pl.326.28"></a><var>326.28</var>moment staff believe the person's conduct no longer poses an imminent risk of physical <br/>
<a id="pl.326.29"></a><var>326.29</var>harm to self or others and less restrictive strategies can be implemented to maintain safety;<br/>
<a id="pl.326.30"></a><var>326.30</var>(2) upon the attempt to release the restraint, the person's behavior immediately <br/>
<a id="pl.326.31"></a><var>326.31</var>re-escalates; and<br/>
<a id="pl.326.32"></a><var>326.32</var>(3) staff must immediately reimplement the restraint in order to maintain safety.<br/>
<a id="pl.326.33"></a><var>326.33</var>    Subd. 8. <b>Internal review of emergency use of manual restraint.</b> (a) Within five <br/>
<a id="pl.326.34"></a><var>326.34</var>working days of the emergency use of manual restraint, the license holder must complete <br/>
<a id="pl.326.35"></a><var>326.35</var>an internal review of each report of emergency use of manual restraint. The review must <br/>
<a id="pl.326.36"></a><var>326.36</var>include an evaluation of whether:<br/>
<a id="pl.327.1"></a><var>327.1</var>(1) the person's service and support strategies developed according to sections <br/>
<a id="pl.327.2"></a><var>327.2</var>245D.07 and 245D.071 need to be revised;<br/>
<a id="pl.327.3"></a><var>327.3</var>(2) related policies and procedures were followed;<br/>
<a id="pl.327.4"></a><var>327.4</var>(3) the policies and procedures were adequate;<br/>
<a id="pl.327.5"></a><var>327.5</var>(4) there is a need for additional staff training;<br/>
<a id="pl.327.6"></a><var>327.6</var>(5) the reported event is similar to past events with the persons, staff, or the services <br/>
<a id="pl.327.7"></a><var>327.7</var>involved; and<br/>
<a id="pl.327.8"></a><var>327.8</var>(6) there is a need for corrective action by the license holder to protect the health <br/>
<a id="pl.327.9"></a><var>327.9</var>and safety of persons.<br/>
<a id="pl.327.10"></a><var>327.10</var>(b) Based on the results of the internal review, the license holder must develop, <br/>
<a id="pl.327.11"></a><var>327.11</var>document, and implement a corrective action plan for the program designed to correct <br/>
<a id="pl.327.12"></a><var>327.12</var>current lapses and prevent future lapses in performance by individuals or the license <br/>
<a id="pl.327.13"></a><var>327.13</var>holder, if any. The corrective action plan, if any, must be implemented within 30 days of <br/>
<a id="pl.327.14"></a><var>327.14</var>the internal review being completed.<br/>
<a id="pl.327.15"></a><var>327.15</var>    Subd. 9. <b>Expanded support team review.</b> Within five working days after the <br/>
<a id="pl.327.16"></a><var>327.16</var>completion of the internal review required in subdivision 8, the license holder must consult <br/>
<a id="pl.327.17"></a><var>327.17</var>with the expanded support team following the emergency use of manual restraint to:<br/>
<a id="pl.327.18"></a><var>327.18</var>(1) discuss the incident reported in subdivision 7, to define the antecedent or event <br/>
<a id="pl.327.19"></a><var>327.19</var>that gave rise to the behavior resulting in the manual restraint and identify the perceived <br/>
<a id="pl.327.20"></a><var>327.20</var>function the behavior served; and<br/>
<a id="pl.327.21"></a><var>327.21</var>(2) determine whether the person's coordinated service and support plan addendum <br/>
<a id="pl.327.22"></a><var>327.22</var>needs to be revised according to sections 245D.07 and 245D.071 to positively and <br/>
<a id="pl.327.23"></a><var>327.23</var>effectively help the person maintain stability and to reduce or eliminate future occurrences <br/>
<a id="pl.327.24"></a><var>327.24</var>requiring emergency use of manual restraint.<br/>
<a id="pl.327.25"></a><var>327.25</var>    Subd. 10. <b>Emergency use of manual restraints policy and procedures.</b> The <br/>
<a id="pl.327.26"></a><var>327.26</var>license holder must develop, document, and implement a policy and procedures that <br/>
<a id="pl.327.27"></a><var>327.27</var>promote service recipient rights and protect health and safety during the emergency use of <br/>
<a id="pl.327.28"></a><var>327.28</var>manual restraints. The policy and procedures must comply with the requirements of this <br/>
<a id="pl.327.29"></a><var>327.29</var>section and must specify the following:<br/>
<a id="pl.327.30"></a><var>327.30</var>(1) a description of the positive support strategies and techniques staff must use to <br/>
<a id="pl.327.31"></a><var>327.31</var>attempt to de-escalate a person's behavior before it poses an imminent risk of physical <br/>
<a id="pl.327.32"></a><var>327.32</var>harm to self or others;<br/>
<a id="pl.327.33"></a><var>327.33</var>(2) a description of the types of manual restraints the license holder allows staff to <br/>
<a id="pl.327.34"></a><var>327.34</var>use on an emergency basis, if any. If the license holder will not allow the emergency use <br/>
<a id="pl.327.35"></a><var>327.35</var>of manual restraint, the policy and procedure must identify the alternative measures the <br/>
<a id="pl.328.1"></a><var>328.1</var>license holder will require staff to use when a person's conduct poses an imminent risk of <br/>
<a id="pl.328.2"></a><var>328.2</var>physical harm to self or others and less restrictive strategies would not achieve safety;<br/>
<a id="pl.328.3"></a><var>328.3</var>(3) instructions for safe and correct implementation of the allowed manual restraint <br/>
<a id="pl.328.4"></a><var>328.4</var>procedures;<br/>
<a id="pl.328.5"></a><var>328.5</var>(4) the training that staff must complete and the timelines for completion, before they <br/>
<a id="pl.328.6"></a><var>328.6</var>may implement an emergency use of manual restraint. In addition to the training on this <br/>
<a id="pl.328.7"></a><var>328.7</var>policy and procedure and the orientation and annual training required in section 245D.09, <br/>
<a id="pl.328.8"></a><var>328.8</var>subdivision 4, the training for emergency use of manual restraint must incorporate the <br/>
<a id="pl.328.9"></a><var>328.9</var>following subjects:<br/>
<a id="pl.328.10"></a><var>328.10</var>(i) alternatives to manual restraint procedures, including techniques to identify <br/>
<a id="pl.328.11"></a><var>328.11</var>events and environmental factors that may escalate conduct that poses an imminent risk of <br/>
<a id="pl.328.12"></a><var>328.12</var>physical harm to self or others;<br/>
<a id="pl.328.13"></a><var>328.13</var>(ii) de-escalation methods, positive support strategies, and how to avoid power <br/>
<a id="pl.328.14"></a><var>328.14</var>struggles;<br/>
<a id="pl.328.15"></a><var>328.15</var>(iii) simulated experiences of administering and receiving manual restraint <br/>
<a id="pl.328.16"></a><var>328.16</var>procedures allowed by the license holder on an emergency basis;<br/>
<a id="pl.328.17"></a><var>328.17</var>(iv) how to properly identify thresholds for implementing and ceasing restrictive <br/>
<a id="pl.328.18"></a><var>328.18</var>procedures;<br/>
<a id="pl.328.19"></a><var>328.19</var>(v) how to recognize, monitor, and respond to the person's physical signs of distress, <br/>
<a id="pl.328.20"></a><var>328.20</var>including positional asphyxia; <br/>
<a id="pl.328.21"></a><var>328.21</var>(vi) the physiological and psychological impact on the person and the staff when <br/>
<a id="pl.328.22"></a><var>328.22</var>restrictive procedures are used;<br/>
<a id="pl.328.23"></a><var>328.23</var>(vii) the communicative intent of behaviors; and<br/>
<a id="pl.328.24"></a><var>328.24</var>(viii) relationship building;<br/>
<a id="pl.328.25"></a><var>328.25</var>(5) the procedures and forms to be used to monitor the emergency use of manual <br/>
<a id="pl.328.26"></a><var>328.26</var>restraints, including what must be monitored and the frequency of monitoring per <br/>
<a id="pl.328.27"></a><var>328.27</var>each incident of emergency use of manual restraint, and the person or position who is <br/>
<a id="pl.328.28"></a><var>328.28</var>responsible for monitoring the use;<br/>
<a id="pl.328.29"></a><var>328.29</var>(6) the instructions, forms, and timelines required for completing and submitting an <br/>
<a id="pl.328.30"></a><var>328.30</var>incident report by the person or persons who implemented the manual restraint; and<br/>
<a id="pl.328.31"></a><var>328.31</var>(7) the procedures and timelines for conducting the internal review and the expanded <br/>
<a id="pl.328.32"></a><var>328.32</var>support team review, and the person or position responsible for completing the reviews and <br/>
<a id="pl.328.33"></a><var>328.33</var>who is responsible for ensuring that corrective action is taken or the person's coordinated <br/>
<a id="pl.328.34"></a><var>328.34</var>service and support plan addendum is revised, when determined necessary.<br/>
<a id="pl.328.35"></a><var>328.35</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.25.0"></a><a id="pl.329.1"></a><var>329.1</var>    Sec. 25. Minnesota Statutes 2012, section 245D.07, is amended to read:<br/>
<a id="pl.329.2"></a><var>329.2</var><b>245D.07 SERVICE </b><b>NEEDS</b><b> PLANNING AND DELIVERY</b><b>.</b><br/>
<a id="pl.329.3"></a><var>329.3</var>    Subdivision 1. <b>Provision of services.</b> The license holder must provide services as <br/>
<a id="pl.329.4"></a><var>329.4</var>specified assigned in the coordinated service and support plan and assigned to the license <br/>
<a id="pl.329.5"></a><var>329.5</var>holder. The provision of services must comply with the requirements of this chapter and <br/>
<a id="pl.329.6"></a><var>329.6</var>the federal waiver plans.<br/>
<a id="pl.329.7"></a><var>329.7</var>    Subd. 1a. <b>Person-centered planning and service delivery.</b> (a) The license holder <br/>
<a id="pl.329.8"></a><var>329.8</var>must provide services in response to the person's identified needs, interests, preferences, <br/>
<a id="pl.329.9"></a><var>329.9</var>and desired outcomes as specified in the coordinated service and support plan, the <br/>
<a id="pl.329.10"></a><var>329.10</var>coordinated service and support plan addendum, and in compliance with the requirements <br/>
<a id="pl.329.11"></a><var>329.11</var>of this chapter. License holders providing intensive support services must also provide <br/>
<a id="pl.329.12"></a><var>329.12</var>outcome-based services according to the requirements in section 245D.071.<br/>
<a id="pl.329.13"></a><var>329.13</var>(b) Services must be provided in a manner that supports the person's preferences, <br/>
<a id="pl.329.14"></a><var>329.14</var>daily needs, and activities and accomplishment of the person's personal goals and service <br/>
<a id="pl.329.15"></a><var>329.15</var>outcomes, consistent with the principles of:<br/>
<a id="pl.329.16"></a><var>329.16</var>(1) person-centered service planning and delivery that:<br/>
<a id="pl.329.17"></a><var>329.17</var>(i) identifies and supports what is important to the person as well as what is <br/>
<a id="pl.329.18"></a><var>329.18</var>important for the person, including preferences for when, how, and by whom direct <br/>
<a id="pl.329.19"></a><var>329.19</var>support service is provided;<br/>
<a id="pl.329.20"></a><var>329.20</var>(ii) uses that information to identify outcomes the person desires; and<br/>
<a id="pl.329.21"></a><var>329.21</var>(iii) respects each person's history, dignity, and cultural background;<br/>
<a id="pl.329.22"></a><var>329.22</var>(2) self-determination that supports and provides:<br/>
<a id="pl.329.23"></a><var>329.23</var>(i) opportunities for the development and exercise of functional and age-appropriate <br/>
<a id="pl.329.24"></a><var>329.24</var>skills, decision making and choice, personal advocacy, and communication; and<br/>
<a id="pl.329.25"></a><var>329.25</var>(ii) the affirmation and protection of each person's civil and legal rights;<br/>
<a id="pl.329.26"></a><var>329.26</var>(3) providing the most integrated setting and inclusive service delivery that supports, <br/>
<a id="pl.329.27"></a><var>329.27</var>promotes, and allows:<br/>
<a id="pl.329.28"></a><var>329.28</var>(i) inclusion and participation in the person's community as desired by the person <br/>
<a id="pl.329.29"></a><var>329.29</var>in a manner that enables the person to interact with nondisabled persons to the fullest <br/>
<a id="pl.329.30"></a><var>329.30</var>extent possible and supports the person in developing and maintaining a role as a valued <br/>
<a id="pl.329.31"></a><var>329.31</var>community member;<br/>
<a id="pl.329.32"></a><var>329.32</var>(ii) opportunities for self-sufficiency as well as developing and maintaining social <br/>
<a id="pl.329.33"></a><var>329.33</var>relationships and natural supports; and<br/>
<a id="pl.329.34"></a><var>329.34</var>(iii) a balance between risk and opportunity, meaning the least restrictive supports or <br/>
<a id="pl.329.35"></a><var>329.35</var>interventions necessary are provided in the most integrated settings in the most inclusive <br/>
<a id="pl.330.1"></a><var>330.1</var>manner possible to support the person to engage in activities of the person's own choosing <br/>
<a id="pl.330.2"></a><var>330.2</var>that may otherwise present a risk to the person's health, safety, or rights.<br/>
<a id="pl.330.3"></a><var>330.3</var>    Subd. 2. <b>Service planning </b><b>requirements for basic support services</b><b>.</b> (a) License <br/>
<a id="pl.330.4"></a><var>330.4</var>holders providing basic support services must meet the requirements of this subdivision.<br/>
<a id="pl.330.5"></a><var>330.5</var>(b) Within 15 days of service initiation the license holder must complete a <br/>
<a id="pl.330.6"></a><var>330.6</var>preliminary coordinated service and support plan addendum based on the coordinated <br/>
<a id="pl.330.7"></a><var>330.7</var>service and support plan.<br/>
<a id="pl.330.8"></a><var>330.8</var>(c) Within 60 days of service initiation the license holder must review and revise as <br/>
<a id="pl.330.9"></a><var>330.9</var>needed the preliminary coordinated service and support plan addendum to document the <br/>
<a id="pl.330.10"></a><var>330.10</var>services that will be provided including how, when, and by whom services will be provided, <br/>
<a id="pl.330.11"></a><var>330.11</var>and the person responsible for overseeing the delivery and coordination of services.<br/>
<a id="pl.330.12"></a><var>330.12</var>(d) The license holder must participate in service planning and support team <br/>
<a id="pl.330.13"></a><var>330.13</var>meetings related to for the person following stated timelines established in the person's<br/>
<a id="pl.330.14"></a><var>330.14</var> coordinated service and support plan or as requested by the support team, the person, or <br/>
<a id="pl.330.15"></a><var>330.15</var>the person's legal representative, the support team or the expanded support team.<br/>
<a id="pl.330.16"></a><var>330.16</var>    Subd. 3. <b>Reports.</b> The license holder must provide written reports regarding the <br/>
<a id="pl.330.17"></a><var>330.17</var>person's progress or status as requested by the person, the person's legal representative, the <br/>
<a id="pl.330.18"></a><var>330.18</var>case manager, or the team.<br/>
<a id="pl.330.19"></a><var>330.19</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.26.0"></a><a id="pl.330.20"></a><var>330.20</var>    Sec. 26. <b>[245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE </b><br/>
<a id="pl.330.21"></a><var>330.21</var><b>SUPPORT SERVICES.</b><br/>
<a id="pl.330.22"></a><var>330.22</var>    Subdivision 1. <b>Requirements for intensive support services.</b> A license holder <br/>
<a id="pl.330.23"></a><var>330.23</var>providing intensive support services identified in section 245D.03, subdivision 1, <br/>
<a id="pl.330.24"></a><var>330.24</var>paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1 <br/>
<a id="pl.330.25"></a><var>330.25</var>and 3, and this section.<br/>
<a id="pl.330.26"></a><var>330.26</var>    Subd. 2. <b>Abuse prevention.</b> Prior to or upon initiating services, the license holder <br/>
<a id="pl.330.27"></a><var>330.27</var>must develop, document, and implement an abuse prevention plan according to section <br/>
<a id="pl.330.28"></a><var>330.28</var>245A.65, subdivision 2.<br/>
<a id="pl.330.29"></a><var>330.29</var>    Subd. 3. <b>Assessment and initial service planning.</b> (a) Within 15 days of service <br/>
<a id="pl.330.30"></a><var>330.30</var>initiation the license holder must complete a preliminary coordinated service and support <br/>
<a id="pl.330.31"></a><var>330.31</var>plan addendum based on the coordinated service and support plan.<br/>
<a id="pl.330.32"></a><var>330.32</var>(b) Within 45 days of service initiation the license holder must meet with the person, <br/>
<a id="pl.330.33"></a><var>330.33</var>the person's legal representative, the case manager, and other members of the support team <br/>
<a id="pl.330.34"></a><var>330.34</var>or expanded support team to assess and determine the following based on the person's <br/>
<a id="pl.331.1"></a><var>331.1</var>coordinated service and support plan and the requirements in subdivision 4 and section <br/>
<a id="pl.331.2"></a><var>331.2</var>245D.07, subdivision 1a:<br/>
<a id="pl.331.3"></a><var>331.3</var>(1) the scope of the services to be provided to support the person's daily needs <br/>
<a id="pl.331.4"></a><var>331.4</var>and activities;<br/>
<a id="pl.331.5"></a><var>331.5</var>(2) the person's desired outcomes and the supports necessary to accomplish the <br/>
<a id="pl.331.6"></a><var>331.6</var>person's desired outcomes;<br/>
<a id="pl.331.7"></a><var>331.7</var>(3) the person's preferences for how services and supports are provided;<br/>
<a id="pl.331.8"></a><var>331.8</var>(4) whether the current service setting is the most integrated setting available and <br/>
<a id="pl.331.9"></a><var>331.9</var>appropriate for the person; and<br/>
<a id="pl.331.10"></a><var>331.10</var>(5) how services must be coordinated across other providers licensed under this <br/>
<a id="pl.331.11"></a><var>331.11</var>chapter serving the same person to ensure continuity of care for the person.<br/>
<a id="pl.331.12"></a><var>331.12</var>(c) Within the scope of services, the license holder must, at a minimum, assess <br/>
<a id="pl.331.13"></a><var>331.13</var>the following areas:<br/>
<a id="pl.331.14"></a><var>331.14</var>(1) the person's ability to self-manage health and medical needs to maintain or <br/>
<a id="pl.331.15"></a><var>331.15</var>improve physical, mental, and emotional well-being, including, when applicable, allergies, <br/>
<a id="pl.331.16"></a><var>331.16</var>seizures, choking, special dietary needs, chronic medical conditions, self-administration <br/>
<a id="pl.331.17"></a><var>331.17</var>of medication or treatment orders, preventative screening, and medical and dental <br/>
<a id="pl.331.18"></a><var>331.18</var>appointments;<br/>
<a id="pl.331.19"></a><var>331.19</var>(2) the person's ability to self-manage personal safety to avoid injury or accident in <br/>
<a id="pl.331.20"></a><var>331.20</var>the service setting, including, when applicable, risk of falling, mobility, regulating water <br/>
<a id="pl.331.21"></a><var>331.21</var>temperature, community survival skills, water safety skills, and sensory disabilities; and<br/>
<a id="pl.331.22"></a><var>331.22</var>(3) the person's ability to self-manage symptoms or behavior that may otherwise <br/>
<a id="pl.331.23"></a><var>331.23</var>result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to <br/>
<a id="pl.331.24"></a><var>331.24</var>(7), suspension or termination of services by the license holder, or other symptoms <br/>
<a id="pl.331.25"></a><var>331.25</var>or behaviors that may jeopardize the health and safety of the person or others. The <br/>
<a id="pl.331.26"></a><var>331.26</var>assessments must produce information about the person that is descriptive of the person's <br/>
<a id="pl.331.27"></a><var>331.27</var>overall strengths, functional skills and abilities, and behaviors or symptoms.<br/>
<a id="pl.331.28"></a><var>331.28</var>    Subd. 4. <b>Service outcomes and supports.</b> (a) Within ten working days of the <br/>
<a id="pl.331.29"></a><var>331.29</var>45-day meeting, the license holder must develop and document the service outcomes and <br/>
<a id="pl.331.30"></a><var>331.30</var>supports based on the assessments completed under subdivision 3 and the requirements <br/>
<a id="pl.331.31"></a><var>331.31</var>in section 245D.07, subdivision 1a. The outcomes and supports must be included in the <br/>
<a id="pl.331.32"></a><var>331.32</var>coordinated service and support plan addendum.<br/>
<a id="pl.331.33"></a><var>331.33</var>(b) The license holder must document the supports and methods to be implemented <br/>
<a id="pl.331.34"></a><var>331.34</var>to support the accomplishment of outcomes related to acquiring, retaining, or improving <br/>
<a id="pl.331.35"></a><var>331.35</var>skills. The documentation must include:<br/>
<a id="pl.332.1"></a><var>332.1</var>(1) the methods or actions that will be used to support the person and to accomplish <br/>
<a id="pl.332.2"></a><var>332.2</var>the service outcomes, including information about:<br/>
<a id="pl.332.3"></a><var>332.3</var>(i) any changes or modifications to the physical and social environments necessary <br/>
<a id="pl.332.4"></a><var>332.4</var>when the service supports are provided;<br/>
<a id="pl.332.5"></a><var>332.5</var>(ii) any equipment and materials required; and<br/>
<a id="pl.332.6"></a><var>332.6</var>(iii) techniques that are consistent with the person's communication mode and <br/>
<a id="pl.332.7"></a><var>332.7</var>learning style;<br/>
<a id="pl.332.8"></a><var>332.8</var>(2) the measurable and observable criteria for identifying when the desired outcome <br/>
<a id="pl.332.9"></a><var>332.9</var>has been achieved and how data will be collected;<br/>
<a id="pl.332.10"></a><var>332.10</var>(3) the projected starting date for implementing the supports and methods and <br/>
<a id="pl.332.11"></a><var>332.11</var>the date by which progress towards accomplishing the outcomes will be reviewed and <br/>
<a id="pl.332.12"></a><var>332.12</var>evaluated; and<br/>
<a id="pl.332.13"></a><var>332.13</var>(4) the names of the staff or position responsible for implementing the supports <br/>
<a id="pl.332.14"></a><var>332.14</var>and methods.<br/>
<a id="pl.332.15"></a><var>332.15</var>(c) Within 20 working days of the 45-day meeting, the license holder must obtain <br/>
<a id="pl.332.16"></a><var>332.16</var>dated signatures from the person or the person's legal representative and case manager <br/>
<a id="pl.332.17"></a><var>332.17</var>to document completion and approval of the assessment and coordinated service and <br/>
<a id="pl.332.18"></a><var>332.18</var>support plan addendum.<br/>
<a id="pl.332.19"></a><var>332.19</var>    Subd. 5. <b>Progress reviews.</b> (a) The license holder must give the person or the <br/>
<a id="pl.332.20"></a><var>332.20</var>person's legal representative and case manager an opportunity to participate in the ongoing <br/>
<a id="pl.332.21"></a><var>332.21</var>review and development of the methods used to support the person and accomplish <br/>
<a id="pl.332.22"></a><var>332.22</var>outcomes identified in subdivisions 3 and 4. The license holder, in coordination with <br/>
<a id="pl.332.23"></a><var>332.23</var>the person's support team or expanded support team, must meet with the person, the <br/>
<a id="pl.332.24"></a><var>332.24</var>person's legal representative, and the case manager, and participate in progress review <br/>
<a id="pl.332.25"></a><var>332.25</var>meetings following stated timelines established in the person's coordinated service and <br/>
<a id="pl.332.26"></a><var>332.26</var>support plan or coordinated service and support plan addendum or within 30 days of a <br/>
<a id="pl.332.27"></a><var>332.27</var>written request by the person, the person's legal representative, or the case manager, <br/>
<a id="pl.332.28"></a><var>332.28</var>at a minimum of once per year.<br/>
<a id="pl.332.29"></a><var>332.29</var>(b) The license holder must summarize the person's progress toward achieving the <br/>
<a id="pl.332.30"></a><var>332.30</var>identified outcomes and make recommendations and identify the rationale for changing, <br/>
<a id="pl.332.31"></a><var>332.31</var>continuing, or discontinuing implementation of supports and methods identified in <br/>
<a id="pl.332.32"></a><var>332.32</var>subdivision 4 in a written report sent to the person or the person's legal representative <br/>
<a id="pl.332.33"></a><var>332.33</var>and case manager five working days prior to the review meeting, unless the person, the <br/>
<a id="pl.332.34"></a><var>332.34</var>person's legal representative, or the case manager request to receive the report at the <br/>
<a id="pl.332.35"></a><var>332.35</var>time of the meeting.<br/>
<a id="pl.333.1"></a><var>333.1</var>(c) Within ten working days of the progress review meeting, the license holder <br/>
<a id="pl.333.2"></a><var>333.2</var>must obtain dated signatures from the person or the person's legal representative and <br/>
<a id="pl.333.3"></a><var>333.3</var>the case manager to document approval of any changes to the coordinated service and <br/>
<a id="pl.333.4"></a><var>333.4</var>support plan addendum.<br/>
<a id="pl.333.5"></a><var>333.5</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.27.0"></a><a id="pl.333.6"></a><var>333.6</var>    Sec. 27. <b>[245D.081] PROGRAM COORDINATION, EVALUATION, AND </b><br/>
<a id="pl.333.7"></a><var>333.7</var><b>OVERSIGHT.</b><br/>
<a id="pl.333.8"></a><var>333.8</var>    Subdivision 1. <b>Program coordination and evaluation.</b> (a) The license holder <br/>
<a id="pl.333.9"></a><var>333.9</var>is responsible for:<br/>
<a id="pl.333.10"></a><var>333.10</var>(1) coordination of service delivery and evaluation for each person served by the <br/>
<a id="pl.333.11"></a><var>333.11</var>program as identified in subdivision 2; and<br/>
<a id="pl.333.12"></a><var>333.12</var>(2) program management and oversight that includes evaluation of the program <br/>
<a id="pl.333.13"></a><var>333.13</var>quality and program improvement for services provided by the license holder as identified <br/>
<a id="pl.333.14"></a><var>333.14</var>in subdivision 3.<br/>
<a id="pl.333.15"></a><var>333.15</var>(b) The same person may perform the functions in paragraph (a) if the work and <br/>
<a id="pl.333.16"></a><var>333.16</var>education qualifications are met in subdivisions 2 and 3.<br/>
<a id="pl.333.17"></a><var>333.17</var>    Subd. 2. <b>Coordination and evaluation of individual service delivery.</b> (a) Delivery <br/>
<a id="pl.333.18"></a><var>333.18</var>and evaluation of services provided by the license holder must be coordinated by a <br/>
<a id="pl.333.19"></a><var>333.19</var>designated staff person. The designated coordinator must provide supervision, support, <br/>
<a id="pl.333.20"></a><var>333.20</var>and evaluation of activities that include:<br/>
<a id="pl.333.21"></a><var>333.21</var>(1) oversight of the license holder's responsibilities assigned in the person's <br/>
<a id="pl.333.22"></a><var>333.22</var>coordinated service and support plan and the coordinated service and support plan <br/>
<a id="pl.333.23"></a><var>333.23</var>addendum;<br/>
<a id="pl.333.24"></a><var>333.24</var>(2) taking the action necessary to facilitate the accomplishment of the outcomes <br/>
<a id="pl.333.25"></a><var>333.25</var>according to the requirements in section 245D.07;<br/>
<a id="pl.333.26"></a><var>333.26</var>(3) instruction and assistance to direct support staff implementing the coordinated <br/>
<a id="pl.333.27"></a><var>333.27</var>service and support plan and the service outcomes, including direct observation of service <br/>
<a id="pl.333.28"></a><var>333.28</var>delivery sufficient to assess staff competency; and<br/>
<a id="pl.333.29"></a><var>333.29</var>(4) evaluation of the effectiveness of service delivery, methodologies, and progress on <br/>
<a id="pl.333.30"></a><var>333.30</var>the person's outcomes based on the measurable and observable criteria for identifying when <br/>
<a id="pl.333.31"></a><var>333.31</var>the desired outcome has been achieved according to the requirements in section 245D.07.<br/>
<a id="pl.333.32"></a><var>333.32</var>(b) The license holder must ensure that the designated coordinator is competent to <br/>
<a id="pl.333.33"></a><var>333.33</var>perform the required duties identified in paragraph (a) through education and training in <br/>
<a id="pl.333.34"></a><var>333.34</var>human services and disability-related fields, and work experience in providing direct care <br/>
<a id="pl.333.35"></a><var>333.35</var>services and supports to persons with disabilities. The designated coordinator must have <br/>
<a id="pl.334.1"></a><var>334.1</var>the skills and ability necessary to develop effective plans and to design and use data <br/>
<a id="pl.334.2"></a><var>334.2</var>systems to measure effectiveness of services and supports. The license holder must verify <br/>
<a id="pl.334.3"></a><var>334.3</var>and document competence according to the requirements in section 245D.09, subdivision <br/>
<a id="pl.334.4"></a><var>334.4</var>3. The designated coordinator must minimally have:<br/>
<a id="pl.334.5"></a><var>334.5</var>(1) a baccalaureate degree in a field related to human services, and one year of <br/>
<a id="pl.334.6"></a><var>334.6</var>full-time work experience providing direct care services to persons with disabilities or <br/>
<a id="pl.334.7"></a><var>334.7</var>persons age 65 and older;<br/>
<a id="pl.334.8"></a><var>334.8</var>(2) an associate degree in a field related to human services, and two years of <br/>
<a id="pl.334.9"></a><var>334.9</var>full-time work experience providing direct care services to persons with disabilities or <br/>
<a id="pl.334.10"></a><var>334.10</var>persons age 65 and older;<br/>
<a id="pl.334.11"></a><var>334.11</var>(3) a diploma in a field related to human services from an accredited postsecondary <br/>
<a id="pl.334.12"></a><var>334.12</var>institution and three years of full-time work experience providing direct care services to <br/>
<a id="pl.334.13"></a><var>334.13</var>persons with disabilities or persons age 65 and older; or<br/>
<a id="pl.334.14"></a><var>334.14</var>(4) a minimum of 50 hours of education and training related to human services <br/>
<a id="pl.334.15"></a><var>334.15</var>and disabilities; and<br/>
<a id="pl.334.16"></a><var>334.16</var>(5) four years of full-time work experience providing direct care services to persons <br/>
<a id="pl.334.17"></a><var>334.17</var>with disabilities or persons age 65 and older under the supervision of a staff person who <br/>
<a id="pl.334.18"></a><var>334.18</var>meets the qualifications identified in clauses (1) to (3).<br/>
<a id="pl.334.19"></a><var>334.19</var>    Subd. 3. <b>Program management and oversight.</b> (a) The license holder must <br/>
<a id="pl.334.20"></a><var>334.20</var>designate a managerial staff person or persons to provide program management and <br/>
<a id="pl.334.21"></a><var>334.21</var>oversight of the services provided by the license holder. The designated manager is <br/>
<a id="pl.334.22"></a><var>334.22</var>responsible for the following:<br/>
<a id="pl.334.23"></a><var>334.23</var>(1) maintaining a current understanding of the licensing requirements sufficient to <br/>
<a id="pl.334.24"></a><var>334.24</var>ensure compliance throughout the program as identified in section 245A.04, subdivision <br/>
<a id="pl.334.25"></a><var>334.25</var>1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, <br/>
<a id="pl.334.26"></a><var>334.26</var>paragraph (b);<br/>
<a id="pl.334.27"></a><var>334.27</var>(2) ensuring the duties of the designated coordinator are fulfilled according to the <br/>
<a id="pl.334.28"></a><var>334.28</var>requirements in subdivision 2;<br/>
<a id="pl.334.29"></a><var>334.29</var>(3) ensuring the program implements corrective action identified as necessary <br/>
<a id="pl.334.30"></a><var>334.30</var>by the program following review of incident and emergency reports according to the <br/>
<a id="pl.334.31"></a><var>334.31</var>requirements in section 245D.11, subdivision 2, clause (7). An internal review of <br/>
<a id="pl.334.32"></a><var>334.32</var>incident reports of alleged or suspected maltreatment must be conducted according to the <br/>
<a id="pl.334.33"></a><var>334.33</var>requirements in section 245A.65, subdivision 1, paragraph (b);<br/>
<a id="pl.334.34"></a><var>334.34</var>(4) evaluation of satisfaction of persons served by the program, the person's legal <br/>
<a id="pl.334.35"></a><var>334.35</var>representative, if any, and the case manager, with the service delivery and progress <br/>
<a id="pl.335.1"></a><var>335.1</var>towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and <br/>
<a id="pl.335.2"></a><var>335.2</var>ensuring and protecting each person's rights as identified in section 245D.04;<br/>
<a id="pl.335.3"></a><var>335.3</var>(5) ensuring staff competency requirements are met according to the requirements in <br/>
<a id="pl.335.4"></a><var>335.4</var>section 245D.09, subdivision 3, and ensuring staff orientation and training is provided <br/>
<a id="pl.335.5"></a><var>335.5</var>according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;<br/>
<a id="pl.335.6"></a><var>335.6</var>(6) ensuring corrective action is taken when ordered by the commissioner and that <br/>
<a id="pl.335.7"></a><var>335.7</var>the terms and condition of the license and any variances are met; and<br/>
<a id="pl.335.8"></a><var>335.8</var>(7) evaluating the information identified in clauses (1) to (6) to develop, document, <br/>
<a id="pl.335.9"></a><var>335.9</var>and implement ongoing program improvements.<br/>
<a id="pl.335.10"></a><var>335.10</var>(b) The designated manager must be competent to perform the duties as required and <br/>
<a id="pl.335.11"></a><var>335.11</var>must minimally meet the education and training requirements identified in subdivision <br/>
<a id="pl.335.12"></a><var>335.12</var>2, paragraph (b), and have a minimum of three years of supervisory level experience in <br/>
<a id="pl.335.13"></a><var>335.13</var>a program providing direct support services to persons with disabilities or persons age <br/>
<a id="pl.335.14"></a><var>335.14</var>65 and older.<br/>
<a id="pl.335.15"></a><var>335.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.28.0"></a><a id="pl.335.16"></a><var>335.16</var>    Sec. 28. Minnesota Statutes 2012, section 245D.09, is amended to read:<br/>
<a id="pl.335.17"></a><var>335.17</var><b>245D.09 STAFFING STANDARDS.</b><br/>
<a id="pl.335.18"></a><var>335.18</var>    Subdivision 1. <b>Staffing requirements. </b> The license holder must provide the level of<br/>
<a id="pl.335.19"></a><var>335.19</var> direct service support staff sufficient supervision, assistance, and training necessary:<br/>
<a id="pl.335.20"></a><var>335.20</var>(1) to ensure the health, safety, and protection of rights of each person; and<br/>
<a id="pl.335.21"></a><var>335.21</var>(2) to be able to implement the responsibilities assigned to the license holder in each <br/>
<a id="pl.335.22"></a><var>335.22</var>person's coordinated service and support plan or identified in the coordinated service and <br/>
<a id="pl.335.23"></a><var>335.23</var>support plan addendum, according to the requirements of this chapter.<br/>
<a id="pl.335.24"></a><var>335.24</var>    Subd. 2. <b>Supervision of staff having direct contact.</b> Except for a license holder <br/>
<a id="pl.335.25"></a><var>335.25</var>who is the sole direct service support staff, the license holder must provide adequate <br/>
<a id="pl.335.26"></a><var>335.26</var>supervision of staff providing direct service support to ensure the health, safety, and <br/>
<a id="pl.335.27"></a><var>335.27</var>protection of rights of each person and implementation of the responsibilities assigned to <br/>
<a id="pl.335.28"></a><var>335.28</var>the license holder in each person's service plan coordinated service and support plan or <br/>
<a id="pl.335.29"></a><var>335.29</var>coordinated service and support plan addendum.<br/>
<a id="pl.335.30"></a><var>335.30</var>    Subd. 3. <b>Staff qualifications.</b> (a) The license holder must ensure that staff is<br/>
<a id="pl.335.31"></a><var>335.31</var> providing direct support, or staff who have responsibilities related to supervising or <br/>
<a id="pl.335.32"></a><var>335.32</var>managing the provision of direct support service, are competent as demonstrated through<br/>
<a id="pl.335.33"></a><var>335.33</var> skills and knowledge training, experience, and education to meet the person's needs <br/>
<a id="pl.335.34"></a><var>335.34</var>and additional requirements as written in the coordinated service and support plan or <br/>
<a id="pl.336.1"></a><var>336.1</var>coordinated service and support plan addendum, or when otherwise required by the case <br/>
<a id="pl.336.2"></a><var>336.2</var>manager or the federal waiver plan. The license holder must verify and maintain evidence <br/>
<a id="pl.336.3"></a><var>336.3</var>of staff competency, including documentation of:<br/>
<a id="pl.336.4"></a><var>336.4</var>(1) education and experience qualifications relevant to the job responsibilities <br/>
<a id="pl.336.5"></a><var>336.5</var>assigned to the staff and the needs of the general population of persons served by the <br/>
<a id="pl.336.6"></a><var>336.6</var>program, including a valid degree and transcript, or a current license, registration, or <br/>
<a id="pl.336.7"></a><var>336.7</var>certification, when a degree or licensure, registration, or certification is required by this <br/>
<a id="pl.336.8"></a><var>336.8</var>chapter or in the coordinated service and support plan or coordinated service and support <br/>
<a id="pl.336.9"></a><var>336.9</var>plan addendum;<br/>
<a id="pl.336.10"></a><var>336.10</var>(2) completion of required demonstrated competency in the orientation and training<br/>
<a id="pl.336.11"></a><var>336.11</var> areas required under this chapter, including and when applicable, completion of continuing <br/>
<a id="pl.336.12"></a><var>336.12</var>education required to maintain professional licensure, registration, or certification <br/>
<a id="pl.336.13"></a><var>336.13</var>requirements. Competency in these areas is determined by the license holder through <br/>
<a id="pl.336.14"></a><var>336.14</var>knowledge testing and observed skill assessment conducted by the trainer or instructor; and<br/>
<a id="pl.336.15"></a><var>336.15</var>(3) except for a license holder who is the sole direct service support staff, periodic<br/>
<a id="pl.336.16"></a><var>336.16</var> performance evaluations completed by the license holder of the direct service support staff <br/>
<a id="pl.336.17"></a><var>336.17</var>person's ability to perform the job functions based on direct observation.<br/>
<a id="pl.336.18"></a><var>336.18</var>(b) Staff under 18 years of age may not perform overnight duties or administer <br/>
<a id="pl.336.19"></a><var>336.19</var>medication.<br/>
<a id="pl.336.20"></a><var>336.20</var>    Subd. 4. <b>Orientation</b><b> to program requirements</b><b>.</b> (a) Except for a license holder <br/>
<a id="pl.336.21"></a><var>336.21</var>who does not supervise any direct service support staff, within 90 days of hiring direct <br/>
<a id="pl.336.22"></a><var>336.22</var>service staff 60 days of hire, unless stated otherwise, the license holder must provide <br/>
<a id="pl.336.23"></a><var>336.23</var>and ensure completion of 30 hours of orientation for direct support staff that combines <br/>
<a id="pl.336.24"></a><var>336.24</var>supervised on-the-job training with review of and instruction on in the following areas:<br/>
<a id="pl.336.25"></a><var>336.25</var>(1) the job description and how to complete specific job functions, including:<br/>
<a id="pl.336.26"></a><var>336.26</var>(i) responding to and reporting incidents as required under section 
         <statute_ref>245D.06</statute_ref>, <br/>
<a id="pl.336.27"></a><var>336.27</var>subdivision 1; and<br/>
<a id="pl.336.28"></a><var>336.28</var>(ii) following safety practices established by the license holder and as required in <br/>
<a id="pl.336.29"></a><var>336.29</var>section 
         <statute_ref>245D.06, subdivision 2</statute_ref>;<br/>
<a id="pl.336.30"></a><var>336.30</var>(2) the license holder's current policies and procedures required under this chapter, <br/>
<a id="pl.336.31"></a><var>336.31</var>including their location and access, and staff responsibilities related to implementation <br/>
<a id="pl.336.32"></a><var>336.32</var>of those policies and procedures;<br/>
<a id="pl.336.33"></a><var>336.33</var>(3) data privacy requirements according to sections 
         <statute_ref>13.01</statute_ref> to 
         <statute_ref>13.10</statute_ref> and 
         <statute_ref>13.46</statute_ref>, the <br/>
<a id="pl.336.34"></a><var>336.34</var>federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff <br/>
<a id="pl.336.35"></a><var>336.35</var>responsibilities related to complying with data privacy practices;<br/>
<a id="pl.337.1"></a><var>337.1</var>(4) the service recipient rights under section 
<statute_ref>245D.04</statute_ref>, and staff responsibilities <br/>
<a id="pl.337.2"></a><var>337.2</var>related to ensuring the exercise and protection of those rights according to the requirements <br/>
<a id="pl.337.3"></a><var>337.3</var>in section 245D.04;<br/>
<a id="pl.337.4"></a><var>337.4</var>(5) sections 
         <statute_ref>245A.65</statute_ref>, 
         <statute_ref>245A.66</statute_ref>, 
         <statute_ref>626.556</statute_ref>, and 
         <statute_ref>626.557</statute_ref>, governing maltreatment <br/>
<a id="pl.337.5"></a><var>337.5</var>reporting and service planning for children and vulnerable adults, and staff responsibilities <br/>
<a id="pl.337.6"></a><var>337.6</var>related to protecting persons from maltreatment and reporting maltreatment. This <br/>
<a id="pl.337.7"></a><var>337.7</var>orientation must be provided within 72 hours of first providing direct contact services and <br/>
<a id="pl.337.8"></a><var>337.8</var>annually thereafter according to section 245A.65, subdivision 3;<br/>
<a id="pl.337.9"></a><var>337.9</var>(6) what constitutes use of restraints, seclusion, and psychotropic medications, <br/>
<a id="pl.337.10"></a><var>337.10</var>and staff responsibilities related to the prohibitions of their use the principles of <br/>
<a id="pl.337.11"></a><var>337.11</var>person-centered service planning and delivery as identified in section 245D.07, subdivision <br/>
<a id="pl.337.12"></a><var>337.12</var>1a, and how they apply to direct support service provided by the staff person; and<br/>
<a id="pl.337.13"></a><var>337.13</var>(7) other topics as determined necessary in the person's coordinated service and <br/>
<a id="pl.337.14"></a><var>337.14</var>support plan by the case manager or other areas identified by the license holder.<br/>
<a id="pl.337.15"></a><var>337.15</var>(b) License holders who provide direct service themselves must complete the <br/>
<a id="pl.337.16"></a><var>337.16</var>orientation required in paragraph (a), clauses (3) to (7).<br/>
<a id="pl.337.17"></a><var>337.17</var>    Subd. 4a. <b>Orientation to individual service recipient needs.</b> (c) (a) Before <br/>
<a id="pl.337.18"></a><var>337.18</var>providing having unsupervised direct service to contact with a person served by the <br/>
<a id="pl.337.19"></a><var>337.19</var>program, or for whom the staff person has not previously provided direct service support, <br/>
<a id="pl.337.20"></a><var>337.20</var>or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to <br/>
<a id="pl.337.21"></a><var>337.21</var>(f) are revised, the staff person must review and receive instruction on the following <br/>
<a id="pl.337.22"></a><var>337.22</var>as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job <br/>
<a id="pl.337.23"></a><var>337.23</var>functions for that person:.<br/>
<a id="pl.337.24"></a><var>337.24</var>(b) Training and competency evaluations must include the following:<br/>
<a id="pl.337.25"></a><var>337.25</var>(1) appropriate and safe techniques in personal hygiene and grooming, including <br/>
<a id="pl.337.26"></a><var>337.26</var>hair care, bathing, care of teeth, gums, oral prosthetic devices, and other activities of daily <br/>
<a id="pl.337.27"></a><var>337.27</var>living (ADLs) as defined under section 256B.0659, subdivision 1;<br/>
<a id="pl.337.28"></a><var>337.28</var>(2) an understanding of what constitutes a healthy diet according to data from the <br/>
<a id="pl.337.29"></a><var>337.29</var>Centers for Disease Control and Prevention and the skills necessary to prepare that diet;<br/>
<a id="pl.337.30"></a><var>337.30</var>(3) skills necessary to provide appropriate support in instrumental activities of daily <br/>
<a id="pl.337.31"></a><var>337.31</var>living (IADLs) as defined under section 256B.0659, subdivision 1; and<br/>
<a id="pl.337.32"></a><var>337.32</var>(4) demonstrated competence in providing first aid.<br/>
<a id="pl.337.33"></a><var>337.33</var>(1) (c) The staff person must review and receive instruction on the person's<br/>
<a id="pl.337.34"></a><var>337.34</var> coordinated service and support plan or coordinated service and support plan addendum as <br/>
<a id="pl.337.35"></a><var>337.35</var>it relates to the responsibilities assigned to the license holder, and when applicable, the <br/>
<a id="pl.337.36"></a><var>337.36</var>person's individual abuse prevention plan according to section 
<statute_ref>245A.65</statute_ref>, to achieve and <br/>
<a id="pl.338.1"></a><var>338.1</var>demonstrate an understanding of the person as a unique individual, and how to implement <br/>
<a id="pl.338.2"></a><var>338.2</var>those plans; and.<br/>
<a id="pl.338.3"></a><var>338.3</var>(2) (d) The staff person must review and receive instruction on medication <br/>
<a id="pl.338.4"></a><var>338.4</var>administration procedures established for the person when medication administration is<br/>
<a id="pl.338.5"></a><var>338.5</var> assigned to the license holder according to section 
         <statute_ref>245D.05, subdivision 1</statute_ref>, paragraph <br/>
<a id="pl.338.6"></a><var>338.6</var>(b). Unlicensed staff may administer medications only after successful completion of a <br/>
<a id="pl.338.7"></a><var>338.7</var>medication administration training, from a training curriculum developed by a registered <br/>
<a id="pl.338.8"></a><var>338.8</var>nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse <br/>
<a id="pl.338.9"></a><var>338.9</var>practitioner, physician's assistant, or physician incorporating. The training curriculum <br/>
<a id="pl.338.10"></a><var>338.10</var>must incorporate an observed skill assessment conducted by the trainer to ensure staff <br/>
<a id="pl.338.11"></a><var>338.11</var>demonstrate the ability to safely and correctly follow medication procedures.<br/>
<a id="pl.338.12"></a><var>338.12</var>Medication administration must be taught by a registered nurse, clinical nurse <br/>
<a id="pl.338.13"></a><var>338.13</var>specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of <br/>
<a id="pl.338.14"></a><var>338.14</var>service initiation or any time thereafter, the person has or develops a health care condition <br/>
<a id="pl.338.15"></a><var>338.15</var>that affects the service options available to the person because the condition requires:<br/>
<a id="pl.338.16"></a><var>338.16</var>(i) (1) specialized or intensive medical or nursing supervision; and<br/>
<a id="pl.338.17"></a><var>338.17</var>(ii) (2) nonmedical service providers to adapt their services to accommodate the <br/>
<a id="pl.338.18"></a><var>338.18</var>health and safety needs of the person; and.<br/>
<a id="pl.338.19"></a><var>338.19</var>(iii) necessary training in order to meet the health service needs of the person as <br/>
<a id="pl.338.20"></a><var>338.20</var>determined by the person's physician.<br/>
<a id="pl.338.21"></a><var>338.21</var>(e) The staff person must review and receive instruction on the safe and correct <br/>
<a id="pl.338.22"></a><var>338.22</var>operation of medical equipment used by the person to sustain life, including but not <br/>
<a id="pl.338.23"></a><var>338.23</var>limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided <br/>
<a id="pl.338.24"></a><var>338.24</var>by a licensed health care professional or a manufacturer's representative and incorporate <br/>
<a id="pl.338.25"></a><var>338.25</var>an observed skill assessment to ensure staff demonstrate the ability to safely and correctly <br/>
<a id="pl.338.26"></a><var>338.26</var>operate the equipment according to the treatment orders and the manufacturer's instructions.<br/>
<a id="pl.338.27"></a><var>338.27</var>(f) The staff person must review and receive instruction on what constitutes use of <br/>
<a id="pl.338.28"></a><var>338.28</var>restraints, time out, and seclusion, including chemical restraint, and staff responsibilities <br/>
<a id="pl.338.29"></a><var>338.29</var>related to the prohibitions of their use according to the requirements in section 245D.06, <br/>
<a id="pl.338.30"></a><var>338.30</var>subdivision 5, why such procedures are not effective for reducing or eliminating symptoms <br/>
<a id="pl.338.31"></a><var>338.31</var>or undesired behavior and why they are not safe, and the safe and correct use of manual <br/>
<a id="pl.338.32"></a><var>338.32</var>restraint on an emergency basis according to the requirements in section 245D.061.<br/>
<a id="pl.338.33"></a><var>338.33</var>(g) In the event of an emergency service initiation, the license holder must ensure <br/>
<a id="pl.338.34"></a><var>338.34</var>the training required in this subdivision occurs within 72 hours of the direct support staff <br/>
<a id="pl.338.35"></a><var>338.35</var>person first having unsupervised contact with the person receiving services. The license <br/>
<a id="pl.339.1"></a><var>339.1</var>holder must document the reason for the unplanned or emergency service initiation and <br/>
<a id="pl.339.2"></a><var>339.2</var>maintain the documentation in the person's service recipient record.<br/>
<a id="pl.339.3"></a><var>339.3</var>(h) License holders who provide direct support services themselves must complete <br/>
<a id="pl.339.4"></a><var>339.4</var>the orientation required in subdivision 4, clauses (3) to (7).<br/>
<a id="pl.339.5"></a><var>339.5</var>    Subd. 5. <b>Annual </b><b>training.</b> (a) A license holder must provide annual training <br/>
<a id="pl.339.6"></a><var>339.6</var>to direct service support staff on the topics identified in subdivision 4, paragraph (a),<br/>
<a id="pl.339.7"></a><var>339.7</var> clauses (3) to (6) (7), and subdivision 4a. A license holder must provide a minimum of 24 <br/>
<a id="pl.339.8"></a><var>339.8</var>hours of annual training to direct service staff with fewer than five years of documented <br/>
<a id="pl.339.9"></a><var>339.9</var>experience and 12 hours of annual training to direct service staff with five or more years <br/>
<a id="pl.339.10"></a><var>339.10</var>of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) <br/>
<a id="pl.339.11"></a><var>339.11</var>to (h). Training on relevant topics received from sources other than the license holder <br/>
<a id="pl.339.12"></a><var>339.12</var>may count toward training requirements.<br/>
<a id="pl.339.13"></a><var>339.13</var>(b) A license holder providing behavioral programming, specialist services, personal <br/>
<a id="pl.339.14"></a><var>339.14</var>support, 24-hour emergency assistance, night supervision, independent living skills, <br/>
<a id="pl.339.15"></a><var>339.15</var>structured day, prevocational, or supported employment services must provide a minimum <br/>
<a id="pl.339.16"></a><var>339.16</var>of eight hours of annual training to direct service staff that addresses:<br/>
<a id="pl.339.17"></a><var>339.17</var>(1) topics related to the general health, safety, and service needs of the population <br/>
<a id="pl.339.18"></a><var>339.18</var>served by the license holder; and<br/>
<a id="pl.339.19"></a><var>339.19</var>(2) other areas identified by the license holder or in the person's current service plan.<br/>
<a id="pl.339.20"></a><var>339.20</var>Training on relevant topics received from sources other than the license holder <br/>
<a id="pl.339.21"></a><var>339.21</var>may count toward training requirements.<br/>
<a id="pl.339.22"></a><var>339.22</var>(c) When the license holder is the owner, lessor, or tenant of the service site and <br/>
<a id="pl.339.23"></a><var>339.23</var>whenever a person receiving services is present at the site, the license holder must have <br/>
<a id="pl.339.24"></a><var>339.24</var>a staff person available on site who is trained in basic first aid and, when required in a <br/>
<a id="pl.339.25"></a><var>339.25</var>person's service plan, cardiopulmonary resuscitation.<br/>
<a id="pl.339.26"></a><var>339.26</var>    Subd. 5a. <b>Alternative sources of training.</b>  Orientation or training received by the <br/>
<a id="pl.339.27"></a><var>339.27</var>staff person from sources other than the license holder in the same subjects as identified <br/>
<a id="pl.339.28"></a><var>339.28</var>in subdivision 4 may count toward the orientation and annual training requirements if <br/>
<a id="pl.339.29"></a><var>339.29</var>received in the 12-month period before the staff person's date of hire. The license holder <br/>
<a id="pl.339.30"></a><var>339.30</var>must maintain documentation of the training received from other sources and of each staff <br/>
<a id="pl.339.31"></a><var>339.31</var>person's competency in the required area according to the requirements in subdivision 3.<br/>
<a id="pl.339.32"></a><var>339.32</var>    Subd. 6. <b>Subcontractors</b><b> and temporary staff</b><b>.</b> If the license holder uses a <br/>
<a id="pl.339.33"></a><var>339.33</var>subcontractor or temporary staff to perform services licensed under this chapter on the <br/>
<a id="pl.339.34"></a><var>339.34</var>license holder's behalf, the license holder must ensure that the subcontractor or temporary <br/>
<a id="pl.339.35"></a><var>339.35</var>staff meets and maintains compliance with all requirements under this chapter that apply <br/>
<a id="pl.339.36"></a><var>339.36</var>to the services to be provided, including training, orientation, and supervision necessary <br/>
<a id="pl.340.1"></a><var>340.1</var>to fulfill their responsibilities. The license holder must ensure that a background study <br/>
<a id="pl.340.2"></a><var>340.2</var>has been completed according to the requirements in sections 245C.03, subdivision 1, <br/>
<a id="pl.340.3"></a><var>340.3</var>and 245C.04. Subcontractors and temporary staff hired by the license holder must meet <br/>
<a id="pl.340.4"></a><var>340.4</var>the Minnesota licensing requirements applicable to the disciplines in which they are <br/>
<a id="pl.340.5"></a><var>340.5</var>providing services. The license holder must maintain documentation that the applicable <br/>
<a id="pl.340.6"></a><var>340.6</var>requirements have been met.<br/>
<a id="pl.340.7"></a><var>340.7</var>    Subd. 7. <b>Volunteers.</b> The license holder must ensure that volunteers who provide <br/>
<a id="pl.340.8"></a><var>340.8</var>direct support services to persons served by the program receive the training, orientation, <br/>
<a id="pl.340.9"></a><var>340.9</var>and supervision necessary to fulfill their responsibilities. The license holder must ensure <br/>
<a id="pl.340.10"></a><var>340.10</var>that a background study has been completed according to the requirements in sections <br/>
<a id="pl.340.11"></a><var>340.11</var>245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation <br/>
<a id="pl.340.12"></a><var>340.12</var>that the applicable requirements have been met.<br/>
<a id="pl.340.13"></a><var>340.13</var>    Subd. 8. <b>Staff orientation and training plan.</b> The license holder must develop <br/>
<a id="pl.340.14"></a><var>340.14</var>a staff orientation and training plan documenting when and how compliance with <br/>
<a id="pl.340.15"></a><var>340.15</var>subdivisions 4, 4a, and 5 will be met.<br/>
<a id="pl.340.16"></a><var>340.16</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.29.0"></a><a id="pl.340.17"></a><var>340.17</var>    Sec. 29. <b>[245D.091] INTERVENTION SERVICES.</b><br/>
<a id="pl.340.18"></a><var>340.18</var>    Subdivision 1. <b>Licensure requirements.</b> An individual meeting the staff <br/>
<a id="pl.340.19"></a><var>340.19</var>qualification requirements of this section who is an employee of a program licensed <br/>
<a id="pl.340.20"></a><var>340.20</var>according to this chapter and providing behavioral support services, specialist services, <br/>
<a id="pl.340.21"></a><var>340.21</var>or crisis respite services is not required to hold a separate license under this chapter. <br/>
<a id="pl.340.22"></a><var>340.22</var>An individual meeting the staff qualifications of this section who is not providing these <br/>
<a id="pl.340.23"></a><var>340.23</var>services as an employee of a program licensed according to this chapter must obtain a <br/>
<a id="pl.340.24"></a><var>340.24</var>license according to this chapter.<br/>
<a id="pl.340.25"></a><var>340.25</var>    Subd. 2. <b>Behavior professional qualifications.</b> A behavior professional, as defined <br/>
<a id="pl.340.26"></a><var>340.26</var>in the brain injury and community alternatives for disabled individuals waiver plans or <br/>
<a id="pl.340.27"></a><var>340.27</var>successor plans, must have competencies in areas related to:<br/>
<a id="pl.340.28"></a><var>340.28</var>(1) ethical considerations;<br/>
<a id="pl.340.29"></a><var>340.29</var>(2) functional assessment;<br/>
<a id="pl.340.30"></a><var>340.30</var>(3) functional analysis;<br/>
<a id="pl.340.31"></a><var>340.31</var>(4) measurement of behavior and interpretation of data;<br/>
<a id="pl.340.32"></a><var>340.32</var>(5) selecting intervention outcomes and strategies;<br/>
<a id="pl.340.33"></a><var>340.33</var>(6) behavior reduction and elimination strategies that promote least restrictive <br/>
<a id="pl.340.34"></a><var>340.34</var>approved alternatives;<br/>
<a id="pl.340.35"></a><var>340.35</var>(7) data collection;<br/>
<a id="pl.341.1"></a><var>341.1</var>(8) staff and caregiver training;<br/>
<a id="pl.341.2"></a><var>341.2</var>(9) support plan monitoring;<br/>
<a id="pl.341.3"></a><var>341.3</var>(10) co-occurring mental disorders or neuro-cognitive disorder;<br/>
<a id="pl.341.4"></a><var>341.4</var>(11) demonstrated expertise with populations being served; and<br/>
<a id="pl.341.5"></a><var>341.5</var>(12) must be a:<br/>
<a id="pl.341.6"></a><var>341.6</var>(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the <br/>
<a id="pl.341.7"></a><var>341.7</var>Board of Psychology competencies in the above identified areas;<br/>
<a id="pl.341.8"></a><var>341.8</var>(ii) clinical social worker licensed as an independent clinical social worker under <br/>
<a id="pl.341.9"></a><var>341.9</var>chapter 148D, or a person with a master's degree in social work from an accredited college <br/>
<a id="pl.341.10"></a><var>341.10</var>or university, with at least 4,000 hours of post-master's supervised experience in the <br/>
<a id="pl.341.11"></a><var>341.11</var>delivery of clinical services in the areas identified in clauses (1) to (11);<br/>
<a id="pl.341.12"></a><var>341.12</var>(iii) physician licensed under chapter 147 and certified by the American Board <br/>
<a id="pl.341.13"></a><var>341.13</var>of Psychiatry and Neurology or eligible for board certification in psychiatry with <br/>
<a id="pl.341.14"></a><var>341.14</var>competencies in the areas identified in clauses (1) to (11);<br/>
<a id="pl.341.15"></a><var>341.15</var>(iv) licensed professional clinical counselor licensed under sections 148B.29 to <br/>
<a id="pl.341.16"></a><var>341.16</var>148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery <br/>
<a id="pl.341.17"></a><var>341.17</var>of clinical services who has demonstrated competencies in the areas identified in clauses <br/>
<a id="pl.341.18"></a><var>341.18</var>(1) to (11);<br/>
<a id="pl.341.19"></a><var>341.19</var>(v) person with a master's degree from an accredited college or university in one <br/>
<a id="pl.341.20"></a><var>341.20</var>of the behavioral sciences or related fields, with at least 4,000 hours of post-master's <br/>
<a id="pl.341.21"></a><var>341.21</var>supervised experience in the delivery of clinical services with demonstrated competencies <br/>
<a id="pl.341.22"></a><var>341.22</var>in the areas identified in clauses (1) to (11); or<br/>
<a id="pl.341.23"></a><var>341.23</var>(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is <br/>
<a id="pl.341.24"></a><var>341.24</var>certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and <br/>
<a id="pl.341.25"></a><var>341.25</var>mental health nursing by a national nurse certification organization, or who has a master's <br/>
<a id="pl.341.26"></a><var>341.26</var>degree in nursing or one of the behavioral sciences or related fields from an accredited <br/>
<a id="pl.341.27"></a><var>341.27</var>college or university or its equivalent, with at least 4,000 hours of post-master's supervised <br/>
<a id="pl.341.28"></a><var>341.28</var>experience in the delivery of clinical services.<br/>
<a id="pl.341.29"></a><var>341.29</var>    Subd. 3. <b>Behavior analyst qualifications.</b> (a) A behavior analyst, as defined in <br/>
<a id="pl.341.30"></a><var>341.30</var>the brain injury and community alternatives for disabled individuals waiver plans or <br/>
<a id="pl.341.31"></a><var>341.31</var>successor plans, must:<br/>
<a id="pl.341.32"></a><var>341.32</var>(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services <br/>
<a id="pl.341.33"></a><var>341.33</var>discipline; or<br/>
<a id="pl.341.34"></a><var>341.34</var>(2) meet the qualifications of a mental health practitioner as defined in section <br/>
<a id="pl.341.35"></a><var>341.35</var>245.462, subdivision 17.<br/>
<a id="pl.341.36"></a><var>341.36</var>(b) In addition, a behavior analyst must:<br/>
<a id="pl.342.1"></a><var>342.1</var>(1) have four years of supervised experience working with individuals who exhibit <br/>
<a id="pl.342.2"></a><var>342.2</var>challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;<br/>
<a id="pl.342.3"></a><var>342.3</var>(2) have received ten hours of instruction in functional assessment and functional <br/>
<a id="pl.342.4"></a><var>342.4</var>analysis;<br/>
<a id="pl.342.5"></a><var>342.5</var>(3) have received 20 hours of instruction in the understanding of the function of <br/>
<a id="pl.342.6"></a><var>342.6</var>behavior;<br/>
<a id="pl.342.7"></a><var>342.7</var>(4) have received ten hours of instruction on design of positive practices behavior <br/>
<a id="pl.342.8"></a><var>342.8</var>support strategies;<br/>
<a id="pl.342.9"></a><var>342.9</var>(5) have received 20 hours of instruction on the use of behavior reduction approved <br/>
<a id="pl.342.10"></a><var>342.10</var>strategies used only in combination with behavior positive practices strategies;<br/>
<a id="pl.342.11"></a><var>342.11</var>(6) be determined by a behavior professional to have the training and prerequisite <br/>
<a id="pl.342.12"></a><var>342.12</var>skills required to provide positive practice strategies as well as behavior reduction <br/>
<a id="pl.342.13"></a><var>342.13</var>approved and permitted intervention to the person who receives behavioral support; and<br/>
<a id="pl.342.14"></a><var>342.14</var>(7) be under the direct supervision of a behavior professional.<br/>
<a id="pl.342.15"></a><var>342.15</var>    Subd. 4. <b>Behavior specialist qualifications.</b> (a) A behavior specialist, as defined <br/>
<a id="pl.342.16"></a><var>342.16</var>in the brain injury and community alternatives for disabled individuals waiver plans or <br/>
<a id="pl.342.17"></a><var>342.17</var>successor plans, must meet the following qualifications:<br/>
<a id="pl.342.18"></a><var>342.18</var>(1) have an associate's degree in a social services discipline; or<br/>
<a id="pl.342.19"></a><var>342.19</var>(2) have two years of supervised experience working with individuals who exhibit <br/>
<a id="pl.342.20"></a><var>342.20</var>challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.<br/>
<a id="pl.342.21"></a><var>342.21</var>(b) In addition, a behavior specialist must:<br/>
<a id="pl.342.22"></a><var>342.22</var>(1) have received a minimum of four hours of training in functional assessment;<br/>
<a id="pl.342.23"></a><var>342.23</var>(2) have received 20 hours of instruction in the understanding of the function of <br/>
<a id="pl.342.24"></a><var>342.24</var>behavior;<br/>
<a id="pl.342.25"></a><var>342.25</var>(3) have received ten hours of instruction on design of positive practices behavioral <br/>
<a id="pl.342.26"></a><var>342.26</var>support strategies;<br/>
<a id="pl.342.27"></a><var>342.27</var>(4) be determined by a behavior professional to have the training and prerequisite <br/>
<a id="pl.342.28"></a><var>342.28</var>skills required to provide positive practices strategies as well as behavior reduction <br/>
<a id="pl.342.29"></a><var>342.29</var>approved intervention to the person who receives behavioral support; and<br/>
<a id="pl.342.30"></a><var>342.30</var>(5) be under the direct supervision of a behavior professional.<br/>
<a id="pl.342.31"></a><var>342.31</var>    Subd. 5. <b>Specialist services qualifications.</b> An individual providing specialist <br/>
<a id="pl.342.32"></a><var>342.32</var>services, as defined in the developmental disabilities waiver plan or successor plan, must <br/>
<a id="pl.342.33"></a><var>342.33</var>have:<br/>
<a id="pl.342.34"></a><var>342.34</var>(1) the specific experience and skills required of the specialist to meet the needs of <br/>
<a id="pl.342.35"></a><var>342.35</var>the person identified by the person's service planning team; and<br/>
<a id="pl.343.1"></a><var>343.1</var>(2) the qualifications of the specialist identified in the person's coordinated service <br/>
<a id="pl.343.2"></a><var>343.2</var>and support plan.<br/>
<a id="pl.343.3"></a><var>343.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.30.0"></a><a id="pl.343.4"></a><var>343.4</var>    Sec. 30. <b>[245D.095] RECORD REQUIREMENTS.</b><br/>
<a id="pl.343.5"></a><var>343.5</var>    Subdivision 1. <b>Record-keeping systems.</b> The license holder must ensure that the <br/>
<a id="pl.343.6"></a><var>343.6</var>content and format of service recipient, personnel, and program records are uniform and <br/>
<a id="pl.343.7"></a><var>343.7</var>legible according to the requirements of this chapter.<br/>
<a id="pl.343.8"></a><var>343.8</var>    Subd. 2. <b>Admission and discharge register.</b> The license holder must keep a written <br/>
<a id="pl.343.9"></a><var>343.9</var>or electronic register, listing in chronological order the dates and names of all persons <br/>
<a id="pl.343.10"></a><var>343.10</var>served by the program who have been admitted, discharged, or transferred, including <br/>
<a id="pl.343.11"></a><var>343.11</var>service terminations initiated by the license holder and deaths.<br/>
<a id="pl.343.12"></a><var>343.12</var>    Subd. 3. <b>Service recipient record.</b> (a) The license holder must maintain a record of <br/>
<a id="pl.343.13"></a><var>343.13</var>current services provided to each person on the premises where the services are provided <br/>
<a id="pl.343.14"></a><var>343.14</var>or coordinated. When the services are provided in a licensed facility, the records must <br/>
<a id="pl.343.15"></a><var>343.15</var>be maintained at the facility, otherwise the records must be maintained at the license <br/>
<a id="pl.343.16"></a><var>343.16</var>holder's program office. The license holder must protect service recipient records against <br/>
<a id="pl.343.17"></a><var>343.17</var>loss, tampering, or unauthorized disclosure according to the requirements in sections <br/>
<a id="pl.343.18"></a><var>343.18</var>13.01 to 13.10 and 13.46.<br/>
<a id="pl.343.19"></a><var>343.19</var>(b) The license holder must maintain the following information for each person:<br/>
<a id="pl.343.20"></a><var>343.20</var>(1) an admission form signed by the person or the person's legal representative <br/>
<a id="pl.343.21"></a><var>343.21</var>that includes:<br/>
<a id="pl.343.22"></a><var>343.22</var>(i) identifying information, including the person's name, date of birth, address, <br/>
<a id="pl.343.23"></a><var>343.23</var>and telephone number; and<br/>
<a id="pl.343.24"></a><var>343.24</var>(ii) the name, address, and telephone number of the person's legal representative, if <br/>
<a id="pl.343.25"></a><var>343.25</var>any, and a primary emergency contact, the case manager, and family members or others as <br/>
<a id="pl.343.26"></a><var>343.26</var>identified by the person or case manager;<br/>
<a id="pl.343.27"></a><var>343.27</var>(2) service information, including service initiation information, verification of the <br/>
<a id="pl.343.28"></a><var>343.28</var>person's eligibility for services, documentation verifying that services have been provided <br/>
<a id="pl.343.29"></a><var>343.29</var>as identified in the coordinated service and support plan or coordinated service and support <br/>
<a id="pl.343.30"></a><var>343.30</var>plan addendum according to paragraph (a), and date of admission or readmission;<br/>
<a id="pl.343.31"></a><var>343.31</var>(3) health information, including medical history, special dietary needs, and <br/>
<a id="pl.343.32"></a><var>343.32</var>allergies, and when the license holder is assigned responsibility for meeting the person's <br/>
<a id="pl.343.33"></a><var>343.33</var>health service needs according to section 245D.05:<br/>
<a id="pl.344.1"></a><var>344.1</var>(i) current orders for medication, treatments, or medical equipment and a signed <br/>
<a id="pl.344.2"></a><var>344.2</var>authorization from the person or the person's legal representative to administer or assist in <br/>
<a id="pl.344.3"></a><var>344.3</var>administering the medication or treatments, if applicable;<br/>
<a id="pl.344.4"></a><var>344.4</var>(ii) a signed statement authorizing the license holder to act in a medical emergency <br/>
<a id="pl.344.5"></a><var>344.5</var>when the person's legal representative, if any, cannot be reached or is delayed in arriving;<br/>
<a id="pl.344.6"></a><var>344.6</var>(iii) medication administration procedures;<br/>
<a id="pl.344.7"></a><var>344.7</var>(iv) a medication administration record documenting the implementation of the <br/>
<a id="pl.344.8"></a><var>344.8</var>medication administration procedures, and the medication administration record reviews, <br/>
<a id="pl.344.9"></a><var>344.9</var>including any agreements for administration of injectable medications by the license <br/>
<a id="pl.344.10"></a><var>344.10</var>holder according to the requirements in section 245D.05; and<br/>
<a id="pl.344.11"></a><var>344.11</var>(v) a medical appointment schedule when the license holder is assigned <br/>
<a id="pl.344.12"></a><var>344.12</var>responsibility for assisting with medical appointments;<br/>
<a id="pl.344.13"></a><var>344.13</var>(4) the person's current coordinated service and support plan or that portion of the <br/>
<a id="pl.344.14"></a><var>344.14</var>plan assigned to the license holder;<br/>
<a id="pl.344.15"></a><var>344.15</var>(5) copies of the individual abuse prevention plan and assessments as required under <br/>
<a id="pl.344.16"></a><var>344.16</var>section 245D.071, subdivisions 2 and 3;<br/>
<a id="pl.344.17"></a><var>344.17</var>(6) a record of other service providers serving the person when the person's <br/>
<a id="pl.344.18"></a><var>344.18</var>coordinated service and support plan or coordinated service and support plan addendum <br/>
<a id="pl.344.19"></a><var>344.19</var>identifies the need for coordination between the service providers, that includes a contact <br/>
<a id="pl.344.20"></a><var>344.20</var>person and telephone numbers, services being provided, and names of staff responsible for <br/>
<a id="pl.344.21"></a><var>344.21</var>coordination;<br/>
<a id="pl.344.22"></a><var>344.22</var>(7) documentation of orientation to service recipient rights according to section <br/>
<a id="pl.344.23"></a><var>344.23</var>245D.04, subdivision 1, and maltreatment reporting policies and procedures according to <br/>
<a id="pl.344.24"></a><var>344.24</var>section 245A.65, subdivision 1, paragraph (c);<br/>
<a id="pl.344.25"></a><var>344.25</var>(8) copies of authorizations to handle a person's funds, according to section 245D.06, <br/>
<a id="pl.344.26"></a><var>344.26</var>subdivision 4, paragraph (a);<br/>
<a id="pl.344.27"></a><var>344.27</var>(9) documentation of complaints received and grievance resolution;<br/>
<a id="pl.344.28"></a><var>344.28</var>(10) incident reports involving the person, required under section 245D.06, <br/>
<a id="pl.344.29"></a><var>344.29</var>subdivision 1;<br/>
<a id="pl.344.30"></a><var>344.30</var>(11) copies of written reports regarding the person's status when requested according <br/>
<a id="pl.344.31"></a><var>344.31</var>to section 245D.07, subdivision 3, progress review reports as required under section <br/>
<a id="pl.344.32"></a><var>344.32</var>245D.071, subdivision 5, progress or daily log notes that are recorded by the program, <br/>
<a id="pl.344.33"></a><var>344.33</var>and reports received from other agencies involved in providing services or care to the <br/>
<a id="pl.344.34"></a><var>344.34</var>person; and<br/>
<a id="pl.344.35"></a><var>344.35</var>(12) discharge summary, including service termination notice and related <br/>
<a id="pl.344.36"></a><var>344.36</var>documentation, when applicable.<br/>
<a id="pl.345.1"></a><var>345.1</var>    Subd. 4. <b>Access to service recipient records.</b> The license holder must ensure that <br/>
<a id="pl.345.2"></a><var>345.2</var>the following people have access to the information in subdivision 1 in accordance with <br/>
<a id="pl.345.3"></a><var>345.3</var>applicable state and federal laws, regulations, or rules:<br/>
<a id="pl.345.4"></a><var>345.4</var>(1) the person, the person's legal representative, and anyone properly authorized <br/>
<a id="pl.345.5"></a><var>345.5</var>by the person;<br/>
<a id="pl.345.6"></a><var>345.6</var>(2) the person's case manager;<br/>
<a id="pl.345.7"></a><var>345.7</var>(3) staff providing services to the person unless the information is not relevant to <br/>
<a id="pl.345.8"></a><var>345.8</var>carrying out the coordinated service and support plan or coordinated service and support <br/>
<a id="pl.345.9"></a><var>345.9</var>plan addendum; and<br/>
<a id="pl.345.10"></a><var>345.10</var>(4) the county child or adult foster care licensor, when services are also licensed as <br/>
<a id="pl.345.11"></a><var>345.11</var>child or adult foster care.<br/>
<a id="pl.345.12"></a><var>345.12</var>    Subd. 5. <b>Personnel records.</b> (a) The license holder must maintain a personnel <br/>
<a id="pl.345.13"></a><var>345.13</var>record of each employee to document and verify staff qualifications, orientation, and <br/>
<a id="pl.345.14"></a><var>345.14</var>training. The personnel record must include:<br/>
<a id="pl.345.15"></a><var>345.15</var>(1) the employee's date of hire, completed application, an acknowledgement signed <br/>
<a id="pl.345.16"></a><var>345.16</var>by the employee that job duties were reviewed with the employee and the employee <br/>
<a id="pl.345.17"></a><var>345.17</var>understands those duties, and documentation that the employee meets the position <br/>
<a id="pl.345.18"></a><var>345.18</var>requirements as determined by the license holder;<br/>
<a id="pl.345.19"></a><var>345.19</var> (2) documentation of staff qualifications, orientation, training, and performance <br/>
<a id="pl.345.20"></a><var>345.20</var>evaluations as required under section 245D.09, subdivisions 3 to 5, including the date <br/>
<a id="pl.345.21"></a><var>345.21</var>the training was completed, the number of hours per subject area, and the name of the <br/>
<a id="pl.345.22"></a><var>345.22</var>trainer or instructor; and<br/>
<a id="pl.345.23"></a><var>345.23</var>(3) a completed background study as required under chapter 245C.<br/>
<a id="pl.345.24"></a><var>345.24</var>(b) For employees hired after January 1, 2014, the license holder must maintain <br/>
<a id="pl.345.25"></a><var>345.25</var>documentation in the personnel record or elsewhere, sufficient to determine the date of the <br/>
<a id="pl.345.26"></a><var>345.26</var>employee's first supervised direct contact with a person served by the program, and the <br/>
<a id="pl.345.27"></a><var>345.27</var>date of first unsupervised direct contact with a person served by the program.<br/>
<a id="pl.345.28"></a><var>345.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.31.0"></a><a id="pl.345.29"></a><var>345.29</var>    Sec. 31. Minnesota Statutes 2012, section 245D.10, is amended to read:<br/>
<a id="pl.345.30"></a><var>345.30</var><b>245D.10 POLICIES AND PROCEDURES.</b><br/>
<a id="pl.345.31"></a><var>345.31</var>    Subdivision 1. <b>Policy and procedure requirements. </b> The A license holder<br/>
<a id="pl.345.32"></a><var>345.32</var> providing either basic or intensive supports and services must establish, enforce, and <br/>
<a id="pl.345.33"></a><var>345.33</var>maintain policies and procedures as required in this chapter, chapter 245A, and other <br/>
<a id="pl.346.1"></a><var>346.1</var>applicable state and federal laws and regulations governing the provision of home and <br/>
<a id="pl.346.2"></a><var>346.2</var>community-based services licensed according to this chapter.<br/>
<a id="pl.346.3"></a><var>346.3</var>    Subd. 2. <b>Grievances.</b> The license holder must establish policies and procedures <br/>
<a id="pl.346.4"></a><var>346.4</var>that provide promote service recipient rights by providing a simple complaint process for <br/>
<a id="pl.346.5"></a><var>346.5</var>persons served by the program and their authorized representatives to bring a grievance that:<br/>
<a id="pl.346.6"></a><var>346.6</var>(1) provides staff assistance with the complaint process when requested, and the <br/>
<a id="pl.346.7"></a><var>346.7</var>addresses and telephone numbers of outside agencies to assist the person;<br/>
<a id="pl.346.8"></a><var>346.8</var>(2) allows the person to bring the complaint to the highest level of authority in the <br/>
<a id="pl.346.9"></a><var>346.9</var>program if the grievance cannot be resolved by other staff members, and that provides <br/>
<a id="pl.346.10"></a><var>346.10</var>the name, address, and telephone number of that person;<br/>
<a id="pl.346.11"></a><var>346.11</var>(3) requires the license holder to promptly respond to all complaints affecting a <br/>
<a id="pl.346.12"></a><var>346.12</var>person's health and safety. For all other complaints, the license holder must provide an <br/>
<a id="pl.346.13"></a><var>346.13</var>initial response within 14 calendar days of receipt of the complaint. All complaints must <br/>
<a id="pl.346.14"></a><var>346.14</var>be resolved within 30 calendar days of receipt or the license holder must document the <br/>
<a id="pl.346.15"></a><var>346.15</var>reason for the delay and a plan for resolution;<br/>
<a id="pl.346.16"></a><var>346.16</var>(4) requires a complaint review that includes an evaluation of whether:<br/>
<a id="pl.346.17"></a><var>346.17</var>(i) related policies and procedures were followed and adequate;<br/>
<a id="pl.346.18"></a><var>346.18</var>(ii) there is a need for additional staff training;<br/>
<a id="pl.346.19"></a><var>346.19</var>(iii) the complaint is similar to past complaints with the persons, staff, or services <br/>
<a id="pl.346.20"></a><var>346.20</var>involved; and<br/>
<a id="pl.346.21"></a><var>346.21</var>(iv) there is a need for corrective action by the license holder to protect the health <br/>
<a id="pl.346.22"></a><var>346.22</var>and safety of persons receiving services;<br/>
<a id="pl.346.23"></a><var>346.23</var>(5) based on the review in clause (4), requires the license holder to develop, <br/>
<a id="pl.346.24"></a><var>346.24</var>document, and implement a corrective action plan designed to correct current lapses and <br/>
<a id="pl.346.25"></a><var>346.25</var>prevent future lapses in performance by staff or the license holder, if any;<br/>
<a id="pl.346.26"></a><var>346.26</var>(6) provides a written summary of the complaint and a notice of the complaint <br/>
<a id="pl.346.27"></a><var>346.27</var>resolution to the person and case manager that:<br/>
<a id="pl.346.28"></a><var>346.28</var>(i) identifies the nature of the complaint and the date it was received;<br/>
<a id="pl.346.29"></a><var>346.29</var>(ii) includes the results of the complaint review;<br/>
<a id="pl.346.30"></a><var>346.30</var>(iii) identifies the complaint resolution, including any corrective action; and<br/>
<a id="pl.346.31"></a><var>346.31</var>(7) requires that the complaint summary and resolution notice be maintained in the <br/>
<a id="pl.346.32"></a><var>346.32</var>service recipient record.<br/>
<a id="pl.346.33"></a><var>346.33</var>    Subd. 3. <b>Service suspension and service termination.</b> (a) The license holder must <br/>
<a id="pl.346.34"></a><var>346.34</var>establish policies and procedures for temporary service suspension and service termination <br/>
<a id="pl.346.35"></a><var>346.35</var>that promote continuity of care and service coordination with the person and the case <br/>
<a id="pl.346.36"></a><var>346.36</var>manager and with other licensed caregivers, if any, who also provide support to the person.<br/>
<a id="pl.347.1"></a><var>347.1</var>(b) The policy must include the following requirements:<br/>
<a id="pl.347.2"></a><var>347.2</var>(1) the license holder must notify the person or the person's legal representative and <br/>
<a id="pl.347.3"></a><var>347.3</var>case manager in writing of the intended termination or temporary service suspension, and <br/>
<a id="pl.347.4"></a><var>347.4</var>the person's right to seek a temporary order staying the termination of service according to <br/>
<a id="pl.347.5"></a><var>347.5</var>the procedures in section 
         <statute_ref>256.045, subdivision 4a</statute_ref>, or 6, paragraph (c);<br/>
<a id="pl.347.6"></a><var>347.6</var>(2) notice of the proposed termination of services, including those situations <br/>
<a id="pl.347.7"></a><var>347.7</var>that began with a temporary service suspension, must be given at least 60 days before <br/>
<a id="pl.347.8"></a><var>347.8</var>the proposed termination is to become effective when a license holder is providing <br/>
<a id="pl.347.9"></a><var>347.9</var>independent living skills training, structured day, prevocational or supported employment <br/>
<a id="pl.347.10"></a><var>347.10</var>services to the person intensive supports and services identified in section 245D.03, <br/>
<a id="pl.347.11"></a><var>347.11</var>subdivision 1, paragraph (c), and 30 days prior to termination for all other services <br/>
<a id="pl.347.12"></a><var>347.12</var>licensed under this chapter;<br/>
<a id="pl.347.13"></a><var>347.13</var>(3) the license holder must provide information requested by the person or case <br/>
<a id="pl.347.14"></a><var>347.14</var>manager when services are temporarily suspended or upon notice of termination;<br/>
<a id="pl.347.15"></a><var>347.15</var>(4) prior to giving notice of service termination or temporary service suspension, <br/>
<a id="pl.347.16"></a><var>347.16</var>the license holder must document actions taken to minimize or eliminate the need for <br/>
<a id="pl.347.17"></a><var>347.17</var>service suspension or termination;<br/>
<a id="pl.347.18"></a><var>347.18</var>(5) during the temporary service suspension or service termination notice period, <br/>
<a id="pl.347.19"></a><var>347.19</var>the license holder will work with the appropriate county agency to develop reasonable <br/>
<a id="pl.347.20"></a><var>347.20</var>alternatives to protect the person and others;<br/>
<a id="pl.347.21"></a><var>347.21</var>(6) the license holder must maintain information about the service suspension or <br/>
<a id="pl.347.22"></a><var>347.22</var>termination, including the written termination notice, in the service recipient record; and<br/>
<a id="pl.347.23"></a><var>347.23</var>(7) the license holder must restrict temporary service suspension to situations in <br/>
<a id="pl.347.24"></a><var>347.24</var>which the person's behavior causes immediate and serious danger to the health and safety <br/>
<a id="pl.347.25"></a><var>347.25</var>of the person or others conduct poses an imminent risk of physical harm to self or others <br/>
<a id="pl.347.26"></a><var>347.26</var>and less restrictive or positive support strategies would not achieve safety.<br/>
<a id="pl.347.27"></a><var>347.27</var>    Subd. 4. <b>Availability of current written policies and procedures.</b> (a) The license <br/>
<a id="pl.347.28"></a><var>347.28</var>holder must review and update, as needed, the written policies and procedures required <br/>
<a id="pl.347.29"></a><var>347.29</var>under this chapter.<br/>
<a id="pl.347.30"></a><var>347.30</var>(b)(1) The license holder must inform the person and case manager of the policies <br/>
<a id="pl.347.31"></a><var>347.31</var>and procedures affecting a person's rights under section 
         <statute_ref>245D.04</statute_ref>, and provide copies of <br/>
<a id="pl.347.32"></a><var>347.32</var>those policies and procedures, within five working days of service initiation.<br/>
<a id="pl.347.33"></a><var>347.33</var>(2) If a license holder only provides basic services and supports, this includes the:<br/>
<a id="pl.347.34"></a><var>347.34</var>(i) grievance policy and procedure required under subdivision 2; and<br/>
<a id="pl.347.35"></a><var>347.35</var>(ii) service suspension and termination policy and procedure required under <br/>
<a id="pl.347.36"></a><var>347.36</var>subdivision 3.<br/>
<a id="pl.348.1"></a><var>348.1</var>(3) For all other license holders this includes the:<br/>
<a id="pl.348.2"></a><var>348.2</var>(i) policies and procedures in clause (2);<br/>
<a id="pl.348.3"></a><var>348.3</var>(ii) emergency use of manual restraints policy and procedure required under <br/>
<a id="pl.348.4"></a><var>348.4</var>subdivision 3a; and<br/>
<a id="pl.348.5"></a><var>348.5</var>(iii) data privacy requirements under section 245D.11, subdivision 3.<br/>
<a id="pl.348.6"></a><var>348.6</var>(c) The license holder must provide a written notice to all persons or their legal <br/>
<a id="pl.348.7"></a><var>348.7</var>representatives and case managers at least 30 days before implementing any revised <br/>
<a id="pl.348.8"></a><var>348.8</var>policies and procedures procedural revisions to policies affecting a person's service-related <br/>
<a id="pl.348.9"></a><var>348.9</var>or protection-related rights under section 
         <statute_ref>245D.04</statute_ref> and maltreatment reporting policies and <br/>
<a id="pl.348.10"></a><var>348.10</var>procedures. The notice must explain the revision that was made and include a copy of the <br/>
<a id="pl.348.11"></a><var>348.11</var>revised policy and procedure. The license holder must document the reason reasonable <br/>
<a id="pl.348.12"></a><var>348.12</var>cause for not providing the notice at least 30 days before implementing the revisions.<br/>
<a id="pl.348.13"></a><var>348.13</var>(d) Before implementing revisions to required policies and procedures, the license <br/>
<a id="pl.348.14"></a><var>348.14</var>holder must inform all employees of the revisions and provide training on implementation <br/>
<a id="pl.348.15"></a><var>348.15</var>of the revised policies and procedures.<br/>
<a id="pl.348.16"></a><var>348.16</var>(e) The license holder must annually notify all persons, or their legal representatives, <br/>
<a id="pl.348.17"></a><var>348.17</var>and case managers of any procedural revisions to policies required under this chapter, <br/>
<a id="pl.348.18"></a><var>348.18</var>other than those in paragraph (c). Upon request, the license holder must provide the <br/>
<a id="pl.348.19"></a><var>348.19</var>person, or the person's legal representative, and case manager with copies of the revised <br/>
<a id="pl.348.20"></a><var>348.20</var>policies and procedures.<br/>
<a id="pl.348.21"></a><var>348.21</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.32.0"></a><a id="pl.348.22"></a><var>348.22</var>    Sec. 32. <b>[245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT </b><br/>
<a id="pl.348.23"></a><var>348.23</var><b>SERVICES.</b><br/>
<a id="pl.348.24"></a><var>348.24</var>    Subdivision 1. <b>Policy and procedure requirements.</b> A license holder providing <br/>
<a id="pl.348.25"></a><var>348.25</var>intensive support services as identified in section 245D.03, subdivision 1, paragraph (c), <br/>
<a id="pl.348.26"></a><var>348.26</var>must establish, enforce, and maintain policies and procedures as required in this section.<br/>
<a id="pl.348.27"></a><var>348.27</var>    Subd. 2. <b>Health and safety.</b> The license holder must establish policies and <br/>
<a id="pl.348.28"></a><var>348.28</var>procedures that promote health and safety by ensuring:<br/>
<a id="pl.348.29"></a><var>348.29</var>(1) use of universal precautions and sanitary practices in compliance with section <br/>
<a id="pl.348.30"></a><var>348.30</var>245D.06, subdivision 2, clause (5);<br/>
<a id="pl.348.31"></a><var>348.31</var>(2) if the license holder operates a residential program, health service coordination <br/>
<a id="pl.348.32"></a><var>348.32</var>and care according to the requirements in section 245D.05, subdivision 1;<br/>
<a id="pl.348.33"></a><var>348.33</var>(3) safe medication assistance and administration according to the requirements <br/>
<a id="pl.348.34"></a><var>348.34</var>in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in <br/>
<a id="pl.348.35"></a><var>348.35</var>consultation with a registered nurse, nurse practitioner, physician's assistant, or medical <br/>
<a id="pl.349.1"></a><var>349.1</var>doctor and require completion of medication administration training according to the <br/>
<a id="pl.349.2"></a><var>349.2</var>requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance <br/>
<a id="pl.349.3"></a><var>349.3</var>and administration includes, but is not limited to:<br/>
<a id="pl.349.4"></a><var>349.4</var>(i) providing medication-related services for a person;<br/>
<a id="pl.349.5"></a><var>349.5</var>(ii) medication setup;<br/>
<a id="pl.349.6"></a><var>349.6</var>(iii) medication administration;<br/>
<a id="pl.349.7"></a><var>349.7</var>(iv) medication storage and security;<br/>
<a id="pl.349.8"></a><var>349.8</var>(v) medication documentation and charting;<br/>
<a id="pl.349.9"></a><var>349.9</var>(vi) verification and monitoring of effectiveness of systems to ensure safe medication <br/>
<a id="pl.349.10"></a><var>349.10</var>handling and administration;<br/>
<a id="pl.349.11"></a><var>349.11</var>(vii) coordination of medication refills;<br/>
<a id="pl.349.12"></a><var>349.12</var>(viii) handling changes to prescriptions and implementation of those changes;<br/>
<a id="pl.349.13"></a><var>349.13</var>(ix) communicating with the pharmacy; and<br/>
<a id="pl.349.14"></a><var>349.14</var>(x) coordination and communication with prescriber;<br/>
<a id="pl.349.15"></a><var>349.15</var>(4) safe transportation, when the license holder is responsible for transportation of <br/>
<a id="pl.349.16"></a><var>349.16</var>persons, with provisions for handling emergency situations according to the requirements <br/>
<a id="pl.349.17"></a><var>349.17</var>in section 245D.06, subdivision 2, clauses (2) to (4);<br/>
<a id="pl.349.18"></a><var>349.18</var>(5) a plan for ensuring the safety of persons served by the program in emergencies as <br/>
<a id="pl.349.19"></a><var>349.19</var>defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies <br/>
<a id="pl.349.20"></a><var>349.20</var>to the license holder. A license holder with a community residential setting or a day service <br/>
<a id="pl.349.21"></a><var>349.21</var>facility license must ensure the policy and procedures comply with the requirements in <br/>
<a id="pl.349.22"></a><var>349.22</var>section 245D.22, subdivision 4;<br/>
<a id="pl.349.23"></a><var>349.23</var>(6) a plan for responding to all incidents as defined in section 245D.02, subdivision <br/>
<a id="pl.349.24"></a><var>349.24</var>11; and reporting all incidents required to be reported according to section 245D.06, <br/>
<a id="pl.349.25"></a><var>349.25</var>subdivision 1. The plan must:<br/>
<a id="pl.349.26"></a><var>349.26</var>(i) provide the contact information of a source of emergency medical care and <br/>
<a id="pl.349.27"></a><var>349.27</var>transportation; and<br/>
<a id="pl.349.28"></a><var>349.28</var>(ii) require staff to first call 911 when the staff believes a medical emergency may be <br/>
<a id="pl.349.29"></a><var>349.29</var>life threatening, or to call the mental health crisis intervention team when the person is <br/>
<a id="pl.349.30"></a><var>349.30</var>experiencing a mental health crisis; and<br/>
<a id="pl.349.31"></a><var>349.31</var>(7) a procedure for the review of incidents and emergencies to identify trends or <br/>
<a id="pl.349.32"></a><var>349.32</var>patterns, and corrective action if needed. The license holder must establish and maintain <br/>
<a id="pl.349.33"></a><var>349.33</var>a record-keeping system for the incident and emergency reports. Each incident and <br/>
<a id="pl.349.34"></a><var>349.34</var>emergency report file must contain a written summary of the incident. The license holder <br/>
<a id="pl.349.35"></a><var>349.35</var>must conduct a review of incident reports for identification of incident patterns, and <br/>
<a id="pl.350.1"></a><var>350.1</var>implementation of corrective action as necessary to reduce occurrences. Each incident <br/>
<a id="pl.350.2"></a><var>350.2</var>report must include:<br/>
<a id="pl.350.3"></a><var>350.3</var>(i) the name of the person or persons involved in the incident. It is not necessary <br/>
<a id="pl.350.4"></a><var>350.4</var>to identify all persons affected by or involved in an emergency unless the emergency <br/>
<a id="pl.350.5"></a><var>350.5</var>resulted in an incident;<br/>
<a id="pl.350.6"></a><var>350.6</var>(ii) the date, time, and location of the incident or emergency;<br/>
<a id="pl.350.7"></a><var>350.7</var>(iii) a description of the incident or emergency;<br/>
<a id="pl.350.8"></a><var>350.8</var>(iv) a description of the response to the incident or emergency and whether a person's <br/>
<a id="pl.350.9"></a><var>350.9</var>coordinated service and support plan addendum or program policies and procedures were <br/>
<a id="pl.350.10"></a><var>350.10</var>implemented as applicable;<br/>
<a id="pl.350.11"></a><var>350.11</var>(v) the name of the staff person or persons who responded to the incident or <br/>
<a id="pl.350.12"></a><var>350.12</var>emergency; and<br/>
<a id="pl.350.13"></a><var>350.13</var>(vi) the determination of whether corrective action is necessary based on the results <br/>
<a id="pl.350.14"></a><var>350.14</var>of the review.<br/>
<a id="pl.350.15"></a><var>350.15</var>    Subd. 3. <b>Data privacy.</b> The license holder must establish policies and procedures that <br/>
<a id="pl.350.16"></a><var>350.16</var>promote service recipient rights by ensuring data privacy according to the requirements in:<br/>
<a id="pl.350.17"></a><var>350.17</var>(1) the Minnesota Government Data Practices Act, section 13.46, and all other <br/>
<a id="pl.350.18"></a><var>350.18</var>applicable Minnesota laws and rules in handling all data related to the services provided; <br/>
<a id="pl.350.19"></a><var>350.19</var>and<br/>
<a id="pl.350.20"></a><var>350.20</var>(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the <br/>
<a id="pl.350.21"></a><var>350.21</var>extent that the license holder performs a function or activity involving the use of protected <br/>
<a id="pl.350.22"></a><var>350.22</var>health information as defined under Code of Federal Regulations, title 45, section 164.501, <br/>
<a id="pl.350.23"></a><var>350.23</var>including, but not limited to, providing health care services; health care claims processing <br/>
<a id="pl.350.24"></a><var>350.24</var>or administration; data analysis, processing, or administration; utilization review; quality <br/>
<a id="pl.350.25"></a><var>350.25</var>assurance; billing; benefit management; practice management; repricing; or as otherwise <br/>
<a id="pl.350.26"></a><var>350.26</var>provided by Code of Federal Regulations, title 45, section 160.103. The license holder <br/>
<a id="pl.350.27"></a><var>350.27</var>must comply with the Health Insurance Portability and Accountability Act of 1996 and <br/>
<a id="pl.350.28"></a><var>350.28</var>its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164, <br/>
<a id="pl.350.29"></a><var>350.29</var>and all applicable requirements.<br/>
<a id="pl.350.30"></a><var>350.30</var>    Subd. 4. <b>Admission criteria.</b> The license holder must establish policies and <br/>
<a id="pl.350.31"></a><var>350.31</var>procedures that promote continuity of care by ensuring that admission or service initiation <br/>
<a id="pl.350.32"></a><var>350.32</var>criteria:<br/>
<a id="pl.350.33"></a><var>350.33</var>(1) is consistent with the license holder's registration information identified in the <br/>
<a id="pl.350.34"></a><var>350.34</var>requirements in section 245D.031, subdivision 2, and with the service-related rights <br/>
<a id="pl.350.35"></a><var>350.35</var>identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);<br/>
<a id="pl.351.1"></a><var>351.1</var>(2) identifies the criteria to be applied in determining whether the license holder <br/>
<a id="pl.351.2"></a><var>351.2</var>can develop services to meet the needs specified in the person's coordinated service and <br/>
<a id="pl.351.3"></a><var>351.3</var>support plan;<br/>
<a id="pl.351.4"></a><var>351.4</var>(3) requires a license holder providing services in a health care facility to comply <br/>
<a id="pl.351.5"></a><var>351.5</var>with the requirements in section 243.166, subdivision 4b, to provide notification to <br/>
<a id="pl.351.6"></a><var>351.6</var>residents when a registered predatory offender is admitted into the program or to a <br/>
<a id="pl.351.7"></a><var>351.7</var>potential admission when the facility was already serving a registered predatory offender. <br/>
<a id="pl.351.8"></a><var>351.8</var>For purposes of this clause, "health care facility" means a facility licensed by the <br/>
<a id="pl.351.9"></a><var>351.9</var>commissioner as a residential facility under chapter 245A to provide adult foster care or <br/>
<a id="pl.351.10"></a><var>351.10</var>residential services to persons with disabilities; and<br/>
<a id="pl.351.11"></a><var>351.11</var>(4) requires that when a person or the person's legal representative requests services <br/>
<a id="pl.351.12"></a><var>351.12</var>from the license holder, a refusal to admit the person must be based on an evaluation of <br/>
<a id="pl.351.13"></a><var>351.13</var>the person's assessed needs and the license holder's lack of capacity to meet the needs of <br/>
<a id="pl.351.14"></a><var>351.14</var>the person. The license holder must not refuse to admit a person based solely on the <br/>
<a id="pl.351.15"></a><var>351.15</var>type of residential services the person is receiving, or solely on the person's severity of <br/>
<a id="pl.351.16"></a><var>351.16</var>disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of <br/>
<a id="pl.351.17"></a><var>351.17</var>communication skills, physical disabilities, toilet habits, behavioral disorders, or past <br/>
<a id="pl.351.18"></a><var>351.18</var>failure to make progress. Documentation of the basis for refusal must be provided to the <br/>
<a id="pl.351.19"></a><var>351.19</var>person or the person's legal representative and case manager upon request.<br/>
<a id="pl.351.20"></a><var>351.20</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.33.0"></a><a id="pl.351.21"></a><var>351.21</var>    Sec. 33. <b>[245D.21] FACILITY LICENSURE REQUIREMENTS AND </b><br/>
<a id="pl.351.22"></a><var>351.22</var><b>APPLICATION PROCESS.</b><br/>
<a id="pl.351.23"></a><var>351.23</var>    Subdivision 1. <b>Community residential settings and day service facilities.</b> For <br/>
<a id="pl.351.24"></a><var>351.24</var>purposes of this section, "facility" means both a community residential setting and day <br/>
<a id="pl.351.25"></a><var>351.25</var>service facility and the physical plant.<br/>
<a id="pl.351.26"></a><var>351.26</var>    Subd. 2. <b>Inspections and code compliance.</b> (a) Physical plants must comply with <br/>
<a id="pl.351.27"></a><var>351.27</var>applicable state and local fire, health, building, and zoning codes.<br/>
<a id="pl.351.28"></a><var>351.28</var>(b)(1) The facility must be inspected by a fire marshal or their delegate within <br/>
<a id="pl.351.29"></a><var>351.29</var>12 months before initial licensure to verify that it meets the applicable occupancy <br/>
<a id="pl.351.30"></a><var>351.30</var>requirements as defined in the State Fire Code and that the facility complies with the fire <br/>
<a id="pl.351.31"></a><var>351.31</var>safety standards for that occupancy code contained in the State Fire Code.<br/>
<a id="pl.351.32"></a><var>351.32</var>(2) The fire marshal inspection of a community residential setting must verify the <br/>
<a id="pl.351.33"></a><var>351.33</var>residence is a dwelling unit within a residential occupancy as defined in section 9.117 of <br/>
<a id="pl.351.34"></a><var>351.34</var>the State Fire Code. A home safety checklist, approved by the commissioner, must be <br/>
<a id="pl.352.1"></a><var>352.1</var>completed for a community residential setting by the license holder and the commissioner <br/>
<a id="pl.352.2"></a><var>352.2</var>before the satellite license is reissued.<br/>
<a id="pl.352.3"></a><var>352.3</var>(3) The facility shall be inspected according to the facility capacity specified on the <br/>
<a id="pl.352.4"></a><var>352.4</var>initial application form.<br/>
<a id="pl.352.5"></a><var>352.5</var>(4) If the commissioner has reasonable cause to believe that a potentially hazardous <br/>
<a id="pl.352.6"></a><var>352.6</var>condition may be present or the licensed capacity is increased, the commissioner shall <br/>
<a id="pl.352.7"></a><var>352.7</var>request a subsequent inspection and written report by a fire marshal to verify the absence <br/>
<a id="pl.352.8"></a><var>352.8</var>of hazard.<br/>
<a id="pl.352.9"></a><var>352.9</var>(5) Any condition cited by a fire marshal, building official, or health authority as <br/>
<a id="pl.352.10"></a><var>352.10</var>hazardous or creating an immediate danger of fire or threat to health and safety must be <br/>
<a id="pl.352.11"></a><var>352.11</var>corrected before a license is issued by the department, and for community residential <br/>
<a id="pl.352.12"></a><var>352.12</var>settings, before a license is reissued.<br/>
<a id="pl.352.13"></a><var>352.13</var>(c) The facility must maintain in a permanent file the reports of health, fire, and <br/>
<a id="pl.352.14"></a><var>352.14</var>other safety inspections.<br/>
<a id="pl.352.15"></a><var>352.15</var>(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other <br/>
<a id="pl.352.16"></a><var>352.16</var>fixtures and equipment, including elevators or food service, if provided, must conform to <br/>
<a id="pl.352.17"></a><var>352.17</var>applicable health, sanitation, and safety codes and regulations.<br/>
<a id="pl.352.18"></a><var>352.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.34.0"></a><a id="pl.352.19"></a><var>352.19</var>    Sec. 34. <b>[245D.22] FACILITY SANITATION AND HEALTH.</b><br/>
<a id="pl.352.20"></a><var>352.20</var>    Subdivision 1. <b>General maintenance.</b> The license holder must maintain the interior <br/>
<a id="pl.352.21"></a><var>352.21</var>and exterior of buildings, structures, or enclosures used by the facility, including walls, <br/>
<a id="pl.352.22"></a><var>352.22</var>floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a <br/>
<a id="pl.352.23"></a><var>352.23</var>sanitary and safe condition. The facility must be clean and free from accumulations of <br/>
<a id="pl.352.24"></a><var>352.24</var>dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must <br/>
<a id="pl.352.25"></a><var>352.25</var>correct building and equipment deterioration, safety hazards, and unsanitary conditions.<br/>
<a id="pl.352.26"></a><var>352.26</var>    Subd. 2. <b>Hazards and toxic substances.</b> The license holder must ensure that <br/>
<a id="pl.352.27"></a><var>352.27</var>service sites owned or leased by the license holder are free from hazards that would <br/>
<a id="pl.352.28"></a><var>352.28</var>threaten the health or safety of a person receiving services by ensuring the requirements <br/>
<a id="pl.352.29"></a><var>352.29</var>in paragraphs (a) to (g) are met.<br/>
<a id="pl.352.30"></a><var>352.30</var>(a) Chemicals, detergents, and other hazardous or toxic substances must not be <br/>
<a id="pl.352.31"></a><var>352.31</var>stored with food products or in any way that poses a hazard to persons receiving services.<br/>
<a id="pl.352.32"></a><var>352.32</var>(b) The license holder must install handrails and nonslip surfaces on interior and <br/>
<a id="pl.352.33"></a><var>352.33</var>exterior runways, stairways, and ramps according to the applicable building code.<br/>
<a id="pl.353.1"></a><var>353.1</var>(c) If there are elevators in the facility, the license holder must have elevators <br/>
<a id="pl.353.2"></a><var>353.2</var>inspected each year. The date of the inspection, any repairs needed, and the date the <br/>
<a id="pl.353.3"></a><var>353.3</var>necessary repairs were made must be documented.<br/>
<a id="pl.353.4"></a><var>353.4</var>(d) The license holder must keep stairways, ramps, and corridors free of obstructions.<br/>
<a id="pl.353.5"></a><var>353.5</var>(e) Outside property must be free from debris and safety hazards. Exterior stairs and <br/>
<a id="pl.353.6"></a><var>353.6</var>walkways must be kept free of ice and snow.<br/>
<a id="pl.353.7"></a><var>353.7</var>(f) Heating, ventilation, air conditioning units, and other hot surfaces and moving <br/>
<a id="pl.353.8"></a><var>353.8</var>parts of machinery must be shielded or enclosed.<br/>
<a id="pl.353.9"></a><var>353.9</var>(g) Use of dangerous items or equipment by persons served by the program must be <br/>
<a id="pl.353.10"></a><var>353.10</var>allowed in accordance with the person's coordinated service and support plan addendum <br/>
<a id="pl.353.11"></a><var>353.11</var>or the program abuse prevention plan, if not addressed in the coordinated service and <br/>
<a id="pl.353.12"></a><var>353.12</var>support plan addendum.<br/>
<a id="pl.353.13"></a><var>353.13</var>    Subd. 3. <b>Storage and disposal of medication.</b> Schedule II controlled substances in <br/>
<a id="pl.353.14"></a><var>353.14</var>the facility that are named in section 152.02, subdivision 3, must be stored in a locked <br/>
<a id="pl.353.15"></a><var>353.15</var>storage area permitting access only by persons and staff authorized to administer the <br/>
<a id="pl.353.16"></a><var>353.16</var>medication. This must be incorporated into the license holder's medication administration <br/>
<a id="pl.353.17"></a><var>353.17</var>policy and procedures required under section 245D.11, subdivision 2, clause (3). <br/>
<a id="pl.353.18"></a><var>353.18</var>Medications must be disposed of according to the Environmental Protection Agency <br/>
<a id="pl.353.19"></a><var>353.19</var>recommendations.<br/>
<a id="pl.353.20"></a><var>353.20</var>    Subd. 4. <b>First aid must be available on site.</b> (a) A staff person trained in first <br/>
<a id="pl.353.21"></a><var>353.21</var>aid must be available on site and, when required in a person's coordinated service and <br/>
<a id="pl.353.22"></a><var>353.22</var>support plan or coordinated service and support plan addendum, be able to provide <br/>
<a id="pl.353.23"></a><var>353.23</var>cardiopulmonary resuscitation, whenever persons are present and staff are required to be <br/>
<a id="pl.353.24"></a><var>353.24</var>at the site to provide direct service. The CPR training must include in-person instruction, <br/>
<a id="pl.353.25"></a><var>353.25</var>hands-on practice, and an observed skills assessment under the direct supervision of a <br/>
<a id="pl.353.26"></a><var>353.26</var>CPR instructor.<br/>
<a id="pl.353.27"></a><var>353.27</var>(b) A facility must have first aid kits readily available for use by, and that meet <br/>
<a id="pl.353.28"></a><var>353.28</var>the needs of, persons receiving services and staff. At a minimum, the first aid kit must <br/>
<a id="pl.353.29"></a><var>353.29</var>be equipped with accessible first aid supplies including bandages, sterile compresses, <br/>
<a id="pl.353.30"></a><var>353.30</var>scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, <br/>
<a id="pl.353.31"></a><var>353.31</var>adhesive tape, and first aid manual.<br/>
<a id="pl.353.32"></a><var>353.32</var>    Subd. 5. <b>Emergencies.</b> (a) The license holder must have a written plan for <br/>
<a id="pl.353.33"></a><var>353.33</var>responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the <br/>
<a id="pl.353.34"></a><var>353.34</var>safety of persons served in the facility. The plan must include:<br/>
<a id="pl.353.35"></a><var>353.35</var>(1) procedures for emergency evacuation and emergency sheltering, including:<br/>
<a id="pl.353.36"></a><var>353.36</var>(i) how to report a fire or other emergency;<br/>
<a id="pl.354.1"></a><var>354.1</var>(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive <br/>
<a id="pl.354.2"></a><var>354.2</var>procedures or equipment to assist with the safe evacuation of persons with physical or <br/>
<a id="pl.354.3"></a><var>354.3</var>sensory disabilities; and<br/>
<a id="pl.354.4"></a><var>354.4</var>(iii) instructions on closing off the fire area, using fire extinguishers, and activating <br/>
<a id="pl.354.5"></a><var>354.5</var>and responding to alarm systems;<br/>
<a id="pl.354.6"></a><var>354.6</var>(2) a floor plan that identifies:<br/>
<a id="pl.354.7"></a><var>354.7</var>(i) the location of fire extinguishers;<br/>
<a id="pl.354.8"></a><var>354.8</var>(ii) the location of audible or visual alarm systems, including but not limited to <br/>
<a id="pl.354.9"></a><var>354.9</var>manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and <br/>
<a id="pl.354.10"></a><var>354.10</var>sprinkler systems;<br/>
<a id="pl.354.11"></a><var>354.11</var>(iii) the location of exits, primary and secondary evacuation routes, and accessible <br/>
<a id="pl.354.12"></a><var>354.12</var>egress routes, if any; and<br/>
<a id="pl.354.13"></a><var>354.13</var>(iv) the location of emergency shelter within the facility;<br/>
<a id="pl.354.14"></a><var>354.14</var>(3) a site plan that identifies:<br/>
<a id="pl.354.15"></a><var>354.15</var>(i) designated assembly points outside the facility;<br/>
<a id="pl.354.16"></a><var>354.16</var>(ii) the locations of fire hydrants; and<br/>
<a id="pl.354.17"></a><var>354.17</var>(iii) the routes of fire department access;<br/>
<a id="pl.354.18"></a><var>354.18</var>(4) the responsibilities each staff person must assume in case of emergency;<br/>
<a id="pl.354.19"></a><var>354.19</var>(5) procedures for conducting quarterly drills each year and recording the date of <br/>
<a id="pl.354.20"></a><var>354.20</var>each drill in the file of emergency plans;<br/>
<a id="pl.354.21"></a><var>354.21</var>(6) procedures for relocation or service suspension when services are interrupted <br/>
<a id="pl.354.22"></a><var>354.22</var>for more than 24 hours;<br/>
<a id="pl.354.23"></a><var>354.23</var>(7) for a community residential setting with three or more dwelling units, a floor <br/>
<a id="pl.354.24"></a><var>354.24</var>plan that identifies the location of enclosed exit stairs; and<br/>
<a id="pl.354.25"></a><var>354.25</var>(8) an emergency escape plan for each resident.<br/>
<a id="pl.354.26"></a><var>354.26</var>(b) The license holder must:<br/>
<a id="pl.354.27"></a><var>354.27</var>(1) maintain a log of quarterly fire drills on file in the facility;<br/>
<a id="pl.354.28"></a><var>354.28</var>(2) provide an emergency response plan that is readily available to staff and persons <br/>
<a id="pl.354.29"></a><var>354.29</var>receiving services;<br/>
<a id="pl.354.30"></a><var>354.30</var>(3) inform each person of a designated area within the facility where the person <br/>
<a id="pl.354.31"></a><var>354.31</var>should go for emergency shelter during severe weather and the designated assembly points <br/>
<a id="pl.354.32"></a><var>354.32</var>outside the facility; and<br/>
<a id="pl.354.33"></a><var>354.33</var>(4) maintain emergency contact information for persons served at the facility that <br/>
<a id="pl.354.34"></a><var>354.34</var>can be readily accessed in an emergency.<br/>
<a id="pl.355.1"></a><var>355.1</var>    Subd. 6. <b>Emergency equipment.</b> The facility must have a flashlight and a portable <br/>
<a id="pl.355.2"></a><var>355.2</var>radio or television set that do not require electricity and can be used if a power failure <br/>
<a id="pl.355.3"></a><var>355.3</var>occurs.<br/>
<a id="pl.355.4"></a><var>355.4</var>    Subd. 7. <b>Telephone and posted numbers.</b> A facility must have a non-coin operated <br/>
<a id="pl.355.5"></a><var>355.5</var>telephone that is readily accessible. A list of emergency numbers must be posted in a <br/>
<a id="pl.355.6"></a><var>355.6</var>prominent location. When an area has a 911 number or a mental health crisis intervention <br/>
<a id="pl.355.7"></a><var>355.7</var>team number, both numbers must be posted and the emergency number listed must be <br/>
<a id="pl.355.8"></a><var>355.8</var>911. In areas of the state without a 911 number, the numbers listed must be those of the <br/>
<a id="pl.355.9"></a><var>355.9</var>local fire department, police department, emergency transportation, and poison control <br/>
<a id="pl.355.10"></a><var>355.10</var>center. The names and telephone numbers of each person's representative, physician, and <br/>
<a id="pl.355.11"></a><var>355.11</var>dentist must be readily available.<br/>
<a id="pl.355.12"></a><var>355.12</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.35.0"></a><a id="pl.355.13"></a><var>355.13</var>    Sec. 35. <b>[245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE </b><br/>
<a id="pl.355.14"></a><var>355.14</var><b>LICENSURE REQUIREMENTS AND APPLICATION PROCESS.</b><br/>
<a id="pl.355.15"></a><var>355.15</var>    Subdivision 1. <b>Separate satellite license required for separate sites.</b> (a) A license <br/>
<a id="pl.355.16"></a><var>355.16</var>holder providing residential support services must obtain a separate satellite license for <br/>
<a id="pl.355.17"></a><var>355.17</var>each community residential setting located at separate addresses when the community <br/>
<a id="pl.355.18"></a><var>355.18</var>residential settings are to be operated by the same license holder. For purposes of this <br/>
<a id="pl.355.19"></a><var>355.19</var>chapter, a community residential setting is a satellite of the home and community-based <br/>
<a id="pl.355.20"></a><var>355.20</var>services license.<br/>
<a id="pl.355.21"></a><var>355.21</var>(b) Community residential settings are permitted single-family use homes. After a <br/>
<a id="pl.355.22"></a><var>355.22</var>license has been issued, the commissioner shall notify the local municipality where the <br/>
<a id="pl.355.23"></a><var>355.23</var>residence is located of the approved license.<br/>
<a id="pl.355.24"></a><var>355.24</var>    Subd. 2. <b>Notification to local agency.</b> The license holder must notify the local <br/>
<a id="pl.355.25"></a><var>355.25</var>agency within 24 hours of the onset of changes in a residence resulting from construction, <br/>
<a id="pl.355.26"></a><var>355.26</var>remodeling, or damages requiring repairs that require a building permit or may affect a <br/>
<a id="pl.355.27"></a><var>355.27</var>licensing requirement in this chapter.<br/>
<a id="pl.355.28"></a><var>355.28</var>    Subd. 3. <b>Alternate overnight supervision.</b> A license holder granted an alternate <br/>
<a id="pl.355.29"></a><var>355.29</var>overnight supervision technology adult foster care license according to section 245A.11, <br/>
<a id="pl.355.30"></a><var>355.30</var>subdivision 7a, that converts to a community residential setting satellite license according <br/>
<a id="pl.355.31"></a><var>355.31</var>to this chapter, must retain that designation.<br/>
<a id="pl.355.32"></a><var>355.32</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.36.0"></a><a id="pl.356.1"></a><var>356.1</var>    Sec. 36. <b>[245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL </b><br/>
<a id="pl.356.2"></a><var>356.2</var><b>PLANT AND ENVIRONMENT.</b><br/>
<a id="pl.356.3"></a><var>356.3</var>    Subdivision 1. <b>Occupancy.</b> The residence must meet the definition of a dwelling <br/>
<a id="pl.356.4"></a><var>356.4</var>unit in a residential occupancy.<br/>
<a id="pl.356.5"></a><var>356.5</var>    Subd. 2. <b>Common area requirements.</b> The living area must be provided with an <br/>
<a id="pl.356.6"></a><var>356.6</var>adequate number of furnishings for the usual functions of daily living and social activities. <br/>
<a id="pl.356.7"></a><var>356.7</var>The dining area must be furnished to accommodate meals shared by all persons living in <br/>
<a id="pl.356.8"></a><var>356.8</var>the residence. These furnishings must be in good repair and functional to meet the daily <br/>
<a id="pl.356.9"></a><var>356.9</var>needs of the persons living in the residence.<br/>
<a id="pl.356.10"></a><var>356.10</var>    Subd. 3. <b>Bedrooms.</b> (a) People receiving services must mutually consent, in <br/>
<a id="pl.356.11"></a><var>356.11</var>writing, to sharing a bedroom with one another. No more than two people receiving <br/>
<a id="pl.356.12"></a><var>356.12</var>services may share one bedroom.<br/>
<a id="pl.356.13"></a><var>356.13</var>(b) A single occupancy bedroom must have at least 80 square feet of floor space with <br/>
<a id="pl.356.14"></a><var>356.14</var>a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor <br/>
<a id="pl.356.15"></a><var>356.15</var>space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and <br/>
<a id="pl.356.16"></a><var>356.16</var>other habitable rooms by floor to ceiling walls containing no openings except doorways <br/>
<a id="pl.356.17"></a><var>356.17</var>and must not serve as a corridor to another room used in daily living.<br/>
<a id="pl.356.18"></a><var>356.18</var>(c) A person's personal possessions and items for the person's own use are the only <br/>
<a id="pl.356.19"></a><var>356.19</var>items permitted to be stored in a person's bedroom.<br/>
<a id="pl.356.20"></a><var>356.20</var>(d) Unless otherwise documented through assessment as a safety concern for the <br/>
<a id="pl.356.21"></a><var>356.21</var>person, each person must be provided with the following furnishings:<br/>
<a id="pl.356.22"></a><var>356.22</var>(1) a separate bed of proper size and height for the convenience and comfort of the <br/>
<a id="pl.356.23"></a><var>356.23</var>person, with a clean mattress in good repair;<br/>
<a id="pl.356.24"></a><var>356.24</var>(2) clean bedding appropriate for the season for each person;<br/>
<a id="pl.356.25"></a><var>356.25</var>(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal <br/>
<a id="pl.356.26"></a><var>356.26</var>possessions and clothing; and<br/>
<a id="pl.356.27"></a><var>356.27</var>(4) a mirror for grooming.<br/>
<a id="pl.356.28"></a><var>356.28</var>(e) When possible, a person must be allowed to have items of furniture that the <br/>
<a id="pl.356.29"></a><var>356.29</var>person personally owns in the bedroom, unless doing so would interfere with safety <br/>
<a id="pl.356.30"></a><var>356.30</var>precautions, violate a building or fire code, or interfere with another person's use of the <br/>
<a id="pl.356.31"></a><var>356.31</var>bedroom. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the <br/>
<a id="pl.356.32"></a><var>356.32</var>bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may <br/>
<a id="pl.356.33"></a><var>356.33</var>choose to use a mattress other than an innerspring mattress and may choose not to have <br/>
<a id="pl.356.34"></a><var>356.34</var>the mattress on a mattress frame or support. If a person chooses not to have a piece of <br/>
<a id="pl.356.35"></a><var>356.35</var>required furniture, the license holder must document this choice and is not required to <br/>
<a id="pl.356.36"></a><var>356.36</var>provide the item. If a person chooses to use a mattress other than an innerspring mattress <br/>
<a id="pl.357.1"></a><var>357.1</var>or chooses not to have a mattress frame or support, the license holder must document this <br/>
<a id="pl.357.2"></a><var>357.2</var>choice and allow the alternative desired by the person.<br/>
<a id="pl.357.3"></a><var>357.3</var>(f) A person must be allowed to bring personal possessions into the bedroom <br/>
<a id="pl.357.4"></a><var>357.4</var>and other designated storage space, if such space is available, in the residence. The <br/>
<a id="pl.357.5"></a><var>357.5</var>person must be allowed to accumulate possessions to the extent the residence is able to <br/>
<a id="pl.357.6"></a><var>357.6</var>accommodate them, unless doing so is contraindicated for the person's physical or mental <br/>
<a id="pl.357.7"></a><var>357.7</var>health, would interfere with safety precautions or another person's use of the bedroom, or <br/>
<a id="pl.357.8"></a><var>357.8</var>would violate a building or fire code. The license holder must allow for locked storage <br/>
<a id="pl.357.9"></a><var>357.9</var>of personal items. Any restriction on the possession or locked storage of personal items, <br/>
<a id="pl.357.10"></a><var>357.10</var>including requiring a person to use a lock provided by the license holder, must comply <br/>
<a id="pl.357.11"></a><var>357.11</var>with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if <br/>
<a id="pl.357.12"></a><var>357.12</var>and when the license holder opens the lock.<br/>
<a id="pl.357.13"></a><var>357.13</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.37.0"></a><a id="pl.357.14"></a><var>357.14</var>    Sec. 37. <b>[245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND </b><br/>
<a id="pl.357.15"></a><var>357.15</var><b>WATER.</b><br/>
<a id="pl.357.16"></a><var>357.16</var>    Subdivision 1. <b>Water.</b> Potable water from privately owned wells must be tested <br/>
<a id="pl.357.17"></a><var>357.17</var>annually by a Department of Health-certified laboratory for coliform bacteria and nitrate <br/>
<a id="pl.357.18"></a><var>357.18</var>nitrogens to verify safety. The health authority may require retesting and corrective <br/>
<a id="pl.357.19"></a><var>357.19</var>measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in <br/>
<a id="pl.357.20"></a><var>357.20</var>the event of flooding or an incident which may put the well at risk of contamination. To <br/>
<a id="pl.357.21"></a><var>357.21</var>prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.<br/>
<a id="pl.357.22"></a><var>357.22</var>    Subd. 2. <b>Food.</b> Food served must meet any special dietary needs of a person as <br/>
<a id="pl.357.23"></a><var>357.23</var>prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day <br/>
<a id="pl.357.24"></a><var>357.24</var>must be served or made available to persons, and nutritious snacks must be available <br/>
<a id="pl.357.25"></a><var>357.25</var>between meals.<br/>
<a id="pl.357.26"></a><var>357.26</var>    Subd. 3. <b>Food safety.</b> Food must be obtained, handled, and properly stored to <br/>
<a id="pl.357.27"></a><var>357.27</var>prevent contamination, spoilage, or a threat to the health of a person.<br/>
<a id="pl.357.28"></a><var>357.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.38.0"></a><a id="pl.357.29"></a><var>357.29</var>    Sec. 38. <b>[245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION </b><br/>
<a id="pl.357.30"></a><var>357.30</var><b>AND HEALTH.</b><br/>
<a id="pl.357.31"></a><var>357.31</var>    Subdivision 1. <b>Goods provided by the license holder.</b> Individual clean bed linens <br/>
<a id="pl.357.32"></a><var>357.32</var>appropriate for the season and the person's comfort, including towels and wash cloths, <br/>
<a id="pl.357.33"></a><var>357.33</var>must be available for each person. Usual or customary goods for the operation of a <br/>
<a id="pl.358.1"></a><var>358.1</var>residence which are communally used by all persons receiving services living in the <br/>
<a id="pl.358.2"></a><var>358.2</var>residence must be provided by the license holder, including household items for meal <br/>
<a id="pl.358.3"></a><var>358.3</var>preparation, cleaning supplies to maintain the cleanliness of the residence, window <br/>
<a id="pl.358.4"></a><var>358.4</var>coverings on windows for privacy, toilet paper, and hand soap.<br/>
<a id="pl.358.5"></a><var>358.5</var>    Subd. 2. <b>Personal items.</b> Personal health and hygiene items must be stored in a <br/>
<a id="pl.358.6"></a><var>358.6</var>safe and sanitary manner.<br/>
<a id="pl.358.7"></a><var>358.7</var>    Subd. 3. <b>Pets and service animals.</b> Pets and service animals housed within <br/>
<a id="pl.358.8"></a><var>358.8</var>the residence must be immunized and maintained in good health as required by local <br/>
<a id="pl.358.9"></a><var>358.9</var>ordinances and state law. The license holder must ensure that the person and the person's <br/>
<a id="pl.358.10"></a><var>358.10</var>representative are notified before admission of the presence of pets in the residence.<br/>
<a id="pl.358.11"></a><var>358.11</var>    Subd. 4. <b>Smoking in the residence.</b> License holders must comply with the <br/>
<a id="pl.358.12"></a><var>358.12</var>requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when <br/>
<a id="pl.358.13"></a><var>358.13</var>smoking is permitted in the residence.<br/>
<a id="pl.358.14"></a><var>358.14</var>    Subd. 5. <b>Weapons.</b> Weapons and ammunition must be stored separately in locked <br/>
<a id="pl.358.15"></a><var>358.15</var>areas that are inaccessible to a person receiving services. For purposes of this subdivision, <br/>
<a id="pl.358.16"></a><var>358.16</var>"weapons" means firearms and other instruments or devices designed for and capable of <br/>
<a id="pl.358.17"></a><var>358.17</var>producing bodily harm.<br/>
<a id="pl.358.18"></a><var>358.18</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.39.0"></a><a id="pl.358.19"></a><var>358.19</var>    Sec. 39. <b>[245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE </b><br/>
<a id="pl.358.20"></a><var>358.20</var><b>REQUIREMENTS AND APPLICATION PROCESS.</b><br/>
<a id="pl.358.21"></a><var>358.21</var>Except for day service facilities on the same or adjoining lot, the license holder <br/>
<a id="pl.358.22"></a><var>358.22</var>providing day services must apply for a separate license for each facility-based service <br/>
<a id="pl.358.23"></a><var>358.23</var>site when the license holder is the owner, lessor, or tenant of the service site at which <br/>
<a id="pl.358.24"></a><var>358.24</var>persons receive day services and the license holder's employees who provide day services <br/>
<a id="pl.358.25"></a><var>358.25</var>are present for a cumulative total of more than 30 days within any 12-month period. For <br/>
<a id="pl.358.26"></a><var>358.26</var>purposes of this chapter, a day services facility license is a satellite license of the day <br/>
<a id="pl.358.27"></a><var>358.27</var>services program. A day services program may operate multiple licensed day service <br/>
<a id="pl.358.28"></a><var>358.28</var>facilities in one or more counties in the state. For the purposes of this section, "adjoining <br/>
<a id="pl.358.29"></a><var>358.29</var>lot" means day services facilities that are next door to or across the street from one another.<br/>
<a id="pl.358.30"></a><var>358.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.40.0"></a><a id="pl.358.31"></a><var>358.31</var>    Sec. 40. <b>[245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND </b><br/>
<a id="pl.358.32"></a><var>358.32</var><b>SPACE REQUIREMENTS.</b><br/>
<a id="pl.359.1"></a><var>359.1</var>    Subdivision 1. <b>Facility capacity and useable space requirements.</b> (a) The facility <br/>
<a id="pl.359.2"></a><var>359.2</var>capacity of each day service facility must be determined by the amount of primary space <br/>
<a id="pl.359.3"></a><var>359.3</var>available, the scheduling of activities at other service sites, and the space requirements of <br/>
<a id="pl.359.4"></a><var>359.4</var>all persons receiving services at the facility, not just the licensed services. The facility <br/>
<a id="pl.359.5"></a><var>359.5</var>capacity must specify the maximum number of persons that may receive services on <br/>
<a id="pl.359.6"></a><var>359.6</var>site at any one time.<br/>
<a id="pl.359.7"></a><var>359.7</var>(b) When a facility is located in a multifunctional organization, the facility may <br/>
<a id="pl.359.8"></a><var>359.8</var>share common space with the multifunctional organization if the required available <br/>
<a id="pl.359.9"></a><var>359.9</var>primary space for use by persons receiving day services is maintained while the facility is <br/>
<a id="pl.359.10"></a><var>359.10</var>operating. The license holder must comply at all times with all applicable fire and safety <br/>
<a id="pl.359.11"></a><var>359.11</var>codes under section 245A.04, subdivision 2a, and adequate supervision requirements <br/>
<a id="pl.359.12"></a><var>359.12</var>under section 245D.31 for all persons receiving day services.<br/>
<a id="pl.359.13"></a><var>359.13</var>(c) A day services facility must have a minimum of 40 square feet of primary space <br/>
<a id="pl.359.14"></a><var>359.14</var>available for each person receiving services who is present at the site at any one time. <br/>
<a id="pl.359.15"></a><var>359.15</var>Primary space does not include:<br/>
<a id="pl.359.16"></a><var>359.16</var>(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms, <br/>
<a id="pl.359.17"></a><var>359.17</var>and kitchens;<br/>
<a id="pl.359.18"></a><var>359.18</var>(2) floor areas beneath stationary equipment; or<br/>
<a id="pl.359.19"></a><var>359.19</var>(3) any space occupied by persons associated with the multifunctional organization <br/>
<a id="pl.359.20"></a><var>359.20</var>while persons receiving day services are using common space.<br/>
<a id="pl.359.21"></a><var>359.21</var>    Subd. 2. <b>Individual personal articles.</b> Each person must be provided space in a <br/>
<a id="pl.359.22"></a><var>359.22</var>closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own <br/>
<a id="pl.359.23"></a><var>359.23</var>use while receiving services at the facility, unless doing so would interfere with safety <br/>
<a id="pl.359.24"></a><var>359.24</var>precautions, another person's work space, or violate a building or fire code.<br/>
<a id="pl.359.25"></a><var>359.25</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.41.0"></a><a id="pl.359.26"></a><var>359.26</var>    Sec. 41. <b>[245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY </b><br/>
<a id="pl.359.27"></a><var>359.27</var><b>REQUIREMENTS.</b><br/>
<a id="pl.359.28"></a><var>359.28</var>    Subdivision 1. <b>Refrigeration.</b> If the license holder provides refrigeration at service <br/>
<a id="pl.359.29"></a><var>359.29</var>sites owned or leased by the license holder for storing perishable foods and perishable <br/>
<a id="pl.359.30"></a><var>359.30</var>portions of bag lunches, whether the foods are supplied by the license holder or the <br/>
<a id="pl.359.31"></a><var>359.31</var>persons receiving services, the refrigeration must have a temperature of 40 degrees <br/>
<a id="pl.359.32"></a><var>359.32</var>Fahrenheit or less.<br/>
<a id="pl.359.33"></a><var>359.33</var>    Subd. 2. <b>Drinking water.</b> Drinking water must be available to all persons <br/>
<a id="pl.359.34"></a><var>359.34</var>receiving services. If a person is unable to request or obtain drinking water, it must be <br/>
<a id="pl.360.1"></a><var>360.1</var>provided according to that person's individual needs. Drinking water must be provided in <br/>
<a id="pl.360.2"></a><var>360.2</var>single-service containers or from drinking fountains accessible to all persons.<br/>
<a id="pl.360.3"></a><var>360.3</var>    Subd. 3. <b>Individuals who become ill during the day.</b> There must be an area in <br/>
<a id="pl.360.4"></a><var>360.4</var>which a person receiving services can rest if:<br/>
<a id="pl.360.5"></a><var>360.5</var>(1) the person becomes ill during the day; <br/>
<a id="pl.360.6"></a><var>360.6</var>(2) the person does not live in a licensed residential site;<br/>
<a id="pl.360.7"></a><var>360.7</var>(3) the person requires supervision; and<br/>
<a id="pl.360.8"></a><var>360.8</var>(4) there is not a caretaker immediately available. Supervision must be provided <br/>
<a id="pl.360.9"></a><var>360.9</var>until the caretaker arrives to bring the person home.<br/>
<a id="pl.360.10"></a><var>360.10</var>    Subd. 4. <b>Safety procedures.</b> The license holder must establish general written <br/>
<a id="pl.360.11"></a><var>360.11</var>safety procedures that include criteria for selecting, training, and supervising persons who <br/>
<a id="pl.360.12"></a><var>360.12</var>work with hazardous machinery, tools, or substances. Safety procedures specific to each <br/>
<a id="pl.360.13"></a><var>360.13</var>person's activities must be explained and be available in writing to all staff members <br/>
<a id="pl.360.14"></a><var>360.14</var>and persons receiving services.<br/>
<a id="pl.360.15"></a><var>360.15</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.42.0"></a><a id="pl.360.16"></a><var>360.16</var>    Sec. 42. <b>[245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND </b><br/>
<a id="pl.360.17"></a><var>360.17</var><b>FACILITY COVERAGE.</b><br/>
<a id="pl.360.18"></a><var>360.18</var>    Subdivision 1. <b>Scope.</b> This section applies only to facility-based day services.<br/>
<a id="pl.360.19"></a><var>360.19</var>    Subd. 2. <b>Factors.</b> (a) The number of direct support service staff members that a <br/>
<a id="pl.360.20"></a><var>360.20</var>license holder must have on duty at the facility at a given time to meet the minimum <br/>
<a id="pl.360.21"></a><var>360.21</var>staffing requirements established in this section varies according to:<br/>
<a id="pl.360.22"></a><var>360.22</var>(1) the number of persons who are enrolled and receiving direct support services <br/>
<a id="pl.360.23"></a><var>360.23</var>at that given time;<br/>
<a id="pl.360.24"></a><var>360.24</var>(2) the staff ratio requirement established under subdivision 3 for each person who <br/>
<a id="pl.360.25"></a><var>360.25</var>is present; and<br/>
<a id="pl.360.26"></a><var>360.26</var>(3) whether the conditions described in subdivision 8 exist and warrant additional <br/>
<a id="pl.360.27"></a><var>360.27</var>staffing beyond the number determined to be needed under subdivision 7.<br/>
<a id="pl.360.28"></a><var>360.28</var>(b) The commissioner must consider the factors in paragraph (a) in determining a <br/>
<a id="pl.360.29"></a><var>360.29</var>license holder's compliance with the staffing requirements and must further consider <br/>
<a id="pl.360.30"></a><var>360.30</var>whether the staff ratio requirement established under subdivision 3 for each person <br/>
<a id="pl.360.31"></a><var>360.31</var>receiving services accurately reflects the person's need for staff time.<br/>
<a id="pl.360.32"></a><var>360.32</var>    Subd. 3. <b>Staff ratio requirement for each person receiving services.</b> The case <br/>
<a id="pl.360.33"></a><var>360.33</var>manager, in consultation with the interdisciplinary team, must determine at least once each <br/>
<a id="pl.360.34"></a><var>360.34</var>year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving <br/>
<a id="pl.360.35"></a><var>360.35</var>services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio <br/>
<a id="pl.361.1"></a><var>361.1</var>assigned each person and the documentation of how the ratio was arrived at must be kept <br/>
<a id="pl.361.2"></a><var>361.2</var>in each person's individual service plan. Documentation must include an assessment of the <br/>
<a id="pl.361.3"></a><var>361.3</var>person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard <br/>
<a id="pl.361.4"></a><var>361.4</var>assessment form required by the commissioner.<br/>
<a id="pl.361.5"></a><var>361.5</var>    Subd. 4. <b>Person requiring staff ratio of one to four.</b> A person must be assigned a <br/>
<a id="pl.361.6"></a><var>361.6</var>staff ratio requirement of one to four if:<br/>
<a id="pl.361.7"></a><var>361.7</var>(1) on a daily basis the person requires total care and monitoring or constant <br/>
<a id="pl.361.8"></a><var>361.8</var>hand-over-hand physical guidance to successfully complete at least three of the following <br/>
<a id="pl.361.9"></a><var>361.9</var>activities: toileting, communicating basic needs, eating, ambulating; or is not capable of <br/>
<a id="pl.361.10"></a><var>361.10</var>taking appropriate action for self-preservation under emergency conditions; or<br/>
<a id="pl.361.11"></a><var>361.11</var>(2) the person engages in conduct that poses an imminent risk of physical harm to <br/>
<a id="pl.361.12"></a><var>361.12</var>self or others at a documented level of frequency, intensity, or duration requiring frequent <br/>
<a id="pl.361.13"></a><var>361.13</var>daily ongoing intervention and monitoring as established in the person's coordinated <br/>
<a id="pl.361.14"></a><var>361.14</var>service and support plan or coordinated service and support plan addendum.<br/>
<a id="pl.361.15"></a><var>361.15</var>    Subd. 5. <b>Person requiring staff ratio of one to eight.</b> A person must be assigned a <br/>
<a id="pl.361.16"></a><var>361.16</var>staff ratio requirement of one to eight if:<br/>
<a id="pl.361.17"></a><var>361.17</var>(1) the person does not meet the requirements in subdivision 4; and<br/>
<a id="pl.361.18"></a><var>361.18</var>(2) on a daily basis the person requires verbal prompts or spot checks and minimal <br/>
<a id="pl.361.19"></a><var>361.19</var>or no physical assistance to successfully complete at least four of the following activities: <br/>
<a id="pl.361.20"></a><var>361.20</var>toileting, communicating basic needs, eating, ambulating, or taking appropriate action for <br/>
<a id="pl.361.21"></a><var>361.21</var>self-preservation under emergency conditions.<br/>
<a id="pl.361.22"></a><var>361.22</var>    Subd. 6. <b>Person requiring staff ratio of one to six.</b> A person who does not have <br/>
<a id="pl.361.23"></a><var>361.23</var>any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio <br/>
<a id="pl.361.24"></a><var>361.24</var>requirement of one to six.<br/>
<a id="pl.361.25"></a><var>361.25</var>    Subd. 7. <b>Determining number of direct support service staff required.</b> The <br/>
<a id="pl.361.26"></a><var>361.26</var>minimum number of direct support service staff members required at any one time to <br/>
<a id="pl.361.27"></a><var>361.27</var>meet the combined staff ratio requirements of the persons present at that time can be <br/>
<a id="pl.361.28"></a><var>361.28</var>determined by the following steps:<br/>
<a id="pl.361.29"></a><var>361.29</var>(1) assign to each person in attendance the three-digit decimal below that corresponds <br/>
<a id="pl.361.30"></a><var>361.30</var>to the staff ratio requirement assigned to that person. A staff ratio requirement of one to <br/>
<a id="pl.361.31"></a><var>361.31</var>four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio <br/>
<a id="pl.361.32"></a><var>361.32</var>requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;<br/>
<a id="pl.361.33"></a><var>361.33</var>(2) add all of the three-digit decimals (one three-digit decimal for every person in <br/>
<a id="pl.361.34"></a><var>361.34</var>attendance) assigned in clause (1);<br/>
<a id="pl.361.35"></a><var>361.35</var>(3) when the sum in clause (2) falls between two whole numbers, round off the sum <br/>
<a id="pl.361.36"></a><var>361.36</var>to the larger of the two whole numbers; and<br/>
<a id="pl.362.1"></a><var>362.1</var>(4) the larger of the two whole numbers in clause (3) equals the number of direct <br/>
<a id="pl.362.2"></a><var>362.2</var>support service staff members needed to meet the staff ratio requirements of the persons <br/>
<a id="pl.362.3"></a><var>362.3</var>in attendance.<br/>
<a id="pl.362.4"></a><var>362.4</var>    Subd. 8. <b>Staff to be included in calculating minimum staffing requirement.</b><br/>
<a id="pl.362.5"></a><var>362.5</var>Only staff providing direct support must be counted as staff members in calculating <br/>
<a id="pl.362.6"></a><var>362.6</var>the staff-to-participant ratio. A volunteer may be counted as a direct support staff in <br/>
<a id="pl.362.7"></a><var>362.7</var>calculating the staff to participant ratio if the volunteer meets the same standards and <br/>
<a id="pl.362.8"></a><var>362.8</var>requirements as paid staff. No person receiving services must be counted as or be <br/>
<a id="pl.362.9"></a><var>362.9</var>substituted for a staff member in calculating the staff-to-participant ratio.<br/>
<a id="pl.362.10"></a><var>362.10</var>    Subd. 9. <b>Conditions requiring additional direct support staff.</b> The license holder <br/>
<a id="pl.362.11"></a><var>362.11</var>must increase the number of direct support staff members present at any one time beyond <br/>
<a id="pl.362.12"></a><var>362.12</var>the number arrived at in subdivision 4 if necessary when any one or combination of the <br/>
<a id="pl.362.13"></a><var>362.13</var>following circumstances can be documented by the commissioner as existing:<br/>
<a id="pl.362.14"></a><var>362.14</var>(1) the health and safety needs of the persons receiving services cannot be met by <br/>
<a id="pl.362.15"></a><var>362.15</var>the number of staff members available under the staffing pattern in effect even though the <br/>
<a id="pl.362.16"></a><var>362.16</var>number has been accurately calculated under subdivision 7; or<br/>
<a id="pl.362.17"></a><var>362.17</var>(2) the person's conduct frequently presents an imminent risk of physical harm to <br/>
<a id="pl.362.18"></a><var>362.18</var>self or others.<br/>
<a id="pl.362.19"></a><var>362.19</var>    Subd. 10. <b>Supervision requirements.</b> (a) At no time must one direct support <br/>
<a id="pl.362.20"></a><var>362.20</var>staff member be assigned responsibility for supervision and training of more than ten <br/>
<a id="pl.362.21"></a><var>362.21</var>persons receiving supervision and training, except as otherwise stated in each person's risk <br/>
<a id="pl.362.22"></a><var>362.22</var>management plan.<br/>
<a id="pl.362.23"></a><var>362.23</var>(b) In the temporary absence of the director or a supervisor, a direct support staff <br/>
<a id="pl.362.24"></a><var>362.24</var>member must be designated to supervise the center.<br/>
<a id="pl.362.25"></a><var>362.25</var>    Subd. 11. <b>Multifunctional programs.</b> A multifunctional program may count other <br/>
<a id="pl.362.26"></a><var>362.26</var>employees of the organization besides direct support staff of the day service facility in <br/>
<a id="pl.362.27"></a><var>362.27</var>calculating the staff-to-participant ratio if the employee is assigned to the day services <br/>
<a id="pl.362.28"></a><var>362.28</var>facility for a specified amount of time, during which the employee is not assigned to <br/>
<a id="pl.362.29"></a><var>362.29</var>another organization or program.<br/>
<a id="pl.362.30"></a><var>362.30</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.43.0"></a><a id="pl.362.31"></a><var>362.31</var>    Sec. 43. <b>[245D.32] ALTERNATIVE LICENSING INSPECTIONS.</b><br/>
<a id="pl.362.32"></a><var>362.32</var>    Subdivision 1. <b>Eligibility for an alternative licensing inspection.</b> (a) A license <br/>
<a id="pl.362.33"></a><var>362.33</var>holder providing services licensed under this chapter, with a qualifying accreditation and <br/>
<a id="pl.362.34"></a><var>362.34</var>meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an <br/>
<a id="pl.362.35"></a><var>362.35</var>alternative licensing inspection when all services provided under the license holder's <br/>
<a id="pl.363.1"></a><var>363.1</var>license are accredited. A license holder with a qualifying accreditation and meeting <br/>
<a id="pl.363.2"></a><var>363.2</var>the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative <br/>
<a id="pl.363.3"></a><var>363.3</var>licensing inspection for individual community residential settings or day services facilities <br/>
<a id="pl.363.4"></a><var>363.4</var>licensed under this chapter.<br/>
<a id="pl.363.5"></a><var>363.5</var>(b) In order to be eligible for an alternative licensing inspection, the program must <br/>
<a id="pl.363.6"></a><var>363.6</var>have had at least one inspection by the commissioner following issuance of the initial <br/>
<a id="pl.363.7"></a><var>363.7</var>license. For programs operating a day services facility, each facility must have had at least <br/>
<a id="pl.363.8"></a><var>363.8</var>one on-site inspection by the commissioner following issuance of the initial license.<br/>
<a id="pl.363.9"></a><var>363.9</var>(c) In order to be eligible for an alternative licensing inspection, the program must <br/>
<a id="pl.363.10"></a><var>363.10</var>have been in substantial and consistent compliance at the time of the last licensing <br/>
<a id="pl.363.11"></a><var>363.11</var>inspection and during the current licensing period. For purposes of this section, <br/>
<a id="pl.363.12"></a><var>363.12</var>"substantial and consistent compliance" means:<br/>
<a id="pl.363.13"></a><var>363.13</var>(1) the license holder's license was not made conditional, suspended, or revoked;<br/>
<a id="pl.363.14"></a><var>363.14</var>(2) there have been no substantiated allegations of maltreatment against the license <br/>
<a id="pl.363.15"></a><var>363.15</var>holder;<br/>
<a id="pl.363.16"></a><var>363.16</var>(3) there were no program deficiencies identified that would jeopardize the health, <br/>
<a id="pl.363.17"></a><var>363.17</var>safety, or rights of persons being served; and<br/>
<a id="pl.363.18"></a><var>363.18</var>(4) the license holder maintained substantial compliance with the other requirements <br/>
<a id="pl.363.19"></a><var>363.19</var>of chapters 245A and 245C and other applicable laws and rules.<br/>
<a id="pl.363.20"></a><var>363.20</var>(d) For the purposes of this section, the license holder's license includes services <br/>
<a id="pl.363.21"></a><var>363.21</var>licensed under this chapter that were previously licensed under chapter 245B until <br/>
<a id="pl.363.22"></a><var>363.22</var>December 31, 2013.<br/>
<a id="pl.363.23"></a><var>363.23</var>    Subd. 2. <b>Qualifying accreditation.</b> The commissioner must accept a three-year <br/>
<a id="pl.363.24"></a><var>363.24</var>accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) <br/>
<a id="pl.363.25"></a><var>363.25</var>as a qualifying accreditation.<br/>
<a id="pl.363.26"></a><var>363.26</var>    Subd. 3. <b>Request for approval of an alternative inspection status.</b> (a) A request <br/>
<a id="pl.363.27"></a><var>363.27</var>for an alternative inspection must be made on the forms and in the manner prescribed <br/>
<a id="pl.363.28"></a><var>363.28</var>by the commissioner. When submitting the request, the license holder must submit all <br/>
<a id="pl.363.29"></a><var>363.29</var>documentation issued by the accrediting body verifying that the license holder has obtained <br/>
<a id="pl.363.30"></a><var>363.30</var>and maintained the qualifying accreditation and has complied with recommendations <br/>
<a id="pl.363.31"></a><var>363.31</var>or requirements from the accrediting body during the period of accreditation. Based <br/>
<a id="pl.363.32"></a><var>363.32</var>on the request and the additional required materials, the commissioner may approve <br/>
<a id="pl.363.33"></a><var>363.33</var>an alternative inspection status.<br/>
<a id="pl.363.34"></a><var>363.34</var>(b) The commissioner must notify the license holder in writing that the request for <br/>
<a id="pl.363.35"></a><var>363.35</var>an alternative inspection status has been approved. Approval must be granted until the <br/>
<a id="pl.363.36"></a><var>363.36</var>end of the qualifying accreditation period.<br/>
<a id="pl.364.1"></a><var>364.1</var>(c) The license holder must submit a written request for approval to be renewed <br/>
<a id="pl.364.2"></a><var>364.2</var>one month before the end of the current approval period according to the requirements <br/>
<a id="pl.364.3"></a><var>364.3</var>in paragraph (a). If the license holder does not submit a request to renew approval as <br/>
<a id="pl.364.4"></a><var>364.4</var>required, the commissioner must conduct a licensing inspection.<br/>
<a id="pl.364.5"></a><var>364.5</var>    Subd. 4. <b>Programs approved for alternative licensing inspection; deemed </b><br/>
<a id="pl.364.6"></a><var>364.6</var><b>compliance licensing requirements.</b> (a) A license holder approved for alternative <br/>
<a id="pl.364.7"></a><var>364.7</var>licensing inspection under this section is required to maintain compliance with all <br/>
<a id="pl.364.8"></a><var>364.8</var>licensing standards according to this chapter.<br/>
<a id="pl.364.9"></a><var>364.9</var>(b) A license holder approved for alternative licensing inspection under this section <br/>
<a id="pl.364.10"></a><var>364.10</var>must be deemed to be in compliance with all the requirements of this chapter, and the <br/>
<a id="pl.364.11"></a><var>364.11</var>commissioner must not perform routine licensing inspections.<br/>
<a id="pl.364.12"></a><var>364.12</var>(c) Upon receipt of a complaint regarding the services of a license holder approved <br/>
<a id="pl.364.13"></a><var>364.13</var>for alternative licensing inspection under this section, the commissioner must investigate <br/>
<a id="pl.364.14"></a><var>364.14</var>the complaint and may take any action as provided under section 245A.06 or 245A.07.<br/>
<a id="pl.364.15"></a><var>364.15</var>    Subd. 5. <b>Investigations of alleged or suspected maltreatment.</b> Nothing in this <br/>
<a id="pl.364.16"></a><var>364.16</var>section changes the commissioner's responsibilities to investigate alleged or suspected <br/>
<a id="pl.364.17"></a><var>364.17</var>maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.<br/>
<a id="pl.364.18"></a><var>364.18</var>    Subd. 6. <b>Termination or denial of subsequent approval.</b> Following approval of <br/>
<a id="pl.364.19"></a><var>364.19</var>an alternative licensing inspection, the commissioner may terminate or deny subsequent <br/>
<a id="pl.364.20"></a><var>364.20</var>approval of an alternative licensing inspection if the commissioner determines that:<br/>
<a id="pl.364.21"></a><var>364.21</var>(1) the license holder has not maintained the qualifying accreditation;<br/>
<a id="pl.364.22"></a><var>364.22</var>(2) the commissioner has substantiated maltreatment for which the license holder or <br/>
<a id="pl.364.23"></a><var>364.23</var>facility is determined to be responsible during the qualifying accreditation period; or<br/>
<a id="pl.364.24"></a><var>364.24</var>(3) during the qualifying accreditation period, the license holder has been issued <br/>
<a id="pl.364.25"></a><var>364.25</var>an order for conditional license, fine, suspension, or license revocation that has not been <br/>
<a id="pl.364.26"></a><var>364.26</var>reversed upon appeal.<br/>
<a id="pl.364.27"></a><var>364.27</var>    Subd. 7. <b>Appeals.</b> The commissioner's decision that the conditions for approval for <br/>
<a id="pl.364.28"></a><var>364.28</var>an alternative licensing inspection have not been met is final and not subject to appeal <br/>
<a id="pl.364.29"></a><var>364.29</var>under the provisions of chapter 14.<br/>
<a id="pl.364.30"></a><var>364.30</var>    Subd. 8. <b>Commissioner's programs.</b> Home and community-based services licensed <br/>
<a id="pl.364.31"></a><var>364.31</var>under this chapter for which the commissioner is the license holder with a qualifying <br/>
<a id="pl.364.32"></a><var>364.32</var>accreditation are excluded from being approved for an alternative licensing inspection.<br/>
<a id="pl.364.33"></a><var>364.33</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.44.0"></a><a id="pl.364.34"></a><var>364.34</var>    Sec. 44. <b>[245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.</b><br/>
<a id="pl.365.1"></a><var>365.1</var>(a) The commissioner of human services shall issue a mental health certification <br/>
<a id="pl.365.2"></a><var>365.2</var>for services licensed under this chapter when a license holder is determined to have met <br/>
<a id="pl.365.3"></a><var>365.3</var>the requirements under paragraph (b). This certification is voluntary for license holders. <br/>
<a id="pl.365.4"></a><var>365.4</var>The certification shall be printed on the license and identified on the commissioner's <br/>
<a id="pl.365.5"></a><var>365.5</var>public Web site.<br/>
<a id="pl.365.6"></a><var>365.6</var>(b) The requirements for certification are:<br/>
<a id="pl.365.7"></a><var>365.7</var>(1) all staff have received at least seven hours of annual training covering all of <br/>
<a id="pl.365.8"></a><var>365.8</var>the following topics:<br/>
<a id="pl.365.9"></a><var>365.9</var>(i) mental health diagnoses;<br/>
<a id="pl.365.10"></a><var>365.10</var>(ii) mental health crisis response and de-escalation techniques;<br/>
<a id="pl.365.11"></a><var>365.11</var>(iii) recovery from mental illness;<br/>
<a id="pl.365.12"></a><var>365.12</var>(iv) treatment options, including evidence-based practices;<br/>
<a id="pl.365.13"></a><var>365.13</var>(v) medications and their side effects;<br/>
<a id="pl.365.14"></a><var>365.14</var>(vi) co-occurring substance abuse and health conditions; and<br/>
<a id="pl.365.15"></a><var>365.15</var>(vii) community resources;<br/>
<a id="pl.365.16"></a><var>365.16</var>(2) a mental health professional, as defined in section 245.462, subdivision 18, or a <br/>
<a id="pl.365.17"></a><var>365.17</var>mental health practitioner as defined in section 245.462, subdivision 17, is available <br/>
<a id="pl.365.18"></a><var>365.18</var>for consultation and assistance;<br/>
<a id="pl.365.19"></a><var>365.19</var>(3) there is a plan and protocol in place to address a mental health crisis; and<br/>
<a id="pl.365.20"></a><var>365.20</var>(4) each person's individual service and support plan identifies who is providing <br/>
<a id="pl.365.21"></a><var>365.21</var>clinical services and their contact information, and includes an individual crisis prevention <br/>
<a id="pl.365.22"></a><var>365.22</var>and management plan developed with the person.<br/>
<a id="pl.365.23"></a><var>365.23</var>(c) License holders seeking certification under this section must request this <br/>
<a id="pl.365.24"></a><var>365.24</var>certification on forms and in the manner prescribed by the commissioner.<br/>
<a id="pl.365.25"></a><var>365.25</var>(d) If the commissioner finds that the license holder has failed to comply with the <br/>
<a id="pl.365.26"></a><var>365.26</var>certification requirements under paragraph (b), the commissioner may issue a correction <br/>
<a id="pl.365.27"></a><var>365.27</var>order and an order of conditional license in accordance with section 245A.06 or may <br/>
<a id="pl.365.28"></a><var>365.28</var>issue a sanction in accordance with section 245A.07, including and up to removal of <br/>
<a id="pl.365.29"></a><var>365.29</var>the certification.<br/>
<a id="pl.365.30"></a><var>365.30</var>(e) A denial of the certification or the removal of the certification based on a <br/>
<a id="pl.365.31"></a><var>365.31</var>determination that the requirements under paragraph (b) have not been met is not subject to <br/>
<a id="pl.365.32"></a><var>365.32</var>appeal. A license holder that has been denied a certification or that has had a certification <br/>
<a id="pl.365.33"></a><var>365.33</var>removed may again request certification when the license holder is in compliance with the <br/>
<a id="pl.365.34"></a><var>365.34</var>requirements of paragraph (b).<br/>
<a id="pl.365.35"></a><var>365.35</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.8.45.0"></a><a id="pl.366.1"></a><var>366.1</var>    Sec. 45. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:<br/>
<a id="pl.366.2"></a><var>366.2</var>    Subd. 11. <b>Residential support services.</b> (a) Upon federal approval, there is <br/>
<a id="pl.366.3"></a><var>366.3</var>established a new service called residential support that is available on the community <br/>
<a id="pl.366.4"></a><var>366.4</var>alternative care, community alternatives for disabled individuals, developmental <br/>
<a id="pl.366.5"></a><var>366.5</var>disabilities, and brain injury waivers. Existing waiver service descriptions must be <br/>
<a id="pl.366.6"></a><var>366.6</var>modified to the extent necessary to ensure there is no duplication between other services. <br/>
<a id="pl.366.7"></a><var>366.7</var>Residential support services must be provided by vendors licensed as a community <br/>
<a id="pl.366.8"></a><var>366.8</var>residential setting as defined in section 
         <statute_ref>245A.11, subdivision 8</statute_ref>, a foster care setting <br/>
<a id="pl.366.9"></a><var>366.9</var>licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care <br/>
<a id="pl.366.10"></a><var>366.10</var>setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.<br/>
<a id="pl.366.11"></a><var>366.11</var>    (b) Residential support services must meet the following criteria:<br/>
<a id="pl.366.12"></a><var>366.12</var>    (1) providers of residential support services must own or control the residential site;<br/>
<a id="pl.366.13"></a><var>366.13</var>    (2) the residential site must not be the primary residence of the license holder;<br/>
<a id="pl.366.14"></a><var>366.14</var>    (3) (1) the residential site must have a designated program supervisor person<br/>
<a id="pl.366.15"></a><var>366.15</var> responsible for program management, oversight, development, and implementation of <br/>
<a id="pl.366.16"></a><var>366.16</var>policies and procedures;<br/>
<a id="pl.366.17"></a><var>366.17</var>    (4) (2) the provider of residential support services must provide supervision, training, <br/>
<a id="pl.366.18"></a><var>366.18</var>and assistance as described in the person's coordinated service and support plan; and<br/>
<a id="pl.366.19"></a><var>366.19</var>    (5) (3) the provider of residential support services must meet the requirements of <br/>
<a id="pl.366.20"></a><var>366.20</var>licensure and additional requirements of the person's coordinated service and support plan.<br/>
<a id="pl.366.21"></a><var>366.21</var>    (c) Providers of residential support services that meet the definition in paragraph (a) <br/>
<a id="pl.366.22"></a><var>366.22</var>must be registered using a process determined by the commissioner beginning July 1, 2009<br/>
<a id="pl.366.23"></a><var>366.23</var> must be licensed according to chapter 245D. Providers licensed to provide child foster care <br/>
<a id="pl.366.24"></a><var>366.24</var>under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under <br/>
<a id="pl.366.25"></a><var>366.25</var>Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section <br/>
<statute_ref><a id="pl.366.26"></a><var>366.26</var>245A.03, subdivision 7
         </statute_ref>, paragraph (g), are considered registered under this section.<br/>
<br/>
<a id="bill.8.46.0"></a><a id="pl.366.27"></a><var>366.27</var>    Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:<br/>
<a id="pl.366.28"></a><var>366.28</var>    Subdivision 1. <b>Provider qualifications.</b> (a) For the home and community-based <br/>
<a id="pl.366.29"></a><var>366.29</var>waivers providing services to seniors and individuals with disabilities under sections <br/>
<a id="pl.366.30"></a><var>366.30</var>256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:<br/>
<a id="pl.366.31"></a><var>366.31</var>(1) agreements with enrolled waiver service providers to ensure providers meet <br/>
<a id="pl.366.32"></a><var>366.32</var>Minnesota health care program requirements;<br/>
<a id="pl.366.33"></a><var>366.33</var>(2) regular reviews of provider qualifications, and including requests of proof of <br/>
<a id="pl.366.34"></a><var>366.34</var>documentation; and<br/>
<a id="pl.366.35"></a><var>366.35</var>(3) processes to gather the necessary information to determine provider qualifications.<br/>
<a id="pl.367.1"></a><var>367.1</var>    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section <br/>
<statute_ref><a id="pl.367.2"></a><var>367.2</var>245C.02, subdivision 11
         </statute_ref>, for services specified in the federally approved waiver plans <br/>
<a id="pl.367.3"></a><var>367.3</var>must meet the requirements of chapter 245C prior to providing waiver services and as <br/>
<a id="pl.367.4"></a><var>367.4</var>part of ongoing enrollment. Upon federal approval, this requirement must also apply to <br/>
<a id="pl.367.5"></a><var>367.5</var>consumer-directed community supports.<br/>
<a id="pl.367.6"></a><var>367.6</var>    (c) Beginning January 1, 2014, service owners and managerial officials overseeing <br/>
<a id="pl.367.7"></a><var>367.7</var>the management or policies of services that provide direct contact as specified in the <br/>
<a id="pl.367.8"></a><var>367.8</var>federally approved waiver plans must meet the requirements of chapter 245C prior to <br/>
<a id="pl.367.9"></a><var>367.9</var>reenrollment or, for new providers, prior to initial enrollment if they have not already done <br/>
<a id="pl.367.10"></a><var>367.10</var>so as a part of service licensure requirements.<br/>
<br/>
<a id="bill.8.47.0"></a><a id="pl.367.11"></a><var>367.11</var>    Sec. 47. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:<br/>
<a id="pl.367.12"></a><var>367.12</var>    Subd. 7. <b>Applicant and license holder training.</b> An applicant or license holder <br/>
<a id="pl.367.13"></a><var>367.13</var>for the home and community-based waivers providing services to seniors and individuals <br/>
<a id="pl.367.14"></a><var>367.14</var>with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is <br/>
<a id="pl.367.15"></a><var>367.15</var>not enrolled as a Minnesota health care program home and community-based services <br/>
<a id="pl.367.16"></a><var>367.16</var>waiver provider at the time of application must ensure that at least one controlling <br/>
<a id="pl.367.17"></a><var>367.17</var>individual completes a onetime training on the requirements for providing home and <br/>
<a id="pl.367.18"></a><var>367.18</var>community-based services from a qualified source as determined by the commissioner, <br/>
<a id="pl.367.19"></a><var>367.19</var>before a provider is enrolled or license is issued. Within six months of enrollment, a newly <br/>
<a id="pl.367.20"></a><var>367.20</var>enrolled home and community-based waiver service provider must ensure that at least one <br/>
<a id="pl.367.21"></a><var>367.21</var>controlling individual has completed training on waiver and related program billing.<br/>
<br/>
<a id="bill.8.48.0"></a><a id="pl.367.22"></a><var>367.22</var>    Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a <br/>
<a id="pl.367.23"></a><var>367.23</var>subdivision to read:<br/>
<a id="pl.367.24"></a><var>367.24</var>    Subd. 8. <b>Data on use of emergency use of manual restraint.</b> Beginning July 1, <br/>
<a id="pl.367.25"></a><var>367.25</var>2013, facilities and services to be licensed under chapter 245D shall submit data regarding <br/>
<a id="pl.367.26"></a><var>367.26</var>the use of emergency use of manual restraint as identified in section 245D.061 in a format <br/>
<a id="pl.367.27"></a><var>367.27</var>and at a frequency identified by the commissioner.<br/>
<br/>
<a id="bill.8.49.0"></a><a id="pl.367.28"></a><var>367.28</var>    Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a <br/>
<a id="pl.367.29"></a><var>367.29</var>subdivision to read:<br/>
<a id="pl.367.30"></a><var>367.30</var>    Subd. 9. <b>Definitions.</b> (a) For the purposes of this section, the following terms <br/>
<a id="pl.367.31"></a><var>367.31</var>have the meanings given them. <br/>
<a id="pl.368.1"></a><var>368.1</var>(b) "Controlling individual" means a public body, governmental agency, business <br/>
<a id="pl.368.2"></a><var>368.2</var>entity, officer, owner, or managerial official whose responsibilities include the direction of <br/>
<a id="pl.368.3"></a><var>368.3</var>the management or policies of a program.<br/>
<a id="pl.368.4"></a><var>368.4</var>(c) "Managerial official" means an individual who has decision-making authority <br/>
<a id="pl.368.5"></a><var>368.5</var>related to the operation of the program and responsibility for the ongoing management of <br/>
<a id="pl.368.6"></a><var>368.6</var>or direction of the policies, services, or employees of the program.<br/>
<a id="pl.368.7"></a><var>368.7</var>(d) "Owner" means an individual who has direct or indirect ownership interest in <br/>
<a id="pl.368.8"></a><var>368.8</var>a corporation or partnership, or business association enrolling with the Department of <br/>
<a id="pl.368.9"></a><var>368.9</var>Human Services as a provider of waiver services.<br/>
<br/>
<a id="bill.8.50.0"></a><a id="pl.368.10"></a><var>368.10</var>    Sec. 50. Minnesota Statutes 2012, section 256B.4912, is amended by adding a <br/>
<a id="pl.368.11"></a><var>368.11</var>subdivision to read:<br/>
<a id="pl.368.12"></a><var>368.12</var>    Subd. 10. <b>Enrollment requirements.</b> All home and community-based waiver <br/>
<a id="pl.368.13"></a><var>368.13</var>providers must provide, at the time of enrollment and within 30 days of a request, in a <br/>
<a id="pl.368.14"></a><var>368.14</var>format determined by the commissioner, information and documentation that includes, but <br/>
<a id="pl.368.15"></a><var>368.15</var>is not limited to, the following:<br/>
<a id="pl.368.16"></a><var>368.16</var>(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the <br/>
<a id="pl.368.17"></a><var>368.17</var>provider's payments from Medicaid in the previous calendar year, whichever is greater;<br/>
<a id="pl.368.18"></a><var>368.18</var>(2) proof of fidelity bond coverage in the amount of $20,000; and<br/>
<a id="pl.368.19"></a><var>368.19</var>(3) proof of liability insurance.<br/>
<br/>
<a id="bill.8.51.0"></a><a id="pl.368.20"></a><var>368.20</var>    Sec. 51. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:<br/>
<a id="pl.368.21"></a><var>368.21</var>    Subd. 9a. <b>Evaluation and referral of reports made to common entry point unit.</b><br/>
<a id="pl.368.22"></a><var>368.22</var>    The common entry point must screen the reports of alleged or suspected maltreatment for <br/>
<a id="pl.368.23"></a><var>368.23</var>immediate risk and make all necessary referrals as follows:<br/>
<a id="pl.368.24"></a><var>368.24</var>    (1) if the common entry point determines that there is an immediate need for <br/>
<a id="pl.368.25"></a><var>368.25</var>adult protective services, the common entry point agency shall immediately notify the <br/>
<a id="pl.368.26"></a><var>368.26</var>appropriate county agency;<br/>
<a id="pl.368.27"></a><var>368.27</var>    (2) if the report contains suspected criminal activity against a vulnerable adult, the <br/>
<a id="pl.368.28"></a><var>368.28</var>common entry point shall immediately notify the appropriate law enforcement agency;<br/>
<a id="pl.368.29"></a><var>368.29</var>    (3) the common entry point shall refer all reports of alleged or suspected <br/>
<a id="pl.368.30"></a><var>368.30</var>maltreatment to the appropriate lead investigative agency as soon as possible, but in any <br/>
<a id="pl.368.31"></a><var>368.31</var>event no longer than two working days; and<br/>
<a id="pl.368.32"></a><var>368.32</var>    (4) if the report involves services licensed by the Department of Human Services <br/>
<a id="pl.368.33"></a><var>368.33</var>and subject to chapter 245D, the common entry point shall refer the report to the county as <br/>
<a id="pl.369.1"></a><var>369.1</var>the lead agency according to clause (3), but shall also notify the Department of Human <br/>
<a id="pl.369.2"></a><var>369.2</var>Services of the report; and<br/>
<a id="pl.369.3"></a><var>369.3</var>    (5) (4) if the report contains information about a suspicious death, the common <br/>
<a id="pl.369.4"></a><var>369.4</var>entry point shall immediately notify the appropriate law enforcement agencies, the local <br/>
<a id="pl.369.5"></a><var>369.5</var>medical examiner, and the ombudsman for mental health and developmental disabilities <br/>
<a id="pl.369.6"></a><var>369.6</var>established under section 
         <statute_ref>245.92</statute_ref>. Law enforcement agencies shall coordinate with the <br/>
<a id="pl.369.7"></a><var>369.7</var>local medical examiner and the ombudsman as provided by law.<br/>
<br/>
<a id="bill.8.52.0"></a><a id="pl.369.8"></a><var>369.8</var>    Sec. 52. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:<br/>
<a id="pl.369.9"></a><var>369.9</var>    Subd. 13. <b>Lead investigative agency.</b> "Lead investigative agency" is the primary <br/>
<a id="pl.369.10"></a><var>369.10</var>administrative agency responsible for investigating reports made under section 
         <statute_ref>626.557</statute_ref>.<br/>
<a id="pl.369.11"></a><var>369.11</var>(a) The Department of Health is the lead investigative agency for facilities or <br/>
<a id="pl.369.12"></a><var>369.12</var>services licensed or required to be licensed as hospitals, home care providers, nursing <br/>
<a id="pl.369.13"></a><var>369.13</var>homes, boarding care homes, hospice providers, residential facilities that are also federally <br/>
<a id="pl.369.14"></a><var>369.14</var>certified as intermediate care facilities that serve people with developmental disabilities, <br/>
<a id="pl.369.15"></a><var>369.15</var>or any other facility or service not listed in this subdivision that is licensed or required to <br/>
<a id="pl.369.16"></a><var>369.16</var>be licensed by the Department of Health for the care of vulnerable adults. "Home care <br/>
<a id="pl.369.17"></a><var>369.17</var>provider" has the meaning provided in section 
         <statute_ref>144A.43, subdivision 4</statute_ref>, and applies when <br/>
<a id="pl.369.18"></a><var>369.18</var>care or services are delivered in the vulnerable adult's home, whether a private home or a <br/>
<a id="pl.369.19"></a><var>369.19</var>housing with services establishment registered under chapter 144D, including those that <br/>
<a id="pl.369.20"></a><var>369.20</var>offer assisted living services under chapter 144G.<br/>
<a id="pl.369.21"></a><var>369.21</var>(b) Except as provided under paragraph (c), for services licensed according to <br/>
<a id="pl.369.22"></a><var>369.22</var>chapter 245D, The Department of Human Services is the lead investigative agency for <br/>
<a id="pl.369.23"></a><var>369.23</var>facilities or services licensed or required to be licensed as adult day care, adult foster care, <br/>
<a id="pl.369.24"></a><var>369.24</var>programs for people with developmental disabilities, family adult day services, mental <br/>
<a id="pl.369.25"></a><var>369.25</var>health programs, mental health clinics, chemical dependency programs, the Minnesota <br/>
<a id="pl.369.26"></a><var>369.26</var>sex offender program, or any other facility or service not listed in this subdivision that is <br/>
<a id="pl.369.27"></a><var>369.27</var>licensed or required to be licensed by the Department of Human Services.<br/>
<a id="pl.369.28"></a><var>369.28</var>(c) The county social service agency or its designee is the lead investigative agency <br/>
<a id="pl.369.29"></a><var>369.29</var>for all other reports, including, but not limited to, reports involving vulnerable adults <br/>
<a id="pl.369.30"></a><var>369.30</var>receiving services from a personal care provider organization under section 
         <statute_ref>256B.0659</statute_ref>, <br/>
<a id="pl.369.31"></a><var>369.31</var>or receiving home and community-based services licensed by the Department of Human <br/>
<a id="pl.369.32"></a><var>369.32</var>Services and subject to chapter 245D.<br/>
<br/>
<a id="bill.8.53.0"></a><a id="pl.369.33"></a><var>369.33</var>    Sec. 53. <b>INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME </b><br/>
<a id="pl.369.34"></a><var>369.34</var><b>AND COMMUNITY-BASED SERVICES.</b><br/>
<a id="pl.370.1"></a><var>370.1</var>(a) The Department of Health Compliance Monitoring Division and the Department <br/>
<a id="pl.370.2"></a><var>370.2</var>of Human Services Licensing Division shall jointly develop an integrated licensing system <br/>
<a id="pl.370.3"></a><var>370.3</var>for providers of both home care services subject to licensure under Minnesota Statutes, <br/>
<a id="pl.370.4"></a><var>370.4</var>chapter 144A, and for home and community-based services subject to licensure under <br/>
<a id="pl.370.5"></a><var>370.5</var>Minnesota Statutes, chapter 245D. The integrated licensing system shall:<br/>
<a id="pl.370.6"></a><var>370.6</var>(1) require only one license of any provider of services under Minnesota Statutes, <br/>
<a id="pl.370.7"></a><var>370.7</var>sections 144A.43 to 144A.482, and 245D.03, subdivision 1;<br/>
<a id="pl.370.8"></a><var>370.8</var>(2) promote quality services that recognize a person's individual needs and protect <br/>
<a id="pl.370.9"></a><var>370.9</var>the person's health, safety, rights, and well-being;<br/>
<a id="pl.370.10"></a><var>370.10</var>(3) promote provider accountability through application requirements, compliance <br/>
<a id="pl.370.11"></a><var>370.11</var>inspections, investigations, and enforcement actions;<br/>
<a id="pl.370.12"></a><var>370.12</var>(4) reference other applicable requirements in existing state and federal laws, <br/>
<a id="pl.370.13"></a><var>370.13</var>including the federal Affordable Care Act;<br/>
<a id="pl.370.14"></a><var>370.14</var>(5) establish internal procedures to facilitate ongoing communications between the <br/>
<a id="pl.370.15"></a><var>370.15</var>agencies and with providers and services recipients about the regulatory activities;<br/>
<a id="pl.370.16"></a><var>370.16</var>(6) create a link between the agency Web sites so that providers and the public can <br/>
<a id="pl.370.17"></a><var>370.17</var>access the same information regardless of which Web site is accessed initially; and<br/>
<a id="pl.370.18"></a><var>370.18</var>(7) collect data on identified outcome measures as necessary for the agencies to <br/>
<a id="pl.370.19"></a><var>370.19</var>report to the Centers for Medicare and Medicaid Services.<br/>
<a id="pl.370.20"></a><var>370.20</var>(b) The joint recommendations for legislative changes to implement the integrated <br/>
<a id="pl.370.21"></a><var>370.21</var>licensing system are due to the legislature by February 15, 2014.<br/>
<a id="pl.370.22"></a><var>370.22</var>(c) Before implementation of the integrated licensing system, providers licensed as <br/>
<a id="pl.370.23"></a><var>370.23</var>home care providers under Minnesota Statutes, chapter 144A, may also provide home <br/>
<a id="pl.370.24"></a><var>370.24</var>and community-based services subject to licensure under Minnesota Statutes, chapter <br/>
<a id="pl.370.25"></a><var>370.25</var>245D, without obtaining a home and community-based services license under Minnesota <br/>
<a id="pl.370.26"></a><var>370.26</var>Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall <br/>
<a id="pl.370.27"></a><var>370.27</var>apply to these providers:<br/>
<a id="pl.370.28"></a><var>370.28</var>(1) the provider must comply with all requirements under Minnesota Statutes, chapter <br/>
<a id="pl.370.29"></a><var>370.29</var>245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;<br/>
<a id="pl.370.30"></a><var>370.30</var>(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be <br/>
<a id="pl.370.31"></a><var>370.31</var>enforced by the Department of Health under the enforcement authority set forth in <br/>
<a id="pl.370.32"></a><var>370.32</var>Minnesota Statutes, section 144A.475; and<br/>
<a id="pl.370.33"></a><var>370.33</var>(3) the Department of Health will provide information to the Department of Human <br/>
<a id="pl.370.34"></a><var>370.34</var>Services about each provider licensed under this section, including the provider's license <br/>
<a id="pl.370.35"></a><var>370.35</var>application, licensing documents, inspections, information about complaints received, and <br/>
<a id="pl.370.36"></a><var>370.36</var>investigations conducted for possible violations of Minnesota Statutes, chapter 245D.<br/>
<br/>
<a id="bill.8.54.0"></a><a id="pl.371.1"></a><var>371.1</var>    Sec. 54. <b> REPEALER.</b><br/>
<a id="pl.371.2"></a><var>371.2</var>(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031; <br/>
<a id="pl.371.3"></a><var>371.3</var>245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and <br/>
<a id="pl.371.4"></a><var>371.4</var>245B.08, are repealed effective January 1, 2014. <br/>
<a id="pl.371.5"></a><var>371.5</var>(b) Minnesota Statutes 2012, section 245D.08, is repealed.<br/>
<br/>
<a id="bill.9.0.0"></a>

<a id="bill.9.1.0"></a><a id="pl.371.8"></a><var>371.8</var>    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:<br/>
<a id="pl.371.9"></a><var>371.9</var>    Subd. 5. <b>Specific purchases.</b> The solicitation process described in this chapter is <br/>
<a id="pl.371.10"></a><var>371.10</var>not required for acquisition of the following:<br/>
<a id="pl.371.11"></a><var>371.11</var>(1) merchandise for resale purchased under policies determined by the commissioner;<br/>
<a id="pl.371.12"></a><var>371.12</var>(2) farm and garden products which, as determined by the commissioner, may be <br/>
<a id="pl.371.13"></a><var>371.13</var>purchased at the prevailing market price on the date of sale;<br/>
<a id="pl.371.14"></a><var>371.14</var>(3) goods and services from the Minnesota correctional facilities;<br/>
<a id="pl.371.15"></a><var>371.15</var>(4) goods and services from rehabilitation facilities and extended employment <br/>
<a id="pl.371.16"></a><var>371.16</var>providers that are certified by the commissioner of employment and economic <br/>
<a id="pl.371.17"></a><var>371.17</var>development, and day training and habilitation services licensed under sections 
<statute_ref>245B.01 <br/>
<a id="pl.371.18"></a><var>371.18</var></statute_ref>to 
<statute_ref>245B.08</statute_ref> chapter 245D;<br/>
<a id="pl.371.19"></a><var>371.19</var>(5) goods and services for use by a community-based facility operated by the <br/>
<a id="pl.371.20"></a><var>371.20</var>commissioner of human services;<br/>
<a id="pl.371.21"></a><var>371.21</var>(6) goods purchased at auction or when submitting a sealed bid at auction provided <br/>
<a id="pl.371.22"></a><var>371.22</var>that before authorizing such an action, the commissioner consult with the requesting <br/>
<a id="pl.371.23"></a><var>371.23</var>agency to determine a fair and reasonable value for the goods considering factors <br/>
<a id="pl.371.24"></a><var>371.24</var>including, but not limited to, costs associated with submitting a bid, travel, transportation, <br/>
<a id="pl.371.25"></a><var>371.25</var>and storage. This fair and reasonable value must represent the limit of the state's bid;<br/>
<a id="pl.371.26"></a><var>371.26</var>(7) utility services where no competition exists or where rates are fixed by law or <br/>
<a id="pl.371.27"></a><var>371.27</var>ordinance; and<br/>
<a id="pl.371.28"></a><var>371.28</var>(8) goods and services from Minnesota sex offender program facilities.<br/>
<a id="pl.371.29"></a><var>371.29</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.2.0"></a><a id="pl.371.30"></a><var>371.30</var>    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:<br/>
<a id="pl.371.31"></a><var>371.31</var>    Subdivision 1. <b>Service contracts.</b> The commissioner of administration shall <br/>
<a id="pl.371.32"></a><var>371.32</var>ensure that a portion of all contracts for janitorial services; document imaging; <br/>
<a id="pl.371.33"></a><var>371.33</var>document shredding; and mailing, collating, and sorting services be awarded by the <br/>
<a id="pl.372.1"></a><var>372.1</var>state to rehabilitation programs and extended employment providers that are certified <br/>
<a id="pl.372.2"></a><var>372.2</var>by the commissioner of employment and economic development, and day training and <br/>
<a id="pl.372.3"></a><var>372.3</var>habilitation services licensed under sections 
<statute_ref>245B.01</statute_ref> to 
<statute_ref>245B.08</statute_ref> chapter 245D. The <br/>
<a id="pl.372.4"></a><var>372.4</var>amount of each contract awarded under this section may exceed the estimated fair market <br/>
<a id="pl.372.5"></a><var>372.5</var>price as determined by the commissioner for the same goods and services by up to six <br/>
<a id="pl.372.6"></a><var>372.6</var>percent. The aggregate value of the contracts awarded to eligible providers under this <br/>
<a id="pl.372.7"></a><var>372.7</var>section in any given year must exceed 19 percent of the total value of all contracts for <br/>
<a id="pl.372.8"></a><var>372.8</var>janitorial services; document imaging; document shredding; and mailing, collating, and <br/>
<a id="pl.372.9"></a><var>372.9</var>sorting services entered into in the same year. For the 19 percent requirement to be <br/>
<a id="pl.372.10"></a><var>372.10</var>applicable in any given year, the contract amounts proposed by eligible providers must be <br/>
<a id="pl.372.11"></a><var>372.11</var>within six percent of the estimated fair market price for at least 19 percent of the contracts <br/>
<a id="pl.372.12"></a><var>372.12</var>awarded for the corresponding service area.<br/>
<a id="pl.372.13"></a><var>372.13</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.3.0"></a><a id="pl.372.14"></a><var>372.14</var>    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:<br/>
<a id="pl.372.15"></a><var>372.15</var>    Subd. 4. <b>Housing with services establishment or establishment.</b> (a) "Housing <br/>
<a id="pl.372.16"></a><var>372.16</var>with services establishment" or "establishment" means:<br/>
<a id="pl.372.17"></a><var>372.17</var>(1) an establishment providing sleeping accommodations to one or more adult <br/>
<a id="pl.372.18"></a><var>372.18</var>residents, at least 80 percent of which are 55 years of age or older, and offering or <br/>
<a id="pl.372.19"></a><var>372.19</var>providing, for a fee, one or more regularly scheduled health-related services or two or <br/>
<a id="pl.372.20"></a><var>372.20</var>more regularly scheduled supportive services, whether offered or provided directly by the <br/>
<a id="pl.372.21"></a><var>372.21</var>establishment or by another entity arranged for by the establishment; or<br/>
<a id="pl.372.22"></a><var>372.22</var>(2) an establishment that registers under section 
         <statute_ref>144D.025</statute_ref>.<br/>
<a id="pl.372.23"></a><var>372.23</var>(b) Housing with services establishment does not include:<br/>
<a id="pl.372.24"></a><var>372.24</var>(1) a nursing home licensed under chapter 144A;<br/>
<a id="pl.372.25"></a><var>372.25</var>(2) a hospital, certified boarding care home, or supervised living facility licensed <br/>
<a id="pl.372.26"></a><var>372.26</var>under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.56</statute_ref>;<br/>
<a id="pl.372.27"></a><var>372.27</var>(3) a board and lodging establishment licensed under chapter 157 and Minnesota <br/>
<a id="pl.372.28"></a><var>372.28</var>Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, <br/>
<a id="pl.372.29"></a><var>372.29</var>or 9530.4100 to 9530.4450, or under chapter 245B 245D;<br/>
<a id="pl.372.30"></a><var>372.30</var>(4) a board and lodging establishment which serves as a shelter for battered women <br/>
<a id="pl.372.31"></a><var>372.31</var>or other similar purpose;<br/>
<a id="pl.372.32"></a><var>372.32</var>(5) a family adult foster care home licensed by the Department of Human Services;<br/>
<a id="pl.372.33"></a><var>372.33</var>(6) private homes in which the residents are related by kinship, law, or affinity with <br/>
<a id="pl.372.34"></a><var>372.34</var>the providers of services;<br/>
<a id="pl.373.1"></a><var>373.1</var>(7) residential settings for persons with developmental disabilities in which the <br/>
<a id="pl.373.2"></a><var>373.2</var>services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable <br/>
<a id="pl.373.3"></a><var>373.3</var>successor rules or laws;<br/>
<a id="pl.373.4"></a><var>373.4</var>(8) a home-sharing arrangement such as when an elderly or disabled person or <br/>
<a id="pl.373.5"></a><var>373.5</var>single-parent family makes lodging in a private residence available to another person <br/>
<a id="pl.373.6"></a><var>373.6</var>in exchange for services or rent, or both;<br/>
<a id="pl.373.7"></a><var>373.7</var>(9) a duly organized condominium, cooperative, common interest community, or <br/>
<a id="pl.373.8"></a><var>373.8</var>owners' association of the foregoing where at least 80 percent of the units that comprise the <br/>
<a id="pl.373.9"></a><var>373.9</var>condominium, cooperative, or common interest community are occupied by individuals <br/>
<a id="pl.373.10"></a><var>373.10</var>who are the owners, members, or shareholders of the units; or<br/>
<a id="pl.373.11"></a><var>373.11</var>(10) services for persons with developmental disabilities that are provided under <br/>
<a id="pl.373.12"></a><var>373.12</var>a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until <br/>
<a id="pl.373.13"></a><var>373.13</var>January 1, 1998, or under chapter 245B 245D.<br/>
<a id="pl.373.14"></a><var>373.14</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.4.0"></a><a id="pl.373.15"></a><var>373.15</var>    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:<br/>
<a id="pl.373.16"></a><var>373.16</var>    Subdivision 1. <b>Applicability.</b> (a) The operating standards for special transportation <br/>
<a id="pl.373.17"></a><var>373.17</var>service adopted under this section do not apply to special transportation provided by:<br/>
<a id="pl.373.18"></a><var>373.18</var>(1) a common carrier operating on fixed routes and schedules;<br/>
<a id="pl.373.19"></a><var>373.19</var>(2) a volunteer driver using a private automobile;<br/>
<a id="pl.373.20"></a><var>373.20</var>(3) a school bus as defined in section 
         <statute_ref>169.011, subdivision 71</statute_ref>; or<br/>
<a id="pl.373.21"></a><var>373.21</var>(4) an emergency ambulance regulated under chapter 144.<br/>
<a id="pl.373.22"></a><var>373.22</var>(b) The operating standards adopted under this section only apply to providers <br/>
<a id="pl.373.23"></a><var>373.23</var>of special transportation service who receive grants or other financial assistance from <br/>
<a id="pl.373.24"></a><var>373.24</var>either the state or the federal government, or both, to provide or assist in providing that <br/>
<a id="pl.373.25"></a><var>373.25</var>service; except that the operating standards adopted under this section do not apply <br/>
<a id="pl.373.26"></a><var>373.26</var>to any nursing home licensed under section 
         <statute_ref>144A.02</statute_ref>, to any board and care facility <br/>
<a id="pl.373.27"></a><var>373.27</var>licensed under section 
         <statute_ref>144.50</statute_ref>, or to any day training and habilitation services, day care, <br/>
<a id="pl.373.28"></a><var>373.28</var>or group home facility licensed under sections 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.19</statute_ref> unless the facility or <br/>
<a id="pl.373.29"></a><var>373.29</var>program provides transportation to nonresidents on a regular basis and the facility receives <br/>
<a id="pl.373.30"></a><var>373.30</var>reimbursement, other than per diem payments, for that service under rules promulgated <br/>
<a id="pl.373.31"></a><var>373.31</var>by the commissioner of human services.<br/>
<a id="pl.373.32"></a><var>373.32</var>(c) Notwithstanding paragraph (b), the operating standards adopted under this <br/>
<a id="pl.373.33"></a><var>373.33</var>section do not apply to any vendor of services licensed under chapter 245B 245D that <br/>
<a id="pl.373.34"></a><var>373.34</var>provides transportation services to consumers or residents of other vendors licensed under <br/>
<a id="pl.374.1"></a><var>374.1</var>chapter 245B 245D and transports 15 or fewer persons, including consumers or residents <br/>
<a id="pl.374.2"></a><var>374.2</var>and the driver.<br/>
<a id="pl.374.3"></a><var>374.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.5.0"></a><a id="pl.374.4"></a><var>374.4</var>    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:<br/>
<a id="pl.374.5"></a><var>374.5</var>    Subdivision 1. <b>Scope.</b> The terms used in this chapter and chapter 245B have the <br/>
<a id="pl.374.6"></a><var>374.6</var>meanings given them in this section.<br/>
<a id="pl.374.7"></a><var>374.7</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.6.0"></a><a id="pl.374.8"></a><var>374.8</var>    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:<br/>
<a id="pl.374.9"></a><var>374.9</var>    Subd. 9. <b>License holder.</b> "License holder" means an individual, corporation, <br/>
<a id="pl.374.10"></a><var>374.10</var>partnership, voluntary association, or other organization that is legally responsible for the <br/>
<a id="pl.374.11"></a><var>374.11</var>operation of the program, has been granted a license by the commissioner under this chapter <br/>
<a id="pl.374.12"></a><var>374.12</var>or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.<br/>
<a id="pl.374.13"></a><var>374.13</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.7.0"></a><a id="pl.374.14"></a><var>374.14</var>    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:<br/>
<a id="pl.374.15"></a><var>374.15</var>    Subd. 9. <b>Permitted services by an individual who is related.</b> Notwithstanding <br/>
<a id="pl.374.16"></a><var>374.16</var>subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a <br/>
<a id="pl.374.17"></a><var>374.17</var>person receiving supported living services may provide licensed services to that person if:<br/>
<a id="pl.374.18"></a><var>374.18</var>(1) the person who receives supported living services received these services in a <br/>
<a id="pl.374.19"></a><var>374.19</var>residential site on July 1, 2005;<br/>
<a id="pl.374.20"></a><var>374.20</var>(2) the services under clause (1) were provided in a corporate foster care setting for <br/>
<a id="pl.374.21"></a><var>374.21</var>adults and were funded by the developmental disabilities home and community-based <br/>
<a id="pl.374.22"></a><var>374.22</var>services waiver defined in section 
         <statute_ref>256B.092</statute_ref>;<br/>
<a id="pl.374.23"></a><var>374.23</var>(3) the individual who is related obtains and maintains both a license under chapter <br/>
<a id="pl.374.24"></a><var>374.24</var>245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105 <br/>
<a id="pl.374.25"></a><var>374.25</var>to 9555.6265; and<br/>
<a id="pl.374.26"></a><var>374.26</var>(4) the individual who is related is not the guardian of the person receiving supported <br/>
<a id="pl.374.27"></a><var>374.27</var>living services.<br/>
<a id="pl.374.28"></a><var>374.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.8.0"></a><a id="pl.374.29"></a><var>374.29</var>    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:<br/>
<a id="pl.375.1"></a><var>375.1</var>    Subd. 13. <b>Funds and property; other requirements.</b> (a) A license holder must <br/>
<a id="pl.375.2"></a><var>375.2</var>ensure that persons served by the program retain the use and availability of personal funds <br/>
<a id="pl.375.3"></a><var>375.3</var>or property unless restrictions are justified in the person's individual plan. This subdivision <br/>
<a id="pl.375.4"></a><var>375.4</var>does not apply to programs governed by the provisions in section 
<statute_ref>245B.07, subdivision 10</statute_ref>.<br/>
<a id="pl.375.5"></a><var>375.5</var>(b) The license holder must ensure separation of funds of persons served by the <br/>
<a id="pl.375.6"></a><var>375.6</var>program from funds of the license holder, the program, or program staff.<br/>
<a id="pl.375.7"></a><var>375.7</var>(c) Whenever the license holder assists a person served by the program with the <br/>
<a id="pl.375.8"></a><var>375.8</var>safekeeping of funds or other property, the license holder must:<br/>
<a id="pl.375.9"></a><var>375.9</var>(1) immediately document receipt and disbursement of the person's funds or other <br/>
<a id="pl.375.10"></a><var>375.10</var>property at the time of receipt or disbursement, including the person's signature, or the <br/>
<a id="pl.375.11"></a><var>375.11</var>signature of the conservator or payee; and<br/>
<a id="pl.375.12"></a><var>375.12</var>(2) return to the person upon the person's request, funds and property in the license <br/>
<a id="pl.375.13"></a><var>375.13</var>holder's possession subject to restrictions in the person's treatment plan, as soon as <br/>
<a id="pl.375.14"></a><var>375.14</var>possible, but no later than three working days after the date of request.<br/>
<a id="pl.375.15"></a><var>375.15</var>(d) License holders and program staff must not:<br/>
<a id="pl.375.16"></a><var>375.16</var>(1) borrow money from a person served by the program;<br/>
<a id="pl.375.17"></a><var>375.17</var>(2) purchase personal items from a person served by the program;<br/>
<a id="pl.375.18"></a><var>375.18</var>(3) sell merchandise or personal services to a person served by the program;<br/>
<a id="pl.375.19"></a><var>375.19</var>(4) require a person served by the program to purchase items for which the license <br/>
<a id="pl.375.20"></a><var>375.20</var>holder is eligible for reimbursement; or<br/>
<a id="pl.375.21"></a><var>375.21</var>(5) use funds of persons served by the program to purchase items for which the <br/>
<a id="pl.375.22"></a><var>375.22</var>facility is already receiving public or private payments.<br/>
<a id="pl.375.23"></a><var>375.23</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.9.0"></a><a id="pl.375.24"></a><var>375.24</var>    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:<br/>
<a id="pl.375.25"></a><var>375.25</var>    Subd. 3. <b>License suspension, revocation, or fine.</b> (a) The commissioner may <br/>
<a id="pl.375.26"></a><var>375.26</var>suspend or revoke a license, or impose a fine if:<br/>
<a id="pl.375.27"></a><var>375.27</var>(1) a license holder fails to comply fully with applicable laws or rules;<br/>
<a id="pl.375.28"></a><var>375.28</var>(2) a license holder, a controlling individual, or an individual living in the household <br/>
<a id="pl.375.29"></a><var>375.29</var>where the licensed services are provided or is otherwise subject to a background study has <br/>
<a id="pl.375.30"></a><var>375.30</var>a disqualification which has not been set aside under section 
         <statute_ref>245C.22</statute_ref>;<br/>
<a id="pl.375.31"></a><var>375.31</var>(3) a license holder knowingly withholds relevant information from or gives false <br/>
<a id="pl.375.32"></a><var>375.32</var>or misleading information to the commissioner in connection with an application for <br/>
<a id="pl.375.33"></a><var>375.33</var>a license, in connection with the background study status of an individual, during an <br/>
<a id="pl.375.34"></a><var>375.34</var>investigation, or regarding compliance with applicable laws or rules; or<br/>
<a id="pl.376.1"></a><var>376.1</var>(4) after July 1, 2012, and upon request by the commissioner, a license holder fails <br/>
<a id="pl.376.2"></a><var>376.2</var>to submit the information required of an applicant under section 
         <statute_ref>245A.04, subdivision 1</statute_ref>, <br/>
<a id="pl.376.3"></a><var>376.3</var>paragraph (f) or (g).<br/>
<a id="pl.376.4"></a><var>376.4</var>A license holder who has had a license suspended, revoked, or has been ordered <br/>
<a id="pl.376.5"></a><var>376.5</var>to pay a fine must be given notice of the action by certified mail or personal service. If <br/>
<a id="pl.376.6"></a><var>376.6</var>mailed, the notice must be mailed to the address shown on the application or the last <br/>
<a id="pl.376.7"></a><var>376.7</var>known address of the license holder. The notice must state the reasons the license was <br/>
<a id="pl.376.8"></a><var>376.8</var>suspended, revoked, or a fine was ordered.<br/>
<a id="pl.376.9"></a><var>376.9</var>    (b) If the license was suspended or revoked, the notice must inform the license <br/>
<a id="pl.376.10"></a><var>376.10</var>holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts <br/>
<a id="pl.376.11"></a><var>376.11</var>1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking <br/>
<a id="pl.376.12"></a><var>376.12</var>a license. The appeal of an order suspending or revoking a license must be made in writing <br/>
<a id="pl.376.13"></a><var>376.13</var>by certified mail or personal service. If mailed, the appeal must be postmarked and sent to <br/>
<a id="pl.376.14"></a><var>376.14</var>the commissioner within ten calendar days after the license holder receives notice that the <br/>
<a id="pl.376.15"></a><var>376.15</var>license has been suspended or revoked. If a request is made by personal service, it must be <br/>
<a id="pl.376.16"></a><var>376.16</var>received by the commissioner within ten calendar days after the license holder received <br/>
<a id="pl.376.17"></a><var>376.17</var>the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits <br/>
<a id="pl.376.18"></a><var>376.18</var>a timely appeal of an order suspending or revoking a license, the license holder may <br/>
<a id="pl.376.19"></a><var>376.19</var>continue to operate the program as provided in section 
         <statute_ref>245A.04, subdivision 7</statute_ref>, paragraphs <br/>
<a id="pl.376.20"></a><var>376.20</var>(g) and (h), until the commissioner issues a final order on the suspension or revocation.<br/>
<a id="pl.376.21"></a><var>376.21</var>    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the <br/>
<a id="pl.376.22"></a><var>376.22</var>license holder of the responsibility for payment of fines and the right to a contested case <br/>
<a id="pl.376.23"></a><var>376.23</var>hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal <br/>
<a id="pl.376.24"></a><var>376.24</var>of an order to pay a fine must be made in writing by certified mail or personal service. If <br/>
<a id="pl.376.25"></a><var>376.25</var>mailed, the appeal must be postmarked and sent to the commissioner within ten calendar <br/>
<a id="pl.376.26"></a><var>376.26</var>days after the license holder receives notice that the fine has been ordered. If a request is <br/>
<a id="pl.376.27"></a><var>376.27</var>made by personal service, it must be received by the commissioner within ten calendar <br/>
<a id="pl.376.28"></a><var>376.28</var>days after the license holder received the order.<br/>
<a id="pl.376.29"></a><var>376.29</var>    (2) The license holder shall pay the fines assessed on or before the payment date <br/>
<a id="pl.376.30"></a><var>376.30</var>specified. If the license holder fails to fully comply with the order, the commissioner <br/>
<a id="pl.376.31"></a><var>376.31</var>may issue a second fine or suspend the license until the license holder complies. If the <br/>
<a id="pl.376.32"></a><var>376.32</var>license holder receives state funds, the state, county, or municipal agencies or departments <br/>
<a id="pl.376.33"></a><var>376.33</var>responsible for administering the funds shall withhold payments and recover any payments <br/>
<a id="pl.376.34"></a><var>376.34</var>made while the license is suspended for failure to pay a fine. A timely appeal shall stay <br/>
<a id="pl.376.35"></a><var>376.35</var>payment of the fine until the commissioner issues a final order.<br/>
<a id="pl.377.1"></a><var>377.1</var>    (3) A license holder shall promptly notify the commissioner of human services, <br/>
<a id="pl.377.2"></a><var>377.2</var>in writing, when a violation specified in the order to forfeit a fine is corrected. If upon <br/>
<a id="pl.377.3"></a><var>377.3</var>reinspection the commissioner determines that a violation has not been corrected as <br/>
<a id="pl.377.4"></a><var>377.4</var>indicated by the order to forfeit a fine, the commissioner may issue a second fine. The <br/>
<a id="pl.377.5"></a><var>377.5</var>commissioner shall notify the license holder by certified mail or personal service that a <br/>
<a id="pl.377.6"></a><var>377.6</var>second fine has been assessed. The license holder may appeal the second fine as provided <br/>
<a id="pl.377.7"></a><var>377.7</var>under this subdivision.<br/>
<a id="pl.377.8"></a><var>377.8</var>    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for <br/>
<a id="pl.377.9"></a><var>377.9</var>each determination of maltreatment of a child under section 
         <statute_ref>626.556</statute_ref> or the maltreatment <br/>
<a id="pl.377.10"></a><var>377.10</var>of a vulnerable adult under section 
         <statute_ref>626.557</statute_ref> for which the license holder is determined <br/>
<a id="pl.377.11"></a><var>377.11</var>responsible for the maltreatment under section 
         <statute_ref>626.556, subdivision 10e</statute_ref>, paragraph (i), <br/>
<a id="pl.377.12"></a><var>377.12</var>or 
         <statute_ref>626.557, subdivision 9c</statute_ref>, paragraph (c); the license holder shall forfeit $200 for each <br/>
<a id="pl.377.13"></a><var>377.13</var>occurrence of a violation of law or rule governing matters of health, safety, or supervision, <br/>
<a id="pl.377.14"></a><var>377.14</var>including but not limited to the provision of adequate staff-to-child or adult ratios, and <br/>
<a id="pl.377.15"></a><var>377.15</var>failure to comply with background study requirements under chapter 245C; and the license <br/>
<a id="pl.377.16"></a><var>377.16</var>holder shall forfeit $100 for each occurrence of a violation of law or rule other than <br/>
<a id="pl.377.17"></a><var>377.17</var>those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence" <br/>
<a id="pl.377.18"></a><var>377.18</var>means each violation identified in the commissioner's fine order. Fines assessed against a <br/>
<a id="pl.377.19"></a><var>377.19</var>license holder that holds a license to provide the residential-based habilitation home and <br/>
<a id="pl.377.20"></a><var>377.20</var>community-based services, as defined under identified in section 
         <statute_ref>245B.02, subdivision <br/>
<a id="pl.377.21"></a><var>377.21</var>20
</statute_ref> 245D.03, subdivision 1, and a community residential setting or day services facility <br/>
<a id="pl.377.22"></a><var>377.22</var>license to provide foster care under chapter 245D where the services are provided, may be <br/>
<a id="pl.377.23"></a><var>377.23</var>assessed against both licenses for the same occurrence, but the combined amount of the <br/>
<a id="pl.377.24"></a><var>377.24</var>fines shall not exceed the amount specified in this clause for that occurrence.<br/>
<a id="pl.377.25"></a><var>377.25</var>    (5) When a fine has been assessed, the license holder may not avoid payment by <br/>
<a id="pl.377.26"></a><var>377.26</var>closing, selling, or otherwise transferring the licensed program to a third party. In such an <br/>
<a id="pl.377.27"></a><var>377.27</var>event, the license holder will be personally liable for payment. In the case of a corporation, <br/>
<a id="pl.377.28"></a><var>377.28</var>each controlling individual is personally and jointly liable for payment.<br/>
<a id="pl.377.29"></a><var>377.29</var>(d) Except for background study violations involving the failure to comply with an <br/>
<a id="pl.377.30"></a><var>377.30</var>order to immediately remove an individual or an order to provide continuous, direct <br/>
<a id="pl.377.31"></a><var>377.31</var>supervision, the commissioner shall not issue a fine under paragraph (c) relating to a <br/>
<a id="pl.377.32"></a><var>377.32</var>background study violation to a license holder who self-corrects a background study <br/>
<a id="pl.377.33"></a><var>377.33</var>violation before the commissioner discovers the violation. A license holder who has <br/>
<a id="pl.377.34"></a><var>377.34</var>previously exercised the provisions of this paragraph to avoid a fine for a background <br/>
<a id="pl.377.35"></a><var>377.35</var>study violation may not avoid a fine for a subsequent background study violation unless at <br/>
<a id="pl.378.1"></a><var>378.1</var>least 365 days have passed since the license holder self-corrected the earlier background <br/>
<a id="pl.378.2"></a><var>378.2</var>study violation.<br/>
<a id="pl.378.3"></a><var>378.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.10.0"></a><a id="pl.378.4"></a><var>378.4</var>    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to <br/>
<a id="pl.378.5"></a><var>378.5</var>read:<br/>
<a id="pl.378.6"></a><var>378.6</var>    Subd. 19c. <b>Personal care.</b> Medical assistance covers personal care assistance <br/>
<a id="pl.378.7"></a><var>378.7</var>services provided by an individual who is qualified to provide the services according to <br/>
<a id="pl.378.8"></a><var>378.8</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.378.9"></a><var>378.9</var>plan, and supervised by a qualified professional.<br/>
<a id="pl.378.10"></a><var>378.10</var>"Qualified professional" means a mental health professional as defined in section <br/>
<statute_ref><a id="pl.378.11"></a><var>378.11</var>245.462, subdivision 18
         </statute_ref>, clauses (1) to (6), or 
         <statute_ref>245.4871, subdivision 27</statute_ref>, clauses (1) to (6); <br/>
<a id="pl.378.12"></a><var>378.12</var>or a registered nurse as defined in sections 
         <statute_ref>148.171</statute_ref> to 
         <statute_ref>148.285</statute_ref>, a licensed social worker <br/>
<a id="pl.378.13"></a><var>378.13</var>as defined in sections 
         <statute_ref>148E.010</statute_ref> and 
         <statute_ref>148E.055</statute_ref>, or a qualified developmental disabilities <br/>
<a id="pl.378.14"></a><var>378.14</var>specialist under section 
<statute_ref>245B.07, subdivision 4</statute_ref> designated coordinator under section <br/>
<a id="pl.378.15"></a><var>378.15</var>245D.081, subdivision 2. The qualified professional shall perform the duties required in <br/>
<a id="pl.378.16"></a><var>378.16</var>section 
         <statute_ref>256B.0659</statute_ref>.<br/>
<a id="pl.378.17"></a><var>378.17</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.11.0"></a><a id="pl.378.18"></a><var>378.18</var>    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:<br/>
<a id="pl.378.19"></a><var>378.19</var>    Subd. 2. <b>Contract provisions.</b> (a) The service contract with each intermediate <br/>
<a id="pl.378.20"></a><var>378.20</var>care facility must include provisions for:<br/>
<a id="pl.378.21"></a><var>378.21</var>(1) modifying payments when significant changes occur in the needs of the <br/>
<a id="pl.378.22"></a><var>378.22</var>consumers;<br/>
<a id="pl.378.23"></a><var>378.23</var>(2) appropriate and necessary statistical information required by the commissioner;<br/>
<a id="pl.378.24"></a><var>378.24</var>(3) annual aggregate facility financial information; and<br/>
<a id="pl.378.25"></a><var>378.25</var>(4) additional requirements for intermediate care facilities not meeting the standards <br/>
<a id="pl.378.26"></a><var>378.26</var>set forth in the service contract.<br/>
<a id="pl.378.27"></a><var>378.27</var>(b) The commissioner of human services and the commissioner of health, in <br/>
<a id="pl.378.28"></a><var>378.28</var>consultation with representatives from counties, advocacy organizations, and the provider <br/>
<a id="pl.378.29"></a><var>378.29</var>community, shall review the consolidated standards under chapter 245B and the home and <br/>
<a id="pl.378.30"></a><var>378.30</var>community-based services standards under chapter 245D and the supervised living facility <br/>
<a id="pl.378.31"></a><var>378.31</var>rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota <br/>
<a id="pl.378.32"></a><var>378.32</var>Rules, chapter 4665, may be waived by the commissioner of health for intermediate care <br/>
<a id="pl.378.33"></a><var>378.33</var>facilities in order to enable facilities to implement the performance measures in their <br/>
<a id="pl.379.1"></a><var>379.1</var>contract and provide quality services to residents without a duplication of or increase in <br/>
<a id="pl.379.2"></a><var>379.2</var>regulatory requirements.<br/>
<a id="pl.379.3"></a><var>379.3</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.12.0"></a><a id="pl.379.4"></a><var>379.4</var>    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:<br/>
<a id="pl.379.5"></a><var>379.5</var>    Subdivision 1. <b>Agreement.</b> Two or more governmental units, by agreement entered <br/>
<a id="pl.379.6"></a><var>379.6</var>into through action of their governing bodies, may jointly or cooperatively exercise <br/>
<a id="pl.379.7"></a><var>379.7</var>any power common to the contracting parties or any similar powers, including those <br/>
<a id="pl.379.8"></a><var>379.8</var>which are the same except for the territorial limits within which they may be exercised. <br/>
<a id="pl.379.9"></a><var>379.9</var>The agreement may provide for the exercise of such powers by one or more of the <br/>
<a id="pl.379.10"></a><var>379.10</var>participating governmental units on behalf of the other participating units. The term <br/>
<a id="pl.379.11"></a><var>379.11</var>"governmental unit" as used in this section includes every city, county, town, school <br/>
<a id="pl.379.12"></a><var>379.12</var>district, independent nonprofit firefighting corporation, other political subdivision of <br/>
<a id="pl.379.13"></a><var>379.13</var>this or another state, another state, federally recognized Indian tribe, the University <br/>
<a id="pl.379.14"></a><var>379.14</var>of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under <br/>
<a id="pl.379.15"></a><var>379.15</var>sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.56</statute_ref>, rehabilitation facilities and extended employment providers <br/>
<a id="pl.379.16"></a><var>379.16</var>that are certified by the commissioner of employment and economic development, day <br/>
<a id="pl.379.17"></a><var>379.17</var>training and habilitation services licensed under sections 
<statute_ref>245B.01</statute_ref> to 
<statute_ref>245B.08</statute_ref>, day and <br/>
<a id="pl.379.18"></a><var>379.18</var>supported employment services licensed under chapter 245D, and any agency of the state <br/>
<a id="pl.379.19"></a><var>379.19</var>of Minnesota or the United States, and includes any instrumentality of a governmental <br/>
<a id="pl.379.20"></a><var>379.20</var>unit. For the purpose of this section, an instrumentality of a governmental unit means an <br/>
<a id="pl.379.21"></a><var>379.21</var>instrumentality having independent policy-making and appropriating authority.<br/>
<a id="pl.379.22"></a><var>379.22</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.13.0"></a><a id="pl.379.23"></a><var>379.23</var>    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:<br/>
<a id="pl.379.24"></a><var>379.24</var>    Subd. 2. <b>Definitions.</b> As used in this section, the following terms have the meanings <br/>
<a id="pl.379.25"></a><var>379.25</var>given them unless the specific content indicates otherwise:<br/>
<a id="pl.379.26"></a><var>379.26</var>    (a) "Family assessment" means a comprehensive assessment of child safety, risk <br/>
<a id="pl.379.27"></a><var>379.27</var>of subsequent child maltreatment, and family strengths and needs that is applied to a <br/>
<a id="pl.379.28"></a><var>379.28</var>child maltreatment report that does not allege substantial child endangerment. Family <br/>
<a id="pl.379.29"></a><var>379.29</var>assessment does not include a determination as to whether child maltreatment occurred <br/>
<a id="pl.379.30"></a><var>379.30</var>but does determine the need for services to address the safety of family members and the <br/>
<a id="pl.379.31"></a><var>379.31</var>risk of subsequent maltreatment.<br/>
<a id="pl.379.32"></a><var>379.32</var>    (b) "Investigation" means fact gathering related to the current safety of a child <br/>
<a id="pl.379.33"></a><var>379.33</var>and the risk of subsequent maltreatment that determines whether child maltreatment <br/>
<a id="pl.380.1"></a><var>380.1</var>occurred and whether child protective services are needed. An investigation must be used <br/>
<a id="pl.380.2"></a><var>380.2</var>when reports involve substantial child endangerment, and for reports of maltreatment in <br/>
<a id="pl.380.3"></a><var>380.3</var>facilities required to be licensed under chapter 245A or 245B; under sections 
         <statute_ref>144.50</statute_ref> to <br/>
<statute_ref><a id="pl.380.4"></a><var>380.4</var>144.58
         </statute_ref> and 
         <statute_ref>241.021</statute_ref>; in a school as defined in sections 
         <statute_ref>120A.05, subdivisions 9</statute_ref>, 11, and <br/>
<a id="pl.380.5"></a><var>380.5</var>13, and 
         <statute_ref>124D.10</statute_ref>; or in a nonlicensed personal care provider association as defined in <br/>
<a id="pl.380.6"></a><var>380.6</var>sections 
         <statute_ref>256B.04, subdivision 16</statute_ref>, and 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>.<br/>
<a id="pl.380.7"></a><var>380.7</var>    (c) "Substantial child endangerment" means a person responsible for a child's care, <br/>
<a id="pl.380.8"></a><var>380.8</var>and in the case of sexual abuse includes a person who has a significant relationship to the <br/>
<a id="pl.380.9"></a><var>380.9</var>child as defined in section 
         <statute_ref>609.341</statute_ref>, or a person in a position of authority as defined in <br/>
<a id="pl.380.10"></a><var>380.10</var>section 
         <statute_ref>609.341</statute_ref>, who by act or omission commits or attempts to commit an act against a <br/>
<a id="pl.380.11"></a><var>380.11</var>child under their care that constitutes any of the following:<br/>
<a id="pl.380.12"></a><var>380.12</var>    (1) egregious harm as defined in section 
         <statute_ref>260C.007, subdivision 14</statute_ref>;<br/>
<a id="pl.380.13"></a><var>380.13</var>    (2) sexual abuse as defined in paragraph (d);<br/>
<a id="pl.380.14"></a><var>380.14</var>    (3) abandonment under section 
         <statute_ref>260C.301, subdivision 2</statute_ref>;<br/>
<a id="pl.380.15"></a><var>380.15</var>    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the <br/>
<a id="pl.380.16"></a><var>380.16</var>child's physical or mental health, including a growth delay, which may be referred to as <br/>
<a id="pl.380.17"></a><var>380.17</var>failure to thrive, that has been diagnosed by a physician and is due to parental neglect;<br/>
<a id="pl.380.18"></a><var>380.18</var>    (5) murder in the first, second, or third degree under section 
         <statute_ref>609.185</statute_ref>, 
         <statute_ref>609.19</statute_ref>, or <br/>
<statute_ref><a id="pl.380.19"></a><var>380.19</var>609.195
         </statute_ref>;<br/>
<a id="pl.380.20"></a><var>380.20</var>    (6) manslaughter in the first or second degree under section 
         <statute_ref>609.20</statute_ref> or 
         <statute_ref>609.205</statute_ref>;<br/>
<a id="pl.380.21"></a><var>380.21</var>    (7) assault in the first, second, or third degree under section 
         <statute_ref>609.221</statute_ref>, 
         <statute_ref>609.222</statute_ref>, or <br/>
<statute_ref><a id="pl.380.22"></a><var>380.22</var>609.223
         </statute_ref>;<br/>
<a id="pl.380.23"></a><var>380.23</var>    (8) solicitation, inducement, and promotion of prostitution under section 
         <statute_ref>609.322</statute_ref>;<br/>
<a id="pl.380.24"></a><var>380.24</var>    (9) criminal sexual conduct under sections 
         <statute_ref>609.342</statute_ref> to 
         <statute_ref>609.3451</statute_ref>;<br/>
<a id="pl.380.25"></a><var>380.25</var>    (10) solicitation of children to engage in sexual conduct under section 
         <statute_ref>609.352</statute_ref>;<br/>
<a id="pl.380.26"></a><var>380.26</var>    (11) malicious punishment or neglect or endangerment of a child under section <br/>
<statute_ref><a id="pl.380.27"></a><var>380.27</var>609.377
         </statute_ref> or 
         <statute_ref>609.378</statute_ref>;<br/>
<a id="pl.380.28"></a><var>380.28</var>    (12) use of a minor in sexual performance under section 
         <statute_ref>617.246</statute_ref>; or<br/>
<a id="pl.380.29"></a><var>380.29</var>    (13) parental behavior, status, or condition which mandates that the county attorney <br/>
<a id="pl.380.30"></a><var>380.30</var>file a termination of parental rights petition under section 
         <statute_ref>260C.301, subdivision 3</statute_ref>, <br/>
<a id="pl.380.31"></a><var>380.31</var>paragraph (a).<br/>
<a id="pl.380.32"></a><var>380.32</var>    (d) "Sexual abuse" means the subjection of a child by a person responsible for the <br/>
<a id="pl.380.33"></a><var>380.33</var>child's care, by a person who has a significant relationship to the child, as defined in <br/>
<a id="pl.380.34"></a><var>380.34</var>section 
         <statute_ref>609.341</statute_ref>, or by a person in a position of authority, as defined in section 
         <statute_ref>609.341</statute_ref>, <br/>
<a id="pl.380.35"></a><var>380.35</var>subdivision 10, to any act which constitutes a violation of section 
         <statute_ref>609.342</statute_ref> (criminal sexual <br/>
<a id="pl.380.36"></a><var>380.36</var>conduct in the first degree), 
         <statute_ref>609.343</statute_ref> (criminal sexual conduct in the second degree), <br/>
<statute_ref><a id="pl.381.1"></a><var>381.1</var>609.344
         </statute_ref> (criminal sexual conduct in the third degree), 
         <statute_ref>609.345</statute_ref> (criminal sexual conduct <br/>
<a id="pl.381.2"></a><var>381.2</var>in the fourth degree), or 
         <statute_ref>609.3451</statute_ref> (criminal sexual conduct in the fifth degree). Sexual <br/>
<a id="pl.381.3"></a><var>381.3</var>abuse also includes any act which involves a minor which constitutes a violation of <br/>
<a id="pl.381.4"></a><var>381.4</var>prostitution offenses under sections 
         <statute_ref>609.321</statute_ref> to 
         <statute_ref>609.324</statute_ref> or 
         <statute_ref>617.246</statute_ref>. Sexual abuse includes <br/>
<a id="pl.381.5"></a><var>381.5</var>threatened sexual abuse which includes the status of a parent or household member <br/>
<a id="pl.381.6"></a><var>381.6</var>who has committed a violation which requires registration as an offender under section <br/>
<a id="pl.381.7"></a><var>381.7</var>243.166, subdivision 1b, paragraph (a) or (b), or required registration under section <br/>
<a id="pl.381.8"></a><var>381.8</var>243.166, subdivision 1b, paragraph (a) or (b).<br/>
<a id="pl.381.9"></a><var>381.9</var>    (e) "Person responsible for the child's care" means (1) an individual functioning <br/>
<a id="pl.381.10"></a><var>381.10</var>within the family unit and having responsibilities for the care of the child such as a <br/>
<a id="pl.381.11"></a><var>381.11</var>parent, guardian, or other person having similar care responsibilities, or (2) an individual <br/>
<a id="pl.381.12"></a><var>381.12</var>functioning outside the family unit and having responsibilities for the care of the child <br/>
<a id="pl.381.13"></a><var>381.13</var>such as a teacher, school administrator, other school employees or agents, or other lawful <br/>
<a id="pl.381.14"></a><var>381.14</var>custodian of a child having either full-time or short-term care responsibilities including, <br/>
<a id="pl.381.15"></a><var>381.15</var>but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, <br/>
<a id="pl.381.16"></a><var>381.16</var>and coaching.<br/>
<a id="pl.381.17"></a><var>381.17</var>    (f) "Neglect" means the commission or omission of any of the acts specified under <br/>
<a id="pl.381.18"></a><var>381.18</var>clauses (1) to (9), other than by accidental means:<br/>
<a id="pl.381.19"></a><var>381.19</var>    (1) failure by a person responsible for a child's care to supply a child with necessary <br/>
<a id="pl.381.20"></a><var>381.20</var>food, clothing, shelter, health, medical, or other care required for the child's physical or <br/>
<a id="pl.381.21"></a><var>381.21</var>mental health when reasonably able to do so;<br/>
<a id="pl.381.22"></a><var>381.22</var>    (2) failure to protect a child from conditions or actions that seriously endanger the <br/>
<a id="pl.381.23"></a><var>381.23</var>child's physical or mental health when reasonably able to do so, including a growth delay, <br/>
<a id="pl.381.24"></a><var>381.24</var>which may be referred to as a failure to thrive, that has been diagnosed by a physician and <br/>
<a id="pl.381.25"></a><var>381.25</var>is due to parental neglect;<br/>
<a id="pl.381.26"></a><var>381.26</var>    (3) failure to provide for necessary supervision or child care arrangements <br/>
<a id="pl.381.27"></a><var>381.27</var>appropriate for a child after considering factors as the child's age, mental ability, physical <br/>
<a id="pl.381.28"></a><var>381.28</var>condition, length of absence, or environment, when the child is unable to care for the <br/>
<a id="pl.381.29"></a><var>381.29</var>child's own basic needs or safety, or the basic needs or safety of another child in their care;<br/>
<a id="pl.381.30"></a><var>381.30</var>    (4) failure to ensure that the child is educated as defined in sections 
         <statute_ref>120A.22</statute_ref> and <br/>
<statute_ref><a id="pl.381.31"></a><var>381.31</var>260C.163, subdivision 11
         </statute_ref>, which does not include a parent's refusal to provide the parent's <br/>
<a id="pl.381.32"></a><var>381.32</var>child with sympathomimetic medications, consistent with section 
         <statute_ref>125A.091, subdivision 5</statute_ref>;<br/>
<a id="pl.381.33"></a><var>381.33</var>    (5) nothing in this section shall be construed to mean that a child is neglected solely <br/>
<a id="pl.381.34"></a><var>381.34</var>because the child's parent, guardian, or other person responsible for the child's care in <br/>
<a id="pl.381.35"></a><var>381.35</var>good faith selects and depends upon spiritual means or prayer for treatment or care of <br/>
<a id="pl.381.36"></a><var>381.36</var>disease or remedial care of the child in lieu of medical care; except that a parent, guardian, <br/>
<a id="pl.382.1"></a><var>382.1</var>or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report <br/>
<a id="pl.382.2"></a><var>382.2</var>if a lack of medical care may cause serious danger to the child's health. This section does <br/>
<a id="pl.382.3"></a><var>382.3</var>not impose upon persons, not otherwise legally responsible for providing a child with <br/>
<a id="pl.382.4"></a><var>382.4</var>necessary food, clothing, shelter, education, or medical care, a duty to provide that care;<br/>
<a id="pl.382.5"></a><var>382.5</var>    (6) prenatal exposure to a controlled substance, as defined in section 
         <statute_ref>253B.02</statute_ref>, <br/>
<a id="pl.382.6"></a><var>382.6</var>subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal <br/>
<a id="pl.382.7"></a><var>382.7</var>symptoms in the child at birth, results of a toxicology test performed on the mother at <br/>
<a id="pl.382.8"></a><var>382.8</var>delivery or the child at birth, medical effects or developmental delays during the child's <br/>
<a id="pl.382.9"></a><var>382.9</var>first year of life that medically indicate prenatal exposure to a controlled substance, or the <br/>
<a id="pl.382.10"></a><var>382.10</var>presence of a fetal alcohol spectrum disorder;<br/>
<a id="pl.382.11"></a><var>382.11</var>    (7) "medical neglect" as defined in section 
         <statute_ref>260C.007, subdivision 6</statute_ref>, clause (5);<br/>
<a id="pl.382.12"></a><var>382.12</var>    (8) chronic and severe use of alcohol or a controlled substance by a parent or <br/>
<a id="pl.382.13"></a><var>382.13</var>person responsible for the care of the child that adversely affects the child's basic needs <br/>
<a id="pl.382.14"></a><var>382.14</var>and safety; or<br/>
<a id="pl.382.15"></a><var>382.15</var>    (9) emotional harm from a pattern of behavior which contributes to impaired <br/>
<a id="pl.382.16"></a><var>382.16</var>emotional functioning of the child which may be demonstrated by a substantial and <br/>
<a id="pl.382.17"></a><var>382.17</var>observable effect in the child's behavior, emotional response, or cognition that is not <br/>
<a id="pl.382.18"></a><var>382.18</var>within the normal range for the child's age and stage of development, with due regard to <br/>
<a id="pl.382.19"></a><var>382.19</var>the child's culture.<br/>
<a id="pl.382.20"></a><var>382.20</var>    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury, <br/>
<a id="pl.382.21"></a><var>382.21</var>inflicted by a person responsible for the child's care on a child other than by accidental <br/>
<a id="pl.382.22"></a><var>382.22</var>means, or any physical or mental injury that cannot reasonably be explained by the child's <br/>
<a id="pl.382.23"></a><var>382.23</var>history of injuries, or any aversive or deprivation procedures, or regulated interventions, <br/>
<a id="pl.382.24"></a><var>382.24</var>that have not been authorized under section 
         <statute_ref>121A.67</statute_ref> or 
         <statute_ref>245.825</statute_ref>.<br/>
<a id="pl.382.25"></a><var>382.25</var>    Abuse does not include reasonable and moderate physical discipline of a child <br/>
<a id="pl.382.26"></a><var>382.26</var>administered by a parent or legal guardian which does not result in an injury. Abuse does <br/>
<a id="pl.382.27"></a><var>382.27</var>not include the use of reasonable force by a teacher, principal, or school employee as <br/>
<a id="pl.382.28"></a><var>382.28</var>allowed by section 
         <statute_ref>121A.582</statute_ref>. Actions which are not reasonable and moderate include, <br/>
<a id="pl.382.29"></a><var>382.29</var>but are not limited to, any of the following that are done in anger or without regard to the <br/>
<a id="pl.382.30"></a><var>382.30</var>safety of the child:<br/>
<a id="pl.382.31"></a><var>382.31</var>    (1) throwing, kicking, burning, biting, or cutting a child;<br/>
<a id="pl.382.32"></a><var>382.32</var>    (2) striking a child with a closed fist;<br/>
<a id="pl.382.33"></a><var>382.33</var>    (3) shaking a child under age three;<br/>
<a id="pl.382.34"></a><var>382.34</var>    (4) striking or other actions which result in any nonaccidental injury to a child <br/>
<a id="pl.382.35"></a><var>382.35</var>under 18 months of age;<br/>
<a id="pl.382.36"></a><var>382.36</var>    (5) unreasonable interference with a child's breathing;<br/>
<a id="pl.383.1"></a><var>383.1</var>    (6) threatening a child with a weapon, as defined in section 
         <statute_ref>609.02, subdivision 6</statute_ref>;<br/>
<a id="pl.383.2"></a><var>383.2</var>    (7) striking a child under age one on the face or head;<br/>
<a id="pl.383.3"></a><var>383.3</var>    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled <br/>
<a id="pl.383.4"></a><var>383.4</var>substances which were not prescribed for the child by a practitioner, in order to control or <br/>
<a id="pl.383.5"></a><var>383.5</var>punish the child; or other substances that substantially affect the child's behavior, motor <br/>
<a id="pl.383.6"></a><var>383.6</var>coordination, or judgment or that results in sickness or internal injury, or subjects the <br/>
<a id="pl.383.7"></a><var>383.7</var>child to medical procedures that would be unnecessary if the child were not exposed <br/>
<a id="pl.383.8"></a><var>383.8</var>to the substances;<br/>
<a id="pl.383.9"></a><var>383.9</var>    (9) unreasonable physical confinement or restraint not permitted under section <br/>
<statute_ref><a id="pl.383.10"></a><var>383.10</var>609.379
         </statute_ref>, including but not limited to tying, caging, or chaining; or<br/>
<a id="pl.383.11"></a><var>383.11</var>    (10) in a school facility or school zone, an act by a person responsible for the child's <br/>
<a id="pl.383.12"></a><var>383.12</var>care that is a violation under section 
         <statute_ref>121A.58</statute_ref>.<br/>
<a id="pl.383.13"></a><var>383.13</var>    (h) "Report" means any report received by the local welfare agency, police <br/>
<a id="pl.383.14"></a><var>383.14</var>department, county sheriff, or agency responsible for assessing or investigating <br/>
<a id="pl.383.15"></a><var>383.15</var>maltreatment pursuant to this section.<br/>
<a id="pl.383.16"></a><var>383.16</var>    (i) "Facility" means:<br/>
<a id="pl.383.17"></a><var>383.17</var>    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital, <br/>
<a id="pl.383.18"></a><var>383.18</var>sanitarium, or other facility or institution required to be licensed under sections 
         <statute_ref>144.50</statute_ref> to <br/>
<statute_ref><a id="pl.383.19"></a><var>383.19</var>144.58
         </statute_ref>, 
         <statute_ref>241.021</statute_ref>, or 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.16</statute_ref>, or chapter 245B 245D;<br/>
<a id="pl.383.20"></a><var>383.20</var>    (2) a school as defined in sections 
         <statute_ref>120A.05, subdivisions 9</statute_ref>, 11, and 13; and <br/>
<statute_ref><a id="pl.383.21"></a><var>383.21</var>124D.10
         </statute_ref>; or<br/>
<a id="pl.383.22"></a><var>383.22</var>    (3) a nonlicensed personal care provider organization as defined in sections 
         <statute_ref>256B.04</statute_ref>, <br/>
<a id="pl.383.23"></a><var>383.23</var>subdivision 16, and 
         <statute_ref>256B.0625, subdivision 19a</statute_ref>.<br/>
<a id="pl.383.24"></a><var>383.24</var>    (j) "Operator" means an operator or agency as defined in section 
         <statute_ref>245A.02</statute_ref>.<br/>
<a id="pl.383.25"></a><var>383.25</var>    (k) "Commissioner" means the commissioner of human services.<br/>
<a id="pl.383.26"></a><var>383.26</var>    (l) "Practice of social services," for the purposes of subdivision 3, includes but is <br/>
<a id="pl.383.27"></a><var>383.27</var>not limited to employee assistance counseling and the provision of guardian ad litem and <br/>
<a id="pl.383.28"></a><var>383.28</var>parenting time expeditor services.<br/>
<a id="pl.383.29"></a><var>383.29</var>    (m) "Mental injury" means an injury to the psychological capacity or emotional <br/>
<a id="pl.383.30"></a><var>383.30</var>stability of a child as evidenced by an observable or substantial impairment in the child's <br/>
<a id="pl.383.31"></a><var>383.31</var>ability to function within a normal range of performance and behavior with due regard to <br/>
<a id="pl.383.32"></a><var>383.32</var>the child's culture.<br/>
<a id="pl.383.33"></a><var>383.33</var>    (n) "Threatened injury" means a statement, overt act, condition, or status that <br/>
<a id="pl.383.34"></a><var>383.34</var>represents a substantial risk of physical or sexual abuse or mental injury. Threatened <br/>
<a id="pl.383.35"></a><var>383.35</var>injury includes, but is not limited to, exposing a child to a person responsible for the <br/>
<a id="pl.383.36"></a><var>383.36</var>child's care, as defined in paragraph (e), clause (1), who has:<br/>
<a id="pl.384.1"></a><var>384.1</var>    (1) subjected a child to, or failed to protect a child from, an overt act or condition <br/>
<a id="pl.384.2"></a><var>384.2</var>that constitutes egregious harm, as defined in section 
         <statute_ref>260C.007, subdivision 14</statute_ref>, or a <br/>
<a id="pl.384.3"></a><var>384.3</var>similar law of another jurisdiction;<br/>
<a id="pl.384.4"></a><var>384.4</var>    (2) been found to be palpably unfit under section 
         <statute_ref>260C.301</statute_ref>, paragraph (b), clause <br/>
<a id="pl.384.5"></a><var>384.5</var>(4), or a similar law of another jurisdiction;<br/>
<a id="pl.384.6"></a><var>384.6</var>    (3) committed an act that has resulted in an involuntary termination of parental rights <br/>
<a id="pl.384.7"></a><var>384.7</var>under section 
         <statute_ref>260C.301</statute_ref>, or a similar law of another jurisdiction; or<br/>
<a id="pl.384.8"></a><var>384.8</var>    (4) committed an act that has resulted in the involuntary transfer of permanent <br/>
<a id="pl.384.9"></a><var>384.9</var>legal and physical custody of a child to a relative under Minnesota Statutes 2010, section <br/>
<statute_ref><a id="pl.384.10"></a><var>384.10</var>260C.201, subdivision 11
         </statute_ref>, paragraph (d), clause (1), section 
         <statute_ref>260C.515, subdivision 4</statute_ref>, or a <br/>
<a id="pl.384.11"></a><var>384.11</var>similar law of another jurisdiction.<br/>
<a id="pl.384.12"></a><var>384.12</var>A child is the subject of a report of threatened injury when the responsible social <br/>
<a id="pl.384.13"></a><var>384.13</var>services agency receives birth match data under paragraph (o) from the Department of <br/>
<a id="pl.384.14"></a><var>384.14</var>Human Services.<br/>
<a id="pl.384.15"></a><var>384.15</var>(o) Upon receiving data under section 
         <statute_ref>144.225, subdivision 2b</statute_ref>, contained in a <br/>
<a id="pl.384.16"></a><var>384.16</var>birth record or recognition of parentage identifying a child who is subject to threatened <br/>
<a id="pl.384.17"></a><var>384.17</var>injury under paragraph (n), the Department of Human Services shall send the data to the <br/>
<a id="pl.384.18"></a><var>384.18</var>responsible social services agency. The data is known as "birth match" data. Unless the <br/>
<a id="pl.384.19"></a><var>384.19</var>responsible social services agency has already begun an investigation or assessment of the <br/>
<a id="pl.384.20"></a><var>384.20</var>report due to the birth of the child or execution of the recognition of parentage and the <br/>
<a id="pl.384.21"></a><var>384.21</var>parent's previous history with child protection, the agency shall accept the birth match <br/>
<a id="pl.384.22"></a><var>384.22</var>data as a report under this section. The agency may use either a family assessment or <br/>
<a id="pl.384.23"></a><var>384.23</var>investigation to determine whether the child is safe. All of the provisions of this section <br/>
<a id="pl.384.24"></a><var>384.24</var>apply. If the child is determined to be safe, the agency shall consult with the county <br/>
<a id="pl.384.25"></a><var>384.25</var>attorney to determine the appropriateness of filing a petition alleging the child is in need <br/>
<a id="pl.384.26"></a><var>384.26</var>of protection or services under section 
         <statute_ref>260C.007, subdivision 6</statute_ref>, clause (16), in order to <br/>
<a id="pl.384.27"></a><var>384.27</var>deliver needed services. If the child is determined not to be safe, the agency and the county <br/>
<a id="pl.384.28"></a><var>384.28</var>attorney shall take appropriate action as required under section 
         <statute_ref>260C.301, subdivision 3</statute_ref>.<br/>
<a id="pl.384.29"></a><var>384.29</var>    (p) Persons who conduct assessments or investigations under this section shall take <br/>
<a id="pl.384.30"></a><var>384.30</var>into account accepted child-rearing practices of the culture in which a child participates <br/>
<a id="pl.384.31"></a><var>384.31</var>and accepted teacher discipline practices, which are not injurious to the child's health, <br/>
<a id="pl.384.32"></a><var>384.32</var>welfare, and safety.<br/>
<a id="pl.384.33"></a><var>384.33</var>    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected <br/>
<a id="pl.384.34"></a><var>384.34</var>occurrence or event which:<br/>
<a id="pl.384.35"></a><var>384.35</var>    (1) is not likely to occur and could not have been prevented by exercise of due <br/>
<a id="pl.384.36"></a><var>384.36</var>care; and<br/>
<a id="pl.385.1"></a><var>385.1</var>    (2) if occurring while a child is receiving services from a facility, happens when the <br/>
<a id="pl.385.2"></a><var>385.2</var>facility and the employee or person providing services in the facility are in compliance <br/>
<a id="pl.385.3"></a><var>385.3</var>with the laws and rules relevant to the occurrence or event.<br/>
<a id="pl.385.4"></a><var>385.4</var>(r) "Nonmaltreatment mistake" means:<br/>
<a id="pl.385.5"></a><var>385.5</var>(1) at the time of the incident, the individual was performing duties identified in the <br/>
<a id="pl.385.6"></a><var>385.6</var>center's child care program plan required under Minnesota Rules, part 9503.0045;<br/>
<a id="pl.385.7"></a><var>385.7</var>(2) the individual has not been determined responsible for a similar incident that <br/>
<a id="pl.385.8"></a><var>385.8</var>resulted in a finding of maltreatment for at least seven years;<br/>
<a id="pl.385.9"></a><var>385.9</var>(3) the individual has not been determined to have committed a similar <br/>
<a id="pl.385.10"></a><var>385.10</var>nonmaltreatment mistake under this paragraph for at least four years;<br/>
<a id="pl.385.11"></a><var>385.11</var>(4) any injury to a child resulting from the incident, if treated, is treated only with <br/>
<a id="pl.385.12"></a><var>385.12</var>remedies that are available over the counter, whether ordered by a medical professional or <br/>
<a id="pl.385.13"></a><var>385.13</var>not; and<br/>
<a id="pl.385.14"></a><var>385.14</var>(5) except for the period when the incident occurred, the facility and the individual <br/>
<a id="pl.385.15"></a><var>385.15</var>providing services were both in compliance with all licensing requirements relevant to the <br/>
<a id="pl.385.16"></a><var>385.16</var>incident.<br/>
<a id="pl.385.17"></a><var>385.17</var>This definition only applies to child care centers licensed under Minnesota <br/>
<a id="pl.385.18"></a><var>385.18</var>Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of <br/>
<a id="pl.385.19"></a><var>385.19</var>substantiated maltreatment by the individual, the commissioner of human services shall <br/>
<a id="pl.385.20"></a><var>385.20</var>determine that a nonmaltreatment mistake was made by the individual.<br/>
<a id="pl.385.21"></a><var>385.21</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.14.0"></a><a id="pl.385.22"></a><var>385.22</var>    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:<br/>
<a id="pl.385.23"></a><var>385.23</var>    Subd. 3. <b>Persons mandated to report.</b> (a) A person who knows or has reason <br/>
<a id="pl.385.24"></a><var>385.24</var>to believe a child is being neglected or physically or sexually abused, as defined in <br/>
<a id="pl.385.25"></a><var>385.25</var>subdivision 2, or has been neglected or physically or sexually abused within the preceding <br/>
<a id="pl.385.26"></a><var>385.26</var>three years, shall immediately report the information to the local welfare agency, agency <br/>
<a id="pl.385.27"></a><var>385.27</var>responsible for assessing or investigating the report, police department, or the county <br/>
<a id="pl.385.28"></a><var>385.28</var>sheriff if the person is:<br/>
<a id="pl.385.29"></a><var>385.29</var>    (1) a professional or professional's delegate who is engaged in the practice of <br/>
<a id="pl.385.30"></a><var>385.30</var>the healing arts, social services, hospital administration, psychological or psychiatric <br/>
<a id="pl.385.31"></a><var>385.31</var>treatment, child care, education, correctional supervision, probation and correctional <br/>
<a id="pl.385.32"></a><var>385.32</var>services, or law enforcement; or<br/>
<a id="pl.385.33"></a><var>385.33</var>    (2) employed as a member of the clergy and received the information while <br/>
<a id="pl.385.34"></a><var>385.34</var>engaged in ministerial duties, provided that a member of the clergy is not required by <br/>
<a id="pl.386.1"></a><var>386.1</var>this subdivision to report information that is otherwise privileged under section 
         <statute_ref>595.02, <br/>
<a id="pl.386.2"></a><var>386.2</var>subdivision 1
         </statute_ref>, paragraph (c).<br/>
<a id="pl.386.3"></a><var>386.3</var>    The police department or the county sheriff, upon receiving a report, shall <br/>
<a id="pl.386.4"></a><var>386.4</var>immediately notify the local welfare agency or agency responsible for assessing or <br/>
<a id="pl.386.5"></a><var>386.5</var>investigating the report, orally and in writing. The local welfare agency, or agency <br/>
<a id="pl.386.6"></a><var>386.6</var>responsible for assessing or investigating the report, upon receiving a report, shall <br/>
<a id="pl.386.7"></a><var>386.7</var>immediately notify the local police department or the county sheriff orally and in writing. <br/>
<a id="pl.386.8"></a><var>386.8</var>The county sheriff and the head of every local welfare agency, agency responsible <br/>
<a id="pl.386.9"></a><var>386.9</var>for assessing or investigating reports, and police department shall each designate a <br/>
<a id="pl.386.10"></a><var>386.10</var>person within their agency, department, or office who is responsible for ensuring that <br/>
<a id="pl.386.11"></a><var>386.11</var>the notification duties of this paragraph and paragraph (b) are carried out. Nothing in <br/>
<a id="pl.386.12"></a><var>386.12</var>this subdivision shall be construed to require more than one report from any institution, <br/>
<a id="pl.386.13"></a><var>386.13</var>facility, school, or agency.<br/>
<a id="pl.386.14"></a><var>386.14</var>    (b) Any person may voluntarily report to the local welfare agency, agency responsible <br/>
<a id="pl.386.15"></a><var>386.15</var>for assessing or investigating the report, police department, or the county sheriff if the <br/>
<a id="pl.386.16"></a><var>386.16</var>person knows, has reason to believe, or suspects a child is being or has been neglected or <br/>
<a id="pl.386.17"></a><var>386.17</var>subjected to physical or sexual abuse. The police department or the county sheriff, upon <br/>
<a id="pl.386.18"></a><var>386.18</var>receiving a report, shall immediately notify the local welfare agency or agency responsible <br/>
<a id="pl.386.19"></a><var>386.19</var>for assessing or investigating the report, orally and in writing. The local welfare agency or <br/>
<a id="pl.386.20"></a><var>386.20</var>agency responsible for assessing or investigating the report, upon receiving a report, shall <br/>
<a id="pl.386.21"></a><var>386.21</var>immediately notify the local police department or the county sheriff orally and in writing.<br/>
<a id="pl.386.22"></a><var>386.22</var>    (c) A person mandated to report physical or sexual child abuse or neglect occurring <br/>
<a id="pl.386.23"></a><var>386.23</var>within a licensed facility shall report the information to the agency responsible for <br/>
<a id="pl.386.24"></a><var>386.24</var>licensing the facility under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.58</statute_ref>; 
         <statute_ref>241.021</statute_ref>; 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.16</statute_ref>; or <br/>
<a id="pl.386.25"></a><var>386.25</var>chapter 245B 245D; or a nonlicensed personal care provider organization as defined in <br/>
<a id="pl.386.26"></a><var>386.26</var>sections 
         <statute_ref>256B.04, subdivision 16</statute_ref>; and 
         <statute_ref>256B.0625, subdivision 19</statute_ref>. A health or corrections <br/>
<a id="pl.386.27"></a><var>386.27</var>agency receiving a report may request the local welfare agency to provide assistance <br/>
<a id="pl.386.28"></a><var>386.28</var>pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees <br/>
<a id="pl.386.29"></a><var>386.29</var>perform work within a school facility, upon receiving a complaint of alleged maltreatment, <br/>
<a id="pl.386.30"></a><var>386.30</var>shall provide information about the circumstances of the alleged maltreatment to the <br/>
<a id="pl.386.31"></a><var>386.31</var>commissioner of education. Section 
         <statute_ref>13.03, subdivision 4</statute_ref>, applies to data received by the <br/>
<a id="pl.386.32"></a><var>386.32</var>commissioner of education from a licensing entity.<br/>
<a id="pl.386.33"></a><var>386.33</var>    (d) Any person mandated to report shall receive a summary of the disposition of <br/>
<a id="pl.386.34"></a><var>386.34</var>any report made by that reporter, including whether the case has been opened for child <br/>
<a id="pl.386.35"></a><var>386.35</var>protection or other services, or if a referral has been made to a community organization, <br/>
<a id="pl.386.36"></a><var>386.36</var>unless release would be detrimental to the best interests of the child. Any person who is <br/>
<a id="pl.387.1"></a><var>387.1</var>not mandated to report shall, upon request to the local welfare agency, receive a concise <br/>
<a id="pl.387.2"></a><var>387.2</var>summary of the disposition of any report made by that reporter, unless release would be <br/>
<a id="pl.387.3"></a><var>387.3</var>detrimental to the best interests of the child.<br/>
<a id="pl.387.4"></a><var>387.4</var>    (e) For purposes of this section, "immediately" means as soon as possible but in <br/>
<a id="pl.387.5"></a><var>387.5</var>no event longer than 24 hours.<br/>
<a id="pl.387.6"></a><var>387.6</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.15.0"></a><a id="pl.387.7"></a><var>387.7</var>    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:<br/>
<a id="pl.387.8"></a><var>387.8</var>    Subd. 10d. <b>Notification of neglect or abuse in facility.</b> (a) When a report is <br/>
<a id="pl.387.9"></a><var>387.9</var>received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while <br/>
<a id="pl.387.10"></a><var>387.10</var>in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital, <br/>
<a id="pl.387.11"></a><var>387.11</var>sanitarium, or other facility or institution required to be licensed according to sections <br/>
<statute_ref><a id="pl.387.12"></a><var>387.12</var>144.50
         </statute_ref> to 
         <statute_ref>144.58</statute_ref>; 
         <statute_ref>241.021</statute_ref>; or 
         <statute_ref>245A.01</statute_ref> to 
         <statute_ref>245A.16</statute_ref>; or chapter 245B 245D, or a school as <br/>
<a id="pl.387.13"></a><var>387.13</var>defined in sections 
         <statute_ref>120A.05, subdivisions 9, 11, and 13</statute_ref>; and 
         <statute_ref>124D.10</statute_ref>; or a nonlicensed <br/>
<a id="pl.387.14"></a><var>387.14</var>personal care provider organization as defined in section 
         <statute_ref>256B.04, subdivision 16</statute_ref>, and <br/>
<statute_ref><a id="pl.387.15"></a><var>387.15</var>256B.0625, subdivision 19a
         </statute_ref>, the commissioner of the agency responsible for assessing <br/>
<a id="pl.387.16"></a><var>387.16</var>or investigating the report or local welfare agency investigating the report shall provide <br/>
<a id="pl.387.17"></a><var>387.17</var>the following information to the parent, guardian, or legal custodian of a child alleged to <br/>
<a id="pl.387.18"></a><var>387.18</var>have been neglected, physically abused, sexually abused, or the victim of maltreatment <br/>
<a id="pl.387.19"></a><var>387.19</var>of a child in the facility: the name of the facility; the fact that a report alleging neglect, <br/>
<a id="pl.387.20"></a><var>387.20</var>physical abuse, sexual abuse, or maltreatment of a child in the facility has been received; <br/>
<a id="pl.387.21"></a><var>387.21</var>the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child <br/>
<a id="pl.387.22"></a><var>387.22</var>in the facility; that the agency is conducting an assessment or investigation; any protective <br/>
<a id="pl.387.23"></a><var>387.23</var>or corrective measures being taken pending the outcome of the investigation; and that a <br/>
<a id="pl.387.24"></a><var>387.24</var>written memorandum will be provided when the investigation is completed.<br/>
<a id="pl.387.25"></a><var>387.25</var>(b) The commissioner of the agency responsible for assessing or investigating the <br/>
<a id="pl.387.26"></a><var>387.26</var>report or local welfare agency may also provide the information in paragraph (a) to the <br/>
<a id="pl.387.27"></a><var>387.27</var>parent, guardian, or legal custodian of any other child in the facility if the investigative <br/>
<a id="pl.387.28"></a><var>387.28</var>agency knows or has reason to believe the alleged neglect, physical abuse, sexual <br/>
<a id="pl.387.29"></a><var>387.29</var>abuse, or maltreatment of a child in the facility has occurred. In determining whether <br/>
<a id="pl.387.30"></a><var>387.30</var>to exercise this authority, the commissioner of the agency responsible for assessing <br/>
<a id="pl.387.31"></a><var>387.31</var>or investigating the report or local welfare agency shall consider the seriousness of the <br/>
<a id="pl.387.32"></a><var>387.32</var>alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the <br/>
<a id="pl.387.33"></a><var>387.33</var>number of children allegedly neglected, physically abused, sexually abused, or victims of <br/>
<a id="pl.387.34"></a><var>387.34</var>maltreatment of a child in the facility; the number of alleged perpetrators; and the length <br/>
<a id="pl.387.35"></a><var>387.35</var>of the investigation. The facility shall be notified whenever this discretion is exercised.<br/>
<a id="pl.388.1"></a><var>388.1</var>(c) When the commissioner of the agency responsible for assessing or investigating <br/>
<a id="pl.388.2"></a><var>388.2</var>the report or local welfare agency has completed its investigation, every parent, guardian, <br/>
<a id="pl.388.3"></a><var>388.3</var>or legal custodian previously notified of the investigation by the commissioner or <br/>
<a id="pl.388.4"></a><var>388.4</var>local welfare agency shall be provided with the following information in a written <br/>
<a id="pl.388.5"></a><var>388.5</var>memorandum: the name of the facility investigated; the nature of the alleged neglect, <br/>
<a id="pl.388.6"></a><var>388.6</var>physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's <br/>
<a id="pl.388.7"></a><var>388.7</var>name; a summary of the investigation findings; a statement whether maltreatment was <br/>
<a id="pl.388.8"></a><var>388.8</var>found; and the protective or corrective measures that are being or will be taken. The <br/>
<a id="pl.388.9"></a><var>388.9</var>memorandum shall be written in a manner that protects the identity of the reporter and <br/>
<a id="pl.388.10"></a><var>388.10</var>the child and shall not contain the name, or to the extent possible, reveal the identity of <br/>
<a id="pl.388.11"></a><var>388.11</var>the alleged perpetrator or of those interviewed during the investigation. If maltreatment <br/>
<a id="pl.388.12"></a><var>388.12</var>is determined to exist, the commissioner or local welfare agency shall also provide the <br/>
<a id="pl.388.13"></a><var>388.13</var>written memorandum to the parent, guardian, or legal custodian of each child in the facility <br/>
<a id="pl.388.14"></a><var>388.14</var>who had contact with the individual responsible for the maltreatment. When the facility is <br/>
<a id="pl.388.15"></a><var>388.15</var>the responsible party for maltreatment, the commissioner or local welfare agency shall also <br/>
<a id="pl.388.16"></a><var>388.16</var>provide the written memorandum to the parent, guardian, or legal custodian of each child <br/>
<a id="pl.388.17"></a><var>388.17</var>who received services in the population of the facility where the maltreatment occurred. <br/>
<a id="pl.388.18"></a><var>388.18</var>This notification must be provided to the parent, guardian, or legal custodian of each child <br/>
<a id="pl.388.19"></a><var>388.19</var>receiving services from the time the maltreatment occurred until either the individual <br/>
<a id="pl.388.20"></a><var>388.20</var>responsible for maltreatment is no longer in contact with a child or children in the facility <br/>
<a id="pl.388.21"></a><var>388.21</var>or the conclusion of the investigation. In the case of maltreatment within a school facility, <br/>
<a id="pl.388.22"></a><var>388.22</var>as defined in sections 
         <statute_ref>120A.05, subdivisions 9, 11, and 13</statute_ref>, and 
         <statute_ref>124D.10</statute_ref>, the commissioner <br/>
<a id="pl.388.23"></a><var>388.23</var>of education need not provide notification to parents, guardians, or legal custodians of <br/>
<a id="pl.388.24"></a><var>388.24</var>each child in the facility, but shall, within ten days after the investigation is completed, <br/>
<a id="pl.388.25"></a><var>388.25</var>provide written notification to the parent, guardian, or legal custodian of any student <br/>
<a id="pl.388.26"></a><var>388.26</var>alleged to have been maltreated. The commissioner of education may notify the parent, <br/>
<a id="pl.388.27"></a><var>388.27</var>guardian, or legal custodian of any student involved as a witness to alleged maltreatment.<br/>
<a id="pl.388.28"></a><var>388.28</var><b>EFFECTIVE DATE.</b>This section is effective January 1, 2014.<br/>
<br/>
<a id="bill.9.16.0"></a><a id="pl.388.29"></a><var>388.29</var>    Sec. 16. <b> REPEALER.</b><br/>
<a id="pl.388.30"></a><var>388.30</var>Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective <br/>
<a id="pl.388.31"></a><var>388.31</var>January 1, 2014.<br/>
<br/>
<a id="bill.10.0.0"></a>

<a id="bill.10.1.0"></a><a id="pl.389.3"></a><var>389.3</var>    Section 1. Minnesota Statutes 2012, section 13.411, subdivision 7, is amended to read:<br/>
<a id="pl.389.4"></a><var>389.4</var>    Subd. 7. <b>Examining and licensing boards.</b> (a) <b>Health licensing boards.</b> Data <br/>
<a id="pl.389.5"></a><var>389.5</var>held by health licensing boards are classified under sections 
         <statute_ref>214.10, subdivision 8</statute_ref>, and <br/>
<statute_ref><a id="pl.389.6"></a><var>389.6</var>214.25, subdivision 1
         </statute_ref>.<br/>
<a id="pl.389.7"></a><var>389.7</var>(b) <b>Combined boards data.</b> Data held by licensing boards participating in a health <br/>
<a id="pl.389.8"></a><var>389.8</var>professional services program are classified under sections 
         <statute_ref>214.34</statute_ref> and 
         <statute_ref>214.35</statute_ref>.<br/>
<a id="pl.389.9"></a><var>389.9</var>(c)<b> Criminal background checks.</b> Criminal history record information obtained by <br/>
<a id="pl.389.10"></a><var>389.10</var>a health-related licensing board is classified under section 214.075, subdivision 7.<br/>
<br/>
<a id="bill.10.2.0"></a><a id="pl.389.11"></a><var>389.11</var>    Sec. 2. Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:<br/>
<a id="pl.389.12"></a><var>389.12</var>    Subd. 2. <b>Licensure and application fees.</b> Nonrefundable licensure and application <br/>
<a id="pl.389.13"></a><var>389.13</var>fees charged established by the board are as follows shall not exceed the following amounts:<br/>
<a id="pl.389.14"></a><var>389.14</var>(1) application fee for national examination is $220 $110;<br/>
<a id="pl.389.15"></a><var>389.15</var>(2) application fee for Licensed Marriage and Family Therapist (LMFT) state <br/>
<a id="pl.389.16"></a><var>389.16</var>examination is $110;<br/>
<a id="pl.389.17"></a><var>389.17</var>(3) initial LMFT license fee is prorated, but cannot exceed $125;<br/>
<a id="pl.389.18"></a><var>389.18</var>(4) annual renewal fee for LMFT license is $125;<br/>
<a id="pl.389.19"></a><var>389.19</var>(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT<br/>
<a id="pl.389.20"></a><var>389.20</var> LMFT license renewal is $50;<br/>
<a id="pl.389.21"></a><var>389.21</var>(6) application fee for LMFT licensure by reciprocity is $340 $220;<br/>
<a id="pl.389.22"></a><var>389.22</var>(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) <br/>
<a id="pl.389.23"></a><var>389.23</var>license is $75;<br/>
<a id="pl.389.24"></a><var>389.24</var>(8) annual renewal fee for LAMFT license is $75;<br/>
<a id="pl.389.25"></a><var>389.25</var>(9) late fee for LAMFT renewal is $50 $25;<br/>
<a id="pl.389.26"></a><var>389.26</var>(10) fee for reinstatement of license is $150; and<br/>
<a id="pl.389.27"></a><var>389.27</var>(11) fee for emeritus status is $125.<br/>
<br/>
<a id="bill.10.3.0"></a><a id="pl.389.28"></a><var>389.28</var>    Sec. 3. Minnesota Statutes 2012, section 151.01, subdivision 27, is amended to read:<br/>
<a id="pl.389.29"></a><var>389.29</var>    Subd. 27. <b>Practice of pharmacy.</b> "Practice of pharmacy" means:<br/>
<a id="pl.389.30"></a><var>389.30</var>    (1) interpretation and evaluation of prescription drug orders;<br/>
<a id="pl.389.31"></a><var>389.31</var>    (2) compounding, labeling, and dispensing drugs and devices (except labeling by <br/>
<a id="pl.389.32"></a><var>389.32</var>a manufacturer or packager of nonprescription drugs or commercially packaged legend <br/>
<a id="pl.389.33"></a><var>389.33</var>drugs and devices);<br/>
<a id="pl.390.1"></a><var>390.1</var>    (3) participation in clinical interpretations and monitoring of drug therapy for <br/>
<a id="pl.390.2"></a><var>390.2</var>assurance of safe and effective use of drugs;<br/>
<a id="pl.390.3"></a><var>390.3</var>    (4) participation in drug and therapeutic device selection; drug administration for first <br/>
<a id="pl.390.4"></a><var>390.4</var>dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;<br/>
<a id="pl.390.5"></a><var>390.5</var>    (5) participation in administration of influenza vaccines to all eligible individuals ten <br/>
<a id="pl.390.6"></a><var>390.6</var>years of age and older and all other vaccines to patients 18 years of age and older under <br/>
<a id="pl.390.7"></a><var>390.7</var>standing orders from a physician licensed under chapter 147 or by written protocol with a <br/>
<a id="pl.390.8"></a><var>390.8</var>physician licensed under chapter 147 provided that:<br/>
<a id="pl.390.9"></a><var>390.9</var>    (i) the standing orders or protocol include, at a minimum, the name, dosage, and <br/>
<a id="pl.390.10"></a><var>390.10</var>route of each vaccine that may be given, the patient population to whom the vaccine may <br/>
<a id="pl.390.11"></a><var>390.11</var>be given, contraindications and precautions to the vaccine, the procedure for handling an <br/>
<a id="pl.390.12"></a><var>390.12</var>adverse reaction, the name and signature of the physician, the address of the physician, a <br/>
<a id="pl.390.13"></a><var>390.13</var>phone number at which the physician can be contacted, and the date and time period for <br/>
<a id="pl.390.14"></a><var>390.14</var>which the standing orders or protocol are valid;<br/>
<a id="pl.390.15"></a><var>390.15</var>    (i) (ii) the pharmacist is trained in has successfully completed a program approved <br/>
<a id="pl.390.16"></a><var>390.16</var>by the American Accreditation Council of Pharmaceutical for Pharmacy Education, <br/>
<a id="pl.390.17"></a><var>390.17</var>specifically for the administration of immunizations, or graduated from a college of <br/>
<a id="pl.390.18"></a><var>390.18</var>pharmacy in 2001 or thereafter; and a program approved according to rules adopted by <br/>
<a id="pl.390.19"></a><var>390.19</var>the board;<br/>
<a id="pl.390.20"></a><var>390.20</var>    (iii) the pharmacist completes continuing education concerning the administration of <br/>
<a id="pl.390.21"></a><var>390.21</var>immunizations, as required by Minnesota Rules;<br/>
<a id="pl.390.22"></a><var>390.22</var>    (iv) the pharmacist has a current cardiopulmonary resuscitation certificate;<br/>
<a id="pl.390.23"></a><var>390.23</var>    (ii) (v) the pharmacist reports the administration of the immunization to the patient's <br/>
<a id="pl.390.24"></a><var>390.24</var>primary physician or clinic or to the Minnesota Immunization Information Connection;<br/>
<a id="pl.390.25"></a><var>390.25</var>    (vi) the pharmacist complies with guidelines for vaccines and immunizations <br/>
<a id="pl.390.26"></a><var>390.26</var>established by the federal Advisory Committee on Immunization Practices (ACIP), except <br/>
<a id="pl.390.27"></a><var>390.27</var>that a pharmacist does not need to comply with those guidelines if administering a vaccine <br/>
<a id="pl.390.28"></a><var>390.28</var>pursuant to a valid, patient-specific order issued by a physician licensed under chapter 147 <br/>
<a id="pl.390.29"></a><var>390.29</var>when the order is consistent with United States Food and Drug Administration-approved <br/>
<a id="pl.390.30"></a><var>390.30</var>labeling of the vaccine; and<br/>
<a id="pl.390.31"></a><var>390.31</var>    (vii) the pharmacist complies with Centers for Disease Control and Prevention <br/>
<a id="pl.390.32"></a><var>390.32</var>guidelines relating to immunization schedules, vaccine storage and handling, and vaccine <br/>
<a id="pl.390.33"></a><var>390.33</var>administration and documentation;<br/>
<a id="pl.390.34"></a><var>390.34</var>    (6) participation in the practice of managing drug therapy and modifying drug <br/>
<a id="pl.390.35"></a><var>390.35</var>therapy, according to section 
<statute_ref>151.21, subdivision 1</statute_ref>, according to a written protocol <br/>
<a id="pl.390.36"></a><var>390.36</var>between the specific pharmacist and the individual dentist, optometrist, physician, <br/>
<a id="pl.391.1"></a><var>391.1</var>podiatrist, or veterinarian who is responsible for the patient's care and authorized to <br/>
<a id="pl.391.2"></a><var>391.2</var>independently prescribe drugs. Any significant changes in drug therapy must be reported <br/>
<a id="pl.391.3"></a><var>391.3</var>by the pharmacist to the patient's medical record;<br/>
<a id="pl.391.4"></a><var>391.4</var>    (7) participation in the storage of drugs and the maintenance of records;<br/>
<a id="pl.391.5"></a><var>391.5</var>    (8) responsibility for participation in patient counseling on therapeutic values, <br/>
<a id="pl.391.6"></a><var>391.6</var>content, hazards, and uses of drugs and devices; and<br/>
<a id="pl.391.7"></a><var>391.7</var>    (9) offering or performing those acts, services, operations, or transactions necessary <br/>
<a id="pl.391.8"></a><var>391.8</var>in the conduct, operation, management, and control of a pharmacy.<br/>
<br/>
<a id="bill.10.4.0"></a><a id="pl.391.9"></a><var>391.9</var>    Sec. 4. Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:<br/>
<a id="pl.391.10"></a><var>391.10</var>    Subdivision 1. <b>Pharmacy </b><b>registration</b><b> licensure requirements</b><b>.</b> The board shall <br/>
<a id="pl.391.11"></a><var>391.11</var>require and provide for the annual registration of every pharmacy now or hereafter doing <br/>
<a id="pl.391.12"></a><var>391.12</var>business within this state. Upon the payment of any applicable fee specified in section <br/>
<a id="pl.391.13"></a><var>391.13</var><statute_ref>151.065</statute_ref>, the board shall issue a registration certificate in such form as it may prescribe to <br/>
<a id="pl.391.14"></a><var>391.14</var>such persons as may be qualified by law to conduct a pharmacy. Such certificate shall <br/>
<a id="pl.391.15"></a><var>391.15</var>be displayed in a conspicuous place in the pharmacy for which it is issued and expire on <br/>
<a id="pl.391.16"></a><var>391.16</var>the 30th day of June following the date of issue. It shall be unlawful for any person to <br/>
<a id="pl.391.17"></a><var>391.17</var>conduct a pharmacy unless such certificate has been issued to the person by the board. (a) <br/>
<a id="pl.391.18"></a><var>391.18</var>No person shall operate a pharmacy without first obtaining a license from the board and <br/>
<a id="pl.391.19"></a><var>391.19</var>paying any applicable fee specified in section 151.065. The license shall be displayed in a <br/>
<a id="pl.391.20"></a><var>391.20</var>conspicuous place in the pharmacy for which it is issued and expires on June 30 following <br/>
<a id="pl.391.21"></a><var>391.21</var>the date of issue. It is unlawful for any person to operate a pharmacy unless the license <br/>
<a id="pl.391.22"></a><var>391.22</var>has been issued to the person by the board.<br/>
<a id="pl.391.23"></a><var>391.23</var>    (b) Application for a pharmacy license under this section shall be made in a manner <br/>
<a id="pl.391.24"></a><var>391.24</var>specified by the board.<br/>
<a id="pl.391.25"></a><var>391.25</var>    (c) No license shall be issued or renewed for a pharmacy located within the state <br/>
<a id="pl.391.26"></a><var>391.26</var>unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and <br/>
<a id="pl.391.27"></a><var>391.27</var>state law and according to rules adopted by the board. No license shall be issued for a <br/>
<a id="pl.391.28"></a><var>391.28</var>pharmacy located outside of the state unless the applicant agrees to operate the pharmacy <br/>
<a id="pl.391.29"></a><var>391.29</var>in a manner prescribed by federal law and, when dispensing medications for residents of <br/>
<a id="pl.391.30"></a><var>391.30</var>this state, the laws of this state, and Minnesota Rules.<br/>
<a id="pl.391.31"></a><var>391.31</var>    (d) No license shall be issued or renewed for a pharmacy that is required to be <br/>
<a id="pl.391.32"></a><var>391.32</var>licensed or registered by the state in which it is physically located unless the applicant <br/>
<a id="pl.391.33"></a><var>391.33</var>supplies the board with proof of such licensure or registration.<br/>
<a id="pl.392.1"></a><var>392.1</var>    (e) The board shall require a separate license for each pharmacy located within <br/>
<a id="pl.392.2"></a><var>392.2</var>the state and for each pharmacy located outside of the state at which any portion of the <br/>
<a id="pl.392.3"></a><var>392.3</var>dispensing process occurs for drugs dispensed to residents of this state.<br/>
<a id="pl.392.4"></a><var>392.4</var>    (f) The board shall not issue an initial or renewed license for a pharmacy unless the <br/>
<a id="pl.392.5"></a><var>392.5</var>pharmacy passes an inspection conducted by an authorized representative of the board. In <br/>
<a id="pl.392.6"></a><var>392.6</var>the case of a pharmacy located outside of the state, the board may require the applicant to <br/>
<a id="pl.392.7"></a><var>392.7</var>pay the cost of the inspection, in addition to the license fee in section 151.065, unless the <br/>
<a id="pl.392.8"></a><var>392.8</var>applicant furnishes the board with a report, issued by the appropriate regulatory agency of <br/>
<a id="pl.392.9"></a><var>392.9</var>the state in which the facility is located, of an inspection that has occurred within the 24 <br/>
<a id="pl.392.10"></a><var>392.10</var>months immediately preceding receipt of the license application by the board. The board <br/>
<a id="pl.392.11"></a><var>392.11</var>may deny licensure unless the applicant submits documentation satisfactory to the board <br/>
<a id="pl.392.12"></a><var>392.12</var>that any deficiencies noted in an inspection report have been corrected.<br/>
<a id="pl.392.13"></a><var>392.13</var>    (g) The board shall not issue an initial or renewed license for a pharmacy located <br/>
<a id="pl.392.14"></a><var>392.14</var>outside of the state unless the applicant discloses and certifies:<br/>
<a id="pl.392.15"></a><var>392.15</var>    (1) the location, names, and titles of all principal corporate officers and all <br/>
<a id="pl.392.16"></a><var>392.16</var>pharmacists who are involved in dispensing drugs to residents of this state;<br/>
<a id="pl.392.17"></a><var>392.17</var>    (2) that it maintains its records of drugs dispensed to residents of this state so that the <br/>
<a id="pl.392.18"></a><var>392.18</var>records are readily retrievable from the records of other drugs dispensed;<br/>
<a id="pl.392.19"></a><var>392.19</var>    (3) that it agrees to cooperate with, and provide information to, the board concerning <br/>
<a id="pl.392.20"></a><var>392.20</var>matters related to dispensing drugs to residents of this state;<br/>
<a id="pl.392.21"></a><var>392.21</var>    (4) that, during its regular hours of operation, but no less than six days per week, for <br/>
<a id="pl.392.22"></a><var>392.22</var>a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate <br/>
<a id="pl.392.23"></a><var>392.23</var>communication between patients in this state and a pharmacist at the pharmacy who has <br/>
<a id="pl.392.24"></a><var>392.24</var>access to the patients' records; the toll-free number must be disclosed on the label affixed <br/>
<a id="pl.392.25"></a><var>392.25</var>to each container of drugs dispensed to residents of this state; and<br/>
<a id="pl.392.26"></a><var>392.26</var>    (5) that, upon request of a resident of a long-term care facility located in this <br/>
<a id="pl.392.27"></a><var>392.27</var>state, the resident's authorized representative, or a contract pharmacy or licensed health <br/>
<a id="pl.392.28"></a><var>392.28</var>care facility acting on behalf of the resident, the pharmacy will dispense medications <br/>
<a id="pl.392.29"></a><var>392.29</var>prescribed for the resident in unit-dose packaging or, alternatively, comply with section <br/>
<a id="pl.392.30"></a><var>392.30</var>151.415, subdivision 5.<br/>
<br/>
<a id="bill.10.5.0"></a><a id="pl.392.31"></a><var>392.31</var>    Sec. 5. Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:<br/>
<a id="pl.392.32"></a><var>392.32</var>    Subd. 3. <b>Sale of federally restricted medical gases.</b> The board shall require and <br/>
<a id="pl.392.33"></a><var>392.33</var>provide for the annual registration of every person or establishment not licensed as a <br/>
<a id="pl.392.34"></a><var>392.34</var>pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted <br/>
<a id="pl.392.35"></a><var>392.35</var>medical gases. Upon the payment of any applicable fee specified in section 
<statute_ref>151.065</statute_ref>, the <br/>
<a id="pl.393.1"></a><var>393.1</var>board shall issue a registration certificate in such form as it may prescribe to those persons <br/>
<a id="pl.393.2"></a><var>393.2</var>or places that may be qualified to sell or distribute federally restricted medical gases. The <br/>
<a id="pl.393.3"></a><var>393.3</var>certificate shall be displayed in a conspicuous place in the business for which it is issued <br/>
<a id="pl.393.4"></a><var>393.4</var>and expire on the date set by the board. It is unlawful for a person to sell or distribute <br/>
<a id="pl.393.5"></a><var>393.5</var>federally restricted medical gases unless a certificate has been issued to that person by the <br/>
<a id="pl.393.6"></a><var>393.6</var>board. (a) A person or establishment not licensed as a pharmacy or a practitioner shall not <br/>
<a id="pl.393.7"></a><var>393.7</var>engage in the retail sale or distribution of federally restricted medical gases without first <br/>
<a id="pl.393.8"></a><var>393.8</var>obtaining a registration from the board and paying the applicable fee specified in section <br/>
<a id="pl.393.9"></a><var>393.9</var>151.065. The registration shall be displayed in a conspicuous place in the business for <br/>
<a id="pl.393.10"></a><var>393.10</var>which it is issued and expires on the date set by the board. It is unlawful for a person to <br/>
<a id="pl.393.11"></a><var>393.11</var>sell or distribute federally restricted medical gases unless a certificate has been issued to <br/>
<a id="pl.393.12"></a><var>393.12</var>that person by the board.<br/>
<a id="pl.393.13"></a><var>393.13</var>    (b) Application for a medical gas distributor registration under this section shall be <br/>
<a id="pl.393.14"></a><var>393.14</var>made in a manner specified by the board.<br/>
<a id="pl.393.15"></a><var>393.15</var>    (c) No registration shall be issued or renewed for a medical gas distributor located <br/>
<a id="pl.393.16"></a><var>393.16</var>within the state unless the applicant agrees to operate in a manner prescribed by federal <br/>
<a id="pl.393.17"></a><var>393.17</var>and state law and according to the rules adopted by the board. No license shall be issued <br/>
<a id="pl.393.18"></a><var>393.18</var>for a medical gas distributor located outside of the state unless the applicant agrees to <br/>
<a id="pl.393.19"></a><var>393.19</var>operate in a manner prescribed by federal law and, when distributing medical gases for <br/>
<a id="pl.393.20"></a><var>393.20</var>residents of this state, the laws of this state and Minnesota Rules.<br/>
<a id="pl.393.21"></a><var>393.21</var>    (d) No registration shall be issued or renewed for a medical gas distributor that is <br/>
<a id="pl.393.22"></a><var>393.22</var>required to be licensed or registered by the state in which it is physically located unless the <br/>
<a id="pl.393.23"></a><var>393.23</var>applicant supplies the board with proof of the licensure or registration. The board may, by <br/>
<a id="pl.393.24"></a><var>393.24</var>rule, establish standards for the registration of a medical gas distributor that is not required <br/>
<a id="pl.393.25"></a><var>393.25</var>to be licensed or registered by the state in which it is physically located.<br/>
<a id="pl.393.26"></a><var>393.26</var>    (e) The board shall require a separate registration for each medical gas distributor <br/>
<a id="pl.393.27"></a><var>393.27</var>located within the state and for each facility located outside of the state from which <br/>
<a id="pl.393.28"></a><var>393.28</var>medical gases are distributed to residents of this state.<br/>
<a id="pl.393.29"></a><var>393.29</var>    (f) The board shall not issue an initial or renewed registration for a medical gas <br/>
<a id="pl.393.30"></a><var>393.30</var>distributor unless the medical gas distributor passes an inspection conducted by an <br/>
<a id="pl.393.31"></a><var>393.31</var>authorized representative of the board. In the case of a medical gas distributor located <br/>
<a id="pl.393.32"></a><var>393.32</var>outside of the state, the board may require the applicant to pay the cost of the inspection, <br/>
<a id="pl.393.33"></a><var>393.33</var>in addition to the license fee in section 151.065, unless the applicant furnishes the board <br/>
<a id="pl.393.34"></a><var>393.34</var>with a report, issued by the appropriate regulatory agency of the state in which the facility <br/>
<a id="pl.393.35"></a><var>393.35</var>is located, of an inspection that has occurred within the 24 months immediately preceding <br/>
<a id="pl.393.36"></a><var>393.36</var>receipt of the license application by the board. The board may deny licensure unless the <br/>
<a id="pl.394.1"></a><var>394.1</var>applicant submits documentation satisfactory to the board that any deficiencies noted in <br/>
<a id="pl.394.2"></a><var>394.2</var>an inspection report have been corrected.<br/>
<br/>
<a id="bill.10.6.0"></a><a id="pl.394.3"></a><var>394.3</var>    Sec. 6. <b>[151.252] LICENSING OF DRUG MANUFACTURERS; FEES; </b><br/>
<a id="pl.394.4"></a><var>394.4</var><b>PROHIBITIONS.</b><br/>
<a id="pl.394.5"></a><var>394.5</var>    Subdivision 1. <b>Requirements.</b> (a) No person shall act as a manufacturer without <br/>
<a id="pl.394.6"></a><var>394.6</var>first obtaining a license from the board and paying any applicable fee specified in section <br/>
<a id="pl.394.7"></a><var>394.7</var>151.065.<br/>
<a id="pl.394.8"></a><var>394.8</var>    (b) Application for a manufacturer license under this section shall be made in a <br/>
<a id="pl.394.9"></a><var>394.9</var>manner specified by the board.<br/>
<a id="pl.394.10"></a><var>394.10</var>    (c) No license shall be issued or renewed for a manufacturer unless the applicant <br/>
<a id="pl.394.11"></a><var>394.11</var>agrees to operate in a manner prescribed by federal and state law and according to <br/>
<a id="pl.394.12"></a><var>394.12</var>Minnesota Rules.<br/>
<a id="pl.394.13"></a><var>394.13</var>    (d) No license shall be issued or renewed for a manufacturer that is required to <br/>
<a id="pl.394.14"></a><var>394.14</var>be registered pursuant to United State Code, title 21, section 360, unless the applicant <br/>
<a id="pl.394.15"></a><var>394.15</var>supplies the board with proof of registration. The board may establish by rule the <br/>
<a id="pl.394.16"></a><var>394.16</var>standards for licensure of manufacturers that are not required to be registered under United <br/>
<a id="pl.394.17"></a><var>394.17</var>States Code, title 21, section 360.<br/>
<a id="pl.394.18"></a><var>394.18</var>    (e) No license shall be issued or renewed for a manufacturer that is required to be <br/>
<a id="pl.394.19"></a><var>394.19</var>licensed or registered by the state in which it is physically located unless the applicant <br/>
<a id="pl.394.20"></a><var>394.20</var>supplies the board with proof of licensure or registration. The board may establish, by <br/>
<a id="pl.394.21"></a><var>394.21</var>rule, standards for the licensure of a manufacturer that is not required to be licensed or <br/>
<a id="pl.394.22"></a><var>394.22</var>registered by the state in which it is physically located.<br/>
<a id="pl.394.23"></a><var>394.23</var>    (f) The board shall require a separate license for each facility located within the state <br/>
<a id="pl.394.24"></a><var>394.24</var>at which manufacturing occurs and for each facility located outside of the state at which <br/>
<a id="pl.394.25"></a><var>394.25</var>drugs that are shipped into the state are manufactured.<br/>
<a id="pl.394.26"></a><var>394.26</var>    (g) The board shall not issue an initial or renewed license for a manufacturing <br/>
<a id="pl.394.27"></a><var>394.27</var>facility unless the facility passes an inspection conducted by an authorized representative <br/>
<a id="pl.394.28"></a><var>394.28</var>of the board. In the case of a manufacturing facility located outside of the state, the board <br/>
<a id="pl.394.29"></a><var>394.29</var>may require the applicant to pay the cost of the inspection, in addition to the license fee <br/>
<a id="pl.394.30"></a><var>394.30</var>in section 151.065, unless the applicant furnishes the board with a report, issued by the <br/>
<a id="pl.394.31"></a><var>394.31</var>appropriate regulatory agency of the state in which the facility is located or by the United <br/>
<a id="pl.394.32"></a><var>394.32</var>States Food and Drug Administration, of an inspection that has occurred within the 24 <br/>
<a id="pl.394.33"></a><var>394.33</var>months immediately preceding receipt of the license application by the board. The board <br/>
<a id="pl.394.34"></a><var>394.34</var>may deny licensure unless the applicant submits documentation satisfactory to the board <br/>
<a id="pl.394.35"></a><var>394.35</var>that any deficiencies noted in an inspection report have been corrected.<br/>
<a id="pl.395.1"></a><var>395.1</var>    Subd. 2. <b>Prohibition.</b> It is unlawful for any person engaged in manufacturing to sell <br/>
<a id="pl.395.2"></a><var>395.2</var>legend drugs to anyone located in this state except as provided in this chapter.<br/>
<br/>
<a id="bill.10.7.0"></a><a id="pl.395.3"></a><var>395.3</var>    Sec. 7. Minnesota Statutes 2012, section 151.26, subdivision 1, is amended to read:<br/>
<a id="pl.395.4"></a><var>395.4</var>    Subdivision 1. <b>Generally.</b> Nothing in this chapter shall subject a person duly <br/>
<a id="pl.395.5"></a><var>395.5</var>licensed in this state to practice medicine, dentistry, or veterinary medicine, to inspection <br/>
<a id="pl.395.6"></a><var>395.6</var>by the State Board of Pharmacy, nor prevent the person from administering drugs, <br/>
<a id="pl.395.7"></a><var>395.7</var>medicines, chemicals, or poisons in the person's practice, nor prevent a duly licensed <br/>
<a id="pl.395.8"></a><var>395.8</var>practitioner from furnishing to a patient properly packaged and labeled drugs, medicines, <br/>
<a id="pl.395.9"></a><var>395.9</var>chemicals, or poisons as may be considered appropriate in the treatment of such patient; <br/>
<a id="pl.395.10"></a><var>395.10</var>unless the person is engaged in the dispensing, sale, or distribution of drugs and the board <br/>
<a id="pl.395.11"></a><var>395.11</var>provides reasonable notice of an inspection.<br/>
<a id="pl.395.12"></a><var>395.12</var>    Except for the provisions of section 
         <statute_ref>151.37</statute_ref>, nothing in this chapter applies to or <br/>
<a id="pl.395.13"></a><var>395.13</var>interferes with the dispensing, in its original package and at no charge to the patient, of <br/>
<a id="pl.395.14"></a><var>395.14</var>a legend drug, other than a controlled substance, that was packaged by a manufacturer <br/>
<a id="pl.395.15"></a><var>395.15</var>and provided to the dispenser for distribution dispensing as a professional sample, so <br/>
<a id="pl.395.16"></a><var>395.16</var>long as the sample is prepared and distributed pursuant to Code of Federal Regulations, <br/>
<a id="pl.395.17"></a><var>395.17</var>title 21, section 203, subpart D.<br/>
<a id="pl.395.18"></a><var>395.18</var>    Nothing in this chapter shall prevent the sale of drugs, medicines, chemicals, or <br/>
<a id="pl.395.19"></a><var>395.19</var>poisons at wholesale to licensed physicians, dentists and veterinarians for use in their <br/>
<a id="pl.395.20"></a><var>395.20</var>practice, nor to hospitals for use therein.<br/>
<a id="pl.395.21"></a><var>395.21</var>    Nothing in this chapter shall prevent the sale of drugs, chemicals, or poisons either <br/>
<a id="pl.395.22"></a><var>395.22</var>at wholesale or retail for use for commercial purposes, or in the arts, nor interfere with the <br/>
<a id="pl.395.23"></a><var>395.23</var>sale of insecticides, as defined in Minnesota Statutes 1974, section 
         <statute_ref>24.069</statute_ref>, and nothing in <br/>
<a id="pl.395.24"></a><var>395.24</var>this chapter shall prevent the sale of common household preparations and other drugs, <br/>
<a id="pl.395.25"></a><var>395.25</var>chemicals, and poisons sold exclusively for use for nonmedicinal purposes.<br/>
<a id="pl.395.26"></a><var>395.26</var>    Nothing in this chapter shall apply to or interfere with the vending or retailing <br/>
<a id="pl.395.27"></a><var>395.27</var>of any nonprescription medicine or drug not otherwise prohibited by statute which is <br/>
<a id="pl.395.28"></a><var>395.28</var>prepackaged, fully prepared by the manufacturer or producer for use by the consumer, and <br/>
<a id="pl.395.29"></a><var>395.29</var>labeled in accordance with the requirements of the state or federal Food and Drug Act; nor <br/>
<a id="pl.395.30"></a><var>395.30</var>to the manufacture, wholesaling, vending, or retailing of flavoring extracts, toilet articles, <br/>
<a id="pl.395.31"></a><var>395.31</var>cosmetics, perfumes, spices, and other commonly used household articles of a chemical <br/>
<a id="pl.395.32"></a><var>395.32</var>nature, for use for nonmedicinal purposes. Nothing in this chapter shall prevent the sale of <br/>
<a id="pl.395.33"></a><var>395.33</var>drugs or medicines by licensed pharmacists at a discount to persons over 65 years of age.<br/>
<br/>
<a id="bill.10.8.0"></a><a id="pl.395.34"></a><var>395.34</var>    Sec. 8. Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:<br/>
<a id="pl.396.1"></a><var>396.1</var>    Subd. 4. <b>Research.</b> (a) Any qualified person may use legend drugs in the course <br/>
<a id="pl.396.2"></a><var>396.2</var>of a bona fide research project, but cannot administer or dispense such drugs to human <br/>
<a id="pl.396.3"></a><var>396.3</var>beings unless such drugs are prescribed, dispensed, and administered by a person lawfully <br/>
<a id="pl.396.4"></a><var>396.4</var>authorized to do so.<br/>
<a id="pl.396.5"></a><var>396.5</var>    (b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for <br/>
<a id="pl.396.6"></a><var>396.6</var>use by, or administration to, patients enrolled in a bona fide research study that is being <br/>
<a id="pl.396.7"></a><var>396.7</var>conducted pursuant to either an investigational new drug application approved by the <br/>
<a id="pl.396.8"></a><var>396.8</var>United States Food and Drug Administration or that has been approved by an institutional <br/>
<a id="pl.396.9"></a><var>396.9</var>review board. For the purposes of this subdivision only:<br/>
<a id="pl.396.10"></a><var>396.10</var>    (1) a prescription drug order is not required for a pharmacy to dispense a research <br/>
<a id="pl.396.11"></a><var>396.11</var>drug, unless the study protocol requires the pharmacy to receive such an order;<br/>
<a id="pl.396.12"></a><var>396.12</var>    (2) notwithstanding the prescription labeling requirements found in this chapter or <br/>
<a id="pl.396.13"></a><var>396.13</var>the rules promulgated by the board, a research drug may be labeled as required by the <br/>
<a id="pl.396.14"></a><var>396.14</var>study protocol; and<br/>
<a id="pl.396.15"></a><var>396.15</var>    (3) dispensing and distribution of research drugs by pharmacies shall not be <br/>
<a id="pl.396.16"></a><var>396.16</var>considered compounding, manufacturing, or wholesaling under this chapter.<br/>
<a id="pl.396.17"></a><var>396.17</var>    (c) An entity that is under contract to a federal agency for the purpose of distributing <br/>
<a id="pl.396.18"></a><var>396.18</var>drugs for bona fide research studies is exempt from the drug wholesaler licensing <br/>
<a id="pl.396.19"></a><var>396.19</var>requirements of this chapter. Any other entity is exempt from the drug wholesaler <br/>
<a id="pl.396.20"></a><var>396.20</var>licensing requirements of this chapter if the board finds that the entity is licensed or <br/>
<a id="pl.396.21"></a><var>396.21</var>registered according to the laws of the state in which it is physically located and it is <br/>
<a id="pl.396.22"></a><var>396.22</var>distributing drugs for use by, or administration to, patients enrolled in a bona fide research <br/>
<a id="pl.396.23"></a><var>396.23</var>study that is being conducted pursuant to either an investigational new drug application <br/>
<a id="pl.396.24"></a><var>396.24</var>approved by the United States Food and Drug Administration or that has been approved <br/>
<a id="pl.396.25"></a><var>396.25</var>by an institutional review board.<br/>
<a id="pl.396.26"></a><var>396.26</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.10.9.0"></a><a id="pl.396.27"></a><var>396.27</var>    Sec. 9. Minnesota Statutes 2012, section 151.47, subdivision 1, is amended to read:<br/>
<a id="pl.396.28"></a><var>396.28</var>    Subdivision 1. <b>Requirements.</b> (a) All wholesale drug distributors are subject to the <br/>
<a id="pl.396.29"></a><var>396.29</var>requirements in paragraphs (a) to (f) of this subdivision.<br/>
<a id="pl.396.30"></a><var>396.30</var>    (a) (b) No person or distribution outlet shall act as a wholesale drug distributor <br/>
<a id="pl.396.31"></a><var>396.31</var>without first obtaining a license from the board and paying any applicable fee specified <br/>
<a id="pl.396.32"></a><var>396.32</var>in section 
         <statute_ref>151.065</statute_ref>.<br/>
<a id="pl.396.33"></a><var>396.33</var>    (c) Application for a wholesale drug distributor license under this section shall be <br/>
<a id="pl.396.34"></a><var>396.34</var>made in a manner specified by the board.<br/>
<a id="pl.397.1"></a><var>397.1</var>    (b) (d) No license shall be issued or renewed for a wholesale drug distributor to <br/>
<a id="pl.397.2"></a><var>397.2</var>operate unless the applicant agrees to operate in a manner prescribed by federal and state <br/>
<a id="pl.397.3"></a><var>397.3</var>law and according to the rules adopted by the board.<br/>
<a id="pl.397.4"></a><var>397.4</var>    (c) The board may require a separate license for each facility directly or indirectly <br/>
<a id="pl.397.5"></a><var>397.5</var>owned or operated by the same business entity within the state, or for a parent entity <br/>
<a id="pl.397.6"></a><var>397.6</var>with divisions, subsidiaries, or affiliate companies within the state, when operations <br/>
<a id="pl.397.7"></a><var>397.7</var>are conducted at more than one location and joint ownership and control exists among <br/>
<a id="pl.397.8"></a><var>397.8</var>all the entities.<br/>
<a id="pl.397.9"></a><var>397.9</var>    (e) No license may be issued or renewed for a drug wholesale distributor that is <br/>
<a id="pl.397.10"></a><var>397.10</var>required to be licensed or registered by the state in which it is physically located unless <br/>
<a id="pl.397.11"></a><var>397.11</var>the applicant supplies the board with proof of licensure or registration. The board may <br/>
<a id="pl.397.12"></a><var>397.12</var>establish, by rule, standards for the licensure of a drug wholesale distributor that is not <br/>
<a id="pl.397.13"></a><var>397.13</var>required to be licensed or registered by the state in which it is physically located.<br/>
<a id="pl.397.14"></a><var>397.14</var>    (f) The board shall require a separate license for each drug wholesale distributor <br/>
<a id="pl.397.15"></a><var>397.15</var>facility located within the state and for each drug wholesale distributor facility located <br/>
<a id="pl.397.16"></a><var>397.16</var>outside of the state from which drugs are shipped into the state or to which drugs are <br/>
<a id="pl.397.17"></a><var>397.17</var>reverse distributed.<br/>
<a id="pl.397.18"></a><var>397.18</var>    (g) The board shall not issue an initial or renewed license for a drug wholesale <br/>
<a id="pl.397.19"></a><var>397.19</var>distributor facility unless the facility passes an inspection conducted by an authorized <br/>
<a id="pl.397.20"></a><var>397.20</var>representative of the board. In the case of a drug wholesale distributor facility located <br/>
<a id="pl.397.21"></a><var>397.21</var>outside of the state, the board may require the applicant to pay the cost of the inspection, <br/>
<a id="pl.397.22"></a><var>397.22</var>in addition to the license fee in section 151.065, unless the applicant furnishes the board <br/>
<a id="pl.397.23"></a><var>397.23</var>with a report, issued by the appropriate regulatory agency of the state in which the facility <br/>
<a id="pl.397.24"></a><var>397.24</var>is located, of an inspection that has occurred within the 24 months immediately preceding <br/>
<a id="pl.397.25"></a><var>397.25</var>receipt of the license application by the board.  The board may deny licensure unless the <br/>
<a id="pl.397.26"></a><var>397.26</var>applicant submits documentation satisfactory to the board that any deficiencies noted in <br/>
<a id="pl.397.27"></a><var>397.27</var>an inspection report have been corrected.<br/>
<a id="pl.397.28"></a><var>397.28</var>    (d) (h) As a condition for receiving and retaining a wholesale drug distributor license <br/>
<a id="pl.397.29"></a><var>397.29</var>issued under sections 
         <statute_ref>151.42</statute_ref> to 
         <statute_ref>151.51</statute_ref>, an applicant shall satisfy the board that it has <br/>
<a id="pl.397.30"></a><var>397.30</var>and will continuously maintain:<br/>
<a id="pl.397.31"></a><var>397.31</var>    (1) adequate storage conditions and facilities;<br/>
<a id="pl.397.32"></a><var>397.32</var>    (2) minimum liability and other insurance as may be required under any applicable <br/>
<a id="pl.397.33"></a><var>397.33</var>federal or state law;<br/>
<a id="pl.397.34"></a><var>397.34</var>    (3) a viable security system that includes an after hours central alarm, or comparable <br/>
<a id="pl.397.35"></a><var>397.35</var>entry detection capability; restricted access to the premises; comprehensive employment <br/>
<a id="pl.397.36"></a><var>397.36</var>applicant screening; and safeguards against all forms of employee theft;<br/>
<a id="pl.398.1"></a><var>398.1</var>    (4) a system of records describing all wholesale drug distributor activities set forth <br/>
<a id="pl.398.2"></a><var>398.2</var>in section 
         <statute_ref>151.44</statute_ref> for at least the most recent two-year period, which shall be reasonably <br/>
<a id="pl.398.3"></a><var>398.3</var>accessible as defined by board regulations in any inspection authorized by the board;<br/>
<a id="pl.398.4"></a><var>398.4</var>    (5) principals and persons, including officers, directors, primary shareholders, <br/>
<a id="pl.398.5"></a><var>398.5</var>and key management executives, who must at all times demonstrate and maintain their <br/>
<a id="pl.398.6"></a><var>398.6</var>capability of conducting business in conformity with sound financial practices as well <br/>
<a id="pl.398.7"></a><var>398.7</var>as state and federal law;<br/>
<a id="pl.398.8"></a><var>398.8</var>    (6) complete, updated information, to be provided to the board as a condition for <br/>
<a id="pl.398.9"></a><var>398.9</var>obtaining and retaining a license, about each wholesale drug distributor to be licensed, <br/>
<a id="pl.398.10"></a><var>398.10</var>including all pertinent corporate licensee information, if applicable, or other ownership, <br/>
<a id="pl.398.11"></a><var>398.11</var>principal, key personnel, and facilities information found to be necessary by the board;<br/>
<a id="pl.398.12"></a><var>398.12</var>    (7) written policies and procedures that assure reasonable wholesale drug distributor <br/>
<a id="pl.398.13"></a><var>398.13</var>preparation for, protection against, and handling of any facility security or operation <br/>
<a id="pl.398.14"></a><var>398.14</var>problems, including, but not limited to, those caused by natural disaster or government <br/>
<a id="pl.398.15"></a><var>398.15</var>emergency, inventory inaccuracies or product shipping and receiving, outdated product <br/>
<a id="pl.398.16"></a><var>398.16</var>or other unauthorized product control, appropriate disposition of returned goods, and <br/>
<a id="pl.398.17"></a><var>398.17</var>product recalls;<br/>
<a id="pl.398.18"></a><var>398.18</var>    (8) sufficient inspection procedures for all incoming and outgoing product <br/>
<a id="pl.398.19"></a><var>398.19</var>shipments; and<br/>
<a id="pl.398.20"></a><var>398.20</var>    (9) operations in compliance with all federal requirements applicable to wholesale <br/>
<a id="pl.398.21"></a><var>398.21</var>drug distribution.<br/>
<a id="pl.398.22"></a><var>398.22</var>    (e) (i)  An agent or employee of any licensed wholesale drug distributor need not <br/>
<a id="pl.398.23"></a><var>398.23</var>seek licensure under this section.<br/>
<a id="pl.398.24"></a><var>398.24</var>    (f) A wholesale drug distributor shall file with the board an annual report, in a <br/>
<a id="pl.398.25"></a><var>398.25</var>form and on the date prescribed by the board, identifying all payments, honoraria, <br/>
<a id="pl.398.26"></a><var>398.26</var>reimbursement or other compensation authorized under section 
<statute_ref>151.461</statute_ref>, clauses (3) to <br/>
<a id="pl.398.27"></a><var>398.27</var>(5), paid to practitioners in Minnesota during the preceding calendar year. The report <br/>
<a id="pl.398.28"></a><var>398.28</var>shall identify the nature and value of any payments totaling $100 or more, to a particular <br/>
<a id="pl.398.29"></a><var>398.29</var>practitioner during the year, and shall identify the practitioner. Reports filed under this <br/>
<a id="pl.398.30"></a><var>398.30</var>provision are public data.<br/>
<br/>
<a id="bill.10.10.0"></a><a id="pl.398.31"></a><var>398.31</var>    Sec. 10. Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision <br/>
<a id="pl.398.32"></a><var>398.32</var>to read:<br/>
<a id="pl.398.33"></a><var>398.33</var>    Subd. 3. <b>Prohibition.</b> It is unlawful for any person engaged in wholesale drug <br/>
<a id="pl.398.34"></a><var>398.34</var>distribution to sell drugs to a person located within the state or to receive drugs in reverse <br/>
<a id="pl.398.35"></a><var>398.35</var>distribution from a person located within the state except as provided in this chapter.<br/>
<br/>
<a id="bill.10.11.0"></a><a id="pl.399.1"></a><var>399.1</var>    Sec. 11. Minnesota Statutes 2012, section 151.49, is amended to read:<br/>
<a id="pl.399.2"></a><var>399.2</var><b>151.49 LICENSE RENEWAL APPLICATION PROCEDURES.</b><br/>
<a id="pl.399.3"></a><var>399.3</var>    Application blanks or notices for renewal of a license required by sections 
         <statute_ref>151.42</statute_ref> <br/>
<a id="pl.399.4"></a><var>399.4</var>to 
         <statute_ref>151.51</statute_ref> shall be mailed or otherwise provided to each licensee on or before the first <br/>
<a id="pl.399.5"></a><var>399.5</var>day of the month prior to the month in which the license expires and, if application for <br/>
<a id="pl.399.6"></a><var>399.6</var>renewal of the license with the required fee and supporting documents is not made before <br/>
<a id="pl.399.7"></a><var>399.7</var>the expiration date, the existing license or renewal shall lapse and become null and void <br/>
<a id="pl.399.8"></a><var>399.8</var>upon the date of expiration.<br/>
<br/>
<a id="bill.10.12.0"></a><a id="pl.399.9"></a><var>399.9</var>    Sec. 12. Minnesota Statutes 2012, section 152.126, is amended to read:<br/>
<a id="pl.399.10"></a><var>399.10</var><b>152.126 </b><b>CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC </b><br/>
<a id="pl.399.11"></a><var>399.11</var><b>REPORTING SYSTEM</b><b> PRESCRIPTION MONITORING PROGRAM</b><b>.</b><br/>
<a id="pl.399.12"></a><var>399.12</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the terms defined in <br/>
<a id="pl.399.13"></a><var>399.13</var>this subdivision have the meanings given.<br/>
<a id="pl.399.14"></a><var>399.14</var>    (a) (b) "Board" means the Minnesota State Board of Pharmacy established under <br/>
<a id="pl.399.15"></a><var>399.15</var>chapter 151.<br/>
<a id="pl.399.16"></a><var>399.16</var>    (b) (c) "Controlled substances" means those substances listed in section 
         <statute_ref>152.02</statute_ref>, <br/>
<a id="pl.399.17"></a><var>399.17</var>subdivisions 3 to 5 6, and those substances defined by the board pursuant to section <br/>
<statute_ref><a id="pl.399.18"></a><var>399.18</var>152.02, subdivisions 7
         </statute_ref>, 8, and 12. For the purpose of this section only, "controlled <br/>
<a id="pl.399.19"></a><var>399.19</var>substances" includes tramadol and butalbital.<br/>
<a id="pl.399.20"></a><var>399.20</var>    (c) (d) "Dispense" or "dispensing" has the meaning given in section 
         <statute_ref>151.01, <br/>
<a id="pl.399.21"></a><var>399.21</var>subdivision 30
         </statute_ref>. Dispensing does not include the direct administering of a controlled <br/>
<a id="pl.399.22"></a><var>399.22</var>substance to a patient by a licensed health care professional.<br/>
<a id="pl.399.23"></a><var>399.23</var>    (d) (e) "Dispenser" means a person authorized by law to dispense a controlled <br/>
<a id="pl.399.24"></a><var>399.24</var>substance, pursuant to a valid prescription. For the purposes of this section, a dispenser does <br/>
<a id="pl.399.25"></a><var>399.25</var>not include a licensed hospital pharmacy that distributes controlled substances for inpatient <br/>
<a id="pl.399.26"></a><var>399.26</var>hospital care or a veterinarian who is dispensing prescriptions under section 
         <statute_ref>156.18</statute_ref>.<br/>
<a id="pl.399.27"></a><var>399.27</var>    (e) (f) "Prescriber" means a licensed health care professional who is authorized to <br/>
<a id="pl.399.28"></a><var>399.28</var>prescribe a controlled substance under section 
         <statute_ref>152.12, subdivision 1</statute_ref>.<br/>
<a id="pl.399.29"></a><var>399.29</var>    (f) (g) "Prescription" has the meaning given in section 
         <statute_ref>151.01, subdivision 16</statute_ref>.<br/>
<a id="pl.399.30"></a><var>399.30</var>    Subd. 1a. <b>Treatment of intractable pain.</b> This section is not intended to limit or <br/>
<a id="pl.399.31"></a><var>399.31</var>interfere with the legitimate prescribing of controlled substances for pain. No prescriber <br/>
<a id="pl.399.32"></a><var>399.32</var>shall be subject to disciplinary action by a health-related licensing board for prescribing a <br/>
<a id="pl.399.33"></a><var>399.33</var>controlled substance according to the provisions of section 
         <statute_ref>152.125</statute_ref>.<br/>
<a id="pl.400.1"></a><var>400.1</var>    Subd. 2. <b>Prescription electronic reporting system.</b> (a) The board shall establish <br/>
<a id="pl.400.2"></a><var>400.2</var>by January 1, 2010, an electronic system for reporting the information required under <br/>
<a id="pl.400.3"></a><var>400.3</var>subdivision 4 for all controlled substances dispensed within the state.<br/>
<a id="pl.400.4"></a><var>400.4</var>    (b) The board may contract with a vendor for the purpose of obtaining technical <br/>
<a id="pl.400.5"></a><var>400.5</var>assistance in the design, implementation, operation, and maintenance of the electronic <br/>
<a id="pl.400.6"></a><var>400.6</var>reporting system.<br/>
<a id="pl.400.7"></a><var>400.7</var>    Subd. 3. <b>Prescription </b><b>Electronic Reporting</b><b> Monitoring Program</b><b> Advisory </b><br/>
<a id="pl.400.8"></a><var>400.8</var><b>Committee.</b> (a) The board shall convene an advisory committee. The committee must <br/>
<a id="pl.400.9"></a><var>400.9</var>include at least one representative of:<br/>
<a id="pl.400.10"></a><var>400.10</var>    (1) the Department of Health;<br/>
<a id="pl.400.11"></a><var>400.11</var>    (2) the Department of Human Services;<br/>
<a id="pl.400.12"></a><var>400.12</var>    (3) each health-related licensing board that licenses prescribers;<br/>
<a id="pl.400.13"></a><var>400.13</var>    (4) a professional medical association, which may include an association of pain <br/>
<a id="pl.400.14"></a><var>400.14</var>management and chemical dependency specialists;<br/>
<a id="pl.400.15"></a><var>400.15</var>    (5) a professional pharmacy association;<br/>
<a id="pl.400.16"></a><var>400.16</var>    (6) a professional nursing association;<br/>
<a id="pl.400.17"></a><var>400.17</var>    (7) a professional dental association;<br/>
<a id="pl.400.18"></a><var>400.18</var>    (8) a consumer privacy or security advocate; and<br/>
<a id="pl.400.19"></a><var>400.19</var>    (9) a consumer or patient rights organization; and<br/>
<a id="pl.400.20"></a><var>400.20</var>    (10) an association of medical examiners and coroners.<br/>
<a id="pl.400.21"></a><var>400.21</var>    (b) The advisory committee shall advise the board on the development and operation <br/>
<a id="pl.400.22"></a><var>400.22</var>of the electronic reporting system prescription monitoring program, including, but not <br/>
<a id="pl.400.23"></a><var>400.23</var>limited to:<br/>
<a id="pl.400.24"></a><var>400.24</var>    (1) technical standards for electronic prescription drug reporting;<br/>
<a id="pl.400.25"></a><var>400.25</var>    (2) proper analysis and interpretation of prescription monitoring data; and<br/>
<a id="pl.400.26"></a><var>400.26</var>    (3) an evaluation process for the program.<br/>
<a id="pl.400.27"></a><var>400.27</var>    Subd. 4. <b>Reporting requirements; notice.</b> (a) Each dispenser must submit the <br/>
<a id="pl.400.28"></a><var>400.28</var>following data to the board or its designated vendor, subject to the notice required under <br/>
<a id="pl.400.29"></a><var>400.29</var>paragraph (d):<br/>
<a id="pl.400.30"></a><var>400.30</var>    (1) name of the prescriber;<br/>
<a id="pl.400.31"></a><var>400.31</var>    (2) national provider identifier of the prescriber;<br/>
<a id="pl.400.32"></a><var>400.32</var>    (3) name of the dispenser;<br/>
<a id="pl.400.33"></a><var>400.33</var>    (4) national provider identifier of the dispenser;<br/>
<a id="pl.400.34"></a><var>400.34</var>    (5) prescription number;<br/>
<a id="pl.400.35"></a><var>400.35</var>    (6) name of the patient for whom the prescription was written;<br/>
<a id="pl.400.36"></a><var>400.36</var>    (7) address of the patient for whom the prescription was written;<br/>
<a id="pl.401.1"></a><var>401.1</var>    (8) date of birth of the patient for whom the prescription was written;<br/>
<a id="pl.401.2"></a><var>401.2</var>    (9) date the prescription was written;<br/>
<a id="pl.401.3"></a><var>401.3</var>    (10) date the prescription was filled;<br/>
<a id="pl.401.4"></a><var>401.4</var>    (11) name and strength of the controlled substance;<br/>
<a id="pl.401.5"></a><var>401.5</var>    (12) quantity of controlled substance prescribed;<br/>
<a id="pl.401.6"></a><var>401.6</var>    (13) quantity of controlled substance dispensed; and<br/>
<a id="pl.401.7"></a><var>401.7</var>    (14) number of days supply.<br/>
<a id="pl.401.8"></a><var>401.8</var>    (b) The dispenser must submit the required information by a procedure and in a <br/>
<a id="pl.401.9"></a><var>401.9</var>format established by the board. The board may allow dispensers to omit data listed in this <br/>
<a id="pl.401.10"></a><var>401.10</var>subdivision or may require the submission of data not listed in this subdivision provided <br/>
<a id="pl.401.11"></a><var>401.11</var>the omission or submission is necessary for the purpose of complying with the electronic <br/>
<a id="pl.401.12"></a><var>401.12</var>reporting or data transmission standards of the American Society for Automation in <br/>
<a id="pl.401.13"></a><var>401.13</var>Pharmacy, the National Council on Prescription Drug Programs, or other relevant national <br/>
<a id="pl.401.14"></a><var>401.14</var>standard-setting body.<br/>
<a id="pl.401.15"></a><var>401.15</var>    (c) A dispenser is not required to submit this data for those controlled substance <br/>
<a id="pl.401.16"></a><var>401.16</var>prescriptions dispensed for:<br/>
<a id="pl.401.17"></a><var>401.17</var>    (1) individuals residing in licensed skilled nursing or intermediate care facilities;<br/>
<a id="pl.401.18"></a><var>401.18</var>    (2) individuals receiving assisted living services under chapter 144G or through a <br/>
<a id="pl.401.19"></a><var>401.19</var>medical assistance home and community-based waiver;<br/>
<a id="pl.401.20"></a><var>401.20</var>    (3) individuals receiving medication intravenously;<br/>
<a id="pl.401.21"></a><var>401.21</var>    (4) individuals receiving hospice and other palliative or end-of-life care; and<br/>
<a id="pl.401.22"></a><var>401.22</var>    (5) individuals receiving services from a home care provider regulated under <br/>
<a id="pl.401.23"></a><var>401.23</var>chapter 144A. individuals residing in a health care facility as defined in section 151.58, <br/>
<a id="pl.401.24"></a><var>401.24</var>subdivision 2, paragraph (b), when a drug is distributed through the use of an automated <br/>
<a id="pl.401.25"></a><var>401.25</var>drug distribution system according to section 151.58; and<br/>
<a id="pl.401.26"></a><var>401.26</var>    (2) individuals receiving a drug sample that was packaged by a manufacturer and <br/>
<a id="pl.401.27"></a><var>401.27</var>provided to the dispenser for dispensing as a professional sample pursuant to Code of <br/>
<a id="pl.401.28"></a><var>401.28</var>Federal Regulations, title 21, section 203, subpart D.<br/>
<a id="pl.401.29"></a><var>401.29</var>    (d) A dispenser must not submit data under this subdivision unless provide a <br/>
<a id="pl.401.30"></a><var>401.30</var>conspicuous notice of the reporting requirements of this section is given to the patient for <br/>
<a id="pl.401.31"></a><var>401.31</var>whom the prescription was written.<br/>
<a id="pl.401.32"></a><var>401.32</var>    Subd. 5. <b>Use of data by board.</b> (a) The board shall develop and maintain a database <br/>
<a id="pl.401.33"></a><var>401.33</var>of the data reported under subdivision 4. The board shall maintain data that could identify <br/>
<a id="pl.401.34"></a><var>401.34</var>an individual prescriber or dispenser in encrypted form. The database may be used by <br/>
<a id="pl.401.35"></a><var>401.35</var>permissible users identified under subdivision 6 for the identification of:<br/>
<a id="pl.402.1"></a><var>402.1</var>    (1) individuals receiving prescriptions for controlled substances from prescribers <br/>
<a id="pl.402.2"></a><var>402.2</var>who subsequently obtain controlled substances from dispensers in quantities or with a <br/>
<a id="pl.402.3"></a><var>402.3</var>frequency inconsistent with generally recognized standards of use for those controlled <br/>
<a id="pl.402.4"></a><var>402.4</var>substances, including standards accepted by national and international pain management <br/>
<a id="pl.402.5"></a><var>402.5</var>associations; and<br/>
<a id="pl.402.6"></a><var>402.6</var>    (2) individuals presenting forged or otherwise false or altered prescriptions for <br/>
<a id="pl.402.7"></a><var>402.7</var>controlled substances to dispensers.<br/>
<a id="pl.402.8"></a><var>402.8</var>    (b) No permissible user identified under subdivision 6 may access the database <br/>
<a id="pl.402.9"></a><var>402.9</var>for the sole purpose of identifying prescribers of controlled substances for unusual or <br/>
<a id="pl.402.10"></a><var>402.10</var>excessive prescribing patterns without a valid search warrant or court order.<br/>
<a id="pl.402.11"></a><var>402.11</var>    (c) No personnel of a state or federal occupational licensing board or agency may <br/>
<a id="pl.402.12"></a><var>402.12</var>access the database for the purpose of obtaining information to be used to initiate or <br/>
<a id="pl.402.13"></a><var>402.13</var>substantiate a disciplinary action against a prescriber.<br/>
<a id="pl.402.14"></a><var>402.14</var>    (d) Data reported under subdivision 4 shall be retained by the board in the an active<br/>
<a id="pl.402.15"></a><var>402.15</var> database for a 12-month period, and shall be removed from the active database no later <br/>
<a id="pl.402.16"></a><var>402.16</var>than 12 months from the last day of the month during which the data was received. The <br/>
<a id="pl.402.17"></a><var>402.17</var>board may transfer the data into a database that may only be used by the authorized staff <br/>
<a id="pl.402.18"></a><var>402.18</var>of the board for the purposes of administering, operating, and maintaining the prescription <br/>
<a id="pl.402.19"></a><var>402.19</var>monitoring program and conducting trend analyses and other studies as necessary to <br/>
<a id="pl.402.20"></a><var>402.20</var>evaluate the effectiveness of the program. No data that can be used to identify an <br/>
<a id="pl.402.21"></a><var>402.21</var>individual may be transferred into this database.<br/>
<a id="pl.402.22"></a><var>402.22</var>    Subd. 6. <b>Access to reporting system data.</b> (a) Except as indicated in this <br/>
<a id="pl.402.23"></a><var>402.23</var>subdivision, the data submitted to the board under subdivision 4 is private data on <br/>
<a id="pl.402.24"></a><var>402.24</var>individuals as defined in section 
         <statute_ref>13.02, subdivision 12</statute_ref>, and not subject to public disclosure.<br/>
<a id="pl.402.25"></a><var>402.25</var>    (b) Except as specified in subdivision 5, the following persons shall be considered <br/>
<a id="pl.402.26"></a><var>402.26</var>permissible users and may access the data submitted under subdivision 4 in the same or <br/>
<a id="pl.402.27"></a><var>402.27</var>similar manner, and for the same or similar purposes, as those persons who are authorized <br/>
<a id="pl.402.28"></a><var>402.28</var>to access similar private data on individuals under federal and state law:<br/>
<a id="pl.402.29"></a><var>402.29</var>    (1) a prescriber or an agent or employee of the prescriber to whom the prescriber has <br/>
<a id="pl.402.30"></a><var>402.30</var>delegated the task of accessing the data, to the extent the information relates specifically to <br/>
<a id="pl.402.31"></a><var>402.31</var>a current patient, to whom the prescriber is prescribing or considering prescribing any <br/>
<a id="pl.402.32"></a><var>402.32</var>controlled substance or to whom the prescriber is providing other medical treatment for <br/>
<a id="pl.402.33"></a><var>402.33</var>which access to the data may be necessary and with the provision that the prescriber remains <br/>
<a id="pl.402.34"></a><var>402.34</var>responsible for the use or misuse of data accessed by a delegated agent or employee;<br/>
<a id="pl.402.35"></a><var>402.35</var>    (2) a dispenser or an agent or employee of the dispenser to whom the dispenser has <br/>
<a id="pl.402.36"></a><var>402.36</var>delegated the task of accessing the data, to the extent the information relates specifically <br/>
<a id="pl.403.1"></a><var>403.1</var>to a current patient to whom that dispenser is dispensing or considering dispensing any <br/>
<a id="pl.403.2"></a><var>403.2</var>controlled substance or to whom the dispenser is providing other pharmaceutical care for <br/>
<a id="pl.403.3"></a><var>403.3</var>which access to the data may be necessary and with the provision that the dispenser remains <br/>
<a id="pl.403.4"></a><var>403.4</var>responsible for the use or misuse of data accessed by a delegated agent or employee;<br/>
<a id="pl.403.5"></a><var>403.5</var>    (3) a licensed pharmacist who is providing pharmaceutical care for which access to <br/>
<a id="pl.403.6"></a><var>403.6</var>the data may be necessary or when consulted by a prescriber who is requesting data in <br/>
<a id="pl.403.7"></a><var>403.7</var>accordance with clause (1);<br/>
<a id="pl.403.8"></a><var>403.8</var>    (3) (4) an individual who is the recipient of a controlled substance prescription for <br/>
<a id="pl.403.9"></a><var>403.9</var>which data was submitted under subdivision 4, or a guardian of the individual, parent or <br/>
<a id="pl.403.10"></a><var>403.10</var>guardian of a minor, or health care agent of the individual acting under a health care <br/>
<a id="pl.403.11"></a><var>403.11</var>directive under chapter 145C;<br/>
<a id="pl.403.12"></a><var>403.12</var>    (4) (5) personnel of the board specifically assigned to conduct a bona fide <br/>
<a id="pl.403.13"></a><var>403.13</var>investigation of a specific licensee;<br/>
<a id="pl.403.14"></a><var>403.14</var>    (5) (6) personnel of the board engaged in the collection of controlled substance <br/>
<a id="pl.403.15"></a><var>403.15</var>prescription information as part of the assigned duties and responsibilities under this <br/>
<a id="pl.403.16"></a><var>403.16</var>section;<br/>
<a id="pl.403.17"></a><var>403.17</var>    (6) (7) authorized personnel of a vendor under contract with the board who are <br/>
<a id="pl.403.18"></a><var>403.18</var>engaged in the design, implementation, operation, and maintenance of the electronic <br/>
<a id="pl.403.19"></a><var>403.19</var>reporting system prescription monitoring program as part of the assigned duties and <br/>
<a id="pl.403.20"></a><var>403.20</var>responsibilities of their employment, provided that access to data is limited to the <br/>
<a id="pl.403.21"></a><var>403.21</var>minimum amount necessary to carry out such duties and responsibilities;<br/>
<a id="pl.403.22"></a><var>403.22</var>    (7) (8) federal, state, and local law enforcement authorities acting pursuant to a <br/>
<a id="pl.403.23"></a><var>403.23</var>valid search warrant; and<br/>
<a id="pl.403.24"></a><var>403.24</var>    (8) (9) personnel of the medical assistance program Minnesota health care programs<br/>
<a id="pl.403.25"></a><var>403.25</var> assigned to use the data collected under this section to identify and manage recipients <br/>
<a id="pl.403.26"></a><var>403.26</var>whose usage of controlled substances may warrant restriction to a single primary care <br/>
<a id="pl.403.27"></a><var>403.27</var>physician provider, a single outpatient pharmacy, or and a single hospital; and<br/>
<a id="pl.403.28"></a><var>403.28</var>    (10) a coroner or medical examiner, or an agent or employee of the coroner or <br/>
<a id="pl.403.29"></a><var>403.29</var>medical examiner to whom the coroner or medical examiner has delegated the task of <br/>
<a id="pl.403.30"></a><var>403.30</var>accessing the data, conducting an investigation pursuant to section 390.11, and with the <br/>
<a id="pl.403.31"></a><var>403.31</var>provision that the coroner or medical examiner remains responsible for the use or misuse <br/>
<a id="pl.403.32"></a><var>403.32</var>of data accessed by a delegated agent or employee.<br/>
<a id="pl.403.33"></a><var>403.33</var>    For purposes of clause (3) (4), access by an individual includes persons in the <br/>
<a id="pl.403.34"></a><var>403.34</var>definition of an individual under section 
         <statute_ref>13.02</statute_ref>.<br/>
<a id="pl.403.35"></a><var>403.35</var>    (c) Any permissible user identified in paragraph (b), who directly accesses <br/>
<a id="pl.403.36"></a><var>403.36</var>the data electronically, shall implement and maintain a comprehensive information <br/>
<a id="pl.404.1"></a><var>404.1</var>security program that contains administrative, technical, and physical safeguards that <br/>
<a id="pl.404.2"></a><var>404.2</var>are appropriate to the user's size and complexity, and the sensitivity of the personal <br/>
<a id="pl.404.3"></a><var>404.3</var>information obtained. The permissible user shall identify reasonably foreseeable internal <br/>
<a id="pl.404.4"></a><var>404.4</var>and external risks to the security, confidentiality, and integrity of personal information <br/>
<a id="pl.404.5"></a><var>404.5</var>that could result in the unauthorized disclosure, misuse, or other compromise of the <br/>
<a id="pl.404.6"></a><var>404.6</var>information and assess the sufficiency of any safeguards in place to control the risks.<br/>
<a id="pl.404.7"></a><var>404.7</var>    (d) The board shall not release data submitted under this section unless it is provided <br/>
<a id="pl.404.8"></a><var>404.8</var>with evidence, satisfactory to the board, that the person requesting the information is <br/>
<a id="pl.404.9"></a><var>404.9</var>entitled to receive the data.<br/>
<a id="pl.404.10"></a><var>404.10</var>    (e) The board shall not release the name of a prescriber without the written consent <br/>
<a id="pl.404.11"></a><var>404.11</var>of the prescriber or a valid search warrant or court order. The board shall provide a <br/>
<a id="pl.404.12"></a><var>404.12</var>mechanism for a prescriber to submit to the board a signed consent authorizing the release <br/>
<a id="pl.404.13"></a><var>404.13</var>of the prescriber's name when data containing the prescriber's name is requested.<br/>
<a id="pl.404.14"></a><var>404.14</var>    (f) The board shall maintain a log of all persons who access the data for a period of <br/>
<a id="pl.404.15"></a><var>404.15</var>at least five years and shall ensure that any permissible user complies with paragraph (c) <br/>
<a id="pl.404.16"></a><var>404.16</var>prior to attaining direct access to the data.<br/>
<a id="pl.404.17"></a><var>404.17</var>    (g) (f) Section 
         <statute_ref>13.05, subdivision 6</statute_ref>, shall apply to any contract the board enters into <br/>
<a id="pl.404.18"></a><var>404.18</var>pursuant to subdivision 2. A vendor shall not use data collected under this section for <br/>
<a id="pl.404.19"></a><var>404.19</var>any purpose not specified in this section.<br/>
<a id="pl.404.20"></a><var>404.20</var>    (g) The board may participate in an interstate prescription monitoring program data <br/>
<a id="pl.404.21"></a><var>404.21</var>exchange system provided that permissible users in other states may have access to the data <br/>
<a id="pl.404.22"></a><var>404.22</var>only as allowed under this section and that section 13.05, subdivision 6, shall apply to any <br/>
<a id="pl.404.23"></a><var>404.23</var>contract or memorandum of understanding that the board enters into under this paragraph.<br/>
<a id="pl.404.24"></a><var>404.24</var>    Subd. 7. <b>Disciplinary action.</b> (a) A dispenser who knowingly fails to submit data to <br/>
<a id="pl.404.25"></a><var>404.25</var>the board as required under this section is subject to disciplinary action by the appropriate <br/>
<a id="pl.404.26"></a><var>404.26</var>health-related licensing board.<br/>
<a id="pl.404.27"></a><var>404.27</var>    (b) A prescriber or dispenser authorized to access the data who knowingly discloses <br/>
<a id="pl.404.28"></a><var>404.28</var>the data in violation of state or federal laws relating to the privacy of health care data <br/>
<a id="pl.404.29"></a><var>404.29</var>shall be subject to disciplinary action by the appropriate health-related licensing board, <br/>
<a id="pl.404.30"></a><var>404.30</var>and appropriate civil penalties.<br/>
<a id="pl.404.31"></a><var>404.31</var>    Subd. 8. <b>Evaluation and reporting.</b> (a) The board shall evaluate the prescription <br/>
<a id="pl.404.32"></a><var>404.32</var>electronic reporting system to determine if the system is negatively impacting appropriate <br/>
<a id="pl.404.33"></a><var>404.33</var>prescribing practices of controlled substances. The board may contract with a vendor to <br/>
<a id="pl.404.34"></a><var>404.34</var>design and conduct the evaluation.<br/>
<a id="pl.404.35"></a><var>404.35</var>    (b) The board shall submit the evaluation of the system to the legislature by July <br/>
<a id="pl.404.36"></a><var>404.36</var>15, 2011.<br/>
<a id="pl.405.1"></a><var>405.1</var>    Subd. 9. <b>Immunity from liability; no requirement to obtain information.</b> (a) A <br/>
<a id="pl.405.2"></a><var>405.2</var>pharmacist, prescriber, or other dispenser making a report to the program in good faith <br/>
<a id="pl.405.3"></a><var>405.3</var>under this section is immune from any civil, criminal, or administrative liability, which <br/>
<a id="pl.405.4"></a><var>405.4</var>might otherwise be incurred or imposed as a result of the report, or on the basis that the <br/>
<a id="pl.405.5"></a><var>405.5</var>pharmacist or prescriber did or did not seek or obtain or use information from the program.<br/>
<a id="pl.405.6"></a><var>405.6</var>    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser <br/>
<a id="pl.405.7"></a><var>405.7</var>to obtain information about a patient from the program, and the pharmacist, prescriber, <br/>
<a id="pl.405.8"></a><var>405.8</var>or other dispenser, if acting in good faith, is immune from any civil, criminal, or <br/>
<a id="pl.405.9"></a><var>405.9</var>administrative liability that might otherwise be incurred or imposed for requesting, <br/>
<a id="pl.405.10"></a><var>405.10</var>receiving, or using information from the program.<br/>
<a id="pl.405.11"></a><var>405.11</var>    Subd. 10. <b>Funding.</b> (a) The board may seek grants and private funds from nonprofit <br/>
<a id="pl.405.12"></a><var>405.12</var>charitable foundations, the federal government, and other sources to fund the enhancement <br/>
<a id="pl.405.13"></a><var>405.13</var>and ongoing operations of the prescription electronic reporting system monitoring <br/>
<a id="pl.405.14"></a><var>405.14</var>program established under this section. Any funds received shall be appropriated to the <br/>
<a id="pl.405.15"></a><var>405.15</var>board for this purpose. The board may not expend funds to enhance the program in a way <br/>
<a id="pl.405.16"></a><var>405.16</var>that conflicts with this section without seeking approval from the legislature.<br/>
<a id="pl.405.17"></a><var>405.17</var>    (b) Notwithstanding any other section, the administrative services unit for the <br/>
<a id="pl.405.18"></a><var>405.18</var>health-related licensing boards shall apportion between the Board of Medical Practice, the <br/>
<a id="pl.405.19"></a><var>405.19</var>Board of Nursing, the Board of Dentistry, the Board of Podiatric Medicine, the Board of <br/>
<a id="pl.405.20"></a><var>405.20</var>Optometry, the Board of Veterinary Medicine, and the Board of Pharmacy an amount to <br/>
<a id="pl.405.21"></a><var>405.21</var>be paid through fees by each respective board. The amount apportioned to each board <br/>
<a id="pl.405.22"></a><var>405.22</var>shall equal each board's share of the annual appropriation to the Board of Pharmacy <br/>
<a id="pl.405.23"></a><var>405.23</var>from the state government special revenue fund for operating the prescription electronic <br/>
<a id="pl.405.24"></a><var>405.24</var>reporting system monitoring program under this section. Each board's apportioned share <br/>
<a id="pl.405.25"></a><var>405.25</var>shall be based on the number of prescribers or dispensers that each board identified in <br/>
<a id="pl.405.26"></a><var>405.26</var>this paragraph licenses as a percentage of the total number of prescribers and dispensers <br/>
<a id="pl.405.27"></a><var>405.27</var>licensed collectively by these boards. Each respective board may adjust the fees that the <br/>
<a id="pl.405.28"></a><var>405.28</var>boards are required to collect to compensate for the amount apportioned to each board by <br/>
<a id="pl.405.29"></a><var>405.29</var>the administrative services unit.<br/>
<br/>
<a id="bill.10.13.0"></a><a id="pl.405.30"></a><var>405.30</var>    Sec. 13. <b>[214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL </b><br/>
<a id="pl.405.31"></a><var>405.31</var><b>BACKGROUND CHECKS.</b><br/>
<a id="pl.405.32"></a><var>405.32</var>    Subdivision 1. <b>Applications.</b> (a) By January 1, 2018, each health-related licensing <br/>
<a id="pl.405.33"></a><var>405.33</var>board, as defined in section 214.01, subdivision 2, shall require applicants for initial <br/>
<a id="pl.405.34"></a><var>405.34</var>licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse <br/>
<a id="pl.405.35"></a><var>405.35</var>in licensure, as defined by the individual health-related licensing boards, to submit to <br/>
<a id="pl.406.1"></a><var>406.1</var>a criminal history records check of state data completed by the Bureau of Criminal <br/>
<a id="pl.406.2"></a><var>406.2</var>Apprehension (BCA) and a national criminal history records check, including a search of <br/>
<a id="pl.406.3"></a><var>406.3</var>the records of the Federal Bureau of Investigation (FBI).<br/>
<a id="pl.406.4"></a><var>406.4</var>(b) An applicant must complete a criminal background check if more than one year <br/>
<a id="pl.406.5"></a><var>406.5</var>has elapsed since the applicant last submitted a background check to the board.<br/>
<a id="pl.406.6"></a><var>406.6</var>    Subd. 2. <b>Investigations.</b> If a health-related licensing board has reasonable cause <br/>
<a id="pl.406.7"></a><var>406.7</var>to believe a licensee has been charged with or convicted of a crime in this or any other <br/>
<a id="pl.406.8"></a><var>406.8</var>jurisdiction, the health-related licensing board may require the licensee to submit to a <br/>
<a id="pl.406.9"></a><var>406.9</var>criminal history records check of state data completed by the BCA and a national criminal <br/>
<a id="pl.406.10"></a><var>406.10</var>history records check, including a search of the records of the FBI.<br/>
<a id="pl.406.11"></a><var>406.11</var>    Subd. 3. <b>Consent form; fees; fingerprints.</b> (a) In order to effectuate the federal <br/>
<a id="pl.406.12"></a><var>406.12</var>and state level, fingerprint-based criminal background check, the applicant or licensee <br/>
<a id="pl.406.13"></a><var>406.13</var>must submit a completed criminal history records check consent form and a full set of <br/>
<a id="pl.406.14"></a><var>406.14</var>fingerprints to the respective health-related licensing board or a designee in the manner <br/>
<a id="pl.406.15"></a><var>406.15</var>and form specified by the board. <br/>
<a id="pl.406.16"></a><var>406.16</var>(b) The applicant or licensee is responsible for all fees associated with preparation of <br/>
<a id="pl.406.17"></a><var>406.17</var>the fingerprints, the criminal records check consent form, and the criminal background <br/>
<a id="pl.406.18"></a><var>406.18</var>check. The fees for the criminal records background check shall be set by the BCA and <br/>
<a id="pl.406.19"></a><var>406.19</var>the FBI and are not refundable. The fees shall be submitted to the respective health-related <br/>
<a id="pl.406.20"></a><var>406.20</var>licensing board by the applicant or licensee as prescribed by the respective board. <br/>
<a id="pl.406.21"></a><var>406.21</var>    (c) All fees received by the health-related licensing boards under this subdivision <br/>
<a id="pl.406.22"></a><var>406.22</var>shall be deposited in a dedicated account in the special revenue fund and are appropriated <br/>
<a id="pl.406.23"></a><var>406.23</var>to the Board of Nursing Home Administrators for the administrative services unit to pay <br/>
<a id="pl.406.24"></a><var>406.24</var>for the criminal background checks conducted by the Bureau of Criminal Apprehension <br/>
<a id="pl.406.25"></a><var>406.25</var>and Federal Bureau of Investigation.<br/>
<a id="pl.406.26"></a><var>406.26</var>    Subd. 4. <b>Refusal to consent.</b> (a) The health-related licensing boards shall not issue <br/>
<a id="pl.406.27"></a><var>406.27</var>a license to any applicant who refuses to consent to a criminal background check or fails <br/>
<a id="pl.406.28"></a><var>406.28</var>to submit fingerprints within 90 days after submission of an application for licensure. Any <br/>
<a id="pl.406.29"></a><var>406.29</var>fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent <br/>
<a id="pl.406.30"></a><var>406.30</var>to the criminal background check or fails to submit the required fingerprints.<br/>
<a id="pl.406.31"></a><var>406.31</var>(b) The failure of a licensee to submit to a criminal background check as provided in <br/>
<a id="pl.406.32"></a><var>406.32</var>subdivision 3 is grounds for disciplinary action by the respective health licensing board.<br/>
<a id="pl.406.33"></a><var>406.33</var>    Subd. 5. <b>Submission of fingerprints to the Bureau of Criminal Apprehension.</b><br/>
<a id="pl.406.34"></a><var>406.34</var>The health-related licensing board or designee shall submit applicant or licensee <br/>
<a id="pl.406.35"></a><var>406.35</var>fingerprints to the BCA. The BCA shall perform a check for state criminal justice <br/>
<a id="pl.406.36"></a><var>406.36</var>information and shall forward the applicant's or licensee's fingerprints to the FBI to <br/>
<a id="pl.407.1"></a><var>407.1</var>perform a check for national criminal justice information regarding the applicant or <br/>
<a id="pl.407.2"></a><var>407.2</var>licensee. The BCA shall report to the board the results of the state and national criminal <br/>
<a id="pl.407.3"></a><var>407.3</var>justice information checks.<br/>
<a id="pl.407.4"></a><var>407.4</var>    Subd. 6. <b>Alternatives to fingerprint-based criminal background checks.</b> The <br/>
<a id="pl.407.5"></a><var>407.5</var>health-related licensing board may require an alternative method of criminal history <br/>
<a id="pl.407.6"></a><var>407.6</var>checks for an applicant or licensee who has submitted at least three sets of fingerprints in <br/>
<a id="pl.407.7"></a><var>407.7</var>accordance with this section that have been unreadable by the BCA or the FBI.<br/>
<a id="pl.407.8"></a><var>407.8</var>    Subd. 7. <b>Data practices.</b> Criminal history record information obtained by the <br/>
<a id="pl.407.9"></a><var>407.9</var>health-related licensing board under this section is private data on individuals under <br/>
<a id="pl.407.10"></a><var>407.10</var>section 13.02, subdivision 12.<br/>
<a id="pl.407.11"></a><var>407.11</var>    Subd. 8. <b>Opportunity to challenge accuracy of report.</b> Prior to taking disciplinary <br/>
<a id="pl.407.12"></a><var>407.12</var>action against an applicant or a licensee based on a criminal conviction, the health-related <br/>
<a id="pl.407.13"></a><var>407.13</var>licensing board shall provide the applicant or the licensee an opportunity to complete or <br/>
<a id="pl.407.14"></a><var>407.14</var>challenge the accuracy of the criminal history information reported to the board. The <br/>
<a id="pl.407.15"></a><var>407.15</var>applicant or licensee shall have 30 calendar days following notice from the board of <br/>
<a id="pl.407.16"></a><var>407.16</var>the intent to deny licensure or to take disciplinary action to request an opportunity to <br/>
<a id="pl.407.17"></a><var>407.17</var>correct or complete the record prior to the board taking disciplinary action based on the <br/>
<a id="pl.407.18"></a><var>407.18</var>information reported to the board. The board shall provide the applicant up to 180 days to <br/>
<a id="pl.407.19"></a><var>407.19</var>challenge the accuracy or completeness of the report with the agency responsible for the <br/>
<a id="pl.407.20"></a><var>407.20</var>record. This subdivision does not affect the right of the subject of the data to contest the <br/>
<a id="pl.407.21"></a><var>407.21</var>accuracy or completeness under section 13.04, subdivision 4.<br/>
<a id="pl.407.22"></a><var>407.22</var>    Subd. 9. <b>Instructions to the board; plans.</b> The health-related licensing boards, in <br/>
<a id="pl.407.23"></a><var>407.23</var>collaboration with the commissioner of human services and the BCA, shall establish a <br/>
<a id="pl.407.24"></a><var>407.24</var>plan for completing criminal background checks of all licensees who were licensed before <br/>
<a id="pl.407.25"></a><var>407.25</var>the effective date requirement under subdivision 1. The plan must seek to minimize <br/>
<a id="pl.407.26"></a><var>407.26</var>duplication of requirements for background checks of licensed health professionals. The <br/>
<a id="pl.407.27"></a><var>407.27</var>plan for background checks of current licensees shall be developed no later than January <br/>
<a id="pl.407.28"></a><var>407.28</var>1, 2017, and may be contingent upon the implementation of a system by the BCA or FBI <br/>
<a id="pl.407.29"></a><var>407.29</var>in which any new crimes that an applicant or licensee commits after an initial background <br/>
<a id="pl.407.30"></a><var>407.30</var>check are flagged in the BCA's or FBI's database and reported back to the board. The plan <br/>
<a id="pl.407.31"></a><var>407.31</var>shall include recommendations for any necessary statutory changes.<br/>
<br/>
<a id="bill.10.14.0"></a><a id="pl.407.32"></a><var>407.32</var>    Sec. 14. Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision <br/>
<a id="pl.407.33"></a><var>407.33</var>to read:<br/>
<a id="pl.407.34"></a><var>407.34</var>    Subd. 4. <b>Parental depression.</b> The health-related licensing boards that regulate <br/>
<a id="pl.407.35"></a><var>407.35</var>professions that serve caregivers at risk of depression, or their children, including <br/>
<a id="pl.408.1"></a><var>408.1</var>behavioral health and therapy, chiropractic, marriage and family therapy, medical practice, <br/>
<a id="pl.408.2"></a><var>408.2</var>nursing, psychology, and social work, shall provide educational materials to licensees on <br/>
<a id="pl.408.3"></a><var>408.3</var>the subject of parental depression and its potential effects on children if unaddressed, <br/>
<a id="pl.408.4"></a><var>408.4</var>including how to:<br/>
<a id="pl.408.5"></a><var>408.5</var>(1) screen mothers for depression;<br/>
<a id="pl.408.6"></a><var>408.6</var>(2) identify children who are affected by their mother's depression; and<br/>
<a id="pl.408.7"></a><var>408.7</var>(3) provide treatment or referral information on needed services.<br/>
<br/>
<a id="bill.10.15.0"></a><a id="pl.408.8"></a><var>408.8</var>    Sec. 15. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:<br/>
<a id="pl.408.9"></a><var>408.9</var>    Subdivision 1. <b>Definitions.</b> (a) The definitions in this subdivision apply to this <br/>
<a id="pl.408.10"></a><var>408.10</var>section.<br/>
<a id="pl.408.11"></a><var>408.11</var>(b) "Administrative services unit" means the administrative services unit for the <br/>
<a id="pl.408.12"></a><var>408.12</var>health-related licensing boards.<br/>
<a id="pl.408.13"></a><var>408.13</var>(c) "Charitable organization" means a charitable organization within the meaning of <br/>
<a id="pl.408.14"></a><var>408.14</var>section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or <br/>
<a id="pl.408.15"></a><var>408.15</var>support of programs designed to improve the quality, awareness, and availability of health <br/>
<a id="pl.408.16"></a><var>408.16</var>care services and that serves as a funding mechanism for providing those services.<br/>
<a id="pl.408.17"></a><var>408.17</var>(d) "Health care facility or organization" means a health care facility licensed under <br/>
<a id="pl.408.18"></a><var>408.18</var>chapter 144 or 144A, or a charitable organization.<br/>
<a id="pl.408.19"></a><var>408.19</var>(e) "Health care provider" means a physician licensed under chapter 147, physician <br/>
<a id="pl.408.20"></a><var>408.20</var>assistant registered licensed and practicing under chapter 147A, nurse licensed and <br/>
<a id="pl.408.21"></a><var>408.21</var>registered to practice under chapter 148, or dentist or, dental hygienist, or dental therapist<br/>
<a id="pl.408.22"></a><var>408.22</var> licensed under chapter 150A, or an advanced dental therapist licensed and certified under <br/>
<a id="pl.408.23"></a><var>408.23</var>chapter 150A.<br/>
<a id="pl.408.24"></a><var>408.24</var>(f) "Health care services" means health promotion, health monitoring, health <br/>
<a id="pl.408.25"></a><var>408.25</var>education, diagnosis, treatment, minor surgical procedures, the administration of local <br/>
<a id="pl.408.26"></a><var>408.26</var>anesthesia for the stitching of wounds, and primary dental services, including preventive, <br/>
<a id="pl.408.27"></a><var>408.27</var>diagnostic, restorative, and emergency treatment. Health care services do not include the <br/>
<a id="pl.408.28"></a><var>408.28</var>administration of general anesthesia or surgical procedures other than minor surgical <br/>
<a id="pl.408.29"></a><var>408.29</var>procedures.<br/>
<a id="pl.408.30"></a><var>408.30</var>(g) "Medical professional liability insurance" means medical malpractice insurance <br/>
<a id="pl.408.31"></a><var>408.31</var>as defined in section 
         <statute_ref>62F.03</statute_ref>.<br/>
<a id="pl.408.32"></a><var>408.32</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.10.16.0"></a><a id="pl.408.33"></a><var>408.33</var>    Sec. 16. <b>INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO </b><br/>
<a id="pl.408.34"></a><var>408.34</var><b>CRIMINAL BACKGROUND CHECKS.</b><br/>
<a id="pl.409.1"></a><var>409.1</var>(a) If the Department of Health is not reviewed by the Sunset Advisory Commission <br/>
<a id="pl.409.2"></a><var>409.2</var>according to the schedule in Minnesota Statutes, section 3D.21, the commissioner <br/>
<a id="pl.409.3"></a><var>409.3</var>of health, as the regulator for occupational therapy practitioners, speech-language <br/>
<a id="pl.409.4"></a><var>409.4</var>pathologists, audiologists, and hearing instrument dispensers, shall require applicants <br/>
<a id="pl.409.5"></a><var>409.5</var>for licensure or renewal to submit to a criminal history records check as required under <br/>
<a id="pl.409.6"></a><var>409.6</var>Minnesota Statutes, section 214.075, for other health-related licensed occupations <br/>
<a id="pl.409.7"></a><var>409.7</var>regulated by the health-related licensing boards.<br/>
<a id="pl.409.8"></a><var>409.8</var>(b) Any statutory changes necessary to include the commissioner of health to <br/>
<a id="pl.409.9"></a><var>409.9</var>Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota <br/>
<a id="pl.409.10"></a><var>409.10</var>Statutes, section 214.075, subdivision 9.<br/>
<br/>
<a id="bill.10.17.0"></a><a id="pl.409.11"></a><var>409.11</var>    Sec. 17. <b> REPEALER.</b><br/>
<a id="pl.409.12"></a><var>409.12</var>Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47, <br/>
<a id="pl.409.13"></a><var>409.13</var>subdivision 2; and 151.48, are repealed.<br/>
<br/>
<a id="bill.11.0.0"></a>

<a id="bill.11.1.0"></a><a id="pl.409.16"></a><var>409.16</var>    Section 1. Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:<br/>
<a id="pl.409.17"></a><var>409.17</var>    Subd. 2. <b>Health occupations data.</b> (a) <b>Health-related licensees and registrants.</b> <br/>
<a id="pl.409.18"></a><var>409.18</var>The collection, analysis, reporting, and use of data on individuals licensed or registered by <br/>
<a id="pl.409.19"></a><var>409.19</var>the commissioner of health or health-related licensing boards are governed by sections <br/>
<statute_ref><a id="pl.409.20"></a><var>409.20</var>144.051, subdivision 2 subdivisions 2 to 6
</statute_ref>, and 
         <statute_ref>144.052</statute_ref>.<br/>
<a id="pl.409.21"></a><var>409.21</var>(b) <b>Health services personnel.</b> Data collected by the commissioner of health for the <br/>
<a id="pl.409.22"></a><var>409.22</var>database on health services personnel are classified under section 
         <statute_ref>144.1485</statute_ref>.<br/>
<br/>
<a id="bill.11.2.0"></a><a id="pl.409.23"></a><var>409.23</var>    Sec. 2. Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:<br/>
<a id="pl.409.24"></a><var>409.24</var>    Subd. 10. <b>Home care and hospice provider.</b> Data regarding a home care provider <br/>
<a id="pl.409.25"></a><var>409.25</var>under sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47</statute_ref> are governed by section 
         <statute_ref>144A.45</statute_ref>. Data regarding <br/>
<a id="pl.409.26"></a><var>409.26</var>home care provider background studies are governed by section 144A.476, subdivision 1. <br/>
<a id="pl.409.27"></a><var>409.27</var>Data regarding a hospice provider under sections 
         <statute_ref>144A.75</statute_ref> to 
         <statute_ref>144A.755</statute_ref> are governed by <br/>
<a id="pl.409.28"></a><var>409.28</var>sections 
         <statute_ref>144A.752</statute_ref> and 
         <statute_ref>144A.754</statute_ref>.<br/>
<br/>
<a id="bill.11.3.0"></a><a id="pl.409.29"></a><var>409.29</var>    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision <br/>
<a id="pl.409.30"></a><var>409.30</var>to read:<br/>
<a id="pl.409.31"></a><var>409.31</var>    Subd. 3. <b>Data classification; private data.</b> For providers regulated pursuant to <br/>
<a id="pl.409.32"></a><var>409.32</var>sections 144A.43 to 144A.482, the following data collected, created, or maintained by <br/>
<a id="pl.410.1"></a><var>410.1</var>the commissioner are classified as private data on individuals as defined in section 13.02, <br/>
<a id="pl.410.2"></a><var>410.2</var>subdivision 12:<br/>
<a id="pl.410.3"></a><var>410.3</var>(1) data submitted by or on behalf of applicants for licenses prior to issuance of <br/>
<a id="pl.410.4"></a><var>410.4</var>the license;<br/>
<a id="pl.410.5"></a><var>410.5</var>(2) the identity of complainants who have made reports concerning licensees or <br/>
<a id="pl.410.6"></a><var>410.6</var>applicants unless the complainant consents to the disclosure;<br/>
<a id="pl.410.7"></a><var>410.7</var>(3) the identity of individuals who provide information as part of surveys and <br/>
<a id="pl.410.8"></a><var>410.8</var>investigations;<br/>
<a id="pl.410.9"></a><var>410.9</var>(4) Social Security numbers; and<br/>
<a id="pl.410.10"></a><var>410.10</var>(5) health record data.<br/>
<br/>
<a id="bill.11.4.0"></a><a id="pl.410.11"></a><var>410.11</var>    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision <br/>
<a id="pl.410.12"></a><var>410.12</var>to read:<br/>
<a id="pl.410.13"></a><var>410.13</var>    Subd. 4. <b>Data classification; public data.</b> For providers regulated pursuant to <br/>
<a id="pl.410.14"></a><var>410.14</var>sections 144A.43 to 144A.482, the following data collected, created, or maintained by the <br/>
<a id="pl.410.15"></a><var>410.15</var>commissioner are public:<br/>
<a id="pl.410.16"></a><var>410.16</var>(1) all application data on licensees, license numbers, license status;<br/>
<a id="pl.410.17"></a><var>410.17</var>(2) licensing information about licenses previously held under this chapter;<br/>
<a id="pl.410.18"></a><var>410.18</var>(3) correction orders, including information about compliance with the order and <br/>
<a id="pl.410.19"></a><var>410.19</var>whether the fine was paid;<br/>
<a id="pl.410.20"></a><var>410.20</var>(4) final enforcement actions pursuant to chapter 14;<br/>
<a id="pl.410.21"></a><var>410.21</var>(5) orders for hearing, findings of fact and conclusions of law; and<br/>
<a id="pl.410.22"></a><var>410.22</var>(6) when the licensee and department agree to resolve the matter without a hearing, <br/>
<a id="pl.410.23"></a><var>410.23</var>the agreement and specific reasons for the agreement are public data.<br/>
<br/>
<a id="bill.11.5.0"></a><a id="pl.410.24"></a><var>410.24</var>    Sec. 5. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision <br/>
<a id="pl.410.25"></a><var>410.25</var>to read:<br/>
<a id="pl.410.26"></a><var>410.26</var>    Subd. 5. <b>Data classification; confidential data.</b> For providers regulated pursuant to <br/>
<a id="pl.410.27"></a><var>410.27</var>sections 144A.43 to 144A.482, the following data collected, created, or maintained by <br/>
<a id="pl.410.28"></a><var>410.28</var>the Department of Health are classified as confidential data on individuals as defined in <br/>
<a id="pl.410.29"></a><var>410.29</var>section 13.02, subdivision 3: active investigative data relating to the investigation of <br/>
<a id="pl.410.30"></a><var>410.30</var>potential violations of law by a licensee including data from the survey process before the <br/>
<a id="pl.410.31"></a><var>410.31</var>correction order is issued by the department.<br/>
<br/>
<a id="bill.11.6.0"></a><a id="pl.410.32"></a><var>410.32</var>    Sec. 6. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision <br/>
<a id="pl.410.33"></a><var>410.33</var>to read:<br/>
<a id="pl.411.1"></a><var>411.1</var>    Subd. 6. <b>Release of private or confidential data.</b> For providers regulated pursuant <br/>
<a id="pl.411.2"></a><var>411.2</var>to sections 144A.43 to 144A.482, the department may release private or confidential data, <br/>
<a id="pl.411.3"></a><var>411.3</var>except Social Security numbers, to the appropriate state, federal, or local agency and law <br/>
<a id="pl.411.4"></a><var>411.4</var>enforcement office to facilitate investigative or enforcement efforts or further the public <br/>
<a id="pl.411.5"></a><var>411.5</var>health protective process. Types of offices include Adult Protective Services, Office of the <br/>
<a id="pl.411.6"></a><var>411.6</var>Ombudsmen for Long-Term Care and Office of the Ombudsmen for Mental Health and <br/>
<a id="pl.411.7"></a><var>411.7</var>Developmental Disabilities, health licensing boards, the Department of Human Services, <br/>
<a id="pl.411.8"></a><var>411.8</var>county or city attorney's offices, police, and local or county public health offices.<br/>
<br/>
<a id="bill.11.7.0"></a><a id="pl.411.9"></a><var>411.9</var>    Sec. 7. Minnesota Statutes 2012, section 144A.43, is amended to read:<br/>
<a id="pl.411.10"></a><var>411.10</var><b>144A.43 DEFINITIONS.</b><br/>
<a id="pl.411.11"></a><var>411.11</var>    Subdivision 1. <b>Applicability.</b> The definitions in this section apply to sections <br/>
<statute_ref><a id="pl.411.12"></a><var>411.12</var>144.699, subdivision 2
         </statute_ref>, and 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47</statute_ref> 144A.482. <br/>
<a id="pl.411.13"></a><var>411.13</var>    Subd. 1a. <b>Agent.</b> "Agent" means the person upon whom all notices and orders shall <br/>
<a id="pl.411.14"></a><var>411.14</var>be served and who is authorized to accept service of notices and orders on behalf of <br/>
<a id="pl.411.15"></a><var>411.15</var>the home care provider.<br/>
<a id="pl.411.16"></a><var>411.16</var>    Subd. 1b. <b>Applicant.</b> "Applicant" means an individual, organization, association, <br/>
<a id="pl.411.17"></a><var>411.17</var>corporation, unit of government, or other entity that applies for a temporary license, <br/>
<a id="pl.411.18"></a><var>411.18</var>license, or renewal of their home care provider license under section 144A.472.<br/>
<a id="pl.411.19"></a><var>411.19</var>    Subd. 1c. <b>Client.</b> "Client" means a person to whom home care services are provided.<br/>
<a id="pl.411.20"></a><var>411.20</var>    Subd. 1d. <b>Client record.</b> "Client record" means all records that document <br/>
<a id="pl.411.21"></a><var>411.21</var>information about the home care services provided to the client by the home care provider.<br/>
<a id="pl.411.22"></a><var>411.22</var>    Subd. 1e. <b>Client representative.</b> "Client representative" means a person who, <br/>
<a id="pl.411.23"></a><var>411.23</var>because of the client's needs, makes decisions about the client's care on behalf of the <br/>
<a id="pl.411.24"></a><var>411.24</var>client. A client representative may be a guardian, health care agent, family member, or <br/>
<a id="pl.411.25"></a><var>411.25</var>other agent of the client. Nothing in this section expands or diminishes the rights of <br/>
<a id="pl.411.26"></a><var>411.26</var>persons to act on behalf of clients under other law.<br/>
<a id="pl.411.27"></a><var>411.27</var>    Subd. 2. <b>Commissioner.</b> "Commissioner" means the commissioner of health.<br/>
<a id="pl.411.28"></a><var>411.28</var>    Subd. 2a. <b>Controlled substance.</b> "Controlled substance" has the meaning given <br/>
<a id="pl.411.29"></a><var>411.29</var>in section 152.01, subdivision 4.<br/>
<a id="pl.411.30"></a><var>411.30</var>    Subd. 2b. <b>Department.</b> "Department" means the Minnesota Department of Health.<br/>
<a id="pl.411.31"></a><var>411.31</var>    Subd. 2c. <b>Dietary supplement.</b> "Dietary supplement" means a product taken by <br/>
<a id="pl.411.32"></a><var>411.32</var>mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary <br/>
<a id="pl.411.33"></a><var>411.33</var>ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and <br/>
<a id="pl.411.34"></a><var>411.34</var>substances such as enzymes, organ tissue, glandulars, or metabolites.<br/>
<a id="pl.412.1"></a><var>412.1</var>    Subd. 2d. <b>Dietitian.</b> "Dietitian" is a person licensed under sections 148.621 to <br/>
<a id="pl.412.2"></a><var>412.2</var>148.633.<br/>
<a id="pl.412.3"></a><var>412.3</var>    Subd. 2e. <b>Dietetics or nutrition practice.</b> "Dietetics or nutrition practice" is <br/>
<a id="pl.412.4"></a><var>412.4</var>performed by a licensed dietitian or licensed nutritionist and includes the activities of <br/>
<a id="pl.412.5"></a><var>412.5</var>assessment, setting priorities and objectives, providing nutrition counseling, developing <br/>
<a id="pl.412.6"></a><var>412.6</var>and implementing nutrition care services, and evaluating and maintaining appropriate <br/>
<a id="pl.412.7"></a><var>412.7</var>standards of quality of nutrition care under sections 148.621 to 148.633.<br/>
<a id="pl.412.8"></a><var>412.8</var>    Subd. 3. <b>Home care service.</b> "Home care service" means any of the following <br/>
<a id="pl.412.9"></a><var>412.9</var>services when delivered in a place of residence to the home of a person whose illness, <br/>
<a id="pl.412.10"></a><var>412.10</var>disability, or physical condition creates a need for the service:<br/>
<a id="pl.412.11"></a><var>412.11</var>(1) nursing services, including the services of a home health aide;<br/>
<a id="pl.412.12"></a><var>412.12</var>(2) personal care services not included under sections 
<statute_ref>148.171</statute_ref> to 
<statute_ref>148.285</statute_ref>; <br/>
<a id="pl.412.13"></a><var>412.13</var>(3) physical therapy;<br/>
<a id="pl.412.14"></a><var>412.14</var>(4) speech therapy;<br/>
<a id="pl.412.15"></a><var>412.15</var>(5) respiratory therapy;<br/>
<a id="pl.412.16"></a><var>412.16</var>(6) occupational therapy;<br/>
<a id="pl.412.17"></a><var>412.17</var>(7) nutritional services;<br/>
<a id="pl.412.18"></a><var>412.18</var>(8) home management services when provided to a person who is unable to perform <br/>
<a id="pl.412.19"></a><var>412.19</var>these activities due to illness, disability, or physical condition. Home management <br/>
<a id="pl.412.20"></a><var>412.20</var>services include at least two of the following services: housekeeping, meal preparation, <br/>
<a id="pl.412.21"></a><var>412.21</var>and shopping;<br/>
<a id="pl.412.22"></a><var>412.22</var>(9) medical social services;<br/>
<a id="pl.412.23"></a><var>412.23</var>(10) the provision of medical supplies and equipment when accompanied by the <br/>
<a id="pl.412.24"></a><var>412.24</var>provision of a home care service; and<br/>
<a id="pl.412.25"></a><var>412.25</var>(11) other similar medical services and health-related support services identified by <br/>
<a id="pl.412.26"></a><var>412.26</var>the commissioner in rule.<br/>
<a id="pl.412.27"></a><var>412.27</var>"Home care service" does not include the following activities conducted by the <br/>
<a id="pl.412.28"></a><var>412.28</var>commissioner of health or a board of health as defined in section 
<statute_ref>145A.02, subdivision 2</statute_ref>: <br/>
<a id="pl.412.29"></a><var>412.29</var>communicable disease investigations or testing; administering or monitoring a prescribed <br/>
<a id="pl.412.30"></a><var>412.30</var>therapy necessary to control or prevent a communicable disease; or the monitoring <br/>
<a id="pl.412.31"></a><var>412.31</var>of an individual's compliance with a health directive as defined in section 
<statute_ref>144.4172, <br/>
<a id="pl.412.32"></a><var>412.32</var>subdivision 6
</statute_ref>. <br/>
<a id="pl.412.33"></a><var>412.33</var>(1) assistive tasks as defined in section 144A.471, subdivision 6, provided by <br/>
<a id="pl.412.34"></a><var>412.34</var>unlicensed personnel;<br/>
<a id="pl.413.1"></a><var>413.1</var>(2) services provided by a registered nurse or licensed practical nurse, physical <br/>
<a id="pl.413.2"></a><var>413.2</var>therapist, respiratory therapist, occupational therapist, speech-language pathologist, <br/>
<a id="pl.413.3"></a><var>413.3</var>dietitian or nutritionist, or social worker;<br/>
<a id="pl.413.4"></a><var>413.4</var>(3) medication and treatment management services; or<br/>
<a id="pl.413.5"></a><var>413.5</var>(4) the provision of durable medical equipment services when provided with any of <br/>
<a id="pl.413.6"></a><var>413.6</var>the home care services listed in clauses (1) to (3).<br/>
<a id="pl.413.7"></a><var>413.7</var>    Subd. 3a. <b>Hands-on-assistance.</b> "Hands-on-assistance" means physical help by <br/>
<a id="pl.413.8"></a><var>413.8</var>another person without which the client is not able to perform the activity.<br/>
<a id="pl.413.9"></a><var>413.9</var>    Subd. 3b. <b>Home.</b> "Home" means the client's temporary or permanent place of <br/>
<a id="pl.413.10"></a><var>413.10</var>residence.<br/>
<a id="pl.413.11"></a><var>413.11</var>    Subd. 4. <b>Home care provider.</b> "Home care provider" means an individual, <br/>
<a id="pl.413.12"></a><var>413.12</var>organization, association, corporation, unit of government, or other entity that is regularly <br/>
<a id="pl.413.13"></a><var>413.13</var>engaged in the delivery of at least one home care service, directly or by contractual <br/>
<a id="pl.413.14"></a><var>413.14</var>arrangement, of home care services in a client's home for a fee and who has a valid current <br/>
<a id="pl.413.15"></a><var>413.15</var>temporary license or license issued under sections 144A.43 to 144A.482. At least one <br/>
<a id="pl.413.16"></a><var>413.16</var>home care service must be provided directly, although additional home care services may <br/>
<a id="pl.413.17"></a><var>413.17</var>be provided by contractual arrangements. "Home care provider" does not include:<br/>
<a id="pl.413.18"></a><var>413.18</var>(1) any home care or nursing services conducted by and for the adherents of any <br/>
<a id="pl.413.19"></a><var>413.19</var>recognized church or religious denomination for the purpose of providing care and <br/>
<a id="pl.413.20"></a><var>413.20</var>services for those who depend upon spiritual means, through prayer alone, for healing;<br/>
<a id="pl.413.21"></a><var>413.21</var>(2) an individual who only provides services to a relative;<br/>
<a id="pl.413.22"></a><var>413.22</var>(3) an individual not connected with a home care provider who provides assistance <br/>
<a id="pl.413.23"></a><var>413.23</var>with home management services or personal care needs if the assistance is provided <br/>
<a id="pl.413.24"></a><var>413.24</var>primarily as a contribution and not as a business;<br/>
<a id="pl.413.25"></a><var>413.25</var>(4) an individual not connected with a home care provider who shares housing with <br/>
<a id="pl.413.26"></a><var>413.26</var>and provides primarily housekeeping or homemaking services to an elderly or disabled <br/>
<a id="pl.413.27"></a><var>413.27</var>person in return for free or reduced-cost housing;<br/>
<a id="pl.413.28"></a><var>413.28</var>(5) an individual or agency providing home-delivered meal services;<br/>
<a id="pl.413.29"></a><var>413.29</var>(6) an agency providing senior companion services and other older American <br/>
<a id="pl.413.30"></a><var>413.30</var>volunteer programs established under the Domestic Volunteer Service Act of 1973, <br/>
<a id="pl.413.31"></a><var>413.31</var>Public Law 98-288;<br/>
<a id="pl.413.32"></a><var>413.32</var>(7) an employee of a nursing home licensed under this chapter or an employee of a <br/>
<a id="pl.413.33"></a><var>413.33</var>boarding care home licensed under sections 
<statute_ref>144.50</statute_ref> to 
<statute_ref>144.56</statute_ref> who responds to occasional <br/>
<a id="pl.413.34"></a><var>413.34</var>emergency calls from individuals residing in a residential setting that is attached to or <br/>
<a id="pl.413.35"></a><var>413.35</var>located on property contiguous to the nursing home or boarding care home; <br/>
<a id="pl.414.1"></a><var>414.1</var>(8) a member of a professional corporation organized under chapter 319B that does <br/>
<a id="pl.414.2"></a><var>414.2</var>not regularly offer or provide home care services as defined in subdivision 3;<br/>
<a id="pl.414.3"></a><var>414.3</var>(9) the following organizations established to provide medical or surgical services <br/>
<a id="pl.414.4"></a><var>414.4</var>that do not regularly offer or provide home care services as defined in subdivision 3: <br/>
<a id="pl.414.5"></a><var>414.5</var>a business trust organized under sections 
<statute_ref>318.01</statute_ref> to 
<statute_ref>318.04</statute_ref>, a nonprofit corporation <br/>
<a id="pl.414.6"></a><var>414.6</var>organized under chapter 317A, a partnership organized under chapter 323, or any other <br/>
<a id="pl.414.7"></a><var>414.7</var>entity determined by the commissioner; <br/>
<a id="pl.414.8"></a><var>414.8</var>(10) an individual or agency that provides medical supplies or durable medical <br/>
<a id="pl.414.9"></a><var>414.9</var>equipment, except when the provision of supplies or equipment is accompanied by a <br/>
<a id="pl.414.10"></a><var>414.10</var>home care service;<br/>
<a id="pl.414.11"></a><var>414.11</var>(11) an individual licensed under chapter 147; or<br/>
<a id="pl.414.12"></a><var>414.12</var>(12) an individual who provides home care services to a person with a developmental <br/>
<a id="pl.414.13"></a><var>414.13</var>disability who lives in a place of residence with a family, foster family, or primary caregiver.<br/>
<a id="pl.414.14"></a><var>414.14</var>    Subd. 5. <b>Medication reminder.</b> "Medication reminder" means providing a verbal <br/>
<a id="pl.414.15"></a><var>414.15</var>or visual reminder to a client to take medication. This includes bringing the medication <br/>
<a id="pl.414.16"></a><var>414.16</var>to the client and providing liquids or nutrition to accompany medication that a client is <br/>
<a id="pl.414.17"></a><var>414.17</var>self-administering.<br/>
<a id="pl.414.18"></a><var>414.18</var>    Subd. 6. <b>License.</b> "License" means a basic or comprehensive home care license <br/>
<a id="pl.414.19"></a><var>414.19</var>issued by the commissioner to a home care provider.<br/>
<a id="pl.414.20"></a><var>414.20</var>    Subd. 7. <b>Licensed health professional.</b> "Licensed health professional" means a <br/>
<a id="pl.414.21"></a><var>414.21</var>person, other than a registered nurse or licensed practical nurse, who provides home care <br/>
<a id="pl.414.22"></a><var>414.22</var>services within the scope of practice of the person's health occupation license, registration, <br/>
<a id="pl.414.23"></a><var>414.23</var>or certification as regulated and who is licensed by the appropriate Minnesota state board <br/>
<a id="pl.414.24"></a><var>414.24</var>or agency.<br/>
<a id="pl.414.25"></a><var>414.25</var>    Subd. 8. <b>Licensee.</b> "Licensee" means a home care provider that is licensed under <br/>
<a id="pl.414.26"></a><var>414.26</var>this chapter.<br/>
<a id="pl.414.27"></a><var>414.27</var>    Subd. 9. <b>Managerial official.</b> "Managerial official" means an administrator, <br/>
<a id="pl.414.28"></a><var>414.28</var>director, officer, trustee, or employee of a home care provider, however designated, who <br/>
<a id="pl.414.29"></a><var>414.29</var>has the authority to establish or control business policy.<br/>
<a id="pl.414.30"></a><var>414.30</var>    Subd. 10. <b>Medication.</b> "Medication" means a prescription or over-the-counter drug. <br/>
<a id="pl.414.31"></a><var>414.31</var>For purposes of this chapter only, medication includes dietary supplements.<br/>
<a id="pl.414.32"></a><var>414.32</var>    Subd. 11. <b>Medication administration.</b> "Medication administration" means <br/>
<a id="pl.414.33"></a><var>414.33</var>performing a set of tasks to ensure a client takes medications, and includes the following:<br/>
<a id="pl.414.34"></a><var>414.34</var>(1) checking the client's medication record;<br/>
<a id="pl.414.35"></a><var>414.35</var>(2) preparing the medication as necessary;<br/>
<a id="pl.414.36"></a><var>414.36</var>(3) administering the medication to the client;<br/>
<a id="pl.415.1"></a><var>415.1</var>(4) documenting the administration or reason for not administering the medication; <br/>
<a id="pl.415.2"></a><var>415.2</var>and<br/>
<a id="pl.415.3"></a><var>415.3</var>(5) reporting to a nurse any concerns about the medication, the client, or the client's <br/>
<a id="pl.415.4"></a><var>415.4</var>refusal to take the medication.<br/>
<a id="pl.415.5"></a><var>415.5</var>    Subd. 12. <b>Medication management.</b> "Medication management" means the <br/>
<a id="pl.415.6"></a><var>415.6</var>provision of any of the following medication-related services to a client:<br/>
<a id="pl.415.7"></a><var>415.7</var>(1) performing medication setup;<br/>
<a id="pl.415.8"></a><var>415.8</var>(2) administering medication;<br/>
<a id="pl.415.9"></a><var>415.9</var>(3) storing and securing medications;<br/>
<a id="pl.415.10"></a><var>415.10</var>(4) documenting medication activities;<br/>
<a id="pl.415.11"></a><var>415.11</var>(5) verifying and monitoring effectiveness of systems to ensure safe handling and <br/>
<a id="pl.415.12"></a><var>415.12</var>administration;<br/>
<a id="pl.415.13"></a><var>415.13</var>(6) coordinating refills;<br/>
<a id="pl.415.14"></a><var>415.14</var>(7) handling and implementing changes to prescriptions;<br/>
<a id="pl.415.15"></a><var>415.15</var>(8) communicating with the pharmacy about the client's medications; and<br/>
<a id="pl.415.16"></a><var>415.16</var>(9) coordinating and communicating with the prescriber.<br/>
<a id="pl.415.17"></a><var>415.17</var>    Subd. 13. <b>Medication setup.</b> "Medication setup" means arranging medications by a <br/>
<a id="pl.415.18"></a><var>415.18</var>nurse, pharmacy, or authorized prescriber for later administration by the client or by <br/>
<a id="pl.415.19"></a><var>415.19</var>comprehensive home care staff.<br/>
<a id="pl.415.20"></a><var>415.20</var>    Subd. 14. <b>Nurse.</b> "Nurse" means a person who is licensed under sections 148.171 to <br/>
<a id="pl.415.21"></a><var>415.21</var>148.285.<br/>
<a id="pl.415.22"></a><var>415.22</var>    Subd. 15. <b>Occupational therapist.</b> "Occupational therapist" means a person who is <br/>
<a id="pl.415.23"></a><var>415.23</var>licensed under sections 148.6401 to 148.6450.<br/>
<a id="pl.415.24"></a><var>415.24</var>    Subd. 16. <b>Over-the-counter drug.</b> "Over-the-counter drug" means a drug that is <br/>
<a id="pl.415.25"></a><var>415.25</var>not required by federal law to bear the symbol "Rx only."<br/>
<a id="pl.415.26"></a><var>415.26</var>    Subd. 17. <b>Owner.</b> "Owner" means a proprietor, general partner, limited partner who <br/>
<a id="pl.415.27"></a><var>415.27</var>has five percent or more of equity interest in a limited partnership, a person who owns or <br/>
<a id="pl.415.28"></a><var>415.28</var>controls voting stock in a corporation in an amount equal to or greater than five percent of <br/>
<a id="pl.415.29"></a><var>415.29</var>the shares issued and outstanding, or a corporation that owns equity interest in a licensee <br/>
<a id="pl.415.30"></a><var>415.30</var>or applicant for a license.<br/>
<a id="pl.415.31"></a><var>415.31</var>    Subd. 18. <b>Pharmacist.</b> "Pharmacist" has the meaning given in section 151.01, <br/>
<a id="pl.415.32"></a><var>415.32</var>subdivision 3.<br/>
<a id="pl.415.33"></a><var>415.33</var>    Subd. 19. <b>Physical therapist.</b> "Physical therapist" means a person who is licensed <br/>
<a id="pl.415.34"></a><var>415.34</var>under sections 148.65 to 148.78.<br/>
<a id="pl.415.35"></a><var>415.35</var>    Subd. 20. <b>Physician.</b> "Physician" means a person who is licensed under chapter 147.<br/>
<a id="pl.416.1"></a><var>416.1</var>    Subd. 21. <b>Prescriber.</b> "Prescriber" means a person who is authorized by sections <br/>
<a id="pl.416.2"></a><var>416.2</var>148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.<br/>
<a id="pl.416.3"></a><var>416.3</var>    Subd. 22. <b>Prescription.</b> "Prescription" has the meaning given in section 151.01, <br/>
<a id="pl.416.4"></a><var>416.4</var>subdivision 16.<br/>
<a id="pl.416.5"></a><var>416.5</var>    Subd. 23. <b>Regularly scheduled.</b> "Regularly scheduled" means ordered or planned <br/>
<a id="pl.416.6"></a><var>416.6</var>to be completed at predetermined times or according to a predetermined routine.<br/>
<a id="pl.416.7"></a><var>416.7</var>    Subd. 24. <b>Reminder.</b> "Reminder" means providing a verbal or visual reminder <br/>
<a id="pl.416.8"></a><var>416.8</var>to a client.<br/>
<a id="pl.416.9"></a><var>416.9</var>    Subd. 25. <b>Respiratory therapist.</b> "Respiratory therapist" means a person who <br/>
<a id="pl.416.10"></a><var>416.10</var>is licensed under chapter 147C.<br/>
<a id="pl.416.11"></a><var>416.11</var>    Subd. 26. <b>Revenues.</b> "Revenues" means all money received by a licensee derived <br/>
<a id="pl.416.12"></a><var>416.12</var>from the provisions of home care services, including fees for services and appropriations <br/>
<a id="pl.416.13"></a><var>416.13</var>of public money for home care services.<br/>
<a id="pl.416.14"></a><var>416.14</var>    Subd. 27. <b>Service plan.</b> "Service plan" means the written plan between the client or <br/>
<a id="pl.416.15"></a><var>416.15</var>client's representative and the temporary licensee or licensee about the services that will <br/>
<a id="pl.416.16"></a><var>416.16</var>be provided to the client.<br/>
<a id="pl.416.17"></a><var>416.17</var>    Subd. 28. <b>Social worker.</b> "Social worker" means a person who is licensed under <br/>
<a id="pl.416.18"></a><var>416.18</var>chapter 148D or 148E.<br/>
<a id="pl.416.19"></a><var>416.19</var>    Subd. 29. <b>Speech language pathologist.</b> "Speech language pathologist" has the <br/>
<a id="pl.416.20"></a><var>416.20</var>meaning given in section 148.512.<br/>
<a id="pl.416.21"></a><var>416.21</var>    Subd. 30. <b>Standby assistance.</b> "Standby assistance" means the presence of another <br/>
<a id="pl.416.22"></a><var>416.22</var>person within arm's reach to minimize the risk of injury while performing daily activities <br/>
<a id="pl.416.23"></a><var>416.23</var>through physical intervention or cuing.<br/>
<a id="pl.416.24"></a><var>416.24</var>    Subd. 31. <b>Substantial compliance.</b> "Substantial compliance" means complying <br/>
<a id="pl.416.25"></a><var>416.25</var>with the requirements in this chapter sufficiently to prevent unacceptable health or safety <br/>
<a id="pl.416.26"></a><var>416.26</var>risks to the home care client.<br/>
<a id="pl.416.27"></a><var>416.27</var>    Subd. 32. <b>Survey.</b> "Survey" means an inspection of a licensee or applicant for <br/>
<a id="pl.416.28"></a><var>416.28</var>licensure for compliance with this chapter.<br/>
<a id="pl.416.29"></a><var>416.29</var>    Subd. 33. <b>Surveyor.</b> "Surveyor" means a staff person of the department authorized <br/>
<a id="pl.416.30"></a><var>416.30</var>to conduct surveys of home care providers and applicants.<br/>
<a id="pl.416.31"></a><var>416.31</var>    Subd. 34. <b>Temporary license.</b> "Temporary license" means the initial basic or <br/>
<a id="pl.416.32"></a><var>416.32</var>comprehensive home care license the department issues after approval of a complete <br/>
<a id="pl.416.33"></a><var>416.33</var>written application and before the department completes the temporary license survey and <br/>
<a id="pl.416.34"></a><var>416.34</var>determines that the temporary licensee is in substantial compliance.<br/>
<a id="pl.417.1"></a><var>417.1</var>    Subd. 35. <b>Treatment or therapy.</b> "Treatment" or "therapy" means the provision <br/>
<a id="pl.417.2"></a><var>417.2</var>of care, other than medications, ordered or prescribed by a licensed health professional <br/>
<a id="pl.417.3"></a><var>417.3</var>provided to a client to cure, rehabilitate, or ease symptoms.<br/>
<a id="pl.417.4"></a><var>417.4</var>    Subd. 36. <b>Unit of government.</b> "Unit of government" means every city, county, <br/>
<a id="pl.417.5"></a><var>417.5</var>town, school district, other political subdivisions of the state, and any agency of the state <br/>
<a id="pl.417.6"></a><var>417.6</var>or federal government, which includes any instrumentality of a unit of government.<br/>
<a id="pl.417.7"></a><var>417.7</var>    Subd. 37. <b>Unlicensed personnel.</b> "Unlicensed personnel" are individuals not <br/>
<a id="pl.417.8"></a><var>417.8</var>otherwise licensed or certified by a governmental health board or agency who provide <br/>
<a id="pl.417.9"></a><var>417.9</var>home care services in the client's home.<br/>
<a id="pl.417.10"></a><var>417.10</var>    Subd. 38. <b>Verbal.</b> "Verbal" means oral and not in writing.<br/>
<br/>
<a id="bill.11.8.0"></a><a id="pl.417.11"></a><var>417.11</var>    Sec. 8. Minnesota Statutes 2012, section 144A.44, is amended to read:<br/>
<a id="pl.417.12"></a><var>417.12</var><b>144A.44 HOME CARE BILL OF RIGHTS.</b><br/>
<a id="pl.417.13"></a><var>417.13</var>    Subdivision 1. <b>Statement of rights.</b> A person who receives home care services <br/>
<a id="pl.417.14"></a><var>417.14</var>has these rights:<br/>
<a id="pl.417.15"></a><var>417.15</var>(1) the right to receive written information about rights in advance of before <br/>
<a id="pl.417.16"></a><var>417.16</var>receiving care or during the initial evaluation visit before the initiation of treatment<br/>
<a id="pl.417.17"></a><var>417.17</var> services, including what to do if rights are violated;<br/>
<a id="pl.417.18"></a><var>417.18</var>(2) the right to receive care and services according to a suitable and up-to-date plan, <br/>
<a id="pl.417.19"></a><var>417.19</var>and subject to accepted health care, medical or nursing standards, to take an active part <br/>
<a id="pl.417.20"></a><var>417.20</var>in creating and changing the plan developing, modifying, and evaluating care the plan<br/>
<a id="pl.417.21"></a><var>417.21</var> and services;<br/>
<a id="pl.417.22"></a><var>417.22</var>(3) the right to be told in advance of before receiving care about the services that will <br/>
<a id="pl.417.23"></a><var>417.23</var>be provided, the disciplines that will furnish care the type and disciplines of staff who will <br/>
<a id="pl.417.24"></a><var>417.24</var>be providing the services, the frequency of visits proposed to be furnished, other choices <br/>
<a id="pl.417.25"></a><var>417.25</var>that are available for addressing home care needs, and the consequences of these choices <br/>
<a id="pl.417.26"></a><var>417.26</var>including the potential consequences of refusing these services;<br/>
<a id="pl.417.27"></a><var>417.27</var>(4) the right to be told in advance of any change recommended changes by the <br/>
<a id="pl.417.28"></a><var>417.28</var>provider in the service plan of care and to take an active part in any change decisions <br/>
<a id="pl.417.29"></a><var>417.29</var>about changes to the service plan;<br/>
<a id="pl.417.30"></a><var>417.30</var>(5) the right to refuse services or treatment;<br/>
<a id="pl.417.31"></a><var>417.31</var>(6) the right to know, in advance before receiving services or during the initial <br/>
<a id="pl.417.32"></a><var>417.32</var>visit, any limits to the services available from a home care provider, and the provider's <br/>
<a id="pl.417.33"></a><var>417.33</var>grounds for a termination of services;<br/>
<a id="pl.418.1"></a><var>418.1</var>(7) the right to know in advance of receiving care whether the services are covered <br/>
<a id="pl.418.2"></a><var>418.2</var>by health insurance, medical assistance, or other health programs, the charges for services <br/>
<a id="pl.418.3"></a><var>418.3</var>that will not be covered by Medicare, and the charges that the individual may have to pay;<br/>
<a id="pl.418.4"></a><var>418.4</var>(8) (7) the right to know be told before services are initiated what the provider <br/>
<a id="pl.418.5"></a><var>418.5</var>charges are for the services, no matter who will be paying the bill and if known, to what <br/>
<a id="pl.418.6"></a><var>418.6</var>extent payment may be expected from health insurance, public programs or other sources, <br/>
<a id="pl.418.7"></a><var>418.7</var>and what charges the client may be responsible for paying;<br/>
<a id="pl.418.8"></a><var>418.8</var>(9) (8) the right to know that there may be other services available in the community, <br/>
<a id="pl.418.9"></a><var>418.9</var>including other home care services and providers, and to know where to go for find<br/>
<a id="pl.418.10"></a><var>418.10</var> information about these services;<br/>
<a id="pl.418.11"></a><var>418.11</var>(10) (9) the right to choose freely among available providers and to change providers <br/>
<a id="pl.418.12"></a><var>418.12</var>after services have begun, within the limits of health insurance, long-term care insurance, <br/>
<a id="pl.418.13"></a><var>418.13</var>medical assistance, or other health programs;<br/>
<a id="pl.418.14"></a><var>418.14</var>(11) (10) the right to have personal, financial, and medical information kept private, <br/>
<a id="pl.418.15"></a><var>418.15</var>and to be advised of the provider's policies and procedures regarding disclosure of such <br/>
<a id="pl.418.16"></a><var>418.16</var>information;<br/>
<a id="pl.418.17"></a><var>418.17</var>(12) (11) the right to be allowed access to the client's own records and written <br/>
<a id="pl.418.18"></a><var>418.18</var>information from those records in accordance with sections 
         <statute_ref>144.291</statute_ref> to 144.298;<br/>
<a id="pl.418.19"></a><var>418.19</var>(13) (12) the right to be served by people who are properly trained and competent <br/>
<a id="pl.418.20"></a><var>418.20</var>to perform their duties;<br/>
<a id="pl.418.21"></a><var>418.21</var>(14) (13) the right to be treated with courtesy and respect, and to have the patient's<br/>
<a id="pl.418.22"></a><var>418.22</var> client's property treated with respect;<br/>
<a id="pl.418.23"></a><var>418.23</var>(15) (14) the right to be free from physical and verbal abuse, neglect, financial <br/>
<a id="pl.418.24"></a><var>418.24</var>exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and <br/>
<a id="pl.418.25"></a><var>418.25</var>the Maltreatment of Minors Act;<br/>
<a id="pl.418.26"></a><var>418.26</var>(16) (15) the right to reasonable, advance notice of changes in services or charges, <br/>
<a id="pl.418.27"></a><var>418.27</var>including;<br/>
<a id="pl.418.28"></a><var>418.28</var>(16) the right to know the provider's reason for termination of services;<br/>
<a id="pl.418.29"></a><var>418.29</var>(17) the right to at least ten days' advance notice of the termination of a service by a <br/>
<a id="pl.418.30"></a><var>418.30</var>provider, except in cases where:<br/>
<a id="pl.418.31"></a><var>418.31</var>(i) the recipient of services client engages in conduct that significantly alters the <br/>
<a id="pl.418.32"></a><var>418.32</var>conditions of employment as specified in the employment contract between terms of <br/>
<a id="pl.418.33"></a><var>418.33</var>the service plan with the home care provider and the individual providing home care <br/>
<a id="pl.418.34"></a><var>418.34</var>services, or creates;<br/>
<a id="pl.418.35"></a><var>418.35</var>(ii) the client, person who lives with the client, or others create an abusive or unsafe <br/>
<a id="pl.418.36"></a><var>418.36</var>work environment for the individual person providing home care services; or<br/>
<a id="pl.419.1"></a><var>419.1</var>(ii) (iii) an emergency for the informal caregiver or a significant change in the <br/>
<a id="pl.419.2"></a><var>419.2</var>recipient's client's condition has resulted in service needs that exceed the current service <br/>
<a id="pl.419.3"></a><var>419.3</var>provider agreement plan and that cannot be safely met by the home care provider;<br/>
<a id="pl.419.4"></a><var>419.4</var>(17) (18) the right to a coordinated transfer when there will be a change in the <br/>
<a id="pl.419.5"></a><var>419.5</var>provider of services;<br/>
<a id="pl.419.6"></a><var>419.6</var>(18) (19) the right to voice grievances regarding treatment or care that is complain <br/>
<a id="pl.419.7"></a><var>419.7</var>about services that are provided, or fails to be, furnished, or regarding fail to be provided, <br/>
<a id="pl.419.8"></a><var>419.8</var>and  the lack of courtesy or respect to the patient client or the patient's client's property;<br/>
<a id="pl.419.9"></a><var>419.9</var>(19) (20) the right to know how to contact an individual associated with the home <br/>
<a id="pl.419.10"></a><var>419.10</var>care provider who is responsible for handling problems and to have the home care provider <br/>
<a id="pl.419.11"></a><var>419.11</var>investigate and attempt to resolve the grievance or complaint;<br/>
<a id="pl.419.12"></a><var>419.12</var>(20) (21) the right to know the name and address of the state or county agency to <br/>
<a id="pl.419.13"></a><var>419.13</var>contact for additional information or assistance; and<br/>
<a id="pl.419.14"></a><var>419.14</var>(21) (22) the right to assert these rights personally, or have them asserted by <br/>
<a id="pl.419.15"></a><var>419.15</var>the patient's family or guardian when the patient has been judged incompetent, client's <br/>
<a id="pl.419.16"></a><var>419.16</var>representative or by anyone on behalf of the client, without retaliation.<br/>
<a id="pl.419.17"></a><var>419.17</var>    Subd. 2. <b>Interpretation and enforcement of rights.</b> These rights are established <br/>
<a id="pl.419.18"></a><var>419.18</var>for the benefit of persons clients who receive home care services. "Home care services" <br/>
<a id="pl.419.19"></a><var>419.19</var>means home care services as defined in section 
<statute_ref>144A.43, subdivision 3</statute_ref>, and unlicensed <br/>
<a id="pl.419.20"></a><var>419.20</var>personal care assistance services, including services covered by medical assistance under <br/>
<a id="pl.419.21"></a><var>419.21</var>section 
<statute_ref>256B.0625, subdivision 19a</statute_ref>. All home care providers, including those exempted <br/>
<a id="pl.419.22"></a><var>419.22</var>under section 144A.471, must comply with this section. The commissioner shall enforce <br/>
<a id="pl.419.23"></a><var>419.23</var>this section and the home care bill of rights requirement against home care providers <br/>
<a id="pl.419.24"></a><var>419.24</var>exempt from licensure in the same manner as for licensees. A home care provider may <br/>
<a id="pl.419.25"></a><var>419.25</var>not request or require a person client to surrender any of these rights as a condition of <br/>
<a id="pl.419.26"></a><var>419.26</var>receiving services. A guardian or conservator or, when there is no guardian or conservator, <br/>
<a id="pl.419.27"></a><var>419.27</var>a designated person, may seek to enforce these rights. This statement of rights does not <br/>
<a id="pl.419.28"></a><var>419.28</var>replace or diminish other rights and liberties that may exist relative to persons clients<br/>
<a id="pl.419.29"></a><var>419.29</var> receiving home care services, persons providing home care services, or providers licensed <br/>
<a id="pl.419.30"></a><var>419.30</var>under Laws 1987, chapter 378. A copy of these rights must be provided to an individual <br/>
<a id="pl.419.31"></a><var>419.31</var>at the time home care services, including personal care assistance services, are initiated. <br/>
<a id="pl.419.32"></a><var>419.32</var>The copy shall also contain the address and phone number of the Office of Health Facility <br/>
<a id="pl.419.33"></a><var>419.33</var>Complaints and the Office of Ombudsman for Long-Term Care and a brief statement <br/>
<a id="pl.419.34"></a><var>419.34</var>describing how to file a complaint with these offices. Information about how to contact <br/>
<a id="pl.419.35"></a><var>419.35</var>the Office of Ombudsman for Long-Term Care shall be included in notices of change in <br/>
<a id="pl.420.1"></a><var>420.1</var>client fees and in notices where home care providers initiate transfer or discontinuation of <br/>
<a id="pl.420.2"></a><var>420.2</var>services sections 144A.43 to 144A.482.<br/>
<br/>
<a id="bill.11.9.0"></a><a id="pl.420.3"></a><var>420.3</var>    Sec. 9. Minnesota Statutes 2012, section 144A.45, is amended to read:<br/>
<a id="pl.420.4"></a><var>420.4</var><b>144A.45 REGULATION OF HOME CARE SERVICES.</b><br/>
<a id="pl.420.5"></a><var>420.5</var>    Subdivision 1. <b>Rules</b><b> Regulations</b><b>.</b> The commissioner shall adopt rules for the <br/>
<a id="pl.420.6"></a><var>420.6</var>regulation of regulate home care providers pursuant to sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47<br/>
<a id="pl.420.7"></a><var>420.7</var></statute_ref> 144A.482. The rules regulations shall include the following:<br/>
<a id="pl.420.8"></a><var>420.8</var>    (1) provisions to assure, to the extent possible, the health, safety and well-being, <br/>
<a id="pl.420.9"></a><var>420.9</var>and appropriate treatment of persons who receive home care services while respecting <br/>
<a id="pl.420.10"></a><var>420.10</var>clients' autonomy and choice;<br/>
<a id="pl.420.11"></a><var>420.11</var>    (2) requirements that home care providers furnish the commissioner with specified <br/>
<a id="pl.420.12"></a><var>420.12</var>information necessary to implement sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47</statute_ref> 144A.482;<br/>
<a id="pl.420.13"></a><var>420.13</var>    (3) standards of training of home care provider personnel, which may vary according <br/>
<a id="pl.420.14"></a><var>420.14</var>to the nature of the services provided or the health status of the consumer;<br/>
<a id="pl.420.15"></a><var>420.15</var>(4) standards for provision of home care services;<br/>
<a id="pl.420.16"></a><var>420.16</var>    (4) (5) standards for medication management which may vary according to the <br/>
<a id="pl.420.17"></a><var>420.17</var>nature of the services provided, the setting in which the services are provided, or the <br/>
<a id="pl.420.18"></a><var>420.18</var>status of the consumer. Medication management includes the central storage, handling, <br/>
<a id="pl.420.19"></a><var>420.19</var>distribution, and administration of medications;<br/>
<a id="pl.420.20"></a><var>420.20</var>    (5) (6) standards for supervision of home care services requiring supervision by a <br/>
<a id="pl.420.21"></a><var>420.21</var>registered nurse or other appropriate health care professional which must occur on site <br/>
<a id="pl.420.22"></a><var>420.22</var>at least every 62 days, or more frequently if indicated by a clinical assessment, and in <br/>
<a id="pl.420.23"></a><var>420.23</var>accordance with sections 
<statute_ref>148.171</statute_ref> to 
<statute_ref>148.285</statute_ref> and rules adopted thereunder, except that a <br/>
<a id="pl.420.24"></a><var>420.24</var>person performing home care aide tasks for a class B licensee providing paraprofessional <br/>
<a id="pl.420.25"></a><var>420.25</var>services does not require nursing supervision;<br/>
<a id="pl.420.26"></a><var>420.26</var>    (6) (7) standards for client evaluation or assessment which may vary according to <br/>
<a id="pl.420.27"></a><var>420.27</var>the nature of the services provided or the status of the consumer;<br/>
<a id="pl.420.28"></a><var>420.28</var>    (7) (8) requirements for the involvement of a consumer's physician client's health <br/>
<a id="pl.420.29"></a><var>420.29</var>care provider, the documentation of physicians' health care providers' orders, if required, <br/>
<a id="pl.420.30"></a><var>420.30</var>and the consumer's treatment client's service plan, and;<br/>
<a id="pl.420.31"></a><var>420.31</var>(9) the maintenance of accurate, current clinical client records;<br/>
<a id="pl.420.32"></a><var>420.32</var>    (8) (10) the establishment of different classes basic and comprehensive levels of <br/>
<a id="pl.420.33"></a><var>420.33</var>licenses for different types of providers and different standards and requirements for <br/>
<a id="pl.420.34"></a><var>420.34</var>different kinds of home care based on services provided; and<br/>
<a id="pl.421.1"></a><var>421.1</var>    (9) operating procedures required to implement (11) provisions to enforce these <br/>
<a id="pl.421.2"></a><var>421.2</var>regulations and the home care bill of rights.<br/>
<a id="pl.421.3"></a><var>421.3</var>    Subd. 1a. <b>Home care aide tasks.</b> Notwithstanding the provisions of Minnesota <br/>
<a id="pl.421.4"></a><var>421.4</var>Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting <br/>
<a id="pl.421.5"></a><var>421.5</var>toileting, transfers, and ambulation if the client is ambulatory and if the client has no <br/>
<a id="pl.421.6"></a><var>421.6</var>serious acute illness or infectious disease.<br/>
<a id="pl.421.7"></a><var>421.7</var>    Subd. 1b. <b>Home health aide qualifications.</b> Notwithstanding the provisions of <br/>
<a id="pl.421.8"></a><var>421.8</var>Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks <br/>
<a id="pl.421.9"></a><var>421.9</var>if the person maintains current registration as a nursing assistant on the Minnesota nursing <br/>
<a id="pl.421.10"></a><var>421.10</var>assistant registry. Maintaining current registration on the Minnesota nursing assistant <br/>
<a id="pl.421.11"></a><var>421.11</var>registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110, <br/>
<a id="pl.421.12"></a><var>421.12</var>subpart 3.<br/>
<a id="pl.421.13"></a><var>421.13</var>    Subd. 2. <b>Regulatory functions.</b> (a) The commissioner shall:<br/>
<a id="pl.421.14"></a><var>421.14</var>(1) evaluate, monitor, and license, survey, and monitor without advance notice,  home <br/>
<a id="pl.421.15"></a><var>421.15</var>care providers in accordance with sections 
         <statute_ref>144A.45</statute_ref> to 
<statute_ref>144A.47</statute_ref> 144A.43 to 144A.482;<br/>
<a id="pl.421.16"></a><var>421.16</var>(2) inspect the office and records of a provider during regular business hours without <br/>
<a id="pl.421.17"></a><var>421.17</var>advance notice to the home care provider;<br/>
<a id="pl.421.18"></a><var>421.18</var>(2) survey every temporary licensee within one year of the temporary license issuance <br/>
<a id="pl.421.19"></a><var>421.19</var>date subject to the temporary licensee providing home care services to a client or clients;<br/>
<a id="pl.421.20"></a><var>421.20</var>(3) survey all licensed home care providers on an interval that will promote the <br/>
<a id="pl.421.21"></a><var>421.21</var>health and safety of clients;<br/>
<a id="pl.421.22"></a><var>421.22</var>(3) (4) with the consent of the consumer client, visit the home where services are <br/>
<a id="pl.421.23"></a><var>421.23</var>being provided;<br/>
<a id="pl.421.24"></a><var>421.24</var>(4) (5) issue correction orders and assess civil penalties in accordance with section <br/>
<statute_ref><a id="pl.421.25"></a><var>421.25</var>144.653, subdivisions 5 to 8
         </statute_ref>, for violations of sections 
         <statute_ref>144A.43</statute_ref> to 
         <statute_ref>144A.47</statute_ref> or the rules <br/>
<a id="pl.421.26"></a><var>421.26</var>adopted under those sections 144A.482;<br/>
<a id="pl.421.27"></a><var>421.27</var>(5) (6) take action as authorized in section 
         <statute_ref>144A.46, subdivision 3</statute_ref> 144A.475; and<br/>
<a id="pl.421.28"></a><var>421.28</var>(6) (7) take other action reasonably required to accomplish the purposes of sections <br/>
<statute_ref><a id="pl.421.29"></a><var>421.29</var>144A.43
         </statute_ref> to 
         <statute_ref>144A.47</statute_ref> 144A.482.<br/>
<a id="pl.421.30"></a><var>421.30</var>(b) In the exercise of the authority granted in sections 
<statute_ref>144A.43</statute_ref> to 
<statute_ref>144A.47</statute_ref>, the <br/>
<a id="pl.421.31"></a><var>421.31</var>commissioner shall comply with the applicable requirements of section 
<statute_ref>144.122</statute_ref>, the <br/>
<a id="pl.421.32"></a><var>421.32</var>Government Data Practices Act, and the Administrative Procedure Act.<br/>
<a id="pl.421.33"></a><var>421.33</var>    Subd. 4. <b>Medicaid reimbursement.</b> Notwithstanding the provisions of section <br/>
<a id="pl.421.34"></a><var>421.34</var><statute_ref>256B.37</statute_ref> or state plan requirements to the contrary, certification by the federal Medicare <br/>
<a id="pl.421.35"></a><var>421.35</var>program must not be a requirement of Medicaid payment for services delivered under <br/>
<a id="pl.421.36"></a><var>421.36</var>section 
<statute_ref>144A.4605</statute_ref>.<br/>
<a id="pl.422.1"></a><var>422.1</var>    Subd. 5. <b>Home care providers; services for Alzheimer's disease or related </b><br/>
<a id="pl.422.2"></a><var>422.2</var><b>disorder.</b> (a) If a home care provider licensed under section 
<statute_ref>144A.46</statute_ref> or 
<statute_ref>144A.4605</statute_ref> markets <br/>
<a id="pl.422.3"></a><var>422.3</var>or otherwise promotes services for persons with Alzheimer's disease or related disorders, <br/>
<a id="pl.422.4"></a><var>422.4</var>the facility's direct care staff and their supervisors must be trained in dementia care.<br/>
<a id="pl.422.5"></a><var>422.5</var>(b) Areas of required training include:<br/>
<a id="pl.422.6"></a><var>422.6</var>(1) an explanation of Alzheimer's disease and related disorders;<br/>
<a id="pl.422.7"></a><var>422.7</var>(2) assistance with activities of daily living;<br/>
<a id="pl.422.8"></a><var>422.8</var>(3) problem solving with challenging behaviors; and<br/>
<a id="pl.422.9"></a><var>422.9</var>(4) communication skills.<br/>
<a id="pl.422.10"></a><var>422.10</var>(c) The licensee shall provide to consumers in written or electronic form a <br/>
<a id="pl.422.11"></a><var>422.11</var>description of the training program, the categories of employees trained, the frequency <br/>
<a id="pl.422.12"></a><var>422.12</var>of training, and the basic topics covered.<br/>
<br/>
<a id="bill.11.10.0"></a><a id="pl.422.13"></a><var>422.13</var>    Sec. 10. <b>[144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.</b><br/>
<a id="pl.422.14"></a><var>422.14</var>    Subdivision 1. <b>License required.</b> A home care provider may not open, operate, <br/>
<a id="pl.422.15"></a><var>422.15</var>manage, conduct, maintain, or advertise itself as a home care provider or provide home <br/>
<a id="pl.422.16"></a><var>422.16</var>care services in Minnesota without a temporary or current home care provider license <br/>
<a id="pl.422.17"></a><var>422.17</var>issued by the commissioner of health.<br/>
<a id="pl.422.18"></a><var>422.18</var>    Subd. 2. <b>Determination of direct home care service.</b> "Direct home care service" <br/>
<a id="pl.422.19"></a><var>422.19</var>means a home care service provided to a client by the home care provider or its employees, <br/>
<a id="pl.422.20"></a><var>422.20</var>and not by contract. Factors that must be considered in determining whether an individual <br/>
<a id="pl.422.21"></a><var>422.21</var>or a business entity provides at least one home care service directly include, but are not <br/>
<a id="pl.422.22"></a><var>422.22</var>limited to, whether the individual or business entity:<br/>
<a id="pl.422.23"></a><var>422.23</var>    (1) has the right to control, and does control, the types of services provided;<br/>
<a id="pl.422.24"></a><var>422.24</var>(2) has the right to control, and does control, when and how the services are provided;<br/>
<a id="pl.422.25"></a><var>422.25</var>    (3) establishes the charges;<br/>
<a id="pl.422.26"></a><var>422.26</var>(4) collects fees from the clients or receives payment from third-party payers on <br/>
<a id="pl.422.27"></a><var>422.27</var>the clients' behalf;<br/>
<a id="pl.422.28"></a><var>422.28</var>(5) pays individuals providing services compensation on an hourly, weekly, or <br/>
<a id="pl.422.29"></a><var>422.29</var>similar basis;<br/>
<a id="pl.422.30"></a><var>422.30</var>(6) treats the individuals providing services as employees for the purposes of payroll <br/>
<a id="pl.422.31"></a><var>422.31</var>taxes and workers' compensation insurance; and<br/>
<a id="pl.422.32"></a><var>422.32</var>(7) holds itself out as a provider of home care services or acts in a manner that <br/>
<a id="pl.422.33"></a><var>422.33</var>leads clients or potential clients to believe that it is a home care provider providing home <br/>
<a id="pl.422.34"></a><var>422.34</var>care services.<br/>
<a id="pl.422.35"></a><var>422.35</var>    None of the factors listed in this subdivision is solely determinative.<br/>
<a id="pl.423.1"></a><var>423.1</var>    Subd. 3. <b>Determination of regularly engaged.</b> "Regularly engaged" means <br/>
<a id="pl.423.2"></a><var>423.2</var>providing, or offering to provide, home care services as a regular part of a business. The <br/>
<a id="pl.423.3"></a><var>423.3</var>following factors must be considered by the commissioner in determining whether an <br/>
<a id="pl.423.4"></a><var>423.4</var>individual or a business entity is regularly engaged in providing home care services:<br/>
<a id="pl.423.5"></a><var>423.5</var>    (1) whether the individual or business entity states or otherwise promotes that the <br/>
<a id="pl.423.6"></a><var>423.6</var>individual or business entity provides home care services;<br/>
<a id="pl.423.7"></a><var>423.7</var>    (2) whether persons receiving home care services constitute a substantial part of the <br/>
<a id="pl.423.8"></a><var>423.8</var>individual's or the business entity's clientele; and<br/>
<a id="pl.423.9"></a><var>423.9</var>(3) whether the home care services provided are other than occasional or incidental <br/>
<a id="pl.423.10"></a><var>423.10</var>to the provision of services other than home care services.<br/>
<a id="pl.423.11"></a><var>423.11</var>    None of the factors listed in this subdivision is solely determinative.<br/>
<a id="pl.423.12"></a><var>423.12</var>    Subd. 4. <b>Penalties for operating without license.</b> A person involved in the <br/>
<a id="pl.423.13"></a><var>423.13</var>management, operation, or control of a home care provider that operates without an <br/>
<a id="pl.423.14"></a><var>423.14</var>appropriate license is guilty of a misdemeanor. This section does not apply to a person <br/>
<a id="pl.423.15"></a><var>423.15</var>who has no legal authority to affect or change decisions related to the management, <br/>
<a id="pl.423.16"></a><var>423.16</var>operation, or control of a home care provider.<br/>
<a id="pl.423.17"></a><var>423.17</var>    Subd. 5. <b>Basic and comprehensive levels of licensure.</b> An applicant seeking <br/>
<a id="pl.423.18"></a><var>423.18</var>to become a home care provider must apply for either a basic or comprehensive home <br/>
<a id="pl.423.19"></a><var>423.19</var>care license.<br/>
<a id="pl.423.20"></a><var>423.20</var>    Subd. 6. <b>Basic home care license provider.</b> Home care services that can be <br/>
<a id="pl.423.21"></a><var>423.21</var>provided with a basic home care license are assistive tasks provided by licensed or <br/>
<a id="pl.423.22"></a><var>423.22</var>unlicensed personnel that include:<br/>
<a id="pl.423.23"></a><var>423.23</var>(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, <br/>
<a id="pl.423.24"></a><var>423.24</var>and bathing;<br/>
<a id="pl.423.25"></a><var>423.25</var>(2) providing standby assistance;<br/>
<a id="pl.423.26"></a><var>423.26</var>(3) providing verbal or visual reminders to the client to take regularly scheduled <br/>
<a id="pl.423.27"></a><var>423.27</var>medication which includes bringing the client previously set-up medication, medication in <br/>
<a id="pl.423.28"></a><var>423.28</var>original containers, or liquid or food to accompany the medication;<br/>
<a id="pl.423.29"></a><var>423.29</var>(4) providing verbal or visual reminders to the client to perform regularly scheduled <br/>
<a id="pl.423.30"></a><var>423.30</var>treatments and exercises;<br/>
<a id="pl.423.31"></a><var>423.31</var>(5) preparing modified diets ordered by a licensed health professional; and<br/>
<a id="pl.423.32"></a><var>423.32</var>(6) assisting with laundry, housekeeping, meal preparation, shopping, or other <br/>
<a id="pl.423.33"></a><var>423.33</var>household chores and services if the provider is also providing at least one of the activities <br/>
<a id="pl.423.34"></a><var>423.34</var>in clauses (1) to (5)<br/>
<a id="pl.424.1"></a><var>424.1</var>    Subd. 7. <b>Comprehensive home care license provider.</b> Home care services that <br/>
<a id="pl.424.2"></a><var>424.2</var>may be provided with a comprehensive home care license include any of the basic home <br/>
<a id="pl.424.3"></a><var>424.3</var>care services listed in subdivision 6, and one or more of the following:<br/>
<a id="pl.424.4"></a><var>424.4</var>(1) services of an advanced practice nurse, registered nurse, licensed practical <br/>
<a id="pl.424.5"></a><var>424.5</var>nurse, physical therapist, respiratory therapist, occupational therapist, speech-language <br/>
<a id="pl.424.6"></a><var>424.6</var>pathologist, dietitian or nutritionist, or social worker;<br/>
<a id="pl.424.7"></a><var>424.7</var>(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a <br/>
<a id="pl.424.8"></a><var>424.8</var>licensed health professional within the person's scope of practice;<br/>
<a id="pl.424.9"></a><var>424.9</var>(3) medication management services;<br/>
<a id="pl.424.10"></a><var>424.10</var>(4) hands-on assistance with transfers and mobility;<br/>
<a id="pl.424.11"></a><var>424.11</var>(5) assisting clients with eating when the clients have complicating eating problems <br/>
<a id="pl.424.12"></a><var>424.12</var>as identified in the client record or through an assessment such as difficulty swallowing, <br/>
<a id="pl.424.13"></a><var>424.13</var>recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous <br/>
<a id="pl.424.14"></a><var>424.14</var>instruments to be fed; or<br/>
<a id="pl.424.15"></a><var>424.15</var>(6) providing other complex or specialty health care services.<br/>
<a id="pl.424.16"></a><var>424.16</var>    Subd. 8. <b>Exemptions from home care services licensure.</b> (a) Except as otherwise <br/>
<a id="pl.424.17"></a><var>424.17</var>provided in this chapter, home care services that are provided by the state, counties, or <br/>
<a id="pl.424.18"></a><var>424.18</var>other units of government must be licensed under this chapter.<br/>
<a id="pl.424.19"></a><var>424.19</var>(b) An exemption under this subdivision does not excuse the exempted individual or <br/>
<a id="pl.424.20"></a><var>424.20</var>organization from complying with applicable provisions of the home care bill of rights <br/>
<a id="pl.424.21"></a><var>424.21</var>in section 144A.44. The following individuals or organizations are exempt from the <br/>
<a id="pl.424.22"></a><var>424.22</var>requirement to obtain a home care provider license:<br/>
<a id="pl.424.23"></a><var>424.23</var>(1) an individual or organization that offers, provides, or arranges for personal care <br/>
<a id="pl.424.24"></a><var>424.24</var>assistance services under the medical assistance program as authorized under sections <br/>
<a id="pl.424.25"></a><var>424.25</var>256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;<br/>
<a id="pl.424.26"></a><var>424.26</var>(2) a provider that is licensed by the commissioner of human services to provide <br/>
<a id="pl.424.27"></a><var>424.27</var>semi-independent living services for persons with developmental disabilities under section <br/>
<a id="pl.424.28"></a><var>424.28</var>252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;<br/>
<a id="pl.424.29"></a><var>424.29</var>(3) a provider that is licensed by the commissioner of human services to provide <br/>
<a id="pl.424.30"></a><var>424.30</var>home and community-based services for persons with developmental disabilities under <br/>
<a id="pl.424.31"></a><var>424.31</var>section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;<br/>
<a id="pl.424.32"></a><var>424.32</var>(4) an individual or organization that provides only home management services, if <br/>
<a id="pl.424.33"></a><var>424.33</var>the individual or organization is registered under section 144A.482; or <br/>
<a id="pl.424.34"></a><var>424.34</var>(5) an individual who is licensed in this state as a nurse, dietitian, social worker, <br/>
<a id="pl.424.35"></a><var>424.35</var>occupational therapist, physical therapist, or speech-language pathologist who provides <br/>
<a id="pl.425.1"></a><var>425.1</var>health care services in the home independently and not through any contractual or <br/>
<a id="pl.425.2"></a><var>425.2</var>employment relationship with a home care provider or other organization.<br/>
<a id="pl.425.3"></a><var>425.3</var>    Subd. 9. <b>Exclusions from home care licensure.</b> The following are excluded from <br/>
<a id="pl.425.4"></a><var>425.4</var>home care licensure and are not required to provide the home care bill of rights:<br/>
<a id="pl.425.5"></a><var>425.5</var>(1) an individual or business entity providing only coordination of home care that <br/>
<a id="pl.425.6"></a><var>425.6</var>includes one or more of the following:<br/>
<a id="pl.425.7"></a><var>425.7</var>(i) determination of whether a client needs home care services, or assisting a client <br/>
<a id="pl.425.8"></a><var>425.8</var>in determining what services are needed;<br/>
<a id="pl.425.9"></a><var>425.9</var>(ii) referral of clients to a home care provider;<br/>
<a id="pl.425.10"></a><var>425.10</var>(iii) administration of payments for home care services; or<br/>
<a id="pl.425.11"></a><var>425.11</var>(iv) administration of a health care home established under section 256B.0751;<br/>
<a id="pl.425.12"></a><var>425.12</var>(2) an individual who is not an employee of a licensed home care provider if the <br/>
<a id="pl.425.13"></a><var>425.13</var>individual:<br/>
<a id="pl.425.14"></a><var>425.14</var>(i) only provides services as an independent contractor to one or more licensed <br/>
<a id="pl.425.15"></a><var>425.15</var>home care providers;<br/>
<a id="pl.425.16"></a><var>425.16</var>(ii) provides no services under direct agreements or contracts with clients; and<br/>
<a id="pl.425.17"></a><var>425.17</var>(iii) is contractually bound to perform services in compliance with the contracting <br/>
<a id="pl.425.18"></a><var>425.18</var>home care provider's policies and service plans;<br/>
<a id="pl.425.19"></a><var>425.19</var>(3) a business that provides staff to home care providers, such as a temporary <br/>
<a id="pl.425.20"></a><var>425.20</var>employment agency, if the business:<br/>
<a id="pl.425.21"></a><var>425.21</var>(i) only provides staff under contract to licensed or exempt providers;<br/>
<a id="pl.425.22"></a><var>425.22</var>(ii) provides no services under direct agreements with clients; and<br/>
<a id="pl.425.23"></a><var>425.23</var>(iii) is contractually bound to perform services under the contracting home care <br/>
<a id="pl.425.24"></a><var>425.24</var>provider's direction and supervision;<br/>
<a id="pl.425.25"></a><var>425.25</var>(4) any home care services conducted by and for the adherents of any recognized <br/>
<a id="pl.425.26"></a><var>425.26</var>church or religious denomination for its members through spiritual means, or by prayer <br/>
<a id="pl.425.27"></a><var>425.27</var>for healing;<br/>
<a id="pl.425.28"></a><var>425.28</var>(5) an individual who only provides home care services to a relative;<br/>
<a id="pl.425.29"></a><var>425.29</var>(6) an individual not connected with a home care provider that provides assistance <br/>
<a id="pl.425.30"></a><var>425.30</var>with basic home care needs if the assistance is provided primarily as a contribution and <br/>
<a id="pl.425.31"></a><var>425.31</var>not as a business;<br/>
<a id="pl.425.32"></a><var>425.32</var>(7) an individual not connected with a home care provider that shares housing with <br/>
<a id="pl.425.33"></a><var>425.33</var>and provides primarily housekeeping or homemaking services to an elderly or disabled <br/>
<a id="pl.425.34"></a><var>425.34</var>person in return for free or reduced-cost housing;<br/>
<a id="pl.425.35"></a><var>425.35</var>(8) an individual or provider providing home-delivered meal services;<br/>
<a id="pl.426.1"></a><var>426.1</var>(9) an individual providing senior companion services and other Older American <br/>
<a id="pl.426.2"></a><var>426.2</var>Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of <br/>
<a id="pl.426.3"></a><var>426.3</var>1973, United States Code, title 42, chapter 66;<br/>
<a id="pl.426.4"></a><var>426.4</var>(10) an employee of a nursing home licensed under this chapter or an employee of a <br/>
<a id="pl.426.5"></a><var>426.5</var>boarding care home licensed under sections 144.50 to 144.56 who responds to occasional <br/>
<a id="pl.426.6"></a><var>426.6</var>emergency calls from individuals residing in a residential setting that is attached to or <br/>
<a id="pl.426.7"></a><var>426.7</var>located on property contiguous to the nursing home or boarding care home;<br/>
<a id="pl.426.8"></a><var>426.8</var>(11) a member of a professional corporation organized under chapter 319B that <br/>
<a id="pl.426.9"></a><var>426.9</var>does not regularly offer or provide home care services as defined in section 144A.43, <br/>
<a id="pl.426.10"></a><var>426.10</var>subdivision 3;<br/>
<a id="pl.426.11"></a><var>426.11</var>(12) the following organizations established to provide medical or surgical services <br/>
<a id="pl.426.12"></a><var>426.12</var>that do not regularly offer or provide home care services as defined in section 144A.43, <br/>
<a id="pl.426.13"></a><var>426.13</var>subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit <br/>
<a id="pl.426.14"></a><var>426.14</var>corporation organized under chapter 317A, a partnership organized under chapter 323, or <br/>
<a id="pl.426.15"></a><var>426.15</var>any other entity determined by the commissioner;<br/>
<a id="pl.426.16"></a><var>426.16</var>(13) an individual or agency that provides medical supplies or durable medical <br/>
<a id="pl.426.17"></a><var>426.17</var>equipment, except when the provision of supplies or equipment is accompanied by a <br/>
<a id="pl.426.18"></a><var>426.18</var>home care service;<br/>
<a id="pl.426.19"></a><var>426.19</var>(14) a physician licensed under chapter 147;<br/>
<a id="pl.426.20"></a><var>426.20</var>(15) an individual who provides home care services to a person with a developmental <br/>
<a id="pl.426.21"></a><var>426.21</var>disability who lives in a place of residence with a family, foster family, or primary caregiver;<br/>
<a id="pl.426.22"></a><var>426.22</var>(16) a business that only provides services that are primarily instructional and not <br/>
<a id="pl.426.23"></a><var>426.23</var>medical services or health-related support services;<br/>
<a id="pl.426.24"></a><var>426.24</var>(17) an individual who performs basic home care services for no more than 14 hours <br/>
<a id="pl.426.25"></a><var>426.25</var>each calendar week to no more than one client;<br/>
<a id="pl.426.26"></a><var>426.26</var>(18) an individual or business licensed as hospice as defined in sections 144A.75 to <br/>
<a id="pl.426.27"></a><var>426.27</var>144A.755 who is not providing home care services independent of hospice service;<br/>
<a id="pl.426.28"></a><var>426.28</var>(19) activities conducted by the commissioner of health or a board of health as <br/>
<a id="pl.426.29"></a><var>426.29</var>defined in section 145A.02, subdivision 2, including communicable disease investigations <br/>
<a id="pl.426.30"></a><var>426.30</var>or testing; or<br/>
<a id="pl.426.31"></a><var>426.31</var>(20) administering or monitoring a prescribed therapy necessary to control or <br/>
<a id="pl.426.32"></a><var>426.32</var>prevent a communicable disease, or the monitoring of an individual's compliance with a <br/>
<a id="pl.426.33"></a><var>426.33</var>health directive as defined in section 144.4172, subdivision 6.<br/>
<br/>
<a id="bill.11.11.0"></a><a id="pl.426.34"></a><var>426.34</var>    Sec. 11. <b>[144A.472] HOME CARE PROVIDER LICENSE; APPLICATION </b><br/>
<a id="pl.426.35"></a><var>426.35</var><b>AND RENEWAL.</b><br/>
<a id="pl.427.1"></a><var>427.1</var>    Subdivision 1. <b>License applications.</b> Each application for a home care provider <br/>
<a id="pl.427.2"></a><var>427.2</var>license must include information sufficient to show that the applicant meets the <br/>
<a id="pl.427.3"></a><var>427.3</var>requirements of licensure, including:<br/>
<a id="pl.427.4"></a><var>427.4</var>    (1) the applicant's name, e-mail address, physical address, and mailing address, <br/>
<a id="pl.427.5"></a><var>427.5</var>including the name of the county in which the applicant resides and has a principal <br/>
<a id="pl.427.6"></a><var>427.6</var>place of business;<br/>
<a id="pl.427.7"></a><var>427.7</var>(2) the initial license fee in the amount specified in subdivision 7;<br/>
<a id="pl.427.8"></a><var>427.8</var>(3) e-mail address, physical address, mailing address, and telephone number of the <br/>
<a id="pl.427.9"></a><var>427.9</var>principal administrative office;<br/>
<a id="pl.427.10"></a><var>427.10</var>(4) e-mail address, physical address, mailing address, and telephone number of <br/>
<a id="pl.427.11"></a><var>427.11</var>each branch office, if any;<br/>
<a id="pl.427.12"></a><var>427.12</var>(5) names, e-mail and mailing addresses, and telephone numbers of all owners <br/>
<a id="pl.427.13"></a><var>427.13</var>and managerial officials;<br/>
<a id="pl.427.14"></a><var>427.14</var>(6) documentation of compliance with the background study requirements of section <br/>
<a id="pl.427.15"></a><var>427.15</var>144A.476 for all persons involved in the management, operation, or control of the home <br/>
<a id="pl.427.16"></a><var>427.16</var>care provider;<br/>
<a id="pl.427.17"></a><var>427.17</var>(7) documentation of a background study as required by section 144.057 for any <br/>
<a id="pl.427.18"></a><var>427.18</var>individual seeking employment, paid or volunteer, with the home care provider;<br/>
<a id="pl.427.19"></a><var>427.19</var>(8) evidence of workers' compensation coverage as required by sections 176.181 <br/>
<a id="pl.427.20"></a><var>427.20</var>and 176.182;<br/>
<a id="pl.427.21"></a><var>427.21</var>(9) documentation of liability coverage, if the provider has it;<br/>
<a id="pl.427.22"></a><var>427.22</var>(10) identification of the license level the provider is seeking;<br/>
<a id="pl.427.23"></a><var>427.23</var>(11) documentation that identifies the managerial official who is in charge of <br/>
<a id="pl.427.24"></a><var>427.24</var>day-to-day operations and attestation that the person has reviewed and understands the <br/>
<a id="pl.427.25"></a><var>427.25</var>home care provider regulations;<br/>
<a id="pl.427.26"></a><var>427.26</var>(12) documentation that the applicant has designated one or more owners, <br/>
<a id="pl.427.27"></a><var>427.27</var>managerial officials, or employees as an agent or agents, which shall not affect the legal <br/>
<a id="pl.427.28"></a><var>427.28</var>responsibility of any other owner or managerial official under this chapter;<br/>
<a id="pl.427.29"></a><var>427.29</var>(13) the signature of the officer or managing agent on behalf of an entity, corporation, <br/>
<a id="pl.427.30"></a><var>427.30</var>association, or unit of government;<br/>
<a id="pl.427.31"></a><var>427.31</var>(14) verification that the applicant has the following policies and procedures in place <br/>
<a id="pl.427.32"></a><var>427.32</var>so that if a license is issued, the applicant will implement the policies and procedures <br/>
<a id="pl.427.33"></a><var>427.33</var>and keep them current:<br/>
<a id="pl.427.34"></a><var>427.34</var>    (i) requirements in sections 626.556, reporting of maltreatment of minors, and <br/>
<a id="pl.427.35"></a><var>427.35</var>626.557, reporting of maltreatment of vulnerable adults;<br/>
<a id="pl.427.36"></a><var>427.36</var>(ii) conducting and handling background studies on employees;<br/>
<a id="pl.428.1"></a><var>428.1</var>(iii) orientation, training, and competency evaluations of home care staff, and a <br/>
<a id="pl.428.2"></a><var>428.2</var>process for evaluating staff performance;<br/>
<a id="pl.428.3"></a><var>428.3</var>(iv) handling complaints from clients, family members, or client representatives <br/>
<a id="pl.428.4"></a><var>428.4</var>regarding staff or services provided by staff;<br/>
<a id="pl.428.5"></a><var>428.5</var>(v) conducting initial evaluation of clients' needs and the providers' ability to provide <br/>
<a id="pl.428.6"></a><var>428.6</var>those services;<br/>
<a id="pl.428.7"></a><var>428.7</var>(vi) conducting initial and ongoing client evaluations and assessments and how <br/>
<a id="pl.428.8"></a><var>428.8</var>changes in a client's condition are identified, managed, and communicated to staff and <br/>
<a id="pl.428.9"></a><var>428.9</var>other health care providers as appropriate;<br/>
<a id="pl.428.10"></a><var>428.10</var>(vii) orientation to and implementation of the home care client bill of rights;<br/>
<a id="pl.428.11"></a><var>428.11</var>(viii) infection control practices;<br/>
<a id="pl.428.12"></a><var>428.12</var>(ix) reminders for medications, treatments, or exercises, if provided; and<br/>
<a id="pl.428.13"></a><var>428.13</var>(x) conducting appropriate screenings, or documentation of prior screenings, to <br/>
<a id="pl.428.14"></a><var>428.14</var>show that staff are free of tuberculosis, consistent with current United States Centers for <br/>
<a id="pl.428.15"></a><var>428.15</var>Disease Control standards; and<br/>
<a id="pl.428.16"></a><var>428.16</var>(15) other information required by the department.<br/>
<a id="pl.428.17"></a><var>428.17</var>    Subd. 2. <b>Comprehensive home care license applications.</b> In addition to the <br/>
<a id="pl.428.18"></a><var>428.18</var>information and fee required in subdivision 1, applicants applying for a comprehensive <br/>
<a id="pl.428.19"></a><var>428.19</var>home care license must also provide verification that the applicant has the following <br/>
<a id="pl.428.20"></a><var>428.20</var>policies and procedures in place so that if a license is issued, the applicant will implement <br/>
<a id="pl.428.21"></a><var>428.21</var>the policies and procedures in this subdivision and keep them current:<br/>
<a id="pl.428.22"></a><var>428.22</var>(1) conducting initial and ongoing assessments of the client's needs by a registered <br/>
<a id="pl.428.23"></a><var>428.23</var>nurse or appropriate licensed health professional, including how changes in the client's <br/>
<a id="pl.428.24"></a><var>428.24</var>conditions are identified, managed, and communicated to staff and other health care <br/>
<a id="pl.428.25"></a><var>428.25</var>providers, as appropriate;<br/>
<a id="pl.428.26"></a><var>428.26</var>(2) ensuring that nurses and licensed health professionals have current and valid <br/>
<a id="pl.428.27"></a><var>428.27</var>licenses to practice;<br/>
<a id="pl.428.28"></a><var>428.28</var>(3) medication and treatment management;<br/>
<a id="pl.428.29"></a><var>428.29</var>(4) delegation of home care tasks by registered nurses or licensed health professionals;<br/>
<a id="pl.428.30"></a><var>428.30</var>(5) supervision of registered nurses and licensed health professionals; and<br/>
<a id="pl.428.31"></a><var>428.31</var>(6) supervision of unlicensed personnel performing delegated home care tasks.<br/>
<a id="pl.428.32"></a><var>428.32</var>    Subd. 3. <b>License renewal.</b> (a) Except as provided in section 144A.475, a license <br/>
<a id="pl.428.33"></a><var>428.33</var>may be renewed for a period of one year if the licensee satisfies the following:<br/>
<a id="pl.428.34"></a><var>428.34</var>(1) submits an application for renewal in the format provided by the commissioner <br/>
<a id="pl.428.35"></a><var>428.35</var>at least 30 days before expiration of the license;<br/>
<a id="pl.428.36"></a><var>428.36</var>(2) submits the renewal fee in the amount specified in subdivision 7;<br/>
<a id="pl.429.1"></a><var>429.1</var>(3) has provided home care services within the past 12 months;<br/>
<a id="pl.429.2"></a><var>429.2</var>(4) complies with sections 144A.43 to 144A.4799;<br/>
<a id="pl.429.3"></a><var>429.3</var>(5) provides information sufficient to show that the applicant meets the requirements <br/>
<a id="pl.429.4"></a><var>429.4</var>of licensure, including items required under subdivision 1;<br/>
<a id="pl.429.5"></a><var>429.5</var>(6) provides verification that all policies under subdivision 1 are current; and <br/>
<a id="pl.429.6"></a><var>429.6</var>(7) provides any other information deemed necessary by the commissioner.<br/>
<a id="pl.429.7"></a><var>429.7</var>(b) A renewal applicant who holds a comprehensive home care license must also <br/>
<a id="pl.429.8"></a><var>429.8</var>provide verification that policies listed under subdivision 2 are current.<br/>
<a id="pl.429.9"></a><var>429.9</var>    Subd. 4. <b>Multiple units.</b> Multiple units or branches of a licensee must be separately <br/>
<a id="pl.429.10"></a><var>429.10</var>licensed if the commissioner determines that the units cannot adequately share supervision <br/>
<a id="pl.429.11"></a><var>429.11</var>and administration of services from the main office.<br/>
<a id="pl.429.12"></a><var>429.12</var>    Subd. 5. <b>Transfers prohibited; changes in ownership.</b> Any home care license <br/>
<a id="pl.429.13"></a><var>429.13</var>issued by the commissioner may not be transferred to another party. Before acquiring <br/>
<a id="pl.429.14"></a><var>429.14</var>ownership of a home care provider business, a prospective applicant must apply for a <br/>
<a id="pl.429.15"></a><var>429.15</var>new temporary license. A change of ownership is a transfer of operational control to <br/>
<a id="pl.429.16"></a><var>429.16</var>a different business entity, and includes:<br/>
<a id="pl.429.17"></a><var>429.17</var>(1) transfer of the business to a different or new corporation;<br/>
<a id="pl.429.18"></a><var>429.18</var>(2) in the case of a partnership, the dissolution or termination of the partnership under <br/>
<a id="pl.429.19"></a><var>429.19</var>chapter 323A, with the business continuing by a successor partnership or other entity; <br/>
<a id="pl.429.20"></a><var>429.20</var>(3) relinquishment of control of the provider to another party, including to a contract <br/>
<a id="pl.429.21"></a><var>429.21</var>management firm that is not under the control of the owner of the business' assets;<br/>
<a id="pl.429.22"></a><var>429.22</var>(4) transfer of the business by a sole proprietor to another party or entity; or<br/>
<a id="pl.429.23"></a><var>429.23</var>(5) in the case of a privately held corporation, the change in ownership or control of <br/>
<a id="pl.429.24"></a><var>429.24</var>50 percent or more of the outstanding voting stock.<br/>
<a id="pl.429.25"></a><var>429.25</var>    Subd. 6. <b>Notification of changes of information.</b> The temporary licensee or <br/>
<a id="pl.429.26"></a><var>429.26</var>licensee shall notify the commissioner in writing within ten working days after any <br/>
<a id="pl.429.27"></a><var>429.27</var>change in the information required in subdivision 1, except the information required in <br/>
<a id="pl.429.28"></a><var>429.28</var>subdivision 1, clause (5), is required at the time of license renewal.<br/>
<a id="pl.429.29"></a><var>429.29</var>    Subd. 7. <b>Fees; application, change of ownership, and renewal.</b> (a) An applicant <br/>
<a id="pl.429.30"></a><var>429.30</var>seeking a temporary home care licensure must submit the following application fee to the <br/>
<a id="pl.429.31"></a><var>429.31</var>commissioner along with a completed application:<br/>
<a id="pl.429.32"></a><var>429.32</var>(1) basic home care provider, $2,100; or<br/>
<a id="pl.429.33"></a><var>429.33</var>(2) comprehensive home care provider, $4,200.<br/>
<a id="pl.429.34"></a><var>429.34</var>(b) A home care provider who is filing a change of ownership as required under <br/>
<a id="pl.429.35"></a><var>429.35</var>subdivision 5 must submit the following application fee to the commissioner, along with <br/>
<a id="pl.429.36"></a><var>429.36</var>the documentation required for the change of ownership:<br/>
<a id="pl.430.1"></a><var>430.1</var>(1) basic home care provider, $2,100; or<br/>
<a id="pl.430.2"></a><var>430.2</var>(2) comprehensive home care provider, $4,200.<br/>
<a id="pl.430.3"></a><var>430.3</var>(c) A home care provider who is seeking to renew the provider's license shall pay a <br/>
<a id="pl.430.4"></a><var>430.4</var>fee to the commissioner based on revenues derived from the provision of home care <br/>
<a id="pl.430.5"></a><var>430.5</var>services during the calendar year prior to the year in which the application is submitted, <br/>
<a id="pl.430.6"></a><var>430.6</var>according to the following schedule:<br/>
<a id="pl.430.7"></a><var>430.7</var>License Renewal Fee<br/>
<table>
<col width="50px"/>
<col width="44.2"/>
<col width="13.3"/>
<col width="21.200000000000003"/>
<col width="21.299999999999997"/>
<tr>
<td><a id="pl.430.8"></a><var>430.8</var><br/>
</td>
<td valign="bottom">Provider Annual Revenue<br/>
</td>
<td></td>
<td align="right" valign="bottom">Fee<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.9"></a><var>430.9</var><br/>
</td>
<td valign="bottom">greater than $1,500,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$6,625<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.10"></a><var>430.10</var><br/>
<a id="pl.430.11"></a><var>430.11</var><br/>
</td>
<td valign="bottom">greater than $1,275,000 and no more <br/>
than $1,500,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$5,797<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.12"></a><var>430.12</var><br/>
<a id="pl.430.13"></a><var>430.13</var><br/>
</td>
<td valign="bottom">greater than $1,100,000 and no more <br/>
than $1,275,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$4,969<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.14"></a><var>430.14</var><br/>
<a id="pl.430.15"></a><var>430.15</var><br/>
</td>
<td valign="bottom">greater than $950,000 and no more <br/>
than $1,100,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$4,141<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.16"></a><var>430.16</var><br/>
<a id="pl.430.17"></a><var>430.17</var><br/>
</td>
<td valign="bottom">greater than $850,000 and no more <br/>
than $950,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$3,727<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.18"></a><var>430.18</var><br/>
<a id="pl.430.19"></a><var>430.19</var><br/>
</td>
<td valign="bottom">greater than $750,000 and no more <br/>
than $850,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$3,313<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.20"></a><var>430.20</var><br/>
<a id="pl.430.21"></a><var>430.21</var><br/>
</td>
<td valign="bottom">greater than $650,000 and no more <br/>
than $750,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$2,898<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.22"></a><var>430.22</var><br/>
<a id="pl.430.23"></a><var>430.23</var><br/>
</td>
<td valign="bottom">greater than $550,000 and no more <br/>
than $650,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$2,485<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.24"></a><var>430.24</var><br/>
<a id="pl.430.25"></a><var>430.25</var><br/>
</td>
<td valign="bottom">greater than $450,000 and no more <br/>
than $550,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$2,070<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.26"></a><var>430.26</var><br/>
<a id="pl.430.27"></a><var>430.27</var><br/>
</td>
<td valign="bottom">greater than $350,000 and no more <br/>
than $450,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$1,656<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.28"></a><var>430.28</var><br/>
<a id="pl.430.29"></a><var>430.29</var><br/>
</td>
<td valign="bottom">greater than $250,000 and no more <br/>
than $350,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$1,242<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.30"></a><var>430.30</var><br/>
<a id="pl.430.31"></a><var>430.31</var><br/>
</td>
<td valign="bottom">greater than $100,000 and no more <br/>
than $250,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$828<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.32"></a><var>430.32</var><br/>
<a id="pl.430.33"></a><var>430.33</var><br/>
</td>
<td valign="bottom">greater than $50,000 and no more than <br/>
$100,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$500<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.34"></a><var>430.34</var><br/>
<a id="pl.430.35"></a><var>430.35</var><br/>
</td>
<td valign="bottom">greater than $25,000 and no more than <br/>
$50,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$400<br/>
</td>
<td></td>
</tr>
<tr>
<td><a id="pl.430.36"></a><var>430.36</var><br/>
</td>
<td valign="bottom">no more than $25,000<br/>
</td>
<td></td>
<td align="right" valign="bottom">$200<br/>
</td>
<td></td>
</tr>
</table><a id="pl.430.37"></a><var>430.37</var>(d) If requested, the home care provider shall provide the commissioner information <br/>
<a id="pl.430.38"></a><var>430.38</var>to verify the provider's annual revenues or other information as needed, including copies <br/>
<a id="pl.430.39"></a><var>430.39</var>of documents submitted to the Department of Revenue.<br/>
<a id="pl.430.40"></a><var>430.40</var>(e) At each annual renewal, a home care provider may elect to pay the highest <br/>
<a id="pl.430.41"></a><var>430.41</var>renewal fee for its license category, and not provide annual revenue information to the <br/>
<a id="pl.430.42"></a><var>430.42</var>commissioner.<br/>
<a id="pl.431.1"></a><var>431.1</var>(f) A temporary license or license applicant, or temporary licensee or licensee that <br/>
<a id="pl.431.2"></a><var>431.2</var>knowingly provides the commissioner incorrect revenue amounts for the purpose of <br/>
<a id="pl.431.3"></a><var>431.3</var>paying a lower license fee, shall be subject to a civil penalty in the amount of double the <br/>
<a id="pl.431.4"></a><var>431.4</var>fee the provider should have paid.<br/>
<a id="pl.431.5"></a><var>431.5</var>(g) Fees and penalties collected under this section shall be deposited in the state <br/>
<a id="pl.431.6"></a><var>431.6</var>treasury and credited to the special state government revenue fund.<br/>
<br/>
<a id="bill.11.12.0"></a><a id="pl.431.7"></a><var>431.7</var>    Sec. 12. <b>[144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE </b><br/>
<a id="pl.431.8"></a><var>431.8</var><b>RENEWAL.</b><br/>
<a id="pl.431.9"></a><var>431.9</var>    Subdivision 1. <b>Temporary license and renewal of license.</b> (a) The department <br/>
<a id="pl.431.10"></a><var>431.10</var>shall review each application to determine the applicant's knowledge of and compliance <br/>
<a id="pl.431.11"></a><var>431.11</var>with Minnesota home care regulations. Before granting a temporary license or renewing a <br/>
<a id="pl.431.12"></a><var>431.12</var>license, the commissioner may further evaluate the applicant or licensee by requesting <br/>
<a id="pl.431.13"></a><var>431.13</var>additional information or documentation or by conducting an on-site survey of the <br/>
<a id="pl.431.14"></a><var>431.14</var>applicant to determine compliance with sections 144A.43 to 144A.482.<br/>
<a id="pl.431.15"></a><var>431.15</var>(b) Within 14 calendar days after receiving an application for a license, <br/>
<a id="pl.431.16"></a><var>431.16</var>the commissioner shall acknowledge receipt of the application in writing. The <br/>
<a id="pl.431.17"></a><var>431.17</var>acknowledgment must indicate whether the application appears to be complete or whether <br/>
<a id="pl.431.18"></a><var>431.18</var>additional information is required before the application will be considered complete.<br/>
<a id="pl.431.19"></a><var>431.19</var>(c) Within 90 days after receiving a complete application, the commissioner shall <br/>
<a id="pl.431.20"></a><var>431.20</var>issue a temporary license, renew the license, or deny the license.<br/>
<a id="pl.431.21"></a><var>431.21</var>(d) The commissioner shall issue a license that contains the home care provider's <br/>
<a id="pl.431.22"></a><var>431.22</var>name, address, license level, expiration date of the license, and unique license number. All <br/>
<a id="pl.431.23"></a><var>431.23</var>licenses are valid for one year from the date of issuance.<br/>
<a id="pl.431.24"></a><var>431.24</var>    Subd. 2. <b>Temporary license.</b> (a) For new license applicants, the commissioner <br/>
<a id="pl.431.25"></a><var>431.25</var>shall issue a temporary license for either the basic or comprehensive home care level. A <br/>
<a id="pl.431.26"></a><var>431.26</var>temporary license is effective for one year from the date of issuance. Temporary licensees <br/>
<a id="pl.431.27"></a><var>431.27</var>must comply with sections 144A.43 to 144A.482.<br/>
<a id="pl.431.28"></a><var>431.28</var>(b) During the temporary license year, the commissioner shall survey the temporary <br/>
<a id="pl.431.29"></a><var>431.29</var>licensee after the commissioner is notified or has evidence that the temporary licensee <br/>
<a id="pl.431.30"></a><var>431.30</var>is providing home care services.<br/>
<a id="pl.431.31"></a><var>431.31</var>(c) Within five days of beginning the provision of services, the temporary <br/>
<a id="pl.431.32"></a><var>431.32</var>licensee must notify the commissioner that it is serving clients. The notification to the <br/>
<a id="pl.431.33"></a><var>431.33</var>commissioner may be mailed or e-mailed to the commissioner at the address provided by <br/>
<a id="pl.431.34"></a><var>431.34</var>the commissioner. If the temporary licensee does not provide home care services during <br/>
<a id="pl.432.1"></a><var>432.1</var>the temporary license year, then the temporary license expires at the end of the year and <br/>
<a id="pl.432.2"></a><var>432.2</var>the applicant must reapply for a temporary home care license.<br/>
<a id="pl.432.3"></a><var>432.3</var>(d) A temporary licensee may request a change in the level of licensure prior to <br/>
<a id="pl.432.4"></a><var>432.4</var>being surveyed and granted a license by notifying the commissioner in writing and <br/>
<a id="pl.432.5"></a><var>432.5</var>providing additional documentation or materials required to update or complete the <br/>
<a id="pl.432.6"></a><var>432.6</var>changed temporary license application. The applicant must pay the difference between the <br/>
<a id="pl.432.7"></a><var>432.7</var>application fees when changing from the basic to the comprehensive level of licensure. <br/>
<a id="pl.432.8"></a><var>432.8</var>No refund will be made if the provider chooses to change the license application to the <br/>
<a id="pl.432.9"></a><var>432.9</var>basic level.<br/>
<a id="pl.432.10"></a><var>432.10</var>(e) If the temporary licensee notifies the commissioner that the licensee has clients <br/>
<a id="pl.432.11"></a><var>432.11</var>within 45 days prior to the temporary license expiration, the commissioner may extend the <br/>
<a id="pl.432.12"></a><var>432.12</var>temporary license for up to 60 days in order to allow the commissioner to complete the <br/>
<a id="pl.432.13"></a><var>432.13</var>on-site survey required under this section and follow-up survey visits.<br/>
<a id="pl.432.14"></a><var>432.14</var>    Subd. 3. <b>Temporary licensee survey.</b> (a) If the temporary licensee is in substantial <br/>
<a id="pl.432.15"></a><var>432.15</var>compliance with the survey, the commissioner shall issue either a basic or comprehensive <br/>
<a id="pl.432.16"></a><var>432.16</var>home care license. If the temporary licensee is not in substantial compliance with the <br/>
<a id="pl.432.17"></a><var>432.17</var>survey, the commissioner shall not issue a basic or comprehensive license and there will <br/>
<a id="pl.432.18"></a><var>432.18</var>be no contested hearing right under chapter 14.<br/>
<a id="pl.432.19"></a><var>432.19</var>(b) If the temporary licensee whose basic or comprehensive license has been denied <br/>
<a id="pl.432.20"></a><var>432.20</var>disagrees with the conclusions of the commissioner, then the licensee may request a <br/>
<a id="pl.432.21"></a><var>432.21</var>reconsideration by the commissioner or commissioner's designee. The reconsideration <br/>
<a id="pl.432.22"></a><var>432.22</var>request process will be conducted internally by the commissioner or commissioner's <br/>
<a id="pl.432.23"></a><var>432.23</var>designee, and chapter 14 does not apply.<br/>
<a id="pl.432.24"></a><var>432.24</var>(c) The temporary licensee requesting reconsideration must make the request in <br/>
<a id="pl.432.25"></a><var>432.25</var>writing and must list and describe the reasons why the licensee disagrees with the decision <br/>
<a id="pl.432.26"></a><var>432.26</var>to deny the basic or comprehensive home care license.<br/>
<a id="pl.432.27"></a><var>432.27</var>(d) A temporary licensee whose license is denied must comply with the requirements <br/>
<a id="pl.432.28"></a><var>432.28</var>for notification and transfer of clients in section 144A.475, subdivision 5.<br/>
<br/>
<a id="bill.11.13.0"></a><a id="pl.432.29"></a><var>432.29</var>    Sec. 13. <b>[144A.474] SURVEYS AND INVESTIGATIONS.</b><br/>
<a id="pl.432.30"></a><var>432.30</var>    Subdivision 1. <b>Surveys.</b> The commissioner shall conduct surveys of each home <br/>
<a id="pl.432.31"></a><var>432.31</var>care provider. By June 30, 2016, the commissioner shall conduct a survey of home care <br/>
<a id="pl.432.32"></a><var>432.32</var>providers on a frequency of at least once every three years. Survey frequency may be <br/>
<a id="pl.432.33"></a><var>432.33</var>based on the license level, the provider's compliance history, number of clients served, <br/>
<a id="pl.432.34"></a><var>432.34</var>or other factors as determined by the department deemed necessary to ensure the health, <br/>
<a id="pl.432.35"></a><var>432.35</var>safety, and welfare of clients and compliance with the law.<br/>
<a id="pl.433.1"></a><var>433.1</var>    Subd. 2. <b>Types of home care surveys.</b> (a) "Initial full survey" is the survey <br/>
<a id="pl.433.2"></a><var>433.2</var>conducted of a new temporary licensee after the department is notified or has evidence that <br/>
<a id="pl.433.3"></a><var>433.3</var>the licensee is providing home care services to determine if the provider is in compliance <br/>
<a id="pl.433.4"></a><var>433.4</var>with home care requirements. Initial surveys must be completed within 14 months after <br/>
<a id="pl.433.5"></a><var>433.5</var>the department's issuance of a temporary basic or comprehensive license.<br/>
<a id="pl.433.6"></a><var>433.6</var>(b) "Core survey" means periodic inspection of home care providers to determine <br/>
<a id="pl.433.7"></a><var>433.7</var>ongoing compliance with the home care requirements focusing on the essential health and <br/>
<a id="pl.433.8"></a><var>433.8</var>safety requirements.  Core surveys are available to licensed home care providers who have <br/>
<a id="pl.433.9"></a><var>433.9</var>been licensed for three years, and been surveyed at least once in the past three years, <br/>
<a id="pl.433.10"></a><var>433.10</var>with the latest survey having no widespread violation or violations beyond Level 1 as <br/>
<a id="pl.433.11"></a><var>433.11</var>provided in subdivision 11.   Providers must also have not had any substantiated licensing <br/>
<a id="pl.433.12"></a><var>433.12</var>complaints, substantiated complaints against the agency under the Vulnerable Adults <br/>
<a id="pl.433.13"></a><var>433.13</var>Act or Maltreatment of Minors Act, or an enforcement action as authorized in section  <br/>
<a id="pl.433.14"></a><var>433.14</var>144A.475 in the past three years. The core survey for basic license level providers will <br/>
<a id="pl.433.15"></a><var>433.15</var>review compliance in the following areas:<br/>
<a id="pl.433.16"></a><var>433.16</var>(1) reporting of maltreatment;<br/>
<a id="pl.433.17"></a><var>433.17</var>(2) orientation to and implementation of home care client bill of rights;<br/>
<a id="pl.433.18"></a><var>433.18</var>(3) statement of home care services;<br/>
<a id="pl.433.19"></a><var>433.19</var>(4) initial evaluation of clients and initiation of services;<br/>
<a id="pl.433.20"></a><var>433.20</var>(5) basic license level client review and monitoring;<br/>
<a id="pl.433.21"></a><var>433.21</var>(6) service plan implementation and changes to the service plan;<br/>
<a id="pl.433.22"></a><var>433.22</var>(7) client complaint and investigative process;<br/>
<a id="pl.433.23"></a><var>433.23</var>(8) competency of unlicensed personnel; and<br/>
<a id="pl.433.24"></a><var>433.24</var>(9) infection control.<br/>
<a id="pl.433.25"></a><var>433.25</var>For comprehensive license level providers, the core survey will include everything <br/>
<a id="pl.433.26"></a><var>433.26</var>in the basic license level core survey plus these areas: <br/>
<a id="pl.433.27"></a><var>433.27</var>(1) assessment, monitoring, and reassessments of clients; and<br/>
<a id="pl.433.28"></a><var>433.28</var>(2) medication, treatment, and therapy management. <br/>
<a id="pl.433.29"></a><var>433.29</var>(c) "Full survey" means the periodic inspection of home care providers to determine <br/>
<a id="pl.433.30"></a><var>433.30</var>ongoing compliance with the home care requirements that cover the core survey areas and <br/>
<a id="pl.433.31"></a><var>433.31</var>all the legal requirements for home care providers. A full survey will be conducted for <br/>
<a id="pl.433.32"></a><var>433.32</var>all temporary licensees, providers who do not meet the requirements needed for a core <br/>
<a id="pl.433.33"></a><var>433.33</var>survey, and when a surveyor identifies unacceptable client health or safety risks during a <br/>
<a id="pl.433.34"></a><var>433.34</var>core survey.  A full survey will include all the tasks identified as part of the core survey <br/>
<a id="pl.433.35"></a><var>433.35</var>and any additional review deemed necessary by the department, including additional <br/>
<a id="pl.433.36"></a><var>433.36</var>observation, interviewing, or records review of additional clients and staff.  <br/>
<a id="pl.434.1"></a><var>434.1</var>(d) "Follow-up surveys" are conducted to determine if a home care provider has <br/>
<a id="pl.434.2"></a><var>434.2</var>corrected deficient issues and systems identified during a core survey, full survey, or <br/>
<a id="pl.434.3"></a><var>434.3</var>complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax, <br/>
<a id="pl.434.4"></a><var>434.4</var>mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be <br/>
<a id="pl.434.5"></a><var>434.5</var>concluded with an exit conference and written information provided on the process for <br/>
<a id="pl.434.6"></a><var>434.6</var>requesting a reconsideration of the survey results.<br/>
<a id="pl.434.7"></a><var>434.7</var>(e) Upon receiving information alleging that a home care provider has violated or <br/>
<a id="pl.434.8"></a><var>434.8</var>is currently violating a requirement of sections  144A.43 to 144A.482, the commissioner <br/>
<a id="pl.434.9"></a><var>434.9</var>shall investigate the complaint according to sections 144A.51 to 144A.54.<br/>
<a id="pl.434.10"></a><var>434.10</var>    Subd. 3. <b>Survey process.</b>  The survey process for core surveys shall include the <br/>
<a id="pl.434.11"></a><var>434.11</var>following as applicable to the particular licensee and setting surveyed:<br/>
<a id="pl.434.12"></a><var>434.12</var>(1) presurvey review of  pertinent documents and notification to the ombudsman <br/>
<a id="pl.434.13"></a><var>434.13</var>for long-term care;  <br/>
<a id="pl.434.14"></a><var>434.14</var>(2) an entrance conference with available staff; <br/>
<a id="pl.434.15"></a><var>434.15</var>(3) communication with managerial officials or the RN in charge, if available, and <br/>
<a id="pl.434.16"></a><var>434.16</var>ongoing communication with key staff throughout the survey regarding information <br/>
<a id="pl.434.17"></a><var>434.17</var>needed by the surveyor, clarifications regarding home care requirements, and applicable <br/>
<a id="pl.434.18"></a><var>434.18</var>standards of practice;<br/>
<a id="pl.434.19"></a><var>434.19</var>(4) presentation of written contact information to the provider about the survey staff <br/>
<a id="pl.434.20"></a><var>434.20</var>conducting the survey, the supervisor, and the process for requesting a reconsideration of <br/>
<a id="pl.434.21"></a><var>434.21</var>the survey results;<br/>
<a id="pl.434.22"></a><var>434.22</var>(5) a brief tour of a sampling of  the housing with services establishments in which <br/>
<a id="pl.434.23"></a><var>434.23</var>the provider is providing home care services; <br/>
<a id="pl.434.24"></a><var>434.24</var>(6) a sample selection of home care clients;<br/>
<a id="pl.434.25"></a><var>434.25</var>(7) information gathering through client and staff observations, client and staff <br/>
<a id="pl.434.26"></a><var>434.26</var>interviews, and reviews of records, policies, procedures, practices, and other agency <br/>
<a id="pl.434.27"></a><var>434.27</var>information; <br/>
<a id="pl.434.28"></a><var>434.28</var>(8) interviews of client's family members, if available, with client's consent when the <br/>
<a id="pl.434.29"></a><var>434.29</var>client can legally give consent;<br/>
<a id="pl.434.30"></a><var>434.30</var>(9) except for complaint surveys conducted by the Office of Health Facilities <br/>
<a id="pl.434.31"></a><var>434.31</var>Complaints, an on-site exit conference with preliminary findings shared and discussed <br/>
<a id="pl.434.32"></a><var>434.32</var>with the provider, documentation that an exit conference occurred, and written information <br/>
<a id="pl.434.33"></a><var>434.33</var>on the process for requesting a reconsideration of the survey results; and<br/>
<a id="pl.434.34"></a><var>434.34</var>(10) postsurvey analysis of findings and formulation of survey results, including <br/>
<a id="pl.434.35"></a><var>434.35</var>correction orders when applicable.<br/>
<a id="pl.435.1"></a><var>435.1</var>    Subd. 4. <b>Scheduling surveys.</b> Surveys and investigations shall be conducted <br/>
<a id="pl.435.2"></a><var>435.2</var>without advance notice to home care providers. Surveyors may contact the home care <br/>
<a id="pl.435.3"></a><var>435.3</var>provider on the day of a survey to arrange for someone to be available at the survey site. <br/>
<a id="pl.435.4"></a><var>435.4</var>The contact does not constitute advance notice.<br/>
<a id="pl.435.5"></a><var>435.5</var>    Subd. 5. <b>Information provided by home care provider.</b> The home care provider <br/>
<a id="pl.435.6"></a><var>435.6</var>shall provide accurate and truthful information to the department during a survey, <br/>
<a id="pl.435.7"></a><var>435.7</var>investigation, or other licensing activities.<br/>
<a id="pl.435.8"></a><var>435.8</var>    Subd. 6. <b>Providing client records.</b> Upon request of a surveyor, home care providers <br/>
<a id="pl.435.9"></a><var>435.9</var>shall provide a list of current and past clients or client representatives that includes <br/>
<a id="pl.435.10"></a><var>435.10</var>addresses and telephone numbers and any other information requested about the services <br/>
<a id="pl.435.11"></a><var>435.11</var>to clients within a reasonable period of time.<br/>
<a id="pl.435.12"></a><var>435.12</var>    Subd. 7. <b>Contacting and visiting clients.</b> Surveyors may contact or visit a home <br/>
<a id="pl.435.13"></a><var>435.13</var>care provider's clients to gather information without notice to the home care provider. <br/>
<a id="pl.435.14"></a><var>435.14</var>Before visiting a client, a surveyor shall obtain the client's or client's representative's <br/>
<a id="pl.435.15"></a><var>435.15</var>permission by telephone, mail, or in person. Surveyors shall inform all clients or client's <br/>
<a id="pl.435.16"></a><var>435.16</var>representatives of their right to decline permission for a visit.<br/>
<a id="pl.435.17"></a><var>435.17</var>    Subd. 8. <b>Correction orders.</b> (a) A correction order may be issued whenever the <br/>
<a id="pl.435.18"></a><var>435.18</var>commissioner finds upon survey or during a complaint investigation that a home care <br/>
<a id="pl.435.19"></a><var>435.19</var>provider, managerial official, or an employee of the provider is not in compliance with <br/>
<a id="pl.435.20"></a><var>435.20</var>sections 144A.43 to 144A.482. The correction order shall cite the specific statute and <br/>
<a id="pl.435.21"></a><var>435.21</var>document areas of noncompliance and the time allowed for correction.<br/>
<a id="pl.435.22"></a><var>435.22</var>(b) The commissioner shall mail copies of any correction order to the last known <br/>
<a id="pl.435.23"></a><var>435.23</var>address of the home care provider. A copy of each correction order and copies of any <br/>
<a id="pl.435.24"></a><var>435.24</var>documentation supplied to the commissioner shall be kept on file by the home care <br/>
<a id="pl.435.25"></a><var>435.25</var>provider, and public documents shall be made available for viewing by any person upon <br/>
<a id="pl.435.26"></a><var>435.26</var>request. Copies may be kept electronically.<br/>
<a id="pl.435.27"></a><var>435.27</var>(c) By the correction order date, the home care provider must document in the <br/>
<a id="pl.435.28"></a><var>435.28</var>provider's records any action taken to comply with the correction order. The commissioner <br/>
<a id="pl.435.29"></a><var>435.29</var>may request a copy of this documentation and the home care provider's action to respond <br/>
<a id="pl.435.30"></a><var>435.30</var>to the correction order in future surveys, upon a complaint investigation, and as otherwise <br/>
<a id="pl.435.31"></a><var>435.31</var>needed.<br/>
<a id="pl.435.32"></a><var>435.32</var>    Subd. 9. <b>Follow-up surveys.</b> For providers that have Level III or Level IV <br/>
<a id="pl.435.33"></a><var>435.33</var>violations or any violations determined to be widespread, the department shall conduct a <br/>
<a id="pl.435.34"></a><var>435.34</var>follow-up survey within 90 calendar days of the survey. When conducting a follow-up <br/>
<a id="pl.435.35"></a><var>435.35</var>survey, the surveyor will focus on whether the previous violations have been corrected and <br/>
<a id="pl.435.36"></a><var>435.36</var>may also address any new violations that are observed while evaluating the corrections <br/>
<a id="pl.436.1"></a><var>436.1</var>that have been made. If a new violation is identified on a follow-up survey, no fine will be <br/>
<a id="pl.436.2"></a><var>436.2</var>imposed unless it is not corrected on the next follow-up survey.<br/>
<a id="pl.436.3"></a><var>436.3</var>    Subd. 10. <b>Performance incentive.</b> A licensee is eligible for a performance <br/>
<a id="pl.436.4"></a><var>436.4</var>incentive if there are no violations identified in a core or full survey.  The performance <br/>
<a id="pl.436.5"></a><var>436.5</var>incentive is a ten percent discount on the licensee's next home care renewal license fee.<br/>
<a id="pl.436.6"></a><var>436.6</var>    Subd. 11. <b>Fines.</b> (a) Fines and enforcement actions under this subdivision may be <br/>
<a id="pl.436.7"></a><var>436.7</var>assessed based on the level and scope of the violations described in paragraph (c) as follows:<br/>
<a id="pl.436.8"></a><var>436.8</var>(1) Level I, no fines or enforcement;<br/>
<a id="pl.436.9"></a><var>436.9</var>(2) Level II, fines ranging from $0 to $500, in addition to any of the enforcement <br/>
<a id="pl.436.10"></a><var>436.10</var>mechanisms authorized in section 144A.475 for widespread violations;<br/>
<a id="pl.436.11"></a><var>436.11</var>(3) Level III, fines ranging from $500 to $1,000, in addition to any of the <br/>
<a id="pl.436.12"></a><var>436.12</var>enforcement mechanisms authorized in section 144A.475; and<br/>
<a id="pl.436.13"></a><var>436.13</var>(4) Level IV, fines ranging from $1,000 to $5,000, in addition to any of the <br/>
<a id="pl.436.14"></a><var>436.14</var>enforcement mechanisms authorized in section 144A.475.<br/>
<a id="pl.436.15"></a><var>436.15</var>(b) Correction orders for violations will be categorized by both level and scope as <br/>
<a id="pl.436.16"></a><var>436.16</var>follows, and fines will be assessed accordingly: <br/>
<a id="pl.436.17"></a><var>436.17</var>(1) level of violation:<br/>
<a id="pl.436.18"></a><var>436.18</var>(i) Level I, a violation that has no potential to cause more than a minimal impact on <br/>
<a id="pl.436.19"></a><var>436.19</var>the client and does not affect health or safety;<br/>
<a id="pl.436.20"></a><var>436.20</var>(ii) Level II, a violation that did not harm the client's health or safety, but had the <br/>
<a id="pl.436.21"></a><var>436.21</var>potential to have harmed a client's health or safety, but not likely to cause serious injury, <br/>
<a id="pl.436.22"></a><var>436.22</var>impairment, or death;<br/>
<a id="pl.436.23"></a><var>436.23</var>(iii) Level III, a violation that harmed a client's health or safety, not including serious <br/>
<a id="pl.436.24"></a><var>436.24</var>injury, impairment, or death, or a violation that has the potential to lead to serious injury, <br/>
<a id="pl.436.25"></a><var>436.25</var>impairment, or death; and<br/>
<a id="pl.436.26"></a><var>436.26</var>(iv) Level IV, a violation that results in serious injury, impairment or death.<br/>
<a id="pl.436.27"></a><var>436.27</var>(2) scope of violation: <br/>
<a id="pl.436.28"></a><var>436.28</var>(i) isolated, when one or a limited number of clients are affected, or one or a limited <br/>
<a id="pl.436.29"></a><var>436.29</var>number of staff are involved,  or the situation has occurred only occasionally;<br/>
<a id="pl.436.30"></a><var>436.30</var>(ii) pattern,  when more than a limited number of clients are affected, more than a <br/>
<a id="pl.436.31"></a><var>436.31</var>limited number of staff are involved, or the situation has had repeated occurrences but <br/>
<a id="pl.436.32"></a><var>436.32</var>is not found to be pervasive; or<br/>
<a id="pl.436.33"></a><var>436.33</var>(iii) widespread; when problems are pervasive or represent a systemic failure that <br/>
<a id="pl.436.34"></a><var>436.34</var>has affected or has the potential to affect a large portion or all of the clients.<br/>
<a id="pl.436.35"></a><var>436.35</var>(c) If the commissioner finds that the applicant or a home care provider required <br/>
<a id="pl.436.36"></a><var>436.36</var>to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the <br/>
<a id="pl.437.1"></a><var>437.1</var>date specified in the correction order or conditional license resulting from a survey or <br/>
<a id="pl.437.2"></a><var>437.2</var>complaint investigation, the commissioner may impose a fine. A notice of noncompliance <br/>
<a id="pl.437.3"></a><var>437.3</var>with a correction order must be mailed to the applicant's or provider's last known address. <br/>
<a id="pl.437.4"></a><var>437.4</var>The noncompliance notice must list the violations not corrected.<br/>
<a id="pl.437.5"></a><var>437.5</var>(d) The license holder must pay the fines assessed on or before the payment date <br/>
<a id="pl.437.6"></a><var>437.6</var>specified. If the license holder fails to fully comply with the order, the commissioner <br/>
<a id="pl.437.7"></a><var>437.7</var>may issue a second fine or suspend the license until the license holder complies by <br/>
<a id="pl.437.8"></a><var>437.8</var>paying the fine. A timely appeal shall stay payment of the fine until the commissioner <br/>
<a id="pl.437.9"></a><var>437.9</var>issues a final order.<br/>
<a id="pl.437.10"></a><var>437.10</var>(e) A license holder shall promptly notify the commissioner in writing when a <br/>
<a id="pl.437.11"></a><var>437.11</var>violation specified in the order is corrected. If upon reinspection, the commissioner <br/>
<a id="pl.437.12"></a><var>437.12</var>determines that a violation has not been corrected as indicated by the order, the <br/>
<a id="pl.437.13"></a><var>437.13</var>commissioner may issue a second fine. The commissioner shall notify the license holder by <br/>
<a id="pl.437.14"></a><var>437.14</var>mail to the last known address in the licensing record that a second fine has been assessed. <br/>
<a id="pl.437.15"></a><var>437.15</var>The license holder may appeal the second fine as provided under this subdivision.<br/>
<a id="pl.437.16"></a><var>437.16</var>(f) A home care provider that has been assessed a fine under this subdivision has a <br/>
<a id="pl.437.17"></a><var>437.17</var>right to a reconsideration or a hearing under this section and chapter 14.<br/>
<a id="pl.437.18"></a><var>437.18</var>(g) When a fine has been assessed, the license holder may not avoid payment by <br/>
<a id="pl.437.19"></a><var>437.19</var>closing, selling, or otherwise transferring the licensed program to a third party. In such an <br/>
<a id="pl.437.20"></a><var>437.20</var>event, the license holder shall be liable for payment of the fine. <br/>
<a id="pl.437.21"></a><var>437.21</var>(h) In addition to any fine imposed under this section, the commissioner may assess <br/>
<a id="pl.437.22"></a><var>437.22</var>costs related to an investigation that results in a final order assessing a fine or other <br/>
<a id="pl.437.23"></a><var>437.23</var>enforcement action authorized by this chapter.<br/>
<a id="pl.437.24"></a><var>437.24</var>(i) Fines collected under this subdivision shall be deposited in the state government <br/>
<a id="pl.437.25"></a><var>437.25</var>special revenue fund and credited to an account separate from the revenue collected under <br/>
<a id="pl.437.26"></a><var>437.26</var>section 144A.472. Subject to an appropriation by the legislature, the revenue from the <br/>
<a id="pl.437.27"></a><var>437.27</var>fines collected may be used by the commissioner for special projects to improve home care <br/>
<a id="pl.437.28"></a><var>437.28</var>in Minnesota as recommended by the advisory council established in section 144A.4799.<br/>
<a id="pl.437.29"></a><var>437.29</var>    Subd. 12. <b>Reconsideration.</b> (a) The commissioner shall make available to home <br/>
<a id="pl.437.30"></a><var>437.30</var>care providers a correction order reconsideration process.  This process may be used <br/>
<a id="pl.437.31"></a><var>437.31</var>to challenge the correction order issued, including the level and scope described in <br/>
<a id="pl.437.32"></a><var>437.32</var>subdivision 11, and any fine assessed. During the correction order reconsideration <br/>
<a id="pl.437.33"></a><var>437.33</var>request, the issuance of the correction orders under reconsideration are not stayed, but <br/>
<a id="pl.437.34"></a><var>437.34</var>the department will post information on the Web site with the correction order that the <br/>
<a id="pl.437.35"></a><var>437.35</var>licensee has requested a reconsideration review and that the review is pending.<br/>
<a id="pl.438.1"></a><var>438.1</var>(b) A licensed home care provider may request from the commissioner, in writing, <br/>
<a id="pl.438.2"></a><var>438.2</var>a correction order reconsideration regarding any correction order issued to the provider. <br/>
<a id="pl.438.3"></a><var>438.3</var>The correction order reconsideration shall not be reviewed by any surveyor, investigator, <br/>
<a id="pl.438.4"></a><var>438.4</var>or supervisor that participated in the writing or reviewing of the correction order being <br/>
<a id="pl.438.5"></a><var>438.5</var>disputed. The correction order reconsiderations may be conducted in person by telephone, <br/>
<a id="pl.438.6"></a><var>438.6</var>by another electronic form, or in writing, as determined by the commissioner. The <br/>
<a id="pl.438.7"></a><var>438.7</var>commissioner shall respond in writing to the request from a home care provider for <br/>
<a id="pl.438.8"></a><var>438.8</var>a correction order reconsideration within 60 days of the date the provider requests a <br/>
<a id="pl.438.9"></a><var>438.9</var>reconsideration. The commissioner's response shall identify the commissioner's decision <br/>
<a id="pl.438.10"></a><var>438.10</var>regarding each citation challenged by the home care provider.<br/>
<a id="pl.438.11"></a><var>438.11</var>(c) The findings of a correction order reconsideration process shall be one or more of <br/>
<a id="pl.438.12"></a><var>438.12</var>the following:<br/>
<a id="pl.438.13"></a><var>438.13</var>(1) supported in full: the correction order is supported in full, with no deletion of <br/>
<a id="pl.438.14"></a><var>438.14</var>findings to the citation;<br/>
<a id="pl.438.15"></a><var>438.15</var>(2) supported in substance: the correction order is supported, but one or more <br/>
<a id="pl.438.16"></a><var>438.16</var>findings are deleted or modified without any change in the citation;<br/>
<a id="pl.438.17"></a><var>438.17</var> (3) correction order cited an incorrect home care licensing requirement: the correction <br/>
<a id="pl.438.18"></a><var>438.18</var>order is amended by changing the correction order to the appropriate statutory reference;<br/>
<a id="pl.438.19"></a><var>438.19</var>(4) correction order was issued under an incorrect citation: the correction order is <br/>
<a id="pl.438.20"></a><var>438.20</var>amended to be issued under the more appropriate correction order citation;<br/>
<a id="pl.438.21"></a><var>438.21</var>(5) the correction order is rescinded;<br/>
<a id="pl.438.22"></a><var>438.22</var>(6) fine is amended: it is determined the fine assigned to the correction order was <br/>
<a id="pl.438.23"></a><var>438.23</var>applied incorrectly; or<br/>
<a id="pl.438.24"></a><var>438.24</var>(7) the level or scope of the citation is modified based on the reconsideration. <br/>
<a id="pl.438.25"></a><var>438.25</var>(d) If the correction order findings are changed by the commissioner, the <br/>
<a id="pl.438.26"></a><var>438.26</var>commissioner shall update the correction order on the Web site accordingly.<br/>
<a id="pl.438.27"></a><var>438.27</var>    Subd. 13. <b>Home care surveyor training.</b> Before conducting a home care survey, <br/>
<a id="pl.438.28"></a><var>438.28</var>each home care surveyor must receive training on the following topics: <br/>
<a id="pl.438.29"></a><var>438.29</var>(1) Minnesota home care licensure requirements;<br/>
<a id="pl.438.30"></a><var>438.30</var>(2) Minnesota home care client bill of rights;<br/>
<a id="pl.438.31"></a><var>438.31</var>(3) Minnesota Vulnerable Adults Act and Reporting of Maltreatment of Minors;<br/>
<a id="pl.438.32"></a><var>438.32</var>(4) principles of documentation;<br/>
<a id="pl.438.33"></a><var>438.33</var>(5) survey protocol and processes;<br/>
<a id="pl.438.34"></a><var>438.34</var>(6) Offices of the Ombudsman roles;<br/>
<a id="pl.438.35"></a><var>438.35</var>(7) Office of Health Facility Complaints;<br/>
<a id="pl.438.36"></a><var>438.36</var>(8) Minnesota landlord and tenant, and housing with services laws;<br/>
<a id="pl.439.1"></a><var>439.1</var>(9) types of payors for home care services; and <br/>
<a id="pl.439.2"></a><var>439.2</var>(10) Minnesota Nurse Practice Act for nurse surveyors.<br/>
<a id="pl.439.3"></a><var>439.3</var>Materials used for this training will be posted on the Department of Health Web <br/>
<a id="pl.439.4"></a><var>439.4</var>site.  Requisite understanding of these topics will be reviewed as part of the quality <br/>
<a id="pl.439.5"></a><var>439.5</var>improvement plan in section 30.<br/>
<br/>
<a id="bill.11.14.0"></a><a id="pl.439.6"></a><var>439.6</var>    Sec. 14. <b>[144A.475] ENFORCEMENT.</b><br/>
<a id="pl.439.7"></a><var>439.7</var>    Subdivision 1. <b>Conditions.</b> (a) The commissioner may refuse to grant a temporary <br/>
<a id="pl.439.8"></a><var>439.8</var>license or refuse to renew a license, may suspend or revoke a license, or may impose a <br/>
<a id="pl.439.9"></a><var>439.9</var>conditional license if the home care provider or owner or managerial official of the home <br/>
<a id="pl.439.10"></a><var>439.10</var>care provider:<br/>
<a id="pl.439.11"></a><var>439.11</var>(1) is in violation of, or during the term of the license has violated, any of the <br/>
<a id="pl.439.12"></a><var>439.12</var>requirements in sections 144A.471 to 144A.482;<br/>
<a id="pl.439.13"></a><var>439.13</var>(2) permits, aids, or abets the commission of any illegal act in the provision of <br/>
<a id="pl.439.14"></a><var>439.14</var>home care;<br/>
<a id="pl.439.15"></a><var>439.15</var>(3) performs any act detrimental to the health, safety, and welfare of a client;<br/>
<a id="pl.439.16"></a><var>439.16</var>(4) obtains the license by fraud or misrepresentation;<br/>
<a id="pl.439.17"></a><var>439.17</var>(5) knowingly made or makes a false statement of a material fact in the application <br/>
<a id="pl.439.18"></a><var>439.18</var>for a license or in any other record or report required by this chapter;<br/>
<a id="pl.439.19"></a><var>439.19</var>(6) denies representatives of the department access to any part of the home care <br/>
<a id="pl.439.20"></a><var>439.20</var>provider's books, records, files, or employees;<br/>
<a id="pl.439.21"></a><var>439.21</var>(7) interferes with or impedes a representative of the department in contacting the <br/>
<a id="pl.439.22"></a><var>439.22</var>home care provider's clients;<br/>
<a id="pl.439.23"></a><var>439.23</var>(8) interferes with or impedes a representative of the department in the enforcement <br/>
<a id="pl.439.24"></a><var>439.24</var>of this chapter or has failed to fully cooperate with an inspection, survey, or investigation <br/>
<a id="pl.439.25"></a><var>439.25</var>by the department;<br/>
<a id="pl.439.26"></a><var>439.26</var>(9) destroys or makes unavailable any records or other evidence relating to the home <br/>
<a id="pl.439.27"></a><var>439.27</var>care provider's compliance with this chapter;<br/>
<a id="pl.439.28"></a><var>439.28</var>(10) refuses to initiate a background study under section 144.057 or 245A.04;<br/>
<a id="pl.439.29"></a><var>439.29</var>(11) fails to timely pay any fines assessed by the department;<br/>
<a id="pl.439.30"></a><var>439.30</var>(12) violates any local, city, or township ordinance relating to home care services;<br/>
<a id="pl.439.31"></a><var>439.31</var>(13) has repeated incidents of personnel performing services beyond their <br/>
<a id="pl.439.32"></a><var>439.32</var>competency level; or<br/>
<a id="pl.439.33"></a><var>439.33</var>(14) has operated beyond the scope of the home care provider's license level.<br/>
<a id="pl.439.34"></a><var>439.34</var>    (b) A violation by a contractor providing the home care services of the home care <br/>
<a id="pl.439.35"></a><var>439.35</var>provider is a violation by the home care provider.<br/>
<a id="pl.440.1"></a><var>440.1</var>    Subd. 2. <b>Terms to suspension or conditional license.</b> A suspension or conditional <br/>
<a id="pl.440.2"></a><var>440.2</var>license designation may include terms that must be completed or met before a suspension <br/>
<a id="pl.440.3"></a><var>440.3</var>or conditional license designation is lifted. A conditional license designation may include <br/>
<a id="pl.440.4"></a><var>440.4</var>restrictions or conditions that are imposed on the provider. Terms for a suspension or <br/>
<a id="pl.440.5"></a><var>440.5</var>conditional license may include one or more of the following and the scope of each will be <br/>
<a id="pl.440.6"></a><var>440.6</var>determined by the commissioner:<br/>
<a id="pl.440.7"></a><var>440.7</var>(1) requiring a consultant to review, evaluate, and make recommended changes to <br/>
<a id="pl.440.8"></a><var>440.8</var>the home care provider's practices and submit reports to the commissioner at the cost of <br/>
<a id="pl.440.9"></a><var>440.9</var>the home care provider;<br/>
<a id="pl.440.10"></a><var>440.10</var>(2) requiring supervision of the home care provider or staff practices at the cost <br/>
<a id="pl.440.11"></a><var>440.11</var>of the home care provider by an unrelated person who has sufficient knowledge and <br/>
<a id="pl.440.12"></a><var>440.12</var>qualifications to oversee the practices and who will submit reports to the commissioner;<br/>
<a id="pl.440.13"></a><var>440.13</var>(3) requiring the home care provider or employees to obtain training at the cost of <br/>
<a id="pl.440.14"></a><var>440.14</var>the home care provider;<br/>
<a id="pl.440.15"></a><var>440.15</var>(4) requiring the home care provider to submit reports to the commissioner;<br/>
<a id="pl.440.16"></a><var>440.16</var>(5) prohibiting the home care provider from taking any new clients for a period <br/>
<a id="pl.440.17"></a><var>440.17</var>of time; or<br/>
<a id="pl.440.18"></a><var>440.18</var>(6) any other action reasonably required to accomplish the purpose of this <br/>
<a id="pl.440.19"></a><var>440.19</var>subdivision and section 144A.45, subdivision 2.<br/>
<a id="pl.440.20"></a><var>440.20</var>    Subd. 3. <b>Notice.</b> Prior to any suspension, revocation, or refusal to renew a license, <br/>
<a id="pl.440.21"></a><var>440.21</var>the home care provider shall be entitled to notice and a hearing as provided by sections <br/>
<a id="pl.440.22"></a><var>440.22</var>14.57 to 14.69. In addition to any other remedy provided by law, the commissioner may, <br/>
<a id="pl.440.23"></a><var>440.23</var>without a prior contested case hearing, temporarily suspend a license or prohibit delivery <br/>
<a id="pl.440.24"></a><var>440.24</var>of services by a provider for not more than 90 days if the commissioner determines that <br/>
<a id="pl.440.25"></a><var>440.25</var>the health or safety of a consumer is in imminent danger, provided:<br/>
<a id="pl.440.26"></a><var>440.26</var>(1) advance notice is given to the home care provider;<br/>
<a id="pl.440.27"></a><var>440.27</var>(2) after notice, the home care provider fails to correct the problem;<br/>
<a id="pl.440.28"></a><var>440.28</var>(3) the commissioner has reason to believe that other administrative remedies are not <br/>
<a id="pl.440.29"></a><var>440.29</var>likely to be effective; and<br/>
<a id="pl.440.30"></a><var>440.30</var>(4) there is an opportunity for a contested case hearing within the 90 days.<br/>
<a id="pl.440.31"></a><var>440.31</var>    Subd. 4. <b>Time limits for appeals.</b> To appeal the assessment of civil penalties <br/>
<a id="pl.440.32"></a><var>440.32</var>under section 144A.45, subdivision 2, clause (5), and an action against a license under <br/>
<a id="pl.440.33"></a><var>440.33</var>this section, a provider must request a hearing no later than 15 days after the provider <br/>
<a id="pl.440.34"></a><var>440.34</var>receives notice of the action.<br/>
<a id="pl.440.35"></a><var>440.35</var>    Subd. 5. <b>Plan required.</b> (a) The process of suspending or revoking a license <br/>
<a id="pl.440.36"></a><var>440.36</var>must include a plan for transferring affected clients to other providers by the home care <br/>
<a id="pl.441.1"></a><var>441.1</var>provider, which will be monitored by the commissioner. Within three business days of <br/>
<a id="pl.441.2"></a><var>441.2</var>being notified of the final revocation or suspension action, the home care provider shall <br/>
<a id="pl.441.3"></a><var>441.3</var>provide the commissioner, the lead agencies as defined in section 256B.0911, and the <br/>
<a id="pl.441.4"></a><var>441.4</var>ombudsman for long-term care with the following information:<br/>
<a id="pl.441.5"></a><var>441.5</var>(1) a list of all clients, including full names and all contact information on file;<br/>
<a id="pl.441.6"></a><var>441.6</var>(2) a list of each client's representative or emergency contact person, including full <br/>
<a id="pl.441.7"></a><var>441.7</var>names and all contact information on file;<br/>
<a id="pl.441.8"></a><var>441.8</var>(3) the location or current residence of each client;<br/>
<a id="pl.441.9"></a><var>441.9</var>(4) the payor sources for each client, including payor source identification numbers; <br/>
<a id="pl.441.10"></a><var>441.10</var>and<br/>
<a id="pl.441.11"></a><var>441.11</var>(5) for each client, a copy of the client's service plan, and a list of the types of <br/>
<a id="pl.441.12"></a><var>441.12</var>services being provided.<br/>
<a id="pl.441.13"></a><var>441.13</var>(b) The revocation or suspension notification requirement is satisfied by mailing the <br/>
<a id="pl.441.14"></a><var>441.14</var>notice to the address in the license record. The home care provider shall cooperate with <br/>
<a id="pl.441.15"></a><var>441.15</var>the commissioner and the lead agencies during the process of transferring care of clients to <br/>
<a id="pl.441.16"></a><var>441.16</var>qualified providers. Within three business days of being notified of the final revocation or <br/>
<a id="pl.441.17"></a><var>441.17</var>suspension action, the home care provider must notify and disclose to each of the home <br/>
<a id="pl.441.18"></a><var>441.18</var>care provider's clients, or the client's representative or emergency contact persons, that <br/>
<a id="pl.441.19"></a><var>441.19</var>the commissioner is taking action against the home care provider's license by providing a <br/>
<a id="pl.441.20"></a><var>441.20</var>copy of the revocation or suspension notice issued by the commissioner.<br/>
<a id="pl.441.21"></a><var>441.21</var>    Subd. 6. <b>Owners and managerial officials; refusal to grant license.</b> (a) The owner <br/>
<a id="pl.441.22"></a><var>441.22</var>and managerial officials of a home care provider whose Minnesota license has not been <br/>
<a id="pl.441.23"></a><var>441.23</var>renewed or that has been revoked because of noncompliance with applicable laws or rules <br/>
<a id="pl.441.24"></a><var>441.24</var>shall not be eligible to apply for and shall not be granted a home care license, including <br/>
<a id="pl.441.25"></a><var>441.25</var>other licenses under this chapter, or be given status as an enrolled personal care assistance <br/>
<a id="pl.441.26"></a><var>441.26</var>provider agency or personal care assistant by the Department of Human Services under <br/>
<a id="pl.441.27"></a><var>441.27</var>section 256B.0659 for five years following the effective date of the nonrenewal or <br/>
<a id="pl.441.28"></a><var>441.28</var>revocation. If the owner and managerial officials already have enrollment status, their <br/>
<a id="pl.441.29"></a><var>441.29</var>enrollment will be terminated by the Department of Human Services.<br/>
<a id="pl.441.30"></a><var>441.30</var>(b) The commissioner shall not issue a license to a home care provider for five <br/>
<a id="pl.441.31"></a><var>441.31</var>years following the effective date of license nonrenewal or revocation if the owner or <br/>
<a id="pl.441.32"></a><var>441.32</var>managerial official, including any individual who was an owner or managerial official <br/>
<a id="pl.441.33"></a><var>441.33</var>of another home care provider, had a Minnesota license that was not renewed or was <br/>
<a id="pl.441.34"></a><var>441.34</var>revoked as described in paragraph (a).<br/>
<a id="pl.441.35"></a><var>441.35</var>(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall <br/>
<a id="pl.441.36"></a><var>441.36</var>suspend or revoke, the license of any home care provider that includes any individual <br/>
<a id="pl.442.1"></a><var>442.1</var>as an owner or managerial official who was an owner or managerial official of a home <br/>
<a id="pl.442.2"></a><var>442.2</var>care provider whose Minnesota license was not renewed or was revoked as described in <br/>
<a id="pl.442.3"></a><var>442.3</var>paragraph (a) for five years following the effective date of the nonrenewal or revocation.<br/>
<a id="pl.442.4"></a><var>442.4</var>(d) The commissioner shall notify the home care provider 30 days in advance of <br/>
<a id="pl.442.5"></a><var>442.5</var>the date of nonrenewal, suspension, or revocation of the license. Within ten days after <br/>
<a id="pl.442.6"></a><var>442.6</var>the receipt of the notification, the home care provider may request, in writing, that the <br/>
<a id="pl.442.7"></a><var>442.7</var>commissioner stay the nonrenewal, revocation, or suspension of the license. The home <br/>
<a id="pl.442.8"></a><var>442.8</var>care provider shall specify the reasons for requesting the stay; the steps that will be taken <br/>
<a id="pl.442.9"></a><var>442.9</var>to attain or maintain compliance with the licensure laws and regulations; any limits on the <br/>
<a id="pl.442.10"></a><var>442.10</var>authority or responsibility of the owners or managerial officials whose actions resulted in <br/>
<a id="pl.442.11"></a><var>442.11</var>the notice of nonrenewal, revocation, or suspension; and any other information to establish <br/>
<a id="pl.442.12"></a><var>442.12</var>that the continuing affiliation with these individuals will not jeopardize client health, safety, <br/>
<a id="pl.442.13"></a><var>442.13</var>or well-being. The commissioner shall determine whether the stay will be granted within <br/>
<a id="pl.442.14"></a><var>442.14</var>30 days of receiving the provider's request. The commissioner may propose additional <br/>
<a id="pl.442.15"></a><var>442.15</var>restrictions or limitations on the provider's license and require that the granting of the stay <br/>
<a id="pl.442.16"></a><var>442.16</var>be contingent upon compliance with those provisions. The commissioner shall take into <br/>
<a id="pl.442.17"></a><var>442.17</var>consideration the following factors when determining whether the stay should be granted:<br/>
<a id="pl.442.18"></a><var>442.18</var>(1) the threat that continued involvement of the owners and managerial officials with <br/>
<a id="pl.442.19"></a><var>442.19</var>the home care provider poses to client health, safety, and well-being;<br/>
<a id="pl.442.20"></a><var>442.20</var>(2) the compliance history of the home care provider; and<br/>
<a id="pl.442.21"></a><var>442.21</var>(3) the appropriateness of any limits suggested by the home care provider.<br/>
<a id="pl.442.22"></a><var>442.22</var>    If the commissioner grants the stay, the order shall include any restrictions or <br/>
<a id="pl.442.23"></a><var>442.23</var>limitation on the provider's license. The failure of the provider to comply with any <br/>
<a id="pl.442.24"></a><var>442.24</var>restrictions or limitations shall result in the immediate removal of the stay and the <br/>
<a id="pl.442.25"></a><var>442.25</var>commissioner shall take immediate action to suspend, revoke, or not renew the license.<br/>
<a id="pl.442.26"></a><var>442.26</var>    Subd. 7. <b>Request for hearing.</b> A request for a hearing must be in writing and must:<br/>
<a id="pl.442.27"></a><var>442.27</var>(1) be mailed or delivered to the department or the commissioner's designee;<br/>
<a id="pl.442.28"></a><var>442.28</var>(2) contain a brief and plain statement describing every matter or issue contested; and<br/>
<a id="pl.442.29"></a><var>442.29</var>(3) contain a brief and plain statement of any new matter that the applicant or home <br/>
<a id="pl.442.30"></a><var>442.30</var>care provider believes constitutes a defense or mitigating factor.<br/>
<a id="pl.442.31"></a><var>442.31</var>    Subd. 8. <b>Informal conference.</b> At any time, the applicant or home care provider <br/>
<a id="pl.442.32"></a><var>442.32</var>and the commissioner may hold an informal conference to exchange information, clarify <br/>
<a id="pl.442.33"></a><var>442.33</var>issues, or resolve issues.<br/>
<a id="pl.442.34"></a><var>442.34</var>    Subd. 9. <b>Injunctive relief.</b> In addition to any other remedy provided by law, the <br/>
<a id="pl.442.35"></a><var>442.35</var>commissioner may bring an action in district court to enjoin a person who is involved in <br/>
<a id="pl.442.36"></a><var>442.36</var>the management, operation, or control of a home care provider or an employee of the <br/>
<a id="pl.443.1"></a><var>443.1</var>home care provider from illegally engaging in activities regulated by sections 144A.43 to <br/>
<a id="pl.443.2"></a><var>443.2</var>144A.482. The commissioner may bring an action under this subdivision in the district <br/>
<a id="pl.443.3"></a><var>443.3</var>court in Ramsey County or in the district in which a home care provider is providing <br/>
<a id="pl.443.4"></a><var>443.4</var>services. The court may grant a temporary restraining order in the proceeding if continued <br/>
<a id="pl.443.5"></a><var>443.5</var>activity by the person who is involved in the management, operation, or control of a home <br/>
<a id="pl.443.6"></a><var>443.6</var>care provider, or by an employee of the home care provider, would create an imminent <br/>
<a id="pl.443.7"></a><var>443.7</var>risk of harm to a recipient of home care services.<br/>
<a id="pl.443.8"></a><var>443.8</var>    Subd. 10. <b>Subpoena.</b> In matters pending before the commissioner under sections <br/>
<a id="pl.443.9"></a><var>443.9</var>144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance <br/>
<a id="pl.443.10"></a><var>443.10</var>of witnesses and the production of all necessary papers, books, records, documents, and <br/>
<a id="pl.443.11"></a><var>443.11</var>other evidentiary material. If a person fails or refuses to comply with a subpoena or <br/>
<a id="pl.443.12"></a><var>443.12</var>order of the commissioner to appear or testify regarding any matter about which the <br/>
<a id="pl.443.13"></a><var>443.13</var>person may be lawfully questioned or to produce any papers, books, records, documents, <br/>
<a id="pl.443.14"></a><var>443.14</var>or evidentiary materials in the matter to be heard, the commissioner may apply to the <br/>
<a id="pl.443.15"></a><var>443.15</var>district court in any district, and the court shall order the person to comply with the <br/>
<a id="pl.443.16"></a><var>443.16</var>commissioner's order or subpoena. The commissioner of health may administer oaths to <br/>
<a id="pl.443.17"></a><var>443.17</var>witnesses or take their affirmation. Depositions may be taken in or outside the state in the <br/>
<a id="pl.443.18"></a><var>443.18</var>manner provided by law for the taking of depositions in civil actions. A subpoena or other <br/>
<a id="pl.443.19"></a><var>443.19</var>process or paper may be served on a named person anywhere in the state by an officer <br/>
<a id="pl.443.20"></a><var>443.20</var>authorized to serve subpoenas in civil actions, with the same fees and mileage and in the <br/>
<a id="pl.443.21"></a><var>443.21</var>same manner as prescribed by law for a process issued out of a district court. A person <br/>
<a id="pl.443.22"></a><var>443.22</var>subpoenaed under this subdivision shall receive the same fees, mileage, and other costs <br/>
<a id="pl.443.23"></a><var>443.23</var>that are paid in proceedings in district court.<br/>
<br/>
<a id="bill.11.15.0"></a><a id="pl.443.24"></a><var>443.24</var>    Sec. 15. <b>[144A.476] BACKGROUND STUDIES.</b><br/>
<a id="pl.443.25"></a><var>443.25</var>    Subdivision 1. <b>Prior criminal convictions; owner and managerial officials.</b> (a) <br/>
<a id="pl.443.26"></a><var>443.26</var>Before the commissioner issues a temporary license or renews a license, an owner or <br/>
<a id="pl.443.27"></a><var>443.27</var>managerial official is required to complete a background study under section 144.057. No <br/>
<a id="pl.443.28"></a><var>443.28</var>person may be involved in the management, operation, or control of a home care provider <br/>
<a id="pl.443.29"></a><var>443.29</var>if the person has been disqualified under chapter 245C. If an individual is disqualified <br/>
<a id="pl.443.30"></a><var>443.30</var>under section 144.057 or chapter 245C, the individual may request reconsideration of <br/>
<a id="pl.443.31"></a><var>443.31</var>the disqualification. If the individual requests reconsideration and the commissioner <br/>
<a id="pl.443.32"></a><var>443.32</var>sets aside or rescinds the disqualification, the individual is eligible to be involved in the <br/>
<a id="pl.443.33"></a><var>443.33</var>management, operation, or control of the provider. If an individual has a disqualification <br/>
<a id="pl.443.34"></a><var>443.34</var>under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's <br/>
<a id="pl.444.1"></a><var>444.1</var>disqualification is barred from a set aside, and the individual must not be involved in the <br/>
<a id="pl.444.2"></a><var>444.2</var>management, operation, or control of the provider.<br/>
<a id="pl.444.3"></a><var>444.3</var>(b) For purposes of this section, owners of a home care provider subject to the <br/>
<a id="pl.444.4"></a><var>444.4</var>background check requirement are those individuals whose ownership interest provides <br/>
<a id="pl.444.5"></a><var>444.5</var>sufficient authority or control to affect or change decisions related to the operation of the <br/>
<a id="pl.444.6"></a><var>444.6</var>home care provider. An owner includes a sole proprietor, a general partner, or any other <br/>
<a id="pl.444.7"></a><var>444.7</var>individual whose individual ownership interest can affect the management and direction <br/>
<a id="pl.444.8"></a><var>444.8</var>of the policies of the home care provider.<br/>
<a id="pl.444.9"></a><var>444.9</var>(c) For the purposes of this section, managerial officials subject to the background <br/>
<a id="pl.444.10"></a><var>444.10</var>check requirement are individuals who provide direct contact as defined in section <br/>
<a id="pl.444.11"></a><var>444.11</var>245C.02, subdivision 11, or individuals who have the responsibility for the ongoing <br/>
<a id="pl.444.12"></a><var>444.12</var>management or direction of the policies, services, or employees of the home care provider. <br/>
<a id="pl.444.13"></a><var>444.13</var>Data collected under this subdivision shall be classified as private data on individuals as <br/>
<a id="pl.444.14"></a><var>444.14</var>defined in section 13.02, subdivision 12.<br/>
<a id="pl.444.15"></a><var>444.15</var>(d) The department shall not issue any license if the applicant, owner, or managerial <br/>
<a id="pl.444.16"></a><var>444.16</var>official has been unsuccessful in having a background study disqualification set aside <br/>
<a id="pl.444.17"></a><var>444.17</var>under section 144.057 and chapter 245C; if the owner or managerial official, as an owner <br/>
<a id="pl.444.18"></a><var>444.18</var>or managerial official of another home care provider, was substantially responsible for <br/>
<a id="pl.444.19"></a><var>444.19</var>the other home care provider's failure to substantially comply with sections 144A.43 to <br/>
<a id="pl.444.20"></a><var>444.20</var>144A.482; or if an owner that has ceased doing business, either individually or as an <br/>
<a id="pl.444.21"></a><var>444.21</var>owner of a home care provider, was issued a correction order for failing to assist clients in <br/>
<a id="pl.444.22"></a><var>444.22</var>violation of this chapter.<br/>
<a id="pl.444.23"></a><var>444.23</var>    Subd. 2. <b>Employees, contractors, and volunteers.</b> (a) Employees, contractors, <br/>
<a id="pl.444.24"></a><var>444.24</var>and volunteers of a home care provider are subject to the background study required by <br/>
<a id="pl.444.25"></a><var>444.25</var>section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall <br/>
<a id="pl.444.26"></a><var>444.26</var>be construed to prohibit a home care provider from requiring self-disclosure of criminal <br/>
<a id="pl.444.27"></a><var>444.27</var>conviction information.<br/>
<a id="pl.444.28"></a><var>444.28</var>(b) Termination of an employee in good faith reliance on information or records <br/>
<a id="pl.444.29"></a><var>444.29</var>obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not <br/>
<a id="pl.444.30"></a><var>444.30</var>subject the home care provider to civil liability or liability for unemployment benefits.<br/>
<br/>
<a id="bill.11.16.0"></a><a id="pl.444.31"></a><var>444.31</var>    Sec. 16. <b>[144A.477] COMPLIANCE.</b><br/>
<a id="pl.444.32"></a><var>444.32</var>    Subdivision 1. <b>Medicare-certified providers; coordination of surveys.</b> If feasible, <br/>
<a id="pl.444.33"></a><var>444.33</var>the commissioner shall survey licensees to determine compliance with this chapter at the <br/>
<a id="pl.444.34"></a><var>444.34</var>same time as surveys for certification for Medicare if Medicare certification is based on <br/>
<a id="pl.444.35"></a><var>444.35</var>compliance with the federal conditions of participation and on survey and enforcement <br/>
<a id="pl.445.1"></a><var>445.1</var>by the Department of Health as agent for the United States Department of Health and <br/>
<a id="pl.445.2"></a><var>445.2</var>Human Services.<br/>
<a id="pl.445.3"></a><var>445.3</var>    Subd. 2. <b>Medicare-certified providers; equivalent requirements.</b> For home care <br/>
<a id="pl.445.4"></a><var>445.4</var>providers licensed to provide comprehensive home care services that are also certified for <br/>
<a id="pl.445.5"></a><var>445.5</var>participation in Medicare as a home health agency under Code of Federal Regulations, <br/>
<a id="pl.445.6"></a><var>445.6</var>title 42, part 484, the following state licensure regulations are considered equivalent to <br/>
<a id="pl.445.7"></a><var>445.7</var>the federal requirements:<br/>
<a id="pl.445.8"></a><var>445.8</var>(1) quality management, section 144A.479, subdivision 3;<br/>
<a id="pl.445.9"></a><var>445.9</var>(2) personnel records, section 144A.479, subdivision 7;<br/>
<a id="pl.445.10"></a><var>445.10</var>(3) acceptance of clients, section 144A.4791, subdivision 4;<br/>
<a id="pl.445.11"></a><var>445.11</var>(4) referrals, section 144A.4791, subdivision 5;<br/>
<a id="pl.445.12"></a><var>445.12</var>(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792, <br/>
<a id="pl.445.13"></a><var>445.13</var>subdivisions 2 and 3;<br/>
<a id="pl.445.14"></a><var>445.14</var>(6) individualized monitoring and reassessment, sections 144A.4791, subdivision <br/>
<a id="pl.445.15"></a><var>445.15</var>8, and 144A.4792, subdivisions 2 and 3;<br/>
<a id="pl.445.16"></a><var>445.16</var>(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792, <br/>
<a id="pl.445.17"></a><var>445.17</var>subdivision 5, and 144A.4793, subdivision 3;<br/>
<a id="pl.445.18"></a><var>445.18</var>(8) client complaint and investigation process, section 144A.4791, subdivision 11;<br/>
<a id="pl.445.19"></a><var>445.19</var>(9) prescription orders, section 144A.4792, subdivisions 13 to 16;<br/>
<a id="pl.445.20"></a><var>445.20</var>(10) client records, section 144A.4794, subdivisions 1 to 3;<br/>
<a id="pl.445.21"></a><var>445.21</var>(11) qualifications for unlicensed personnel performing delegated tasks, section <br/>
<a id="pl.445.22"></a><var>445.22</var>144A.4795;<br/>
<a id="pl.445.23"></a><var>445.23</var>(12) training and competency staff, section 144A.4795;<br/>
<a id="pl.445.24"></a><var>445.24</var>(13) training and competency for unlicensed personnel, section 144A.4795, <br/>
<a id="pl.445.25"></a><var>445.25</var>subdivision 7;<br/>
<a id="pl.445.26"></a><var>445.26</var>(14) delegation of home care services, section 144A.4795, subdivision 4;<br/>
<a id="pl.445.27"></a><var>445.27</var>(15) availability of contact person, section 144A.4797, subdivision 1; and<br/>
<a id="pl.445.28"></a><var>445.28</var>(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.<br/>
<a id="pl.445.29"></a><var>445.29</var>Violations of the requirements in clauses (1) to (16) may lead to enforcement actions <br/>
<a id="pl.445.30"></a><var>445.30</var>under section 144A.474.<br/>
<br/>
<a id="bill.11.17.0"></a><a id="pl.445.31"></a><var>445.31</var>    Sec. 17. <b>[144A.478] INNOVATION VARIANCE.</b><br/>
<a id="pl.445.32"></a><var>445.32</var>    Subdivision 1. <b>Definition.</b> For purposes of this section, "innovation variance" <br/>
<a id="pl.445.33"></a><var>445.33</var>means a specified alternative to a requirement of this chapter. An innovation variance may <br/>
<a id="pl.445.34"></a><var>445.34</var>be granted to allow a home care provider to offer home care services of a type or in a <br/>
<a id="pl.445.35"></a><var>445.35</var>manner that is innovative, will not impair the services provided, will not adversely affect <br/>
<a id="pl.446.1"></a><var>446.1</var>the health, safety, or welfare of the clients, and is likely to improve the services provided. <br/>
<a id="pl.446.2"></a><var>446.2</var>The innovative variance cannot change any of the client's rights under section 144A.44.<br/>
<a id="pl.446.3"></a><var>446.3</var>    Subd. 2. <b>Conditions.</b> The commissioner may impose conditions on the granting of <br/>
<a id="pl.446.4"></a><var>446.4</var>an innovation variance that the commissioner considers necessary.<br/>
<a id="pl.446.5"></a><var>446.5</var>    Subd. 3. <b>Duration and renewal.</b> The commissioner may limit the duration of any <br/>
<a id="pl.446.6"></a><var>446.6</var>innovation variance and may renew a limited innovation variance.<br/>
<a id="pl.446.7"></a><var>446.7</var>    Subd. 4. <b>Applications; innovation variance.</b> An application for innovation <br/>
<a id="pl.446.8"></a><var>446.8</var>variance from the requirements of this chapter may be made at any time, must be made in <br/>
<a id="pl.446.9"></a><var>446.9</var>writing to the commissioner, and must specify the following:<br/>
<a id="pl.446.10"></a><var>446.10</var>(1) the statute or law from which the innovation variance is requested;<br/>
<a id="pl.446.11"></a><var>446.11</var>(2) the time period for which the innovation variance is requested;<br/>
<a id="pl.446.12"></a><var>446.12</var>(3) the specific alternative action that the licensee proposes;<br/>
<a id="pl.446.13"></a><var>446.13</var>(4) the reasons for the request; and<br/>
<a id="pl.446.14"></a><var>446.14</var>(5) justification that an innovation variance will not impair the services provided; <br/>
<a id="pl.446.15"></a><var>446.15</var>will not adversely affect the health, safety, or welfare of clients; and is likely to improve <br/>
<a id="pl.446.16"></a><var>446.16</var>the services provided.<br/>
<a id="pl.446.17"></a><var>446.17</var>The commissioner may require additional information from the home care provider before <br/>
<a id="pl.446.18"></a><var>446.18</var>acting on the request.<br/>
<a id="pl.446.19"></a><var>446.19</var>    Subd. 5. <b>Grants and denials.</b> The commissioner shall grant or deny each request <br/>
<a id="pl.446.20"></a><var>446.20</var>for an innovation variance in writing within 45 days of receipt of a complete request. <br/>
<a id="pl.446.21"></a><var>446.21</var>Notice of a denial shall contain the reasons for the denial. The terms of a requested <br/>
<a id="pl.446.22"></a><var>446.22</var>innovation variance may be modified upon agreement between the commissioner and <br/>
<a id="pl.446.23"></a><var>446.23</var>the home care provider.<br/>
<a id="pl.446.24"></a><var>446.24</var>    Subd. 6. <b>Violation of innovation variances.</b> A failure to comply with the terms of <br/>
<a id="pl.446.25"></a><var>446.25</var>an innovation variance shall be deemed to be a violation of this chapter.<br/>
<a id="pl.446.26"></a><var>446.26</var>    Subd. 7. <b>Revocation or denial of renewal.</b> The commissioner shall revoke or <br/>
<a id="pl.446.27"></a><var>446.27</var>deny renewal of an innovation variance if:<br/>
<a id="pl.446.28"></a><var>446.28</var>(1) it is determined that the innovation variance is adversely affecting the health, <br/>
<a id="pl.446.29"></a><var>446.29</var>safety, or welfare of the licensee's clients;<br/>
<a id="pl.446.30"></a><var>446.30</var>(2) the home care provider has failed to comply with the terms of the innovation <br/>
<a id="pl.446.31"></a><var>446.31</var>variance;<br/>
<a id="pl.446.32"></a><var>446.32</var>(3) the home care provider notifies the commissioner in writing that it wishes to <br/>
<a id="pl.446.33"></a><var>446.33</var>relinquish the innovation variance and be subject to the statute previously varied; or<br/>
<a id="pl.446.34"></a><var>446.34</var>(4) the revocation or denial is required by a change in law.<br/>
<br/>
<a id="bill.11.18.0"></a><a id="pl.447.1"></a><var>447.1</var>    Sec. 18. <b>[144A.479] HOME CARE PROVIDER RESPONSIBILITIES; </b><br/>
<a id="pl.447.2"></a><var>447.2</var><b>BUSINESS OPERATION.</b><br/>
<a id="pl.447.3"></a><var>447.3</var>    Subdivision 1. <b>Display of license.</b> The original current license must be displayed <br/>
<a id="pl.447.4"></a><var>447.4</var>in the home care provider's principal business office and copies must be displayed in <br/>
<a id="pl.447.5"></a><var>447.5</var>any branch office. The home care provider must provide a copy of the license to any <br/>
<a id="pl.447.6"></a><var>447.6</var>person who requests it.<br/>
<a id="pl.447.7"></a><var>447.7</var>    Subd. 2. <b>Advertising.</b> Home care providers shall not use false, fraudulent, <br/>
<a id="pl.447.8"></a><var>447.8</var>or misleading advertising in the marketing of services. For purposes of this section, <br/>
<a id="pl.447.9"></a><var>447.9</var>advertising includes any verbal, written, or electronic means of communicating to <br/>
<a id="pl.447.10"></a><var>447.10</var>potential clients about the availability, nature, or terms of home care services.<br/>
<a id="pl.447.11"></a><var>447.11</var>    Subd. 3. <b>Quality management.</b> The home care provider shall engage in quality <br/>
<a id="pl.447.12"></a><var>447.12</var>management appropriate to the size of the home care provider and relevant to the type <br/>
<a id="pl.447.13"></a><var>447.13</var>of services the home care provider provides. The quality management activity means <br/>
<a id="pl.447.14"></a><var>447.14</var>evaluating the quality of care by periodically reviewing client services, complaints made, <br/>
<a id="pl.447.15"></a><var>447.15</var>and other issues that have occurred and determining whether changes in services, staffing, <br/>
<a id="pl.447.16"></a><var>447.16</var>or other procedures need to be made in order to ensure safe and competent services to <br/>
<a id="pl.447.17"></a><var>447.17</var>clients. Documentation about quality management activity must be available for two <br/>
<a id="pl.447.18"></a><var>447.18</var>years. Information about quality management must be available to the commissioner at <br/>
<a id="pl.447.19"></a><var>447.19</var>the time of the survey, investigation, or renewal.<br/>
<a id="pl.447.20"></a><var>447.20</var>    Subd. 4. <b>Provider restrictions.</b> (a) This subdivision does not apply to licensees <br/>
<a id="pl.447.21"></a><var>447.21</var>that are Minnesota counties or other units of government.<br/>
<a id="pl.447.22"></a><var>447.22</var>(b) A home care provider or staff cannot accept powers-of-attorney from clients for <br/>
<a id="pl.447.23"></a><var>447.23</var>any purpose, and may not accept appointments as guardians or conservators of clients.<br/>
<a id="pl.447.24"></a><var>447.24</var>(c) A home care provider cannot serve as a client's representative. <br/>
<a id="pl.447.25"></a><var>447.25</var>    Subd. 5. <b>Handling of client's finances and property.</b> (a) A home care provider <br/>
<a id="pl.447.26"></a><var>447.26</var>may assist clients with household budgeting, including paying bills and purchasing <br/>
<a id="pl.447.27"></a><var>447.27</var>household goods, but may not otherwise manage a client's property. A home care provider <br/>
<a id="pl.447.28"></a><var>447.28</var>must provide a client with receipts for all transactions and purchases paid with the client's <br/>
<a id="pl.447.29"></a><var>447.29</var>funds. When receipts are not available, the transaction or purchase must be documented. <br/>
<a id="pl.447.30"></a><var>447.30</var>A home care provider must maintain records of all such transactions.<br/>
<a id="pl.447.31"></a><var>447.31</var>(b) A home care provider or staff may not borrow a client's funds or personal or <br/>
<a id="pl.447.32"></a><var>447.32</var>real property, nor in any way convert a client's property to the home care provider's or <br/>
<a id="pl.447.33"></a><var>447.33</var>staff's possession.<br/>
<a id="pl.447.34"></a><var>447.34</var>(c) Nothing in this section precludes a home care provider or staff from accepting <br/>
<a id="pl.447.35"></a><var>447.35</var>gifts of minimal value, or precludes the acceptance of donations or bequests made to a <br/>
<a id="pl.448.1"></a><var>448.1</var>home care provider that are exempt from income tax under section 501(c) of the Internal <br/>
<a id="pl.448.2"></a><var>448.2</var>Revenue Code of 1986.<br/>
<a id="pl.448.3"></a><var>448.3</var>    Subd. 6. <b>Reporting maltreatment of vulnerable adults and minors.</b> (a) All <br/>
<a id="pl.448.4"></a><var>448.4</var>home care providers must comply with requirements for the reporting of maltreatment <br/>
<a id="pl.448.5"></a><var>448.5</var>of minors in section 626.556 and the requirements for the reporting of maltreatment <br/>
<a id="pl.448.6"></a><var>448.6</var>of vulnerable adults in section 626.557. Home care providers must report suspected <br/>
<a id="pl.448.7"></a><var>448.7</var>maltreatment of minors and vulnerable adults to the common entry point. Each home <br/>
<a id="pl.448.8"></a><var>448.8</var>care provider must establish and implement a written procedure to ensure that all cases <br/>
<a id="pl.448.9"></a><var>448.9</var>of suspected maltreatment are reported.<br/>
<a id="pl.448.10"></a><var>448.10</var>(b) Each home care provider must develop and implement an individual abuse <br/>
<a id="pl.448.11"></a><var>448.11</var>prevention plan for each vulnerable minor or adult for whom home care services are <br/>
<a id="pl.448.12"></a><var>448.12</var>provided by a home care provider. The plan shall contain an individualized review or <br/>
<a id="pl.448.13"></a><var>448.13</var>assessment of the person's susceptibility to abuse by another individual, including other <br/>
<a id="pl.448.14"></a><var>448.14</var>vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors; <br/>
<a id="pl.448.15"></a><var>448.15</var>and statements of the specific measures to be taken to minimize the risk of abuse to that <br/>
<a id="pl.448.16"></a><var>448.16</var>person and other vulnerable adults or minors. For purposes of the abuse prevention plan, <br/>
<a id="pl.448.17"></a><var>448.17</var>the term abuse includes self-abuse.<br/>
<a id="pl.448.18"></a><var>448.18</var>    Subd. 7. <b>Employee records.</b> The home care provider must maintain current records <br/>
<a id="pl.448.19"></a><var>448.19</var>of each paid employee, regularly scheduled volunteers providing home care services, <br/>
<a id="pl.448.20"></a><var>448.20</var>and each individual contractor providing home care services. The records must include <br/>
<a id="pl.448.21"></a><var>448.21</var>the following information:<br/>
<a id="pl.448.22"></a><var>448.22</var>(1) evidence of current professional licensure, registration, or certification, if <br/>
<a id="pl.448.23"></a><var>448.23</var>licensure, registration, or certification is required by this statute, or other rules;<br/>
<a id="pl.448.24"></a><var>448.24</var>(2) records of orientation, required annual training and infection control training, <br/>
<a id="pl.448.25"></a><var>448.25</var>and competency evaluations;<br/>
<a id="pl.448.26"></a><var>448.26</var>(3) current job description, including qualifications, responsibilities, and <br/>
<a id="pl.448.27"></a><var>448.27</var>identification of staff providing supervision;<br/>
<a id="pl.448.28"></a><var>448.28</var>(4) documentation of annual performance reviews which identify areas of <br/>
<a id="pl.448.29"></a><var>448.29</var>improvement needed and training needs;<br/>
<a id="pl.448.30"></a><var>448.30</var>(5) for individuals providing home care services, verification that required health <br/>
<a id="pl.448.31"></a><var>448.31</var>screenings under section 144A.4798 have taken place and the dates of those screenings; and<br/>
<a id="pl.448.32"></a><var>448.32</var>(6) documentation of the background study as required under section 144.057.<br/>
<a id="pl.448.33"></a><var>448.33</var>Each employee record must be retained for at least three years after a paid employee, <br/>
<a id="pl.448.34"></a><var>448.34</var>home care volunteer, or contractor ceases to be employed by or under contract with the <br/>
<a id="pl.448.35"></a><var>448.35</var>home care provider. If a home care provider ceases operation, employee records must be <br/>
<a id="pl.448.36"></a><var>448.36</var>maintained for three years.<br/>
<br/>
<a id="bill.11.19.0"></a><a id="pl.449.1"></a><var>449.1</var>    Sec. 19. <b>[144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH </b><br/>
<a id="pl.449.2"></a><var>449.2</var><b>RESPECT TO CLIENTS.</b><br/>
<a id="pl.449.3"></a><var>449.3</var>    Subdivision 1. <b>Home care bill of rights; notification to client.</b> (a) The home care <br/>
<a id="pl.449.4"></a><var>449.4</var>provider shall make all reasonable efforts to provide the client or the client's representative <br/>
<a id="pl.449.5"></a><var>449.5</var>a written notice of the rights under section 144A.44 before the initiation of services. The <br/>
<a id="pl.449.6"></a><var>449.6</var>home care provider shall make all reasonable efforts to provide the notice in a language <br/>
<a id="pl.449.7"></a><var>449.7</var>the client or client's representative understands. If a written version is not effective or <br/>
<a id="pl.449.8"></a><var>449.8</var>available, the notice may be provided verbally.<br/>
<a id="pl.449.9"></a><var>449.9</var>(b) In addition to the text of the home care bill of rights in section 144A.44, <br/>
<a id="pl.449.10"></a><var>449.10</var>subdivision 1, the notice shall also contain the following statement describing how to file <br/>
<a id="pl.449.11"></a><var>449.11</var>a complaint with these offices.<br/>
<a id="pl.449.12"></a><var>449.12</var>"If you have a complaint about the provider or the person providing your <br/>
<a id="pl.449.13"></a><var>449.13</var>home care services, you may call, write, or visit the Office of Health Facility <br/>
<a id="pl.449.14"></a><var>449.14</var>Complaints, Minnesota Department of Health. You may also contact the Office of <br/>
<a id="pl.449.15"></a><var>449.15</var>Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health <br/>
<a id="pl.449.16"></a><var>449.16</var>and Developmental Disabilities."<br/>
<a id="pl.449.17"></a><var>449.17</var>The statement should include the telephone number, Web site address, e-mail <br/>
<a id="pl.449.18"></a><var>449.18</var>address, mailing address, and street address of the Office of Health Facility Complaints at <br/>
<a id="pl.449.19"></a><var>449.19</var>the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, <br/>
<a id="pl.449.20"></a><var>449.20</var>and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The <br/>
<a id="pl.449.21"></a><var>449.21</var>statement should also include the home care provider's name, address, e-mail, telephone <br/>
<a id="pl.449.22"></a><var>449.22</var>number, and name or title of the person at the provider to whom problems or complaints <br/>
<a id="pl.449.23"></a><var>449.23</var>may be directed. It must also include a statement that the home care provider will not <br/>
<a id="pl.449.24"></a><var>449.24</var>retaliate because of a complaint.<br/>
<a id="pl.449.25"></a><var>449.25</var>(c) The home care provider shall obtain written acknowledgment of the client's <br/>
<a id="pl.449.26"></a><var>449.26</var>receipt of the home care bill of rights or shall document why an acknowledgment cannot <br/>
<a id="pl.449.27"></a><var>449.27</var>be obtained. The acknowledgment may be obtained from the client or the client's <br/>
<a id="pl.449.28"></a><var>449.28</var>representative. Acknowledgment of receipt shall be retained in the client's record.<br/>
<a id="pl.449.29"></a><var>449.29</var>    Subd. 2. <b>Notice of services for dementia, Alzheimer's disease, or related </b><br/>
<a id="pl.449.30"></a><var>449.30</var><b>disorders.</b> The home care provider that provides services to clients with dementia shall <br/>
<a id="pl.449.31"></a><var>449.31</var>provide in written or electronic form, to clients and families or other persons who request <br/>
<a id="pl.449.32"></a><var>449.32</var>it, a description of the training program and related training it provides, including the <br/>
<a id="pl.449.33"></a><var>449.33</var>categories of employees trained, the frequency of training, and the basic topics covered. <br/>
<a id="pl.449.34"></a><var>449.34</var>This information satisfies the disclosure requirements in section 325F.72, subdivision <br/>
<a id="pl.449.35"></a><var>449.35</var>2, clause (4).<br/>
<a id="pl.450.1"></a><var>450.1</var>    Subd. 3. <b>Statement of home care services.</b> Prior to the initiation of services, <br/>
<a id="pl.450.2"></a><var>450.2</var>a home care provider must provide to the client or the client's representative a written <br/>
<a id="pl.450.3"></a><var>450.3</var>statement which identifies if they have a basic or comprehensive home care license, the <br/>
<a id="pl.450.4"></a><var>450.4</var>services they are authorized to provide, and which services they cannot provide under the <br/>
<a id="pl.450.5"></a><var>450.5</var>scope of their license. The home care provider shall obtain written acknowledgment <br/>
<a id="pl.450.6"></a><var>450.6</var>from the clients that they have provided the statement or must document why they could <br/>
<a id="pl.450.7"></a><var>450.7</var>not obtain the acknowledgment.<br/>
<a id="pl.450.8"></a><var>450.8</var>    Subd. 4. <b>Acceptance of clients.</b> No home care provider may accept a person as a <br/>
<a id="pl.450.9"></a><var>450.9</var>client unless the home care provider has staff, sufficient in qualifications, competency, <br/>
<a id="pl.450.10"></a><var>450.10</var>and numbers, to adequately provide the services agreed to in the service plan and that <br/>
<a id="pl.450.11"></a><var>450.11</var>are within the provider's scope of practice.<br/>
<a id="pl.450.12"></a><var>450.12</var>    Subd. 5. <b>Referrals.</b> If a home care provider reasonably believes that a client is in <br/>
<a id="pl.450.13"></a><var>450.13</var>need of another medical or health service, including a licensed health professional, or <br/>
<a id="pl.450.14"></a><var>450.14</var>social service provider, the home care provider shall:<br/>
<a id="pl.450.15"></a><var>450.15</var>(1) determine the client's preferences with respect to obtaining the service; and<br/>
<a id="pl.450.16"></a><var>450.16</var>(2) inform the client of resources available, if known, to assist the client in obtaining <br/>
<a id="pl.450.17"></a><var>450.17</var>services.<br/>
<a id="pl.450.18"></a><var>450.18</var>    Subd. 6. <b>Initiation of services.</b> When a provider initiates services and the <br/>
<a id="pl.450.19"></a><var>450.19</var>individualized review or assessment required in subdivisions 7 and 8 has not been <br/>
<a id="pl.450.20"></a><var>450.20</var>completed, the provider must complete a temporary plan and agreement with the client for <br/>
<a id="pl.450.21"></a><var>450.21</var>services.<br/>
<a id="pl.450.22"></a><var>450.22</var>    Subd. 7. <b>Basic individualized client review and monitoring.</b> (a) When services <br/>
<a id="pl.450.23"></a><var>450.23</var>being provided are basic home care services, an individualized initial review of the client's <br/>
<a id="pl.450.24"></a><var>450.24</var>needs and preferences must be conducted at the client's residence with the client or client's <br/>
<a id="pl.450.25"></a><var>450.25</var>representative. This initial review must be completed within 30 days after the initiation of <br/>
<a id="pl.450.26"></a><var>450.26</var>the home care services.<br/>
<a id="pl.450.27"></a><var>450.27</var>(b) Client monitoring and review must be conducted as needed based on changes <br/>
<a id="pl.450.28"></a><var>450.28</var>in the needs of the client and cannot exceed 90 days from the date of the last review. <br/>
<a id="pl.450.29"></a><var>450.29</var>The monitoring and review may be conducted at the client's residence or through the <br/>
<a id="pl.450.30"></a><var>450.30</var>utilization of telecommunication methods based on practice standards that meet the <br/>
<a id="pl.450.31"></a><var>450.31</var>individual client's needs.<br/>
<a id="pl.450.32"></a><var>450.32</var>    Subd. 8. <b>Comprehensive assessment, monitoring, and reassessment.</b> (a) When <br/>
<a id="pl.450.33"></a><var>450.33</var>the services being provided are comprehensive home care services, an individualized <br/>
<a id="pl.450.34"></a><var>450.34</var>initial assessment must be conducted in-person by a registered nurse. When the services <br/>
<a id="pl.450.35"></a><var>450.35</var>are provided by other licensed health professionals, the assessment must be conducted by <br/>
<a id="pl.451.1"></a><var>451.1</var>the appropriate health professional. This initial assessment must be completed within five <br/>
<a id="pl.451.2"></a><var>451.2</var>days after initiation of home care services.<br/>
<a id="pl.451.3"></a><var>451.3</var>(b) Client monitoring and reassessment must be conducted in the client's home no <br/>
<a id="pl.451.4"></a><var>451.4</var>more than 14 days after initiation of services.<br/>
<a id="pl.451.5"></a><var>451.5</var>(c) Ongoing client monitoring and reassessment must be conducted as needed based <br/>
<a id="pl.451.6"></a><var>451.6</var>on changes in the needs of the client and cannot exceed 90 days from the last date of the <br/>
<a id="pl.451.7"></a><var>451.7</var>assessment. The monitoring and reassessment may be conducted at the client's residence <br/>
<a id="pl.451.8"></a><var>451.8</var>or through the utilization of telecommunication methods based on practice standards that <br/>
<a id="pl.451.9"></a><var>451.9</var>meet the individual client's needs.<br/>
<a id="pl.451.10"></a><var>451.10</var>    Subd. 9. <b>Service plan, implementation, and revisions to service plan.</b> (a) No later <br/>
<a id="pl.451.11"></a><var>451.11</var>than 14 days after the initiation of services, a home care provider shall finalize a current <br/>
<a id="pl.451.12"></a><var>451.12</var>written service plan.<br/>
<a id="pl.451.13"></a><var>451.13</var>(b) The service plan and any revisions must include a signature or other <br/>
<a id="pl.451.14"></a><var>451.14</var>authentication by the home care provider and by the client or the client's representative <br/>
<a id="pl.451.15"></a><var>451.15</var>documenting agreement on the services to be provided. The service plan must be revised, <br/>
<a id="pl.451.16"></a><var>451.16</var>if needed, based on client review or reassessment under subdivisions 7 and 8. The provider <br/>
<a id="pl.451.17"></a><var>451.17</var>must provide information to the client about changes to the provider's fee for services and <br/>
<a id="pl.451.18"></a><var>451.18</var>how to contact the Office of the Ombudsman for Long-Term Care.<br/>
<a id="pl.451.19"></a><var>451.19</var>(c) The home care provider must implement and provide all services required by <br/>
<a id="pl.451.20"></a><var>451.20</var>the current service plan.<br/>
<a id="pl.451.21"></a><var>451.21</var>(d) The service plan and revised service plan must be entered into the client's record, <br/>
<a id="pl.451.22"></a><var>451.22</var>including notice of a change in a client's fees when applicable.<br/>
<a id="pl.451.23"></a><var>451.23</var>(e) Staff providing home care services must be informed of the current written <br/>
<a id="pl.451.24"></a><var>451.24</var>service plan.<br/>
<a id="pl.451.25"></a><var>451.25</var>(f) The service plan must include:<br/>
<a id="pl.451.26"></a><var>451.26</var>(1) a description of the home care services to be provided, the fees for services, and <br/>
<a id="pl.451.27"></a><var>451.27</var>the frequency of each service, according to the client's current review or assessment and <br/>
<a id="pl.451.28"></a><var>451.28</var>client preferences;<br/>
<a id="pl.451.29"></a><var>451.29</var>(2) the identification of the staff or categories of staff who will provide the services;<br/>
<a id="pl.451.30"></a><var>451.30</var>(3) the schedule and methods of monitoring reviews or assessments of the client;<br/>
<a id="pl.451.31"></a><var>451.31</var>(4) the frequency of sessions of supervision of staff and type of personnel who <br/>
<a id="pl.451.32"></a><var>451.32</var>will supervise staff; and<br/>
<a id="pl.451.33"></a><var>451.33</var>(5) a contingency plan that includes:<br/>
<a id="pl.451.34"></a><var>451.34</var>(i) the action to be taken by the home care provider and by the client or client's <br/>
<a id="pl.451.35"></a><var>451.35</var>representative if the scheduled service cannot be provided;<br/>
<a id="pl.452.1"></a><var>452.1</var>(ii) information and method for a client or client's representative to contact the <br/>
<a id="pl.452.2"></a><var>452.2</var>home care provider;<br/>
<a id="pl.452.3"></a><var>452.3</var>(iii) names and contact information of persons the client wishes to have notified <br/>
<a id="pl.452.4"></a><var>452.4</var>in an emergency or if there is a significant adverse change in the client's condition, <br/>
<a id="pl.452.5"></a><var>452.5</var>including identification of and information as to who has authority to sign for the client in <br/>
<a id="pl.452.6"></a><var>452.6</var>an emergency; and<br/>
<a id="pl.452.7"></a><var>452.7</var>(iv) the circumstances in which emergency medical services are not to be summoned <br/>
<a id="pl.452.8"></a><var>452.8</var>consistent with chapters 145B and 145C, and declarations made by the client under those <br/>
<a id="pl.452.9"></a><var>452.9</var>chapters.<br/>
<a id="pl.452.10"></a><var>452.10</var>    Subd. 10. <b>Termination of service plan.</b> (a) If a home care provider terminates a <br/>
<a id="pl.452.11"></a><var>452.11</var>service plan with a client, and the client continues to need home care services, the home <br/>
<a id="pl.452.12"></a><var>452.12</var>care provider shall provide the client and the client's representative, if any, with a written <br/>
<a id="pl.452.13"></a><var>452.13</var>notice of termination which includes the following information:<br/>
<a id="pl.452.14"></a><var>452.14</var>(1) the effective date of termination;<br/>
<a id="pl.452.15"></a><var>452.15</var>(2) the reason for termination;<br/>
<a id="pl.452.16"></a><var>452.16</var>(3) a list of known licensed home care providers in the client's immediate geographic <br/>
<a id="pl.452.17"></a><var>452.17</var>area;<br/>
<a id="pl.452.18"></a><var>452.18</var>(4) a statement that the home care provider will participate in a coordinated transfer <br/>
<a id="pl.452.19"></a><var>452.19</var>of care of the client to another home care provider, health care provider, or caregiver, as <br/>
<a id="pl.452.20"></a><var>452.20</var>required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);<br/>
<a id="pl.452.21"></a><var>452.21</var>(5) the name and contact information of a person employed by the home care <br/>
<a id="pl.452.22"></a><var>452.22</var>provider with whom the client may discuss the notice of termination; and<br/>
<a id="pl.452.23"></a><var>452.23</var>(6) if applicable, a statement that the notice of termination of home care services <br/>
<a id="pl.452.24"></a><var>452.24</var>does not constitute notice of termination of the housing with services contract with a <br/>
<a id="pl.452.25"></a><var>452.25</var>housing with services establishment.<br/>
<a id="pl.452.26"></a><var>452.26</var>(b) When the home care provider voluntarily discontinues services to all clients, the <br/>
<a id="pl.452.27"></a><var>452.27</var>home care provider must notify the commissioner, lead agencies, and the ombudsman for <br/>
<a id="pl.452.28"></a><var>452.28</var>long-term care about its clients and comply with the requirements in this subdivision.<br/>
<a id="pl.452.29"></a><var>452.29</var>    Subd. 11. <b>Client complaint and investigative process.</b> (a) The home care <br/>
<a id="pl.452.30"></a><var>452.30</var>provider must have a written policy and system for receiving, investigating, reporting, <br/>
<a id="pl.452.31"></a><var>452.31</var>and attempting to resolve complaints from its clients or clients' representatives. The <br/>
<a id="pl.452.32"></a><var>452.32</var>policy should clearly identify the process by which clients may file a complaint or concern <br/>
<a id="pl.452.33"></a><var>452.33</var>about home care services and an explicit statement that the home care provider will not <br/>
<a id="pl.452.34"></a><var>452.34</var>discriminate or retaliate against a client for expressing concerns or complaints. A home <br/>
<a id="pl.452.35"></a><var>452.35</var>care provider must have a process in place to conduct investigations of complaints made <br/>
<a id="pl.452.36"></a><var>452.36</var>by the client or the client's representative about the services in the client's plan that are or <br/>
<a id="pl.453.1"></a><var>453.1</var>are not being provided or other items covered in the client's home care bill of rights. This <br/>
<a id="pl.453.2"></a><var>453.2</var>complaint system must provide reasonable accommodations for any special needs of the <br/>
<a id="pl.453.3"></a><var>453.3</var>client or client's representative if requested.<br/>
<a id="pl.453.4"></a><var>453.4</var>(b) The home care provider must document the complaint, name of the client, <br/>
<a id="pl.453.5"></a><var>453.5</var>investigation, and resolution of each complaint filed. The home care provider must <br/>
<a id="pl.453.6"></a><var>453.6</var>maintain a record of all activities regarding complaints received, including the date the <br/>
<a id="pl.453.7"></a><var>453.7</var>complaint was received, and the home care provider's investigation and resolution of the <br/>
<a id="pl.453.8"></a><var>453.8</var>complaint. This complaint record must be kept for each event for at least two years after <br/>
<a id="pl.453.9"></a><var>453.9</var>the date of entry and must be available to the commissioner for review.<br/>
<a id="pl.453.10"></a><var>453.10</var>(c) The required complaint system must provide for written notice to each client or <br/>
<a id="pl.453.11"></a><var>453.11</var>client's representative that includes:<br/>
<a id="pl.453.12"></a><var>453.12</var>(1) the client's right to complain to the home care provider about the services received;<br/>
<a id="pl.453.13"></a><var>453.13</var>(2) the name or title of the person or persons with the home care provider to contact <br/>
<a id="pl.453.14"></a><var>453.14</var>with complaints;<br/>
<a id="pl.453.15"></a><var>453.15</var>(3) the method of submitting a complaint to the home care provider; and<br/>
<a id="pl.453.16"></a><var>453.16</var>(4) a statement that the provider is prohibited against retaliation according to <br/>
<a id="pl.453.17"></a><var>453.17</var>paragraph (d).<br/>
<a id="pl.453.18"></a><var>453.18</var>(d) A home care provider must not take any action that negatively affects a client <br/>
<a id="pl.453.19"></a><var>453.19</var>in retaliation for a complaint made or a concern expressed by the client or the client's <br/>
<a id="pl.453.20"></a><var>453.20</var>representative.<br/>
<a id="pl.453.21"></a><var>453.21</var>    Subd. 12. <b>Disaster planning and emergency preparedness plan.</b> The home care <br/>
<a id="pl.453.22"></a><var>453.22</var>provider must have a written plan of action to facilitate the management of the client's care <br/>
<a id="pl.453.23"></a><var>453.23</var>and services in response to a natural disaster, such as flood and storms, or other emergencies <br/>
<a id="pl.453.24"></a><var>453.24</var>that may disrupt the home care provider's ability to provide care or services. The licensee <br/>
<a id="pl.453.25"></a><var>453.25</var>must provide adequate orientation and training of staff on emergency preparedness.<br/>
<a id="pl.453.26"></a><var>453.26</var>    Subd. 13. <b>Request for discontinuation of life-sustaining treatment.</b> (a) If a <br/>
<a id="pl.453.27"></a><var>453.27</var>client, family member, or other caregiver of the client requests that an employee or other <br/>
<a id="pl.453.28"></a><var>453.28</var>agent of the home care provider discontinue a life-sustaining treatment, the employee or <br/>
<a id="pl.453.29"></a><var>453.29</var>agent receiving the request:<br/>
<a id="pl.453.30"></a><var>453.30</var>(1) shall take no action to discontinue the treatment; and<br/>
<a id="pl.453.31"></a><var>453.31</var>(2) shall promptly inform their supervisor or other agent of the home care provider <br/>
<a id="pl.453.32"></a><var>453.32</var>of the client's request.<br/>
<a id="pl.453.33"></a><var>453.33</var>(b) Upon being informed of a request for termination of treatment, the home care <br/>
<a id="pl.453.34"></a><var>453.34</var>provider shall promptly:<br/>
<a id="pl.453.35"></a><var>453.35</var>(1) inform the client that the request will be made known to the physician who <br/>
<a id="pl.453.36"></a><var>453.36</var>ordered the client's treatment;<br/>
<a id="pl.454.1"></a><var>454.1</var>(2) inform the physician of the client's request; and<br/>
<a id="pl.454.2"></a><var>454.2</var>(3) work with the client and the client's physician to comply with the provisions of <br/>
<a id="pl.454.3"></a><var>454.3</var>the Health Care Directive Act in chapter 145C.<br/>
<a id="pl.454.4"></a><var>454.4</var>(c) This section does not require the home care provider to discontinue treatment, <br/>
<a id="pl.454.5"></a><var>454.5</var>except as may be required by law or court order.<br/>
<a id="pl.454.6"></a><var>454.6</var>(d) This section does not diminish the rights of clients to control their treatments, <br/>
<a id="pl.454.7"></a><var>454.7</var>refuse services, or terminate their relationships with the home care provider.<br/>
<a id="pl.454.8"></a><var>454.8</var>(e) This section shall be construed in a manner consistent with chapter 145B or <br/>
<a id="pl.454.9"></a><var>454.9</var>145C, whichever applies, and declarations made by clients under those chapters.<br/>
<br/>
<a id="bill.11.20.0"></a><a id="pl.454.10"></a><var>454.10</var>    Sec. 20. <b>[144A.4792] MEDICATION MANAGEMENT.</b><br/>
<a id="pl.454.11"></a><var>454.11</var>    Subdivision 1. <b>Medication management services; comprehensive home care </b><br/>
<a id="pl.454.12"></a><var>454.12</var><b>license.</b> (a) This subdivision applies only to home care providers with a comprehensive <br/>
<a id="pl.454.13"></a><var>454.13</var>home care license that provides medication management services to clients. Medication <br/>
<a id="pl.454.14"></a><var>454.14</var>management services may not be provided by a home care provider that has a basic <br/>
<a id="pl.454.15"></a><var>454.15</var>home care license.<br/>
<a id="pl.454.16"></a><var>454.16</var>(b) A comprehensive home care provider who provides medication management <br/>
<a id="pl.454.17"></a><var>454.17</var>services must develop, implement, and maintain current written medication management <br/>
<a id="pl.454.18"></a><var>454.18</var>policies and procedures. The policies and procedures must be developed under the <br/>
<a id="pl.454.19"></a><var>454.19</var>supervision and direction of a registered nurse, licensed health professional, or pharmacist <br/>
<a id="pl.454.20"></a><var>454.20</var>consistent with current practice standards and guidelines.<br/>
<a id="pl.454.21"></a><var>454.21</var>(c) The written policies and procedures must address requesting and receiving <br/>
<a id="pl.454.22"></a><var>454.22</var>prescriptions for medications; preparing and giving medications; verifying that <br/>
<a id="pl.454.23"></a><var>454.23</var>prescription drugs are administered as prescribed; documenting medication management <br/>
<a id="pl.454.24"></a><var>454.24</var>activities; controlling and storing medications; monitoring and evaluating medication use; <br/>
<a id="pl.454.25"></a><var>454.25</var>resolving medication errors; communicating with the prescriber, pharmacist, client, and <br/>
<a id="pl.454.26"></a><var>454.26</var>client representative, if any; disposing of unused medications; and educating clients and <br/>
<a id="pl.454.27"></a><var>454.27</var>client representatives about medications. When controlled substances are being managed, <br/>
<a id="pl.454.28"></a><var>454.28</var>the policies and procedures must also identify how the provider will ensure security and <br/>
<a id="pl.454.29"></a><var>454.29</var>accountability for the overall management, control, and disposition of those substances in <br/>
<a id="pl.454.30"></a><var>454.30</var>compliance with state and federal regulations and with subdivision 22.<br/>
<a id="pl.454.31"></a><var>454.31</var>    Subd. 2. <b>Provision of medication management services.</b> (a) For each client who <br/>
<a id="pl.454.32"></a><var>454.32</var>requests medication management services, the comprehensive home care provider shall, <br/>
<a id="pl.454.33"></a><var>454.33</var>prior to providing medication management services, have a registered nurse, licensed <br/>
<a id="pl.454.34"></a><var>454.34</var>health professional, or authorized prescriber under section 151.37 conduct an assessment <br/>
<a id="pl.454.35"></a><var>454.35</var>to determine what medication management services will be provided and how the services <br/>
<a id="pl.455.1"></a><var>455.1</var>will be provided. This assessment must be conducted face-to-face with the client. The <br/>
<a id="pl.455.2"></a><var>455.2</var>assessment must include an identification and review of all medications the client is known <br/>
<a id="pl.455.3"></a><var>455.3</var>to be taking. The review and identification must include indications for medications, side <br/>
<a id="pl.455.4"></a><var>455.4</var>effects, contraindications, allergic or adverse reactions, and actions to address these issues.<br/>
<a id="pl.455.5"></a><var>455.5</var>(b) The assessment must identify interventions needed in management of <br/>
<a id="pl.455.6"></a><var>455.6</var>medications to prevent diversion of medication by the client or others who may have <br/>
<a id="pl.455.7"></a><var>455.7</var>access to the medications. Diversion of medications means the misuse, theft, or illegal <br/>
<a id="pl.455.8"></a><var>455.8</var>or improper disposition of medications.<br/>
<a id="pl.455.9"></a><var>455.9</var>    Subd. 3. <b>Individualized medication monitoring and reassessment.</b> The <br/>
<a id="pl.455.10"></a><var>455.10</var>comprehensive home care provider must monitor and reassess the client's medication <br/>
<a id="pl.455.11"></a><var>455.11</var>management services as needed under subdivision 14 when the client presents with <br/>
<a id="pl.455.12"></a><var>455.12</var>symptoms or other issues that may be medication-related and, at a minimum, annually.<br/>
<a id="pl.455.13"></a><var>455.13</var>    Subd. 4. <b>Client refusal.</b> The home care provider must document in the client's <br/>
<a id="pl.455.14"></a><var>455.14</var>record any refusal for an assessment for medication management by the client. The <br/>
<a id="pl.455.15"></a><var>455.15</var>provider must discuss with the client the possible consequences of the client's refusal and <br/>
<a id="pl.455.16"></a><var>455.16</var>document the discussion in the client's record.<br/>
<a id="pl.455.17"></a><var>455.17</var>    Subd. 5. <b>Individualized medication management plan.</b> (a) For each client <br/>
<a id="pl.455.18"></a><var>455.18</var>receiving medication management services, the comprehensive home care provider must <br/>
<a id="pl.455.19"></a><var>455.19</var>prepare and include in the service plan a written statement of the medication management <br/>
<a id="pl.455.20"></a><var>455.20</var>services that will be provided to the client. The provider must develop and maintain a <br/>
<a id="pl.455.21"></a><var>455.21</var>current individualized medication management record for each client based on the client's <br/>
<a id="pl.455.22"></a><var>455.22</var>assessment that contains the following:<br/>
<a id="pl.455.23"></a><var>455.23</var>(1) a statement describing the medication management services that will be provided;<br/>
<a id="pl.455.24"></a><var>455.24</var>(2) a description of storage of medications based on the client's needs and <br/>
<a id="pl.455.25"></a><var>455.25</var>preferences, risk of diversion, and consistent with the manufacturer's directions;<br/>
<a id="pl.455.26"></a><var>455.26</var>(3) documentation of specific client instructions relating to the administration <br/>
<a id="pl.455.27"></a><var>455.27</var>of medications;<br/>
<a id="pl.455.28"></a><var>455.28</var>(4) identification of persons responsible for monitoring medication supplies and <br/>
<a id="pl.455.29"></a><var>455.29</var>ensuring that medication refills are ordered on a timely basis;<br/>
<a id="pl.455.30"></a><var>455.30</var>(5) identification of medication management tasks that may be delegated to <br/>
<a id="pl.455.31"></a><var>455.31</var>unlicensed personnel;<br/>
<a id="pl.455.32"></a><var>455.32</var>(6) procedures for staff notifying a registered nurse or appropriate licensed health <br/>
<a id="pl.455.33"></a><var>455.33</var>professional when a problem arises with medication management services; and<br/>
<a id="pl.455.34"></a><var>455.34</var>(7) any client-specific requirements relating to documenting medication <br/>
<a id="pl.455.35"></a><var>455.35</var>administration, verification that all medications are administered as prescribed, and <br/>
<a id="pl.455.36"></a><var>455.36</var>monitoring of medication use to prevent possible complications or adverse reactions.<br/>
<a id="pl.456.1"></a><var>456.1</var>(b) The medication management record must be current and updated when there are <br/>
<a id="pl.456.2"></a><var>456.2</var>any changes.<br/>
<a id="pl.456.3"></a><var>456.3</var>    Subd. 6. <b>Administration of medication.</b> Medications may be administered by a <br/>
<a id="pl.456.4"></a><var>456.4</var>nurse, physician, or other licensed health practitioner authorized to administer medications <br/>
<a id="pl.456.5"></a><var>456.5</var>or by unlicensed personnel who have been delegated medication administration tasks by <br/>
<a id="pl.456.6"></a><var>456.6</var>a registered nurse.<br/>
<a id="pl.456.7"></a><var>456.7</var>    Subd. 7. <b>Delegation of medication administration.</b> When administration of <br/>
<a id="pl.456.8"></a><var>456.8</var>medications is delegated to unlicensed personnel, the comprehensive home care provider <br/>
<a id="pl.456.9"></a><var>456.9</var>must ensure that the registered nurse has:<br/>
<a id="pl.456.10"></a><var>456.10</var>(1) instructed the unlicensed personnel in the proper methods to administer the <br/>
<a id="pl.456.11"></a><var>456.11</var>medications, and the unlicensed personnel has demonstrated ability to competently follow <br/>
<a id="pl.456.12"></a><var>456.12</var>the procedures;<br/>
<a id="pl.456.13"></a><var>456.13</var>(2) specified, in writing, specific instructions for each client and documented those <br/>
<a id="pl.456.14"></a><var>456.14</var>instructions in the client's records; and<br/>
<a id="pl.456.15"></a><var>456.15</var>(3) communicated with the unlicensed personnel about the individual needs of <br/>
<a id="pl.456.16"></a><var>456.16</var>the client.<br/>
<a id="pl.456.17"></a><var>456.17</var>    Subd. 8. <b>Documentation of administration of medications.</b> Each medication <br/>
<a id="pl.456.18"></a><var>456.18</var>administered by comprehensive home care provider staff must be documented in the <br/>
<a id="pl.456.19"></a><var>456.19</var>client's record. The documentation must include the signature and title of the person <br/>
<a id="pl.456.20"></a><var>456.20</var>who administered the medication. The documentation must include the medication <br/>
<a id="pl.456.21"></a><var>456.21</var>name, dosage, date and time administered, and method and route of administration. The <br/>
<a id="pl.456.22"></a><var>456.22</var>staff must document the reason why medication administration was not completed as <br/>
<a id="pl.456.23"></a><var>456.23</var>prescribed and document any follow-up procedures that were provided to meet the client's <br/>
<a id="pl.456.24"></a><var>456.24</var>needs when medication was not administered as prescribed and in compliance with the <br/>
<a id="pl.456.25"></a><var>456.25</var>client's medication management plan.<br/>
<a id="pl.456.26"></a><var>456.26</var>    Subd. 9. <b>Documentation of medication set up.</b> Documentation of dates of <br/>
<a id="pl.456.27"></a><var>456.27</var>medication set up, name of medication, quantity of dose, times to be administered, route <br/>
<a id="pl.456.28"></a><var>456.28</var>of administration, and name of person completing medication set up must be done at <br/>
<a id="pl.456.29"></a><var>456.29</var>time of set up.<br/>
<a id="pl.456.30"></a><var>456.30</var>    Subd. 10. <b>Medications management for clients who will be away from home.</b><br/>
<a id="pl.456.31"></a><var>456.31</var>(a) A home care provider that is providing medication management services to the client <br/>
<a id="pl.456.32"></a><var>456.32</var>and controls the client's access to the medications must develop and implement policies <br/>
<a id="pl.456.33"></a><var>456.33</var>and procedures for giving accurate and current medications to clients for planned or <br/>
<a id="pl.456.34"></a><var>456.34</var>unplanned times away from home according to the client's individualized medication <br/>
<a id="pl.456.35"></a><var>456.35</var>management plan.<br/>
<a id="pl.456.36"></a><var>456.36</var>The policy and procedures must state that: <br/>
<a id="pl.457.1"></a><var>457.1</var>(1) for planned time away, the medications must be obtained from the pharmacy or <br/>
<a id="pl.457.2"></a><var>457.2</var>set up by the registered nurse according to appropriate state and federal laws and nursing <br/>
<a id="pl.457.3"></a><var>457.3</var>standards of  practice;<br/>
<a id="pl.457.4"></a><var>457.4</var>(2) for unplanned time away, when the pharmacy is not able to provide the <br/>
<a id="pl.457.5"></a><var>457.5</var>medications, a licensed nurse or unlicensed personnel shall give the client or the client's <br/>
<a id="pl.457.6"></a><var>457.6</var>representative medications in  amounts and dosages needed for the length of the anticipated <br/>
<a id="pl.457.7"></a><var>457.7</var>absence, not to exceed 120 hours;<br/>
<a id="pl.457.8"></a><var>457.8</var>(3) the client, or the client's representative, must be provided written information <br/>
<a id="pl.457.9"></a><var>457.9</var>on medications, including any special instructions for administering or handling the <br/>
<a id="pl.457.10"></a><var>457.10</var>medications, including controlled substances;<br/>
<a id="pl.457.11"></a><var>457.11</var>(4) the medications must be placed in a medication container or containers <br/>
<a id="pl.457.12"></a><var>457.12</var>appropriate to the provider's medication system and must be labeled with the client's name <br/>
<a id="pl.457.13"></a><var>457.13</var>and the dates and times that the medications are scheduled; and<br/>
<a id="pl.457.14"></a><var>457.14</var>(5) the client or client's representative must be provided in writing the home  care <br/>
<a id="pl.457.15"></a><var>457.15</var>provider's name and information on how to contact them.<br/>
<a id="pl.457.16"></a><var>457.16</var>(b) For unplanned time away when the licensed nurse is not available, the registered <br/>
<a id="pl.457.17"></a><var>457.17</var>nurse may delegate this task to unlicensed personnel if: <br/>
<a id="pl.457.18"></a><var>457.18</var>(1) the registered nurse has trained and determined the unlicensed staff to be <br/>
<a id="pl.457.19"></a><var>457.19</var>competent to follow the procedures for giving medications to clients;<br/>
<a id="pl.457.20"></a><var>457.20</var>(2) the registered nurse has developed written procedures for the unlicensed <br/>
<a id="pl.457.21"></a><var>457.21</var>personnel, including any special instructions or procedures regarding controlled substances <br/>
<a id="pl.457.22"></a><var>457.22</var>that are prescribed for the client.  The procedures must address: <br/>
<a id="pl.457.23"></a><var>457.23</var>(i) the type of container or containers to be used for the medications appropriate to <br/>
<a id="pl.457.24"></a><var>457.24</var>the provider's medication system;<br/>
<a id="pl.457.25"></a><var>457.25</var>(ii) how the container or containers must be labeled;<br/>
<a id="pl.457.26"></a><var>457.26</var>(iii) the written information about the medications to be given to the client or the <br/>
<a id="pl.457.27"></a><var>457.27</var>client' s representative;<br/>
<a id="pl.457.28"></a><var>457.28</var>(iv) how the unlicensed staff will document in the client's record that medications <br/>
<a id="pl.457.29"></a><var>457.29</var>have been given to the client or the client's responsible person, including documenting the <br/>
<a id="pl.457.30"></a><var>457.30</var>date the medications were given to the client or the client's responsible person and who <br/>
<a id="pl.457.31"></a><var>457.31</var>received the medications, the person who gave the medications to the client, the number of <br/>
<a id="pl.457.32"></a><var>457.32</var>medications that were given to the client, and other required information;<br/>
<a id="pl.457.33"></a><var>457.33</var>(v) how the registered nurse will be notified that medications have been given to <br/>
<a id="pl.457.34"></a><var>457.34</var>the client or the client's responsible person and whether the registered nurse needs to <br/>
<a id="pl.457.35"></a><var>457.35</var>be contacted before the medications are given to the client or the client's responsible <br/>
<a id="pl.457.36"></a><var>457.36</var>person; and<br/>
<a id="pl.458.1"></a><var>458.1</var>(vi) a review by the registered nurse of the completion of this task to verify that this <br/>
<a id="pl.458.2"></a><var>458.2</var>task was completed accurately by the unlicensed personnel.<br/>
<a id="pl.458.3"></a><var>458.3</var>    Subd. 11. <b>Prescribed and nonprescribed medication.</b> The comprehensive home <br/>
<a id="pl.458.4"></a><var>458.4</var>care provider must determine whether it will require a prescription for all medications it <br/>
<a id="pl.458.5"></a><var>458.5</var>manages. The comprehensive home care provider must inform the client or the client's <br/>
<a id="pl.458.6"></a><var>458.6</var>representative whether the comprehensive home care provider requires a prescription <br/>
<a id="pl.458.7"></a><var>458.7</var>for all over-the-counter and dietary supplements before the comprehensive home care <br/>
<a id="pl.458.8"></a><var>458.8</var>provider will agree to manage those medications.<br/>
<a id="pl.458.9"></a><var>458.9</var>    Subd. 12. <b>Medications; over-the-counter; dietary supplements not prescribed.</b><br/>
<a id="pl.458.10"></a><var>458.10</var>A comprehensive home care provider providing medication management services for <br/>
<a id="pl.458.11"></a><var>458.11</var>over-the-counter drugs or dietary supplements must retain those items in the original labeled <br/>
<a id="pl.458.12"></a><var>458.12</var>container with directions for use prior to setting up for immediate or later administration. <br/>
<a id="pl.458.13"></a><var>458.13</var>The provider must verify that the medications are up-to-date and stored as appropriate.<br/>
<a id="pl.458.14"></a><var>458.14</var>    Subd. 13. <b>Prescriptions.</b> There must be a current written or electronically recorded <br/>
<a id="pl.458.15"></a><var>458.15</var>prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed <br/>
<a id="pl.458.16"></a><var>458.16</var>medications that the comprehensive home care provider is managing for the client.<br/>
<a id="pl.458.17"></a><var>458.17</var>    Subd. 14. <b>Renewal of prescriptions.</b> Prescriptions must be renewed at least <br/>
<a id="pl.458.18"></a><var>458.18</var>every 12 months or more frequently as indicated by the assessment in subdivision 2. <br/>
<a id="pl.458.19"></a><var>458.19</var>Prescriptions for controlled substances must comply with chapter 152.<br/>
<a id="pl.458.20"></a><var>458.20</var>    Subd. 15. <b>Verbal prescription orders.</b> Verbal prescription orders from an <br/>
<a id="pl.458.21"></a><var>458.21</var>authorized prescriber must be received by a nurse or pharmacist. The order must be <br/>
<a id="pl.458.22"></a><var>458.22</var>handled according to Minnesota Rules, part 6800.6200. <br/>
<a id="pl.458.23"></a><var>458.23</var>    Subd. 16. <b>Written or electronic prescription.</b> When a written or electronic <br/>
<a id="pl.458.24"></a><var>458.24</var>prescription is received, it must be communicated to the registered nurse in charge and <br/>
<a id="pl.458.25"></a><var>458.25</var>recorded or placed in the client's record.<br/>
<a id="pl.458.26"></a><var>458.26</var>    Subd. 17. <b>Records confidential.</b> A prescription or order received verbally, in <br/>
<a id="pl.458.27"></a><var>458.27</var>writing, or electronically must be kept according to sections 144.291 to 144.298 and <br/>
<a id="pl.458.28"></a><var>458.28</var>144A.44.<br/>
<a id="pl.458.29"></a><var>458.29</var>    Subd. 18. <b>Medications provided by client or family members.</b> When the <br/>
<a id="pl.458.30"></a><var>458.30</var>comprehensive home care provider is aware of any medications or dietary supplements <br/>
<a id="pl.458.31"></a><var>458.31</var>that are being used by the client and are not included in the assessment for medication <br/>
<a id="pl.458.32"></a><var>458.32</var>management services, the staff must advise the registered nurse and document that in <br/>
<a id="pl.458.33"></a><var>458.33</var>the client's record.<br/>
<a id="pl.458.34"></a><var>458.34</var>    Subd. 19. <b>Storage of drugs.</b> A comprehensive home care provider providing <br/>
<a id="pl.458.35"></a><var>458.35</var>storage of medications outside of the client's private living space must store all prescription <br/>
<a id="pl.459.1"></a><var>459.1</var>drugs in securely locked and substantially constructed compartments according to the <br/>
<a id="pl.459.2"></a><var>459.2</var>manufacturer's directions and permit only authorized personnel to have access.<br/>
<a id="pl.459.3"></a><var>459.3</var>    Subd. 20. <b>Prescription drugs.</b> A prescription drug, prior to being set up for <br/>
<a id="pl.459.4"></a><var>459.4</var>immediate or later administration, must be kept in the original container in which it was <br/>
<a id="pl.459.5"></a><var>459.5</var>dispensed by the pharmacy bearing the original prescription label with legible information <br/>
<a id="pl.459.6"></a><var>459.6</var>including the expiration or beyond-use date of a time-dated drug.<br/>
<a id="pl.459.7"></a><var>459.7</var>    Subd. 21. <b>Prohibitions.</b> No prescription drug supply for one client may be used or <br/>
<a id="pl.459.8"></a><var>459.8</var>saved for use by anyone other than the client.<br/>
<a id="pl.459.9"></a><var>459.9</var>    Subd. 22. <b>Disposition of drugs.</b> (a) Any current medications being managed by the <br/>
<a id="pl.459.10"></a><var>459.10</var>comprehensive home care provider must be given to the client or the client's representative <br/>
<a id="pl.459.11"></a><var>459.11</var>when the client's service plan ends or medication management services are no longer part <br/>
<a id="pl.459.12"></a><var>459.12</var>of the service plan. Medications that have been stored in the client's private living space <br/>
<a id="pl.459.13"></a><var>459.13</var>for a client that is deceased or that have been discontinued or that have expired may be <br/>
<a id="pl.459.14"></a><var>459.14</var>given to the client or the client's representative for disposal.<br/>
<a id="pl.459.15"></a><var>459.15</var>(b) The comprehensive home care provider will dispose of any medications <br/>
<a id="pl.459.16"></a><var>459.16</var>remaining with the comprehensive home care provider that are discontinued or expired or <br/>
<a id="pl.459.17"></a><var>459.17</var>upon the termination of the service contract or the client's death according to state and <br/>
<a id="pl.459.18"></a><var>459.18</var>federal regulations for disposition of drugs and controlled substances.<br/>
<a id="pl.459.19"></a><var>459.19</var>(c) Upon disposition, the comprehensive home care provider must document in the <br/>
<a id="pl.459.20"></a><var>459.20</var>client's record the disposition of the medications including the medication's name, strength, <br/>
<a id="pl.459.21"></a><var>459.21</var>prescription number as applicable, quantity, to whom the medications were given, date of <br/>
<a id="pl.459.22"></a><var>459.22</var>disposition, and names of staff and other individuals involved in the disposition.<br/>
<a id="pl.459.23"></a><var>459.23</var>    Subd. 23. <b>Loss or spillage.</b> (a) Comprehensive home care providers providing <br/>
<a id="pl.459.24"></a><var>459.24</var>medication management must develop and implement procedures for loss or spillage of all <br/>
<a id="pl.459.25"></a><var>459.25</var>controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must <br/>
<a id="pl.459.26"></a><var>459.26</var>require that when a spillage of a controlled substance occurs, a notation must be made <br/>
<a id="pl.459.27"></a><var>459.27</var>in the client's record explaining the spillage and the actions taken. The notation must <br/>
<a id="pl.459.28"></a><var>459.28</var>be signed by the person responsible for the spillage and include verification that any <br/>
<a id="pl.459.29"></a><var>459.29</var>contaminated substance was disposed of according to state or federal regulations.<br/>
<a id="pl.459.30"></a><var>459.30</var>(b) The procedures must require the comprehensive home care provider of <br/>
<a id="pl.459.31"></a><var>459.31</var>medication management to investigate any known loss or unaccounted for prescription <br/>
<a id="pl.459.32"></a><var>459.32</var>drugs and take appropriate action required under state or federal regulations and document <br/>
<a id="pl.459.33"></a><var>459.33</var>the investigation in required records.<br/>
<br/>
<a id="bill.11.21.0"></a><a id="pl.459.34"></a><var>459.34</var>    Sec. 21. <b>[144A.4793] TREATMENT AND THERAPY MANAGEMENT </b><br/>
<a id="pl.459.35"></a><var>459.35</var><b>SERVICES.</b><br/>
<a id="pl.460.1"></a><var>460.1</var>    Subdivision 1. <b>Providers with a comprehensive home care license.</b> This section <br/>
<a id="pl.460.2"></a><var>460.2</var>applies only to home care providers with a comprehensive home care license that provide <br/>
<a id="pl.460.3"></a><var>460.3</var>treatment or therapy management services to clients. Treatment or therapy management <br/>
<a id="pl.460.4"></a><var>460.4</var>services cannot be provided by a home care provider that has a basic home care license.<br/>
<a id="pl.460.5"></a><var>460.5</var>    Subd. 2. <b>Policies and procedures.</b> (a) A comprehensive home care provider who <br/>
<a id="pl.460.6"></a><var>460.6</var>provides treatment and therapy management services must develop, implement, and <br/>
<a id="pl.460.7"></a><var>460.7</var>maintain up-to-date written treatment or therapy management policies and procedures. <br/>
<a id="pl.460.8"></a><var>460.8</var>The policies and procedures must be developed under the supervision and direction of <br/>
<a id="pl.460.9"></a><var>460.9</var>a registered nurse or appropriate licensed health professional consistent with current <br/>
<a id="pl.460.10"></a><var>460.10</var>practice standards and guidelines.<br/>
<a id="pl.460.11"></a><var>460.11</var>(b) The written policies and procedures must address requesting and receiving <br/>
<a id="pl.460.12"></a><var>460.12</var>orders or prescriptions for treatments or therapies, providing the treatment or therapy, <br/>
<a id="pl.460.13"></a><var>460.13</var>documenting of treatment or therapy activities, educating and communicating with clients <br/>
<a id="pl.460.14"></a><var>460.14</var>about treatments or therapy they are receiving, monitoring and evaluating the treatment <br/>
<a id="pl.460.15"></a><var>460.15</var>and therapy, and communicating with the prescriber.<br/>
<a id="pl.460.16"></a><var>460.16</var>    Subd. 3. <b>Individualized treatment or therapy management plan.</b> For each <br/>
<a id="pl.460.17"></a><var>460.17</var>client receiving management of ordered or prescribed treatments or therapy services, the <br/>
<a id="pl.460.18"></a><var>460.18</var>comprehensive home care provider must prepare and include in the service plan a written <br/>
<a id="pl.460.19"></a><var>460.19</var>statement of the treatment or therapy services that will be provided to the client. The <br/>
<a id="pl.460.20"></a><var>460.20</var>provider must also develop and maintain a current individualized treatment and therapy <br/>
<a id="pl.460.21"></a><var>460.21</var>management record for each client that contains at least the following:<br/>
<a id="pl.460.22"></a><var>460.22</var>(1) a statement of the type of services that will be provided;<br/>
<a id="pl.460.23"></a><var>460.23</var>(2) documentation of specific client instructions relating to the treatments or therapy <br/>
<a id="pl.460.24"></a><var>460.24</var>administration;<br/>
<a id="pl.460.25"></a><var>460.25</var>(3) identification of treatment or therapy tasks that will be delegated to unlicensed <br/>
<a id="pl.460.26"></a><var>460.26</var>personnel; <br/>
<a id="pl.460.27"></a><var>460.27</var>(4) procedures for notifying a registered nurse or appropriate licensed health <br/>
<a id="pl.460.28"></a><var>460.28</var>professional when a problem arises with treatments or therapy services; and<br/>
<a id="pl.460.29"></a><var>460.29</var>(5) any client-specific requirements relating to documentation of treatment and <br/>
<a id="pl.460.30"></a><var>460.30</var>therapy received, verification that all treatments and therapy was administered as <br/>
<a id="pl.460.31"></a><var>460.31</var>prescribed, and monitoring of treatment or therapy to prevent possible complications or <br/>
<a id="pl.460.32"></a><var>460.32</var>adverse reactions. The treatment or therapy management record must be current and <br/>
<a id="pl.460.33"></a><var>460.33</var>updated when there are any changes.<br/>
<a id="pl.460.34"></a><var>460.34</var>    Subd. 4. <b>Administration of treatments and therapy.</b> Ordered or prescribed <br/>
<a id="pl.460.35"></a><var>460.35</var>treatments or therapies must be administered by a nurse, physician, or other licensed health <br/>
<a id="pl.460.36"></a><var>460.36</var>professional authorized to perform the treatment or therapy, or may be delegated or assigned <br/>
<a id="pl.461.1"></a><var>461.1</var>to unlicensed personnel by the licensed health professional according to the appropriate <br/>
<a id="pl.461.2"></a><var>461.2</var>practice standards for delegation or assignment. When administration of a treatment or <br/>
<a id="pl.461.3"></a><var>461.3</var>therapy is delegated or assigned to unlicensed personnel, the home care provider must <br/>
<a id="pl.461.4"></a><var>461.4</var>ensure that the registered nurse or authorized licensed health professional has:<br/>
<a id="pl.461.5"></a><var>461.5</var>(1) instructed the unlicensed personnel in the proper methods with respect to each <br/>
<a id="pl.461.6"></a><var>461.6</var>client and has demonstrated their ability to competently follow the procedures;<br/>
<a id="pl.461.7"></a><var>461.7</var>(2) specified, in writing, specific instructions for each client and documented those <br/>
<a id="pl.461.8"></a><var>461.8</var>instructions in the client's record; and<br/>
<a id="pl.461.9"></a><var>461.9</var>(3) communicated with the unlicensed personnel about the individual needs of <br/>
<a id="pl.461.10"></a><var>461.10</var>the client.<br/>
<a id="pl.461.11"></a><var>461.11</var>    Subd. 5. <b>Documentation of administration of treatments and therapies.</b> Each <br/>
<a id="pl.461.12"></a><var>461.12</var>treatment or therapy administered by a comprehensive home care provider must be <br/>
<a id="pl.461.13"></a><var>461.13</var>documented in the client's record. The documentation must include the signature and title <br/>
<a id="pl.461.14"></a><var>461.14</var>of the person who administered the treatment or therapy and must include the date and <br/>
<a id="pl.461.15"></a><var>461.15</var>time of administration. When treatment or therapies are not administered as ordered or <br/>
<a id="pl.461.16"></a><var>461.16</var>prescribed, the provider must document the reason why it was not administered and any <br/>
<a id="pl.461.17"></a><var>461.17</var>follow-up procedures that were provided to meet the client's needs.<br/>
<a id="pl.461.18"></a><var>461.18</var>    Subd. 6. <b>Orders or prescriptions.</b> There must be an up-to-date written or <br/>
<a id="pl.461.19"></a><var>461.19</var>electronically recorded order or prescription for all treatments and therapies. The order <br/>
<a id="pl.461.20"></a><var>461.20</var>must contain the name of the client, description of the treatment or therapy to be provided, <br/>
<a id="pl.461.21"></a><var>461.21</var>and the frequency and other information needed to administer the treatment or therapy.<br/>
<br/>
<a id="bill.11.22.0"></a><a id="pl.461.22"></a><var>461.22</var>    Sec. 22. <b>[144A.4794] CLIENT RECORD REQUIREMENTS.</b><br/>
<a id="pl.461.23"></a><var>461.23</var>    Subdivision 1. <b>Client record.</b> (a) The home care provider must maintain records <br/>
<a id="pl.461.24"></a><var>461.24</var>for each client to whom it is providing services. Entries in the client records must be <br/>
<a id="pl.461.25"></a><var>461.25</var>current, legible, permanently recorded, dated, and authenticated with the name and title <br/>
<a id="pl.461.26"></a><var>461.26</var>of the person making the entry.<br/>
<a id="pl.461.27"></a><var>461.27</var>(b) Client records, whether written or electronic, must be protected against loss, <br/>
<a id="pl.461.28"></a><var>461.28</var>tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable <br/>
<a id="pl.461.29"></a><var>461.29</var>relevant federal and state laws. The home care provider shall establish and implement <br/>
<a id="pl.461.30"></a><var>461.30</var>written procedures to control use, storage, and security of client's records and establish <br/>
<a id="pl.461.31"></a><var>461.31</var>criteria for release of client information.<br/>
<a id="pl.461.32"></a><var>461.32</var>(c) The home care provider may not disclose to any other person any personal, <br/>
<a id="pl.461.33"></a><var>461.33</var>financial, medical, or other information about the client, except:<br/>
<a id="pl.461.34"></a><var>461.34</var>(1) as may be required by law;<br/>
<a id="pl.462.1"></a><var>462.1</var>(2) to employees or contractors of the home care provider, another home care <br/>
<a id="pl.462.2"></a><var>462.2</var>provider, other health care practitioner or provider, or inpatient facility needing <br/>
<a id="pl.462.3"></a><var>462.3</var>information in order to provide services to the client, but only such information that <br/>
<a id="pl.462.4"></a><var>462.4</var>is necessary for the provision of services;<br/>
<a id="pl.462.5"></a><var>462.5</var>(3) to persons authorized in writing by the client or the client's representative to <br/>
<a id="pl.462.6"></a><var>462.6</var>receive the information, including third-party payers; and<br/>
<a id="pl.462.7"></a><var>462.7</var>(4) to representatives of the commissioner authorized to survey or investigate home <br/>
<a id="pl.462.8"></a><var>462.8</var>care providers under this chapter or federal laws.<br/>
<a id="pl.462.9"></a><var>462.9</var>    Subd. 2. <b>Access to records.</b> The home care provider must ensure that the <br/>
<a id="pl.462.10"></a><var>462.10</var>appropriate records are readily available to employees or contractors authorized to access <br/>
<a id="pl.462.11"></a><var>462.11</var>the records. Client records must be maintained in a manner that allows for timely access, <br/>
<a id="pl.462.12"></a><var>462.12</var>printing, or transmission of the records.<br/>
<a id="pl.462.13"></a><var>462.13</var>    Subd. 3. <b>Contents of client record.</b> Contents of a client record include the <br/>
<a id="pl.462.14"></a><var>462.14</var>following for each client:<br/>
<a id="pl.462.15"></a><var>462.15</var>(1) identifying information, including the client's name, date of birth, address, and <br/>
<a id="pl.462.16"></a><var>462.16</var>telephone number;<br/>
<a id="pl.462.17"></a><var>462.17</var>(2) the name, address, and telephone number of an emergency contact, family <br/>
<a id="pl.462.18"></a><var>462.18</var>members, client's representative, if any, or others as identified;<br/>
<a id="pl.462.19"></a><var>462.19</var>(3) names, addresses, and telephone numbers of the client's health and medical <br/>
<a id="pl.462.20"></a><var>462.20</var>service providers and other home care providers, if known;<br/>
<a id="pl.462.21"></a><var>462.21</var>(4) health information, including medical history, allergies, and when the provider <br/>
<a id="pl.462.22"></a><var>462.22</var>is managing medications, treatments or therapies that require documentation, and other <br/>
<a id="pl.462.23"></a><var>462.23</var>relevant health records;<br/>
<a id="pl.462.24"></a><var>462.24</var>(5) client's advance directives, if any;<br/>
<a id="pl.462.25"></a><var>462.25</var>(6) the home care provider's current and previous assessments and service plans;<br/>
<a id="pl.462.26"></a><var>462.26</var>(7) all records of communications pertinent to the client's home care services;<br/>
<a id="pl.462.27"></a><var>462.27</var>(8) documentation of significant changes in the client's status and actions taken in <br/>
<a id="pl.462.28"></a><var>462.28</var>response to the needs of the client including reporting to the appropriate supervisor or <br/>
<a id="pl.462.29"></a><var>462.29</var>health care professional;<br/>
<a id="pl.462.30"></a><var>462.30</var>(9) documentation of incidents involving the client and actions taken in response <br/>
<a id="pl.462.31"></a><var>462.31</var>to the needs of the client including reporting to the appropriate supervisor or health <br/>
<a id="pl.462.32"></a><var>462.32</var>care professional;<br/>
<a id="pl.462.33"></a><var>462.33</var>(10) documentation that services have been provided as identified in the service plan;<br/>
<a id="pl.462.34"></a><var>462.34</var>(11) documentation that the client has received and reviewed the home care bill <br/>
<a id="pl.462.35"></a><var>462.35</var>of rights;<br/>
<a id="pl.463.1"></a><var>463.1</var>(12) documentation that the client has been provided the statement of disclosure on <br/>
<a id="pl.463.2"></a><var>463.2</var>limitations of services under section 144A.4791, subdivision 3;<br/>
<a id="pl.463.3"></a><var>463.3</var>(13) documentation of complaints received and resolution;<br/>
<a id="pl.463.4"></a><var>463.4</var>(14) discharge summary, including service termination notice and related <br/>
<a id="pl.463.5"></a><var>463.5</var>documentation, when applicable; and<br/>
<a id="pl.463.6"></a><var>463.6</var>(15) other documentation required under this chapter and relevant to the client's <br/>
<a id="pl.463.7"></a><var>463.7</var>services or status.<br/>
<a id="pl.463.8"></a><var>463.8</var>    Subd. 4. <b>Transfer of client records.</b> If a client transfers to another home care <br/>
<a id="pl.463.9"></a><var>463.9</var>provider or other health care practitioner or provider, or is admitted to an inpatient facility, <br/>
<a id="pl.463.10"></a><var>463.10</var>the home care provider, upon request of the client or the client's representative, shall take <br/>
<a id="pl.463.11"></a><var>463.11</var>steps to ensure a coordinated transfer including sending a copy or summary of the client's <br/>
<a id="pl.463.12"></a><var>463.12</var>record to the new home care provider, facility, or the client, as appropriate.<br/>
<a id="pl.463.13"></a><var>463.13</var>    Subd. 5. <b>Record retention.</b> Following the client's discharge or termination of <br/>
<a id="pl.463.14"></a><var>463.14</var>services, a home care provider must retain a client's record for at least five years, or as <br/>
<a id="pl.463.15"></a><var>463.15</var>otherwise required by state or federal regulations. Arrangements must be made for secure <br/>
<a id="pl.463.16"></a><var>463.16</var>storage and retrieval of client records if the home care provider ceases business.<br/>
<br/>
<a id="bill.11.23.0"></a><a id="pl.463.17"></a><var>463.17</var>    Sec. 23. <b>[144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.</b><br/>
<a id="pl.463.18"></a><var>463.18</var>    Subdivision 1. <b>Qualifications, training, and competency.</b> All staff providing <br/>
<a id="pl.463.19"></a><var>463.19</var>home care services must be trained and competent in the provision of home care services <br/>
<a id="pl.463.20"></a><var>463.20</var>consistent with current practice standards appropriate to the client's needs.<br/>
<a id="pl.463.21"></a><var>463.21</var>    Subd. 2. <b>Licensed health professionals and nurses.</b> (a) Licensed health <br/>
<a id="pl.463.22"></a><var>463.22</var>professionals and nurses providing home care services as an employee of a licensed home <br/>
<a id="pl.463.23"></a><var>463.23</var>care provider must possess current Minnesota license or registration to practice.<br/>
<a id="pl.463.24"></a><var>463.24</var>(b) Licensed health professionals and registered nurses must be competent in <br/>
<a id="pl.463.25"></a><var>463.25</var>assessing client needs, planning appropriate home care services to meet client needs, <br/>
<a id="pl.463.26"></a><var>463.26</var>implementing services, and supervising staff if assigned.<br/>
<a id="pl.463.27"></a><var>463.27</var>(c) Nothing in this section limits or expands the rights of nurses or licensed health <br/>
<a id="pl.463.28"></a><var>463.28</var>professionals to provide services within the scope of their licenses or registrations, as <br/>
<a id="pl.463.29"></a><var>463.29</var>provided by law.<br/>
<a id="pl.463.30"></a><var>463.30</var>    Subd. 3. <b>Unlicensed personnel.</b> (a) Unlicensed personnel providing basic home <br/>
<a id="pl.463.31"></a><var>463.31</var>care services must have:<br/>
<a id="pl.463.32"></a><var>463.32</var>(1) successfully completed a training and competency evaluation appropriate to <br/>
<a id="pl.463.33"></a><var>463.33</var>the services provided by the home care provider and the topics listed in subdivision 7, <br/>
<a id="pl.463.34"></a><var>463.34</var>paragraph (b); or<br/>
<a id="pl.464.1"></a><var>464.1</var>(2) demonstrated competency by satisfactorily completing a written or oral test on <br/>
<a id="pl.464.2"></a><var>464.2</var>the tasks the unlicensed personnel will perform and in the topics listed in subdivision <br/>
<a id="pl.464.3"></a><var>464.3</var>7, paragraph (b); and successfully demonstrate competency of topics in subdivision 7, <br/>
<a id="pl.464.4"></a><var>464.4</var>paragraph (b), clauses (5), (7), and (8), by a practical skills test.<br/>
<a id="pl.464.5"></a><var>464.5</var>Unlicensed personnel providing home care services for a basic home care provider may <br/>
<a id="pl.464.6"></a><var>464.6</var>not perform delegated nursing or therapy tasks.<br/>
<a id="pl.464.7"></a><var>464.7</var>(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive <br/>
<a id="pl.464.8"></a><var>464.8</var>home care provider must have:<br/>
<a id="pl.464.9"></a><var>464.9</var>(1) successfully completed training and demonstrated competency by successfully <br/>
<a id="pl.464.10"></a><var>464.10</var>completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and <br/>
<a id="pl.464.11"></a><var>464.11</var>a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7), <br/>
<a id="pl.464.12"></a><var>464.12</var>and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; or<br/>
<a id="pl.464.13"></a><var>464.13</var>(2) satisfy the current requirements of Medicare for training or competency of home <br/>
<a id="pl.464.14"></a><var>464.14</var>health aides or nursing assistants, as provided by Code of Federal Regulations, title 42, <br/>
<a id="pl.464.15"></a><var>464.15</var>section 483 or section 484.36; or<br/>
<a id="pl.464.16"></a><var>464.16</var>(3) before April 19, 1993, completed a training course for nursing assistants that was <br/>
<a id="pl.464.17"></a><var>464.17</var>approved by the commissioner.<br/>
<a id="pl.464.18"></a><var>464.18</var>(c) Unlicensed personnel performing therapy or treatment tasks delegated or <br/>
<a id="pl.464.19"></a><var>464.19</var>assigned by a licensed health professional must meet the requirements for delegated <br/>
<a id="pl.464.20"></a><var>464.20</var>tasks in subdivision 4 and any other training or competency requirements within the <br/>
<a id="pl.464.21"></a><var>464.21</var>licensed health professional scope of practice relating to delegation or assignment of tasks <br/>
<a id="pl.464.22"></a><var>464.22</var>to unlicensed personnel.<br/>
<a id="pl.464.23"></a><var>464.23</var>    Subd. 4. <b>Delegation of home care tasks.</b> A registered nurse or licensed health <br/>
<a id="pl.464.24"></a><var>464.24</var>professional may delegate tasks only to staff that are competent and possess the knowledge <br/>
<a id="pl.464.25"></a><var>464.25</var>and skills consistent with the complexity of the tasks and according to the appropriate <br/>
<a id="pl.464.26"></a><var>464.26</var>Minnesota Practice Act. The comprehensive home care provider must establish and <br/>
<a id="pl.464.27"></a><var>464.27</var>implement a system to communicate up-to-date information to the registered nurse or <br/>
<a id="pl.464.28"></a><var>464.28</var>licensed health professional regarding the current available staff and their competency so <br/>
<a id="pl.464.29"></a><var>464.29</var>the registered nurse or licensed health professional has sufficient information to determine <br/>
<a id="pl.464.30"></a><var>464.30</var>the appropriateness of delegating tasks to meet individual client needs and preferences.<br/>
<a id="pl.464.31"></a><var>464.31</var>    Subd. 5. <b>Individual contractors.</b> When a home care provider contracts with an <br/>
<a id="pl.464.32"></a><var>464.32</var>individual contractor excluded from licensure under section 144A.471 to provide home <br/>
<a id="pl.464.33"></a><var>464.33</var>care services, the contractor must meet the same requirements required by this section for <br/>
<a id="pl.464.34"></a><var>464.34</var>personnel employed by the home care provider.<br/>
<a id="pl.464.35"></a><var>464.35</var>    Subd. 6. <b>Temporary staff.</b> When a home care provider contracts with a temporary <br/>
<a id="pl.464.36"></a><var>464.36</var>staffing agency excluded from licensure under section 144A.471, those individuals must <br/>
<a id="pl.465.1"></a><var>465.1</var>meet the same requirements required by this section for personnel employed by the home <br/>
<a id="pl.465.2"></a><var>465.2</var>care provider and shall be treated as if they are staff of the home care provider.<br/>
<a id="pl.465.3"></a><var>465.3</var>    Subd. 7. <b>Requirements for instructors, training content, and competency </b><br/>
<a id="pl.465.4"></a><var>465.4</var><b>evaluations for unlicensed personnel.</b> (a) Instructors and competency evaluators must <br/>
<a id="pl.465.5"></a><var>465.5</var>meet the following requirements:<br/>
<a id="pl.465.6"></a><var>465.6</var>(1) training and competency evaluations of unlicensed personnel providing basic <br/>
<a id="pl.465.7"></a><var>465.7</var>home care services must be conducted by individuals with work experience and training in <br/>
<a id="pl.465.8"></a><var>465.8</var>providing home care services listed in section 144A.471, subdivisions 6 and 7; and<br/>
<a id="pl.465.9"></a><var>465.9</var>(2) training and competency evaluations of unlicensed personnel providing <br/>
<a id="pl.465.10"></a><var>465.10</var>comprehensive home care services must be conducted by a registered nurse, or another <br/>
<a id="pl.465.11"></a><var>465.11</var>instructor may provide training in conjunction with the registered nurse. If the home care <br/>
<a id="pl.465.12"></a><var>465.12</var>provider is providing services by licensed health professionals only, then that specific <br/>
<a id="pl.465.13"></a><var>465.13</var>training and competency evaluation may be conducted by the licensed health professionals <br/>
<a id="pl.465.14"></a><var>465.14</var>as appropriate.<br/>
<a id="pl.465.15"></a><var>465.15</var>(b) Training and competency evaluations for all unlicensed personnel must include <br/>
<a id="pl.465.16"></a><var>465.16</var>the following:<br/>
<a id="pl.465.17"></a><var>465.17</var>(1) documentation requirements for all services provided;<br/>
<a id="pl.465.18"></a><var>465.18</var>(2) reports of changes in the client's condition to the supervisor designated by the <br/>
<a id="pl.465.19"></a><var>465.19</var>home care provider;<br/>
<a id="pl.465.20"></a><var>465.20</var>(3) basic infection control, including blood-borne pathogens;<br/>
<a id="pl.465.21"></a><var>465.21</var>(4) maintenance of a clean and safe environment;<br/>
<a id="pl.465.22"></a><var>465.22</var>(5) appropriate and safe techniques in personal hygiene and grooming, including:<br/>
<a id="pl.465.23"></a><var>465.23</var>(i) hair care and bathing;<br/>
<a id="pl.465.24"></a><var>465.24</var>(ii) care of teeth, gums, and oral prosthetic devices;<br/>
<a id="pl.465.25"></a><var>465.25</var>(iii) care and use of hearing aids; and<br/>
<a id="pl.465.26"></a><var>465.26</var>(iv) dressing and assisting with toileting;<br/>
<a id="pl.465.27"></a><var>465.27</var>(6) training on the prevention of falls for providers working with the elderly or <br/>
<a id="pl.465.28"></a><var>465.28</var>individuals at risk of falls;<br/>
<a id="pl.465.29"></a><var>465.29</var>(7) standby assistance techniques and how to perform them;<br/>
<a id="pl.465.30"></a><var>465.30</var>(8) medication, exercise, and treatment reminders;<br/>
<a id="pl.465.31"></a><var>465.31</var>(9) basic nutrition, meal preparation, food safety, and assistance with eating;<br/>
<a id="pl.465.32"></a><var>465.32</var>(10) preparation of modified diets as ordered by a licensed health professional;<br/>
<a id="pl.465.33"></a><var>465.33</var>(11) communication skills that include preserving the dignity of the client and <br/>
<a id="pl.465.34"></a><var>465.34</var>showing respect for the client and the client's preferences, cultural background, and family;<br/>
<a id="pl.465.35"></a><var>465.35</var>(12) awareness of confidentiality and privacy;<br/>
<a id="pl.466.1"></a><var>466.1</var>(13) understanding appropriate boundaries between staff and clients and the client's <br/>
<a id="pl.466.2"></a><var>466.2</var>family;<br/>
<a id="pl.466.3"></a><var>466.3</var>(14) procedures to utilize in handling various emergency situations; and<br/>
<a id="pl.466.4"></a><var>466.4</var>(15) awareness of commonly used health technology equipment and assistive devices.<br/>
<a id="pl.466.5"></a><var>466.5</var>(c) In addition to paragraph (b), training and competency evaluation for unlicensed <br/>
<a id="pl.466.6"></a><var>466.6</var>personnel providing comprehensive home care services must include:<br/>
<a id="pl.466.7"></a><var>466.7</var>(1) observation, reporting, and documenting of client status;<br/>
<a id="pl.466.8"></a><var>466.8</var>(2) basic knowledge of body functioning and changes in body functioning, injuries, <br/>
<a id="pl.466.9"></a><var>466.9</var>or other observed changes that must be reported to appropriate personnel;<br/>
<a id="pl.466.10"></a><var>466.10</var>(3) reading and recording temperature, pulse, and respirations of the client;<br/>
<a id="pl.466.11"></a><var>466.11</var>(4) recognizing physical, emotional, cognitive, and developmental needs of the client;<br/>
<a id="pl.466.12"></a><var>466.12</var>(5) safe transfer techniques and ambulation;<br/>
<a id="pl.466.13"></a><var>466.13</var>(6) range of motioning and positioning; and<br/>
<a id="pl.466.14"></a><var>466.14</var>(7) administering medications or treatments as required.<br/>
<a id="pl.466.15"></a><var>466.15</var>(d) When the registered nurse or licensed health professional delegates tasks, they <br/>
<a id="pl.466.16"></a><var>466.16</var>must ensure that prior to the delegation the unlicensed personnel is trained in the proper <br/>
<a id="pl.466.17"></a><var>466.17</var>methods to perform the tasks or procedures for each client and are able to demonstrate <br/>
<a id="pl.466.18"></a><var>466.18</var>the ability to competently follow the procedures and perform the tasks. If an unlicensed <br/>
<a id="pl.466.19"></a><var>466.19</var>personnel has not regularly performed the delegated home care task for a period of 24 <br/>
<a id="pl.466.20"></a><var>466.20</var>consecutive months, the unlicensed personnel must demonstrate competency in the task <br/>
<a id="pl.466.21"></a><var>466.21</var>to the registered nurse or appropriate licensed health professional. The registered nurse <br/>
<a id="pl.466.22"></a><var>466.22</var>or licensed health professional must document instructions for the delegated tasks in <br/>
<a id="pl.466.23"></a><var>466.23</var>the client's record.<br/>
<br/>
<a id="bill.11.24.0"></a><a id="pl.466.24"></a><var>466.24</var>    Sec. 24. <b>[144A.4796] ORIENTATION AND ANNUAL TRAINING </b><br/>
<a id="pl.466.25"></a><var>466.25</var><b>REQUIREMENTS.</b><br/>
<a id="pl.466.26"></a><var>466.26</var>    Subdivision 1. <b>Orientation of staff and supervisors to home care.</b> All staff <br/>
<a id="pl.466.27"></a><var>466.27</var>providing and supervising direct home care services must complete an orientation to home <br/>
<a id="pl.466.28"></a><var>466.28</var>care licensing requirements and regulations before providing home care services to clients. <br/>
<a id="pl.466.29"></a><var>466.29</var>The orientation may be incorporated into the training required under subdivision 6. The <br/>
<a id="pl.466.30"></a><var>466.30</var>orientation need only be completed once for each staff person and is not transferable <br/>
<a id="pl.466.31"></a><var>466.31</var>to another home care provider.<br/>
<a id="pl.466.32"></a><var>466.32</var>    Subd. 2. <b>Content.</b> The orientation must contain the following topics:<br/>
<a id="pl.466.33"></a><var>466.33</var>    (1) an overview of sections 144A.43 to 144A.4798;<br/>
<a id="pl.466.34"></a><var>466.34</var>(2) introduction and review of all the provider's policies and procedures related to <br/>
<a id="pl.466.35"></a><var>466.35</var>the provision of home care services;<br/>
<a id="pl.467.1"></a><var>467.1</var>(3) handling of emergencies and use of emergency services;<br/>
<a id="pl.467.2"></a><var>467.2</var>(4) compliance with and reporting the maltreatment of minors or vulnerable adults <br/>
<a id="pl.467.3"></a><var>467.3</var>under sections 626.556 and 626.557;<br/>
<a id="pl.467.4"></a><var>467.4</var>(5) home care bill of rights, under section 144A.44;<br/>
<a id="pl.467.5"></a><var>467.5</var>(6) handling of clients' complaints, reporting of complaints, and where to report <br/>
<a id="pl.467.6"></a><var>467.6</var>complaints including information on the Office of Health Facility Complaints and the <br/>
<a id="pl.467.7"></a><var>467.7</var>Common Entry Point;<br/>
<a id="pl.467.8"></a><var>467.8</var>(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care, <br/>
<a id="pl.467.9"></a><var>467.9</var>Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care <br/>
<a id="pl.467.10"></a><var>467.10</var>Ombudsman at the Department of Human Services, county managed care advocates, <br/>
<a id="pl.467.11"></a><var>467.11</var>or other relevant advocacy services; and<br/>
<a id="pl.467.12"></a><var>467.12</var>(8) review of the types of home care services the employee will be providing and <br/>
<a id="pl.467.13"></a><var>467.13</var>the provider's scope of licensure.<br/>
<a id="pl.467.14"></a><var>467.14</var>    Subd. 3. <b>Verification and documentation of orientation.</b> Each home care provider <br/>
<a id="pl.467.15"></a><var>467.15</var>shall retain evidence in the employee record of each staff person having completed the <br/>
<a id="pl.467.16"></a><var>467.16</var>orientation required by this section.<br/>
<a id="pl.467.17"></a><var>467.17</var>    Subd. 4. <b>Orientation to client.</b> Staff providing home care services must be oriented <br/>
<a id="pl.467.18"></a><var>467.18</var>specifically to each individual client and the services to be provided. This orientation may <br/>
<a id="pl.467.19"></a><var>467.19</var>be provided in person, orally, in writing, or electronically.<br/>
<a id="pl.467.20"></a><var>467.20</var>    Subd. 5. <b>Training required relating to Alzheimer's disease and related disorders.</b><br/>
<a id="pl.467.21"></a><var>467.21</var>For home care providers that provide services for persons with Alzheimer's or related <br/>
<a id="pl.467.22"></a><var>467.22</var>disorders, all direct care staff and supervisors working with these clients must receive <br/>
<a id="pl.467.23"></a><var>467.23</var>training that includes a current explanation of Alzheimer's disease and related disorders, <br/>
<a id="pl.467.24"></a><var>467.24</var>effective approaches to use to problem solve when working with a client's challenging <br/>
<a id="pl.467.25"></a><var>467.25</var>behaviors, and how to communicate with clients who have Alzheimer's or related disorders.<br/>
<a id="pl.467.26"></a><var>467.26</var>    Subd. 6. <b>Required annual training.</b> All staff that perform direct home care <br/>
<a id="pl.467.27"></a><var>467.27</var>services must complete at least eight hours of annual training for each 12 months of <br/>
<a id="pl.467.28"></a><var>467.28</var>employment. The training may be obtained from the home care provider or another source <br/>
<a id="pl.467.29"></a><var>467.29</var>and must include topics relevant to the provision of home care services. The annual <br/>
<a id="pl.467.30"></a><var>467.30</var>training must include:<br/>
<a id="pl.467.31"></a><var>467.31</var>(1) training on reporting of maltreatment of minors under section 626.556 and <br/>
<a id="pl.467.32"></a><var>467.32</var>maltreatment of vulnerable adults under section 626.557, whichever is applicable to the <br/>
<a id="pl.467.33"></a><var>467.33</var>services provided;<br/>
<a id="pl.467.34"></a><var>467.34</var>(2) review of the home care bill of rights in section 144A.44;<br/>
<a id="pl.467.35"></a><var>467.35</var>(3) review of infection control techniques used in the home and implementation of <br/>
<a id="pl.467.36"></a><var>467.36</var>infection control standards including a review of hand washing techniques; the need for <br/>
<a id="pl.468.1"></a><var>468.1</var>and use of protective gloves, gowns, and masks; appropriate disposal of contaminated <br/>
<a id="pl.468.2"></a><var>468.2</var>materials and equipment, such as dressings, needles, syringes, and razor blades; <br/>
<a id="pl.468.3"></a><var>468.3</var>disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of <br/>
<a id="pl.468.4"></a><var>468.4</var>communicable diseases; and<br/>
<a id="pl.468.5"></a><var>468.5</var>(4) review of the provider's policies and procedures relating to the provision of home <br/>
<a id="pl.468.6"></a><var>468.6</var>care services and how to implement those policies and procedures.<br/>
<a id="pl.468.7"></a><var>468.7</var>    Subd. 7. <b>Documentation.</b> A home care provider must retain documentation in the <br/>
<a id="pl.468.8"></a><var>468.8</var>employee records of the staff that have satisfied the orientation and training requirements <br/>
<a id="pl.468.9"></a><var>468.9</var>of this section.<br/>
<br/>
<a id="bill.11.25.0"></a><a id="pl.468.10"></a><var>468.10</var>    Sec. 25. <b>[144A.4797] PROVISION OF SERVICES.</b><br/>
<a id="pl.468.11"></a><var>468.11</var>    Subdivision 1. <b>Availability of contact person to staff.</b> (a) A home care provider <br/>
<a id="pl.468.12"></a><var>468.12</var>with a basic home care license must have a person available to staff for consultation on <br/>
<a id="pl.468.13"></a><var>468.13</var>items relating to the provision of services or about the client.<br/>
<a id="pl.468.14"></a><var>468.14</var>(b) A home care provider with a comprehensive home care license must have a <br/>
<a id="pl.468.15"></a><var>468.15</var>registered nurse available for consultation to staff performing delegated nursing tasks <br/>
<a id="pl.468.16"></a><var>468.16</var>and must have an appropriate licensed health professional available if performing other <br/>
<a id="pl.468.17"></a><var>468.17</var>delegated services such as therapies.<br/>
<a id="pl.468.18"></a><var>468.18</var>(c) The appropriate contact person must be readily available either in person, by <br/>
<a id="pl.468.19"></a><var>468.19</var>telephone, or by other means to the staff at times when the staff is providing services.<br/>
<a id="pl.468.20"></a><var>468.20</var>    Subd. 2. <b>Supervision of staff; basic home care services.</b> (a) Staff who perform <br/>
<a id="pl.468.21"></a><var>468.21</var>basic home care services must be supervised periodically where the services are being <br/>
<a id="pl.468.22"></a><var>468.22</var>provided to verify that the work is being performed competently and to identify problems <br/>
<a id="pl.468.23"></a><var>468.23</var>and solutions to address issues relating to the staff's ability to provide the services. The <br/>
<a id="pl.468.24"></a><var>468.24</var>supervision of the unlicensed personnel must be done by staff of the home care provider <br/>
<a id="pl.468.25"></a><var>468.25</var>having the authority, skills, and ability to provide the supervision of unlicensed personnel <br/>
<a id="pl.468.26"></a><var>468.26</var>and who can implement changes as needed, and train staff.<br/>
<a id="pl.468.27"></a><var>468.27</var>(b) Supervision includes direct observation of unlicensed personnel while they <br/>
<a id="pl.468.28"></a><var>468.28</var>are providing the services and may also include indirect methods of gaining input such <br/>
<a id="pl.468.29"></a><var>468.29</var>as gathering feedback from the client. Supervisory review of staff must be provided at a <br/>
<a id="pl.468.30"></a><var>468.30</var>frequency based on the staff person's competency and performance.<br/>
<a id="pl.468.31"></a><var>468.31</var>(c) For an individual who is licensed as a home care provider, this section does <br/>
<a id="pl.468.32"></a><var>468.32</var>not apply.<br/>
<a id="pl.468.33"></a><var>468.33</var>    Subd. 3. <b>Supervision of staff performing delegated nursing or therapy home </b><br/>
<a id="pl.468.34"></a><var>468.34</var><b>care tasks.</b> (a) Staff who perform delegated nursing or therapy home care tasks must <br/>
<a id="pl.468.35"></a><var>468.35</var>be supervised by an appropriately licensed health professional or a registered nurse <br/>
<a id="pl.469.1"></a><var>469.1</var>periodically where the services are being provided to verify that the work is being <br/>
<a id="pl.469.2"></a><var>469.2</var>performed competently and to identify problems and solutions related to the staff person's <br/>
<a id="pl.469.3"></a><var>469.3</var>ability to perform the tasks. Supervision of staff performing medication or treatment <br/>
<a id="pl.469.4"></a><var>469.4</var>administration shall be provided by a registered nurse or appropriately licensed health <br/>
<a id="pl.469.5"></a><var>469.5</var>professional and must include observation of the staff administering the medication or <br/>
<a id="pl.469.6"></a><var>469.6</var>treatment and the interaction with the client.<br/>
<a id="pl.469.7"></a><var>469.7</var>(b) The direct supervision of staff performing delegated tasks must be provided <br/>
<a id="pl.469.8"></a><var>469.8</var>within 30 days after the individual begins working for the home care provider and <br/>
<a id="pl.469.9"></a><var>469.9</var>thereafter as needed based on performance. This requirement also applies to staff who <br/>
<a id="pl.469.10"></a><var>469.10</var>have not performed delegated tasks for one year or longer.<br/>
<a id="pl.469.11"></a><var>469.11</var>    Subd. 4. <b>Documentation.</b> A home care provider must retain documentation of <br/>
<a id="pl.469.12"></a><var>469.12</var>supervision activities in the personnel records.<br/>
<a id="pl.469.13"></a><var>469.13</var>    Subd. 5. <b>Exemption.</b> This section does not apply to an individual licensed under <br/>
<a id="pl.469.14"></a><var>469.14</var>sections 144A.43 to 144A.4799.<br/>
<br/>
<a id="bill.11.26.0"></a><a id="pl.469.15"></a><var>469.15</var>    Sec. 26. <b>[144A.4798] EMPLOYEE HEALTH STATUS.</b><br/>
<a id="pl.469.16"></a><var>469.16</var>    Subdivision 1. <b>Tuberculosis (TB) prevention and control.</b> A home care provider <br/>
<a id="pl.469.17"></a><var>469.17</var>must establish and maintain a TB prevention and control program based on the most <br/>
<a id="pl.469.18"></a><var>469.18</var>current guidelines issued by the Centers for Disease Control and Prevention (CDC). <br/>
<a id="pl.469.19"></a><var>469.19</var>Components of a TB prevention and control program include screening all staff providing <br/>
<a id="pl.469.20"></a><var>469.20</var>home care services, both paid and unpaid, at the time of hire for active TB disease and <br/>
<a id="pl.469.21"></a><var>469.21</var>latent TB infection, and developing and implementing a written TB infection control plan. <br/>
<a id="pl.469.22"></a><var>469.22</var>The commissioner shall make the most recent CDC standards available to home care <br/>
<a id="pl.469.23"></a><var>469.23</var>providers on the department's Web site.<br/>
<a id="pl.469.24"></a><var>469.24</var>    Subd. 2. <b>Communicable diseases.</b> A home care provider must follow <br/>
<a id="pl.469.25"></a><var>469.25</var>current federal or state guidelines for prevention, control, and reporting of human <br/>
<a id="pl.469.26"></a><var>469.26</var>immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other <br/>
<a id="pl.469.27"></a><var>469.27</var>communicable diseases as defined in Minnesota Rules, part 4605.7040.<br/>
<br/>
<a id="bill.11.27.0"></a><a id="pl.469.28"></a><var>469.28</var>    Sec. 27. <b>[144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE </b><br/>
<a id="pl.469.29"></a><var>469.29</var><b>PROVIDER ADVISORY COUNCIL.</b><br/>
<a id="pl.469.30"></a><var>469.30</var>    Subdivision 1. <b>Membership.</b> The commissioner of health shall appoint eight <br/>
<a id="pl.469.31"></a><var>469.31</var>persons to a home care provider advisory council consisting of the following:<br/>
<a id="pl.469.32"></a><var>469.32</var>(1) three public members as defined in section 214.02 who shall be either persons <br/>
<a id="pl.469.33"></a><var>469.33</var>who are currently receiving home care services or have family members receiving home <br/>
<a id="pl.470.1"></a><var>470.1</var>care services, or persons who have family members who have received home care services <br/>
<a id="pl.470.2"></a><var>470.2</var>within five years of the application date;<br/>
<a id="pl.470.3"></a><var>470.3</var>(2) three Minnesota home care licensees representing basic and comprehensive <br/>
<a id="pl.470.4"></a><var>470.4</var>levels of licensure who may be a managerial official, an administrator, a supervising <br/>
<a id="pl.470.5"></a><var>470.5</var>registered nurse, or an unlicensed personnel performing home care tasks;<br/>
<a id="pl.470.6"></a><var>470.6</var>(3) one member representing the Minnesota Board of Nursing; and<br/>
<a id="pl.470.7"></a><var>470.7</var>(4) one member representing the ombudsman for long-term care.<br/>
<a id="pl.470.8"></a><var>470.8</var>    Subd. 2. <b>Organizations and meetings.</b> The advisory council shall be organized <br/>
<a id="pl.470.9"></a><var>470.9</var>and administered under section 15.059 with per diems and costs paid within the limits of <br/>
<a id="pl.470.10"></a><var>470.10</var>available appropriations. Meetings will be held quarterly and hosted by the department. <br/>
<a id="pl.470.11"></a><var>470.11</var>Subcommittees may be developed as necessary by the commissioner. Advisory council <br/>
<a id="pl.470.12"></a><var>470.12</var>meetings are subject to the Open Meeting Law under chapter 13D.<br/>
<a id="pl.470.13"></a><var>470.13</var>    Subd. 3. <b>Duties.</b> At the commissioner's request, the advisory council shall provide <br/>
<a id="pl.470.14"></a><var>470.14</var>advice regarding regulations of Department of Health licensed home care providers in <br/>
<a id="pl.470.15"></a><var>470.15</var>this chapter such as:<br/>
<a id="pl.470.16"></a><var>470.16</var>(1) advice to the commissioner regarding community standards for home care <br/>
<a id="pl.470.17"></a><var>470.17</var>practices;<br/>
<a id="pl.470.18"></a><var>470.18</var>(2) advice to the commissioner on enforcement of licensing standards and whether <br/>
<a id="pl.470.19"></a><var>470.19</var>certain disciplinary actions are appropriate;<br/>
<a id="pl.470.20"></a><var>470.20</var>(3) advice to the commissioner about ways of distributing information to licensees <br/>
<a id="pl.470.21"></a><var>470.21</var>and consumers of home care;<br/>
<a id="pl.470.22"></a><var>470.22</var>(4) advice to the commissioner about training standards;<br/>
<a id="pl.470.23"></a><var>470.23</var>(5) identify emerging issues and opportunities in the home care field, including the <br/>
<a id="pl.470.24"></a><var>470.24</var>use of technology in home and telehealth capabilities; and<br/>
<a id="pl.470.25"></a><var>470.25</var>(6) perform other duties as directed by the commissioner.<br/>
<br/>
<a id="bill.11.28.0"></a><a id="pl.470.26"></a><var>470.26</var>    Sec. 28. <b>[144A.481] HOME CARE LICENSING IMPLEMENTATION FOR </b><br/>
<a id="pl.470.27"></a><var>470.27</var><b>NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.</b><br/>
<a id="pl.470.28"></a><var>470.28</var>    Subdivision 1. <b>Temporary home care licenses and changes of ownership.</b> (a) <br/>
<a id="pl.470.29"></a><var>470.29</var>Beginning January 1, 2014, all temporary license applicants must apply for either a <br/>
<a id="pl.470.30"></a><var>470.30</var>temporary basic or comprehensive home care license.<br/>
<a id="pl.470.31"></a><var>470.31</var>(b) Temporary home care licenses issued beginning January 1, 2014, will be <br/>
<a id="pl.470.32"></a><var>470.32</var>issued according to the provisions in sections 144A.43 to 144A.4799 and fees in section <br/>
<a id="pl.470.33"></a><var>470.33</var>144A.472 and will be required to comply with this chapter.<br/>
<a id="pl.470.34"></a><var>470.34</var>(c) No temporary licenses will be accepted or issued between December 1, 2013, <br/>
<a id="pl.470.35"></a><var>470.35</var>and December 31, 2013.<br/>
<a id="pl.471.1"></a><var>471.1</var>(d) Beginning October 1, 2013, changes in ownership applications will require <br/>
<a id="pl.471.2"></a><var>471.2</var>payment of the new fees listed in section 144A.472. Providers who are providing <br/>
<a id="pl.471.3"></a><var>471.3</var>nursing, delegated nursing, or professional health care services, must submit the fee for <br/>
<a id="pl.471.4"></a><var>471.4</var>comprehensive home care providers, and all other providers must submit the fee for basic <br/>
<a id="pl.471.5"></a><var>471.5</var>home care providers as provided in section 144A.472. Change of ownership applicants will <br/>
<a id="pl.471.6"></a><var>471.6</var>be issued a new home care license based on the licensure law in effect on June 30, 2013.<br/>
<a id="pl.471.7"></a><var>471.7</var>    Subd. 2. <b>Current home care licensees with licenses prior to July 1, 2013.</b> (a) <br/>
<a id="pl.471.8"></a><var>471.8</var>Beginning July 1, 2014, department licensed home care providers must apply for either <br/>
<a id="pl.471.9"></a><var>471.9</var>the basic or comprehensive home care license on their regularly scheduled renewal date.<br/>
<a id="pl.471.10"></a><var>471.10</var>(b) By June 30, 2015, all home care providers must either have a basic or <br/>
<a id="pl.471.11"></a><var>471.11</var>comprehensive home care license or temporary license.<br/>
<a id="pl.471.12"></a><var>471.12</var>    Subd. 3. <b>Renewal and change of ownership application of home care licensure </b><br/>
<a id="pl.471.13"></a><var>471.13</var><b>during transition period.</b> Renewal and change of ownership applications of home care <br/>
<a id="pl.471.14"></a><var>471.14</var>licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 <br/>
<a id="pl.471.15"></a><var>471.15</var>to 144A.4799, and upon license renewal or issuance of a new license for a change of <br/>
<a id="pl.471.16"></a><var>471.16</var>ownership, providers must comply with sections 144A.43 to 144A.4799. Prior to renewal, <br/>
<a id="pl.471.17"></a><var>471.17</var>providers must comply with the home care licensure law in effect on June 30, 2013.<br/>
<a id="pl.471.18"></a><var>471.18</var>The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, <br/>
<a id="pl.471.19"></a><var>471.19</var>shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 <br/>
<a id="pl.471.20"></a><var>471.20</var>increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.<br/>
<a id="pl.471.21"></a><var>471.21</var>For fiscal year 2014 only the fees for providers with revenues greater than $25,000 <br/>
<a id="pl.471.22"></a><var>471.22</var>and no more than $100,000 will be $313 and for providers with revenues no more than <br/>
<a id="pl.471.23"></a><var>471.23</var>$25,000 the fee will be $125.<br/>
<a id="pl.471.24"></a><var>471.24</var>The license renewal fee schedule in section 144A.472 will be effective July 1, 2016.<br/>
<br/>
<a id="bill.11.29.0"></a><a id="pl.471.25"></a><var>471.25</var>    Sec. 29. <b>[144A.482] REGISTRATION OF HOME MANAGEMENT </b><br/>
<a id="pl.471.26"></a><var>471.26</var><b>PROVIDERS.</b><br/>
<a id="pl.471.27"></a><var>471.27</var>(a) For purposes of this section, a home management provider is an individual or <br/>
<a id="pl.471.28"></a><var>471.28</var>organization that provides at least two of the following services: housekeeping, meal <br/>
<a id="pl.471.29"></a><var>471.29</var>preparation, and shopping, to a person who is unable to perform these activities due to <br/>
<a id="pl.471.30"></a><var>471.30</var>illness, disability, or physical condition.<br/>
<a id="pl.471.31"></a><var>471.31</var>(b) A person or organization that provides only home management services may not <br/>
<a id="pl.471.32"></a><var>471.32</var>operate in the state without a current certificate of registration issued by the commissioner <br/>
<a id="pl.471.33"></a><var>471.33</var>of health. To obtain a certificate of registration, the person or organization must annually <br/>
<a id="pl.471.34"></a><var>471.34</var>submit to the commissioner the name, mailing and physical address, e-mail address, and <br/>
<a id="pl.471.35"></a><var>471.35</var>telephone number of the individual or organization and a signed statement declaring that <br/>
<a id="pl.472.1"></a><var>472.1</var>the individual or organization is aware that the home care bill of rights applies to their <br/>
<a id="pl.472.2"></a><var>472.2</var>clients and that the person or organization will comply with the home care bill of rights <br/>
<a id="pl.472.3"></a><var>472.3</var>provisions contained in section 144A.44. An individual or organization applying for a <br/>
<a id="pl.472.4"></a><var>472.4</var>certificate must also provide the name, business address, and telephone number of each of <br/>
<a id="pl.472.5"></a><var>472.5</var>the individuals responsible for the management or direction of the organization. <br/>
<a id="pl.472.6"></a><var>472.6</var>(c) The commissioner shall charge an annual registration fee of $20 for individuals <br/>
<a id="pl.472.7"></a><var>472.7</var>and $50 for organizations. The registration fee shall be deposited in the state treasury and <br/>
<a id="pl.472.8"></a><var>472.8</var>credited to the state government special revenue fund.<br/>
<a id="pl.472.9"></a><var>472.9</var>(d) A home care provider that provides home management services and other home <br/>
<a id="pl.472.10"></a><var>472.10</var>care services must be licensed, but licensure requirements other than the home care bill of <br/>
<a id="pl.472.11"></a><var>472.11</var>rights do not apply to those employees or volunteers who provide only home management <br/>
<a id="pl.472.12"></a><var>472.12</var>services to clients who do not receive any other home care services from the provider. <br/>
<a id="pl.472.13"></a><var>472.13</var>A licensed home care provider need not be registered as a home management service <br/>
<a id="pl.472.14"></a><var>472.14</var>provider, but must provide an orientation on the home care bill of rights to its employees <br/>
<a id="pl.472.15"></a><var>472.15</var>or volunteers who provide home management services.<br/>
<a id="pl.472.16"></a><var>472.16</var>(e) An individual who provides home management services under this section must, <br/>
<a id="pl.472.17"></a><var>472.17</var>within 120 days after beginning to provide services, attend an orientation session approved <br/>
<a id="pl.472.18"></a><var>472.18</var>by the commissioner that provides training on the home care bill of rights and an orientation <br/>
<a id="pl.472.19"></a><var>472.19</var>on the aging process and the needs and concerns of elderly and disabled persons.<br/>
<a id="pl.472.20"></a><var>472.20</var>(f) The commissioner may suspend or revoke a provider's certificate of registration <br/>
<a id="pl.472.21"></a><var>472.21</var>or assess fines for violation of the home care bill of rights. Any fine assessed for a <br/>
<a id="pl.472.22"></a><var>472.22</var>violation of the home care bill of rights by a provider registered under this section shall be <br/>
<a id="pl.472.23"></a><var>472.23</var>in the amount established in the licensure rules for home care providers. As a condition <br/>
<a id="pl.472.24"></a><var>472.24</var>of registration, a provider must cooperate fully with any investigation conducted by the <br/>
<a id="pl.472.25"></a><var>472.25</var>commissioner, including providing specific information requested by the commissioner on <br/>
<a id="pl.472.26"></a><var>472.26</var>clients served and the employees and volunteers who provide services. Fines collected <br/>
<a id="pl.472.27"></a><var>472.27</var>under this paragraph shall be deposited in the state treasury and credited to the fund <br/>
<a id="pl.472.28"></a><var>472.28</var>specified in the statute or rule in which the penalty was established.<br/>
<a id="pl.472.29"></a><var>472.29</var>(g) The commissioner may use any of the powers granted in sections 144A.43 to <br/>
<a id="pl.472.30"></a><var>472.30</var>144A.4799 to administer the registration system and enforce the home care bill of rights <br/>
<a id="pl.472.31"></a><var>472.31</var>under this section.<br/>
<br/>
<a id="bill.11.30.0"></a><a id="pl.472.32"></a><var>472.32</var>    Sec. 30. <b>AGENCY QUALITY IMPROVEMENT PROGRAM.</b><br/>
<a id="pl.472.33"></a><var>472.33</var>    Subdivision 1. <b>Annual legislative report on home care licensing.</b> The <br/>
<a id="pl.472.34"></a><var>472.34</var>commissioner shall establish a quality improvement program for the home care survey <br/>
<a id="pl.472.35"></a><var>472.35</var>and home care complaint investigation processes.  The commissioner shall submit to the <br/>
<a id="pl.473.1"></a><var>473.1</var>legislature an annual report, beginning October 1, 2015, and each October 1 thereafter. <br/>
<a id="pl.473.2"></a><var>473.2</var>Each report will review the previous state fiscal year of home care licensing and regulatory <br/>
<a id="pl.473.3"></a><var>473.3</var>activities.  The report must include, but is not limited to, an analysis of:<br/>
<a id="pl.473.4"></a><var>473.4</var>(1) the number of FTE's in the Compliance Monitoring Division, including the <br/>
<a id="pl.473.5"></a><var>473.5</var>Office of Health Facilities Complaint units assigned to home care licensing, survey, <br/>
<a id="pl.473.6"></a><var>473.6</var>investigation, and enforcement process;<br/>
<a id="pl.473.7"></a><var>473.7</var>(2) numbers of and descriptive information about licenses issued, complaints <br/>
<a id="pl.473.8"></a><var>473.8</var>received and investigated, including allegations made and correction orders issued, <br/>
<a id="pl.473.9"></a><var>473.9</var>surveys completed and timelines, correction order reconsiderations, and results;<br/>
<a id="pl.473.10"></a><var>473.10</var>(3) descriptions of emerging trends in home care provision and areas of concern <br/>
<a id="pl.473.11"></a><var>473.11</var>identified by the department in its regulation of home care providers;<br/>
<a id="pl.473.12"></a><var>473.12</var>(4) information and data regarding performance improvement projects underway <br/>
<a id="pl.473.13"></a><var>473.13</var>and planned by the commissioner in the area of home care surveys; and <br/>
<a id="pl.473.14"></a><var>473.14</var>(5) work of the Department of Health Home Care Advisory Council.<br/>
<a id="pl.473.15"></a><var>473.15</var>    Subd. 2. <b>Study of correction order appeal process.</b> Starting July 1, 2015, the <br/>
<a id="pl.473.16"></a><var>473.16</var>commissioner shall study whether to add a correction order appeal process conducted by <br/>
<a id="pl.473.17"></a><var>473.17</var>an independent reviewer, such as an administrative law judge or other office, and submit a <br/>
<a id="pl.473.18"></a><var>473.18</var>report to the legislature by February 1, 2016.  The commissioner shall review home care <br/>
<a id="pl.473.19"></a><var>473.19</var>regulatory systems in other states as part of that study.  The commissioner shall consult <br/>
<a id="pl.473.20"></a><var>473.20</var>with the home care providers and representatives.  <br/>
<br/>
<a id="bill.11.31.0"></a><a id="pl.473.21"></a><var>473.21</var>    Sec. 31. <b>INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME </b><br/>
<a id="pl.473.22"></a><var>473.22</var><b>AND COMMUNITY-BASED SERVICES.</b><br/>
<a id="pl.473.23"></a><var>473.23</var>(a) The Department of Health Compliance Monitoring Division and the Department <br/>
<a id="pl.473.24"></a><var>473.24</var>of Human Services Licensing Division shall jointly develop an integrated licensing system <br/>
<a id="pl.473.25"></a><var>473.25</var>for providers of both home care services subject to licensure under Minnesota Statutes, <br/>
<a id="pl.473.26"></a><var>473.26</var>chapter 144A, and for home and community-based services subject to licensure under <br/>
<a id="pl.473.27"></a><var>473.27</var>Minnesota Statutes, chapter 245D. The integrated licensing system shall:<br/>
<a id="pl.473.28"></a><var>473.28</var>(1) require only one license of any provider of services under Minnesota Statutes, <br/>
<a id="pl.473.29"></a><var>473.29</var>sections 144A.43 to 144A.482, and 245D.03, subdivision 1;<br/>
<a id="pl.473.30"></a><var>473.30</var>(2) promote quality services that recognize a person's individual needs and protect <br/>
<a id="pl.473.31"></a><var>473.31</var>the person's health, safety, rights, and well-being;<br/>
<a id="pl.473.32"></a><var>473.32</var>(3) promote provider accountability through application requirements, compliance <br/>
<a id="pl.473.33"></a><var>473.33</var>inspections, investigations, and enforcement actions;<br/>
<a id="pl.473.34"></a><var>473.34</var>(4) reference other applicable requirements in existing state and federal laws, <br/>
<a id="pl.473.35"></a><var>473.35</var>including the federal Affordable Care Act;<br/>
<a id="pl.474.1"></a><var>474.1</var>(5) establish internal procedures to facilitate ongoing communications between the <br/>
<a id="pl.474.2"></a><var>474.2</var>agencies, and with providers and services recipients about the regulatory activities;<br/>
<a id="pl.474.3"></a><var>474.3</var>(6) create a link between the agency Web sites so that providers and the public can <br/>
<a id="pl.474.4"></a><var>474.4</var>access the same information regardless of which Web site is accessed initially; and<br/>
<a id="pl.474.5"></a><var>474.5</var>(7) collect data on identified outcome measures as necessary for the agencies to <br/>
<a id="pl.474.6"></a><var>474.6</var>report to the Centers for Medicare and Medicaid Services.<br/>
<a id="pl.474.7"></a><var>474.7</var>(b) The joint recommendations for legislative changes to implement the integrated <br/>
<a id="pl.474.8"></a><var>474.8</var>licensing system are due to the legislature by February 15, 2014.<br/>
<a id="pl.474.9"></a><var>474.9</var>(c) Before implementation of the integrated licensing system, providers licensed as <br/>
<a id="pl.474.10"></a><var>474.10</var>home care providers under Minnesota Statutes, chapter 144A, may also provide home <br/>
<a id="pl.474.11"></a><var>474.11</var>and community-based services subject to licensure under Minnesota Statutes, chapter <br/>
<a id="pl.474.12"></a><var>474.12</var>245D, without obtaining a home and community-based services license under Minnesota <br/>
<a id="pl.474.13"></a><var>474.13</var>Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall <br/>
<a id="pl.474.14"></a><var>474.14</var>apply to these providers:<br/>
<a id="pl.474.15"></a><var>474.15</var>(1) the provider must comply with all requirements under Minnesota Statutes, chapter <br/>
<a id="pl.474.16"></a><var>474.16</var>245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;<br/>
<a id="pl.474.17"></a><var>474.17</var>(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be <br/>
<a id="pl.474.18"></a><var>474.18</var>enforced by the Department of Health under the enforcement authority set forth in <br/>
<a id="pl.474.19"></a><var>474.19</var>Minnesota Statutes, section 144A.475; and<br/>
<a id="pl.474.20"></a><var>474.20</var>(3) the Department of Health will provide information to the Department of Human <br/>
<a id="pl.474.21"></a><var>474.21</var>Services about each provider licensed under this section, including the provider's license <br/>
<a id="pl.474.22"></a><var>474.22</var>application, licensing documents, inspections, information about complaints received, and <br/>
<a id="pl.474.23"></a><var>474.23</var>investigations conducted for possible violations of Minnesota Statutes, chapter 245D.<br/>
<br/>
<a id="bill.11.32.0"></a><a id="pl.474.24"></a><var>474.24</var>    Sec. 32. <b>STUDY OF CORRECTION ORDER APPEAL PROCESS.</b><br/>
<a id="pl.474.25"></a><var>474.25</var>Beginning July 1, 2015, the commissioner of health shall study whether to use <br/>
<a id="pl.474.26"></a><var>474.26</var>a correction order appeal process conducted by an independent reviewer, such as <br/>
<a id="pl.474.27"></a><var>474.27</var>an administrative law judge or other office. The commissioner shall review home <br/>
<a id="pl.474.28"></a><var>474.28</var>care regulatory systems in other states and consult with the home care providers and <br/>
<a id="pl.474.29"></a><var>474.29</var>representatives. By February 1, 2016, the commissioner shall submit a report to the chairs <br/>
<a id="pl.474.30"></a><var>474.30</var>and ranking minority members of the committees of the legislature with jurisdiction over <br/>
<a id="pl.474.31"></a><var>474.31</var>health and human services and judiciary issues with any recommendations regarding <br/>
<a id="pl.474.32"></a><var>474.32</var>an independent appeal process.<br/>
<br/>
<a id="bill.11.33.0"></a><a id="pl.474.33"></a><var>474.33</var>    Sec. 33. <b> REPEALER.</b><br/>
<a id="pl.474.34"></a><var>474.34</var>(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.<br/>
<a id="pl.475.1"></a><var>475.1</var>(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; <br/>
<a id="pl.475.2"></a><var>475.2</var>4668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; <br/>
<a id="pl.475.3"></a><var>475.3</var>4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100; <br/>
<a id="pl.475.4"></a><var>475.4</var>4668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170; <br/>
<a id="pl.475.5"></a><var>475.5</var>4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240; <br/>
<a id="pl.475.6"></a><var>475.6</var>4668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; <br/>
<a id="pl.475.7"></a><var>475.7</var>4668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870; <br/>
<a id="pl.475.8"></a><var>475.8</var>4669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.<br/>
<br/>
<a id="bill.11.34.0"></a><a id="pl.475.9"></a><var>475.9</var>    Sec. 34. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.475.10"></a><var>475.10</var>Sections 1 to 33 are effective the day following final enactment, unless a different <br/>
<a id="pl.475.11"></a><var>475.11</var>effective date is specified.<br/>
<br/>
<a id="bill.12.0.0"></a>

<a id="bill.12.1.0"></a><a id="pl.475.14"></a><var>475.14</var>    Section 1. Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:<br/>
<a id="pl.475.15"></a><var>475.15</var>    Subdivision 1. <b>Definitions.</b> For purposes of this section, the following definitions <br/>
<a id="pl.475.16"></a><var>475.16</var>apply:<br/>
<a id="pl.475.17"></a><var>475.17</var>    (a) "Accredited clinical training" means the clinical training provided by a medical <br/>
<a id="pl.475.18"></a><var>475.18</var>education program that is accredited through an organization recognized by the Department <br/>
<a id="pl.475.19"></a><var>475.19</var>of Education, the Centers for Medicare and Medicaid Services, or another national body <br/>
<a id="pl.475.20"></a><var>475.20</var>who reviews the accrediting organizations for multiple disciplines and whose standards <br/>
<a id="pl.475.21"></a><var>475.21</var>for recognizing accrediting organizations are reviewed and approved by the commissioner <br/>
<a id="pl.475.22"></a><var>475.22</var>of health in consultation with the Medical Education and Research Advisory Committee.<br/>
<a id="pl.475.23"></a><var>475.23</var>    (b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.475.24"></a><var>475.24</var>    (c) "Clinical medical education program" means the accredited clinical training of <br/>
<a id="pl.475.25"></a><var>475.25</var>physicians (medical students and residents), doctor of pharmacy practitioners, doctors <br/>
<a id="pl.475.26"></a><var>475.26</var>of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified <br/>
<a id="pl.475.27"></a><var>475.27</var>registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and<br/>
<a id="pl.475.28"></a><var>475.28</var> physician assistants, dental therapists and advanced dental therapists, psychologists, <br/>
<a id="pl.475.29"></a><var>475.29</var>clinical social workers, community paramedics, and community health workers.<br/>
<a id="pl.475.30"></a><var>475.30</var>    (d) "Sponsoring institution" means a hospital, school, or consortium located in <br/>
<a id="pl.475.31"></a><var>475.31</var>Minnesota that sponsors and maintains primary organizational and financial responsibility <br/>
<a id="pl.475.32"></a><var>475.32</var>for a clinical medical education program in Minnesota and which is accountable to the <br/>
<a id="pl.475.33"></a><var>475.33</var>accrediting body.<br/>
<a id="pl.476.1"></a><var>476.1</var>    (e) "Teaching institution" means a hospital, medical center, clinic, or other <br/>
<a id="pl.476.2"></a><var>476.2</var>organization that conducts a clinical medical education program in Minnesota.<br/>
<a id="pl.476.3"></a><var>476.3</var>    (f) "Trainee" means a student or resident involved in a clinical medical education <br/>
<a id="pl.476.4"></a><var>476.4</var>program.<br/>
<a id="pl.476.5"></a><var>476.5</var>    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time <br/>
<a id="pl.476.6"></a><var>476.6</var>equivalent counts, that are at training sites located in Minnesota with currently active <br/>
<a id="pl.476.7"></a><var>476.7</var>medical assistance enrollment status and a National Provider Identification (NPI) number <br/>
<a id="pl.476.8"></a><var>476.8</var>where training occurs in either an inpatient or ambulatory patient care setting and where <br/>
<a id="pl.476.9"></a><var>476.9</var>the training is funded, in part, by patient care revenues. Training that occurs in nursing <br/>
<a id="pl.476.10"></a><var>476.10</var>facility settings is not eligible for funding under this section.<br/>
<br/>
<a id="bill.12.2.0"></a><a id="pl.476.11"></a><var>476.11</var>    Sec. 2. Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:<br/>
<a id="pl.476.12"></a><var>476.12</var>    Subd. 3. <b>Application process.</b> (a) A clinical medical education program conducted <br/>
<a id="pl.476.13"></a><var>476.13</var>in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, <br/>
<a id="pl.476.14"></a><var>476.14</var>dentists, chiropractors, or physician assistants is, dental therapists and advanced dental <br/>
<a id="pl.476.15"></a><var>476.15</var>therapists, psychologists, clinical social workers, community paramedics, or community <br/>
<a id="pl.476.16"></a><var>476.16</var>health workers are eligible for funds under subdivision 4 if the program:<br/>
<a id="pl.476.17"></a><var>476.17</var>(1) is funded, in part, by patient care revenues;<br/>
<a id="pl.476.18"></a><var>476.18</var>(2) occurs in patient care settings that face increased financial pressure as a result <br/>
<a id="pl.476.19"></a><var>476.19</var>of competition with nonteaching patient care entities; and<br/>
<a id="pl.476.20"></a><var>476.20</var>(3) emphasizes primary care or specialties that are in undersupply in Minnesota.<br/>
<a id="pl.476.21"></a><var>476.21</var>(b) A clinical medical education program for advanced practice nursing is eligible for <br/>
<a id="pl.476.22"></a><var>476.22</var>funds under subdivision 4 if the program meets the eligibility requirements in paragraph <br/>
<a id="pl.476.23"></a><var>476.23</var>(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health <br/>
<a id="pl.476.24"></a><var>476.24</var>Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges <br/>
<a id="pl.476.25"></a><var>476.25</var>and Universities system or members of the Minnesota Private College Council.<br/>
<a id="pl.476.26"></a><var>476.26</var>(c) Applications must be submitted to the commissioner by a sponsoring institution <br/>
<a id="pl.476.27"></a><var>476.27</var>on behalf of an eligible clinical medical education program and must be received by <br/>
<a id="pl.476.28"></a><var>476.28</var>October 31 of each year for distribution in the following year. An application for funds <br/>
<a id="pl.476.29"></a><var>476.29</var>must contain the following information:<br/>
<a id="pl.476.30"></a><var>476.30</var>(1) the official name and address of the sponsoring institution and the official <br/>
<a id="pl.476.31"></a><var>476.31</var>name and site address of the clinical medical education programs on whose behalf the <br/>
<a id="pl.476.32"></a><var>476.32</var>sponsoring institution is applying;<br/>
<a id="pl.476.33"></a><var>476.33</var>(2) the name, title, and business address of those persons responsible for <br/>
<a id="pl.476.34"></a><var>476.34</var>administering the funds;<br/>
<a id="pl.477.1"></a><var>477.1</var>(3) for each clinical medical education program for which funds are being sought; <br/>
<a id="pl.477.2"></a><var>477.2</var>the type and specialty orientation of trainees in the program; the name, site address, and <br/>
<a id="pl.477.3"></a><var>477.3</var>medical assistance provider number and national provider identification number of each <br/>
<a id="pl.477.4"></a><var>477.4</var>training site used in the program; the federal tax identification number of each training site <br/>
<a id="pl.477.5"></a><var>477.5</var>used in the program, where available; the total number of trainees at each training site; and <br/>
<a id="pl.477.6"></a><var>477.6</var>the total number of eligible trainee FTEs at each site; and<br/>
<a id="pl.477.7"></a><var>477.7</var>(4) other supporting information the commissioner deems necessary to determine <br/>
<a id="pl.477.8"></a><var>477.8</var>program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the <br/>
<a id="pl.477.9"></a><var>477.9</var>equitable distribution of funds.<br/>
<a id="pl.477.10"></a><var>477.10</var>(d) An application must include the information specified in clauses (1) to (3) for <br/>
<a id="pl.477.11"></a><var>477.11</var>each clinical medical education program on an annual basis for three consecutive years. <br/>
<a id="pl.477.12"></a><var>477.12</var>After that time, an application must include the information specified in clauses (1) to (3) <br/>
<a id="pl.477.13"></a><var>477.13</var>when requested, at the discretion of the commissioner:<br/>
<a id="pl.477.14"></a><var>477.14</var>(1) audited clinical training costs per trainee for each clinical medical education <br/>
<a id="pl.477.15"></a><var>477.15</var>program when available or estimates of clinical training costs based on audited financial <br/>
<a id="pl.477.16"></a><var>477.16</var>data;<br/>
<a id="pl.477.17"></a><var>477.17</var>(2) a description of current sources of funding for clinical medical education costs, <br/>
<a id="pl.477.18"></a><var>477.18</var>including a description and dollar amount of all state and federal financial support, <br/>
<a id="pl.477.19"></a><var>477.19</var>including Medicare direct and indirect payments; and<br/>
<a id="pl.477.20"></a><var>477.20</var>(3) other revenue received for the purposes of clinical training.<br/>
<a id="pl.477.21"></a><var>477.21</var>(e) An applicant that does not provide information requested by the commissioner <br/>
<a id="pl.477.22"></a><var>477.22</var>shall not be eligible for funds for the current funding cycle.<br/>
<br/>
<a id="bill.12.3.0"></a><a id="pl.477.23"></a><var>477.23</var>    Sec. 3. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:<br/>
<a id="pl.477.24"></a><var>477.24</var>    Subd. 4. <b>Distribution of funds.</b> (a) The commissioner shall annually distribute the <br/>
<a id="pl.477.25"></a><var>477.25</var>available medical education funds to all qualifying applicants based on a distribution <br/>
<a id="pl.477.26"></a><var>477.26</var>formula that reflects a summation of two factors:<br/>
<a id="pl.477.27"></a><var>477.27</var>    (1) a public program volume factor, which is determined by the total volume of <br/>
<a id="pl.477.28"></a><var>477.28</var>public program revenue received by each training site as a percentage of all public <br/>
<a id="pl.477.29"></a><var>477.29</var>program revenue received by all training sites in the fund pool; and<br/>
<a id="pl.477.30"></a><var>477.30</var>    (2) a supplemental public program volume factor, which is determined by providing <br/>
<a id="pl.477.31"></a><var>477.31</var>a supplemental payment of 20 percent of each training site's grant to training sites whose <br/>
<a id="pl.477.32"></a><var>477.32</var>public program revenue accounted for at least 0.98 percent of the total public program <br/>
<a id="pl.477.33"></a><var>477.33</var>revenue received by all eligible training sites. Grants to training sites whose public <br/>
<a id="pl.477.34"></a><var>477.34</var>program revenue accounted for less than 0.98 percent of the total public program revenue <br/>
<a id="pl.478.1"></a><var>478.1</var>received by all eligible training sites shall be reduced by an amount equal to the total <br/>
<a id="pl.478.2"></a><var>478.2</var>value of the supplemental payment.<br/>
<a id="pl.478.3"></a><var>478.3</var>    Public program revenue for the distribution formula includes revenue from medical <br/>
<a id="pl.478.4"></a><var>478.4</var>assistance, prepaid medical assistance, general assistance medical care, and prepaid <br/>
<a id="pl.478.5"></a><var>478.5</var>general assistance medical care. Training sites that receive no public program revenue <br/>
<a id="pl.478.6"></a><var>478.6</var>are ineligible for funds available under this subdivision. For purposes of determining <br/>
<a id="pl.478.7"></a><var>478.7</var>training-site level grants to be distributed under paragraph (a), total statewide average <br/>
<a id="pl.478.8"></a><var>478.8</var>costs per trainee for medical residents is based on audited clinical training costs per trainee <br/>
<a id="pl.478.9"></a><var>478.9</var>in primary care clinical medical education programs for medical residents. Total statewide <br/>
<a id="pl.478.10"></a><var>478.10</var>average costs per trainee for dental residents is based on audited clinical training costs <br/>
<a id="pl.478.11"></a><var>478.11</var>per trainee in clinical medical education programs for dental students. Total statewide <br/>
<a id="pl.478.12"></a><var>478.12</var>average costs per trainee for pharmacy residents is based on audited clinical training costs <br/>
<a id="pl.478.13"></a><var>478.13</var>per trainee in clinical medical education programs for pharmacy students. Training sites <br/>
<a id="pl.478.14"></a><var>478.14</var>whose training site level grant is less than $1,000 $5,000, based on the formula described <br/>
<a id="pl.478.15"></a><var>478.15</var>in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for <br/>
<a id="pl.478.16"></a><var>478.16</var>funds available under this subdivision. No training sites shall receive a grant per FTE <br/>
<a id="pl.478.17"></a><var>478.17</var>trainee that is in excess of the 95th percentile grant per FTE across all eligible training <br/>
<a id="pl.478.18"></a><var>478.18</var>sites; grants in excess of this amount will be redistributed to other eligible sites based on <br/>
<a id="pl.478.19"></a><var>478.19</var>the formula described in this paragraph.<br/>
<a id="pl.478.20"></a><var>478.20</var>    (b) Funds distributed shall not be used to displace current funding appropriations <br/>
<a id="pl.478.21"></a><var>478.21</var>from federal or state sources.<br/>
<a id="pl.478.22"></a><var>478.22</var>    (c) Funds shall be distributed to the sponsoring institutions indicating the amount <br/>
<a id="pl.478.23"></a><var>478.23</var>to be distributed to each of the sponsor's clinical medical education programs based on <br/>
<a id="pl.478.24"></a><var>478.24</var>the criteria in this subdivision and in accordance with the commissioner's approval letter. <br/>
<a id="pl.478.25"></a><var>478.25</var>Each clinical medical education program must distribute funds allocated under paragraph <br/>
<a id="pl.478.26"></a><var>478.26</var>(a) to the training sites as specified in the commissioner's approval letter. Sponsoring <br/>
<a id="pl.478.27"></a><var>478.27</var>institutions, which are accredited through an organization recognized by the Department <br/>
<a id="pl.478.28"></a><var>478.28</var>of Education or the Centers for Medicare and Medicaid Services, may contract directly <br/>
<a id="pl.478.29"></a><var>478.29</var>with training sites to provide clinical training. To ensure the quality of clinical training, <br/>
<a id="pl.478.30"></a><var>478.30</var>those accredited sponsoring institutions must:<br/>
<a id="pl.478.31"></a><var>478.31</var>    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical <br/>
<a id="pl.478.32"></a><var>478.32</var>training conducted at sites; and<br/>
<a id="pl.478.33"></a><var>478.33</var>    (2) take necessary action if the contract requirements are not met. Action may include <br/>
<a id="pl.478.34"></a><var>478.34</var>the withholding of payments under this section or the removal of students from the site.<br/>
<a id="pl.478.35"></a><var>478.35</var>    (d) Use of funds is limited to expenses related to clinical training program costs for <br/>
<a id="pl.478.36"></a><var>478.36</var>eligible programs.<br/>
<a id="pl.479.1"></a><var>479.1</var>    (e) Any funds not distributed in accordance with the commissioner's approval letter <br/>
<a id="pl.479.2"></a><var>479.2</var>must be returned to the medical education and research fund within 30 days of receiving <br/>
<a id="pl.479.3"></a><var>479.3</var>notice from the commissioner. The commissioner shall distribute returned funds to the <br/>
<a id="pl.479.4"></a><var>479.4</var>appropriate training sites in accordance with the commissioner's approval letter.<br/>
<a id="pl.479.5"></a><var>479.5</var>    (e) (f) A maximum of $150,000 of the funds dedicated to the commissioner <br/>
<a id="pl.479.6"></a><var>479.6</var>under section 
         <statute_ref>297F.10, subdivision 1</statute_ref>, clause (2), may be used by the commissioner for <br/>
<a id="pl.479.7"></a><var>479.7</var>administrative expenses associated with implementing this section.<br/>
<br/>
<a id="bill.12.4.0"></a><a id="pl.479.8"></a><var>479.8</var>    Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:<br/>
<a id="pl.479.9"></a><var>479.9</var>    Subd. 5. <b>Report.</b> (a) Sponsoring institutions receiving funds under this section <br/>
<a id="pl.479.10"></a><var>479.10</var>must sign and submit a medical education grant verification report (GVR) to verify that <br/>
<a id="pl.479.11"></a><var>479.11</var>the correct grant amount was forwarded to each eligible training site. If the sponsoring <br/>
<a id="pl.479.12"></a><var>479.12</var>institution fails to submit the GVR by the stated deadline, or to request and meet <br/>
<a id="pl.479.13"></a><var>479.13</var>the deadline for an extension, the sponsoring institution is required to return the full <br/>
<a id="pl.479.14"></a><var>479.14</var>amount of funds received to the commissioner within 30 days of receiving notice from <br/>
<a id="pl.479.15"></a><var>479.15</var>the commissioner. The commissioner shall distribute returned funds to the appropriate <br/>
<a id="pl.479.16"></a><var>479.16</var>training sites in accordance with the commissioner's approval letter.<br/>
<a id="pl.479.17"></a><var>479.17</var>    (b) The reports must provide verification of the distribution of the funds and must <br/>
<a id="pl.479.18"></a><var>479.18</var>include:<br/>
<a id="pl.479.19"></a><var>479.19</var>    (1) the total number of eligible trainee FTEs in each clinical medical education <br/>
<a id="pl.479.20"></a><var>479.20</var>program;<br/>
<a id="pl.479.21"></a><var>479.21</var>    (2) the name of each funded program and, for each program, the dollar amount <br/>
<a id="pl.479.22"></a><var>479.22</var>distributed to each training site and a training site expenditure report;<br/>
<a id="pl.479.23"></a><var>479.23</var>    (3) documentation of any discrepancies between the initial grant distribution notice <br/>
<a id="pl.479.24"></a><var>479.24</var>included in the commissioner's approval letter and the actual distribution;<br/>
<a id="pl.479.25"></a><var>479.25</var>    (4) a statement by the sponsoring institution stating that the completed grant <br/>
<a id="pl.479.26"></a><var>479.26</var>verification report is valid and accurate; and<br/>
<a id="pl.479.27"></a><var>479.27</var>    (5) other information the commissioner, with advice from the advisory committee,<br/>
<a id="pl.479.28"></a><var>479.28</var> deems appropriate to evaluate the effectiveness of the use of funds for medical education.<br/>
<a id="pl.479.29"></a><var>479.29</var>    (c) By February 15 of Each year, the commissioner, with advice from the <br/>
<a id="pl.479.30"></a><var>479.30</var>advisory committee, shall provide an annual summary report to the legislature on the <br/>
<a id="pl.479.31"></a><var>479.31</var>implementation of this section.<br/>
<br/>
<a id="bill.12.5.0"></a><a id="pl.479.32"></a><var>479.32</var>    Sec. 5. Minnesota Statutes 2012, section 62J.692, subdivision 7a, is amended to read:<br/>
<a id="pl.479.33"></a><var>479.33</var>    Subd. 7a. <b>Clinical medical education innovations grants.</b> (a) The commissioner <br/>
<a id="pl.479.34"></a><var>479.34</var>shall award grants to teaching institutions and clinical training sites for projects that <br/>
<a id="pl.480.1"></a><var>480.1</var>increase dental access for underserved populations and promote innovative clinical <br/>
<a id="pl.480.2"></a><var>480.2</var>training of dental professionals.<br/>
<a id="pl.480.3"></a><var>480.3</var>(b) $1,000,000 of the funds dedicated to the commissioner under section 297F.10, <br/>
<a id="pl.480.4"></a><var>480.4</var>subdivision 1, clause (2), plus any federal financial participation on these funds, shall <br/>
<a id="pl.480.5"></a><var>480.5</var>be distributed by the commissioner for primary care development grants pursuant to <br/>
<a id="pl.480.6"></a><var>480.6</var>paragraph (c).<br/>
<a id="pl.480.7"></a><var>480.7</var>(c) The commissioner shall award grants to teaching institutions and clinical training <br/>
<a id="pl.480.8"></a><var>480.8</var>sites for projects that increase the supply and availability of primary care providers for <br/>
<a id="pl.480.9"></a><var>480.9</var>public program enrollees, improve access for underserved and rural populations, and <br/>
<a id="pl.480.10"></a><var>480.10</var>promote interdisciplinary and team training of primary care providers and related personnel.<br/>
<a id="pl.480.11"></a><var>480.11</var>(d) In awarding the grants, the commissioner, in consultation with the commissioner <br/>
<a id="pl.480.12"></a><var>480.12</var>of human services, shall consider the following:<br/>
<a id="pl.480.13"></a><var>480.13</var>(1) potential to successfully increase access to an underserved population;<br/>
<a id="pl.480.14"></a><var>480.14</var>(2) the long-term viability of the project to improve access beyond the period <br/>
<a id="pl.480.15"></a><var>480.15</var>of initial funding;<br/>
<a id="pl.480.16"></a><var>480.16</var>(3) evidence of collaboration between the applicant and local communities;<br/>
<a id="pl.480.17"></a><var>480.17</var>(4) the efficiency in the use of the funding; and<br/>
<a id="pl.480.18"></a><var>480.18</var>(5) the priority level of the project in relation to state clinical education, access, <br/>
<a id="pl.480.19"></a><var>480.19</var>and workforce goals.<br/>
<a id="pl.480.20"></a><var>480.20</var>(b) (e) The commissioner shall periodically evaluate the priorities in awarding the <br/>
<a id="pl.480.21"></a><var>480.21</var>innovations grants in order to ensure that the priorities meet the changing workforce <br/>
<a id="pl.480.22"></a><var>480.22</var>needs of the state.<br/>
<br/>
<a id="bill.12.6.0"></a><a id="pl.480.23"></a><var>480.23</var>    Sec. 6. Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:<br/>
<a id="pl.480.24"></a><var>480.24</var>    Subd. 9. <b>Review of eligible providers.</b> The commissioner and the Medical <br/>
<a id="pl.480.25"></a><var>480.25</var>Education and Research Costs Advisory Committee may review provider groups included <br/>
<a id="pl.480.26"></a><var>480.26</var>in the definition of a clinical medical education program to assure that the distribution <br/>
<a id="pl.480.27"></a><var>480.27</var>of the funds continue to be consistent with the purpose of this section. The results of <br/>
<a id="pl.480.28"></a><var>480.28</var>any such reviews must be reported to the chairs and ranking minority members of the <br/>
<a id="pl.480.29"></a><var>480.29</var>legislative committees with jurisdiction over health care policy and finance.<br/>
<br/>
<a id="bill.12.7.0"></a><a id="pl.480.30"></a><var>480.30</var>    Sec. 7. Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision <br/>
<a id="pl.480.31"></a><var>480.31</var>to read:<br/>
<a id="pl.480.32"></a><var>480.32</var>    Subd. 11. <b>Distribution of funds.</b> If federal approval is not received for the formula <br/>
<a id="pl.480.33"></a><var>480.33</var>described in subdivision 4, paragraph (a), 100 percent of available medical education <br/>
<a id="pl.481.1"></a><var>481.1</var>and research funds shall be distributed based on a distribution formula that reflects as <br/>
<a id="pl.481.2"></a><var>481.2</var>summation of two factors:<br/>
<a id="pl.481.3"></a><var>481.3</var>(1) a public program volume factor, that is determined by the total volume of public <br/>
<a id="pl.481.4"></a><var>481.4</var>program revenue received by each training site as a percentage of all public program <br/>
<a id="pl.481.5"></a><var>481.5</var>revenue received by all training sites in the fund pool; and<br/>
<a id="pl.481.6"></a><var>481.6</var>(2) a supplemental public program volume factor, that is determined by providing a <br/>
<a id="pl.481.7"></a><var>481.7</var>supplemental payment of 20 percent of each training site's grant to training sites whose <br/>
<a id="pl.481.8"></a><var>481.8</var>public program revenue accounted for a least 0.98 percent of the total public program <br/>
<a id="pl.481.9"></a><var>481.9</var>revenue received by all eligible training sites. Grants to training sites whose public <br/>
<a id="pl.481.10"></a><var>481.10</var>program revenue accounted for less than 0.98 percent of the total public program revenue <br/>
<a id="pl.481.11"></a><var>481.11</var>received by all eligible training sites shall be reduced by an amount equal to the total <br/>
<a id="pl.481.12"></a><var>481.12</var>value of the supplemental payment.<br/>
<br/>
<a id="bill.12.8.0"></a><a id="pl.481.13"></a><var>481.13</var>    Sec. 8. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:<br/>
<a id="pl.481.14"></a><var>481.14</var>    Subdivision 1. <b>Designation.</b> (a) The commissioner shall designate essential <br/>
<a id="pl.481.15"></a><var>481.15</var>community providers. The criteria for essential community provider designation shall be <br/>
<a id="pl.481.16"></a><var>481.16</var>the following:<br/>
<a id="pl.481.17"></a><var>481.17</var>(1) a demonstrated ability to integrate applicable supportive and stabilizing services <br/>
<a id="pl.481.18"></a><var>481.18</var>with medical care for uninsured persons and high-risk and special needs populations, <br/>
<a id="pl.481.19"></a><var>481.19</var>underserved, and other special needs populations; and<br/>
<a id="pl.481.20"></a><var>481.20</var>(2) a commitment to serve low-income and underserved populations by meeting the <br/>
<a id="pl.481.21"></a><var>481.21</var>following requirements:<br/>
<a id="pl.481.22"></a><var>481.22</var>(i) has nonprofit status in accordance with chapter 317A;<br/>
<a id="pl.481.23"></a><var>481.23</var>(ii) has tax-exempt status in accordance with the Internal Revenue Service Code, <br/>
<a id="pl.481.24"></a><var>481.24</var>section 501(c)(3);<br/>
<a id="pl.481.25"></a><var>481.25</var>(iii) charges for services on a sliding fee schedule based on current poverty income <br/>
<a id="pl.481.26"></a><var>481.26</var>guidelines; and<br/>
<a id="pl.481.27"></a><var>481.27</var>(iv) does not restrict access or services because of a client's financial limitation;<br/>
<a id="pl.481.28"></a><var>481.28</var>(3) status as a local government unit as defined in section 
         <statute_ref>62D.02, subdivision 11</statute_ref>, a <br/>
<a id="pl.481.29"></a><var>481.29</var>hospital district created or reorganized under sections 
         <statute_ref>447.31</statute_ref> to 
         <statute_ref>447.37</statute_ref>, an Indian tribal <br/>
<a id="pl.481.30"></a><var>481.30</var>government, an Indian health service unit, or a community health board as defined in <br/>
<a id="pl.481.31"></a><var>481.31</var>chapter 145A;<br/>
<a id="pl.481.32"></a><var>481.32</var>(4) a former state hospital that specializes in the treatment of cerebral palsy, spina <br/>
<a id="pl.481.33"></a><var>481.33</var>bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling <br/>
<a id="pl.481.34"></a><var>481.34</var>conditions;<br/>
<a id="pl.482.1"></a><var>482.1</var>(5) a sole community hospital. For these rural hospitals, the essential community <br/>
<a id="pl.482.2"></a><var>482.2</var>provider designation applies to all health services provided, including both inpatient and <br/>
<a id="pl.482.3"></a><var>482.3</var>outpatient services. For purposes of this section, "sole community hospital" means a <br/>
<a id="pl.482.4"></a><var>482.4</var>rural hospital that:<br/>
<a id="pl.482.5"></a><var>482.5</var>(i) is eligible to be classified as a sole community hospital according to Code <br/>
<a id="pl.482.6"></a><var>482.6</var>of Federal Regulations, title 42, section 412.92, or is located in a community with a <br/>
<a id="pl.482.7"></a><var>482.7</var>population of less than 5,000 and located more than 25 miles from a like hospital currently <br/>
<a id="pl.482.8"></a><var>482.8</var>providing acute short-term services;<br/>
<a id="pl.482.9"></a><var>482.9</var>(ii) has experienced net operating income losses in two of the previous three <br/>
<a id="pl.482.10"></a><var>482.10</var>most recent consecutive hospital fiscal years for which audited financial information is <br/>
<a id="pl.482.11"></a><var>482.11</var>available; and<br/>
<a id="pl.482.12"></a><var>482.12</var>(iii) consists of 40 or fewer licensed beds; or<br/>
<a id="pl.482.13"></a><var>482.13</var>(6) a birth center licensed under section 
         <statute_ref>144.615</statute_ref>; or<br/>
<a id="pl.482.14"></a><var>482.14</var>(7) a hospital or affiliated specialty clinic that:<br/>
<a id="pl.482.15"></a><var>482.15</var>(i) serves patients who are predominately under the age of 21;<br/>
<a id="pl.482.16"></a><var>482.16</var>(ii) provides intensive specialty pediatric services that are only routinely provided <br/>
<a id="pl.482.17"></a><var>482.17</var>in less than five hospitals in the state; and<br/>
<a id="pl.482.18"></a><var>482.18</var>(iii) serves children from at least half the counties in the state.<br/>
<a id="pl.482.19"></a><var>482.19</var>(b) Prior to designation, the commissioner shall publish the names of all applicants <br/>
<a id="pl.482.20"></a><var>482.20</var>in the State Register. The public shall have 30 days from the date of publication to submit <br/>
<a id="pl.482.21"></a><var>482.21</var>written comments to the commissioner on the application. No designation shall be made <br/>
<a id="pl.482.22"></a><var>482.22</var>by the commissioner until the 30-day period has expired.<br/>
<a id="pl.482.23"></a><var>482.23</var>(c) The commissioner may designate an eligible provider as an essential community <br/>
<a id="pl.482.24"></a><var>482.24</var>provider for all the services offered by that provider or for specific services designated by <br/>
<a id="pl.482.25"></a><var>482.25</var>the commissioner.<br/>
<a id="pl.482.26"></a><var>482.26</var>(d) For the purpose of this subdivision, supportive and stabilizing services include at <br/>
<a id="pl.482.27"></a><var>482.27</var>a minimum, transportation, child care, cultural, and linguistic services where appropriate.<br/>
<br/>
<a id="bill.12.9.0"></a><a id="pl.482.28"></a><var>482.28</var>    Sec. 9. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision <br/>
<a id="pl.482.29"></a><var>482.29</var>to read:<br/>
<a id="pl.482.30"></a><var>482.30</var>    Subd. 1a. <b>Bored geothermal heat exchanger.</b> "Bored geothermal heat exchanger" <br/>
<a id="pl.482.31"></a><var>482.31</var>means an earth-coupled heating or cooling device consisting of a sealed closed-loop <br/>
<a id="pl.482.32"></a><var>482.32</var>piping system installed in a boring in the ground to transfer heat to or from the surrounding <br/>
<a id="pl.482.33"></a><var>482.33</var>earth with no discharge.<br/>
<br/>
<a id="bill.12.10.0"></a><a id="pl.483.1"></a><var>483.1</var>    Sec. 10. Minnesota Statutes 2012, section 103I.521, is amended to read:<br/>
<a id="pl.483.2"></a><var>483.2</var><b>103I.521 FEES </b><b>DEPOSITED WITH COMMISSIONER OF MANAGEMENT </b><br/>
<a id="pl.483.3"></a><var>483.3</var><b>AND BUDGET</b><b>.</b><br/>
<a id="pl.483.4"></a><var>483.4</var>Unless otherwise specified, fees collected for licenses or registration by the <br/>
<a id="pl.483.5"></a><var>483.5</var>commissioner under this chapter shall be deposited in the state treasury and credited to <br/>
<a id="pl.483.6"></a><var>483.6</var>the state government special revenue fund.<br/>
<br/>
<a id="bill.12.11.0"></a><a id="pl.483.7"></a><var>483.7</var>    Sec. 11. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:<br/>
<a id="pl.483.8"></a><var>483.8</var>    Subdivision 1. <b>Who must pay.</b> Except for the limitation contained in this section, <br/>
<a id="pl.483.9"></a><var>483.9</var>the commissioner of health shall charge a handling fee may enter into a contractual <br/>
<a id="pl.483.10"></a><var>483.10</var>agreement to recover costs incurred for analysis for diagnostic purposes for each specimen <br/>
<a id="pl.483.11"></a><var>483.11</var>submitted to the Department of Health for analysis for diagnostic purposes by any hospital, <br/>
<a id="pl.483.12"></a><var>483.12</var>private laboratory, private clinic, or physician. No fee shall be charged to any entity which <br/>
<a id="pl.483.13"></a><var>483.13</var>receives direct or indirect financial assistance from state or federal funds administered by <br/>
<a id="pl.483.14"></a><var>483.14</var>the Department of Health, including any public health department, nonprofit community <br/>
<a id="pl.483.15"></a><var>483.15</var>clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The <br/>
<a id="pl.483.16"></a><var>483.16</var>commissioner shall not charge for any biological materials submitted to the Department <br/>
<a id="pl.483.17"></a><var>483.17</var>of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological <br/>
<a id="pl.483.18"></a><var>483.18</var>materials requested by the department to gather information for disease prevention or <br/>
<a id="pl.483.19"></a><var>483.19</var>control purposes. The commissioner of health may establish other exceptions to the <br/>
<a id="pl.483.20"></a><var>483.20</var>handling fee as may be necessary to protect the public's health. All fees collected pursuant <br/>
<a id="pl.483.21"></a><var>483.21</var>to this section shall be deposited in the state treasury and credited to the state government <br/>
<a id="pl.483.22"></a><var>483.22</var>special revenue fund. Funds generated in a contractual agreement made pursuant to this <br/>
<a id="pl.483.23"></a><var>483.23</var>section shall be deposited in a special account and are appropriated to the commissioner <br/>
<a id="pl.483.24"></a><var>483.24</var>for purposes of providing the services specified in the contracts. All such contractual <br/>
<a id="pl.483.25"></a><var>483.25</var>agreements shall be processed in accordance with the provisions of chapter 16C.<br/>
<a id="pl.483.26"></a><var>483.26</var><b>EFFECTIVE DATE.</b>This section is effective July 1, 2014.<br/>
<br/>
<a id="bill.12.12.0"></a><a id="pl.483.27"></a><var>483.27</var>    Sec. 12. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:<br/>
<a id="pl.483.28"></a><var>483.28</var>    Subdivision 1. <b>Duty to perform testing.</b> (a) It is the duty of (1) the administrative <br/>
<a id="pl.483.29"></a><var>483.29</var>officer or other person in charge of each institution caring for infants 28 days or less <br/>
<a id="pl.483.30"></a><var>483.30</var>of age, (2) the person required in pursuance of the provisions of section 
         <statute_ref>144.215</statute_ref>, to <br/>
<a id="pl.483.31"></a><var>483.31</var>register the birth of a child, or (3) the nurse midwife or midwife in attendance at the <br/>
<a id="pl.483.32"></a><var>483.32</var>birth, to arrange to have administered to every infant or child in its care tests for heritable <br/>
<a id="pl.484.1"></a><var>484.1</var>and congenital disorders according to subdivision 2 and rules prescribed by the state <br/>
<a id="pl.484.2"></a><var>484.2</var>commissioner of health.<br/>
<a id="pl.484.3"></a><var>484.3</var>    (b) Testing and the, recording and of test results, reporting of test results, and <br/>
<a id="pl.484.4"></a><var>484.4</var>follow-up of infants with heritable congenital disorders, including hearing loss detected <br/>
<a id="pl.484.5"></a><var>484.5</var>through the early hearing detection and intervention program in section 144.966, shall be <br/>
<a id="pl.484.6"></a><var>484.6</var>performed at the times and in the manner prescribed by the commissioner of health. The <br/>
<a id="pl.484.7"></a><var>484.7</var>commissioner shall charge a fee so that the total of fees collected will approximate the <br/>
<a id="pl.484.8"></a><var>484.8</var>costs of conducting the tests and implementing and maintaining a system to follow-up <br/>
<a id="pl.484.9"></a><var>484.9</var>infants with heritable or congenital disorders, including hearing loss detected through the <br/>
<a id="pl.484.10"></a><var>484.10</var>early hearing detection and intervention program under section 
<statute_ref>144.966</statute_ref>.<br/>
<a id="pl.484.11"></a><var>484.11</var>    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased <br/>
<a id="pl.484.12"></a><var>484.12</var>to $106 to support the newborn screening program, including tests administered under <br/>
<a id="pl.484.13"></a><var>484.13</var>this section and section 144.966, shall be $135 per specimen. The increased fee amount <br/>
<a id="pl.484.14"></a><var>484.14</var>shall be deposited in the general fund. Costs associated with capital expenditures and <br/>
<a id="pl.484.15"></a><var>484.15</var>the development of new procedures may be prorated over a three-year period when <br/>
<a id="pl.484.16"></a><var>484.16</var>calculating the amount of the fees. This fee amount shall be deposited in the state treasury <br/>
<a id="pl.484.17"></a><var>484.17</var>and credited to the state government special revenue fund.<br/>
<a id="pl.484.18"></a><var>484.18</var>(d) The fee to offset the cost of the support services provided under section 144.966, <br/>
<a id="pl.484.19"></a><var>484.19</var>subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury <br/>
<a id="pl.484.20"></a><var>484.20</var>and credited to the general fund.<br/>
<br/>
<a id="bill.12.13.0"></a><a id="pl.484.21"></a><var>484.21</var>    Sec. 13. <b>[144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL </b><br/>
<a id="pl.484.22"></a><var>484.22</var><b>HEART DISEASE (CCHD).</b><br/>
<a id="pl.484.23"></a><var>484.23</var>    Subdivision 1. <b>Required testing and reporting.</b> (a) Each licensed hospital or <br/>
<a id="pl.484.24"></a><var>484.24</var>state-licensed birthing center or facility that provides maternity and newborn care services <br/>
<a id="pl.484.25"></a><var>484.25</var>shall provide screening for congenital heart disease to all newborns prior to discharge <br/>
<a id="pl.484.26"></a><var>484.26</var>using pulse oximetry screening. The screening must occur after the infant is 24 hours old, <br/>
<a id="pl.484.27"></a><var>484.27</var>before discharge from the nursery. If discharge occurs before the infant is 24 hours old, <br/>
<a id="pl.484.28"></a><var>484.28</var>the screening must occur as close as possible to the time of discharge.<br/>
<a id="pl.484.29"></a><var>484.29</var>(b) For premature infants (less than 36 weeks of gestation) and infants admitted to a <br/>
<a id="pl.484.30"></a><var>484.30</var>higher-level nursery (special care or intensive care), pulse oximetry must be performed <br/>
<a id="pl.484.31"></a><var>484.31</var>when medically appropriate prior to discharge.<br/>
<a id="pl.484.32"></a><var>484.32</var>(c) Results of the screening must be reported to the Department of Health.<br/>
<a id="pl.484.33"></a><var>484.33</var>    Subd. 2. <b>Implementation.</b> The Department of Health shall:<br/>
<a id="pl.484.34"></a><var>484.34</var>(1) communicate the screening protocol requirements;<br/>
<a id="pl.485.1"></a><var>485.1</var>(2) make information and forms available to the hospitals, birthing centers, and other <br/>
<a id="pl.485.2"></a><var>485.2</var>facilities that are required to provide the screening, health care providers who provide <br/>
<a id="pl.485.3"></a><var>485.3</var>prenatal care and care to newborns, and expectant parents and parents of newborns. The <br/>
<a id="pl.485.4"></a><var>485.4</var>information and forms must include screening protocol and reporting requirements and <br/>
<a id="pl.485.5"></a><var>485.5</var>parental options;<br/>
<a id="pl.485.6"></a><var>485.6</var>(3) provide training to ensure compliance with and appropriate implementation of <br/>
<a id="pl.485.7"></a><var>485.7</var>the screening;<br/>
<a id="pl.485.8"></a><var>485.8</var>(4) establish the mechanism for the required data collection and reporting of <br/>
<a id="pl.485.9"></a><var>485.9</var>screening and follow-up diagnostic results to the Department of Health according to the <br/>
<a id="pl.485.10"></a><var>485.10</var>Department of Health's recommendations;<br/>
<a id="pl.485.11"></a><var>485.11</var>(5) coordinate the implementation of universal standardized screening;<br/>
<a id="pl.485.12"></a><var>485.12</var>(6) act as a resource for providers as the screening program is implemented, and in <br/>
<a id="pl.485.13"></a><var>485.13</var>consultation with the Advisory Committee on Heritable and Congenital Disorders, develop <br/>
<a id="pl.485.14"></a><var>485.14</var>and implement policies for early medical and developmental intervention services and <br/>
<a id="pl.485.15"></a><var>485.15</var>long-term follow-up services for children and their families identified with a CCHD; and<br/>
<a id="pl.485.16"></a><var>485.16</var>(7) comply with sections 144.125 to 144.128.<br/>
<br/>
<a id="bill.12.14.0"></a><a id="pl.485.17"></a><var>485.17</var>    Sec. 14. Minnesota Statutes 2012, section 144.212, is amended to read:<br/>
<a id="pl.485.18"></a><var>485.18</var><b>144.212 DEFINITIONS.</b><br/>
<a id="pl.485.19"></a><var>485.19</var>    Subdivision 1. <b>Scope.</b> As used in sections 
         <statute_ref>144.211</statute_ref> to 
         <statute_ref>144.227</statute_ref>, the following terms <br/>
<a id="pl.485.20"></a><var>485.20</var>have the meanings given.<br/>
<a id="pl.485.21"></a><var>485.21</var>    Subd. 1a. <b>Amendment.</b> "Amendment" means completion or correction of made <br/>
<a id="pl.485.22"></a><var>485.22</var>to certification items on  a vital record. after a certification has been issued or more <br/>
<a id="pl.485.23"></a><var>485.23</var>than one year after the event, whichever occurs first, that does not result in a sealed or <br/>
<a id="pl.485.24"></a><var>485.24</var>replaced record.<br/>
<a id="pl.485.25"></a><var>485.25</var>    Subd. 1b. <b>Authorized representative.</b> "Authorized representative" means an agent <br/>
<a id="pl.485.26"></a><var>485.26</var>designated in a written and witnessed statement signed by the subject of the record or <br/>
<a id="pl.485.27"></a><var>485.27</var>other qualified applicant.<br/>
<a id="pl.485.28"></a><var>485.28</var>    Subd. 1c. <b>Certification item.</b> "Certification item" means all individual items <br/>
<a id="pl.485.29"></a><var>485.29</var>appearing on a certificate of birth and the demographic and legal items on a certificate <br/>
<a id="pl.485.30"></a><var>485.30</var>of death.<br/>
<a id="pl.485.31"></a><var>485.31</var>    Subd. 2. <b>Commissioner.</b> "Commissioner" means the commissioner of health.<br/>
<a id="pl.485.32"></a><var>485.32</var>    Subd. 2a. <b>Correction.</b> "Correction" means a change made to a noncertification <br/>
<a id="pl.485.33"></a><var>485.33</var>item, including information collected for medical and statistical purposes. A correction <br/>
<a id="pl.485.34"></a><var>485.34</var>also means a change to a certification item within one year of the event provided that no <br/>
<a id="pl.485.35"></a><var>485.35</var>certification, whether paper or electronic, has been issued.<br/>
<a id="pl.486.1"></a><var>486.1</var>    Subd. 2b. <b>Court of competent jurisdiction.</b> "Court of competent jurisdiction" <br/>
<a id="pl.486.2"></a><var>486.2</var>means a court within the United States with jurisdiction over the individual and such other <br/>
<a id="pl.486.3"></a><var>486.3</var>individuals that the court deems necessary.<br/>
<a id="pl.486.4"></a><var>486.4</var>    Subd. 2a 2c. <b>Delayed registration.</b> "Delayed registration" means registration of a <br/>
<a id="pl.486.5"></a><var>486.5</var>record of birth or death filed one or more years after the date of birth or death.<br/>
<a id="pl.486.6"></a><var>486.6</var>    Subd. 2d. <b>Disclosure.</b> "Disclosure" means to make available or make known <br/>
<a id="pl.486.7"></a><var>486.7</var>personally identifiable information contained in a vital record, by any means of <br/>
<a id="pl.486.8"></a><var>486.8</var>communication.<br/>
<a id="pl.486.9"></a><var>486.9</var>    Subd. 3. <b>File.</b> "File" means to present a vital record or report for registration to the <br/>
<a id="pl.486.10"></a><var>486.10</var>Office of the State Registrar Vital Records and to have the vital record or report accepted <br/>
<a id="pl.486.11"></a><var>486.11</var>for registration by the Office of the State Registrar Vital Records.<br/>
<a id="pl.486.12"></a><var>486.12</var>    Subd. 4. <b>Final disposition.</b> "Final disposition" means the burial, interment, <br/>
<a id="pl.486.13"></a><var>486.13</var>cremation, removal from the state, or other authorized disposition of a dead body or <br/>
<a id="pl.486.14"></a><var>486.14</var>dead fetus.<br/>
<a id="pl.486.15"></a><var>486.15</var>    Subd. 4a. <b>Institution.</b> "Institution" means a public or private establishment that:<br/>
<a id="pl.486.16"></a><var>486.16</var>(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment; <br/>
<a id="pl.486.17"></a><var>486.17</var>or<br/>
<a id="pl.486.18"></a><var>486.18</var>(2) provides nursing, custodial, or domiciliary care, or to which persons are <br/>
<a id="pl.486.19"></a><var>486.19</var>committed by law.<br/>
<a id="pl.486.20"></a><var>486.20</var>    Subd. 4b. <b>Legal representative.</b> "Legal representative" means a licensed attorney <br/>
<a id="pl.486.21"></a><var>486.21</var>representing an individual.<br/>
<a id="pl.486.22"></a><var>486.22</var>    Subd. 4c. <b>Local issuance office.</b> "Local issuance office" means a county <br/>
<a id="pl.486.23"></a><var>486.23</var>governmental office authorized by the state registrar to issue certified birth and death <br/>
<a id="pl.486.24"></a><var>486.24</var>records.<br/>
<a id="pl.486.25"></a><var>486.25</var>    Subd. 4d. <b>Record.</b> "Record" means a report of a vital event that has been registered <br/>
<a id="pl.486.26"></a><var>486.26</var>by the state registrar.<br/>
<a id="pl.486.27"></a><var>486.27</var>    Subd. 5. <b>Registration.</b> "Registration" means the process by which vital records <br/>
<a id="pl.486.28"></a><var>486.28</var>are completed, filed, and incorporated into the official records of the Office of the State <br/>
<a id="pl.486.29"></a><var>486.29</var>Registrar.<br/>
<a id="pl.486.30"></a><var>486.30</var>    Subd. 6. <b>State registrar.</b> "State registrar" means the commissioner of health or a <br/>
<a id="pl.486.31"></a><var>486.31</var>designee.<br/>
<a id="pl.486.32"></a><var>486.32</var>    Subd. 7. <b>System of vital statistics.</b> "System of vital statistics" includes the <br/>
<a id="pl.486.33"></a><var>486.33</var>registration, collection, preservation, amendment, verification, maintenance of the security <br/>
<a id="pl.486.34"></a><var>486.34</var>and integrity of, and certification of vital records, the collection of other reports required <br/>
<a id="pl.486.35"></a><var>486.35</var>by sections 
         <statute_ref>144.211</statute_ref> to 
         <statute_ref>144.227</statute_ref>, and related activities including the tabulation, analysis, <br/>
<a id="pl.486.36"></a><var>486.36</var>publication, and dissemination of vital statistics.<br/>
<a id="pl.487.1"></a><var>487.1</var>    Subd. 7a. <b>Verification.</b> "Verification" means a confirmation of the information on a <br/>
<a id="pl.487.2"></a><var>487.2</var>vital record based on the facts contained in a certification.<br/>
<a id="pl.487.3"></a><var>487.3</var>    Subd. 8. <b>Vital record.</b> "Vital record" means a record or report of birth, stillbirth, <br/>
<a id="pl.487.4"></a><var>487.4</var>death, marriage, dissolution and annulment, and data related thereto. The birth record is <br/>
<a id="pl.487.5"></a><var>487.5</var>not a medical record of the mother or the child.<br/>
<a id="pl.487.6"></a><var>487.6</var>    Subd. 9. <b>Vital statistics.</b> "Vital statistics" means the data derived from records and <br/>
<a id="pl.487.7"></a><var>487.7</var>reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment, <br/>
<a id="pl.487.8"></a><var>487.8</var>and related reports.<br/>
<a id="pl.487.9"></a><var>487.9</var>    Subd. 10. <b>Local registrar.</b> "Local registrar" means an individual designated under <br/>
<a id="pl.487.10"></a><var>487.10</var>section 
<statute_ref>144.214, subdivision 1</statute_ref>, to perform the duties of a local registrar.<br/>
<a id="pl.487.11"></a><var>487.11</var>    Subd. 11. <b>Consent to disclosure.</b> "Consent to disclosure" means an affidavit filed <br/>
<a id="pl.487.12"></a><var>487.12</var>with the state registrar which sets forth the following information:<br/>
<a id="pl.487.13"></a><var>487.13</var>(1) the current name and address of the affiant;<br/>
<a id="pl.487.14"></a><var>487.14</var>(2) any previous name by which the affiant was known;<br/>
<a id="pl.487.15"></a><var>487.15</var>(3) the original and adopted names, if known, of the adopted child whose original <br/>
<a id="pl.487.16"></a><var>487.16</var>birth record is to be disclosed;<br/>
<a id="pl.487.17"></a><var>487.17</var>(4) the place and date of birth of the adopted child;<br/>
<a id="pl.487.18"></a><var>487.18</var>(5) the biological relationship of the affiant to the adopted child; and<br/>
<a id="pl.487.19"></a><var>487.19</var>(6) the affiant's consent to disclosure of information from the original birth record of <br/>
<a id="pl.487.20"></a><var>487.20</var>the adopted child.<br/>
<br/>
<a id="bill.12.15.0"></a><a id="pl.487.21"></a><var>487.21</var>    Sec. 15. Minnesota Statutes 2012, section 144.213, is amended to read:<br/>
<a id="pl.487.22"></a><var>487.22</var><b>144.213 OFFICE OF </b><b>THE STATE REGISTRAR</b><b> VITAL RECORDS</b><b>.</b><br/>
<a id="pl.487.23"></a><var>487.23</var>    Subdivision 1. <b>Creation; state registrar</b><b>; Office of Vital Records</b><b>.</b> The <br/>
<a id="pl.487.24"></a><var>487.24</var>commissioner shall establish an Office of the State Registrar Vital Records under the <br/>
<a id="pl.487.25"></a><var>487.25</var>supervision of the state registrar. The commissioner shall furnish to local registrars the <br/>
<a id="pl.487.26"></a><var>487.26</var>forms necessary for correct reporting of vital statistics, and shall instruct the local registrars <br/>
<a id="pl.487.27"></a><var>487.27</var>in the collection and compilation of the data. The commissioner shall promulgate rules for <br/>
<a id="pl.487.28"></a><var>487.28</var>the collection, filing, and registering of vital statistics information by the state and local <br/>
<a id="pl.487.29"></a><var>487.29</var>registrars registrar, physicians, morticians, and others. Except as otherwise provided in <br/>
<a id="pl.487.30"></a><var>487.30</var>sections 
         <statute_ref>144.211</statute_ref> to 
         <statute_ref>144.227</statute_ref>, rules previously promulgated by the commissioner relating to <br/>
<a id="pl.487.31"></a><var>487.31</var>the collection, filing and registering of vital statistics shall remain in effect until repealed, <br/>
<a id="pl.487.32"></a><var>487.32</var>modified or superseded by a rule promulgated by the commissioner.<br/>
<a id="pl.487.33"></a><var>487.33</var>    Subd. 2. <b>General duties.</b> (a) The state registrar shall coordinate the work of <br/>
<a id="pl.487.34"></a><var>487.34</var>local registrars to maintain a statewide system of vital statistics. The state registrar is <br/>
<a id="pl.487.35"></a><var>487.35</var>responsible for the administration and enforcement of sections 
         <statute_ref>144.211</statute_ref> to 
         <statute_ref>144.227</statute_ref>, and <br/>
<a id="pl.488.1"></a><var>488.1</var>shall supervise local registrars in the enforcement of sections 
         <statute_ref>144.211</statute_ref> to 
         <statute_ref>144.227</statute_ref> and the <br/>
<a id="pl.488.2"></a><var>488.2</var>rules promulgated thereunder. Local issuance offices that fail to comply with the statutes <br/>
<a id="pl.488.3"></a><var>488.3</var>or rules or to properly train employees may have their issuance privileges and access to <br/>
<a id="pl.488.4"></a><var>488.4</var>the vital records system revoked.<br/>
<a id="pl.488.5"></a><var>488.5</var>(b) To preserve vital records the state registrar is authorized to prepare typewritten, <br/>
<a id="pl.488.6"></a><var>488.6</var>photographic, electronic or other reproductions of original records and files in the Office <br/>
<a id="pl.488.7"></a><var>488.7</var>of Vital Records. The reproductions when certified by the state registrar shall be accepted <br/>
<a id="pl.488.8"></a><var>488.8</var>as the original records.<br/>
<a id="pl.488.9"></a><var>488.9</var>(c) The state registrar shall also:<br/>
<a id="pl.488.10"></a><var>488.10</var>(1) establish, designate, and eliminate offices in the state to aid in the efficient <br/>
<a id="pl.488.11"></a><var>488.11</var>issuance of vital records;<br/>
<a id="pl.488.12"></a><var>488.12</var>(2) direct the activities of all persons engaged in activities pertaining to the operation <br/>
<a id="pl.488.13"></a><var>488.13</var>of the system of vital statistics;<br/>
<a id="pl.488.14"></a><var>488.14</var>(3) develop and conduct training programs to promote uniformity of policy and <br/>
<a id="pl.488.15"></a><var>488.15</var>procedures throughout the state in matters pertaining to the system of vital statistics; and<br/>
<a id="pl.488.16"></a><var>488.16</var>(4) prescribe, furnish, and distribute all forms required by sections 144.211 to <br/>
<a id="pl.488.17"></a><var>488.17</var>144.227 and any rules adopted under these sections, and prescribe other means for the <br/>
<a id="pl.488.18"></a><var>488.18</var>transmission of data, including electronic submission, that will accomplish the purpose of <br/>
<a id="pl.488.19"></a><var>488.19</var>complete, accurate, and timely reporting and registration.<br/>
<a id="pl.488.20"></a><var>488.20</var>    Subd. 3. <b>Record keeping.</b> To preserve vital records the state registrar is authorized <br/>
<a id="pl.488.21"></a><var>488.21</var>to prepare typewritten, photographic, electronic or other reproductions of original records <br/>
<a id="pl.488.22"></a><var>488.22</var>and files in the Office of the State Registrar. The reproductions when certified by the state <br/>
<a id="pl.488.23"></a><var>488.23</var>or local registrar shall be accepted as the original records.<br/>
<br/>
<a id="bill.12.16.0"></a><a id="pl.488.24"></a><var>488.24</var>    Sec. 16. <b>[144.2131] SECURITY OF VITAL RECORDS SYSTEM.</b><br/>
<a id="pl.488.25"></a><var>488.25</var>The state registrar shall:<br/>
<a id="pl.488.26"></a><var>488.26</var>(1) authenticate all users of the system of vital statistics and document that all users <br/>
<a id="pl.488.27"></a><var>488.27</var>require access based on their official duties;<br/>
<a id="pl.488.28"></a><var>488.28</var>(2) authorize authenticated users of the system of vital statistics to access specific <br/>
<a id="pl.488.29"></a><var>488.29</var>components of the vital statistics systems necessary for their official roles and duties;<br/>
<a id="pl.488.30"></a><var>488.30</var>(3) establish separation of duties between staff roles that may be susceptible to fraud <br/>
<a id="pl.488.31"></a><var>488.31</var>or misuse and routinely perform audits of staff work for the purposes of identifying fraud <br/>
<a id="pl.488.32"></a><var>488.32</var>or misuse within the vital statistics system;<br/>
<a id="pl.488.33"></a><var>488.33</var>(4) require that authenticated and authorized users of the system of vital <br/>
<a id="pl.488.34"></a><var>488.34</var>statistics maintain a specified level of training related to security and provide written <br/>
<a id="pl.488.35"></a><var>488.35</var>acknowledgment of security procedures and penalties;<br/>
<a id="pl.489.1"></a><var>489.1</var>(5) validate data submitted for registration through site visits or with independent <br/>
<a id="pl.489.2"></a><var>489.2</var>sources outside the registration system at a frequency specified by the state registrar to <br/>
<a id="pl.489.3"></a><var>489.3</var>maximize the integrity of the data collected;<br/>
<a id="pl.489.4"></a><var>489.4</var>(6) protect personally identifiable information and maintain systems pursuant to <br/>
<a id="pl.489.5"></a><var>489.5</var>applicable state and federal laws;<br/>
<a id="pl.489.6"></a><var>489.6</var>(7) accept a report of death if the decedent was born in Minnesota or if the decedent <br/>
<a id="pl.489.7"></a><var>489.7</var>was a resident of Minnesota from the United States Department of Defense or the United <br/>
<a id="pl.489.8"></a><var>489.8</var>States Department of State when the death of a United States citizen occurs outside the <br/>
<a id="pl.489.9"></a><var>489.9</var>United States;<br/>
<a id="pl.489.10"></a><var>489.10</var>(8) match death records registered in Minnesota and death records provided from <br/>
<a id="pl.489.11"></a><var>489.11</var>other jurisdictions to live birth records in Minnesota;<br/>
<a id="pl.489.12"></a><var>489.12</var>(9) match death records received from the United States Department of Defense <br/>
<a id="pl.489.13"></a><var>489.13</var>or the United States Department of State for deaths of United States citizens occurring <br/>
<a id="pl.489.14"></a><var>489.14</var>outside the United States to live birth records in Minnesota;<br/>
<a id="pl.489.15"></a><var>489.15</var>(10) work with law enforcement to initiate and provide evidence for active fraud <br/>
<a id="pl.489.16"></a><var>489.16</var>investigations;<br/>
<a id="pl.489.17"></a><var>489.17</var>(11) provide secure workplace, storage, and technology environments that have <br/>
<a id="pl.489.18"></a><var>489.18</var>limited role-based access;<br/>
<a id="pl.489.19"></a><var>489.19</var>(12) maintain overt, covert, and forensic security measures for certifications, <br/>
<a id="pl.489.20"></a><var>489.20</var>verifications, and automated systems that are part of the vital statistics system; and<br/>
<a id="pl.489.21"></a><var>489.21</var>(13) comply with applicable state and federal laws and rules associated with <br/>
<a id="pl.489.22"></a><var>489.22</var>information technology systems and related information security requirements.<br/>
<br/>
<a id="bill.12.17.0"></a><a id="pl.489.23"></a><var>489.23</var>    Sec. 17. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:<br/>
<a id="pl.489.24"></a><var>489.24</var>    Subd. 3. <b>Father's name; child's name.</b> In any case in which paternity of a child is <br/>
<a id="pl.489.25"></a><var>489.25</var>determined by a court of competent jurisdiction, a declaration of parentage is executed <br/>
<a id="pl.489.26"></a><var>489.26</var>under section 
<statute_ref>257.34</statute_ref>, or a recognition of parentage is executed under section 
         <statute_ref>257.75</statute_ref>, the <br/>
<a id="pl.489.27"></a><var>489.27</var>name of the father shall be entered on the birth record. If the order of the court declares <br/>
<a id="pl.489.28"></a><var>489.28</var>the name of the child, it shall also be entered on the birth record. If the order of the court <br/>
<a id="pl.489.29"></a><var>489.29</var>does not declare the name of the child, or there is no court order, then upon the request of <br/>
<a id="pl.489.30"></a><var>489.30</var>both parents in writing, the surname of the child shall be defined by both parents.<br/>
<br/>
<a id="bill.12.18.0"></a><a id="pl.489.31"></a><var>489.31</var>    Sec. 18. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:<br/>
<a id="pl.489.32"></a><var>489.32</var>    Subd. 4. <b>Social Security number registration.</b> (a) Parents of a child born within <br/>
<a id="pl.489.33"></a><var>489.33</var>this state shall give the parents' Social Security numbers to the Office of the State Registrar<br/>
<a id="pl.490.1"></a><var>490.1</var> Vital Records at the time of filing the birth record, but the numbers shall not appear on <br/>
<a id="pl.490.2"></a><var>490.2</var>the certified record.<br/>
<a id="pl.490.3"></a><var>490.3</var>(b) The Social Security numbers are classified as private data, as defined in section <br/>
<a id="pl.490.4"></a><var>490.4</var><statute_ref>13.02, subdivision 12</statute_ref>, on individuals, but the Office of the State Registrar Vital Records<br/>
<a id="pl.490.5"></a><var>490.5</var> shall provide a Social Security number to the public authority responsible for child support <br/>
<a id="pl.490.6"></a><var>490.6</var>services upon request by the public authority for use in the establishment of parentage and <br/>
<a id="pl.490.7"></a><var>490.7</var>the enforcement of child support obligations.<br/>
<br/>
<a id="bill.12.19.0"></a><a id="pl.490.8"></a><var>490.8</var>    Sec. 19. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:<br/>
<a id="pl.490.9"></a><var>490.9</var>    Subdivision 1. <b>Reporting a foundling.</b> Whoever finds a live born infant of unknown <br/>
<a id="pl.490.10"></a><var>490.10</var>parentage shall report within five days to the Office of the State Registrar Vital Records<br/>
<a id="pl.490.11"></a><var>490.11</var> such information as the commissioner may by rule require to identify the foundling.<br/>
<br/>
<a id="bill.12.20.0"></a><a id="pl.490.12"></a><var>490.12</var>    Sec. 20. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:<br/>
<a id="pl.490.13"></a><var>490.13</var>    Subd. 2. <b>Court petition.</b> If a delayed record of birth is rejected under subdivision <br/>
<a id="pl.490.14"></a><var>490.14</var>1, a person may petition the appropriate court in the county in which the birth allegedly <br/>
<a id="pl.490.15"></a><var>490.15</var>occurred for an order establishing a record of the date and place of the birth and the <br/>
<a id="pl.490.16"></a><var>490.16</var>parentage of the person whose birth is to be registered. The petition shall state:<br/>
<a id="pl.490.17"></a><var>490.17</var>(1) that the person for whom a delayed record of birth is sought was born in this state;<br/>
<a id="pl.490.18"></a><var>490.18</var>(2) that no record of birth can be found in the Office of the State Registrar Vital <br/>
<a id="pl.490.19"></a><var>490.19</var>Records;<br/>
<a id="pl.490.20"></a><var>490.20</var>(3) that diligent efforts by the petitioner have failed to obtain the evidence required <br/>
<a id="pl.490.21"></a><var>490.21</var>in subdivision 1;<br/>
<a id="pl.490.22"></a><var>490.22</var>(4) that the state registrar has refused to register a delayed record of birth; and<br/>
<a id="pl.490.23"></a><var>490.23</var>(5) other information as may be required by the court.<br/>
<br/>
<a id="bill.12.21.0"></a><a id="pl.490.24"></a><var>490.24</var>    Sec. 21. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:<br/>
<a id="pl.490.25"></a><var>490.25</var>    Subd. 5. <b>Replacement of vital records.</b> Upon the order of a court of this state, upon <br/>
<a id="pl.490.26"></a><var>490.26</var>the request of a court of another state, upon the filing of a declaration of parentage under <br/>
<a id="pl.490.27"></a><var>490.27</var>section 
<statute_ref>257.34</statute_ref>, or upon the filing of a recognition of parentage with a the state registrar, a <br/>
<a id="pl.490.28"></a><var>490.28</var>replacement birth record must be registered consistent with the findings of the court, the <br/>
<a id="pl.490.29"></a><var>490.29</var>declaration of parentage, or the recognition of parentage.<br/>
<br/>
<a id="bill.12.22.0"></a><a id="pl.490.30"></a><var>490.30</var>    Sec. 22. <b>[144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.</b><br/>
<a id="pl.491.1"></a><var>491.1</var>(a) A vital record registered under sections 144.212 to 144.227 may be amended <br/>
<a id="pl.491.2"></a><var>491.2</var>or corrected only according to sections 144.212 to 144.227 and rules adopted by the <br/>
<a id="pl.491.3"></a><var>491.3</var>commissioner of health to protect the integrity and accuracy of vital records.<br/>
<a id="pl.491.4"></a><var>491.4</var>(b)(1) A vital record that is amended under this section shall indicate that it has been <br/>
<a id="pl.491.5"></a><var>491.5</var>amended, except as otherwise provided in this section or by rule.<br/>
<a id="pl.491.6"></a><var>491.6</var>(2) Electronic documentation shall be maintained by the state registrar that <br/>
<a id="pl.491.7"></a><var>491.7</var>identifies the evidence upon which the amendment or correction was based, the date <br/>
<a id="pl.491.8"></a><var>491.8</var>of the amendment or correction, and the identity of the authorized person making the <br/>
<a id="pl.491.9"></a><var>491.9</var>amendment or correction.<br/>
<a id="pl.491.10"></a><var>491.10</var>(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction <br/>
<a id="pl.491.11"></a><var>491.11</var>changing the name of a person whose birth is registered in Minnesota and upon request of <br/>
<a id="pl.491.12"></a><var>491.12</var>such person if 18 years of age or older or having the status of emancipated minor, the state <br/>
<a id="pl.491.13"></a><var>491.13</var>registrar shall amend the birth record to show the new name. If the person is a minor or <br/>
<a id="pl.491.14"></a><var>491.14</var>an incapacitated person then a parent, guardian, or legal representative of the minor or <br/>
<a id="pl.491.15"></a><var>491.15</var>incapacitated person may make the request.<br/>
<a id="pl.491.16"></a><var>491.16</var>(d) When an applicant does not submit the minimum documentation required for <br/>
<a id="pl.491.17"></a><var>491.17</var>amending a vital record or when the state registrar has cause to question the validity <br/>
<a id="pl.491.18"></a><var>491.18</var>or completeness of the applicant's statements or the documentary evidence, and the <br/>
<a id="pl.491.19"></a><var>491.19</var>deficiencies are not corrected, the state registrar shall not amend the vital record. The <br/>
<a id="pl.491.20"></a><var>491.20</var>state registrar shall advise the applicant of the reason for this action and shall further <br/>
<a id="pl.491.21"></a><var>491.21</var>advise the applicant of the right of appeal to a court with competent jurisdiction over <br/>
<a id="pl.491.22"></a><var>491.22</var>the Department of Health.<br/>
<br/>
<a id="bill.12.23.0"></a><a id="pl.491.23"></a><var>491.23</var>    Sec. 23. Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:<br/>
<a id="pl.491.24"></a><var>491.24</var>    Subdivision 1. <b>Public information; access to vital records.</b> Except as otherwise <br/>
<a id="pl.491.25"></a><var>491.25</var>provided for in this section and section 
         <statute_ref>144.2252</statute_ref>, information contained in vital records <br/>
<a id="pl.491.26"></a><var>491.26</var>shall be public information. Physical access to vital records shall be subject to the <br/>
<a id="pl.491.27"></a><var>491.27</var>supervision and regulation of the state and local registrars registrar and their employees <br/>
<a id="pl.491.28"></a><var>491.28</var>pursuant to rules promulgated by the commissioner in order to protect vital records from <br/>
<a id="pl.491.29"></a><var>491.29</var>loss, mutilation or destruction and to prevent improper disclosure of vital records which <br/>
<a id="pl.491.30"></a><var>491.30</var>are confidential or private data on individuals, as defined in section 
         <statute_ref>13.02</statute_ref>, subdivisions <br/>
<a id="pl.491.31"></a><var>491.31</var>3 and 12.<br/>
<br/>
<a id="bill.12.24.0"></a><a id="pl.491.32"></a><var>491.32</var>    Sec. 24. Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:<br/>
<a id="pl.491.33"></a><var>491.33</var>    Subd. 4. <b>Access to records for research purposes.</b> The state registrar may permit <br/>
<a id="pl.491.34"></a><var>491.34</var>persons performing medical research access to the information restricted in subdivision <br/>
<a id="pl.492.1"></a><var>492.1</var>2 or 2a if those persons agree in writing not to disclose private or confidential data on <br/>
<a id="pl.492.2"></a><var>492.2</var>individuals.<br/>
<br/>
<a id="bill.12.25.0"></a><a id="pl.492.3"></a><var>492.3</var>    Sec. 25. Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:<br/>
<a id="pl.492.4"></a><var>492.4</var>    Subd. 7. <b>Certified birth or death record.</b> (a) The state or local registrar or local <br/>
<a id="pl.492.5"></a><var>492.5</var>issuance office shall issue a certified birth or death record or a statement of no vital record <br/>
<a id="pl.492.6"></a><var>492.6</var>found to an individual upon the individual's proper completion of an attestation provided <br/>
<a id="pl.492.7"></a><var>492.7</var>by the commissioner and payment of the required fee:<br/>
<a id="pl.492.8"></a><var>492.8</var>    (1) to a person who has a tangible interest in the requested vital record. A person <br/>
<a id="pl.492.9"></a><var>492.9</var>who has a tangible interest is:<br/>
<a id="pl.492.10"></a><var>492.10</var>    (i) the subject of the vital record;<br/>
<a id="pl.492.11"></a><var>492.11</var>    (ii) a child of the subject;<br/>
<a id="pl.492.12"></a><var>492.12</var>    (iii) the spouse of the subject;<br/>
<a id="pl.492.13"></a><var>492.13</var>    (iv) a parent of the subject;<br/>
<a id="pl.492.14"></a><var>492.14</var>    (v) the grandparent or grandchild of the subject;<br/>
<a id="pl.492.15"></a><var>492.15</var>    (vi) if the requested record is a death record, a sibling of the subject;<br/>
<a id="pl.492.16"></a><var>492.16</var>    (vii) the party responsible for filing the vital record;<br/>
<a id="pl.492.17"></a><var>492.17</var>    (viii) the legal custodian, guardian or conservator, or health care agent of the subject;<br/>
<a id="pl.492.18"></a><var>492.18</var>    (ix) a personal representative, by sworn affidavit of the fact that the certified copy is <br/>
<a id="pl.492.19"></a><var>492.19</var>required for administration of the estate;<br/>
<a id="pl.492.20"></a><var>492.20</var>    (x) a successor of the subject, as defined in section 
         <statute_ref>524.1-201</statute_ref>, if the subject is <br/>
<a id="pl.492.21"></a><var>492.21</var>deceased, by sworn affidavit of the fact that the certified copy is required for administration <br/>
<a id="pl.492.22"></a><var>492.22</var>of the estate;<br/>
<a id="pl.492.23"></a><var>492.23</var>    (xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of <br/>
<a id="pl.492.24"></a><var>492.24</var>the fact that the certified copy is needed for the proper administration of the trust;<br/>
<a id="pl.492.25"></a><var>492.25</var>    (xii) a person or entity who demonstrates that a certified vital record is necessary for <br/>
<a id="pl.492.26"></a><var>492.26</var>the determination or protection of a personal or property right, pursuant to rules adopted <br/>
<a id="pl.492.27"></a><var>492.27</var>by the commissioner; or<br/>
<a id="pl.492.28"></a><var>492.28</var>    (xiii) adoption agencies in order to complete confidential postadoption searches as <br/>
<a id="pl.492.29"></a><var>492.29</var>required by section 
         <statute_ref>259.83</statute_ref>;<br/>
<a id="pl.492.30"></a><var>492.30</var>    (2) to any local, state, or federal governmental agency upon request if the certified <br/>
<a id="pl.492.31"></a><var>492.31</var>vital record is necessary for the governmental agency to perform its authorized duties. <br/>
<a id="pl.492.32"></a><var>492.32</var>An authorized governmental agency includes the Department of Human Services, the <br/>
<a id="pl.492.33"></a><var>492.33</var>Department of Revenue, and the United States Citizenship and Immigration Services;<br/>
<a id="pl.492.34"></a><var>492.34</var>    (3) to an attorney upon evidence of the attorney's license;<br/>
<a id="pl.493.1"></a><var>493.1</var>    (4) pursuant to a court order issued by a court of competent jurisdiction. For <br/>
<a id="pl.493.2"></a><var>493.2</var>purposes of this section, a subpoena does not constitute a court order; or<br/>
<a id="pl.493.3"></a><var>493.3</var>    (5) to a representative authorized by a person under clauses (1) to (4).<br/>
<a id="pl.493.4"></a><var>493.4</var>    (b) The state or local registrar or local issuance office shall also issue a certified <br/>
<a id="pl.493.5"></a><var>493.5</var>death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if, <br/>
<a id="pl.493.6"></a><var>493.6</var>on behalf of the individual, a licensed mortician furnishes the registrar with a properly <br/>
<a id="pl.493.7"></a><var>493.7</var>completed attestation in the form provided by the commissioner within 180 days of the <br/>
<a id="pl.493.8"></a><var>493.8</var>time of death of the subject of the death record. This paragraph is not subject to the <br/>
<a id="pl.493.9"></a><var>493.9</var>requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.<br/>
<br/>
<a id="bill.12.26.0"></a><a id="pl.493.10"></a><var>493.10</var>    Sec. 26. Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:<br/>
<a id="pl.493.11"></a><var>493.11</var>    Subd. 8. <b>Standardized format for certified birth and death records.</b> No later than <br/>
<a id="pl.493.12"></a><var>493.12</var>July 1, 2000, The commissioner shall develop maintain a standardized format for certified <br/>
<a id="pl.493.13"></a><var>493.13</var>birth records and death records issued by the state and local registrars registrar and local <br/>
<a id="pl.493.14"></a><var>493.14</var>issuance offices. The format shall incorporate security features in accordance with this <br/>
<a id="pl.493.15"></a><var>493.15</var>section. The standardized format must be implemented on a statewide basis by July 1, 2001.<br/>
<br/>
<a id="bill.12.27.0"></a><a id="pl.493.16"></a><var>493.16</var>    Sec. 27. Minnesota Statutes 2012, section 144.226, is amended to read:<br/>
<a id="pl.493.17"></a><var>493.17</var><b>144.226 FEES.</b><br/>
<a id="pl.493.18"></a><var>493.18</var>    Subdivision 1. <b>Which services are for fee.</b> The fees for the following services shall <br/>
<a id="pl.493.19"></a><var>493.19</var>be the following or an amount prescribed by rule of the commissioner:<br/>
<a id="pl.493.20"></a><var>493.20</var>(a) The fee for the issuance of administrative review and processing of a request for<br/>
<a id="pl.493.21"></a><var>493.21</var> a certified vital record or a certification that the vital record cannot be found is $9. No <br/>
<a id="pl.493.22"></a><var>493.22</var>fee shall be charged for a certified birth, stillbirth, or death record that is reissued within <br/>
<a id="pl.493.23"></a><var>493.23</var>one year of the original issue, if an amendment is made to the vital record and if the <br/>
<a id="pl.493.24"></a><var>493.24</var>previously issued vital record is surrendered. The fee is payable at the time of application <br/>
<a id="pl.493.25"></a><var>493.25</var>and is nonrefundable.<br/>
<a id="pl.493.26"></a><var>493.26</var>(b) The fee for processing a request for the replacement of a birth record for <br/>
<a id="pl.493.27"></a><var>493.27</var>all events, except when filing a recognition of parentage pursuant to section 
         <statute_ref>257.73, <br/>
<a id="pl.493.28"></a><var>493.28</var>subdivision 1
         </statute_ref>, is $40. The fee is payable at the time of application and is nonrefundable.<br/>
<a id="pl.493.29"></a><var>493.29</var>(c) The fee for administrative review and processing of a request for the filing of a <br/>
<a id="pl.493.30"></a><var>493.30</var>delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of <br/>
<a id="pl.493.31"></a><var>493.31</var>application and is nonrefundable. This fee includes one subsequent review of the request <br/>
<a id="pl.493.32"></a><var>493.32</var>if the request is not acceptable upon the initial receipt.<br/>
<a id="pl.493.33"></a><var>493.33</var>(d) The fee for administrative review and processing of a request for the amendment <br/>
<a id="pl.493.34"></a><var>493.34</var>of any vital record when requested more than 45 days after the filing of the vital record is <br/>
<a id="pl.494.1"></a><var>494.1</var>$40. No fee shall be charged for an amendment requested within 45 days after the filing <br/>
<a id="pl.494.2"></a><var>494.2</var>of the vital record. The fee is payable at the time of application and is nonrefundable. <br/>
<a id="pl.494.3"></a><var>494.3</var>This fee includes one subsequent review of the request if the request is not acceptable <br/>
<a id="pl.494.4"></a><var>494.4</var>upon the initial receipt.<br/>
<a id="pl.494.5"></a><var>494.5</var>(e) The fee for administrative review and processing of a request for the verification <br/>
<a id="pl.494.6"></a><var>494.6</var>of information from vital records is $9 when the applicant furnishes the specific <br/>
<a id="pl.494.7"></a><var>494.7</var>information to locate the vital record. When the applicant does not furnish specific <br/>
<a id="pl.494.8"></a><var>494.8</var>information, the fee is $20 per hour for staff time expended. Specific information includes <br/>
<a id="pl.494.9"></a><var>494.9</var>the correct date of the event and the correct name of the registrant subject of the record. <br/>
<a id="pl.494.10"></a><var>494.10</var>Fees charged shall approximate the costs incurred in searching and copying the vital <br/>
<a id="pl.494.11"></a><var>494.11</var>records. The fee is payable at the time of application and is nonrefundable.<br/>
<a id="pl.494.12"></a><var>494.12</var>(f) The fee for administrative review and processing of a request for the issuance <br/>
<a id="pl.494.13"></a><var>494.13</var>of a copy of any document on file pertaining to a vital record or statement that a related <br/>
<a id="pl.494.14"></a><var>494.14</var>document cannot be found is $9. The fee is payable at the time of application and is <br/>
<a id="pl.494.15"></a><var>494.15</var>nonrefundable.<br/>
<a id="pl.494.16"></a><var>494.16</var>    Subd. 2. <b>Fees to state government special revenue fund.</b> Fees collected under <br/>
<a id="pl.494.17"></a><var>494.17</var>this section by the state registrar shall be deposited in the state treasury and credited to <br/>
<a id="pl.494.18"></a><var>494.18</var>the state government special revenue fund.<br/>
<a id="pl.494.19"></a><var>494.19</var>    Subd. 3. <b>Birth record surcharge.</b> (a) In addition to any fee prescribed under <br/>
<a id="pl.494.20"></a><var>494.20</var>subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or <br/>
<a id="pl.494.21"></a><var>494.21</var>stillbirth record and for a certification that the vital record cannot be found. The local or<br/>
<a id="pl.494.22"></a><var>494.22</var> state registrar or local issuance office shall forward this amount to the commissioner of <br/>
<a id="pl.494.23"></a><var>494.23</var>management and budget for deposit into the account for the children's trust fund for the <br/>
<a id="pl.494.24"></a><var>494.24</var>prevention of child abuse established under section 
         <statute_ref>256E.22</statute_ref>. This surcharge shall not be <br/>
<a id="pl.494.25"></a><var>494.25</var>charged under those circumstances in which no fee for a certified birth or stillbirth record <br/>
<a id="pl.494.26"></a><var>494.26</var>is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of <br/>
<a id="pl.494.27"></a><var>494.27</var>management and budget that the assets in that fund exceed $20,000,000, this surcharge <br/>
<a id="pl.494.28"></a><var>494.28</var>shall be discontinued.<br/>
<a id="pl.494.29"></a><var>494.29</var>(b) In addition to any fee prescribed under subdivision 1, there shall be a <br/>
<a id="pl.494.30"></a><var>494.30</var>nonrefundable surcharge of $10 for each certified birth record. The local or state registrar <br/>
<a id="pl.494.31"></a><var>494.31</var>or local issuance office shall forward this amount to the commissioner of management and <br/>
<a id="pl.494.32"></a><var>494.32</var>budget for deposit in the general fund. This surcharge shall not be charged under those <br/>
<a id="pl.494.33"></a><var>494.33</var>circumstances in which no fee for a certified birth record is permitted under subdivision 1, <br/>
<a id="pl.494.34"></a><var>494.34</var>paragraph (a).<br/>
<a id="pl.494.35"></a><var>494.35</var>    Subd. 4. <b>Vital records surcharge.</b> (a) In addition to any fee prescribed under <br/>
<a id="pl.494.36"></a><var>494.36</var>subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and <br/>
<a id="pl.495.1"></a><var>495.1</var>noncertified birth, stillbirth, or death record, and for a certification that the record cannot <br/>
<a id="pl.495.2"></a><var>495.2</var>be found. The local issuance office or state registrar shall forward this amount to the <br/>
<a id="pl.495.3"></a><var>495.3</var>commissioner of management and budget to be deposited into the state government special <br/>
<a id="pl.495.4"></a><var>495.4</var>revenue fund. This surcharge shall not be charged under those circumstances in which no <br/>
<a id="pl.495.5"></a><var>495.5</var>fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).<br/>
<a id="pl.495.6"></a><var>495.6</var>(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.<br/>
<a id="pl.495.7"></a><var>495.7</var>    Subd. 5. <b>Electronic verification.</b> A fee for the electronic verification or electronic <br/>
<a id="pl.495.8"></a><var>495.8</var>certification of a vital event, when the information being verified or certified is obtained <br/>
<a id="pl.495.9"></a><var>495.9</var>from a certified birth or death record, shall be established through contractual or <br/>
<a id="pl.495.10"></a><var>495.10</var>interagency agreements with interested local, state, or federal government agencies.<br/>
<a id="pl.495.11"></a><var>495.11</var>    Subd. 6. <b>Alternative payment methods.</b> Notwithstanding subdivision 1, alternative <br/>
<a id="pl.495.12"></a><var>495.12</var>payment methods may be approved and implemented by the state registrar or a local <br/>
<a id="pl.495.13"></a><var>495.13</var>registrar issuance office.<br/>
<br/>
<a id="bill.12.28.0"></a><a id="pl.495.14"></a><var>495.14</var>    Sec. 28. <b>[144.492] DEFINITIONS.</b><br/>
<a id="pl.495.15"></a><var>495.15</var>    Subdivision 1. <b>Applicability.</b> For the purposes of sections 144.492 to 144.494, the <br/>
<a id="pl.495.16"></a><var>495.16</var>terms defined in this section have the meanings given them.<br/>
<a id="pl.495.17"></a><var>495.17</var>    Subd. 2. <b>Commissioner.</b> "Commissioner" means the commissioner of health.<br/>
<a id="pl.495.18"></a><var>495.18</var>    Subd. 3. <b>Joint commission.</b> "Joint commission" means the independent, <br/>
<a id="pl.495.19"></a><var>495.19</var>not-for-profit organization that accredits and certifies health care organizations and <br/>
<a id="pl.495.20"></a><var>495.20</var>programs in the United States.<br/>
<a id="pl.495.21"></a><var>495.21</var>    Subd. 4. <b>Stroke.</b> "Stroke" means the sudden death of brain cells in a localized <br/>
<a id="pl.495.22"></a><var>495.22</var>area due to inadequate blood flow.<br/>
<br/>
<a id="bill.12.29.0"></a><a id="pl.495.23"></a><var>495.23</var>    Sec. 29. <b>[144.493] CRITERIA.</b><br/>
<a id="pl.495.24"></a><var>495.24</var>    Subdivision 1. <b>Comprehensive stroke center.</b> A hospital meets the criteria for a <br/>
<a id="pl.495.25"></a><var>495.25</var>comprehensive stroke center if the hospital has been certified as a comprehensive stroke <br/>
<a id="pl.495.26"></a><var>495.26</var>center by the joint commission or another nationally recognized accreditation entity.<br/>
<a id="pl.495.27"></a><var>495.27</var>    Subd. 2. <b>Primary stroke center.</b> A hospital meets the criteria for a primary stroke <br/>
<a id="pl.495.28"></a><var>495.28</var>center if the hospital has been certified as a primary stroke center by the joint commission <br/>
<a id="pl.495.29"></a><var>495.29</var>or another nationally recognized accreditation entity.<br/>
<a id="pl.495.30"></a><var>495.30</var>    Subd. 3. <b>Acute stroke ready hospital.</b> A hospital meets the criteria for an acute <br/>
<a id="pl.495.31"></a><var>495.31</var>stroke ready hospital if the hospital has the following elements of an acute stroke ready <br/>
<a id="pl.495.32"></a><var>495.32</var>hospital:<br/>
<a id="pl.495.33"></a><var>495.33</var>(1) an acute stroke team available or on-call 24 hours a days, seven days a week;<br/>
<a id="pl.496.1"></a><var>496.1</var>(2) written stroke protocols, including triage, stabilization of vital functions, initial <br/>
<a id="pl.496.2"></a><var>496.2</var>diagnostic tests, and use of medications;<br/>
<a id="pl.496.3"></a><var>496.3</var>(3) a written plan and letter of cooperation with emergency medical services regarding <br/>
<a id="pl.496.4"></a><var>496.4</var>triage and communication that are consistent with regional patient care procedures;<br/>
<a id="pl.496.5"></a><var>496.5</var>(4) emergency department personnel who are trained in diagnosing and treating <br/>
<a id="pl.496.6"></a><var>496.6</var>acute stroke;<br/>
<a id="pl.496.7"></a><var>496.7</var>(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest <br/>
<a id="pl.496.8"></a><var>496.8</var>x-rays 24 hours a day, seven days a week;<br/>
<a id="pl.496.9"></a><var>496.9</var>(6) the capacity to perform and interpret brain injury imaging studies 24 hours a <br/>
<a id="pl.496.10"></a><var>496.10</var>days, seven days a week;<br/>
<a id="pl.496.11"></a><var>496.11</var>(7) written protocols that detail available emergent therapies and reflect current <br/>
<a id="pl.496.12"></a><var>496.12</var>treatment guidelines, which include performance measures and are revised at least annually;<br/>
<a id="pl.496.13"></a><var>496.13</var>(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;<br/>
<a id="pl.496.14"></a><var>496.14</var>(9) transfer protocols and agreements for stroke patients; and<br/>
<a id="pl.496.15"></a><var>496.15</var>(10) a designated medical director with experience and expertise in acute stroke care.<br/>
<br/>
<a id="bill.12.30.0"></a><a id="pl.496.16"></a><var>496.16</var>    Sec. 30. <b>[144.494] DESIGNATING STROKE HOSPITALS.</b><br/>
<a id="pl.496.17"></a><var>496.17</var>    Subdivision 1. <b>Naming privileges.</b> Unless it has been designated a stroke hospital <br/>
<a id="pl.496.18"></a><var>496.18</var>by the commissioner, the joint commission, or another nationally recognized accreditation <br/>
<a id="pl.496.19"></a><var>496.19</var>entity, no hospital shall use the term "stroke center" or "stroke hospital" in its name or its <br/>
<a id="pl.496.20"></a><var>496.20</var>advertising or shall otherwise indicate it has stroke treatment capabilities.<br/>
<a id="pl.496.21"></a><var>496.21</var>    Subd. 2. <b>Designation.</b> A hospital that voluntarily meets the criteria for a <br/>
<a id="pl.496.22"></a><var>496.22</var>comprehensive stroke center, primary stroke center, or acute stroke ready hospital may <br/>
<a id="pl.496.23"></a><var>496.23</var>apply to the commissioner for designation, and upon the commissioner's review and <br/>
<a id="pl.496.24"></a><var>496.24</var>approval of the application, shall be designated as a comprehensive stroke center, a <br/>
<a id="pl.496.25"></a><var>496.25</var>primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital <br/>
<a id="pl.496.26"></a><var>496.26</var>loses its certification as a comprehensive stroke center or primary stroke center from <br/>
<a id="pl.496.27"></a><var>496.27</var>the joint commission or other nationally recognized accreditation entity, its Minnesota <br/>
<a id="pl.496.28"></a><var>496.28</var>designation will be immediately withdrawn. Prior to the expiration of the three-year <br/>
<a id="pl.496.29"></a><var>496.29</var>designation, a hospital seeking to remain part of the voluntary acute stroke system may <br/>
<a id="pl.496.30"></a><var>496.30</var>reapply to the commissioner for designation.<br/>
<br/>
<a id="bill.12.31.0"></a><a id="pl.496.31"></a><var>496.31</var>    Sec. 31. <b>[144.554] HEALTH FACILITIES CONSTRUCTION PLAN </b><br/>
<a id="pl.496.32"></a><var>496.32</var><b>SUBMITTAL AND FEES.</b><br/>
<a id="pl.496.33"></a><var>496.33</var>For hospitals, nursing homes, boarding care homes, residential hospices, supervised <br/>
<a id="pl.496.34"></a><var>496.34</var>living facilities, freestanding outpatient surgical centers, and end-stage renal disease <br/>
<a id="pl.497.1"></a><var>497.1</var>facilities, the commissioner shall collect a fee for the review and approval of architectural, <br/>
<a id="pl.497.2"></a><var>497.2</var>mechanical, and electrical plans and specifications submitted before construction begins <br/>
<a id="pl.497.3"></a><var>497.3</var>for each project relative to construction of new buildings, additions to existing buildings, <br/>
<a id="pl.497.4"></a><var>497.4</var>or for remodeling or alterations of existing buildings. All fees collected in this section <br/>
<a id="pl.497.5"></a><var>497.5</var>shall be deposited in the state treasury and credited to the state government special revenue <br/>
<a id="pl.497.6"></a><var>497.6</var>fund. Fees must be paid at the time of submission of final plans for review and are not <br/>
<a id="pl.497.7"></a><var>497.7</var>refundable. The fee is calculated as follows:<br/>
<table>
<col width="50px"/>
<col width=""/>
<col width=""/>
<tr>
<td><a id="pl.497.8"></a><var>497.8</var><br/>
</td>
<td align="right">Construction project total estimated cost<br/>
</td>
<td align="right">Fee<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.9"></a><var>497.9</var><br/>
</td>
<td align="right">$0 - $10,000<br/>
</td>
<td align="right">$30<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.10"></a><var>497.10</var><br/>
</td>
<td align="right">$10,001 - $50,000<br/>
</td>
<td align="right">$150<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.11"></a><var>497.11</var><br/>
</td>
<td align="right">$50,001 - $100,000<br/>
</td>
<td align="right">$300<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.12"></a><var>497.12</var><br/>
</td>
<td align="right">$100,001 - $150,000<br/>
</td>
<td align="right">$450<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.13"></a><var>497.13</var><br/>
</td>
<td align="right">$150,001 - $200,000<br/>
</td>
<td align="right">$600<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.14"></a><var>497.14</var><br/>
</td>
<td align="right">$200,001 - $250,000<br/>
</td>
<td align="right">$750<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.15"></a><var>497.15</var><br/>
</td>
<td align="right">$250,001 - $300,000<br/>
</td>
<td align="right">$900<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.16"></a><var>497.16</var><br/>
</td>
<td align="right">$300,001 - $350,000<br/>
</td>
<td align="right">$1,050<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.17"></a><var>497.17</var><br/>
</td>
<td align="right">$350,001 - $400,000<br/>
</td>
<td align="right">$1,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.18"></a><var>497.18</var><br/>
</td>
<td align="right">$400,001 - $450,000<br/>
</td>
<td align="right">$1,350<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.19"></a><var>497.19</var><br/>
</td>
<td align="right">$450,001 - $500,000<br/>
</td>
<td align="right">$1,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.20"></a><var>497.20</var><br/>
</td>
<td align="right">$500,001 - $550,000<br/>
</td>
<td align="right">$1,650<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.21"></a><var>497.21</var><br/>
</td>
<td align="right">$550,001 - $600,000<br/>
</td>
<td align="right">$1,800<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.22"></a><var>497.22</var><br/>
</td>
<td align="right">$600,001 - $650,000<br/>
</td>
<td align="right">$1,950<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.23"></a><var>497.23</var><br/>
</td>
<td align="right">$650,001 - $700,000<br/>
</td>
<td align="right">$2,100<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.24"></a><var>497.24</var><br/>
</td>
<td align="right">$700,001 - $750,000<br/>
</td>
<td align="right">$2,250<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.25"></a><var>497.25</var><br/>
</td>
<td align="right">$750,001 - $800,000<br/>
</td>
<td align="right">$2,400<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.26"></a><var>497.26</var><br/>
</td>
<td align="right">$800,001 - $850,000<br/>
</td>
<td align="right">$2,550<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.27"></a><var>497.27</var><br/>
</td>
<td align="right">$850,001 - $900,000<br/>
</td>
<td align="right">$2,700<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.28"></a><var>497.28</var><br/>
</td>
<td align="right">$900,001 - $950,000<br/>
</td>
<td align="right">$2,850<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.29"></a><var>497.29</var><br/>
</td>
<td align="right">$950,001 - $1,000,000<br/>
</td>
<td align="right">$3,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.30"></a><var>497.30</var><br/>
</td>
<td align="right">$1,000,001 - $1,050,000<br/>
</td>
<td align="right">$3,150<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.31"></a><var>497.31</var><br/>
</td>
<td align="right">$1,050,001 - $1,100,000<br/>
</td>
<td align="right">$3,300<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.32"></a><var>497.32</var><br/>
</td>
<td align="right">$1,100,001 - $1,150,000<br/>
</td>
<td align="right">$3,450<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.33"></a><var>497.33</var><br/>
</td>
<td align="right">$1,150,001 - $1,200,000<br/>
</td>
<td align="right">$3,600<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.34"></a><var>497.34</var><br/>
</td>
<td align="right">$1,200,001 - $1,250,000<br/>
</td>
<td align="right">$3,750<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.35"></a><var>497.35</var><br/>
</td>
<td align="right">$1,250,001 - $1,300,000<br/>
</td>
<td align="right">$3,900<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.36"></a><var>497.36</var><br/>
</td>
<td align="right">$1,300,001 - $1,350,000<br/>
</td>
<td align="right">$4,050<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.37"></a><var>497.37</var><br/>
</td>
<td align="right">$1,350,001 - $1,400,000<br/>
</td>
<td align="right">$4,200<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.38"></a><var>497.38</var><br/>
</td>
<td align="right">$1,400,001 - $1,450,000<br/>
</td>
<td align="right">$4,350<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.39"></a><var>497.39</var><br/>
</td>
<td align="right">$1,450,001 - $1,500,000<br/>
</td>
<td align="right">$4,500<br/>
</td>
</tr>
<tr>
<td><a id="pl.497.40"></a><var>497.40</var><br/>
</td>
<td align="right">$1,500,001 and over<br/>
</td>
<td align="right">$4,800<br/>
</td>
</tr>
</table><br/>
<a id="bill.12.32.0"></a><a id="pl.497.41"></a><var>497.41</var>    Sec. 32. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:<br/>
<a id="pl.498.1"></a><var>498.1</var>    Subd. 2. <b>Newborn Hearing Screening Advisory Committee.</b> (a) The <br/>
<a id="pl.498.2"></a><var>498.2</var>commissioner of health shall establish a Newborn Hearing Screening Advisory Committee <br/>
<a id="pl.498.3"></a><var>498.3</var>to advise and assist the Department of Health and the Department of Education in:<br/>
<a id="pl.498.4"></a><var>498.4</var>    (1) developing protocols and timelines for screening, rescreening, and diagnostic <br/>
<a id="pl.498.5"></a><var>498.5</var>audiological assessment and early medical, audiological, and educational intervention <br/>
<a id="pl.498.6"></a><var>498.6</var>services for children who are deaf or hard-of-hearing;<br/>
<a id="pl.498.7"></a><var>498.7</var>    (2) designing protocols for tracking children from birth through age three that may <br/>
<a id="pl.498.8"></a><var>498.8</var>have passed newborn screening but are at risk for delayed or late onset of permanent <br/>
<a id="pl.498.9"></a><var>498.9</var>hearing loss;<br/>
<a id="pl.498.10"></a><var>498.10</var>    (3) designing a technical assistance program to support facilities implementing the <br/>
<a id="pl.498.11"></a><var>498.11</var>screening program and facilities conducting rescreening and diagnostic audiological <br/>
<a id="pl.498.12"></a><var>498.12</var>assessment;<br/>
<a id="pl.498.13"></a><var>498.13</var>    (4) designing implementation and evaluation of a system of follow-up and tracking; <br/>
<a id="pl.498.14"></a><var>498.14</var>and<br/>
<a id="pl.498.15"></a><var>498.15</var>    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure <br/>
<a id="pl.498.16"></a><var>498.16</var>culturally appropriate services for children with a confirmed hearing loss and their families.<br/>
<a id="pl.498.17"></a><var>498.17</var>    (b) The commissioner of health shall appoint at least one member from each of the <br/>
<a id="pl.498.18"></a><var>498.18</var>following groups with no less than two of the members being deaf or hard-of-hearing:<br/>
<a id="pl.498.19"></a><var>498.19</var>    (1) a representative from a consumer organization representing culturally deaf <br/>
<a id="pl.498.20"></a><var>498.20</var>persons;<br/>
<a id="pl.498.21"></a><var>498.21</var>    (2) a parent with a child with hearing loss representing a parent organization;<br/>
<a id="pl.498.22"></a><var>498.22</var>    (3) a consumer from an organization representing oral communication options;<br/>
<a id="pl.498.23"></a><var>498.23</var>    (4) a consumer from an organization representing cued speech communication <br/>
<a id="pl.498.24"></a><var>498.24</var>options;<br/>
<a id="pl.498.25"></a><var>498.25</var>    (5) an audiologist who has experience in evaluation and intervention of infants <br/>
<a id="pl.498.26"></a><var>498.26</var>and young children;<br/>
<a id="pl.498.27"></a><var>498.27</var>    (6) a speech-language pathologist who has experience in evaluation and intervention <br/>
<a id="pl.498.28"></a><var>498.28</var>of infants and young children;<br/>
<a id="pl.498.29"></a><var>498.29</var>    (7) two primary care providers who have experience in the care of infants and young <br/>
<a id="pl.498.30"></a><var>498.30</var>children, one of which shall be a pediatrician;<br/>
<a id="pl.498.31"></a><var>498.31</var>    (8) a representative from the early hearing detection intervention teams;<br/>
<a id="pl.498.32"></a><var>498.32</var>    (9) a representative from the Department of Education resource center for the deaf <br/>
<a id="pl.498.33"></a><var>498.33</var>and hard-of-hearing or the representative's designee;<br/>
<a id="pl.498.34"></a><var>498.34</var>    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing <br/>
<a id="pl.498.35"></a><var>498.35</var>Minnesotans;<br/>
<a id="pl.499.1"></a><var>499.1</var>    (11) a representative from the Department of Human Services Deaf and <br/>
<a id="pl.499.2"></a><var>499.2</var>Hard-of-Hearing Services Division;<br/>
<a id="pl.499.3"></a><var>499.3</var>    (12) one or more of the Part C coordinators from the Department of Education, the <br/>
<a id="pl.499.4"></a><var>499.4</var>Department of Health, or the Department of Human Services or the department's designees;<br/>
<a id="pl.499.5"></a><var>499.5</var>    (13) the Department of Health early hearing detection and intervention coordinators;<br/>
<a id="pl.499.6"></a><var>499.6</var>    (14) two birth hospital representatives from one rural and one urban hospital;<br/>
<a id="pl.499.7"></a><var>499.7</var>    (15) a pediatric geneticist;<br/>
<a id="pl.499.8"></a><var>499.8</var>    (16) an otolaryngologist;<br/>
<a id="pl.499.9"></a><var>499.9</var>    (17) a representative from the Newborn Screening Advisory Committee under <br/>
<a id="pl.499.10"></a><var>499.10</var>this subdivision; and<br/>
<a id="pl.499.11"></a><var>499.11</var>    (18) a representative of the Department of Education regional low-incidence <br/>
<a id="pl.499.12"></a><var>499.12</var>facilitators.<br/>
<a id="pl.499.13"></a><var>499.13</var>The commissioner must complete the appointments required under this subdivision by <br/>
<a id="pl.499.14"></a><var>499.14</var>September 1, 2007.<br/>
<a id="pl.499.15"></a><var>499.15</var>    (c) The Department of Health member shall chair the first meeting of the committee. <br/>
<a id="pl.499.16"></a><var>499.16</var>At the first meeting, the committee shall elect a chair from its membership. The committee <br/>
<a id="pl.499.17"></a><var>499.17</var>shall meet at the call of the chair, at least four times a year. The committee shall adopt <br/>
<a id="pl.499.18"></a><var>499.18</var>written bylaws to govern its activities. The Department of Health shall provide technical <br/>
<a id="pl.499.19"></a><var>499.19</var>and administrative support services as required by the committee. These services shall <br/>
<a id="pl.499.20"></a><var>499.20</var>include technical support from individuals qualified to administer infant hearing screening, <br/>
<a id="pl.499.21"></a><var>499.21</var>rescreening, and diagnostic audiological assessments.<br/>
<a id="pl.499.22"></a><var>499.22</var>    Members of the committee shall receive no compensation for their service, but <br/>
<a id="pl.499.23"></a><var>499.23</var>shall be reimbursed as provided in section 
         <statute_ref>15.059</statute_ref> for expenses incurred as a result of <br/>
<a id="pl.499.24"></a><var>499.24</var>their duties as members of the committee.<br/>
<a id="pl.499.25"></a><var>499.25</var>    (d) This subdivision expires June 30, 2013 2019.<br/>
<br/>
<a id="bill.12.33.0"></a><a id="pl.499.26"></a><var>499.26</var>    Sec. 33. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:<br/>
<a id="pl.499.27"></a><var>499.27</var>    Subd. 3a. <b>Support services to families.</b> (a) The commissioner shall contract with a <br/>
<a id="pl.499.28"></a><var>499.28</var>nonprofit organization to provide support and assistance to families with children who are <br/>
<a id="pl.499.29"></a><var>499.29</var>deaf or have a hearing loss. The family support provided must include:<br/>
<a id="pl.499.30"></a><var>499.30</var>    (1) direct hearing loss specific parent-to-parent assistance and unbiased information <br/>
<a id="pl.499.31"></a><var>499.31</var>on communication, educational, and medical options; and<br/>
<a id="pl.499.32"></a><var>499.32</var>    (2) individualized deaf or hard-of-hearing mentors who provide education, including <br/>
<a id="pl.499.33"></a><var>499.33</var>instruction in American Sign Language as an available option. <br/>
<a id="pl.499.34"></a><var>499.34</var>The commissioner shall give preference to a nonprofit organization that has the ability to <br/>
<a id="pl.499.35"></a><var>499.35</var>provide these services throughout the state.<br/>
<a id="pl.500.1"></a><var>500.1</var>    (b) Family participation in the support and assistance services is voluntary.<br/>
<br/>
<a id="bill.12.34.0"></a><a id="pl.500.2"></a><var>500.2</var>    Sec. 34. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:<br/>
<a id="pl.500.3"></a><var>500.3</var>    Subd. 3. <b>Annual fees.</b> (a) An application for accreditation under subdivision 6 must <br/>
<a id="pl.500.4"></a><var>500.4</var>be accompanied by the annual fees specified in this subdivision. The annual fees include:<br/>
<a id="pl.500.5"></a><var>500.5</var>(1) base accreditation fee, $1,500 $600;<br/>
<a id="pl.500.6"></a><var>500.6</var>(2) sample preparation techniques fee, $200 per technique;<br/>
<a id="pl.500.7"></a><var>500.7</var>(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and<br/>
<a id="pl.500.8"></a><var>500.8</var>(4) test category fees.<br/>
<a id="pl.500.9"></a><var>500.9</var>(b) For the programs in subdivision 3a, the commissioner may accredit laboratories <br/>
<a id="pl.500.10"></a><var>500.10</var>for fields of testing under the categories listed in clauses (1) to (10) upon completion of <br/>
<a id="pl.500.11"></a><var>500.11</var>the application requirements provided by subdivision 6 and receipt of the fees for each <br/>
<a id="pl.500.12"></a><var>500.12</var>category under each program that accreditation is requested. The categories offered and <br/>
<a id="pl.500.13"></a><var>500.13</var>related fees include:<br/>
<a id="pl.500.14"></a><var>500.14</var>(1) microbiology, $450 $200;<br/>
<a id="pl.500.15"></a><var>500.15</var>(2) inorganics, $450 $200;<br/>
<a id="pl.500.16"></a><var>500.16</var>(3) metals, $1,000 $500;<br/>
<a id="pl.500.17"></a><var>500.17</var>(4) volatile organics, $1,300 $1,000;<br/>
<a id="pl.500.18"></a><var>500.18</var>(5) other organics, $1,300 $1,000;<br/>
<a id="pl.500.19"></a><var>500.19</var>(6) radiochemistry, $1,500 $750;<br/>
<a id="pl.500.20"></a><var>500.20</var>(7) emerging contaminants, $1,500 $1,000;<br/>
<a id="pl.500.21"></a><var>500.21</var>(8) agricultural contaminants, $1,250 $1,000;<br/>
<a id="pl.500.22"></a><var>500.22</var>(9) toxicity (bioassay), $1,000 $500; and<br/>
<a id="pl.500.23"></a><var>500.23</var>(10) physical characterization, $250.<br/>
<a id="pl.500.24"></a><var>500.24</var>(c) The total annual fee includes the base fee, the sample preparation techniques <br/>
<a id="pl.500.25"></a><var>500.25</var>fees, the test category fees per program, and, when applicable, an administrative fee for <br/>
<a id="pl.500.26"></a><var>500.26</var>out-of-state laboratories.<br/>
<a id="pl.500.27"></a><var>500.27</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.12.35.0"></a><a id="pl.500.28"></a><var>500.28</var>    Sec. 35. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:<br/>
<a id="pl.500.29"></a><var>500.29</var>    Subd. 5. <b>State government special revenue fund.</b> Fees collected by the <br/>
<a id="pl.500.30"></a><var>500.30</var>commissioner under this section must be deposited in the state treasury and credited to <br/>
<a id="pl.500.31"></a><var>500.31</var>the state government special revenue fund.<br/>
<a id="pl.500.32"></a><var>500.32</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.12.36.0"></a><a id="pl.501.1"></a><var>501.1</var>    Sec. 36. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.501.2"></a><var>501.2</var>to read:<br/>
<a id="pl.501.3"></a><var>501.3</var>    Subd. 10. <b>Establishing a selection committee.</b> (a) The commissioner shall <br/>
<a id="pl.501.4"></a><var>501.4</var>establish a selection committee for the purpose of recommending approval of qualified <br/>
<a id="pl.501.5"></a><var>501.5</var>laboratory assessors and assessment bodies. Committee members shall demonstrate <br/>
<a id="pl.501.6"></a><var>501.6</var>competence in assessment practices. The committee shall initially consist of seven <br/>
<a id="pl.501.7"></a><var>501.7</var>members appointed by the commissioner as follows:<br/>
<a id="pl.501.8"></a><var>501.8</var>(1) one member from a municipal laboratory accredited by the commissioner;<br/>
<a id="pl.501.9"></a><var>501.9</var>(2) one member from an industrial treatment laboratory accredited by the <br/>
<a id="pl.501.10"></a><var>501.10</var>commissioner;<br/>
<a id="pl.501.11"></a><var>501.11</var>(3) one member from a commercial laboratory located in this state and accredited by <br/>
<a id="pl.501.12"></a><var>501.12</var>the commissioner;<br/>
<a id="pl.501.13"></a><var>501.13</var>(4) one member from a commercial laboratory located outside the state and <br/>
<a id="pl.501.14"></a><var>501.14</var>accredited by the commissioner;<br/>
<a id="pl.501.15"></a><var>501.15</var>(5) one member from a nongovernmental client of environmental laboratories;<br/>
<a id="pl.501.16"></a><var>501.16</var>(6) one member from a professional organization with a demonstrated interest in <br/>
<a id="pl.501.17"></a><var>501.17</var>environmental laboratory data and accreditation; and<br/>
<a id="pl.501.18"></a><var>501.18</var>(7) one employee of the laboratory accreditation program administered by the <br/>
<a id="pl.501.19"></a><var>501.19</var>department.<br/>
<a id="pl.501.20"></a><var>501.20</var>(b) Committee appointments begin on January 1 and end on December 31 of the <br/>
<a id="pl.501.21"></a><var>501.21</var>same year.<br/>
<a id="pl.501.22"></a><var>501.22</var>(c) The commissioner shall appoint persons to fill vacant committee positions, <br/>
<a id="pl.501.23"></a><var>501.23</var>expand the total number of appointed positions, or change the designated positions upon <br/>
<a id="pl.501.24"></a><var>501.24</var>the advice of the committee.<br/>
<a id="pl.501.25"></a><var>501.25</var>(d) The commissioner shall rescind the appointment of a selection committee <br/>
<a id="pl.501.26"></a><var>501.26</var>member for sufficient cause as the commissioner determines, such as:<br/>
<a id="pl.501.27"></a><var>501.27</var>(1) neglect of duty;<br/>
<a id="pl.501.28"></a><var>501.28</var>(2) failure to notify the commissioner of a real or perceived conflict of interest;<br/>
<a id="pl.501.29"></a><var>501.29</var>(3) nonconformance with committee procedures;<br/>
<a id="pl.501.30"></a><var>501.30</var>(4) failure to demonstrate competence in assessment practices; or<br/>
<a id="pl.501.31"></a><var>501.31</var>(5) official misconduct.<br/>
<a id="pl.501.32"></a><var>501.32</var>(e) Members of the selection committee shall be compensated according to the <br/>
<a id="pl.501.33"></a><var>501.33</var>provisions in section 15.059, subdivision 3.<br/>
<br/>
<a id="bill.12.37.0"></a><a id="pl.501.34"></a><var>501.34</var>    Sec. 37. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.501.35"></a><var>501.35</var>to read:<br/>
<a id="pl.502.1"></a><var>502.1</var>    Subd. 11. <b>Activities of the selection committee.</b> (a) The selection committee <br/>
<a id="pl.502.2"></a><var>502.2</var>shall determine assessor and assessment body application requirements, the frequency <br/>
<a id="pl.502.3"></a><var>502.3</var>of application submittal, and the application review schedule. The commissioner shall <br/>
<a id="pl.502.4"></a><var>502.4</var>publish the application requirements and procedures on the accreditation program Web site.<br/>
<a id="pl.502.5"></a><var>502.5</var>(b) In its selection process, the committee shall ensure its application requirements <br/>
<a id="pl.502.6"></a><var>502.6</var>and review process:<br/>
<a id="pl.502.7"></a><var>502.7</var>(1) meet the standards implemented in subdivision 2a;<br/>
<a id="pl.502.8"></a><var>502.8</var>(2) ensure assessors have demonstrated competence in technical disciplines offered <br/>
<a id="pl.502.9"></a><var>502.9</var>for accreditation by the commissioner; and<br/>
<a id="pl.502.10"></a><var>502.10</var>(3) consider any history of repeated nonconformance or complaints regarding <br/>
<a id="pl.502.11"></a><var>502.11</var>assessors or assessment bodies.<br/>
<a id="pl.502.12"></a><var>502.12</var>(c) The selection committee shall consider an application received from qualified <br/>
<a id="pl.502.13"></a><var>502.13</var>applicants and shall supply a list of recommended assessors and assessment bodies to <br/>
<a id="pl.502.14"></a><var>502.14</var>the commissioner of health no later than 90 days after the commissioner notifies the <br/>
<a id="pl.502.15"></a><var>502.15</var>committee of the need for review of applications.<br/>
<br/>
<a id="bill.12.38.0"></a><a id="pl.502.16"></a><var>502.16</var>    Sec. 38. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.502.17"></a><var>502.17</var>to read:<br/>
<a id="pl.502.18"></a><var>502.18</var>    Subd. 12. <b>Commissioner approval of assessors and scheduling of assessments.</b><br/>
<a id="pl.502.19"></a><var>502.19</var>(a) The commissioner shall approve assessors who:<br/>
<a id="pl.502.20"></a><var>502.20</var>(1) are employed by the commissioner for the purpose of accrediting laboratories <br/>
<a id="pl.502.21"></a><var>502.21</var>and demonstrate competence in assessment practices for environmental laboratories; or<br/>
<a id="pl.502.22"></a><var>502.22</var>(2) are employed by a state or federal agency with established agreements for <br/>
<a id="pl.502.23"></a><var>502.23</var>mutual assistance or recognition with the commissioner and demonstrate competence in <br/>
<a id="pl.502.24"></a><var>502.24</var>assessment practices for environmental laboratories.<br/>
<a id="pl.502.25"></a><var>502.25</var>(b) The commissioner may approve other assessors or assessment bodies who are <br/>
<a id="pl.502.26"></a><var>502.26</var>recommended by the selection committee according to subdivision 11, paragraph (c). The <br/>
<a id="pl.502.27"></a><var>502.27</var>commissioner shall publish the list of assessors and assessment bodies approved from the <br/>
<a id="pl.502.28"></a><var>502.28</var>recommendations.<br/>
<a id="pl.502.29"></a><var>502.29</var>(c) The commissioner shall rescind approval for an assessor or assessment body for <br/>
<a id="pl.502.30"></a><var>502.30</var>sufficient cause as the commissioner determines, such as:<br/>
<a id="pl.502.31"></a><var>502.31</var>(1) failure to meet the minimum qualifications for performing assessments;<br/>
<a id="pl.502.32"></a><var>502.32</var>(2) lack of availability;<br/>
<a id="pl.502.33"></a><var>502.33</var>(3) nonconformance with the applicable laws, rules, standards, policies, and <br/>
<a id="pl.502.34"></a><var>502.34</var>procedures;<br/>
<a id="pl.503.1"></a><var>503.1</var>(4) misrepresentation of application information regarding qualifications and <br/>
<a id="pl.503.2"></a><var>503.2</var>training; or<br/>
<a id="pl.503.3"></a><var>503.3</var>(5) excessive cost to perform the assessment activities.<br/>
<br/>
<a id="bill.12.39.0"></a><a id="pl.503.4"></a><var>503.4</var>    Sec. 39. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision <br/>
<a id="pl.503.5"></a><var>503.5</var>to read:<br/>
<a id="pl.503.6"></a><var>503.6</var>    Subd. 13. <b>Laboratory requirements for assessor selection and scheduling </b><br/>
<a id="pl.503.7"></a><var>503.7</var><b>assessments.</b> (a) A laboratory accredited or seeking accreditation that requires an <br/>
<a id="pl.503.8"></a><var>503.8</var>assessment by the commissioner must select an assessor, group of assessors, or an <br/>
<a id="pl.503.9"></a><var>503.9</var>assessment body from the published list specified in subdivision 12, paragraph (b). An <br/>
<a id="pl.503.10"></a><var>503.10</var>accredited laboratory must complete an assessment and make all corrective actions at least <br/>
<a id="pl.503.11"></a><var>503.11</var>once every 24 months. Unless the commissioner grants interim accreditation, a laboratory <br/>
<a id="pl.503.12"></a><var>503.12</var>seeking accreditation must complete an assessment and make all corrective actions <br/>
<a id="pl.503.13"></a><var>503.13</var>prior to, but no earlier than, 18 months prior to the date the application is submitted to <br/>
<a id="pl.503.14"></a><var>503.14</var>the commissioner.<br/>
<a id="pl.503.15"></a><var>503.15</var>(b) A laboratory shall not select the same assessor more than twice in succession <br/>
<a id="pl.503.16"></a><var>503.16</var>for assessments of the same facility unless the laboratory receives written approval <br/>
<a id="pl.503.17"></a><var>503.17</var>from the commissioner for the selection. The laboratory must supply a written request <br/>
<a id="pl.503.18"></a><var>503.18</var>to the commissioner for approval and must justify the reason for the request and provide <br/>
<a id="pl.503.19"></a><var>503.19</var>the alternate options considered.<br/>
<a id="pl.503.20"></a><var>503.20</var>(c) A laboratory must select assessors appropriate to the size and scope of the <br/>
<a id="pl.503.21"></a><var>503.21</var>laboratory's application or existing accreditation.<br/>
<a id="pl.503.22"></a><var>503.22</var>(d) A laboratory must enter into its own contract for direct payment of the assessors <br/>
<a id="pl.503.23"></a><var>503.23</var>or assessment body. The contract must authorize the assessor, assessment body, or <br/>
<a id="pl.503.24"></a><var>503.24</var>subcontractors to release all records to the commissioner regarding the assessment activity, <br/>
<a id="pl.503.25"></a><var>503.25</var>when the assessment is performed in compliance with this statute.<br/>
<a id="pl.503.26"></a><var>503.26</var>(e) A laboratory must agree to permit other assessors as selected by the commissioner <br/>
<a id="pl.503.27"></a><var>503.27</var>to participate in the assessment activities.<br/>
<a id="pl.503.28"></a><var>503.28</var>(f) If the laboratory determines no approved assessor is available to perform <br/>
<a id="pl.503.29"></a><var>503.29</var>the assessment, the laboratory must notify the commissioner in writing and provide a <br/>
<a id="pl.503.30"></a><var>503.30</var>justification for the determination. If the commissioner confirms no approved assessor <br/>
<a id="pl.503.31"></a><var>503.31</var>is available, the commissioner may designate an alternate assessor from those approved <br/>
<a id="pl.503.32"></a><var>503.32</var>in subdivision 12, paragraph (a), or the commissioner may delay the assessment until <br/>
<a id="pl.503.33"></a><var>503.33</var>an assessor is available. If an approved alternate assessor performs the assessment, the <br/>
<a id="pl.503.34"></a><var>503.34</var>commissioner may collect fees equivalent to the cost of performing the assessment <br/>
<a id="pl.503.35"></a><var>503.35</var>activities.<br/>
<a id="pl.504.1"></a><var>504.1</var>(g) Fees collected under this section are deposited in a special account and are <br/>
<a id="pl.504.2"></a><var>504.2</var>annually appropriated to the commissioner for the purpose of performing assessment <br/>
<a id="pl.504.3"></a><var>504.3</var>activities.<br/>
<a id="pl.504.4"></a><var>504.4</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>
<br/>
<a id="bill.12.40.0"></a><a id="pl.504.5"></a><var>504.5</var>    Sec. 40. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:<br/>
<a id="pl.504.6"></a><var>504.6</var>    Subd. 4. <b>Administrative penalty orders.</b> (a) The commissioner may issue an <br/>
<a id="pl.504.7"></a><var>504.7</var>order requiring violations to be corrected and administratively assessing monetary <br/>
<a id="pl.504.8"></a><var>504.8</var>penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The <br/>
<a id="pl.504.9"></a><var>504.9</var>procedures in section 
         <statute_ref>144.991</statute_ref> must be followed when issuing administrative penalty <br/>
<a id="pl.504.10"></a><var>504.10</var>orders. Except in the case of repeated or serious violations, the penalty assessed in the <br/>
<a id="pl.504.11"></a><var>504.11</var>order must be forgiven if the person who is subject to the order demonstrates in writing <br/>
<a id="pl.504.12"></a><var>504.12</var>to the commissioner before the 31st day after receiving the order that the person has <br/>
<a id="pl.504.13"></a><var>504.13</var>corrected the violation or has developed a corrective plan acceptable to the commissioner. <br/>
<a id="pl.504.14"></a><var>504.14</var>The maximum amount of an administrative penalty order is $10,000 for each violator for <br/>
<a id="pl.504.15"></a><var>504.15</var>all violations by that violator identified in an inspection or review of compliance.<br/>
<a id="pl.504.16"></a><var>504.16</var>(b) Notwithstanding paragraph (a), the commissioner may issue to a large public <br/>
<a id="pl.504.17"></a><var>504.17</var>water supply, serving a population of more than 10,000 persons, an administrative penalty <br/>
<a id="pl.504.18"></a><var>504.18</var>order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000 <br/>
<a id="pl.504.19"></a><var>504.19</var>for each violation of sections 
         <statute_ref>144.381</statute_ref> to 
         <statute_ref>144.385</statute_ref> and rules adopted thereunder.<br/>
<a id="pl.504.20"></a><var>504.20</var>(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead <br/>
<a id="pl.504.21"></a><var>504.21</var>firm or person performing regulated lead work, an administrative penalty order imposing a <br/>
<a id="pl.504.22"></a><var>504.22</var>penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of <br/>
<a id="pl.504.23"></a><var>504.23</var>sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from <br/>
<a id="pl.504.24"></a><var>504.24</var>monetary penalties in this section shall be deposited in the state treasury and credited to <br/>
<a id="pl.504.25"></a><var>504.25</var>the state government special revenue fund.<br/>
<br/>
<a id="bill.12.41.0"></a><a id="pl.504.26"></a><var>504.26</var>    Sec. 41. Minnesota Statutes 2012, section 145.906, is amended to read:<br/>
<a id="pl.504.27"></a><var>504.27</var><b>145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.</b><br/>
<a id="pl.504.28"></a><var>504.28</var>(a) The commissioner of health shall work with health care facilities, licensed health <br/>
<a id="pl.504.29"></a><var>504.29</var>and mental health care professionals, the women, infants, and children (WIC) program, <br/>
<a id="pl.504.30"></a><var>504.30</var>mental health advocates, consumers, and families in the state to develop materials and <br/>
<a id="pl.504.31"></a><var>504.31</var>information about postpartum depression, including treatment resources, and develop <br/>
<a id="pl.504.32"></a><var>504.32</var>policies and procedures to comply with this section.<br/>
<a id="pl.505.1"></a><var>505.1</var>(b) Physicians, traditional midwives, and other licensed health care professionals <br/>
<a id="pl.505.2"></a><var>505.2</var>providing prenatal care to women must have available to women and their families <br/>
<a id="pl.505.3"></a><var>505.3</var>information about postpartum depression.<br/>
<a id="pl.505.4"></a><var>505.4</var>(c) Hospitals and other health care facilities in the state must provide departing new <br/>
<a id="pl.505.5"></a><var>505.5</var>mothers and fathers and other family members, as appropriate, with written information <br/>
<a id="pl.505.6"></a><var>505.6</var>about postpartum depression, including its symptoms, methods of coping with the illness, <br/>
<a id="pl.505.7"></a><var>505.7</var>and treatment resources.<br/>
<a id="pl.505.8"></a><var>505.8</var>(d) Information about postpartum depression, including its symptoms, potential <br/>
<a id="pl.505.9"></a><var>505.9</var>impact on families, and treatment resources, must be available at WIC sites.<br/>
<a id="pl.505.10"></a><var>505.10</var>(e) The commissioner of health, in collaboration with the commissioner of human <br/>
<a id="pl.505.11"></a><var>505.11</var>services and to the extent authorized by the federal Centers for Disease Control and <br/>
<a id="pl.505.12"></a><var>505.12</var>Prevention, shall review the materials and information related to postpartum depression to <br/>
<a id="pl.505.13"></a><var>505.13</var>determine their effectiveness in transmitting the information in a way that reduces racial <br/>
<a id="pl.505.14"></a><var>505.14</var>health disparities as reported in surveys of maternal attitudes and experiences before, <br/>
<a id="pl.505.15"></a><var>505.15</var>during, and after pregnancy, including those conducted by the commissioner of health. The <br/>
<a id="pl.505.16"></a><var>505.16</var>commissioner shall implement changes to reduce racial health disparities in the information <br/>
<a id="pl.505.17"></a><var>505.17</var>reviewed, as needed, and ensure that women of color are receiving the information.<br/>
<br/>
<a id="bill.12.42.0"></a><a id="pl.505.18"></a><var>505.18</var>    Sec. 42. <b>[145.907] MATERNAL DEPRESSION; DEFINITION.</b><br/>
<a id="pl.505.19"></a><var>505.19</var>"Maternal depression" means depression or other perinatal mood or anxiety disorder <br/>
<a id="pl.505.20"></a><var>505.20</var>experienced by a woman during pregnancy or during the first year following the birth of <br/>
<a id="pl.505.21"></a><var>505.21</var>her child.<br/>
<br/>
<a id="bill.12.43.0"></a><a id="pl.505.22"></a><var>505.22</var>    Sec. 43. Minnesota Statutes 2012, section 145.986, is amended to read:<br/>
<a id="pl.505.23"></a><var>505.23</var><b>145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.</b><br/>
<a id="pl.505.24"></a><var>505.24</var>    Subdivision 1. <b>Grants to local communities</b><b> Purpose</b><b>.</b> The purpose of the statewide <br/>
<a id="pl.505.25"></a><var>505.25</var>health improvement program is to:<br/>
<a id="pl.505.26"></a><var>505.26</var>(1) address the top three leading preventable causes of illness and death: tobacco use <br/>
<a id="pl.505.27"></a><var>505.27</var>and exposure, poor diet, and lack of regular physical activity;<br/>
<a id="pl.505.28"></a><var>505.28</var>(2) promote the development, availability, and use of evidence-based, community <br/>
<a id="pl.505.29"></a><var>505.29</var>level, comprehensive strategies to create healthy communities; and<br/>
<a id="pl.505.30"></a><var>505.30</var>(3) measure the impact of the evidence-based, community health improvement <br/>
<a id="pl.505.31"></a><var>505.31</var>practices which over time work to contain health care costs and reduce chronic diseases.<br/>
<a id="pl.505.32"></a><var>505.32</var>    Subd. 1a. <b>Grants to local communities.</b> (a) Beginning July 1, 2009, the <br/>
<a id="pl.505.33"></a><var>505.33</var>commissioner of health shall award competitive grants to community health boards <br/>
<a id="pl.505.34"></a><var>505.34</var>established pursuant to section 
         <statute_ref>145A.09</statute_ref> and tribal governments to convene, coordinate, <br/>
<a id="pl.506.1"></a><var>506.1</var>and implement evidence-based strategies targeted at reducing the percentage of <br/>
<a id="pl.506.2"></a><var>506.2</var>Minnesotans who are obese or overweight and to reduce the use of tobacco.<br/>
<a id="pl.506.3"></a><var>506.3</var>    (b) Grantee activities shall:<br/>
<a id="pl.506.4"></a><var>506.4</var>    (1) be based on scientific evidence;<br/>
<a id="pl.506.5"></a><var>506.5</var>    (2) be based on community input;<br/>
<a id="pl.506.6"></a><var>506.6</var>    (3) address behavior change at the individual, community, and systems levels;<br/>
<a id="pl.506.7"></a><var>506.7</var>    (4) occur in community, school, worksite, and health care settings; and<br/>
<a id="pl.506.8"></a><var>506.8</var>    (5) be focused on policy, systems, and environmental changes that support healthy <br/>
<a id="pl.506.9"></a><var>506.9</var>behaviors.; and<br/>
<a id="pl.506.10"></a><var>506.10</var>(6) address the health disparities and inequities that exist in the grantee's community.<br/>
<a id="pl.506.11"></a><var>506.11</var>    (c) To receive a grant under this section, community health boards and tribal <br/>
<a id="pl.506.12"></a><var>506.12</var>governments must submit proposals to the commissioner. A local match of ten percent <br/>
<a id="pl.506.13"></a><var>506.13</var>of the total funding allocation is required. This local match may include funds donated <br/>
<a id="pl.506.14"></a><var>506.14</var>by community partners.<br/>
<a id="pl.506.15"></a><var>506.15</var>    (d) In order to receive a grant, community health boards and tribal governments <br/>
<a id="pl.506.16"></a><var>506.16</var>must submit a health improvement plan to the commissioner of health for approval. The <br/>
<a id="pl.506.17"></a><var>506.17</var>commissioner may require the plan to identify a community leadership team, community <br/>
<a id="pl.506.18"></a><var>506.18</var>partners, and a community action plan that includes an assessment of area strengths and <br/>
<a id="pl.506.19"></a><var>506.19</var>needs, proposed action strategies, technical assistance needs, and a staffing plan.<br/>
<a id="pl.506.20"></a><var>506.20</var>    (e) The grant recipient must implement the health improvement plan, evaluate the <br/>
<a id="pl.506.21"></a><var>506.21</var>effectiveness of the interventions strategies, and modify or discontinue interventions<br/>
<a id="pl.506.22"></a><var>506.22</var> strategies found to be ineffective.<br/>
<a id="pl.506.23"></a><var>506.23</var>    (f) By January 15, 2011, the commissioner of health shall recommend whether any <br/>
<a id="pl.506.24"></a><var>506.24</var>funding should be distributed to community health boards and tribal governments based <br/>
<a id="pl.506.25"></a><var>506.25</var>on health disparities demonstrated in the populations served.<br/>
<a id="pl.506.26"></a><var>506.26</var>    (g) (f) Grant recipients shall report their activities and their progress toward the <br/>
<a id="pl.506.27"></a><var>506.27</var>outcomes established under subdivision 2 to the commissioner in a format and at a time <br/>
<a id="pl.506.28"></a><var>506.28</var>specified by the commissioner.<br/>
<a id="pl.506.29"></a><var>506.29</var>    (h) (g) All grant recipients shall be held accountable for making progress toward <br/>
<a id="pl.506.30"></a><var>506.30</var>the measurable outcomes established in subdivision 2. The commissioner shall require a <br/>
<a id="pl.506.31"></a><var>506.31</var>corrective action plan and may reduce the funding level of grant recipients that do not <br/>
<a id="pl.506.32"></a><var>506.32</var>make adequate progress toward the measurable outcomes.<br/>
<a id="pl.506.33"></a><var>506.33</var>(h) Notwithstanding paragraph (a), the commissioner may award funding to <br/>
<a id="pl.506.34"></a><var>506.34</var>convene, coordinate, and implement evidence-based strategies targeted at reducing other <br/>
<a id="pl.506.35"></a><var>506.35</var>risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical <br/>
<a id="pl.507.1"></a><var>507.1</var>activity, that are associated with chronic disease and may impact public health. The <br/>
<a id="pl.507.2"></a><var>507.2</var>commissioner shall develop a criteria and procedures to allocate funding under this section.<br/>
<a id="pl.507.3"></a><var>507.3</var>    Subd. 2. <b>Outcomes.</b> (a) The commissioner shall set measurable outcomes to meet <br/>
<a id="pl.507.4"></a><var>507.4</var>the goals specified in subdivision 1, and annually review the progress of grant recipients <br/>
<a id="pl.507.5"></a><var>507.5</var>in meeting the outcomes.<br/>
<a id="pl.507.6"></a><var>507.6</var>    (b) The commissioner shall measure current public health status, using existing <br/>
<a id="pl.507.7"></a><var>507.7</var>measures and data collection systems when available, to determine baseline data against <br/>
<a id="pl.507.8"></a><var>507.8</var>which progress shall be monitored.<br/>
<a id="pl.507.9"></a><var>507.9</var>    Subd. 3. <b>Technical assistance and oversight.</b> (a) The commissioner shall provide <br/>
<a id="pl.507.10"></a><var>507.10</var>content expertise, technical expertise, and training to grant recipients and advice on <br/>
<a id="pl.507.11"></a><var>507.11</var>evidence-based strategies, including those based on populations and types of communities <br/>
<a id="pl.507.12"></a><var>507.12</var>served. The commissioner shall ensure that the statewide health improvement program <br/>
<a id="pl.507.13"></a><var>507.13</var>meets the outcomes established under subdivision 2 by conducting a comprehensive <br/>
<a id="pl.507.14"></a><var>507.14</var>statewide evaluation and assisting grant recipients to modify or discontinue interventions <br/>
<a id="pl.507.15"></a><var>507.15</var>found to be ineffective.<br/>
<a id="pl.507.16"></a><var>507.16</var>(b) For the purposes of carrying out the grant program under this section, including <br/>
<a id="pl.507.17"></a><var>507.17</var>for administrative purposes, the commissioner shall award contracts to appropriate entities <br/>
<a id="pl.507.18"></a><var>507.18</var>to assist in training and provide technical assistance to grantees.<br/>
<a id="pl.507.19"></a><var>507.19</var>(c) Contracts awarded under paragraph (b) may be used to provide technical <br/>
<a id="pl.507.20"></a><var>507.20</var>assistance and training in the areas of:<br/>
<a id="pl.507.21"></a><var>507.21</var>(1) community engagement and capacity building;<br/>
<a id="pl.507.22"></a><var>507.22</var>(2) tribal support;<br/>
<a id="pl.507.23"></a><var>507.23</var>(3) community asset building and risk behavior reduction;<br/>
<a id="pl.507.24"></a><var>507.24</var>(4) legal;<br/>
<a id="pl.507.25"></a><var>507.25</var>(5) communications;<br/>
<a id="pl.507.26"></a><var>507.26</var>(6) community, school, health care, work site, and other site-specific strategies; and<br/>
<a id="pl.507.27"></a><var>507.27</var>(7) health equity.<br/>
<a id="pl.507.28"></a><var>507.28</var>    Subd. 4. <b>Evaluation.</b> (a) Using the outcome measures established in subdivision 3, <br/>
<a id="pl.507.29"></a><var>507.29</var>the commissioner shall conduct a biennial evaluation of the statewide health improvement <br/>
<a id="pl.507.30"></a><var>507.30</var>program funded under this section. Grant recipients shall cooperate with the commissioner <br/>
<a id="pl.507.31"></a><var>507.31</var>in the evaluation and provide the commissioner with the information necessary to conduct <br/>
<a id="pl.507.32"></a><var>507.32</var>the evaluation.<br/>
<a id="pl.507.33"></a><var>507.33</var>(b) Grant recipients will collect, monitor, and submit to the Department of Health <br/>
<a id="pl.507.34"></a><var>507.34</var>baseline and annual data and provide information to improve the quality and impact of <br/>
<a id="pl.507.35"></a><var>507.35</var>community health improvement strategies.<br/>
<a id="pl.508.1"></a><var>508.1</var>(c) For the purposes of carrying out the grant program under this section, including <br/>
<a id="pl.508.2"></a><var>508.2</var>for administrative purposes, the commissioner shall award contracts to appropriate entities <br/>
<a id="pl.508.3"></a><var>508.3</var>to assist in designing and implementing evaluation systems.<br/>
<a id="pl.508.4"></a><var>508.4</var>(d) Contracts awarded under paragraph (c) may be used to:<br/>
<a id="pl.508.5"></a><var>508.5</var>(1) develop grantee monitoring and reporting systems to track grantee progress, <br/>
<a id="pl.508.6"></a><var>508.6</var>including aggregated and disaggregated data;<br/>
<a id="pl.508.7"></a><var>508.7</var>(2) manage, analyze, and report program evaluation data results; and<br/>
<a id="pl.508.8"></a><var>508.8</var>(3) utilize innovative support tools to analyze and predict the impact of prevention <br/>
<a id="pl.508.9"></a><var>508.9</var>strategies on health outcomes and state health care costs over time.<br/>
<a id="pl.508.10"></a><var>508.10</var>    Subd. 5. <b>Report.</b> The commissioner shall submit a biennial report to the legislature <br/>
<a id="pl.508.11"></a><var>508.11</var>on the statewide health improvement program funded under this section. These reports <br/>
<a id="pl.508.12"></a><var>508.12</var> The report must include information on each grant recipients recipient, including the <br/>
<a id="pl.508.13"></a><var>508.13</var>activities that were conducted by the grantee using grant funds, evaluation data, and <br/>
<a id="pl.508.14"></a><var>508.14</var>outcome measures, if available. the grantee's progress toward achieving the measurable <br/>
<a id="pl.508.15"></a><var>508.15</var>outcomes established under subdivision 2, and the data provided to the commissioner by <br/>
<a id="pl.508.16"></a><var>508.16</var>the grantee to measure these outcomes for grant activities. The commissioner shall provide <br/>
<a id="pl.508.17"></a><var>508.17</var>information on grants in which a corrective action plan was required under subdivision <br/>
<a id="pl.508.18"></a><var>508.18</var>1a, the types of plan action, and the progress that has been made toward meeting the <br/>
<a id="pl.508.19"></a><var>508.19</var>measurable outcomes. In addition, the commissioner shall provide recommendations <br/>
<a id="pl.508.20"></a><var>508.20</var>on future areas of focus for health improvement. These reports are due by January 15 <br/>
<a id="pl.508.21"></a><var>508.21</var>of every other year, beginning in 2010. In the report due on January 15, 2010, the <br/>
<a id="pl.508.22"></a><var>508.22</var>commissioner shall include recommendations on a sustainable funding source for the <br/>
<a id="pl.508.23"></a><var>508.23</var>statewide health improvement program other than the health care access fund In the report <br/>
<a id="pl.508.24"></a><var>508.24</var>due on January 15, 2014, the commissioner shall include a description of the contracts <br/>
<a id="pl.508.25"></a><var>508.25</var>awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems <br/>
<a id="pl.508.26"></a><var>508.26</var>that were designed and implemented under these contracts. <br/>
<a id="pl.508.27"></a><var>508.27</var>    Subd. 6. <b>Supplantation of existing funds.</b> Community health boards and tribal <br/>
<a id="pl.508.28"></a><var>508.28</var>governments must use funds received under this section to develop new programs, expand <br/>
<a id="pl.508.29"></a><var>508.29</var>current programs that work to reduce the percentage of Minnesotans who are obese or <br/>
<a id="pl.508.30"></a><var>508.30</var>overweight or who use tobacco, or replace discontinued state or federal funds previously <br/>
<a id="pl.508.31"></a><var>508.31</var>used to reduce the percentage of Minnesotans who are obese or overweight or who use <br/>
<a id="pl.508.32"></a><var>508.32</var>tobacco. Funds must not be used to supplant current state or local funding to community <br/>
<a id="pl.508.33"></a><var>508.33</var>health boards or tribal governments used to reduce the percentage of Minnesotans who are <br/>
<a id="pl.508.34"></a><var>508.34</var>obese or overweight or to reduce tobacco use.<br/>
<br/>
<a id="bill.12.44.0"></a><a id="pl.508.35"></a><var>508.35</var>    Sec. 44. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:<br/>
<a id="pl.509.1"></a><var>509.1</var>    Subdivision 1. <b>Establishment; goals.</b> The commissioner shall establish a program <br/>
<a id="pl.509.2"></a><var>509.2</var>to fund family home visiting programs designed to foster healthy beginnings, improve <br/>
<a id="pl.509.3"></a><var>509.3</var>pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce <br/>
<a id="pl.509.4"></a><var>509.4</var>juvenile delinquency, promote positive parenting and resiliency in children, and promote <br/>
<a id="pl.509.5"></a><var>509.5</var>family health and economic self-sufficiency for children and families. The commissioner <br/>
<a id="pl.509.6"></a><var>509.6</var>shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of <br/>
<a id="pl.509.7"></a><var>509.7</var>professionals and paraprofessionals from the fields of public health nursing, social work, <br/>
<a id="pl.509.8"></a><var>509.8</var>and early childhood education. A program funded under this section must serve families <br/>
<a id="pl.509.9"></a><var>509.9</var>at or below 200 percent of the federal poverty guidelines, and other families determined <br/>
<a id="pl.509.10"></a><var>509.10</var>to be at risk, including but not limited to being at risk for child abuse, child neglect, or <br/>
<a id="pl.509.11"></a><var>509.11</var>juvenile delinquency. Programs must begin prenatally whenever possible and must be <br/>
<a id="pl.509.12"></a><var>509.12</var>targeted to families with:<br/>
<a id="pl.509.13"></a><var>509.13</var>    (1) adolescent parents;<br/>
<a id="pl.509.14"></a><var>509.14</var>    (2) a history of alcohol or other drug abuse;<br/>
<a id="pl.509.15"></a><var>509.15</var>    (3) a history of child abuse, domestic abuse, or other types of violence;<br/>
<a id="pl.509.16"></a><var>509.16</var>    (4) a history of domestic abuse, rape, or other forms of victimization;<br/>
<a id="pl.509.17"></a><var>509.17</var>    (5) reduced cognitive functioning;<br/>
<a id="pl.509.18"></a><var>509.18</var>    (6) a lack of knowledge of child growth and development stages;<br/>
<a id="pl.509.19"></a><var>509.19</var>    (7) low resiliency to adversities and environmental stresses;<br/>
<a id="pl.509.20"></a><var>509.20</var>    (8) insufficient financial resources to meet family needs;<br/>
<a id="pl.509.21"></a><var>509.21</var>    (9) a history of homelessness;<br/>
<a id="pl.509.22"></a><var>509.22</var>    (10) a risk of long-term welfare dependence or family instability due to employment <br/>
<a id="pl.509.23"></a><var>509.23</var>barriers; or<br/>
<a id="pl.509.24"></a><var>509.24</var>(11) a serious mental health disorder, including maternal depression as defined in <br/>
<a id="pl.509.25"></a><var>509.25</var>section 145.907; or<br/>
<a id="pl.509.26"></a><var>509.26</var>    (11) (12) other risk factors as determined by the commissioner.<br/>
<br/>
<a id="bill.12.45.0"></a><a id="pl.509.27"></a><var>509.27</var>    Sec. 45. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:<br/>
<a id="pl.509.28"></a><var>509.28</var>    Subd. 1a. <b>Alkaline hydrolysis.</b> "Alkaline hydrolysis" means the reduction of a dead <br/>
<a id="pl.509.29"></a><var>509.29</var>human body to essential elements through exposure to a combination of heat and alkaline <br/>
<a id="pl.509.30"></a><var>509.30</var>hydrolysis and the repositioning or movement of the body during the process to facilitate <br/>
<a id="pl.509.31"></a><var>509.31</var>reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and <br/>
<a id="pl.509.32"></a><var>509.32</var>pressure to accelerate natural decomposition; the processing of the hydrolyzed remains <br/>
<a id="pl.509.33"></a><var>509.33</var>after removal from the alkaline hydrolysis chamber, vessel; placement of the processed <br/>
<a id="pl.509.34"></a><var>509.34</var>remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an <br/>
<a id="pl.509.35"></a><var>509.35</var>appropriate party. Alkaline hydrolysis is a form of final disposition.<br/>
<br/>
<a id="bill.12.46.0"></a><a id="pl.510.1"></a><var>510.1</var>    Sec. 46. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.510.2"></a><var>510.2</var>subdivision to read:<br/>
<a id="pl.510.3"></a><var>510.3</var>    Subd. 1b. <b>Alkaline hydrolysis container.</b> "Alkaline hydrolysis container" means a <br/>
<a id="pl.510.4"></a><var>510.4</var>hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily <br/>
<a id="pl.510.5"></a><var>510.5</var>fluids that encases the body and into which a dead human body is placed prior to insertion <br/>
<a id="pl.510.6"></a><var>510.6</var>into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or <br/>
<a id="pl.510.7"></a><var>510.7</var>biodegradable alternative containers or caskets.<br/>
<br/>
<a id="bill.12.47.0"></a><a id="pl.510.8"></a><var>510.8</var>    Sec. 47. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.510.9"></a><var>510.9</var>subdivision to read:<br/>
<a id="pl.510.10"></a><var>510.10</var>    Subd. 1c. <b>Alkaline hydrolysis facility.</b> "Alkaline hydrolysis facility" means a <br/>
<a id="pl.510.11"></a><var>510.11</var>building or structure containing one or more alkaline hydrolysis vessels for the alkaline <br/>
<a id="pl.510.12"></a><var>510.12</var>hydrolysis of dead human bodies.<br/>
<br/>
<a id="bill.12.48.0"></a><a id="pl.510.13"></a><var>510.13</var>    Sec. 48. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.510.14"></a><var>510.14</var>subdivision to read:<br/>
<a id="pl.510.15"></a><var>510.15</var>    Subd. 1d. <b>Alkaline hydrolysis vessel.</b> "Alkaline hydrolysis vessel" means the <br/>
<a id="pl.510.16"></a><var>510.16</var>container in which the alkaline hydrolysis of a dead human body is performed.<br/>
<br/>
<a id="bill.12.49.0"></a><a id="pl.510.17"></a><var>510.17</var>    Sec. 49. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:<br/>
<a id="pl.510.18"></a><var>510.18</var>    Subd. 2. <b>Alternative container.</b> "Alternative container" means a nonmetal <br/>
<a id="pl.510.19"></a><var>510.19</var>receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed <br/>
<a id="pl.510.20"></a><var>510.20</var>for the encasement of dead human bodies and is made of hydrolyzable or biodegradable <br/>
<a id="pl.510.21"></a><var>510.21</var>materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.<br/>
<br/>
<a id="bill.12.50.0"></a><a id="pl.510.22"></a><var>510.22</var>    Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:<br/>
<a id="pl.510.23"></a><var>510.23</var>    Subd. 3. <b>Arrangements for disposition.</b> "Arrangements for disposition" means <br/>
<a id="pl.510.24"></a><var>510.24</var>any action normally taken by a funeral provider in anticipation of or preparation for the <br/>
<a id="pl.510.25"></a><var>510.25</var>entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.<br/>
<br/>
<a id="bill.12.51.0"></a><a id="pl.510.26"></a><var>510.26</var>    Sec. 51. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:<br/>
<a id="pl.510.27"></a><var>510.27</var>    Subd. 4. <b>Cash advance item.</b> "Cash advance item" means any item of service <br/>
<a id="pl.510.28"></a><var>510.28</var>or merchandise described to a purchaser as a "cash advance," "accommodation," "cash <br/>
<a id="pl.510.29"></a><var>510.29</var>disbursement," or similar term. A cash advance item is also any item obtained from a <br/>
<a id="pl.510.30"></a><var>510.30</var>third party and paid for by the funeral provider on the purchaser's behalf. Cash advance <br/>
<a id="pl.510.31"></a><var>510.31</var>items include, but are not limited to, cemetery, alkaline hydrolysis,  or crematory services, <br/>
<a id="pl.511.1"></a><var>511.1</var>pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary <br/>
<a id="pl.511.2"></a><var>511.2</var>notices, gratuities, and death records.<br/>
<br/>
<a id="bill.12.52.0"></a><a id="pl.511.3"></a><var>511.3</var>    Sec. 52. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:<br/>
<a id="pl.511.4"></a><var>511.4</var>    Subd. 5. <b>Casket.</b> "Casket" means a rigid container which is designed for the <br/>
<a id="pl.511.5"></a><var>511.5</var>encasement of a dead human body and is usually constructed of hydrolyzable or <br/>
<a id="pl.511.6"></a><var>511.6</var>biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented <br/>
<a id="pl.511.7"></a><var>511.7</var>and lined with fabric.<br/>
<br/>
<a id="bill.12.53.0"></a><a id="pl.511.8"></a><var>511.8</var>    Sec. 53. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.511.9"></a><var>511.9</var>subdivision to read:<br/>
<a id="pl.511.10"></a><var>511.10</var>    Subd. 12a. <b>Crypt.</b> "Crypt" means a space in a mausoleum of sufficient size, used or <br/>
<a id="pl.511.11"></a><var>511.11</var>intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.<br/>
<br/>
<a id="bill.12.54.0"></a><a id="pl.511.12"></a><var>511.12</var>    Sec. 54. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.511.13"></a><var>511.13</var>subdivision to read:<br/>
<a id="pl.511.14"></a><var>511.14</var>    Subd. 12b. <b>Direct alkaline hydrolysis.</b> "Direct alkaline hydrolysis" means a <br/>
<a id="pl.511.15"></a><var>511.15</var>final disposition of a dead human body by alkaline hydrolysis, without formal viewing, <br/>
<a id="pl.511.16"></a><var>511.16</var>visitation, or ceremony with the body present.<br/>
<br/>
<a id="bill.12.55.0"></a><a id="pl.511.17"></a><var>511.17</var>    Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:<br/>
<a id="pl.511.18"></a><var>511.18</var>    Subd. 16. <b>Final disposition.</b> "Final disposition" means the acts leading to and the <br/>
<a id="pl.511.19"></a><var>511.19</var>entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.<br/>
<br/>
<a id="bill.12.56.0"></a><a id="pl.511.20"></a><var>511.20</var>    Sec. 56. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:<br/>
<a id="pl.511.21"></a><var>511.21</var>    Subd. 23. <b>Funeral services.</b> "Funeral services" means any services which may <br/>
<a id="pl.511.22"></a><var>511.22</var>be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis, <br/>
<a id="pl.511.23"></a><var>511.23</var>cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral <br/>
<a id="pl.511.24"></a><var>511.24</var>ceremony or the final disposition of dead human bodies.<br/>
<br/>
<a id="bill.12.57.0"></a><a id="pl.511.25"></a><var>511.25</var>    Sec. 57. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.511.26"></a><var>511.26</var>subdivision to read:<br/>
<a id="pl.511.27"></a><var>511.27</var>    Subd. 24a. <b>Holding facility.</b> "Holding facility" means a secure enclosed room or <br/>
<a id="pl.511.28"></a><var>511.28</var>confined area within a funeral establishment, crematory, or alkaline hydrolysis facility <br/>
<a id="pl.511.29"></a><var>511.29</var>used for temporary storage of human remains awaiting final disposition.<br/>
<br/>
<a id="bill.12.58.0"></a><a id="pl.512.1"></a><var>512.1</var>    Sec. 58. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.512.2"></a><var>512.2</var>subdivision to read:<br/>
<a id="pl.512.3"></a><var>512.3</var>    Subd. 24b. <b>Hydrolyzed remains.</b> "Hydrolyzed remains" means the remains of a <br/>
<a id="pl.512.4"></a><var>512.4</var>dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not <br/>
<a id="pl.512.5"></a><var>512.5</var>include pacemakers, prostheses, or similar foreign materials.<br/>
<br/>
<a id="bill.12.59.0"></a><a id="pl.512.6"></a><var>512.6</var>    Sec. 59. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.512.7"></a><var>512.7</var>subdivision to read:<br/>
<a id="pl.512.8"></a><var>512.8</var>    Subd. 24c. <b>Hydrolyzed remains container.</b> "Hydrolyzed remains container" means <br/>
<a id="pl.512.9"></a><var>512.9</var>a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a <br/>
<a id="pl.512.10"></a><var>512.10</var>hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage <br/>
<a id="pl.512.11"></a><var>512.11</var>jewelry.<br/>
<br/>
<a id="bill.12.60.0"></a><a id="pl.512.12"></a><var>512.12</var>    Sec. 60. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.512.13"></a><var>512.13</var>subdivision to read:<br/>
<a id="pl.512.14"></a><var>512.14</var>    Subd. 26a. <b>Inurnment.</b> "Inurnment" means placing hydrolyzed or cremated remains <br/>
<a id="pl.512.15"></a><var>512.15</var>in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.<br/>
<br/>
<a id="bill.12.61.0"></a><a id="pl.512.16"></a><var>512.16</var>    Sec. 61. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:<br/>
<a id="pl.512.17"></a><var>512.17</var>    Subd. 27. <b>Licensee.</b> "Licensee" means any person or entity that has been issued <br/>
<a id="pl.512.18"></a><var>512.18</var>a license to practice mortuary science, to operate a funeral establishment, to operate an <br/>
<a id="pl.512.19"></a><var>512.19</var>alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner <br/>
<a id="pl.512.20"></a><var>512.20</var>of health.<br/>
<br/>
<a id="bill.12.62.0"></a><a id="pl.512.21"></a><var>512.21</var>    Sec. 62. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.512.22"></a><var>512.22</var>subdivision to read:<br/>
<a id="pl.512.23"></a><var>512.23</var>    Subd. 30a. <b>Niche.</b> "Niche" means a space in a columbarium used, or intended to be <br/>
<a id="pl.512.24"></a><var>512.24</var>used, for the placement of hydrolyzed or cremated remains.<br/>
<br/>
<a id="bill.12.63.0"></a><a id="pl.512.25"></a><var>512.25</var>    Sec. 63. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.512.26"></a><var>512.26</var>subdivision to read:<br/>
<a id="pl.512.27"></a><var>512.27</var>    Subd. 32a. <b>Placement.</b> "Placement" means the placing of a container holding <br/>
<a id="pl.512.28"></a><var>512.28</var>hydrolyzed or cremated remains in a crypt, vault, or niche.<br/>
<br/>
<a id="bill.12.64.0"></a><a id="pl.512.29"></a><var>512.29</var>    Sec. 64. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:<br/>
<a id="pl.513.1"></a><var>513.1</var>    Subd. 34. <b>Preparation of the body.</b> "Preparation of the body" means placement of <br/>
<a id="pl.513.2"></a><var>513.2</var>the body into an appropriate cremation or alkaline hydrolysis container, embalming of <br/>
<a id="pl.513.3"></a><var>513.3</var>the body or such items of care as washing, disinfecting, shaving, positioning of features, <br/>
<a id="pl.513.4"></a><var>513.4</var>restorative procedures, application of cosmetics, dressing, and casketing.<br/>
<br/>
<a id="bill.12.65.0"></a><a id="pl.513.5"></a><var>513.5</var>    Sec. 65. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:<br/>
<a id="pl.513.6"></a><var>513.6</var>    Subd. 35. <b>Processing.</b> "Processing" means the removal of foreign objects, drying or <br/>
<a id="pl.513.7"></a><var>513.7</var>cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means <br/>
<a id="pl.513.8"></a><var>513.8</var>including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance <br/>
<a id="pl.513.9"></a><var>513.9</var>appropriate for final disposition.<br/>
<br/>
<a id="bill.12.66.0"></a><a id="pl.513.10"></a><var>513.10</var>    Sec. 66. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:<br/>
<a id="pl.513.11"></a><var>513.11</var>    Subd. 37. <b>Public transportation.</b> "Public transportation" means all manner of <br/>
<a id="pl.513.12"></a><var>513.12</var>transportation via common carrier available to the general public including airlines, buses, <br/>
<a id="pl.513.13"></a><var>513.13</var>railroads, and ships. For purposes of this chapter, a livery service providing transportation <br/>
<a id="pl.513.14"></a><var>513.14</var>to private funeral establishments, alkaline hydrolysis facilities,  or crematories is not public <br/>
<a id="pl.513.15"></a><var>513.15</var>transportation.<br/>
<br/>
<a id="bill.12.67.0"></a><a id="pl.513.16"></a><var>513.16</var>    Sec. 67. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.513.17"></a><var>513.17</var>subdivision to read:<br/>
<a id="pl.513.18"></a><var>513.18</var>    Subd. 37c. <b>Scattering.</b> "Scattering" means the authorized dispersal of hydrolyzed <br/>
<a id="pl.513.19"></a><var>513.19</var>or cremated remains in a defined area of a dedicated cemetery or in areas where no local <br/>
<a id="pl.513.20"></a><var>513.20</var>prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable <br/>
<a id="pl.513.21"></a><var>513.21</var>to the public, are not in a container, and that the person who has control over disposition <br/>
<a id="pl.513.22"></a><var>513.22</var>of the hydrolyzed or cremated remains has obtained written permission of the property <br/>
<a id="pl.513.23"></a><var>513.23</var>owner or governing agency to scatter on the property.<br/>
<br/>
<a id="bill.12.68.0"></a><a id="pl.513.24"></a><var>513.24</var>    Sec. 68. Minnesota Statutes 2012, section 149A.02, is amended by adding a <br/>
<a id="pl.513.25"></a><var>513.25</var>subdivision to read:<br/>
<a id="pl.513.26"></a><var>513.26</var>    Subd. 41. <b>Vault.</b> "Vault" means a space in a mausoleum of sufficient size, used or <br/>
<a id="pl.513.27"></a><var>513.27</var>intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains. <br/>
<a id="pl.513.28"></a><var>513.28</var>Vault may also mean a sealed and lined casket enclosure.<br/>
<br/>
<a id="bill.12.69.0"></a><a id="pl.513.29"></a><var>513.29</var>    Sec. 69. Minnesota Statutes 2012, section 149A.03, is amended to read:<br/>
<a id="pl.513.30"></a><var>513.30</var><b>149A.03 DUTIES OF COMMISSIONER.</b><br/>
<a id="pl.513.31"></a><var>513.31</var>    The commissioner shall:<br/>
<a id="pl.514.1"></a><var>514.1</var>    (1) enforce all laws and adopt and enforce rules relating to the:<br/>
<a id="pl.514.2"></a><var>514.2</var>    (i) removal, preparation, transportation, arrangements for disposition, and final <br/>
<a id="pl.514.3"></a><var>514.3</var>disposition of dead human bodies;<br/>
<a id="pl.514.4"></a><var>514.4</var>    (ii) licensure and professional conduct of funeral directors, morticians, interns, <br/>
<a id="pl.514.5"></a><var>514.5</var>practicum students, and clinical students;<br/>
<a id="pl.514.6"></a><var>514.6</var>    (iii) licensing and operation of a funeral establishment; and<br/>
<a id="pl.514.7"></a><var>514.7</var>(iv) licensing and operation of an alkaline hydrolysis facility; and<br/>
<a id="pl.514.8"></a><var>514.8</var>    (iv) (v) licensing and operation of a crematory;<br/>
<a id="pl.514.9"></a><var>514.9</var>    (2) provide copies of the requirements for licensure and permits to all applicants;<br/>
<a id="pl.514.10"></a><var>514.10</var>    (3) administer examinations and issue licenses and permits to qualified persons <br/>
<a id="pl.514.11"></a><var>514.11</var>and other legal entities;<br/>
<a id="pl.514.12"></a><var>514.12</var>    (4) maintain a record of the name and location of all current licensees and interns;<br/>
<a id="pl.514.13"></a><var>514.13</var>    (5) perform periodic compliance reviews and premise inspections of licensees;<br/>
<a id="pl.514.14"></a><var>514.14</var>    (6) accept and investigate complaints relating to conduct governed by this chapter;<br/>
<a id="pl.514.15"></a><var>514.15</var>    (7) maintain a record of all current preneed arrangement trust accounts;<br/>
<a id="pl.514.16"></a><var>514.16</var>    (8) maintain a schedule of application, examination, permit, and licensure fees, <br/>
<a id="pl.514.17"></a><var>514.17</var>initial and renewal, sufficient to cover all necessary operating expenses;<br/>
<a id="pl.514.18"></a><var>514.18</var>    (9) educate the public about the existence and content of the laws and rules for <br/>
<a id="pl.514.19"></a><var>514.19</var>mortuary science licensing and the removal, preparation, transportation, arrangements <br/>
<a id="pl.514.20"></a><var>514.20</var>for disposition, and final disposition of dead human bodies to enable consumers to file <br/>
<a id="pl.514.21"></a><var>514.21</var>complaints against licensees and others who may have violated those laws or rules;<br/>
<a id="pl.514.22"></a><var>514.22</var>    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary <br/>
<a id="pl.514.23"></a><var>514.23</var>science in order to refine the standards for licensing and to improve the regulatory and <br/>
<a id="pl.514.24"></a><var>514.24</var>enforcement methods used; and<br/>
<a id="pl.514.25"></a><var>514.25</var>    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in <br/>
<a id="pl.514.26"></a><var>514.26</var>the laws, rules, or procedures governing the practice of mortuary science and the removal, <br/>
<a id="pl.514.27"></a><var>514.27</var>preparation, transportation, arrangements for disposition, and final disposition of dead <br/>
<a id="pl.514.28"></a><var>514.28</var>human bodies.<br/>
<br/>
<a id="bill.12.70.0"></a><a id="pl.514.29"></a><var>514.29</var>    Sec. 70. <b>[149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS </b><br/>
<a id="pl.514.30"></a><var>514.30</var><b>FACILITY.</b><br/>
<a id="pl.514.31"></a><var>514.31</var>    Subdivision 1. <b>License requirement.</b> Except as provided in section 149A.01, <br/>
<a id="pl.514.32"></a><var>514.32</var>subdivision 3, a place or premise shall not be maintained, managed, or operated which <br/>
<a id="pl.514.33"></a><var>514.33</var>is devoted to or used in the holding and alkaline hydrolysis of a dead human body <br/>
<a id="pl.514.34"></a><var>514.34</var>without possessing a valid license to operate an alkaline hydrolysis facility issued by the <br/>
<a id="pl.514.35"></a><var>514.35</var>commissioner of health.<br/>
<a id="pl.515.1"></a><var>515.1</var>    Subd. 2. <b>Requirements for an alkaline hydrolysis facility.</b> (a) An alkaline <br/>
<a id="pl.515.2"></a><var>515.2</var>hydrolysis facility licensed under this section must consist of:<br/>
<a id="pl.515.3"></a><var>515.3</var>(1) a building or structure that complies with applicable local and state building <br/>
<a id="pl.515.4"></a><var>515.4</var>codes, zoning laws and ordinances, wastewater management and environmental standards, <br/>
<a id="pl.515.5"></a><var>515.5</var>containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead <br/>
<a id="pl.515.6"></a><var>515.6</var>human bodies;<br/>
<a id="pl.515.7"></a><var>515.7</var>(2) a method approved by the commissioner of health to dry the hydrolyzed remains <br/>
<a id="pl.515.8"></a><var>515.8</var>and which is located within the licensed facility;<br/>
<a id="pl.515.9"></a><var>515.9</var>(3) a means approved by the commissioner of health for refrigeration of dead human <br/>
<a id="pl.515.10"></a><var>515.10</var>bodies awaiting alkaline hydrolysis;<br/>
<a id="pl.515.11"></a><var>515.11</var>(4) an appropriate means of processing hydrolyzed remains to a granulated <br/>
<a id="pl.515.12"></a><var>515.12</var>appearance appropriate for final disposition; and<br/>
<a id="pl.515.13"></a><var>515.13</var>(5) an appropriate holding facility for dead human bodies awaiting alkaline <br/>
<a id="pl.515.14"></a><var>515.14</var>hydrolysis.<br/>
<a id="pl.515.15"></a><var>515.15</var>(b) An alkaline hydrolysis facility licensed under this section may also contain a <br/>
<a id="pl.515.16"></a><var>515.16</var>display room for funeral goods.<br/>
<a id="pl.515.17"></a><var>515.17</var>    Subd. 3. <b>Application procedure; documentation; initial inspection.</b> An <br/>
<a id="pl.515.18"></a><var>515.18</var>application to license and operate an alkaline hydrolysis facility shall be submitted to the <br/>
<a id="pl.515.19"></a><var>515.19</var>commissioner of health. A completed application includes:<br/>
<a id="pl.515.20"></a><var>515.20</var>(1) a completed application form, as provided by the commissioner;<br/>
<a id="pl.515.21"></a><var>515.21</var>(2) proof of business form and ownership;<br/>
<a id="pl.515.22"></a><var>515.22</var>(3) proof of liability insurance coverage or other financial documentation, as <br/>
<a id="pl.515.23"></a><var>515.23</var>determined by the commissioner, that demonstrates the applicant's ability to respond in <br/>
<a id="pl.515.24"></a><var>515.24</var>damages for liability arising from the ownership, maintenance management, or operation <br/>
<a id="pl.515.25"></a><var>515.25</var>of an alkaline hydrolysis facility; and<br/>
<a id="pl.515.26"></a><var>515.26</var>(4) copies of wastewater and other environmental regulatory permits and <br/>
<a id="pl.515.27"></a><var>515.27</var>environmental regulatory licenses necessary to conduct operations.<br/>
<a id="pl.515.28"></a><var>515.28</var>Upon receipt of the application and appropriate fee, the commissioner shall review and <br/>
<a id="pl.515.29"></a><var>515.29</var>verify all information. Upon completion of the verification process and resolution of any <br/>
<a id="pl.515.30"></a><var>515.30</var>deficiencies in the application information, the commissioner shall conduct an initial <br/>
<a id="pl.515.31"></a><var>515.31</var>inspection of the premises to be licensed. After the inspection and resolution of any <br/>
<a id="pl.515.32"></a><var>515.32</var>deficiencies found and any reinspections as may be necessary, the commissioner shall <br/>
<a id="pl.515.33"></a><var>515.33</var>make a determination, based on all the information available, to grant or deny licensure. If <br/>
<a id="pl.515.34"></a><var>515.34</var>the commissioner's determination is to grant the license, the applicant shall be notified and <br/>
<a id="pl.515.35"></a><var>515.35</var>the license shall issue and remain valid for a period prescribed on the license, but not to <br/>
<a id="pl.515.36"></a><var>515.36</var>exceed one calendar year from the date of issuance of the license. If the commissioner's <br/>
<a id="pl.516.1"></a><var>516.1</var>determination is to deny the license, the commissioner must notify the applicant in writing <br/>
<a id="pl.516.2"></a><var>516.2</var>of the denial and provide the specific reason for denial.<br/>
<a id="pl.516.3"></a><var>516.3</var>    Subd. 4. <b>Nontransferability of license.</b> A license to operate an alkaline hydrolysis <br/>
<a id="pl.516.4"></a><var>516.4</var>facility is not assignable or transferable and shall not be valid for any entity other than the <br/>
<a id="pl.516.5"></a><var>516.5</var>one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the <br/>
<a id="pl.516.6"></a><var>516.6</var>location identified on the license. A 50 percent or more change in ownership or location of <br/>
<a id="pl.516.7"></a><var>516.7</var>the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall <br/>
<a id="pl.516.8"></a><var>516.8</var>be required of two or more persons or other legal entities operating from the same location.<br/>
<a id="pl.516.9"></a><var>516.9</var>    Subd. 5. <b>Display of license.</b> Each license to operate an alkaline hydrolysis <br/>
<a id="pl.516.10"></a><var>516.10</var>facility must be conspicuously displayed in the alkaline hydrolysis facility at all times. <br/>
<a id="pl.516.11"></a><var>516.11</var>Conspicuous display means in a location where a member of the general public within the <br/>
<a id="pl.516.12"></a><var>516.12</var>alkaline hydrolysis facility will be able to observe and read the license.<br/>
<a id="pl.516.13"></a><var>516.13</var>    Subd. 6. <b>Period of licensure.</b> All licenses to operate an alkaline hydrolysis facility <br/>
<a id="pl.516.14"></a><var>516.14</var>issued by the commissioner are valid for a period of one calendar year beginning on July 1 <br/>
<a id="pl.516.15"></a><var>516.15</var>and ending on June 30, regardless of the date of issuance.<br/>
<a id="pl.516.16"></a><var>516.16</var>    Subd. 7. <b>Reporting changes in license information.</b> Any change of license <br/>
<a id="pl.516.17"></a><var>516.17</var>information must be reported to the commissioner, on forms provided by the <br/>
<a id="pl.516.18"></a><var>516.18</var>commissioner, no later than 30 calendar days after the change occurs. Failure to report <br/>
<a id="pl.516.19"></a><var>516.19</var>changes is grounds for disciplinary action.<br/>
<a id="pl.516.20"></a><var>516.20</var>    Subd. 8. <b>Notification to the commissioner.</b> If the licensee is operating under a <br/>
<a id="pl.516.21"></a><var>516.21</var>wastewater or an environmental permit or license that is subsequently revoked, denied, <br/>
<a id="pl.516.22"></a><var>516.22</var>or terminated, the licensee shall notify the commissioner.<br/>
<a id="pl.516.23"></a><var>516.23</var>    Subd. 9. <b>Application information.</b> All information submitted to the commissioner <br/>
<a id="pl.516.24"></a><var>516.24</var>for a license to operate an alkaline hydrolysis facility is classified as licensing data under <br/>
<a id="pl.516.25"></a><var>516.25</var>section 13.41, subdivision 5.<br/>
<br/>
<a id="bill.12.71.0"></a><a id="pl.516.26"></a><var>516.26</var>    Sec. 71. <b>[149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE </b><br/>
<a id="pl.516.27"></a><var>516.27</var><b>HYDROLYSIS FACILITY.</b><br/>
<a id="pl.516.28"></a><var>516.28</var>    Subdivision 1. <b>Renewal required.</b> All licenses to operate an alkaline hydrolysis <br/>
<a id="pl.516.29"></a><var>516.29</var>facility issued by the commissioner expire on June 30 following the date of issuance of the <br/>
<a id="pl.516.30"></a><var>516.30</var>license and must be renewed to remain valid.<br/>
<a id="pl.516.31"></a><var>516.31</var>    Subd. 2. <b>Renewal procedure and documentation.</b> Licensees who wish to renew <br/>
<a id="pl.516.32"></a><var>516.32</var>their licenses must submit to the commissioner a completed renewal application no later <br/>
<a id="pl.516.33"></a><var>516.33</var>than June 30 following the date the license was issued. A completed renewal application <br/>
<a id="pl.516.34"></a><var>516.34</var>includes:<br/>
<a id="pl.516.35"></a><var>516.35</var>(1) a completed renewal application form, as provided by the commissioner; and<br/>
<a id="pl.517.1"></a><var>517.1</var>(2) proof of liability insurance coverage or other financial documentation, as <br/>
<a id="pl.517.2"></a><var>517.2</var>determined by the commissioner, that demonstrates the applicant's ability to respond in <br/>
<a id="pl.517.3"></a><var>517.3</var>damages for liability arising from the ownership, maintenance, management, or operation <br/>
<a id="pl.517.4"></a><var>517.4</var>of an alkaline hydrolysis facility.<br/>
<a id="pl.517.5"></a><var>517.5</var>Upon receipt of the completed renewal application, the commissioner shall review and <br/>
<a id="pl.517.6"></a><var>517.6</var>verify the information. Upon completion of the verification process and resolution of <br/>
<a id="pl.517.7"></a><var>517.7</var>any deficiencies in the renewal application information, the commissioner shall make a <br/>
<a id="pl.517.8"></a><var>517.8</var>determination, based on all the information available, to reissue or refuse to reissue the <br/>
<a id="pl.517.9"></a><var>517.9</var>license. If the commissioner's determination is to reissue the license, the applicant shall <br/>
<a id="pl.517.10"></a><var>517.10</var>be notified and the license shall issue and remain valid for a period prescribed on the <br/>
<a id="pl.517.11"></a><var>517.11</var>license, but not to exceed one calendar year from the date of issuance of the license. If <br/>
<a id="pl.517.12"></a><var>517.12</var>the commissioner's determination is to refuse to reissue the license, section 149A.09, <br/>
<a id="pl.517.13"></a><var>517.13</var>subdivision 2, applies.<br/>
<a id="pl.517.14"></a><var>517.14</var>    Subd. 3. <b>Penalty for late filing.</b> Renewal applications received after the expiration <br/>
<a id="pl.517.15"></a><var>517.15</var>date of a license will result in the assessment of a late filing penalty. The late filing penalty <br/>
<a id="pl.517.16"></a><var>517.16</var>must be paid before the reissuance of the license and received by the commissioner no <br/>
<a id="pl.517.17"></a><var>517.17</var>later than 31 calendar days after the expiration date of the license.<br/>
<a id="pl.517.18"></a><var>517.18</var>    Subd. 4. <b>Lapse of license.</b> Licenses to operate alkaline hydrolysis facilities <br/>
<a id="pl.517.19"></a><var>517.19</var>shall automatically lapse when a completed renewal application is not received by the <br/>
<a id="pl.517.20"></a><var>517.20</var>commissioner within 31 calendar days after the expiration date of a license, or a late <br/>
<a id="pl.517.21"></a><var>517.21</var>filing penalty assessed under subdivision 3 is not received by the commissioner within 31 <br/>
<a id="pl.517.22"></a><var>517.22</var>calendar days after the expiration of a license.<br/>
<a id="pl.517.23"></a><var>517.23</var>    Subd. 5. <b>Effect of lapse of license.</b> Upon the lapse of a license, the person to whom <br/>
<a id="pl.517.24"></a><var>517.24</var>the license was issued is no longer licensed to operate an alkaline hydrolysis facility in <br/>
<a id="pl.517.25"></a><var>517.25</var>Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed <br/>
<a id="pl.517.26"></a><var>517.26</var>license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue <br/>
<a id="pl.517.27"></a><var>517.27</var>any additional lawful remedies as justified by the case.<br/>
<a id="pl.517.28"></a><var>517.28</var>    Subd. 6. <b>Restoration of lapsed license.</b> The commissioner may restore a lapsed <br/>
<a id="pl.517.29"></a><var>517.29</var>license upon receipt and review of a completed renewal application, receipt of the late <br/>
<a id="pl.517.30"></a><var>517.30</var>filing penalty, and reinspection of the premises, provided that the receipt is made within <br/>
<a id="pl.517.31"></a><var>517.31</var>one calendar year from the expiration date of the lapsed license and the cease and desist <br/>
<a id="pl.517.32"></a><var>517.32</var>order issued by the commissioner has not been violated. If a lapsed license is not restored <br/>
<a id="pl.517.33"></a><var>517.33</var>within one calendar year from the expiration date of the lapsed license, the holder of the <br/>
<a id="pl.517.34"></a><var>517.34</var>lapsed license cannot be relicensed until the requirements in section 149A.54 are met.<br/>
<a id="pl.517.35"></a><var>517.35</var>    Subd. 7. <b>Reporting changes in license information.</b> Any change of license <br/>
<a id="pl.517.36"></a><var>517.36</var>information must be reported to the commissioner, on forms provided by the <br/>
<a id="pl.518.1"></a><var>518.1</var>commissioner, no later than 30 calendar days after the change occurs. Failure to report <br/>
<a id="pl.518.2"></a><var>518.2</var>changes is grounds for disciplinary action.<br/>
<a id="pl.518.3"></a><var>518.3</var>    Subd. 8. <b>Application information.</b> All information submitted to the commissioner <br/>
<a id="pl.518.4"></a><var>518.4</var>by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is <br/>
<a id="pl.518.5"></a><var>518.5</var>classified as licensing data under section 13.41, subdivision 5.<br/>
<br/>
<a id="bill.12.72.0"></a><a id="pl.518.6"></a><var>518.6</var>    Sec. 72. Minnesota Statutes 2012, section 149A.65, is amended by adding a <br/>
<a id="pl.518.7"></a><var>518.7</var>subdivision to read:<br/>
<a id="pl.518.8"></a><var>518.8</var>    Subd. 6. <b>Alkaline hydrolysis facilities.</b> The initial and renewal fee for an alkaline <br/>
<a id="pl.518.9"></a><var>518.9</var>hydrolysis facility is $300. The late fee charge for a license renewal is $25.<br/>
<br/>
<a id="bill.12.73.0"></a><a id="pl.518.10"></a><var>518.10</var>    Sec. 73. Minnesota Statutes 2012, section 149A.65, is amended by adding a <br/>
<a id="pl.518.11"></a><var>518.11</var>subdivision to read:<br/>
<a id="pl.518.12"></a><var>518.12</var>    Subd. 7. <b>State government special revenue fund.</b> Fees collected by the <br/>
<a id="pl.518.13"></a><var>518.13</var>commissioner under this section must be deposited in the state treasury and credited to <br/>
<a id="pl.518.14"></a><var>518.14</var>the state government special revenue fund.<br/>
<br/>
<a id="bill.12.74.0"></a><a id="pl.518.15"></a><var>518.15</var>    Sec. 74. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:<br/>
<a id="pl.518.16"></a><var>518.16</var>    Subdivision 1. <b>Use of titles.</b> Only a person holding a valid license to practice <br/>
<a id="pl.518.17"></a><var>518.17</var>mortuary science issued by the commissioner may use the title of mortician, funeral <br/>
<a id="pl.518.18"></a><var>518.18</var>director, or any other title implying that the licensee is engaged in the business or practice <br/>
<a id="pl.518.19"></a><var>518.19</var>of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis <br/>
<a id="pl.518.20"></a><var>518.20</var>facility issued by the commissioner may use the title of alkaline hydrolysis facility, water <br/>
<a id="pl.518.21"></a><var>518.21</var>cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or <br/>
<a id="pl.518.22"></a><var>518.22</var>any other title, word, or term implying that the licensee operates an alkaline hydrolysis <br/>
<a id="pl.518.23"></a><var>518.23</var>facility. Only the holder of a valid license to operate a funeral establishment issued by the <br/>
<a id="pl.518.24"></a><var>518.24</var>commissioner may use the title of funeral home, funeral chapel, funeral service, or any <br/>
<a id="pl.518.25"></a><var>518.25</var>other title, word, or term implying that the licensee is engaged in the business or practice <br/>
<a id="pl.518.26"></a><var>518.26</var>of mortuary science. Only the holder of a valid license to operate a crematory issued by <br/>
<a id="pl.518.27"></a><var>518.27</var>the commissioner may use the title of crematory, crematorium, green-cremation, or any <br/>
<a id="pl.518.28"></a><var>518.28</var>other title, word, or term implying that the licensee operates a crematory or crematorium.<br/>
<br/>
<a id="bill.12.75.0"></a><a id="pl.518.29"></a><var>518.29</var>    Sec. 75. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:<br/>
<a id="pl.518.30"></a><var>518.30</var>    Subd. 2. <b>Business location.</b> A funeral establishment, alkaline hydrolysis facility,  or <br/>
<a id="pl.518.31"></a><var>518.31</var>crematory shall not do business in a location that is not licensed as a funeral establishment, <br/>
<a id="pl.519.1"></a><var>519.1</var>alkaline hydrolysis facility,  or crematory and shall not advertise a service that is available <br/>
<a id="pl.519.2"></a><var>519.2</var>from an unlicensed location.<br/>
<br/>
<a id="bill.12.76.0"></a><a id="pl.519.3"></a><var>519.3</var>    Sec. 76. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:<br/>
<a id="pl.519.4"></a><var>519.4</var>    Subd. 3. <b>Advertising.</b> No licensee, clinical student, practicum student, or intern <br/>
<a id="pl.519.5"></a><var>519.5</var>shall publish or disseminate false, misleading, or deceptive advertising. False, misleading, <br/>
<a id="pl.519.6"></a><var>519.6</var>or deceptive advertising includes, but is not limited to:<br/>
<a id="pl.519.7"></a><var>519.7</var>    (1) identifying, by using the names or pictures of, persons who are not licensed to <br/>
<a id="pl.519.8"></a><var>519.8</var>practice mortuary science in a way that leads the public to believe that those persons will <br/>
<a id="pl.519.9"></a><var>519.9</var>provide mortuary science services;<br/>
<a id="pl.519.10"></a><var>519.10</var>    (2) using any name other than the names under which the funeral establishment, <br/>
<a id="pl.519.11"></a><var>519.11</var>alkaline hydrolysis facility,  or crematory is known to or licensed by the commissioner;<br/>
<a id="pl.519.12"></a><var>519.12</var>    (3) using a surname not directly, actively, or presently associated with a licensed <br/>
<a id="pl.519.13"></a><var>519.13</var>funeral establishment, alkaline hydrolysis facility,  or crematory, unless the surname had <br/>
<a id="pl.519.14"></a><var>519.14</var>been previously and continuously used by the licensed funeral establishment, alkaline <br/>
<a id="pl.519.15"></a><var>519.15</var>hydrolysis facility,  or crematory; and<br/>
<a id="pl.519.16"></a><var>519.16</var>    (4) using a founding or establishing date or total years of service not directly or <br/>
<a id="pl.519.17"></a><var>519.17</var>continuously related to a name under which the funeral establishment, alkaline hydrolysis <br/>
<a id="pl.519.18"></a><var>519.18</var>facility,  or crematory is currently or was previously licensed.<br/>
<a id="pl.519.19"></a><var>519.19</var>    Any advertising or other printed material that contains the names or pictures of <br/>
<a id="pl.519.20"></a><var>519.20</var>persons affiliated with a funeral establishment, alkaline hydrolysis facility,  or crematory <br/>
<a id="pl.519.21"></a><var>519.21</var>shall state the position held by the persons and shall identify each person who is licensed <br/>
<a id="pl.519.22"></a><var>519.22</var>or unlicensed under this chapter.<br/>
<br/>
<a id="bill.12.77.0"></a><a id="pl.519.23"></a><var>519.23</var>    Sec. 77. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:<br/>
<a id="pl.519.24"></a><var>519.24</var>    Subd. 5. <b>Reimbursement prohibited.</b> No licensee, clinical student, practicum <br/>
<a id="pl.519.25"></a><var>519.25</var>student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other <br/>
<a id="pl.519.26"></a><var>519.26</var>reimbursement in consideration for recommending or causing a dead human body to <br/>
<a id="pl.519.27"></a><var>519.27</var>be disposed of by a specific body donation program, funeral establishment, alkaline <br/>
<a id="pl.519.28"></a><var>519.28</var>hydrolysis facility, crematory, mausoleum, or cemetery.<br/>
<br/>
<a id="bill.12.78.0"></a><a id="pl.519.29"></a><var>519.29</var>    Sec. 78. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:<br/>
<a id="pl.519.30"></a><var>519.30</var>    Subd. 2. <b>Preventive requirements.</b> (a) To prevent unfair or deceptive acts or <br/>
<a id="pl.519.31"></a><var>519.31</var>practices, the requirements of this subdivision must be met.<br/>
<a id="pl.519.32"></a><var>519.32</var>    (b) Funeral providers must tell persons who ask by telephone about the funeral <br/>
<a id="pl.519.33"></a><var>519.33</var>provider's offerings or prices any accurate information from the price lists described in <br/>
<a id="pl.520.1"></a><var>520.1</var>paragraphs (c) to (e) and any other readily available information that reasonably answers <br/>
<a id="pl.520.2"></a><var>520.2</var>the questions asked.<br/>
<a id="pl.520.3"></a><var>520.3</var>    (c) Funeral providers must make available for viewing to people who inquire in <br/>
<a id="pl.520.4"></a><var>520.4</var>person about the offerings or prices of funeral goods or burial site goods, separate printed <br/>
<a id="pl.520.5"></a><var>520.5</var>or typewritten price lists using a ten-point font or larger. Each funeral provider must have a <br/>
<a id="pl.520.6"></a><var>520.6</var>separate price list for each of the following types of goods that are sold or offered for sale:<br/>
<a id="pl.520.7"></a><var>520.7</var>    (1) caskets;<br/>
<a id="pl.520.8"></a><var>520.8</var>    (2) alternative containers;<br/>
<a id="pl.520.9"></a><var>520.9</var>    (3) outer burial containers;<br/>
<a id="pl.520.10"></a><var>520.10</var>(4) alkaline hydrolysis containers;<br/>
<a id="pl.520.11"></a><var>520.11</var>    (4) (5) cremation containers;<br/>
<a id="pl.520.12"></a><var>520.12</var>(6) hydrolyzed remains containers;<br/>
<a id="pl.520.13"></a><var>520.13</var>    (5) (7) cremated remains containers;<br/>
<a id="pl.520.14"></a><var>520.14</var>    (6) (8) markers; and<br/>
<a id="pl.520.15"></a><var>520.15</var>    (7) (9) headstones.<br/>
<a id="pl.520.16"></a><var>520.16</var>    (d) Each separate price list must contain the name of the funeral provider's place <br/>
<a id="pl.520.17"></a><var>520.17</var>of business, address, and telephone number and a caption describing the list as a price <br/>
<a id="pl.520.18"></a><var>520.18</var>list for one of the types of funeral goods or burial site goods described in paragraph (c), <br/>
<a id="pl.520.19"></a><var>520.19</var>clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion <br/>
<a id="pl.520.20"></a><var>520.20</var>of, but in any event before showing, the specific funeral goods or burial site goods and <br/>
<a id="pl.520.21"></a><var>520.21</var>must provide a photocopy of the price list, for retention, if so asked by the consumer. The <br/>
<a id="pl.520.22"></a><var>520.22</var>list must contain, at least, the retail prices of all the specific funeral goods and burial site <br/>
<a id="pl.520.23"></a><var>520.23</var>goods offered which do not require special ordering, enough information to identify each, <br/>
<a id="pl.520.24"></a><var>520.24</var>and the effective date for the price list. However, funeral providers are not required to <br/>
<a id="pl.520.25"></a><var>520.25</var>make a specific price list available if the funeral providers place the information required <br/>
<a id="pl.520.26"></a><var>520.26</var>by this paragraph on the general price list described in paragraph (e).<br/>
<a id="pl.520.27"></a><var>520.27</var>    (e) Funeral providers must give a printed price list, for retention, to persons who <br/>
<a id="pl.520.28"></a><var>520.28</var>inquire in person about the funeral goods, funeral services, burial site goods, or burial site <br/>
<a id="pl.520.29"></a><var>520.29</var>services or prices offered by the funeral provider. The funeral provider must give the list <br/>
<a id="pl.520.30"></a><var>520.30</var>upon beginning discussion of either the prices of or the overall type of funeral service or <br/>
<a id="pl.520.31"></a><var>520.31</var>disposition or specific funeral goods, funeral services, burial site goods, or burial site <br/>
<a id="pl.520.32"></a><var>520.32</var>services offered by the provider. This requirement applies whether the discussion takes <br/>
<a id="pl.520.33"></a><var>520.33</var>place in the funeral establishment or elsewhere. However, when the deceased is removed <br/>
<a id="pl.520.34"></a><var>520.34</var>for transportation to the funeral establishment, an in-person request for authorization to <br/>
<a id="pl.520.35"></a><var>520.35</var>embalm does not, by itself, trigger the requirement to offer the general price list. If the <br/>
<a id="pl.520.36"></a><var>520.36</var>provider, in making an in-person request for authorization to embalm, discloses that <br/>
<a id="pl.521.1"></a><var>521.1</var>embalming is not required by law except in certain special cases, the provider is not <br/>
<a id="pl.521.2"></a><var>521.2</var>required to offer the general price list. Any other discussion during that time about prices <br/>
<a id="pl.521.3"></a><var>521.3</var>or the selection of funeral goods, funeral services, burial site goods, or burial site services <br/>
<a id="pl.521.4"></a><var>521.4</var>triggers the requirement to give the consumer a general price list. The general price list <br/>
<a id="pl.521.5"></a><var>521.5</var>must contain the following information:<br/>
<a id="pl.521.6"></a><var>521.6</var>    (1) the name, address, and telephone number of the funeral provider's place of <br/>
<a id="pl.521.7"></a><var>521.7</var>business;<br/>
<a id="pl.521.8"></a><var>521.8</var>    (2) a caption describing the list as a "general price list";<br/>
<a id="pl.521.9"></a><var>521.9</var>    (3) the effective date for the price list;<br/>
<a id="pl.521.10"></a><var>521.10</var>    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per <br/>
<a id="pl.521.11"></a><var>521.11</var>hour, mile, or other unit of computation, and other information described as follows:<br/>
<a id="pl.521.12"></a><var>521.12</var>    (i) forwarding of remains to another funeral establishment, together with a list of <br/>
<a id="pl.521.13"></a><var>521.13</var>the services provided for any quoted price;<br/>
<a id="pl.521.14"></a><var>521.14</var>    (ii) receiving remains from another funeral establishment, together with a list of <br/>
<a id="pl.521.15"></a><var>521.15</var>the services provided for any quoted price;<br/>
<a id="pl.521.16"></a><var>521.16</var>    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral <br/>
<a id="pl.521.17"></a><var>521.17</var>provider, with the price including an alternative container or alkaline hydrolysis or <br/>
<a id="pl.521.18"></a><var>521.18</var>cremation container, any alkaline hydrolysis or crematory charges, and a description of the <br/>
<a id="pl.521.19"></a><var>521.19</var>services and container included in the price, where applicable, and the price of alkaline <br/>
<a id="pl.521.20"></a><var>521.20</var>hydrolysis or cremation where the purchaser provides the container;<br/>
<a id="pl.521.21"></a><var>521.21</var>    (iv) separate prices for each immediate burial offered by the funeral provider, <br/>
<a id="pl.521.22"></a><var>521.22</var>including a casket or alternative container, and a description of the services and container <br/>
<a id="pl.521.23"></a><var>521.23</var>included in that price, and the price of immediate burial where the purchaser provides the <br/>
<a id="pl.521.24"></a><var>521.24</var>casket or alternative container;<br/>
<a id="pl.521.25"></a><var>521.25</var>    (v) transfer of remains to the funeral establishment or other location;<br/>
<a id="pl.521.26"></a><var>521.26</var>    (vi) embalming;<br/>
<a id="pl.521.27"></a><var>521.27</var>    (vii) other preparation of the body;<br/>
<a id="pl.521.28"></a><var>521.28</var>    (viii) use of facilities, equipment, or staff for viewing;<br/>
<a id="pl.521.29"></a><var>521.29</var>    (ix) use of facilities, equipment, or staff for funeral ceremony;<br/>
<a id="pl.521.30"></a><var>521.30</var>    (x) use of facilities, equipment, or staff for memorial service;<br/>
<a id="pl.521.31"></a><var>521.31</var>    (xi) use of equipment or staff for graveside service;<br/>
<a id="pl.521.32"></a><var>521.32</var>    (xii) hearse or funeral coach;<br/>
<a id="pl.521.33"></a><var>521.33</var>    (xiii) limousine; and<br/>
<a id="pl.521.34"></a><var>521.34</var>    (xiv) separate prices for all cemetery-specific goods and services, including all goods <br/>
<a id="pl.521.35"></a><var>521.35</var>and services associated with interment and burial site goods and services and excluding <br/>
<a id="pl.521.36"></a><var>521.36</var>markers and headstones;<br/>
<a id="pl.522.1"></a><var>522.1</var>    (5) the price range for the caskets offered by the funeral provider, together with the <br/>
<a id="pl.522.2"></a><var>522.2</var>statement "A complete price list will be provided at the funeral establishment or casket <br/>
<a id="pl.522.3"></a><var>522.3</var>sale location." or the prices of individual caskets, as disclosed in the manner described <br/>
<a id="pl.522.4"></a><var>522.4</var>in paragraphs (c) and (d);<br/>
<a id="pl.522.5"></a><var>522.5</var>    (6) the price range for the alternative containers offered by the funeral provider, <br/>
<a id="pl.522.6"></a><var>522.6</var>together with the statement "A complete price list will be provided at the funeral <br/>
<a id="pl.522.7"></a><var>522.7</var>establishment or alternative container sale location." or the prices of individual alternative <br/>
<a id="pl.522.8"></a><var>522.8</var>containers, as disclosed in the manner described in paragraphs (c) and (d);<br/>
<a id="pl.522.9"></a><var>522.9</var>    (7) the price range for the outer burial containers offered by the funeral provider, <br/>
<a id="pl.522.10"></a><var>522.10</var>together with the statement "A complete price list will be provided at the funeral <br/>
<a id="pl.522.11"></a><var>522.11</var>establishment or outer burial container sale location." or the prices of individual outer <br/>
<a id="pl.522.12"></a><var>522.12</var>burial containers, as disclosed in the manner described in paragraphs (c) and (d);<br/>
<a id="pl.522.13"></a><var>522.13</var>(8) the price range for the alkaline hydrolysis container offered by the funeral <br/>
<a id="pl.522.14"></a><var>522.14</var>provider, together with the statement: "A complete price list will be provided at the funeral <br/>
<a id="pl.522.15"></a><var>522.15</var>establishment or alkaline hydrolysis container sale location.", or the prices of individual <br/>
<a id="pl.522.16"></a><var>522.16</var>alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) <br/>
<a id="pl.522.17"></a><var>522.17</var>and (d);<br/>
<a id="pl.522.18"></a><var>522.18</var>(9) the price range for the hydrolyzed remains container offered by the funeral <br/>
<a id="pl.522.19"></a><var>522.19</var>provider, together with the statement: "A complete price list will be provided at the <br/>
<a id="pl.522.20"></a><var>522.20</var>funeral establishment or hydrolyzed remains container sale location.", or the prices <br/>
<a id="pl.522.21"></a><var>522.21</var>of individual hydrolyzed remains container, as disclosed in the manner described in <br/>
<a id="pl.522.22"></a><var>522.22</var>paragraphs (c) and (d);<br/>
<a id="pl.522.23"></a><var>522.23</var>    (8) (10) the price range for the cremation containers offered by the funeral provider, <br/>
<a id="pl.522.24"></a><var>522.24</var>together with the statement "A complete price list will be provided at the funeral <br/>
<a id="pl.522.25"></a><var>522.25</var>establishment or cremation container sale location." or the prices of individual cremation <br/>
<a id="pl.522.26"></a><var>522.26</var>containers and cremated remains containers, as disclosed in the manner described in <br/>
<a id="pl.522.27"></a><var>522.27</var>paragraphs (c) and (d);<br/>
<a id="pl.522.28"></a><var>522.28</var>    (9) (11) the price range for the cremated remains containers offered by the funeral <br/>
<a id="pl.522.29"></a><var>522.29</var>provider, together with the statement, "A complete price list will be provided at the funeral <br/>
<a id="pl.522.30"></a><var>522.30</var>establishment or cremation cremated remains container sale location," or the prices of <br/>
<a id="pl.522.31"></a><var>522.31</var>individual cremation containers as disclosed in the manner described in paragraphs (c) <br/>
<a id="pl.522.32"></a><var>522.32</var>and (d);<br/>
<a id="pl.522.33"></a><var>522.33</var>    (10) (12) the price for the basic services of funeral provider and staff, together with a <br/>
<a id="pl.522.34"></a><var>522.34</var>list of the principal basic services provided for any quoted price and, if the charge cannot <br/>
<a id="pl.522.35"></a><var>522.35</var>be declined by the purchaser, the statement "This fee for our basic services will be added <br/>
<a id="pl.522.36"></a><var>522.36</var>to the total cost of the funeral arrangements you select. (This fee is already included in <br/>
<a id="pl.523.1"></a><var>523.1</var>our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding <br/>
<a id="pl.523.2"></a><var>523.2</var>or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted <br/>
<a id="pl.523.3"></a><var>523.3</var>price shall include all charges for the recovery of unallocated funeral provider overhead, <br/>
<a id="pl.523.4"></a><var>523.4</var>and funeral providers may include in the required disclosure the phrase "and overhead" <br/>
<a id="pl.523.5"></a><var>523.5</var>after the word "services." This services fee is the only funeral provider fee for services, <br/>
<a id="pl.523.6"></a><var>523.6</var>facilities, or unallocated overhead permitted by this subdivision to be nondeclinable, <br/>
<a id="pl.523.7"></a><var>523.7</var>unless otherwise required by law;<br/>
<a id="pl.523.8"></a><var>523.8</var>    (11) (13) the price range for the markers and headstones offered by the funeral <br/>
<a id="pl.523.9"></a><var>523.9</var>provider, together with the statement "A complete price list will be provided at the funeral <br/>
<a id="pl.523.10"></a><var>523.10</var>establishment or marker or headstone sale location." or the prices of individual markers <br/>
<a id="pl.523.11"></a><var>523.11</var>and headstones, as disclosed in the manner described in paragraphs (c) and (d); and<br/>
<a id="pl.523.12"></a><var>523.12</var>    (12) (14) any package priced funerals offered must be listed in addition to and <br/>
<a id="pl.523.13"></a><var>523.13</var>following the information required in this paragraph (e) and must clearly state the funeral <br/>
<a id="pl.523.14"></a><var>523.14</var>goods and services being offered, the price being charged for those goods and services, <br/>
<a id="pl.523.15"></a><var>523.15</var>and the discounted savings.<br/>
<a id="pl.523.16"></a><var>523.16</var>    (f) Funeral providers must give an itemized written statement, for retention, to each <br/>
<a id="pl.523.17"></a><var>523.17</var>consumer who arranges an at-need funeral or other disposition of human remains at the <br/>
<a id="pl.523.18"></a><var>523.18</var>conclusion of the discussion of the arrangements. The itemized written statement must be <br/>
<a id="pl.523.19"></a><var>523.19</var>signed by the consumer selecting the goods and services as required in section 
         <statute_ref>149A.80</statute_ref>. <br/>
<a id="pl.523.20"></a><var>523.20</var>If the statement is provided by a funeral establishment, the statement must be signed by <br/>
<a id="pl.523.21"></a><var>523.21</var>the licensed funeral director or mortician planning the arrangements. If the statement is <br/>
<a id="pl.523.22"></a><var>523.22</var>provided by any other funeral provider, the statement must be signed by an authorized <br/>
<a id="pl.523.23"></a><var>523.23</var>agent of the funeral provider. The statement must list the funeral goods, funeral services, <br/>
<a id="pl.523.24"></a><var>523.24</var>burial site goods, or burial site services selected by that consumer and the prices to be paid <br/>
<a id="pl.523.25"></a><var>523.25</var>for each item, specifically itemized cash advance items (these prices must be given to the <br/>
<a id="pl.523.26"></a><var>523.26</var>extent then known or reasonably ascertainable if the prices are not known or reasonably <br/>
<a id="pl.523.27"></a><var>523.27</var>ascertainable, a good faith estimate shall be given and a written statement of the actual <br/>
<a id="pl.523.28"></a><var>523.28</var>charges shall be provided before the final bill is paid), and the total cost of goods and <br/>
<a id="pl.523.29"></a><var>523.29</var>services selected. At the conclusion of an at-need arrangement, the funeral provider is <br/>
<a id="pl.523.30"></a><var>523.30</var>required to give the consumer a copy of the signed itemized written contract that must <br/>
<a id="pl.523.31"></a><var>523.31</var>contain the information required in this paragraph.<br/>
<a id="pl.523.32"></a><var>523.32</var>    (g) Upon receiving actual notice of the death of an individual with whom a funeral <br/>
<a id="pl.523.33"></a><var>523.33</var>provider has entered a preneed funeral agreement, the funeral provider must provide <br/>
<a id="pl.523.34"></a><var>523.34</var>a copy of all preneed funeral agreement documents to the person who controls final <br/>
<a id="pl.523.35"></a><var>523.35</var>disposition of the human remains or to the designee of the person controlling disposition. <br/>
<a id="pl.523.36"></a><var>523.36</var>The person controlling final disposition shall be provided with these documents at the time <br/>
<a id="pl.524.1"></a><var>524.1</var>of the person's first in-person contact with the funeral provider, if the first contact occurs <br/>
<a id="pl.524.2"></a><var>524.2</var>in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place <br/>
<a id="pl.524.3"></a><var>524.3</var>of business of the funeral provider. If the contact occurs by other means or at another <br/>
<a id="pl.524.4"></a><var>524.4</var>location, the documents must be provided within 24 hours of the first contact.<br/>
<br/>
<a id="bill.12.79.0"></a><a id="pl.524.5"></a><var>524.5</var>    Sec. 79. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:<br/>
<a id="pl.524.6"></a><var>524.6</var>    Subd. 4. <b>Casket, alternate container, </b><b>alkaline hydrolysis containers, </b><b>and </b><br/>
<a id="pl.524.7"></a><var>524.7</var><b>cremation container sales; records; required disclosures.</b> Any funeral provider who <br/>
<a id="pl.524.8"></a><var>524.8</var>sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed <br/>
<a id="pl.524.9"></a><var>524.9</var>remains container, or cremation container, or cremated remains container to the public <br/>
<a id="pl.524.10"></a><var>524.10</var>must maintain a record of each sale that includes the name of the purchaser, the purchaser's <br/>
<a id="pl.524.11"></a><var>524.11</var>mailing address, the name of the decedent, the date of the decedent's death, and the place <br/>
<a id="pl.524.12"></a><var>524.12</var>of death. These records shall be open to inspection by the regulatory agency. Any funeral <br/>
<a id="pl.524.13"></a><var>524.13</var>provider selling a casket, alternate container, or cremation container to the public, and not <br/>
<a id="pl.524.14"></a><var>524.14</var>having charge of the final disposition of the dead human body, shall provide a copy of the <br/>
<a id="pl.524.15"></a><var>524.15</var>statutes and rules controlling the removal, preparation, transportation, arrangements for <br/>
<a id="pl.524.16"></a><var>524.16</var>disposition, and final disposition of a dead human body. This subdivision does not apply to <br/>
<a id="pl.524.17"></a><var>524.17</var>morticians, funeral directors, funeral establishments, crematories, or wholesale distributors <br/>
<a id="pl.524.18"></a><var>524.18</var>of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.<br/>
<br/>
<a id="bill.12.80.0"></a><a id="pl.524.19"></a><var>524.19</var>    Sec. 80. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:<br/>
<a id="pl.524.20"></a><var>524.20</var>    Subd. 3. <b>Casket for </b><b>alkaline hydrolysis or </b><b>cremation provisions; deceptive acts </b><br/>
<a id="pl.524.21"></a><var>524.21</var><b>or practices.</b> In selling or offering to sell funeral goods or funeral services to the public, it <br/>
<a id="pl.524.22"></a><var>524.22</var>is a deceptive act or practice for a funeral provider to represent that a casket is required for <br/>
<a id="pl.524.23"></a><var>524.23</var>alkaline hydrolysis or cremations by state or local law or otherwise.<br/>
<br/>
<a id="bill.12.81.0"></a><a id="pl.524.24"></a><var>524.24</var>    Sec. 81. Minnesota Statutes 2012, section 149A.72, is amended by adding a <br/>
<a id="pl.524.25"></a><var>524.25</var>subdivision to read:<br/>
<a id="pl.524.26"></a><var>524.26</var>    Subd. 3a. <b>Casket for alkaline hydrolysis provision; preventive measures.</b> To <br/>
<a id="pl.524.27"></a><var>524.27</var>prevent deceptive acts or practices, funeral providers must place the following disclosure <br/>
<a id="pl.524.28"></a><var>524.28</var>in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota <br/>
<a id="pl.524.29"></a><var>524.29</var>law does not require you to purchase a casket for alkaline hydrolysis. If you want to <br/>
<a id="pl.524.30"></a><var>524.30</var>arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline <br/>
<a id="pl.524.31"></a><var>524.31</var>hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant <br/>
<a id="pl.524.32"></a><var>524.32</var>to leakage of bodily fluids that encases the body and into which a dead human body is <br/>
<a id="pl.524.33"></a><var>524.33</var>placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide <br/>
<a id="pl.525.1"></a><var>525.1</var>are (specify containers provided)." This disclosure is required only if the funeral provider <br/>
<a id="pl.525.2"></a><var>525.2</var>arranges alkaline hydrolysis.<br/>
<br/>
<a id="bill.12.82.0"></a><a id="pl.525.3"></a><var>525.3</var>    Sec. 82. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:<br/>
<a id="pl.525.4"></a><var>525.4</var>    Subd. 9. <b>Deceptive acts or practices.</b> In selling or offering to sell funeral goods, <br/>
<a id="pl.525.5"></a><var>525.5</var>funeral services, burial site goods, or burial site services to the public, it is a deceptive act <br/>
<a id="pl.525.6"></a><var>525.6</var>or practice for a funeral provider to represent that federal, state, or local laws, or particular <br/>
<a id="pl.525.7"></a><var>525.7</var>cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral <br/>
<a id="pl.525.8"></a><var>525.8</var>goods, funeral services, burial site goods, or burial site services when that is not the case.<br/>
<br/>
<a id="bill.12.83.0"></a><a id="pl.525.9"></a><var>525.9</var>    Sec. 83. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:<br/>
<a id="pl.525.10"></a><var>525.10</var>    Subdivision 1. <b>Casket for </b><b>alkaline hydrolysis or </b><b>cremation provisions; deceptive </b><br/>
<a id="pl.525.11"></a><var>525.11</var><b>acts or practices.</b> In selling or offering to sell funeral goods, funeral services, burial site <br/>
<a id="pl.525.12"></a><var>525.12</var>goods, or burial site services to the public, it is a deceptive act or practice for a funeral <br/>
<a id="pl.525.13"></a><var>525.13</var>provider to require that a casket be purchased for alkaline hydrolysis or cremation.<br/>
<br/>
<a id="bill.12.84.0"></a><a id="pl.525.14"></a><var>525.14</var>    Sec. 84. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:<br/>
<a id="pl.525.15"></a><var>525.15</var>    Subd. 2. <b>Casket for </b><b>alkaline hydrolysis or </b><b>cremation; preventive requirements.</b><br/>
<a id="pl.525.16"></a><var>525.16</var>To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline <br/>
<a id="pl.525.17"></a><var>525.17</var>hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation <br/>
<a id="pl.525.18"></a><var>525.18</var>container available for alkaline hydrolysis or cremations.<br/>
<br/>
<a id="bill.12.85.0"></a><a id="pl.525.19"></a><var>525.19</var>    Sec. 85. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:<br/>
<a id="pl.525.20"></a><var>525.20</var>    Subd. 4. <b>Required purchases of funeral goods or services; preventive </b><br/>
<a id="pl.525.21"></a><var>525.21</var><b>requirements.</b> To prevent unfair or deceptive acts or practices, funeral providers must <br/>
<a id="pl.525.22"></a><var>525.22</var>place the following disclosure in the general price list, immediately above the prices <br/>
<a id="pl.525.23"></a><var>525.23</var>required by section 
         <statute_ref>149A.71, subdivision 2</statute_ref>, paragraph (e), clauses (4) to (10): "The goods <br/>
<a id="pl.525.24"></a><var>525.24</var>and services shown below are those we can provide to our customers. You may choose <br/>
<a id="pl.525.25"></a><var>525.25</var>only the items you desire. If legal or other requirements mean that you must buy any items <br/>
<a id="pl.525.26"></a><var>525.26</var>you did not specifically ask for, we will explain the reason in writing on the statement we <br/>
<a id="pl.525.27"></a><var>525.27</var>provide describing the funeral goods, funeral services, burial site goods, and burial site <br/>
<a id="pl.525.28"></a><var>525.28</var>services you selected." However, if the charge for "services of funeral director and staff" <br/>
<a id="pl.525.29"></a><var>525.29</var>cannot be declined by the purchaser, the statement shall include the sentence "However, <br/>
<a id="pl.525.30"></a><var>525.30</var>any funeral arrangements you select will include a charge for our basic services." between <br/>
<a id="pl.525.31"></a><var>525.31</var>the second and third sentences of the sentences specified in this subdivision. The statement <br/>
<a id="pl.525.32"></a><var>525.32</var>may include the phrase "and overhead" after the word "services" if the fee includes a <br/>
<a id="pl.526.1"></a><var>526.1</var>charge for the recovery of unallocated funeral overhead. If the funeral provider does <br/>
<a id="pl.526.2"></a><var>526.2</var>not include this disclosure statement, then the following disclosure statement must be <br/>
<a id="pl.526.3"></a><var>526.3</var>placed in the statement of funeral goods, funeral services, burial site goods, and burial site <br/>
<a id="pl.526.4"></a><var>526.4</var>services selected, as described in section 
         <statute_ref>149A.71, subdivision 2</statute_ref>, paragraph (f): "Charges <br/>
<a id="pl.526.5"></a><var>526.5</var>are only for those items that you selected or that are required. If we are required by law or <br/>
<a id="pl.526.6"></a><var>526.6</var>by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain <br/>
<a id="pl.526.7"></a><var>526.7</var>the reasons in writing below." A funeral provider is not in violation of this subdivision by <br/>
<a id="pl.526.8"></a><var>526.8</var>failing to comply with a request for a combination of goods or services which would be <br/>
<a id="pl.526.9"></a><var>526.9</var>impossible, impractical, or excessively burdensome to provide.<br/>
<br/>
<a id="bill.12.86.0"></a><a id="pl.526.10"></a><var>526.10</var>    Sec. 86. Minnesota Statutes 2012, section 149A.74, is amended to read:<br/>
<a id="pl.526.11"></a><var>526.11</var><b>149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.</b><br/>
<a id="pl.526.12"></a><var>526.12</var>    Subdivision 1. <b>Services provided without prior approval; deceptive acts or </b><br/>
<a id="pl.526.13"></a><var>526.13</var><b>practices.</b> In selling or offering to sell funeral goods or funeral services to the public, it <br/>
<a id="pl.526.14"></a><var>526.14</var>is a deceptive act or practice for any funeral provider to embalm a dead human body <br/>
<a id="pl.526.15"></a><var>526.15</var>unless state or local law or regulation requires embalming in the particular circumstances <br/>
<a id="pl.526.16"></a><var>526.16</var>regardless of any funeral choice which might be made, or prior approval for embalming <br/>
<a id="pl.526.17"></a><var>526.17</var>has been obtained from an individual legally authorized to make such a decision. In <br/>
<a id="pl.526.18"></a><var>526.18</var>seeking approval to embalm, the funeral provider must disclose that embalming is not <br/>
<a id="pl.526.19"></a><var>526.19</var>required by law except in certain circumstances; that a fee will be charged if a funeral <br/>
<a id="pl.526.20"></a><var>526.20</var>is selected which requires embalming, such as a funeral with viewing; and that no <br/>
<a id="pl.526.21"></a><var>526.21</var>embalming fee will be charged if the family selects a service which does not require <br/>
<a id="pl.526.22"></a><var>526.22</var>embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.<br/>
<a id="pl.526.23"></a><var>526.23</var>    Subd. 2. <b>Services provided without prior approval; preventive requirement.</b><br/>
<a id="pl.526.24"></a><var>526.24</var>To prevent unfair or deceptive acts or practices, funeral providers must include on <br/>
<a id="pl.526.25"></a><var>526.25</var>the itemized statement of funeral goods or services, as described in section 
         <statute_ref>149A.71, <br/>
<a id="pl.526.26"></a><var>526.26</var>subdivision 2
         </statute_ref>, paragraph (f), the statement "If you selected a funeral that may require <br/>
<a id="pl.526.27"></a><var>526.27</var>embalming, such as a funeral with viewing, you may have to pay for embalming. You do <br/>
<a id="pl.526.28"></a><var>526.28</var>not have to pay for embalming you did not approve if you selected arrangements such <br/>
<a id="pl.526.29"></a><var>526.29</var>as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for <br/>
<a id="pl.526.30"></a><var>526.30</var>embalming, we will explain why below."<br/>
<br/>
<a id="bill.12.87.0"></a><a id="pl.526.31"></a><var>526.31</var>    Sec. 87. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:<br/>
<a id="pl.526.32"></a><var>526.32</var>    Subd. 9. <b>Embalmed</b><b> Bodies awaiting </b><b>final </b><b>disposition.</b> All embalmed bodies <br/>
<a id="pl.526.33"></a><var>526.33</var>awaiting final disposition shall be kept in an appropriate holding facility or preparation <br/>
<a id="pl.526.34"></a><var>526.34</var>and embalming room. The holding facility must be secure from access by anyone except <br/>
<a id="pl.527.1"></a><var>527.1</var>the authorized personnel of the funeral establishment, preserve the dignity and integrity of <br/>
<a id="pl.527.2"></a><var>527.2</var>the body, and protect the health and safety of the personnel of the funeral establishment.<br/>
<br/>
<a id="bill.12.88.0"></a><a id="pl.527.3"></a><var>527.3</var>    Sec. 88. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:<br/>
<a id="pl.527.4"></a><var>527.4</var>    Subd. 3. <b>Disposition permit.</b> A disposition permit is required before a body can <br/>
<a id="pl.527.5"></a><var>527.5</var>be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be <br/>
<a id="pl.527.6"></a><var>527.6</var>issued until a fact of death record has been completed and filed with the local or state <br/>
<a id="pl.527.7"></a><var>527.7</var>registrar of vital statistics.<br/>
<br/>
<a id="bill.12.89.0"></a><a id="pl.527.8"></a><var>527.8</var>    Sec. 89. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:<br/>
<a id="pl.527.9"></a><var>527.9</var>    Subd. 6. <b>Conveyances permitted for transportation.</b> A dead human body may be <br/>
<a id="pl.527.10"></a><var>527.10</var>transported by means of private vehicle or private aircraft, provided that the body must be <br/>
<a id="pl.527.11"></a><var>527.11</var>encased in an appropriate container, that meets the following standards:<br/>
<a id="pl.527.12"></a><var>527.12</var>    (1) promotes respect for and preserves the dignity of the dead human body;<br/>
<a id="pl.527.13"></a><var>527.13</var>    (2) shields the body from being viewed from outside of the conveyance;<br/>
<a id="pl.527.14"></a><var>527.14</var>    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket, <br/>
<a id="pl.527.15"></a><var>527.15</var>alternative container, alkaline hydrolysis container, or cremation container in a horizontal <br/>
<a id="pl.527.16"></a><var>527.16</var>position;<br/>
<a id="pl.527.17"></a><var>527.17</var>    (4) is designed to permit loading and unloading of the body without excessive tilting <br/>
<a id="pl.527.18"></a><var>527.18</var>of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,<br/>
<a id="pl.527.19"></a><var>527.19</var> or cremation container; and<br/>
<a id="pl.527.20"></a><var>527.20</var>    (5) if used for the transportation of more than one dead human body at one time, <br/>
<a id="pl.527.21"></a><var>527.21</var>the vehicle must be designed so that a body or container does not rest directly on top of <br/>
<a id="pl.527.22"></a><var>527.22</var>another body or container and that each body or container is secured to prevent the body <br/>
<a id="pl.527.23"></a><var>527.23</var>or container from excessive movement within the conveyance.<br/>
<a id="pl.527.24"></a><var>527.24</var>    A vehicle that is a dignified conveyance and was specified for use by the deceased <br/>
<a id="pl.527.25"></a><var>527.25</var>or by the family of the deceased may be used to transport the body to the place of final <br/>
<a id="pl.527.26"></a><var>527.26</var>disposition.<br/>
<br/>
<a id="bill.12.90.0"></a><a id="pl.527.27"></a><var>527.27</var>    Sec. 90. Minnesota Statutes 2012, section 149A.94, is amended to read:<br/>
<a id="pl.527.28"></a><var>527.28</var><b>149A.94 FINAL DISPOSITION.</b><br/>
<a id="pl.527.29"></a><var>527.29</var>    Subdivision 1. <b>Generally.</b> Every dead human body lying within the state, except <br/>
<a id="pl.527.30"></a><var>527.30</var>unclaimed bodies delivered for dissection by the medical examiner, those delivered for <br/>
<a id="pl.527.31"></a><var>527.31</var>anatomical study pursuant to section 
         <statute_ref>149A.81, subdivision 2</statute_ref>, or lawfully carried through <br/>
<a id="pl.527.32"></a><var>527.32</var>the state for the purpose of disposition elsewhere; and the remains of any dead human <br/>
<a id="pl.527.33"></a><var>527.33</var>body after dissection or anatomical study, shall be decently buried, or entombed in a <br/>
<a id="pl.528.1"></a><var>528.1</var>public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time <br/>
<a id="pl.528.2"></a><var>528.2</var>after death. Where final disposition of a body will not be accomplished within 72 hours <br/>
<a id="pl.528.3"></a><var>528.3</var>following death or release of the body by a competent authority with jurisdiction over the <br/>
<a id="pl.528.4"></a><var>528.4</var>body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body <br/>
<a id="pl.528.5"></a><var>528.5</var>may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry <br/>
<a id="pl.528.6"></a><var>528.6</var>ice for a period that exceeds four calendar days, from the time of death or release of the <br/>
<a id="pl.528.7"></a><var>528.7</var>body from the coroner or medical examiner.<br/>
<a id="pl.528.8"></a><var>528.8</var>    Subd. 3. <b>Permit required.</b> No dead human body shall be buried, entombed, or <br/>
<a id="pl.528.9"></a><var>528.9</var>cremated without a disposition permit. The disposition permit must be filed with the person <br/>
<a id="pl.528.10"></a><var>528.10</var>in charge of the place of final disposition. Where a dead human body will be transported out <br/>
<a id="pl.528.11"></a><var>528.11</var>of this state for final disposition, the body must be accompanied by a certificate of removal.<br/>
<a id="pl.528.12"></a><var>528.12</var>    Subd. 4. <b>Alkaline hydrolysis or </b><b>cremation.</b> Inurnment of alkaline hydrolyzed or <br/>
<a id="pl.528.13"></a><var>528.13</var>cremated remains and release to an appropriate party is considered final disposition and no <br/>
<a id="pl.528.14"></a><var>528.14</var>further permits or authorizations are required for transportation, interment, entombment, or <br/>
<a id="pl.528.15"></a><var>528.15</var>placement of the cremated remains, except as provided in section 
         <statute_ref>149A.95, subdivision 16</statute_ref>.<br/>
<br/>
<a id="bill.12.91.0"></a><a id="pl.528.16"></a><var>528.16</var>    Sec. 91. <b>[149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE </b><br/>
<a id="pl.528.17"></a><var>528.17</var><b>HYDROLYSIS.</b><br/>
<a id="pl.528.18"></a><var>528.18</var>    Subdivision 1. <b>License required.</b> A dead human body may only be hydrolyzed in <br/>
<a id="pl.528.19"></a><var>528.19</var>this state at an alkaline hydrolysis facility licensed by the commissioner of health.<br/>
<a id="pl.528.20"></a><var>528.20</var>    Subd. 2. <b>General requirements.</b> Any building to be used as an alkaline hydrolysis <br/>
<a id="pl.528.21"></a><var>528.21</var>facility must comply with all applicable local and state building codes, zoning laws and <br/>
<a id="pl.528.22"></a><var>528.22</var>ordinances, wastewater management regulations, and environmental statutes, rules, and <br/>
<a id="pl.528.23"></a><var>528.23</var>standards. An alkaline hydrolysis facility must have, on site, a purpose built human <br/>
<a id="pl.528.24"></a><var>528.24</var>alkaline hydrolysis system approved by the commissioner of health, a system approved by <br/>
<a id="pl.528.25"></a><var>528.25</var>the commissioner of health for drying the hydrolyzed remains, a motorized mechanical <br/>
<a id="pl.528.26"></a><var>528.26</var>device approved by the commissioner of health for processing hydrolyzed remains and <br/>
<a id="pl.528.27"></a><var>528.27</var>must have in the building a holding facility approved by the commissioner of health for <br/>
<a id="pl.528.28"></a><var>528.28</var>the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility <br/>
<a id="pl.528.29"></a><var>528.29</var>must be secure from access by anyone except the authorized personnel of the alkaline <br/>
<a id="pl.528.30"></a><var>528.30</var>hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of <br/>
<a id="pl.528.31"></a><var>528.31</var>the alkaline hydrolysis facility personnel.<br/>
<a id="pl.528.32"></a><var>528.32</var>    Subd. 3. <b>Lighting and ventilation.</b> The room where the alkaline hydrolysis vessel <br/>
<a id="pl.528.33"></a><var>528.33</var>is located and the room where the chemical storage takes place shall be properly lit and <br/>
<a id="pl.528.34"></a><var>528.34</var>ventilated with an exhaust fan that provides at least 12 air changes per hour.<br/>
<a id="pl.529.1"></a><var>529.1</var>    Subd. 4. <b>Plumbing connections.</b> All plumbing fixtures, water supply lines, <br/>
<a id="pl.529.2"></a><var>529.2</var>plumbing vents, and waste drains shall be properly vented and connected pursuant to the <br/>
<a id="pl.529.3"></a><var>529.3</var>Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a <br/>
<a id="pl.529.4"></a><var>529.4</var>functional sink with hot and cold running water.<br/>
<a id="pl.529.5"></a><var>529.5</var>    Subd. 5. <b>Flooring, walls, ceiling, doors, and windows.</b> The room where the <br/>
<a id="pl.529.6"></a><var>529.6</var>alkaline hydrolysis vessel is located and the room where the chemical storage takes place <br/>
<a id="pl.529.7"></a><var>529.7</var>shall have nonporous flooring, so that a sanitary condition is provided. The walls and <br/>
<a id="pl.529.8"></a><var>529.8</var>ceiling of the room where the alkaline hydrolysis vessel is located and the room where <br/>
<a id="pl.529.9"></a><var>529.9</var>the chemical storage takes place shall run from floor to ceiling and be covered with tile, <br/>
<a id="pl.529.10"></a><var>529.10</var>or by plaster or sheetrock painted with washable paint or other appropriate material so <br/>
<a id="pl.529.11"></a><var>529.11</var>that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be <br/>
<a id="pl.529.12"></a><var>529.12</var>constructed to prevent odors from entering any other part of the building. All windows <br/>
<a id="pl.529.13"></a><var>529.13</var>or other openings to the outside must be screened and all windows must be treated in a <br/>
<a id="pl.529.14"></a><var>529.14</var>manner that prevents viewing into the room where the alkaline hydrolysis vessel is located <br/>
<a id="pl.529.15"></a><var>529.15</var>and the room where the chemical storage takes place. A viewing window for authorized <br/>
<a id="pl.529.16"></a><var>529.16</var>family members or their designees is not a violation of this subdivision.<br/>
<a id="pl.529.17"></a><var>529.17</var>    Subd. 6. <b>Equipment and supplies.</b> The alkaline hydrolysis facility must have a <br/>
<a id="pl.529.18"></a><var>529.18</var>functional emergency eye wash and quick drench shower.<br/>
<a id="pl.529.19"></a><var>529.19</var>    Subd. 7. <b>Access and privacy.</b> (a) The room where the alkaline hydrolysis vessel is <br/>
<a id="pl.529.20"></a><var>529.20</var>located and the room where the chemical storage takes place must be private and have no <br/>
<a id="pl.529.21"></a><var>529.21</var>general passageway through it. The room shall, at all times, be secure from the entrance of <br/>
<a id="pl.529.22"></a><var>529.22</var>unauthorized persons. Authorized persons are:<br/>
<a id="pl.529.23"></a><var>529.23</var>(1) licensed morticians;<br/>
<a id="pl.529.24"></a><var>529.24</var>(2) registered interns or students as described in section 149A.91, subdivision 6;<br/>
<a id="pl.529.25"></a><var>529.25</var>(3) public officials or representatives in the discharge of their official duties; <br/>
<a id="pl.529.26"></a><var>529.26</var>(4) trained alkaline hydrolysis facility operators; and<br/>
<a id="pl.529.27"></a><var>529.27</var>(5) the persons with the right to control the dead human body as defined in section <br/>
<a id="pl.529.28"></a><var>529.28</var>149A.80, subdivision 2, and their designees.<br/>
<a id="pl.529.29"></a><var>529.29</var>    (b) Each door allowing ingress or egress shall carry a sign that indicates that the <br/>
<a id="pl.529.30"></a><var>529.30</var>room is private and access is limited. All authorized persons who are present in or enter <br/>
<a id="pl.529.31"></a><var>529.31</var>the room where the alkaline hydrolysis vessel is located while a body is being prepared for <br/>
<a id="pl.529.32"></a><var>529.32</var>final disposition must be attired according to all applicable state and federal regulations <br/>
<a id="pl.529.33"></a><var>529.33</var>regarding the control of infectious disease and occupational and workplace health and <br/>
<a id="pl.529.34"></a><var>529.34</var>safety.<br/>
<a id="pl.529.35"></a><var>529.35</var>    Subd. 8. <b>Sanitary conditions and permitted use.</b> The room where the alkaline <br/>
<a id="pl.529.36"></a><var>529.36</var>hydrolysis vessel is located and the room where the chemical storage takes place and all <br/>
<a id="pl.530.1"></a><var>530.1</var>fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies <br/>
<a id="pl.530.2"></a><var>530.2</var>stored or used in the room must be maintained in a clean and sanitary condition at all times.<br/>
<a id="pl.530.3"></a><var>530.3</var>    Subd. 9. <b>Boiler use.</b> When a boiler is required by the manufacturer of the alkaline <br/>
<a id="pl.530.4"></a><var>530.4</var>hydrolysis vessel for its operation, all state and local regulations for that boiler must be <br/>
<a id="pl.530.5"></a><var>530.5</var>followed.<br/>
<a id="pl.530.6"></a><var>530.6</var>    Subd. 10. <b>Occupational and workplace safety.</b> All applicable provisions of state <br/>
<a id="pl.530.7"></a><var>530.7</var>and federal regulations regarding exposure to workplace hazards and accidents shall be <br/>
<a id="pl.530.8"></a><var>530.8</var>followed in order to protect the health and safety of all authorized persons at the alkaline <br/>
<a id="pl.530.9"></a><var>530.9</var>hydrolysis facility.<br/>
<a id="pl.530.10"></a><var>530.10</var>    Subd. 11. <b>Licensed personnel.</b> A licensed alkaline hydrolysis facility must employ <br/>
<a id="pl.530.11"></a><var>530.11</var>a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body. <br/>
<a id="pl.530.12"></a><var>530.12</var>It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for <br/>
<a id="pl.530.13"></a><var>530.13</var>all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for <br/>
<a id="pl.530.14"></a><var>530.14</var>compliance with this chapter and other applicable state and federal regulations regarding <br/>
<a id="pl.530.15"></a><var>530.15</var>occupational and workplace health and safety.<br/>
<a id="pl.530.16"></a><var>530.16</var>    Subd. 12. <b>Authorization to hydrolyze required.</b> No alkaline hydrolysis facility <br/>
<a id="pl.530.17"></a><var>530.17</var>shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part <br/>
<a id="pl.530.18"></a><var>530.18</var>without receiving written authorization to do so from the person or persons who have the <br/>
<a id="pl.530.19"></a><var>530.19</var>legal right to control disposition as described in section 149A.80 or the person's legal <br/>
<a id="pl.530.20"></a><var>530.20</var>designee. The written authorization must include:<br/>
<a id="pl.530.21"></a><var>530.21</var>(1) the name of the deceased and the date of death of the deceased;<br/>
<a id="pl.530.22"></a><var>530.22</var>(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;<br/>
<a id="pl.530.23"></a><var>530.23</var>(3) the name, address, telephone number, relationship to the deceased, and signature <br/>
<a id="pl.530.24"></a><var>530.24</var>of the person or persons with legal right to control final disposition or a legal designee;<br/>
<a id="pl.530.25"></a><var>530.25</var>(4) directions for the disposition of any nonhydrolyzed materials or items recovered <br/>
<a id="pl.530.26"></a><var>530.26</var>from the alkaline hydrolysis vessel;<br/>
<a id="pl.530.27"></a><var>530.27</var>(5) acknowledgment that the hydrolyzed remains will be dried and mechanically <br/>
<a id="pl.530.28"></a><var>530.28</var>reduced to a granulated appearance and placed in an appropriate container and <br/>
<a id="pl.530.29"></a><var>530.29</var>authorization to place any hydrolyzed remains that a selected urn or container will not <br/>
<a id="pl.530.30"></a><var>530.30</var>accommodate into a temporary container;<br/>
<a id="pl.530.31"></a><var>530.31</var>(6) acknowledgment that, even with the exercise of reasonable care, it is not possible <br/>
<a id="pl.530.32"></a><var>530.32</var>to recover all particles of the hydrolyzed remains and that some particles may inadvertently <br/>
<a id="pl.530.33"></a><var>530.33</var>become commingled with particles of other hydrolyzed remains that remain in the alkaline <br/>
<a id="pl.530.34"></a><var>530.34</var>hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;<br/>
<a id="pl.530.35"></a><var>530.35</var>(7) directions for the ultimate disposition of the hydrolyzed remains; and<br/>
<a id="pl.531.1"></a><var>531.1</var>(8) a statement that includes, but is not limited to, the following information: <br/>
<a id="pl.531.2"></a><var>531.2</var>"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an <br/>
<a id="pl.531.3"></a><var>531.3</var>alkaline solution is used to chemically break down the human tissue and the hydrolyzable <br/>
<a id="pl.531.4"></a><var>531.4</var>alkaline hydrolysis container. After the process is complete, the liquid effluent solution <br/>
<a id="pl.531.5"></a><var>531.5</var>contains the chemical by-products of the alkaline hydrolysis process except for the <br/>
<a id="pl.531.6"></a><var>531.6</var>deceased's bone fragments. The solution is cooled and released according to local <br/>
<a id="pl.531.7"></a><var>531.7</var>environmental regulations. A water rinse is applied to the hydrolyzed remains which are <br/>
<a id="pl.531.8"></a><var>531.8</var>then dried and processed to facilitate inurnment or scattering."<br/>
<a id="pl.531.9"></a><var>531.9</var>    Subd. 13. <b>Limitation of liability.</b> A licensed alkaline hydrolysis facility acting in <br/>
<a id="pl.531.10"></a><var>531.10</var>good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an <br/>
<a id="pl.531.11"></a><var>531.11</var>authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from <br/>
<a id="pl.531.12"></a><var>531.12</var>civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis <br/>
<a id="pl.531.13"></a><var>531.13</var>facility.<br/>
<a id="pl.531.14"></a><var>531.14</var>    Subd. 14. <b>Acceptance of delivery of body.</b> (a) No dead human body shall be <br/>
<a id="pl.531.15"></a><var>531.15</var>accepted for final disposition by alkaline hydrolysis unless:<br/>
<a id="pl.531.16"></a><var>531.16</var>(1) encased in an appropriate alkaline hydrolysis container;<br/>
<a id="pl.531.17"></a><var>531.17</var>(2) accompanied by a disposition permit issued pursuant to section 149A.93, <br/>
<a id="pl.531.18"></a><var>531.18</var>subdivision 3, including a photocopy of the completed death record or a signed release <br/>
<a id="pl.531.19"></a><var>531.19</var>authorizing alkaline hydrolysis of the body received from the coroner or medical <br/>
<a id="pl.531.20"></a><var>531.20</var>examiner; and<br/>
<a id="pl.531.21"></a><var>531.21</var>(3) accompanied by an alkaline hydrolysis authorization that complies with <br/>
<a id="pl.531.22"></a><var>531.22</var>subdivision 12.<br/>
<a id="pl.531.23"></a><var>531.23</var>    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline <br/>
<a id="pl.531.24"></a><var>531.24</var>hydrolysis container where there is:<br/>
<a id="pl.531.25"></a><var>531.25</var>(1) evidence of leakage of fluids from the alkaline hydrolysis container;<br/>
<a id="pl.531.26"></a><var>531.26</var>(2) a known dispute concerning hydrolysis of the body delivered;<br/>
<a id="pl.531.27"></a><var>531.27</var>(3) a reasonable basis for questioning any of the representations made on the written <br/>
<a id="pl.531.28"></a><var>531.28</var>authorization to hydrolyze; or<br/>
<a id="pl.531.29"></a><var>531.29</var>(4) any other lawful reason.<br/>
<a id="pl.531.30"></a><var>531.30</var>    Subd. 15. <b>Bodies awaiting hydrolysis.</b> A dead human body must be hydrolyzed <br/>
<a id="pl.531.31"></a><var>531.31</var>within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of <br/>
<a id="pl.531.32"></a><var>531.32</var>the body.<br/>
<a id="pl.531.33"></a><var>531.33</var>    Subd. 16. <b>Handling of alkaline hydrolysis containers for dead human bodies.</b><br/>
<a id="pl.531.34"></a><var>531.34</var>All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for <br/>
<a id="pl.531.35"></a><var>531.35</var>dead human bodies shall use universal precautions and otherwise exercise all reasonable <br/>
<a id="pl.532.1"></a><var>532.1</var>precautions to minimize the risk of transmitting any communicable disease from the body. <br/>
<a id="pl.532.2"></a><var>532.2</var>No dead human body shall be removed from the container in which it is delivered.<br/>
<a id="pl.532.3"></a><var>532.3</var>    Subd. 17. <b>Identification of body.</b> All licensed alkaline hydrolysis facilities shall <br/>
<a id="pl.532.4"></a><var>532.4</var>develop, implement, and maintain an identification procedure whereby dead human <br/>
<a id="pl.532.5"></a><var>532.5</var>bodes can be identified from the time the alkaline hydrolysis facility accepts delivery <br/>
<a id="pl.532.6"></a><var>532.6</var>of the remains until the hydrolyzed remains are released to an authorized party. After <br/>
<a id="pl.532.7"></a><var>532.7</var>hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the <br/>
<a id="pl.532.8"></a><var>532.8</var>hydrolyzed remains container before the hydrolyzed remains are released from the alkaline <br/>
<a id="pl.532.9"></a><var>532.9</var>hydrolysis facility. Each identification disk, tab, or label shall have a number that shall <br/>
<a id="pl.532.10"></a><var>532.10</var>be recorded on all paperwork regarding the decedent. This procedure shall be designed <br/>
<a id="pl.532.11"></a><var>532.11</var>to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains <br/>
<a id="pl.532.12"></a><var>532.12</var>are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the <br/>
<a id="pl.532.13"></a><var>532.13</var>inability to individually identify the hydrolyzed remains is a violation of this subdivision.<br/>
<a id="pl.532.14"></a><var>532.14</var>    Subd. 18. <b>Alkaline hydrolysis vessel for human remains.</b> A licensed alkaline <br/>
<a id="pl.532.15"></a><var>532.15</var>hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains <br/>
<a id="pl.532.16"></a><var>532.16</var>in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for <br/>
<a id="pl.532.17"></a><var>532.17</var>infectious disease control.<br/>
<a id="pl.532.18"></a><var>532.18</var>    Subd. 19. <b>Alkaline hydrolysis procedures; privacy.</b> The final disposition of <br/>
<a id="pl.532.19"></a><var>532.19</var>dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is <br/>
<a id="pl.532.20"></a><var>532.20</var>written authorization from the person with the legal right to control the disposition, <br/>
<a id="pl.532.21"></a><var>532.21</var>only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline <br/>
<a id="pl.532.22"></a><var>532.22</var>hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting <br/>
<a id="pl.532.23"></a><var>532.23</var>alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline <br/>
<a id="pl.532.24"></a><var>532.24</var>hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.<br/>
<a id="pl.532.25"></a><var>532.25</var>    Subd. 20. <b>Alkaline hydrolysis procedures; commingling of hydrolyzed remains </b><br/>
<a id="pl.532.26"></a><var>532.26</var><b>prohibited.</b> Except with the express written permission of the person with the legal right <br/>
<a id="pl.532.27"></a><var>532.27</var>to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one <br/>
<a id="pl.532.28"></a><var>532.28</var>dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce <br/>
<a id="pl.532.29"></a><var>532.29</var>a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have <br/>
<a id="pl.532.30"></a><var>532.30</var>been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze <br/>
<a id="pl.532.31"></a><var>532.31</var>a dead human body and other human remains at the same time and in the same alkaline <br/>
<a id="pl.532.32"></a><var>532.32</var>hydrolysis vessel. This section does not apply where commingling of human remains <br/>
<a id="pl.532.33"></a><var>532.33</var>during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental <br/>
<a id="pl.532.34"></a><var>532.34</var>and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is <br/>
<a id="pl.532.35"></a><var>532.35</var>not a violation of this subdivision.<br/>
<a id="pl.533.1"></a><var>533.1</var>    Subd. 21. <b>Alkaline hydrolysis procedures; removal from alkaline hydrolysis </b><br/>
<a id="pl.533.2"></a><var>533.2</var><b>vessel.</b> Upon completion of the alkaline hydrolysis process, reasonable efforts shall be <br/>
<a id="pl.533.3"></a><var>533.3</var>made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed <br/>
<a id="pl.533.4"></a><var>533.4</var>remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be <br/>
<a id="pl.533.5"></a><var>533.5</var>made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed <br/>
<a id="pl.533.6"></a><var>533.6</var>human remains and dispose of these materials in a lawful manner, by the alkaline <br/>
<a id="pl.533.7"></a><var>533.7</var>hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate <br/>
<a id="pl.533.8"></a><var>533.8</var>container to be transported to the processing area.<br/>
<a id="pl.533.9"></a><var>533.9</var>    Subd. 22. <b>Drying device or mechanical processor procedures; commingling of </b><br/>
<a id="pl.533.10"></a><var>533.10</var><b>hydrolyzed remains prohibited.</b> Except with the express written permission of the <br/>
<a id="pl.533.11"></a><var>533.11</var>person with the legal right to control the final disposition or otherwise provided by <br/>
<a id="pl.533.12"></a><var>533.12</var>law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed <br/>
<a id="pl.533.13"></a><var>533.13</var>human remains of more than one body at a time in the same drying device or mechanical <br/>
<a id="pl.533.14"></a><var>533.14</var>processor, or introduce the hydrolyzed human remains of a second body into a drying <br/>
<a id="pl.533.15"></a><var>533.15</var>device or mechanical processor until processing of any preceding hydrolyzed human <br/>
<a id="pl.533.16"></a><var>533.16</var>remains has been terminated and reasonable efforts have been employed to remove all <br/>
<a id="pl.533.17"></a><var>533.17</var>fragments of the preceding hydrolyzed remains. The fact that there is incidental and <br/>
<a id="pl.533.18"></a><var>533.18</var>unavoidable residue in the drying device, the mechanical processor, or any container used <br/>
<a id="pl.533.19"></a><var>533.19</var>in a prior alkaline hydrolysis process, is not a violation of this provision.<br/>
<a id="pl.533.20"></a><var>533.20</var>    Subd. 23. <b>Alkaline hydrolysis procedures; processing hydrolyzed remains.</b> The <br/>
<a id="pl.533.21"></a><var>533.21</var>hydrolyzed human remains shall be dried and then reduced by a motorized mechanical <br/>
<a id="pl.533.22"></a><var>533.22</var>device to a granulated appearance appropriate for final disposition and placed in an <br/>
<a id="pl.533.23"></a><var>533.23</var>alkaline hydrolysis remains container along with the appropriate identifying disk, tab, <br/>
<a id="pl.533.24"></a><var>533.24</var>or permanent label. Processing must take place within the licensed alkaline hydrolysis <br/>
<a id="pl.533.25"></a><var>533.25</var>facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they <br/>
<a id="pl.533.26"></a><var>533.26</var>can be identified, may be removed prior to processing the hydrolyzed remains, only by <br/>
<a id="pl.533.27"></a><var>533.27</var>staff licensed or registered by the commissioner of health; however, any dental gold and <br/>
<a id="pl.533.28"></a><var>533.28</var>silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains <br/>
<a id="pl.533.29"></a><var>533.29</var>container unless otherwise directed by the person or persons having the right to control the <br/>
<a id="pl.533.30"></a><var>533.30</var>final disposition. Every person who removes or possesses dental gold or silver, jewelry, <br/>
<a id="pl.533.31"></a><var>533.31</var>or mementos from any hydrolyzed remains without specific written permission of the <br/>
<a id="pl.533.32"></a><var>533.32</var>person or persons having the right to control those remains is guilty of a misdemeanor. <br/>
<a id="pl.533.33"></a><var>533.33</var>The fact that residue and any unavoidable dental gold or dental silver, or other precious <br/>
<a id="pl.533.34"></a><var>533.34</var>metals remain in the alkaline hydrolysis vessel or other equipment or any container used <br/>
<a id="pl.533.35"></a><var>533.35</var>in a prior hydrolysis is not a violation of this section.<br/>
<a id="pl.534.1"></a><var>534.1</var>    Subd. 24. <b>Alkaline hydrolysis procedures; container of insufficient capacity.</b><br/>
<a id="pl.534.2"></a><var>534.2</var>If a hydrolyzed remains container is of insufficient capacity to accommodate all <br/>
<a id="pl.534.3"></a><var>534.3</var>hydrolyzed remains of a given dead human body, subject to directives provided in the <br/>
<a id="pl.534.4"></a><var>534.4</var>written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess <br/>
<a id="pl.534.5"></a><var>534.5</var>hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the <br/>
<a id="pl.534.6"></a><var>534.6</var>second container, in a manner so as not to be easily detached through incidental contact, to <br/>
<a id="pl.534.7"></a><var>534.7</var>the primary alkaline hydrolysis remains container. The secondary container shall contain a <br/>
<a id="pl.534.8"></a><var>534.8</var>duplicate of the identification disk, tab, or permanent label that was placed in the primary <br/>
<a id="pl.534.9"></a><var>534.9</var>container and all paperwork regarding the given body shall include a notation that the <br/>
<a id="pl.534.10"></a><var>534.10</var>hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature <br/>
<a id="pl.534.11"></a><var>534.11</var>hydrolyzed remains containers are not subject to the requirements of this subdivision.<br/>
<a id="pl.534.12"></a><var>534.12</var>    Subd. 25. <b>Disposition procedures; commingling of hydrolyzed remains </b><br/>
<a id="pl.534.13"></a><var>534.13</var><b>prohibited.</b> No hydrolyzed remains shall be disposed of or scattered in a manner or in <br/>
<a id="pl.534.14"></a><var>534.14</var>a location where the hydrolyzed remains are commingled with those of another person <br/>
<a id="pl.534.15"></a><var>534.15</var>without the express written permission of the person with the legal right to control <br/>
<a id="pl.534.16"></a><var>534.16</var>disposition or as otherwise provided by law. This subdivision does not apply to the <br/>
<a id="pl.534.17"></a><var>534.17</var>scattering or burial of hydrolyzed remains at sea or in a body of water from individual <br/>
<a id="pl.534.18"></a><var>534.18</var>containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to <br/>
<a id="pl.534.19"></a><var>534.19</var>the disposal in a dedicated cemetery of accumulated residue removed from an alkaline <br/>
<a id="pl.534.20"></a><var>534.20</var>hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members <br/>
<a id="pl.534.21"></a><var>534.21</var>of the same family in a common container designed for the hydrolyzed remains of more <br/>
<a id="pl.534.22"></a><var>534.22</var>than one body, or to the inurnment in a container or interment in a space that has been <br/>
<a id="pl.534.23"></a><var>534.23</var>previously designated, at the time of sale or purchase, as being intended for the inurnment <br/>
<a id="pl.534.24"></a><var>534.24</var>or interment of the hydrolyzed remains of more than one person.<br/>
<a id="pl.534.25"></a><var>534.25</var>    Subd. 26. <b>Alkaline hydrolysis procedures; disposition of accumulated residue.</b><br/>
<a id="pl.534.26"></a><var>534.26</var>Every alkaline hydrolysis facility shall provide for the removal and disposition in a <br/>
<a id="pl.534.27"></a><var>534.27</var>dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel, <br/>
<a id="pl.534.28"></a><var>534.28</var>drying device, mechanical processor, container, or other equipment used in alkaline <br/>
<a id="pl.534.29"></a><var>534.29</var>hydrolysis. Disposition of accumulated residue shall be according to the regulations of the <br/>
<a id="pl.534.30"></a><var>534.30</var>dedicated cemetery and any applicable local ordinances.<br/>
<a id="pl.534.31"></a><var>534.31</var>    Subd. 27. <b>Alkaline hydrolysis procedures; release of hydrolyzed remains.</b><br/>
<a id="pl.534.32"></a><var>534.32</var>Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be <br/>
<a id="pl.534.33"></a><var>534.33</var>released according to the instructions given on the written authorization to hydrolyze. If <br/>
<a id="pl.534.34"></a><var>534.34</var>the hydrolyzed remains are to be shipped, they must be securely packaged and transported <br/>
<a id="pl.534.35"></a><var>534.35</var>by a method which has an internal tracing system available and which provides for a <br/>
<a id="pl.534.36"></a><var>534.36</var>receipt signed by the person accepting delivery. Where there is a dispute over release <br/>
<a id="pl.535.1"></a><var>535.1</var>or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit <br/>
<a id="pl.535.2"></a><var>535.2</var>the hydrolyzed remains with a court of competent jurisdiction pending resolution of the <br/>
<a id="pl.535.3"></a><var>535.3</var>dispute or retain the hydrolyzed remains until the person with the legal right to control <br/>
<a id="pl.535.4"></a><var>535.4</var>disposition presents satisfactory indication that the dispute is resolved.<br/>
<a id="pl.535.5"></a><var>535.5</var>    Subd. 28. <b>Unclaimed hydrolyzed remains.</b> If, after 30 calendar days following <br/>
<a id="pl.535.6"></a><var>535.6</var>the inurnment, the hydrolyzed remains are not claimed or disposed of according to the <br/>
<a id="pl.535.7"></a><var>535.7</var>written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment <br/>
<a id="pl.535.8"></a><var>535.8</var>may give written notice, by certified mail, to the person with the legal right to control <br/>
<a id="pl.535.9"></a><var>535.9</var>the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and <br/>
<a id="pl.535.10"></a><var>535.10</var>requesting further release directions. Should the hydrolyzed remains be unclaimed 120 <br/>
<a id="pl.535.11"></a><var>535.11</var>calendar days following the mailing of the written notification, the alkaline hydrolysis <br/>
<a id="pl.535.12"></a><var>535.12</var>facility or funeral establishment may dispose of the hydrolyzed remains in any lawful <br/>
<a id="pl.535.13"></a><var>535.13</var>manner deemed appropriate.<br/>
<a id="pl.535.14"></a><var>535.14</var>    Subd. 29. <b>Required records.</b> Every alkaline hydrolysis facility shall create and <br/>
<a id="pl.535.15"></a><var>535.15</var>maintain on its premises or other business location in Minnesota an accurate record of <br/>
<a id="pl.535.16"></a><var>535.16</var>every hydrolyzation provided. The record shall include all of the following information <br/>
<a id="pl.535.17"></a><var>535.17</var>for each hydrolyzation:<br/>
<a id="pl.535.18"></a><var>535.18</var>(1) the name of the person or funeral establishment delivering the body for alkaline <br/>
<a id="pl.535.19"></a><var>535.19</var>hydrolysis;<br/>
<a id="pl.535.20"></a><var>535.20</var>(2) the name of the deceased and the identification number assigned to the body;<br/>
<a id="pl.535.21"></a><var>535.21</var>(3) the date of acceptance of delivery;<br/>
<a id="pl.535.22"></a><var>535.22</var>(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical <br/>
<a id="pl.535.23"></a><var>535.23</var>processor operator;<br/>
<a id="pl.535.24"></a><var>535.24</var>(5) the time and date that the body was placed in and removed from the alkaline <br/>
<a id="pl.535.25"></a><var>535.25</var>hydrolysis vessel;<br/>
<a id="pl.535.26"></a><var>535.26</var>(6) the time and date that processing and inurnment of the hydrolyzed remains <br/>
<a id="pl.535.27"></a><var>535.27</var>was completed;<br/>
<a id="pl.535.28"></a><var>535.28</var>(7) the time, date, and manner of release of the hydrolyzed remains;<br/>
<a id="pl.535.29"></a><var>535.29</var>(8) the name and address of the person who signed the authorization to hydrolyze;<br/>
<a id="pl.535.30"></a><var>535.30</var>(9) all supporting documentation, including any transit or disposition permits, a <br/>
<a id="pl.535.31"></a><var>535.31</var>photocopy of the death record, and the authorization to hydrolyze; and<br/>
<a id="pl.535.32"></a><var>535.32</var>(10) the type of alkaline hydrolysis container.<br/>
<a id="pl.535.33"></a><var>535.33</var>    Subd. 30. <b>Retention of records.</b> Records required under subdivision 29 shall be <br/>
<a id="pl.535.34"></a><var>535.34</var>maintained for a period of three calendar years after the release of the hydrolyzed remains. <br/>
<a id="pl.535.35"></a><var>535.35</var>Following this period and subject to any other laws requiring retention of records, the <br/>
<a id="pl.535.36"></a><var>535.36</var>alkaline hydrolysis facility may then place the records in storage or reduce them to <br/>
<a id="pl.536.1"></a><var>536.1</var>microfilm, microfiche, laser disc, or any other method that can produce an accurate <br/>
<a id="pl.536.2"></a><var>536.2</var>reproduction of the original record, for retention for a period of ten calendar years from <br/>
<a id="pl.536.3"></a><var>536.3</var>the date of release of the hydrolyzed remains. At the end of this period and subject to any <br/>
<a id="pl.536.4"></a><var>536.4</var>other laws requiring retention of records, the alkaline hydrolysis facility may destroy <br/>
<a id="pl.536.5"></a><var>536.5</var>the records by shredding, incineration, or any other manner that protects the privacy of <br/>
<a id="pl.536.6"></a><var>536.6</var>the individuals identified.<br/>
<br/>
<a id="bill.12.92.0"></a><a id="pl.536.7"></a><var>536.7</var>    Sec. 92. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:<br/>
<a id="pl.536.8"></a><var>536.8</var>    Subd. 9. <b>Hydrolyzed and </b><b>cremated remains.</b> Subject to section 
         <statute_ref>149A.95, <br/>
<a id="pl.536.9"></a><var>536.9</var>subdivision 16
         </statute_ref>, inurnment of the hydrolyzed or cremated remains and release to an <br/>
<a id="pl.536.10"></a><var>536.10</var>appropriate party is considered final disposition and no further permits or authorizations <br/>
<a id="pl.536.11"></a><var>536.11</var>are required for disinterment, transportation, or placement of the hydrolyzed or cremated <br/>
<a id="pl.536.12"></a><var>536.12</var>remains.<br/>
<br/>
<a id="bill.12.93.0"></a><a id="pl.536.13"></a><var>536.13</var>    Sec. 93. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:<br/>
<a id="pl.536.14"></a><var>536.14</var>    Subd. 7. <b>Hospital and Department of Health; recognition form.</b> Hospitals that <br/>
<a id="pl.536.15"></a><var>536.15</var>provide obstetric services and the state registrar of vital statistics shall distribute the <br/>
<a id="pl.536.16"></a><var>536.16</var>educational materials and recognition of parentage forms prepared by the commissioner of <br/>
<a id="pl.536.17"></a><var>536.17</var>human services to new parents, shall assist parents in understanding the recognition of <br/>
<a id="pl.536.18"></a><var>536.18</var>parentage form, including following the provisions for notice under subdivision 5, shall <br/>
<a id="pl.536.19"></a><var>536.19</var>provide notary services for parents who complete the recognition of parentage form, and <br/>
<a id="pl.536.20"></a><var>536.20</var>shall timely file the completed recognition of parentage form with the Office of the State <br/>
<a id="pl.536.21"></a><var>536.21</var>Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State <br/>
<a id="pl.536.22"></a><var>536.22</var>Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not <br/>
<a id="pl.536.23"></a><var>536.23</var>distribute the declaration of parentage forms.<br/>
<br/>
<a id="bill.12.94.0"></a><a id="pl.536.24"></a><var>536.24</var>    Sec. 94. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:<br/>
<a id="pl.536.25"></a><var>536.25</var>    Subdivision 1. <b>Legal effect.</b> (a) Upon adoption, the adopted child becomes the legal <br/>
<a id="pl.536.26"></a><var>536.26</var>child of the adopting parent and the adopting parent becomes the legal parent of the child <br/>
<a id="pl.536.27"></a><var>536.27</var>with all the rights and duties between them of a birth parent and child.<br/>
<a id="pl.536.28"></a><var>536.28</var>(b) The child shall inherit from the adoptive parent and the adoptive parent's <br/>
<a id="pl.536.29"></a><var>536.29</var>relatives the same as though the child were the birth child of the parent, and in case of the <br/>
<a id="pl.536.30"></a><var>536.30</var>child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit <br/>
<a id="pl.536.31"></a><var>536.31</var>the child's estate as if the child had been the adoptive parent's birth child.<br/>
<a id="pl.536.32"></a><var>536.32</var>(c) After a decree of adoption is entered, the birth parents or previous legal parents <br/>
<a id="pl.536.33"></a><var>536.33</var>of the child shall be relieved of all parental responsibilities for the child except child <br/>
<a id="pl.537.1"></a><var>537.1</var>support that has accrued to the date of the order for guardianship to the commissioner <br/>
<a id="pl.537.2"></a><var>537.2</var>which continues to be due and owing. The child's birth or previous legal parent shall not <br/>
<a id="pl.537.3"></a><var>537.3</var>exercise or have any rights over the adopted child or the adopted child's property, person, <br/>
<a id="pl.537.4"></a><var>537.4</var>privacy, or reputation.<br/>
<a id="pl.537.5"></a><var>537.5</var>(d) The adopted child shall not owe the birth parents or the birth parent's relatives <br/>
<a id="pl.537.6"></a><var>537.6</var>any legal duty nor shall the adopted child inherit from the birth parents or kindred unless <br/>
<a id="pl.537.7"></a><var>537.7</var>otherwise provided for in a will of the birth parent or kindred.<br/>
<a id="pl.537.8"></a><var>537.8</var>    (e) Upon adoption, the court shall complete a certificate of adoption form and mail <br/>
<a id="pl.537.9"></a><var>537.9</var>the form to the Office of the State Registrar Vital Records at the Minnesota Department <br/>
<a id="pl.537.10"></a><var>537.10</var>of Health. Upon receiving the certificate of adoption, the state registrar shall register a <br/>
<a id="pl.537.11"></a><var>537.11</var>replacement vital record in the new name of the adopted child as required under section <br/>
<statute_ref><a id="pl.537.12"></a><var>537.12</var>144.218
         </statute_ref>.<br/>
<br/>
<a id="bill.12.95.0"></a><a id="pl.537.13"></a><var>537.13</var>    Sec. 95. Minnesota Statutes 2012, section 517.001, is amended to read:<br/>
<a id="pl.537.14"></a><var>537.14</var><b>517.001 DEFINITION.</b><br/>
<a id="pl.537.15"></a><var>537.15</var>As used in this chapter, "local registrar" has the meaning given in section 
<statute_ref>144.212, <br/>
<a id="pl.537.16"></a><var>537.16</var>subdivision 10
</statute_ref> means an individual designated by the county board of commissioners to <br/>
<a id="pl.537.17"></a><var>537.17</var>register marriages.<br/>
<br/>
<a id="bill.12.96.0"></a><a id="pl.537.18"></a><var>537.18</var>    Sec. 96. <b>FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.</b><br/>
<a id="pl.537.19"></a><var>537.19</var>    The commissioner of health shall review the statutory requirements for preparation <br/>
<a id="pl.537.20"></a><var>537.20</var>and embalming rooms and develop legislation with input from stakeholders that provides <br/>
<a id="pl.537.21"></a><var>537.21</var>appropriate health and safety protection for funeral home locations where deceased bodies <br/>
<a id="pl.537.22"></a><var>537.22</var>are present, but are branch locations associated through a majority ownership of a licensed <br/>
<a id="pl.537.23"></a><var>537.23</var>funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50 <br/>
<a id="pl.537.24"></a><var>537.24</var>and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance <br/>
<a id="pl.537.25"></a><var>537.25</var>between the main location and branch, and other health and safety issues.<br/>
<br/>
<a id="bill.12.97.0"></a><a id="pl.537.26"></a><var>537.26</var>    Sec. 97. <b>REVISOR'S INSTRUCTION.</b><br/>
<a id="pl.537.27"></a><var>537.27</var>The revisor shall substitute the term "vertical heat exchangers" or "vertical <br/>
<a id="pl.537.28"></a><var>537.28</var>heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat <br/>
<a id="pl.537.29"></a><var>537.29</var>exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions <br/>
<a id="pl.537.30"></a><var>537.30</var>2 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208, <br/>
<a id="pl.537.31"></a><var>537.31</var>subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.<br/>
<br/>
<a id="bill.12.98.0"></a><a id="pl.537.32"></a><var>537.32</var>    Sec. 98. <b> REPEALER.</b><br/>
<a id="pl.538.1"></a><var>538.1</var>(a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025; <br/>
<a id="pl.538.2"></a><var>538.2</var>149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, <br/>
<a id="pl.538.3"></a><var>538.3</var>subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; <br/>
<a id="pl.538.4"></a><var>538.4</var>149A.53, subdivision 9; and 485.14, are repealed.<br/>
<a id="pl.538.5"></a><var>538.5</var>(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective <br/>
<a id="pl.538.6"></a><var>538.6</var>July 1, 2014.<br/>
<br/>
<a id="bill.13.0.0"></a>

<a id="pl.538.9"></a><var>538.9</var><b>COMMUNITY-BASED SERVICES</b><br/>

<a id="bill.13.1.0"></a><a id="pl.538.10"></a><var>538.10</var>    Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to <br/>
<a id="pl.538.11"></a><var>538.11</var>read:<br/>
<a id="pl.538.12"></a><var>538.12</var>    Subd. 2. <b>Payment methodologies.</b> (a) The commissioner shall establish, as defined <br/>
<a id="pl.538.13"></a><var>538.13</var>under section 256B.4914, statewide payment methodologies that meet federal waiver <br/>
<a id="pl.538.14"></a><var>538.14</var>requirements for home and community-based waiver services for individuals with <br/>
<a id="pl.538.15"></a><var>538.15</var>disabilities. The payment methodologies must abide by the principles of transparency <br/>
<a id="pl.538.16"></a><var>538.16</var>and equitability across the state. The methodologies must involve a uniform process of <br/>
<a id="pl.538.17"></a><var>538.17</var>structuring rates for each service and must promote quality and participant choice.<br/>
<a id="pl.538.18"></a><var>538.18</var>    (b) As of January 1, 2012, counties shall not implement changes to established <br/>
<a id="pl.538.19"></a><var>538.19</var>processes for rate-setting methodologies for individuals using components of or data <br/>
<a id="pl.538.20"></a><var>538.20</var>from research rates.<br/>
<br/>
<a id="bill.13.2.0"></a><a id="pl.538.21"></a><var>538.21</var>    Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:<br/>
<a id="pl.538.22"></a><var>538.22</var>    Subd. 3. <b>Payment requirements.</b> The payment methodologies established under <br/>
<a id="pl.538.23"></a><var>538.23</var>this section shall accommodate:<br/>
<a id="pl.538.24"></a><var>538.24</var>(1) supervision costs;<br/>
<a id="pl.538.25"></a><var>538.25</var>(2) staffing patterns staff compensation;<br/>
<a id="pl.538.26"></a><var>538.26</var>(3) staffing and supervisory patterns;<br/>
<a id="pl.538.27"></a><var>538.27</var>(3) (4) program-related expenses;<br/>
<a id="pl.538.28"></a><var>538.28</var>(4) (5) general and administrative expenses; and<br/>
<a id="pl.538.29"></a><var>538.29</var>(5) (6) consideration of recipient intensity.<br/>
<br/>
<a id="bill.13.3.0"></a><a id="pl.538.30"></a><var>538.30</var>    Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended by adding a <br/>
<a id="pl.538.31"></a><var>538.31</var>subdivision to read:<br/>
<a id="pl.538.32"></a><var>538.32</var>    Subd. 4a. <b>Rate stabilization adjustment.</b> (a) The commissioner of human services <br/>
<a id="pl.538.33"></a><var>538.33</var>shall adjust individual reimbursement rates by no more than 1.0 percent per year effective <br/>
<a id="pl.539.1"></a><var>539.1</var>January 1, 2016. Rates determined under section 256B.4914 must be adjusted so that <br/>
<a id="pl.539.2"></a><var>539.2</var>the unit rate varies no more than 1.0 percent per year from the rate effective December <br/>
<a id="pl.539.3"></a><var>539.3</var>1 of the prior calendar year. This adjustment is made annually for three calendar years <br/>
<a id="pl.539.4"></a><var>539.4</var>from the date of implementation.<br/>
<a id="pl.539.5"></a><var>539.5</var>(b) Rate stabilization adjustment applies to services that are authorized in a <br/>
<a id="pl.539.6"></a><var>539.6</var>recipient's service plan prior to January 1, 2016.<br/>
<a id="pl.539.7"></a><var>539.7</var>(c) Exemptions shall be made only when there is a significant change in the <br/>
<a id="pl.539.8"></a><var>539.8</var>recipient's assessed needs that results in a service authorization change. Exemption <br/>
<a id="pl.539.9"></a><var>539.9</var>adjustments shall be limited to the difference in the authorized framework rate specific to <br/>
<a id="pl.539.10"></a><var>539.10</var>change in assessed need. Exemptions shall be managed within lead agencies' budgets per <br/>
<a id="pl.539.11"></a><var>539.11</var>existing allocation procedures.<br/>
<a id="pl.539.12"></a><var>539.12</var>(d) This subdivision expires January 1, 2019.<br/>
<br/>
<a id="bill.13.4.0"></a><a id="pl.539.13"></a><var>539.13</var>    Sec. 4. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:<br/>
<a id="pl.539.14"></a><var>539.14</var>    Subd. 5. <b>Stakeholder consultation.</b> The commissioner shall continue consultation <br/>
<a id="pl.539.15"></a><var>539.15</var>on regular intervals with the existing stakeholder group established as part of the <br/>
<a id="pl.539.16"></a><var>539.16</var>rate-setting methodology process and others, to gather input, concerns, and data, and <br/>
<a id="pl.539.17"></a><var>539.17</var>exchange ideas for the legislative proposals for to assist in the full implementation of<br/>
<a id="pl.539.18"></a><var>539.18</var> the new rate payment system and to make pertinent information available to the public <br/>
<a id="pl.539.19"></a><var>539.19</var>through the department's Web site.<br/>
<br/>
<a id="bill.13.5.0"></a><a id="pl.539.20"></a><var>539.20</var>    Sec. 5. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:<br/>
<a id="pl.539.21"></a><var>539.21</var>    Subd. 6. <b>Implementation.</b> (a) The commissioner may shall implement changes <br/>
<a id="pl.539.22"></a><var>539.22</var>no sooner than on January 1, 2014, to payment rates for individuals receiving home and <br/>
<a id="pl.539.23"></a><var>539.23</var>community-based waivered services after the enactment of legislation that establishes <br/>
<a id="pl.539.24"></a><var>539.24</var>specific payment methodology frameworks, processes for rate calculations, and specific <br/>
<a id="pl.539.25"></a><var>539.25</var>values to populate the payment methodology frameworks disability waiver rates system.<br/>
<a id="pl.539.26"></a><var>539.26</var>(b) On January 1, 2014, all new service authorizations must use the disability waiver <br/>
<a id="pl.539.27"></a><var>539.27</var>rates system. Beginning January 1, 2014, all renewing individual service plans must use the <br/>
<a id="pl.539.28"></a><var>539.28</var>disability waiver rates system as reassessment and reauthorization occurs. By December <br/>
<a id="pl.539.29"></a><var>539.29</var>31, 2014, data for all recipients must be entered into the disability waiver rates system.<br/>
<br/>
<a id="bill.13.6.0"></a><a id="pl.539.30"></a><var>539.30</var>    Sec. 6. <b>[256B.4914] HOME AND COMMUNITY-BASED SERVICES WAIVERS; </b><br/>
<a id="pl.539.31"></a><var>539.31</var><b>RATE SETTING.</b><br/>
<a id="pl.540.1"></a><var>540.1</var>    Subdivision 1. <b>Application.</b> The payment methodologies in this section apply to <br/>
<a id="pl.540.2"></a><var>540.2</var>home and community-based services waivers under sections 256B.092 and 256B.49. This <br/>
<a id="pl.540.3"></a><var>540.3</var>section does not change existing waiver policies and procedures.<br/>
<a id="pl.540.4"></a><var>540.4</var>    Subd. 2. <b>Definitions.</b> (a) For purposes of this section, the following terms have the <br/>
<a id="pl.540.5"></a><var>540.5</var>meanings given them, unless the context clearly indicates otherwise.<br/>
<a id="pl.540.6"></a><var>540.6</var>(b) "Commissioner" means the commissioner of human services.<br/>
<a id="pl.540.7"></a><var>540.7</var>(c) "Component value" means underlying factors that are part of the cost of providing <br/>
<a id="pl.540.8"></a><var>540.8</var>services that are built into the waiver rates methodology to calculate service rates.<br/>
<a id="pl.540.9"></a><var>540.9</var>(d) "Customized living tool" means a methodology for setting service rates that <br/>
<a id="pl.540.10"></a><var>540.10</var>delineates and documents the amount of each component service included in a recipient's <br/>
<a id="pl.540.11"></a><var>540.11</var>customized living service plan.<br/>
<a id="pl.540.12"></a><var>540.12</var>(e) "Disability waiver rates system" means a statewide system that establishes rates <br/>
<a id="pl.540.13"></a><var>540.13</var>that are based on uniform processes and captures the individualized nature of waiver <br/>
<a id="pl.540.14"></a><var>540.14</var>services and recipient needs.<br/>
<a id="pl.540.15"></a><var>540.15</var>(f) "Lead agency" means a county, partnership of counties, or tribal agency charged <br/>
<a id="pl.540.16"></a><var>540.16</var>with administering waivered services under sections 256B.092 and 256B.49.<br/>
<a id="pl.540.17"></a><var>540.17</var>(g) "Median" means the amount that divides distribution into two equal groups, <br/>
<a id="pl.540.18"></a><var>540.18</var>one-half above the median and one-half below the median.<br/>
<a id="pl.540.19"></a><var>540.19</var>(h) "Payment or rate" means reimbursement to an eligible provider for services <br/>
<a id="pl.540.20"></a><var>540.20</var>provided to a qualified individual based on an approved service authorization.<br/>
<a id="pl.540.21"></a><var>540.21</var>(i) "Rates management system" means a Web-based software application that uses <br/>
<a id="pl.540.22"></a><var>540.22</var>a framework and component values, as determined by the commissioner, to establish <br/>
<a id="pl.540.23"></a><var>540.23</var>service rates.<br/>
<a id="pl.540.24"></a><var>540.24</var>(j) "Recipient" means a person receiving home and community-based services <br/>
<a id="pl.540.25"></a><var>540.25</var>funded under any of the disability waivers.<br/>
<a id="pl.540.26"></a><var>540.26</var>    Subd. 3. <b>Applicable services.</b> Applicable services are those authorized under <br/>
<a id="pl.540.27"></a><var>540.27</var>the state's home and community-based services waivers under sections 256B.092 and <br/>
<a id="pl.540.28"></a><var>540.28</var>256B.49, including the following, as defined in the federally approved home and <br/>
<a id="pl.540.29"></a><var>540.29</var>community-based services plan:<br/>
<a id="pl.540.30"></a><var>540.30</var>(1) 24 hour customized living;<br/>
<a id="pl.540.31"></a><var>540.31</var>(2) adult day care;<br/>
<a id="pl.540.32"></a><var>540.32</var>(3) adult day care bath;<br/>
<a id="pl.540.33"></a><var>540.33</var>(4) behavioral programming;<br/>
<a id="pl.540.34"></a><var>540.34</var>(5) companion services;<br/>
<a id="pl.540.35"></a><var>540.35</var>(6) customized living;<br/>
<a id="pl.540.36"></a><var>540.36</var>(7) day training and habilitation;<br/>
<a id="pl.541.1"></a><var>541.1</var>(8) housing access coordination;<br/>
<a id="pl.541.2"></a><var>541.2</var>(9) independent living skills;<br/>
<a id="pl.541.3"></a><var>541.3</var>(10) in-home family support;<br/>
<a id="pl.541.4"></a><var>541.4</var>(11) night supervision;<br/>
<a id="pl.541.5"></a><var>541.5</var>(12) personal support;<br/>
<a id="pl.541.6"></a><var>541.6</var>(13) prevocational services;<br/>
<a id="pl.541.7"></a><var>541.7</var>(14) residential care services;<br/>
<a id="pl.541.8"></a><var>541.8</var>(15) residential support services;<br/>
<a id="pl.541.9"></a><var>541.9</var>(16) respite services;<br/>
<a id="pl.541.10"></a><var>541.10</var>(17) structured day services;<br/>
<a id="pl.541.11"></a><var>541.11</var>(18) supported employment services;<br/>
<a id="pl.541.12"></a><var>541.12</var>(19) supported living services;<br/>
<a id="pl.541.13"></a><var>541.13</var>(20) transportation services; and<br/>
<a id="pl.541.14"></a><var>541.14</var>(21) other services as approved by the federal government in the state home and <br/>
<a id="pl.541.15"></a><var>541.15</var>community-based services plan.<br/>
<a id="pl.541.16"></a><var>541.16</var>    Subd. 4. <b>Data collection for rate determination.</b> (a) Rates for all applicable home <br/>
<a id="pl.541.17"></a><var>541.17</var>and community-based waivered services, including rate exceptions under subdivision 12, <br/>
<a id="pl.541.18"></a><var>541.18</var>are set via the rates management system.<br/>
<a id="pl.541.19"></a><var>541.19</var>(b) Only data and information in the rates management system may be used to <br/>
<a id="pl.541.20"></a><var>541.20</var>calculate an individual's rate.<br/>
<a id="pl.541.21"></a><var>541.21</var>(c) Service providers, with information from the community support plan, shall enter <br/>
<a id="pl.541.22"></a><var>541.22</var>values and information needed to calculate an individual's rate into the rates management <br/>
<a id="pl.541.23"></a><var>541.23</var>system. These values and information include:<br/>
<a id="pl.541.24"></a><var>541.24</var>(1) shared staffing hours;<br/>
<a id="pl.541.25"></a><var>541.25</var>(2) individual staffing hours;<br/>
<a id="pl.541.26"></a><var>541.26</var>(3) staffing ratios;<br/>
<a id="pl.541.27"></a><var>541.27</var>(4) information to document variable levels of service qualification for variable <br/>
<a id="pl.541.28"></a><var>541.28</var>levels of reimbursement in each framework;<br/>
<a id="pl.541.29"></a><var>541.29</var>(5) shared or individualized arrangements for unit-based services, including the <br/>
<a id="pl.541.30"></a><var>541.30</var>staffing ratio; and<br/>
<a id="pl.541.31"></a><var>541.31</var>(6) number of trips and miles for transportation services.<br/>
<a id="pl.541.32"></a><var>541.32</var>(d) Updates to individual data shall include:<br/>
<a id="pl.541.33"></a><var>541.33</var>(1) data for each individual that is updated annually when renewing service plans; and<br/>
<a id="pl.541.34"></a><var>541.34</var>(2) requests by individuals or lead agencies to update a rate whenever there is a <br/>
<a id="pl.541.35"></a><var>541.35</var>change in an individual's service needs, with accompanying documentation.<br/>
<a id="pl.542.1"></a><var>542.1</var>(e) Lead agencies shall review and approve values to calculate the final payment rate <br/>
<a id="pl.542.2"></a><var>542.2</var>for each individual. Lead agencies must notify the individual and the service provider <br/>
<a id="pl.542.3"></a><var>542.3</var>of the final agreed-upon values and rate. If a value used was mistakenly or erroneously <br/>
<a id="pl.542.4"></a><var>542.4</var>entered and used to calculate a rate, a provider may petition lead agencies to correct it. <br/>
<a id="pl.542.5"></a><var>542.5</var>Lead agencies must respond to these requests.<br/>
<a id="pl.542.6"></a><var>542.6</var>    Subd. 5. <b>Base wage index and standard component values.</b> (a) The base wage <br/>
<a id="pl.542.7"></a><var>542.7</var>index is established to determine staffing costs associated with providing services to <br/>
<a id="pl.542.8"></a><var>542.8</var>individuals receiving home and community-based services. For purposes of developing <br/>
<a id="pl.542.9"></a><var>542.9</var>and calculating the proposed base wage, Minnesota-specific wages taken from job <br/>
<a id="pl.542.10"></a><var>542.10</var>descriptions and standard occupational classification (SOC) codes from the Bureau of <br/>
<a id="pl.542.11"></a><var>542.11</var>Labor Statistics as defined in the most recent edition of the Occupational Handbook shall <br/>
<a id="pl.542.12"></a><var>542.12</var>be used. The base wage index shall be calculated as follows:<br/>
<a id="pl.542.13"></a><var>542.13</var>(1) for residential direct-care basic staff, 50 percent of the median wage for personal <br/>
<a id="pl.542.14"></a><var>542.14</var>and home health aide (SOC code 39-9021); 30 percent of the median wage for nursing <br/>
<a id="pl.542.15"></a><var>542.15</var>aide (SOC code 31-1012); and 20 percent of the median wage for social and human <br/>
<a id="pl.542.16"></a><var>542.16</var>services aide (SOC code 21-1093);<br/>
<a id="pl.542.17"></a><var>542.17</var>(2) for residential direct-care intensive staff, 20 percent of the median wage for home <br/>
<a id="pl.542.18"></a><var>542.18</var>health aide (SOC code 31-1011); 20 percent of the median wage for personal and home <br/>
<a id="pl.542.19"></a><var>542.19</var>health aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code <br/>
<a id="pl.542.20"></a><var>542.20</var>21-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); <br/>
<a id="pl.542.21"></a><var>542.21</var>and 20 percent of the median wage for social and human services aide (SOC code 21-1093);<br/>
<a id="pl.542.22"></a><var>542.22</var>(3) for day services, 20 percent of the median wage for nursing aide (SOC code <br/>
<a id="pl.542.23"></a><var>542.23</var>31-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); <br/>
<a id="pl.542.24"></a><var>542.24</var>and 60 percent of the median wage for social and human services code (SOC code 21-1093);<br/>
<a id="pl.542.25"></a><var>542.25</var>(4) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in <br/>
<a id="pl.542.26"></a><var>542.26</var>a family foster care setting, the wage is $2.80 per hour;<br/>
<a id="pl.542.27"></a><var>542.27</var>(5) for behavior program analyst staff, 100 percent of the median wage for mental <br/>
<a id="pl.542.28"></a><var>542.28</var>health counselors (SOC code 21-1014);<br/>
<a id="pl.542.29"></a><var>542.29</var>(6) for behavior program professional staff, 100 percent of the median wage for <br/>
<a id="pl.542.30"></a><var>542.30</var>clinical counseling and school psychologist (SOC code 19-3031);<br/>
<a id="pl.542.31"></a><var>542.31</var>(7) for behavior program specialist staff, 100 percent of the median wage for <br/>
<a id="pl.542.32"></a><var>542.32</var>psychiatric technicians (SOC code 29-2053);<br/>
<a id="pl.542.33"></a><var>542.33</var>(8) for supportive living services staff, 20 percent of the median wage for nursing <br/>
<a id="pl.542.34"></a><var>542.34</var>aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC <br/>
<a id="pl.542.35"></a><var>542.35</var>code 29-2053); and 60 percent of the median wage for social and human services aide <br/>
<a id="pl.542.36"></a><var>542.36</var>(SOC code 21-1093);<br/>
<a id="pl.543.1"></a><var>543.1</var>(9) for housing access coordination staff, 50 percent of the median wage for <br/>
<a id="pl.543.2"></a><var>543.2</var>community and social services specialist (SOC code 21-1099); and 50 percent of the <br/>
<a id="pl.543.3"></a><var>543.3</var>median wage for social and human services aide (SOC code 21-1093);<br/>
<a id="pl.543.4"></a><var>543.4</var>(10) for in-home family support staff, 20 percent of the median wage for nursing <br/>
<a id="pl.543.5"></a><var>543.5</var>aide (SOC code 31-1012); 30 percent of community social service specialist (SOC code <br/>
<a id="pl.543.6"></a><var>543.6</var>21-1099); 40 percent of the median wage for social and human services aide (SOC code <br/>
<a id="pl.543.7"></a><var>543.7</var>21-1093); and ten percent of the median wage for psychiatric technician (SOC code <br/>
<a id="pl.543.8"></a><var>543.8</var>29-2053);<br/>
<a id="pl.543.9"></a><var>543.9</var>(11) for independent living skills staff, 40 percent of the median wage for community <br/>
<a id="pl.543.10"></a><var>543.10</var>social service specialist (SOC code 21-1099); 50 percent of the median wage for social <br/>
<a id="pl.543.11"></a><var>543.11</var>and human services aide (SOC code 21-1093); and ten percent of the median wage for <br/>
<a id="pl.543.12"></a><var>543.12</var>psychiatric technician (SOC code 29-2053);<br/>
<a id="pl.543.13"></a><var>543.13</var>(12) for supported employment staff, 20 percent of the median wage for nursing aide <br/>
<a id="pl.543.14"></a><var>543.14</var>(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC <br/>
<a id="pl.543.15"></a><var>543.15</var>code 29-2053); and 60 percent of the median wage for social and human services aide <br/>
<a id="pl.543.16"></a><var>543.16</var>(SOC code 21-1093);<br/>
<a id="pl.543.17"></a><var>543.17</var>(13) for adult companion staff, 50 percent of the median wage for personal and home <br/>
<a id="pl.543.18"></a><var>543.18</var>care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, <br/>
<a id="pl.543.19"></a><var>543.19</var>orderlies, and attendants (SOC code 31-1012);<br/>
<a id="pl.543.20"></a><var>543.20</var>(14) for night supervision staff, 20 percent of the median wage for home health aide <br/>
<a id="pl.543.21"></a><var>543.21</var>(SOC code 31-1011); 20 percent of the median wage for personal and home health aide <br/>
<a id="pl.543.22"></a><var>543.22</var>(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012); <br/>
<a id="pl.543.23"></a><var>543.23</var>20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20 <br/>
<a id="pl.543.24"></a><var>543.24</var>percent of the median wage for social and human services aide (SOC code 21-1093);<br/>
<a id="pl.543.25"></a><var>543.25</var>(15) for respite staff, 50 percent of the median wage for personal and home care aide <br/>
<a id="pl.543.26"></a><var>543.26</var>(SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, and <br/>
<a id="pl.543.27"></a><var>543.27</var>attendants (SOC code 31-1012);<br/>
<a id="pl.543.28"></a><var>543.28</var>(16) for personal support staff, 50 percent of the median wage for personal and home <br/>
<a id="pl.543.29"></a><var>543.29</var>care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, <br/>
<a id="pl.543.30"></a><var>543.30</var>orderlies, and attendants (SOC code 31-1012); and<br/>
<a id="pl.543.31"></a><var>543.31</var>(17) for supervisory staff, the basic wage is $17.43 per hour with exception of the <br/>
<a id="pl.543.32"></a><var>543.32</var>supervisor of behavior analyst and behavior specialists, which shall be $30.75 per hour.<br/>
<a id="pl.543.33"></a><var>543.33</var>(b) Component values for residential support services, excluding family foster <br/>
<a id="pl.543.34"></a><var>543.34</var>care, are:<br/>
<a id="pl.543.35"></a><var>543.35</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.543.36"></a><var>543.36</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.544.1"></a><var>544.1</var>(3) employee-related cost ratio: 23.6 percent;<br/>
<a id="pl.544.2"></a><var>544.2</var>(4) general administrative support ratio: 13.25 percent;<br/>
<a id="pl.544.3"></a><var>544.3</var>(5) program-related expense ratio: 1.3 percent; and<br/>
<a id="pl.544.4"></a><var>544.4</var>(6) absence and utilization factor ratio: 3.9 percent.<br/>
<a id="pl.544.5"></a><var>544.5</var>(c) Component values for family foster care are:<br/>
<a id="pl.544.6"></a><var>544.6</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.544.7"></a><var>544.7</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.544.8"></a><var>544.8</var>(3) employee-related cost ratio: 23.6 percent;<br/>
<a id="pl.544.9"></a><var>544.9</var>(4) general administrative support ratio: 3.3 percent; and<br/>
<a id="pl.544.10"></a><var>544.10</var>(5) program-related expense ratio: 1.3 percent.<br/>
<a id="pl.544.11"></a><var>544.11</var>(d) Component values for day services for all services are:<br/>
<a id="pl.544.12"></a><var>544.12</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.544.13"></a><var>544.13</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.544.14"></a><var>544.14</var>(3) employee-related cost ratio: 23.6 percent;<br/>
<a id="pl.544.15"></a><var>544.15</var>(4) program plan support ratio: 5.6 percent;<br/>
<a id="pl.544.16"></a><var>544.16</var>(5) client programming and support ratio: ten percent;<br/>
<a id="pl.544.17"></a><var>544.17</var>(6) general administrative support ratio: 13.25 percent;<br/>
<a id="pl.544.18"></a><var>544.18</var>(7) program-related expense ratio: 1.8 percent; and<br/>
<a id="pl.544.19"></a><var>544.19</var>(8) absence and utilization factor ratio: 3.9 percent.<br/>
<a id="pl.544.20"></a><var>544.20</var>(e) Component values for unit-based with program services are:<br/>
<a id="pl.544.21"></a><var>544.21</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.544.22"></a><var>544.22</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.544.23"></a><var>544.23</var>(3) employee-related cost ratio: 23.6 percent; <br/>
<a id="pl.544.24"></a><var>544.24</var>(4) program plan supports ratio: 3.1 percent;<br/>
<a id="pl.544.25"></a><var>544.25</var>(5) client programming and supports ratio: 8.6 percent;<br/>
<a id="pl.544.26"></a><var>544.26</var>(6) general administrative support ratio: 13.25 percent;<br/>
<a id="pl.544.27"></a><var>544.27</var>(7) program-related expense ratio: 6.1 percent; and<br/>
<a id="pl.544.28"></a><var>544.28</var>(8) absence and utilization factor ratio: 3.9 percent.<br/>
<a id="pl.544.29"></a><var>544.29</var>(f) Component values for unit-based services without programming except respite <br/>
<a id="pl.544.30"></a><var>544.30</var>are:<br/>
<a id="pl.544.31"></a><var>544.31</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.544.32"></a><var>544.32</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.544.33"></a><var>544.33</var>(3) employee-related cost ratio: 23.6 percent;<br/>
<a id="pl.544.34"></a><var>544.34</var>(4) program plan support ratio: 3.1 percent;<br/>
<a id="pl.544.35"></a><var>544.35</var>(5) client programming and support ratio: 8.6 percent;<br/>
<a id="pl.544.36"></a><var>544.36</var>(6) general administrative support ratio: 13.25 percent;<br/>
<a id="pl.545.1"></a><var>545.1</var>(7) program-related expense ratio: 6.1 percent; and<br/>
<a id="pl.545.2"></a><var>545.2</var>(8) absence and utilization factor ratio: 3.9 percent.<br/>
<a id="pl.545.3"></a><var>545.3</var>(g) Component values for unit-based services without programming for respite are:<br/>
<a id="pl.545.4"></a><var>545.4</var>(1) supervisory span of control ratio: 11 percent;<br/>
<a id="pl.545.5"></a><var>545.5</var>(2) employee vacation, sick, and training allowance ratio: 8.71 percent;<br/>
<a id="pl.545.6"></a><var>545.6</var>(3) employee-related cost ratio: 23.6 percent;<br/>
<a id="pl.545.7"></a><var>545.7</var>(4) general administrative support ratio: 13.25 percent;<br/>
<a id="pl.545.8"></a><var>545.8</var>(5) program-related expense ratio: 6.1 percent; and<br/>
<a id="pl.545.9"></a><var>545.9</var>(6) absence and utilization factor ratio: 3.9 percent.<br/>
<a id="pl.545.10"></a><var>545.10</var>(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph <br/>
<a id="pl.545.11"></a><var>545.11</var>(b) based on the wage data by standard occupational code (SOC) from the Bureau of <br/>
<a id="pl.545.12"></a><var>545.12</var>Labor Statistics available on December 31, 2016. The commissioner shall publish these <br/>
<a id="pl.545.13"></a><var>545.13</var>updated values and load them into the rate management system. This adjustment occurs <br/>
<a id="pl.545.14"></a><var>545.14</var>every five years. For adjustments in 2021 and beyond, the commissioner shall use the data <br/>
<a id="pl.545.15"></a><var>545.15</var>available on December 31 of the calendar year five years prior.<br/>
<a id="pl.545.16"></a><var>545.16</var>(i) On July 1, 2017, the commissioner shall update the framework components in <br/>
<a id="pl.545.17"></a><var>545.17</var>paragraph (c) for changes in the Consumer Price Index. The commissioner will adjust <br/>
<a id="pl.545.18"></a><var>545.18</var>these values higher or lower by the percentage change in the Consumer Price Index-All <br/>
<a id="pl.545.19"></a><var>545.19</var>Items, United States city average (CPI-U) from January 1, 2014, to January 1, 2017. The <br/>
<a id="pl.545.20"></a><var>545.20</var>commissioner shall publish these updated values and load them into the rate management <br/>
<a id="pl.545.21"></a><var>545.21</var>system. This adjustment occurs every five years. For adjustments in 2021 and beyond, the <br/>
<a id="pl.545.22"></a><var>545.22</var>commissioner shall use the data available on January 1 of the calendar year four years <br/>
<a id="pl.545.23"></a><var>545.23</var>prior and January 1 of the current calendar year.<br/>
<a id="pl.545.24"></a><var>545.24</var>    Subd. 6. <b>Payments for residential support services.</b> (a) Payments for residential <br/>
<a id="pl.545.25"></a><var>545.25</var>support services, as defined in sections 256B.092, subdivision 11, and 256B.49, <br/>
<a id="pl.545.26"></a><var>545.26</var>subdivision 22, must be calculated as follows:<br/>
<a id="pl.545.27"></a><var>545.27</var>(1) determine the number of units of service to meet a recipient's needs;<br/>
<a id="pl.545.28"></a><var>545.28</var>(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics <br/>
<a id="pl.545.29"></a><var>545.29</var>national and Minnesota-specific rates or rates derived by the commissioner as provided <br/>
<a id="pl.545.30"></a><var>545.30</var>in subdivision 5.  This is defined as the direct-care rate;<br/>
<a id="pl.545.31"></a><var>545.31</var>(3) for a recipient requiring customization for deaf and hard-of-hearing language <br/>
<a id="pl.545.32"></a><var>545.32</var>accessibility under subdivision 12, add the customization rate provided in subdivision 12 <br/>
<a id="pl.545.33"></a><var>545.33</var>to the result of clause (2). This is defined as the customized direct-care rate;<br/>
<a id="pl.545.34"></a><var>545.34</var>(4) multiply the number of residential services direct staff hours by the appropriate <br/>
<a id="pl.545.35"></a><var>545.35</var>staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;<br/>
<a id="pl.546.1"></a><var>546.1</var>(5) multiply the number of direct staff hours by the product of the supervision span <br/>
<a id="pl.546.2"></a><var>546.2</var>of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision <br/>
<a id="pl.546.3"></a><var>546.3</var>wage in subdivision 5, paragraph (a), clause (17);<br/>
<a id="pl.546.4"></a><var>546.4</var>(6) combine the results of clauses (4) and (5), and multiply the result by one plus <br/>
<a id="pl.546.5"></a><var>546.5</var>the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), <br/>
<a id="pl.546.6"></a><var>546.6</var>clause (2). This is defined as the direct staffing cost;<br/>
<a id="pl.546.7"></a><var>546.7</var>(7) for employee-related expenses, multiply the direct staffing cost by one plus the <br/>
<a id="pl.546.8"></a><var>546.8</var>employee-related cost ratio in subdivision 5, paragraph (b), clause (3);<br/>
<a id="pl.546.9"></a><var>546.9</var>(8) for client programming and supports, the commissioner shall add $2,179; and<br/>
<a id="pl.546.10"></a><var>546.10</var>(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if <br/>
<a id="pl.546.11"></a><var>546.11</var>customized for adapted transport, per year.<br/>
<a id="pl.546.12"></a><var>546.12</var>(b) The total rate shall be calculated using the following steps:<br/>
<a id="pl.546.13"></a><var>546.13</var>(1) subtotal paragraph (a), clauses (7) to (9);<br/>
<a id="pl.546.14"></a><var>546.14</var>(2) sum the standard general and administrative rate, the program-related expense <br/>
<a id="pl.546.15"></a><var>546.15</var>ratio, and the absence and utilization ratio; and<br/>
<a id="pl.546.16"></a><var>546.16</var>(3) divide the result of clause (1) by one minus the result of clause (2). This is <br/>
<a id="pl.546.17"></a><var>546.17</var>the total payment amount.<br/>
<a id="pl.546.18"></a><var>546.18</var>    Subd. 7. <b>Payments for day programs.</b> Payments for services with day programs <br/>
<a id="pl.546.19"></a><var>546.19</var>including adult day care, day treatment and habilitation, prevocational services, and <br/>
<a id="pl.546.20"></a><var>546.20</var>structured day services must be calculated as follows:<br/>
<a id="pl.546.21"></a><var>546.21</var>(1) determine the number of units of service to meet a recipient's needs;<br/>
<a id="pl.546.22"></a><var>546.22</var>(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics <br/>
<a id="pl.546.23"></a><var>546.23</var>Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;<br/>
<a id="pl.546.24"></a><var>546.24</var>(3) for a recipient requiring customization for deaf and hard-of-hearing language <br/>
<a id="pl.546.25"></a><var>546.25</var>accessibility under subdivision 12, add the customization rate provided in subdivision 12 <br/>
<a id="pl.546.26"></a><var>546.26</var>to the result of clause (2). This is defined as the customized direct-care rate;<br/>
<a id="pl.546.27"></a><var>546.27</var>(4) multiply the number of day program direct staff hours by the appropriate staff <br/>
<a id="pl.546.28"></a><var>546.28</var>wage in subdivision 5, paragraph (a), or the customized direct-care rate;<br/>
<a id="pl.546.29"></a><var>546.29</var>(5) multiply the number of day direct staff hours by the product of the supervision <br/>
<a id="pl.546.30"></a><var>546.30</var>span of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate <br/>
<a id="pl.546.31"></a><var>546.31</var>supervision wage in subdivision 5, paragraph (a), clause (17);<br/>
<a id="pl.546.32"></a><var>546.32</var>(6) combine the results of clauses (4) and (5), and multiply the result by one plus <br/>
<a id="pl.546.33"></a><var>546.33</var>the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d), <br/>
<a id="pl.546.34"></a><var>546.34</var>clause (2). This is defined as the direct staffing rate;<br/>
<a id="pl.546.35"></a><var>546.35</var>(7) for program plan support, multiply the result of clause (6) by one plus the <br/>
<a id="pl.546.36"></a><var>546.36</var>program plan support ratio in subdivision 5, paragraph (d), clause (4);<br/>
<a id="pl.547.1"></a><var>547.1</var>(8) for employee-related expenses, multiply the result of clause (7) by one plus the <br/>
<a id="pl.547.2"></a><var>547.2</var>employee-related cost ratio in subdivision 5, paragraph (d), clause (3);<br/>
<a id="pl.547.3"></a><var>547.3</var>(9) for client programming and supports, multiply the result of clause (8) by one plus <br/>
<a id="pl.547.4"></a><var>547.4</var>the client programming and support ratio in subdivision 5, paragraph (d), clause (5);<br/>
<a id="pl.547.5"></a><var>547.5</var>(10) for program facility costs, add $8.30 per week with consideration of staffing <br/>
<a id="pl.547.6"></a><var>547.6</var>ratios to meet individual needs;<br/>
<a id="pl.547.7"></a><var>547.7</var>(11) for adult day bath services, add $7.01 per 15 minute unit;<br/>
<a id="pl.547.8"></a><var>547.8</var>(12) this is the subtotal rate;<br/>
<a id="pl.547.9"></a><var>547.9</var>(13) sum the standard general and administrative rate, the program-related expense <br/>
<a id="pl.547.10"></a><var>547.10</var>ratio, and the absence and utilization factor ratio;<br/>
<a id="pl.547.11"></a><var>547.11</var>(14) divide the result of clause (12) by one minus the result of clause (13). This is <br/>
<a id="pl.547.12"></a><var>547.12</var>the total payment amount;<br/>
<a id="pl.547.13"></a><var>547.13</var>(15) for transportation provided as part of day training and habilitation for an <br/>
<a id="pl.547.14"></a><var>547.14</var>individual who does not require a lift, add:<br/>
<a id="pl.547.15"></a><var>547.15</var>(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle <br/>
<a id="pl.547.16"></a><var>547.16</var>without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared <br/>
<a id="pl.547.17"></a><var>547.17</var>ride in a vehicle with a lift;<br/>
<a id="pl.547.18"></a><var>547.18</var>(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle <br/>
<a id="pl.547.19"></a><var>547.19</var>without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared <br/>
<a id="pl.547.20"></a><var>547.20</var>ride in a vehicle with a lift;<br/>
<a id="pl.547.21"></a><var>547.21</var>(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle <br/>
<a id="pl.547.22"></a><var>547.22</var>without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared <br/>
<a id="pl.547.23"></a><var>547.23</var>ride in a vehicle with a lift; or<br/>
<a id="pl.547.24"></a><var>547.24</var>(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a <br/>
<a id="pl.547.25"></a><var>547.25</var>lift, $16.50 for a shared ride in a vehicle without a lift. and $20.75 for a shared ride in a <br/>
<a id="pl.547.26"></a><var>547.26</var>vehicle with a lift;<br/>
<a id="pl.547.27"></a><var>547.27</var>(16) for transportation provide as part of day training and habilitation for an <br/>
<a id="pl.547.28"></a><var>547.28</var>individual who does require a lift, add:<br/>
<a id="pl.547.29"></a><var>547.29</var>(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with <br/>
<a id="pl.547.30"></a><var>547.30</var>a lift, and $15.05 for a shared ride in a vehicle with a lift;<br/>
<a id="pl.547.31"></a><var>547.31</var>(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a <br/>
<a id="pl.547.32"></a><var>547.32</var>lift, and $28.16 for a shared ride in a vehicle with a lift;<br/>
<a id="pl.547.33"></a><var>547.33</var>(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with <br/>
<a id="pl.547.34"></a><var>547.34</var>a lift, and $58.76 for a shared ride in a vehicle with a lift; or<br/>
<a id="pl.547.35"></a><var>547.35</var>(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a <br/>
<a id="pl.547.36"></a><var>547.36</var>lift, and $80.93 for a shared ride in a vehicle with a lift.<br/>
<a id="pl.548.1"></a><var>548.1</var>    Subd. 8. <b>Payments for unit-based services with programming.</b> Payments for <br/>
<a id="pl.548.2"></a><var>548.2</var>unit-based with program services, including behavior programming, housing access <br/>
<a id="pl.548.3"></a><var>548.3</var>coordination, in-home family support, independent living skills training, hourly supported <br/>
<a id="pl.548.4"></a><var>548.4</var>living services, and supported employment provided to an individual outside of any day or <br/>
<a id="pl.548.5"></a><var>548.5</var>residential service plan must be calculated as follows, unless the services are authorized <br/>
<a id="pl.548.6"></a><var>548.6</var>separately under subdivision 6 or 7:<br/>
<a id="pl.548.7"></a><var>548.7</var>(1) determine the number of units of service to meet a recipient's needs;<br/>
<a id="pl.548.8"></a><var>548.8</var>(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics <br/>
<a id="pl.548.9"></a><var>548.9</var>Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;<br/>
<a id="pl.548.10"></a><var>548.10</var>(3) for a recipient requiring customization for deaf and hard-of-hearing language <br/>
<a id="pl.548.11"></a><var>548.11</var>accessibility under subdivision 12, add the customization rate provided in subdivision 12 <br/>
<a id="pl.548.12"></a><var>548.12</var>to the result of clause (2). This is defined as the customized direct-care rate;<br/>
<a id="pl.548.13"></a><var>548.13</var>(4) multiply the number of direct staff hours by the appropriate staff wage in <br/>
<a id="pl.548.14"></a><var>548.14</var>subdivision 5, paragraph (a), or the customized direct care rate;<br/>
<a id="pl.548.15"></a><var>548.15</var>(5) multiply the number of direct staff hours by the product of the supervision span <br/>
<a id="pl.548.16"></a><var>548.16</var>of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision <br/>
<a id="pl.548.17"></a><var>548.17</var>wage in subdivision 5, paragraph (a), clause (17);<br/>
<a id="pl.548.18"></a><var>548.18</var>(6) combine the results of clauses (4) and (5), and multiply the result by one plus <br/>
<a id="pl.548.19"></a><var>548.19</var>the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), <br/>
<a id="pl.548.20"></a><var>548.20</var>clause (2). This is defined as the direct staffing rate;<br/>
<a id="pl.548.21"></a><var>548.21</var>(7) for program plan support, multiply the result of clause (6) by one plus the <br/>
<a id="pl.548.22"></a><var>548.22</var>program plan supports ratio in subdivision 5, paragraph (e), clause (4);<br/>
<a id="pl.548.23"></a><var>548.23</var>(8) for employee-related expenses, multiply the result of clause (7) by one plus the <br/>
<a id="pl.548.24"></a><var>548.24</var>employee-related cost ratio in subdivision 5, paragraph (e), clause (3);<br/>
<a id="pl.548.25"></a><var>548.25</var>(9) for client programming and supports, multiply the result of clause (8) by one plus <br/>
<a id="pl.548.26"></a><var>548.26</var>the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);<br/>
<a id="pl.548.27"></a><var>548.27</var>(10) this is the subtotal rate;<br/>
<a id="pl.548.28"></a><var>548.28</var>(11) sum the standard general and administrative rate, the program-related expense <br/>
<a id="pl.548.29"></a><var>548.29</var>ratio, and the absence and utilization factor ratio; and<br/>
<a id="pl.548.30"></a><var>548.30</var>(12) divide the result of clause (10) by one minus the result of clause (11). This is <br/>
<a id="pl.548.31"></a><var>548.31</var>the total payment amount.<br/>
<a id="pl.548.32"></a><var>548.32</var>    Subd. 9. <b>Payments for unit-based services without programming.</b> Payments <br/>
<a id="pl.548.33"></a><var>548.33</var>for unit-based without program services, including night supervision, personal support, <br/>
<a id="pl.548.34"></a><var>548.34</var>respite, and companion care provided to an individual outside of any day or residential <br/>
<a id="pl.548.35"></a><var>548.35</var>service plan must be calculated as follows unless the services are authorized separately <br/>
<a id="pl.548.36"></a><var>548.36</var>under subdivision 6 or 7:<br/>
<a id="pl.549.1"></a><var>549.1</var>(1) for all services except respite, determine the number of units of service to meet <br/>
<a id="pl.549.2"></a><var>549.2</var>a recipient's needs;<br/>
<a id="pl.549.3"></a><var>549.3</var>(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics <br/>
<a id="pl.549.4"></a><var>549.4</var>Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;<br/>
<a id="pl.549.5"></a><var>549.5</var>(3) for a recipient requiring customization for deaf and hard-of-hearing language <br/>
<a id="pl.549.6"></a><var>549.6</var>accessibility under subdivision 12, add the customization rate provided in subdivision 12 <br/>
<a id="pl.549.7"></a><var>549.7</var>to the result of clause (2). This is defined as the customized direct care rate;<br/>
<a id="pl.549.8"></a><var>549.8</var>(4) multiply the number of direct staff hours by the appropriate staff wage in <br/>
<a id="pl.549.9"></a><var>549.9</var>subdivision 5 or the customized direct care rate;<br/>
<a id="pl.549.10"></a><var>549.10</var>(5) multiply the number of direct staff hours by the product of the supervision span <br/>
<a id="pl.549.11"></a><var>549.11</var>of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision <br/>
<a id="pl.549.12"></a><var>549.12</var>wage in subdivision 5, paragraph (a), clause (17);<br/>
<a id="pl.549.13"></a><var>549.13</var>(6) combine the results of clauses (4) and (5), and multiply the result by one plus <br/>
<a id="pl.549.14"></a><var>549.14</var>the employee vacation, sick, and training allowance ratio in, subdivision 5, paragraph (f), <br/>
<a id="pl.549.15"></a><var>549.15</var>clause (2). This is defined as the direct staffing rate;<br/>
<a id="pl.549.16"></a><var>549.16</var>(7) for program plan support, multiply the result of clause (6) by one plus the <br/>
<a id="pl.549.17"></a><var>549.17</var>program plan support ratio in subdivision 5, paragraph (f), clause (4);<br/>
<a id="pl.549.18"></a><var>549.18</var>(8) for employee-related expenses, multiply the result of clause (7) by one plus the <br/>
<a id="pl.549.19"></a><var>549.19</var>employee-related cost ratio in subdivision 5, paragraph (f), clause (3);<br/>
<a id="pl.549.20"></a><var>549.20</var>(9) for client programming and supports, multiply the result of clause (8) by one plus <br/>
<a id="pl.549.21"></a><var>549.21</var>the client programming and support ratio in subdivision 5, paragraph (f), clause (5);<br/>
<a id="pl.549.22"></a><var>549.22</var>(10) this is the subtotal rate;<br/>
<a id="pl.549.23"></a><var>549.23</var>(11) sum the standard general and administrative rate, the program-related expense <br/>
<a id="pl.549.24"></a><var>549.24</var>ratio, and the absence and utilization factor ratio;<br/>
<a id="pl.549.25"></a><var>549.25</var>(12) divide the result of clause (10) by one minus the result of clause (11). This is <br/>
<a id="pl.549.26"></a><var>549.26</var>the total payment amount;<br/>
<a id="pl.549.27"></a><var>549.27</var>(13) for respite services, determine the number of daily units of service to meet an <br/>
<a id="pl.549.28"></a><var>549.28</var>individual's needs;<br/>
<a id="pl.549.29"></a><var>549.29</var>(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics <br/>
<a id="pl.549.30"></a><var>549.30</var>Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;<br/>
<a id="pl.549.31"></a><var>549.31</var>(15) for a recipient requiring deaf and hard-of-hearing customization under <br/>
<a id="pl.549.32"></a><var>549.32</var>subdivision 12, add the customization rate provided in subdivision 12 to the result of <br/>
<a id="pl.549.33"></a><var>549.33</var>clause (14). This is defined as the customized direct care rate;<br/>
<a id="pl.549.34"></a><var>549.34</var>(16) multiply the number of direct staff hours by the appropriate staff wage in <br/>
<a id="pl.549.35"></a><var>549.35</var>subdivision 5, paragraph (a);<br/>
<a id="pl.550.1"></a><var>550.1</var>(17) multiply the number of direct staff hours by the product of the supervisory span <br/>
<a id="pl.550.2"></a><var>550.2</var>of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision <br/>
<a id="pl.550.3"></a><var>550.3</var>wage in subdivision 5, paragraph (a), clause (17);<br/>
<a id="pl.550.4"></a><var>550.4</var>(18) combine the results of clauses (16) and (17), and multiply the result by one plus <br/>
<a id="pl.550.5"></a><var>550.5</var>the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g), <br/>
<a id="pl.550.6"></a><var>550.6</var>clause (2). This is defined as the direct staffing rate;<br/>
<a id="pl.550.7"></a><var>550.7</var>(19) for employee-related expenses, multiply the result of clause (18) by one plus <br/>
<a id="pl.550.8"></a><var>550.8</var>the employee-related cost ratio in subdivision 5, paragraph (g), clause (3).<br/>
<a id="pl.550.9"></a><var>550.9</var>(20) this is the subtotal rate;<br/>
<a id="pl.550.10"></a><var>550.10</var>(21) sum the standard general and administrative rate, the program-related expense <br/>
<a id="pl.550.11"></a><var>550.11</var>ratio, and the absence and utilization factor ratio; and<br/>
<a id="pl.550.12"></a><var>550.12</var>(22) divide the result of clause (20) by one minus the result of clause (21). This is <br/>
<a id="pl.550.13"></a><var>550.13</var>the total payment amount.<br/>
<a id="pl.550.14"></a><var>550.14</var>    Subd. 10. <b>Updating payment values and additional information.</b> (a) The <br/>
<a id="pl.550.15"></a><var>550.15</var>commissioner shall develop and implement uniform procedures to refine terms and update <br/>
<a id="pl.550.16"></a><var>550.16</var>or adjust values used to calculate payment rates in this section. For calendar year 2014, <br/>
<a id="pl.550.17"></a><var>550.17</var>the commissioner shall use the values, terms, and procedures provided in this section.<br/>
<a id="pl.550.18"></a><var>550.18</var>(b) The commissioner shall work with stakeholders to assess efficacy of values <br/>
<a id="pl.550.19"></a><var>550.19</var>and payment rates. The commissioner shall report back to the legislature with proposed <br/>
<a id="pl.550.20"></a><var>550.20</var>changes for component values and recommendations for revisions on the schedule <br/>
<a id="pl.550.21"></a><var>550.21</var>provided in paragraphs (c) and (d).<br/>
<a id="pl.550.22"></a><var>550.22</var>(c) The commissioner shall work with stakeholders to continue refining a <br/>
<a id="pl.550.23"></a><var>550.23</var>subset of component values, which are to be referred to as interim values, and report <br/>
<a id="pl.550.24"></a><var>550.24</var>recommendations to the legislature by February 15, 2014. Interim component values are: <br/>
<a id="pl.550.25"></a><var>550.25</var>transportation rates for day training and habilitation; transportation for adult day, structured <br/>
<a id="pl.550.26"></a><var>550.26</var>day, and prevocational services; geographic difference factor; day program facility rate; <br/>
<a id="pl.550.27"></a><var>550.27</var>services where monitoring technology replaces staff time; shared services for independent <br/>
<a id="pl.550.28"></a><var>550.28</var>living skills training; and supported employment and billing for indirect services.<br/>
<a id="pl.550.29"></a><var>550.29</var>(d) The commissioner shall report and make recommendations to the legislature on: <br/>
<a id="pl.550.30"></a><var>550.30</var>February 15, 2015; February 15, 2017; February 15, 2019; and February 15, 2021. After <br/>
<a id="pl.550.31"></a><var>550.31</var>2021 reports shall be provided on a four-year cycle.<br/>
<a id="pl.550.32"></a><var>550.32</var>(e) The commissioner shall provide a public notice via LISTSERV in October of <br/>
<a id="pl.550.33"></a><var>550.33</var>each year beginning October 1, 2014. The notice shall contain information detailing <br/>
<a id="pl.550.34"></a><var>550.34</var>legislatively approved changes in: calculation values, including derived wage rates <br/>
<a id="pl.550.35"></a><var>550.35</var>and related employee and administrative factors; services utilization; county and tribal <br/>
<a id="pl.550.36"></a><var>550.36</var>allocation changes; and information on adjustments to be made to calculation values <br/>
<a id="pl.551.1"></a><var>551.1</var>and timing of those adjustments. Information in this notice shall be effective January <br/>
<a id="pl.551.2"></a><var>551.2</var>1 of the following year.<br/>
<a id="pl.551.3"></a><var>551.3</var>    Subd. 11. <b>Payment implementation.</b> Upon implementation of the payment <br/>
<a id="pl.551.4"></a><var>551.4</var>methodologies under this section, those payment rates supersede rates established in county <br/>
<a id="pl.551.5"></a><var>551.5</var>contracts for recipients receiving waiver services under section 256B.092 or 256B.49.<br/>
<a id="pl.551.6"></a><var>551.6</var>    Subd. 12. <b>Customization of rates for individuals. </b> (a) For persons determined to <br/>
<a id="pl.551.7"></a><var>551.7</var>have higher needs based on being deaf or hard-of-hearing, the direct-care costs must be <br/>
<a id="pl.551.8"></a><var>551.8</var>increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8, <br/>
<a id="pl.551.9"></a><var>551.9</var>and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be <br/>
<a id="pl.551.10"></a><var>551.10</var>$2.50 per hour for waiver recipients who meet the respective criteria as determined by <br/>
<a id="pl.551.11"></a><var>551.11</var>the commissioner.  <br/>
<a id="pl.551.12"></a><var>551.12</var>(b) For the purposes of this section, "deaf or hard-of-hearing" means:<br/>
<a id="pl.551.13"></a><var>551.13</var>(1) the person has a developmental disability and an assessment score which <br/>
<a id="pl.551.14"></a><var>551.14</var>indicates a hearing impairment that is severe or that the person has no useful hearing;<br/>
<a id="pl.551.15"></a><var>551.15</var>(2) the person has a developmental disability and an expressive communications <br/>
<a id="pl.551.16"></a><var>551.16</var>score that indicates the person uses single signs or gestures, uses an augmentative <br/>
<a id="pl.551.17"></a><var>551.17</var>communication aid, or does not have functional communication, or the person's expressive <br/>
<a id="pl.551.18"></a><var>551.18</var>communications is unknown; and<br/>
<a id="pl.551.19"></a><var>551.19</var>(3) the person has a developmental disability and a communication score which <br/>
<a id="pl.551.20"></a><var>551.20</var>indicates the person comprehends signs, gestures and modeling prompts or does not <br/>
<a id="pl.551.21"></a><var>551.21</var>comprehend verbal, visual or gestural communication or that the person's receptive <br/>
<a id="pl.551.22"></a><var>551.22</var>communication score is unknown; or<br/>
<a id="pl.551.23"></a><var>551.23</var>(4) the person receives long-term care services and has an assessment score that <br/>
<a id="pl.551.24"></a><var>551.24</var>indicates they hear only very loud sounds, have no useful hearing, or a determination <br/>
<a id="pl.551.25"></a><var>551.25</var>cannot be made; and the person receives long-term care services and has an assessment <br/>
<a id="pl.551.26"></a><var>551.26</var>that indicates the person communicates needs with sign language, symbol board, written <br/>
<a id="pl.551.27"></a><var>551.27</var>messages, gestures or an interpreter; communicates with inappropriate content, makes <br/>
<a id="pl.551.28"></a><var>551.28</var>garbled sounds or displays echolalia, or does not communicate needs.<br/>
<a id="pl.551.29"></a><var>551.29</var>    Subd. 13. <b>Transportation.</b> The commissioner shall require that the purchase <br/>
<a id="pl.551.30"></a><var>551.30</var>of transportation services be cost-effective and be limited to market rates where the <br/>
<a id="pl.551.31"></a><var>551.31</var>transportation mode is generally available and accessible.<br/>
<a id="pl.551.32"></a><var>551.32</var>    Subd. 14. <b>Exceptions.</b> (a) In a format prescribed by the commissioner, lead <br/>
<a id="pl.551.33"></a><var>551.33</var>agencies must identify individuals with exceptional needs that cannot be met under the <br/>
<a id="pl.551.34"></a><var>551.34</var>disability waiver rate system. The commissioner shall use that information to evaluate <br/>
<a id="pl.551.35"></a><var>551.35</var>and, if necessary, approve an alternative payment rate for those individuals.<br/>
<a id="pl.551.36"></a><var>551.36</var>(b) Lead agencies must submit exceptions requests to the state.<br/>
<a id="pl.552.1"></a><var>552.1</var>(c) An application for a rate exception may be submitted for the following criteria:<br/>
<a id="pl.552.2"></a><var>552.2</var>(1) an individual has service needs that cannot be met through additional units <br/>
<a id="pl.552.3"></a><var>552.3</var>of service; or<br/>
<a id="pl.552.4"></a><var>552.4</var>(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an <br/>
<a id="pl.552.5"></a><var>552.5</var>individual being discharged.<br/>
<a id="pl.552.6"></a><var>552.6</var>(d) Exception requests will include the following information:<br/>
<a id="pl.552.7"></a><var>552.7</var>(1) the service needs required by each individual that are not accounted for in <br/>
<a id="pl.552.8"></a><var>552.8</var>subdivisions 6, 7, 8, and 9;<br/>
<a id="pl.552.9"></a><var>552.9</var>(2) the service rate requested and the difference from the rate determined in <br/>
<a id="pl.552.10"></a><var>552.10</var>subdivisions 6, 7, 8, and 9;<br/>
<a id="pl.552.11"></a><var>552.11</var>(3) a basis for the underlying costs used for the rate exception and any accompanying <br/>
<a id="pl.552.12"></a><var>552.12</var>documentation;<br/>
<a id="pl.552.13"></a><var>552.13</var>(4) the duration of the rate exception; and<br/>
<a id="pl.552.14"></a><var>552.14</var>(5) any contingencies for approval.<br/>
<a id="pl.552.15"></a><var>552.15</var>(e) Approved rate exceptions shall be managed within lead agency allocations under <br/>
<a id="pl.552.16"></a><var>552.16</var>sections 256B.092 and 256B.49.<br/>
<a id="pl.552.17"></a><var>552.17</var>(f) Individual disability waiver recipients may request that a lead agency submit an <br/>
<a id="pl.552.18"></a><var>552.18</var>exceptions request. A lead agency that denies such a request shall notify the individual <br/>
<a id="pl.552.19"></a><var>552.19</var>waiver recipient of its decision and the reasons for denying the request in writing no later <br/>
<a id="pl.552.20"></a><var>552.20</var>than 30 days after the individual's request has been made.<br/>
<a id="pl.552.21"></a><var>552.21</var>(g) The commissioner shall determine whether to approve or deny an exception <br/>
<a id="pl.552.22"></a><var>552.22</var>request no more than 30 days after receiving the request. If the commissioner denies the <br/>
<a id="pl.552.23"></a><var>552.23</var>request, the commissioner shall notify the lead agency and the individual disability waiver <br/>
<a id="pl.552.24"></a><var>552.24</var>recipient in writing of the reasons for the denial.<br/>
<a id="pl.552.25"></a><var>552.25</var>(h) The individual disability waiver recipient may appeal any denial of an exception <br/>
<a id="pl.552.26"></a><var>552.26</var>request by either the lead agency or the commissioner, pursuant to sections 256.045 and <br/>
<a id="pl.552.27"></a><var>552.27</var>256.0451. When the denial of an exception request results in the proposed demission of a <br/>
<a id="pl.552.28"></a><var>552.28</var>waiver recipient from a residential or day habilitation program, the commissioner shall <br/>
<a id="pl.552.29"></a><var>552.29</var>issue a temporary stay of demission, when requested by the disability waiver recipient, <br/>
<a id="pl.552.30"></a><var>552.30</var>consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). <br/>
<a id="pl.552.31"></a><var>552.31</var>The temporary stay shall remain in effect until the lead agency can provide an informed <br/>
<a id="pl.552.32"></a><var>552.32</var>choice of appropriate, alternative services to the disability waiver.<br/>
<a id="pl.552.33"></a><var>552.33</var>(i) Providers may petition lead agencies to update values that were entered <br/>
<a id="pl.552.34"></a><var>552.34</var>incorrectly or erroneously into the rate management system, based on past service level <br/>
<a id="pl.552.35"></a><var>552.35</var>discussions and determination in subdivision 4, without applying for a rate exception.<br/>
<a id="pl.553.1"></a><var>553.1</var>    Subd. 15. <b>County or tribal allocations.</b> (a) Upon implementation of the disability <br/>
<a id="pl.553.2"></a><var>553.2</var>waiver rates management system on January 1, 2014, the commissioner shall establish <br/>
<a id="pl.553.3"></a><var>553.3</var>a method of tracking and reporting the fiscal impact of the disability waiver rates <br/>
<a id="pl.553.4"></a><var>553.4</var>management system on individual lead agencies.<br/>
<a id="pl.553.5"></a><var>553.5</var>(b) Beginning January 1, 2014, and continuing through full implementation on <br/>
<a id="pl.553.6"></a><var>553.6</var>December 31, 2017, the commissioner shall make annual adjustments to lead agencies' <br/>
<a id="pl.553.7"></a><var>553.7</var>home and community-based waivered service budget allocations to adjust for rate <br/>
<a id="pl.553.8"></a><var>553.8</var>differences and the resulting impact on county allocations upon implementation of the <br/>
<a id="pl.553.9"></a><var>553.9</var>disability waiver rates system.<br/>
<a id="pl.553.10"></a><var>553.10</var>    Subd. 16. <b>Budget neutrality adjustment.</b> The commissioner shall calculate the <br/>
<a id="pl.553.11"></a><var>553.11</var>total spending for all home and community-based waiver services under the payments as <br/>
<a id="pl.553.12"></a><var>553.12</var>defined in subdivisions 6, 7, 8, and 9 for all recipients as of July 1, 2013, and compare it to <br/>
<a id="pl.553.13"></a><var>553.13</var>spending for services defined for subdivisions 6, 7, 8, and 9 under current law. If spending <br/>
<a id="pl.553.14"></a><var>553.14</var>for services in one particular subdivision differs, there will be a percentage adjustment <br/>
<a id="pl.553.15"></a><var>553.15</var>to increase or decrease individual rates for the services defined in each subdivision so <br/>
<a id="pl.553.16"></a><var>553.16</var>aggregate spending matches projections under current law.<br/>
<a id="pl.553.17"></a><var>553.17</var>    Subd. 17. <b>Implementation.</b> (a) On January 1, 2014, the commissioner shall fully <br/>
<a id="pl.553.18"></a><var>553.18</var>implement the calculation of rates for waivered services under sections 256B.092 and <br/>
<a id="pl.553.19"></a><var>553.19</var>256B.49 without additional legislative approval.<br/>
<a id="pl.553.20"></a><var>553.20</var>(b) The commissioner shall phase in the application of rates determined in <br/>
<a id="pl.553.21"></a><var>553.21</var>subdivisions 6 to 9 for two years.<br/>
<a id="pl.553.22"></a><var>553.22</var>(c) The commissioner shall preserve rates in effect on December 31, 2013, for <br/>
<a id="pl.553.23"></a><var>553.23</var>the two-year period.<br/>
<a id="pl.553.24"></a><var>553.24</var>(d) The commissioner shall calculate and measure the difference in cost per <br/>
<a id="pl.553.25"></a><var>553.25</var>individual using the historical rate and the rates under subdivisions 6 to 9 for all existing <br/>
<a id="pl.553.26"></a><var>553.26</var>individuals. This measurement shall occur statewide, and for individuals in every county. <br/>
<a id="pl.553.27"></a><var>553.27</var>The commissioner shall provide the results of this analysis by county for calendar year <br/>
<a id="pl.553.28"></a><var>553.28</var>2014 to the legislative committees and divisions with jurisdiction over health and human <br/>
<a id="pl.553.29"></a><var>553.29</var>services finance by February 15, 2015.<br/>
<a id="pl.553.30"></a><var>553.30</var>(e) The commissioner shall calculate the average rate per unit for each service by <br/>
<a id="pl.553.31"></a><var>553.31</var>county. For individuals enrolled after January 1, 2014, individuals will receive the higher <br/>
<a id="pl.553.32"></a><var>553.32</var>of the rate produced under subdivisions 6 to 9, or the by-county average rate.<br/>
<a id="pl.553.33"></a><var>553.33</var>(f) On January 1, 2016, the rates determined in subdivisions 6 to 9 shall be applied.<br/>
<br/>
<a id="bill.13.7.0"></a><a id="pl.553.34"></a><var>553.34</var>    Sec. 7. <b> REPEALER.</b><br/>
<a id="pl.553.35"></a><var>553.35</var>Minnesota Statutes 2012, section 256B.4913, subdivisions 1, 2, 3, and 4, is repealed.<br/>
<br/>
<a id="bill.14.0.0"></a>

<a id="bill.14.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.554.3"></a><var>554.3</var><br/>
</td>
<td colspan="7">Section 1. <b>HEALTH AND HUMAN SERVICES APPROPRIATIONS.</b><b> </b><br/>
</td>
</tr>
</table><a id="pl.554.4"></a><var>554.4</var>The sums shown in the columns marked "Appropriations" are appropriated to the <br/>
<a id="pl.554.5"></a><var>554.5</var>agencies and for the purposes specified in this article. The appropriations are from the <br/>
<a id="pl.554.6"></a><var>554.6</var>general fund, or another named fund, and are available for the fiscal years indicated <br/>
<a id="pl.554.7"></a><var>554.7</var>for each purpose. The figures "2014" and "2015" used in this article mean that the <br/>
<a id="pl.554.8"></a><var>554.8</var>appropriations listed under them are available for the fiscal year ending June 30, 2014, or <br/>
<a id="pl.554.9"></a><var>554.9</var>June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal <br/>
<a id="pl.554.10"></a><var>554.10</var>year 2015. "The biennium" is fiscal years 2014 and 2015.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.554.11"></a><var>554.11</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.554.12"></a><var>554.12</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.554.13"></a><var>554.13</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.554.14"></a><var>554.14</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td align="center"><b>2014</b><br/>
</td>
<td></td>
<td align="center"><b>2015</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.14.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.554.15"></a><var>554.15</var><br/>
<a id="pl.554.16"></a><var>554.16</var><br/>
</td>
<td colspan="3">Sec. 2. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.554.17"></a><var>554.17</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 6,411,182,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 6,392,303,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.554.18"></a><var>554.18</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.19"></a><var>554.19</var><br/>
</td>
<td></td>
<td align="center">2014<br/>
</td>
<td align="center">2015<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.20"></a><var>554.20</var><br/>
</td>
<td>General<br/>
</td>
<td align="right"> 5,807,515,000<br/>
</td>
<td align="right"> 5,831,770,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.21"></a><var>554.21</var><br/>
<a id="pl.554.22"></a><var>554.22</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">3,815,000<br/>
</td>
<td align="right">4,915,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.23"></a><var>554.23</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right"> 340,047,000<br/>
</td>
<td align="right"> 298,915,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.24"></a><var>554.24</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">257,915,000<br/>
</td>
<td align="right">254,813,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.554.25"></a><var>554.25</var><br/>
</td>
<td>Lottery Prize Fund<br/>
</td>
<td align="right">1,890,000<br/>
</td>
<td align="right">1,890,000<br/>
</td>
</tr>
</table><a id="pl.554.26"></a><var>554.26</var><b>Receipts for Systems Projects. </b><br/>
<a id="pl.554.27"></a><var>554.27</var>Appropriations and federal receipts for <br/>
<a id="pl.554.28"></a><var>554.28</var>information systems projects for MAXIS, <br/>
<a id="pl.554.29"></a><var>554.29</var>PRISM, MMIS, and SSIS must be deposited <br/>
<a id="pl.554.30"></a><var>554.30</var>in the state system account authorized <br/>
<a id="pl.554.31"></a><var>554.31</var>in Minnesota Statutes, section 256.014. <br/>
<a id="pl.554.32"></a><var>554.32</var>Money appropriated for computer projects <br/>
<a id="pl.554.33"></a><var>554.33</var>approved by the commissioner of Minnesota <br/>
<a id="pl.554.34"></a><var>554.34</var>information technology services, funded <br/>
<a id="pl.554.35"></a><var>554.35</var>by the legislature, and approved by the <br/>
<a id="pl.554.36"></a><var>554.36</var>commissioner of management and budget, <br/>
<a id="pl.555.1"></a><var>555.1</var>may be transferred from one project to <br/>
<a id="pl.555.2"></a><var>555.2</var>another and from development to operations <br/>
<a id="pl.555.3"></a><var>555.3</var>as the commissioner of human services <br/>
<a id="pl.555.4"></a><var>555.4</var>considers necessary. Any unexpended <br/>
<a id="pl.555.5"></a><var>555.5</var>balance in the appropriation for these <br/>
<a id="pl.555.6"></a><var>555.6</var>projects does not cancel but is available for <br/>
<a id="pl.555.7"></a><var>555.7</var>ongoing development and operations.<br/>
<a id="pl.555.8"></a><var>555.8</var><b>Nonfederal Share Transfers. </b>The <br/>
<a id="pl.555.9"></a><var>555.9</var>nonfederal share of activities for which <br/>
<a id="pl.555.10"></a><var>555.10</var>federal administrative reimbursement is <br/>
<a id="pl.555.11"></a><var>555.11</var>appropriated to the commissioner may be <br/>
<a id="pl.555.12"></a><var>555.12</var>transferred to the special revenue fund.<br/>
<a id="pl.555.13"></a><var>555.13</var><b>ARRA Supplemental Nutrition Assistance </b><br/>
<a id="pl.555.14"></a><var>555.14</var><b>Benefit Increases. </b>The funds provided for <br/>
<a id="pl.555.15"></a><var>555.15</var>food support benefit increases under the <br/>
<a id="pl.555.16"></a><var>555.16</var>Supplemental Nutrition Assistance Program <br/>
<a id="pl.555.17"></a><var>555.17</var>provisions of the American Recovery and <br/>
<a id="pl.555.18"></a><var>555.18</var>Reinvestment Act (ARRA) of 2009 must be <br/>
<a id="pl.555.19"></a><var>555.19</var>used for benefit increases beginning July 1, <br/>
<a id="pl.555.20"></a><var>555.20</var>2009.<br/>
<a id="pl.555.21"></a><var>555.21</var><b>Supplemental Nutrition Assistance </b><br/>
<a id="pl.555.22"></a><var>555.22</var><b>Program Employment and Training. </b><br/>
<a id="pl.555.23"></a><var>555.23</var>(1) Notwithstanding Minnesota Statutes, <br/>
<a id="pl.555.24"></a><var>555.24</var>sections 256D.051, subdivisions 1a, 6b, <br/>
<a id="pl.555.25"></a><var>555.25</var>and 6c, and 256J.626, federal Supplemental <br/>
<a id="pl.555.26"></a><var>555.26</var>Nutrition Assistance employment and <br/>
<a id="pl.555.27"></a><var>555.27</var>training funds received as reimbursement of <br/>
<a id="pl.555.28"></a><var>555.28</var>MFIP consolidated fund grant expenditures <br/>
<a id="pl.555.29"></a><var>555.29</var>for diversionary work program participants <br/>
<a id="pl.555.30"></a><var>555.30</var>and child care assistance program <br/>
<a id="pl.555.31"></a><var>555.31</var>expenditures must be deposited in the general <br/>
<a id="pl.555.32"></a><var>555.32</var>fund. The amount of funds must be limited to <br/>
<a id="pl.555.33"></a><var>555.33</var>$4,900,000 per year in fiscal years 2014 and <br/>
<a id="pl.555.34"></a><var>555.34</var>2015, and to $4,400,000 per year in fiscal <br/>
<a id="pl.556.1"></a><var>556.1</var>years 2016 and 2017, contingent on approval <br/>
<a id="pl.556.2"></a><var>556.2</var>by the federal Food and Nutrition Service.<br/>
<a id="pl.556.3"></a><var>556.3</var>(2) Consistent with the receipt of the federal <br/>
<a id="pl.556.4"></a><var>556.4</var>funds, the commissioner may adjust the <br/>
<a id="pl.556.5"></a><var>556.5</var>level of working family credit expenditures <br/>
<a id="pl.556.6"></a><var>556.6</var>claimed as TANF maintenance of effort. <br/>
<a id="pl.556.7"></a><var>556.7</var>Notwithstanding any contrary provision in <br/>
<a id="pl.556.8"></a><var>556.8</var>this article, this rider expires June 30, 2017.<br/>
<a id="pl.556.9"></a><var>556.9</var><b>TANF Maintenance of Effort. </b>(a) In order <br/>
<a id="pl.556.10"></a><var>556.10</var>to meet the basic maintenance of effort <br/>
<a id="pl.556.11"></a><var>556.11</var>(MOE) requirements of the TANF block grant <br/>
<a id="pl.556.12"></a><var>556.12</var>specified under Code of Federal Regulations, <br/>
<a id="pl.556.13"></a><var>556.13</var>title 45, section 263.1, the commissioner may <br/>
<a id="pl.556.14"></a><var>556.14</var>only report nonfederal money expended for <br/>
<a id="pl.556.15"></a><var>556.15</var>allowable activities listed in the following <br/>
<a id="pl.556.16"></a><var>556.16</var>clauses as TANF/MOE expenditures:<br/>
<a id="pl.556.17"></a><var>556.17</var>(1) MFIP cash, diversionary work program, <br/>
<a id="pl.556.18"></a><var>556.18</var>and food assistance benefits under Minnesota <br/>
<a id="pl.556.19"></a><var>556.19</var>Statutes, chapter 256J;<br/>
<a id="pl.556.20"></a><var>556.20</var>(2) the child care assistance programs <br/>
<a id="pl.556.21"></a><var>556.21</var>under Minnesota Statutes, sections 119B.03 <br/>
<a id="pl.556.22"></a><var>556.22</var>and 119B.05, and county child care <br/>
<a id="pl.556.23"></a><var>556.23</var>administrative costs under Minnesota <br/>
<a id="pl.556.24"></a><var>556.24</var>Statutes, section 119B.15;<br/>
<a id="pl.556.25"></a><var>556.25</var>(3) state and county MFIP administrative <br/>
<a id="pl.556.26"></a><var>556.26</var>costs under Minnesota Statutes, chapters <br/>
<a id="pl.556.27"></a><var>556.27</var>256J and 256K;<br/>
<a id="pl.556.28"></a><var>556.28</var>(4) state, county, and tribal MFIP <br/>
<a id="pl.556.29"></a><var>556.29</var>employment services under Minnesota <br/>
<a id="pl.556.30"></a><var>556.30</var>Statutes, chapters 256J and 256K;<br/>
<a id="pl.556.31"></a><var>556.31</var>(5) expenditures made on behalf of legal <br/>
<a id="pl.556.32"></a><var>556.32</var>noncitizen MFIP recipients who qualify for <br/>
<a id="pl.556.33"></a><var>556.33</var>the MinnesotaCare program under Minnesota <br/>
<a id="pl.556.34"></a><var>556.34</var>Statutes, chapter 256L;<br/>
<a id="pl.557.1"></a><var>557.1</var>(6) qualifying working family credit <br/>
<a id="pl.557.2"></a><var>557.2</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.557.3"></a><var>557.3</var>section 290.0671;<br/>
<a id="pl.557.4"></a><var>557.4</var>(7) qualifying Minnesota education credit <br/>
<a id="pl.557.5"></a><var>557.5</var>expenditures under Minnesota Statutes, <br/>
<a id="pl.557.6"></a><var>557.6</var>section 290.0674; and<br/>
<a id="pl.557.7"></a><var>557.7</var>(8) qualifying Head Start expenditures under <br/>
<a id="pl.557.8"></a><var>557.8</var>Minnesota Statutes, section 119A.50.<br/>
<a id="pl.557.9"></a><var>557.9</var>(b) The commissioner shall ensure that <br/>
<a id="pl.557.10"></a><var>557.10</var>sufficient qualified nonfederal expenditures <br/>
<a id="pl.557.11"></a><var>557.11</var>are made each year to meet the state's <br/>
<a id="pl.557.12"></a><var>557.12</var>TANF/MOE requirements. For the activities <br/>
<a id="pl.557.13"></a><var>557.13</var>listed in paragraph (a), clauses (2) to <br/>
<a id="pl.557.14"></a><var>557.14</var>(8), the commissioner may only report <br/>
<a id="pl.557.15"></a><var>557.15</var>expenditures that are excluded from the <br/>
<a id="pl.557.16"></a><var>557.16</var>definition of assistance under Code of <br/>
<a id="pl.557.17"></a><var>557.17</var>Federal Regulations, title 45, section 260.31.<br/>
<a id="pl.557.18"></a><var>557.18</var>(c) For fiscal years beginning with state fiscal <br/>
<a id="pl.557.19"></a><var>557.19</var>year 2003, the commissioner shall ensure <br/>
<a id="pl.557.20"></a><var>557.20</var>that the maintenance of effort used by the <br/>
<a id="pl.557.21"></a><var>557.21</var>commissioner of management and budget <br/>
<a id="pl.557.22"></a><var>557.22</var>for the February and November forecasts <br/>
<a id="pl.557.23"></a><var>557.23</var>required under Minnesota Statutes, section <br/>
<a id="pl.557.24"></a><var>557.24</var>16A.103, contains expenditures under <br/>
<a id="pl.557.25"></a><var>557.25</var>paragraph (a), clause (1), equal to at least 16 <br/>
<a id="pl.557.26"></a><var>557.26</var>percent of the total required under Code of <br/>
<a id="pl.557.27"></a><var>557.27</var>Federal Regulations, title 45, section 263.1.<br/>
<a id="pl.557.28"></a><var>557.28</var>(d) The requirement in Minnesota Statutes, <br/>
<a id="pl.557.29"></a><var>557.29</var>section 256.011, subdivision 3, that federal <br/>
<a id="pl.557.30"></a><var>557.30</var>grants or aids secured or obtained under that <br/>
<a id="pl.557.31"></a><var>557.31</var>subdivision be used to reduce any direct <br/>
<a id="pl.557.32"></a><var>557.32</var>appropriations provided by law, do not apply <br/>
<a id="pl.557.33"></a><var>557.33</var>if the grants or aids are federal TANF funds.<br/>
<a id="pl.557.34"></a><var>557.34</var>(e) For the federal fiscal years beginning on <br/>
<a id="pl.557.35"></a><var>557.35</var>or after October 1, 2007, the commissioner <br/>
<a id="pl.558.1"></a><var>558.1</var>may not claim an amount of TANF/MOE in <br/>
<a id="pl.558.2"></a><var>558.2</var>excess of the 75 percent standard in Code <br/>
<a id="pl.558.3"></a><var>558.3</var>of Federal Regulations, title 45, section <br/>
<a id="pl.558.4"></a><var>558.4</var>263.1(a)(2), except:<br/>
<a id="pl.558.5"></a><var>558.5</var>(1) to the extent necessary to meet the 80 <br/>
<a id="pl.558.6"></a><var>558.6</var>percent standard under Code of Federal <br/>
<a id="pl.558.7"></a><var>558.7</var>Regulations, title 45, section 263.1(a)(1), <br/>
<a id="pl.558.8"></a><var>558.8</var>if it is determined by the commissioner <br/>
<a id="pl.558.9"></a><var>558.9</var>that the state will not meet the TANF work <br/>
<a id="pl.558.10"></a><var>558.10</var>participation target rate for the current year;<br/>
<a id="pl.558.11"></a><var>558.11</var>(2) to provide any additional amounts <br/>
<a id="pl.558.12"></a><var>558.12</var>under Code of Federal Regulations, title 45, <br/>
<a id="pl.558.13"></a><var>558.13</var>section 264.5, that relate to replacement of <br/>
<a id="pl.558.14"></a><var>558.14</var>TANF funds due to the operation of TANF <br/>
<a id="pl.558.15"></a><var>558.15</var>penalties; and<br/>
<a id="pl.558.16"></a><var>558.16</var>(3) to provide any additional amounts that <br/>
<a id="pl.558.17"></a><var>558.17</var>may contribute to avoiding or reducing <br/>
<a id="pl.558.18"></a><var>558.18</var>TANF work participation penalties through <br/>
<a id="pl.558.19"></a><var>558.19</var>the operation of the excess MOE provisions <br/>
<a id="pl.558.20"></a><var>558.20</var>of Code of Federal Regulations, title 45, <br/>
<a id="pl.558.21"></a><var>558.21</var>section 261.43(a)(2).<br/>
<a id="pl.558.22"></a><var>558.22</var>For the purposes of clauses (1) to (3), <br/>
<a id="pl.558.23"></a><var>558.23</var>the commissioner may supplement the <br/>
<a id="pl.558.24"></a><var>558.24</var>MOE claim with working family credit <br/>
<a id="pl.558.25"></a><var>558.25</var>expenditures or other qualified expenditures <br/>
<a id="pl.558.26"></a><var>558.26</var>to the extent such expenditures are otherwise <br/>
<a id="pl.558.27"></a><var>558.27</var>available after considering the expenditures <br/>
<a id="pl.558.28"></a><var>558.28</var>allowed in this subdivision and subdivisions <br/>
<a id="pl.558.29"></a><var>558.29</var>2 and 3.<br/>
<a id="pl.558.30"></a><var>558.30</var>(f) Notwithstanding any contrary provision <br/>
<a id="pl.558.31"></a><var>558.31</var>in this article, paragraphs (a) to (e) expire <br/>
<a id="pl.558.32"></a><var>558.32</var>June 30, 2017.<br/>
<a id="pl.558.33"></a><var>558.33</var><b>Working Family Credit Expenditures </b><br/>
<a id="pl.558.34"></a><var>558.34</var><b>as TANF/MOE. </b>The commissioner may <br/>
<a id="pl.558.35"></a><var>558.35</var>claim as TANF maintenance of effort up to <br/>
<a id="pl.559.1"></a><var>559.1</var>$6,707,000 per year of working family credit <br/>
<a id="pl.559.2"></a><var>559.2</var>expenditures in each fiscal year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.559.3"></a><var>559.3</var><br/>
<a id="pl.559.4"></a><var>559.4</var><br/>
</td>
<td colspan="3">Subd. 2.<b>Working Family Credit to be Claimed </b><br/>
<b>for TANF/MOE</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.559.5"></a><var>559.5</var>The commissioner may count the following <br/>
<a id="pl.559.6"></a><var>559.6</var>amounts of working family credit <br/>
<a id="pl.559.7"></a><var>559.7</var>expenditures as TANF/MOE:<br/>
<a id="pl.559.8"></a><var>559.8</var>(1) fiscal year 2014, $45,196,000;<br/>
<a id="pl.559.9"></a><var>559.9</var>(2) fiscal year 2015, $41,885,000;<br/>
<a id="pl.559.10"></a><var>559.10</var>(3) fiscal year 2016, $8,869,000; and<br/>
<a id="pl.559.11"></a><var>559.11</var>(4) fiscal year 2017, $11,181,000.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.559.12"></a><var>559.12</var><br/>
<a id="pl.559.13"></a><var>559.13</var><br/>
</td>
<td colspan="3">Subd. 3.<b>TANF Transfer to Federal Child Care </b><br/>
<b>and Development Fund</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.559.14"></a><var>559.14</var>(a) The following TANF fund amounts <br/>
<a id="pl.559.15"></a><var>559.15</var>are appropriated to the commissioner for <br/>
<a id="pl.559.16"></a><var>559.16</var>purposes of MFIP/transition year child care <br/>
<a id="pl.559.17"></a><var>559.17</var>assistance under Minnesota Statutes, section <br/>
<a id="pl.559.18"></a><var>559.18</var>119B.05:<br/>
<a id="pl.559.19"></a><var>559.19</var>(1) fiscal year 2014; $14,020,000; and<br/>
<a id="pl.559.20"></a><var>559.20</var>(2) fiscal year 2015, $14,020,000.<br/>
<a id="pl.559.21"></a><var>559.21</var>(b) The commissioner shall authorize the <br/>
<a id="pl.559.22"></a><var>559.22</var>transfer of sufficient TANF funds to the <br/>
<a id="pl.559.23"></a><var>559.23</var>federal child care and development fund to <br/>
<a id="pl.559.24"></a><var>559.24</var>meet this appropriation and shall ensure that <br/>
<a id="pl.559.25"></a><var>559.25</var>all transferred funds are expended according <br/>
<a id="pl.559.26"></a><var>559.26</var>to federal child care and development fund <br/>
<a id="pl.559.27"></a><var>559.27</var>regulations.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.559.28"></a><var>559.28</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Central Office</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.559.29"></a><var>559.29</var>The amounts that may be spent from this <br/>
<a id="pl.559.30"></a><var>559.30</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.559.31"></a><var>559.31</var><br/>
</td>
<td colspan="3"><b>(a) Operations</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.559.32"></a><var>559.32</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.559.33"></a><var>559.33</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">88,876,000<br/>
</td>
<td align="right">91,189,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.560.1"></a><var>560.1</var><br/>
<a id="pl.560.2"></a><var>560.2</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">3,690,000<br/>
</td>
<td align="right">4,790,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.560.3"></a><var>560.3</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right"> 13,177,000<br/>
</td>
<td align="right">13,004,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.560.4"></a><var>560.4</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">100,000<br/>
</td>
<td align="right">100,000<br/>
</td>
</tr>
</table><a id="pl.560.5"></a><var>560.5</var><b>DHS Receipt Center Accounting. </b>The <br/>
<a id="pl.560.6"></a><var>560.6</var>commissioner is authorized to transfer <br/>
<a id="pl.560.7"></a><var>560.7</var>appropriations to, and account for DHS <br/>
<a id="pl.560.8"></a><var>560.8</var>receipt center operations in, the special <br/>
<a id="pl.560.9"></a><var>560.9</var>revenue fund.<br/>
<a id="pl.560.10"></a><var>560.10</var><b>Administrative Recovery; Set-Aside. </b>The <br/>
<a id="pl.560.11"></a><var>560.11</var>commissioner may invoice local entities <br/>
<a id="pl.560.12"></a><var>560.12</var>through the SWIFT accounting system as an <br/>
<a id="pl.560.13"></a><var>560.13</var>alternative means to recover the actual cost <br/>
<a id="pl.560.14"></a><var>560.14</var>of administering the following provisions:<br/>
<a id="pl.560.15"></a><var>560.15</var>(1) Minnesota Statutes, section 125A.744, <br/>
<a id="pl.560.16"></a><var>560.16</var>subdivision 3;<br/>
<a id="pl.560.17"></a><var>560.17</var>(2) Minnesota Statutes, section 245.495, <br/>
<a id="pl.560.18"></a><var>560.18</var>paragraph (b);<br/>
<a id="pl.560.19"></a><var>560.19</var>(3) Minnesota Statutes, section 256B.0625, <br/>
<a id="pl.560.20"></a><var>560.20</var>subdivision 20, paragraph (k);<br/>
<a id="pl.560.21"></a><var>560.21</var>(4) Minnesota Statutes, section 256B.0924, <br/>
<a id="pl.560.22"></a><var>560.22</var>subdivision 6, paragraph (g);<br/>
<a id="pl.560.23"></a><var>560.23</var>(5) Minnesota Statutes, section 256B.0945, <br/>
<a id="pl.560.24"></a><var>560.24</var>subdivision 4, paragraph (d); and<br/>
<a id="pl.560.25"></a><var>560.25</var>(6) Minnesota Statutes, section 256F.10, <br/>
<a id="pl.560.26"></a><var>560.26</var>subdivision 6, paragraph (b).<br/>
<a id="pl.560.27"></a><var>560.27</var><b>Systems Modernization. </b>The following <br/>
<a id="pl.560.28"></a><var>560.28</var>amounts are appropriated for transfer to <br/>
<a id="pl.560.29"></a><var>560.29</var>the state systems account authorized in <br/>
<a id="pl.560.30"></a><var>560.30</var>Minnesota Statutes, section 256.014:<br/>
<a id="pl.560.31"></a><var>560.31</var>(1) $1,825,000 in fiscal year 2014 and <br/>
<a id="pl.560.32"></a><var>560.32</var>$2,502,000 in fiscal year 2015 is for the <br/>
<a id="pl.560.33"></a><var>560.33</var>state share of Medicaid-allocated costs of <br/>
<a id="pl.560.34"></a><var>560.34</var>the health insurance exchange information <br/>
<a id="pl.561.1"></a><var>561.1</var>technology and operational structure. The <br/>
<a id="pl.561.2"></a><var>561.2</var>funding base is $3,222,000 in fiscal year 2016 <br/>
<a id="pl.561.3"></a><var>561.3</var>and $3,037,000 in fiscal year 2017 but shall <br/>
<a id="pl.561.4"></a><var>561.4</var>not be included in the base thereafter; and<br/>
<a id="pl.561.5"></a><var>561.5</var>(2) $1,000,000 in fiscal year 2014 and <br/>
<a id="pl.561.6"></a><var>561.6</var>$2,000,000 in fiscal year 2015 are for the <br/>
<a id="pl.561.7"></a><var>561.7</var>modernization and streamlining of agency <br/>
<a id="pl.561.8"></a><var>561.8</var>eligibility and child support systems. The <br/>
<a id="pl.561.9"></a><var>561.9</var>funding base is $2,000,000 in fiscal year <br/>
<a id="pl.561.10"></a><var>561.10</var>2016 and $2,000,000 in fiscal year 2017 but <br/>
<a id="pl.561.11"></a><var>561.11</var>shall not be included in the base thereafter.<br/>
<a id="pl.561.12"></a><var>561.12</var>The unexpended balance of the $1,000,000 <br/>
<a id="pl.561.13"></a><var>561.13</var>appropriation in fiscal year 2014 and the <br/>
<a id="pl.561.14"></a><var>561.14</var>$2,000,000 appropriation in fiscal year 2015 <br/>
<a id="pl.561.15"></a><var>561.15</var>must be transferred from the Department of <br/>
<a id="pl.561.16"></a><var>561.16</var>Human Services state systems account to <br/>
<a id="pl.561.17"></a><var>561.17</var>the Office of Enterprise Technology when <br/>
<a id="pl.561.18"></a><var>561.18</var>the Office of Enterprise Technology has <br/>
<a id="pl.561.19"></a><var>561.19</var>negotiated a federally approved internal <br/>
<a id="pl.561.20"></a><var>561.20</var>service fund rates and billing process with <br/>
<a id="pl.561.21"></a><var>561.21</var>sufficient internal accounting controls to <br/>
<a id="pl.561.22"></a><var>561.22</var>properly maximize federal reimbursement <br/>
<a id="pl.561.23"></a><var>561.23</var>to Minnesota for human services system <br/>
<a id="pl.561.24"></a><var>561.24</var>modernization projects, but not later than <br/>
<a id="pl.561.25"></a><var>561.25</var>June 30, 2015.<br/>
<a id="pl.561.26"></a><var>561.26</var>If contingent funding is fully or partially <br/>
<a id="pl.561.27"></a><var>561.27</var>disbursed under article 15, section 3, and <br/>
<a id="pl.561.28"></a><var>561.28</var>transferred to the state systems account, the <br/>
<a id="pl.561.29"></a><var>561.29</var>unexpended balance of that appropriation <br/>
<a id="pl.561.30"></a><var>561.30</var>must be transferred to the Office of Enterprise <br/>
<a id="pl.561.31"></a><var>561.31</var>Technology in accordance with this clause. <br/>
<a id="pl.561.32"></a><var>561.32</var>Contingent funding must not exceed <br/>
<a id="pl.561.33"></a><var>561.33</var>$15,463,000 for the biennium.<br/>
<a id="pl.561.34"></a><var>561.34</var><b>Base Adjustment. </b>The general fund base <br/>
<a id="pl.561.35"></a><var>561.35</var>is increased by $646,000 in fiscal year 2016 <br/>
<a id="pl.562.1"></a><var>562.1</var>and $461,000 in fiscal year 2017. The health <br/>
<a id="pl.562.2"></a><var>562.2</var>access fund base is decreased by $551,000 in <br/>
<a id="pl.562.3"></a><var>562.3</var>fiscal years 2016 and 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.562.4"></a><var>562.4</var><br/>
</td>
<td colspan="3"><b>(b) Children and Families</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.562.5"></a><var>562.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.6"></a><var>562.6</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">7,569,000<br/>
</td>
<td align="right">7,519,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.7"></a><var>562.7</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">2,282,000<br/>
</td>
<td align="right">2,282,000<br/>
</td>
</tr>
</table><a id="pl.562.8"></a><var>562.8</var><b>Financial Institution Data Match and </b><br/>
<a id="pl.562.9"></a><var>562.9</var><b>Payment of Fees. </b>The commissioner is <br/>
<a id="pl.562.10"></a><var>562.10</var>authorized to allocate up to $310,000 each <br/>
<a id="pl.562.11"></a><var>562.11</var>year in fiscal years 2014 and 2015 from the <br/>
<a id="pl.562.12"></a><var>562.12</var>PRISM special revenue account to make <br/>
<a id="pl.562.13"></a><var>562.13</var>payments to financial institutions in exchange <br/>
<a id="pl.562.14"></a><var>562.14</var>for performing data matches between account <br/>
<a id="pl.562.15"></a><var>562.15</var>information held by financial institutions <br/>
<a id="pl.562.16"></a><var>562.16</var>and the public authority's database of child <br/>
<a id="pl.562.17"></a><var>562.17</var>support obligors as authorized by Minnesota <br/>
<a id="pl.562.18"></a><var>562.18</var>Statutes, section 13B.06, subdivision 7.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.562.19"></a><var>562.19</var><br/>
</td>
<td colspan="3"><b>(c) Health Care</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.562.20"></a><var>562.20</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.21"></a><var>562.21</var><br/>
</td>
<td>General<br/>
</td>
<td align="right"> 13,643,000<br/>
</td>
<td align="right"> 13,227,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.22"></a><var>562.22</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">24,602,000<br/>
</td>
<td align="right">26,728,000<br/>
</td>
</tr>
</table><a id="pl.562.23"></a><var>562.23</var><b>Base Adjustment. </b> The general fund base <br/>
<a id="pl.562.24"></a><var>562.24</var>is decreased by $86,000 in fiscal year 2016 <br/>
<a id="pl.562.25"></a><var>562.25</var>and by $86,000 in fiscal year 2017. The <br/>
<a id="pl.562.26"></a><var>562.26</var>health care access fund base is increased <br/>
<a id="pl.562.27"></a><var>562.27</var>by $7,956,000 in fiscal year 2016 and by <br/>
<a id="pl.562.28"></a><var>562.28</var>$6,354,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.562.29"></a><var>562.29</var><br/>
</td>
<td colspan="3"><b>(d) Continuing Care</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.562.30"></a><var>562.30</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.31"></a><var>562.31</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">17,361,000<br/>
</td>
<td align="right">17,426,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.562.32"></a><var>562.32</var><br/>
<a id="pl.562.33"></a><var>562.33</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">125,000<br/>
</td>
<td align="right">125,000<br/>
</td>
</tr>
</table><a id="pl.563.1"></a><var>563.1</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.563.2"></a><var>563.2</var>decreased by $1,000 in fiscal year 2016 and <br/>
<a id="pl.563.3"></a><var>563.3</var>by $1,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.4"></a><var>563.4</var><br/>
</td>
<td colspan="3"><b>(e) Chemical and Mental Health</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.563.5"></a><var>563.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.563.6"></a><var>563.6</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">4,313,000<br/>
</td>
<td align="right">4,179,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.563.7"></a><var>563.7</var><br/>
</td>
<td>Lottery Prize Fund<br/>
</td>
<td align="right">157,000<br/>
</td>
<td align="right">157,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.8"></a><var>563.8</var><br/>
</td>
<td colspan="3">Subd. 5.<b>Forecasted Programs</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.563.9"></a><var>563.9</var>The amounts that may be spent from this <br/>
<a id="pl.563.10"></a><var>563.10</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.11"></a><var>563.11</var><br/>
</td>
<td colspan="3"><b>(a) MFIP/DWP</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.563.12"></a><var>563.12</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.563.13"></a><var>563.13</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">73,742,000<br/>
</td>
<td align="right">79,302,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.563.14"></a><var>563.14</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">80,342,000<br/>
</td>
<td align="right">76,851,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.15"></a><var>563.15</var><br/>
</td>
<td colspan="3"><b>(b) MFIP Child Care Assistance</b><br/>
</td>
<td align="center"></td>
<td align="right">62,030,000<br/>
</td>
<td align="center"></td>
<td align="right">64,731,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.16"></a><var>563.16</var><br/>
</td>
<td colspan="3"><b>(c) General Assistance</b><br/>
</td>
<td align="center"></td>
<td align="right">54,787,000<br/>
</td>
<td align="center"></td>
<td align="right">56,068,000<br/>
</td>
</tr>
</table><a id="pl.563.17"></a><var>563.17</var><b>General Assistance Standard. </b>The <br/>
<a id="pl.563.18"></a><var>563.18</var>commissioner shall set the monthly standard <br/>
<a id="pl.563.19"></a><var>563.19</var>of assistance for general assistance units <br/>
<a id="pl.563.20"></a><var>563.20</var>consisting of an adult recipient who is <br/>
<a id="pl.563.21"></a><var>563.21</var>childless and unmarried or living apart <br/>
<a id="pl.563.22"></a><var>563.22</var>from parents or a legal guardian at $203. <br/>
<a id="pl.563.23"></a><var>563.23</var>The commissioner may reduce this amount <br/>
<a id="pl.563.24"></a><var>563.24</var>according to Laws 1997, chapter 85, article <br/>
<a id="pl.563.25"></a><var>563.25</var>3, section 54.<br/>
<a id="pl.563.26"></a><var>563.26</var><b>Emergency General Assistance. </b>The <br/>
<a id="pl.563.27"></a><var>563.27</var>amount appropriated for emergency general <br/>
<a id="pl.563.28"></a><var>563.28</var>assistance funds is limited to no more <br/>
<a id="pl.563.29"></a><var>563.29</var>than $6,729,812 in fiscal year 2014 and <br/>
<a id="pl.563.30"></a><var>563.30</var>$6,729,812 in fiscal year 2015. Funds <br/>
<a id="pl.563.31"></a><var>563.31</var>to counties shall be allocated by the <br/>
<a id="pl.563.32"></a><var>563.32</var>commissioner using the allocation method in <br/>
<a id="pl.563.33"></a><var>563.33</var>Minnesota Statutes, section 256D.06.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.563.34"></a><var>563.34</var><br/>
</td>
<td colspan="3"><b>(d) MN Supplemental Assistance</b><br/>
</td>
<td align="center"></td>
<td align="right">38,646,000<br/>
</td>
<td align="center"></td>
<td align="right">39,821,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.564.1"></a><var>564.1</var><br/>
</td>
<td colspan="3"><b>(e) Group Residential Housing</b><br/>
</td>
<td align="center"></td>
<td align="right">140,447,000<br/>
</td>
<td align="center"></td>
<td align="right">149,984,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.564.2"></a><var>564.2</var><br/>
</td>
<td colspan="3"><b>(f) MinnesotaCare</b><br/>
</td>
<td align="center"></td>
<td align="right"> 299,290,000<br/>
</td>
<td align="center"></td>
<td align="right"> 257,020,000<br/>
</td>
</tr>
</table><a id="pl.564.3"></a><var>564.3</var>This appropriation is from the health care <br/>
<a id="pl.564.4"></a><var>564.4</var>access fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.564.5"></a><var>564.5</var><br/>
</td>
<td colspan="3"><b>(g) Medical Assistance</b><br/>
</td>
<td align="center"></td>
<td align="right"> 4,609,672,000<br/>
</td>
<td align="center"></td>
<td align="right"> 4,615,440,000<br/>
</td>
</tr>
</table><a id="pl.564.6"></a><var>564.6</var><b>Medical Eligibility for Inmates in Medical </b><br/>
<a id="pl.564.7"></a><var>564.7</var><b>Institutions.</b> The commissioner of human <br/>
<a id="pl.564.8"></a><var>564.8</var>services shall execute an interagency <br/>
<a id="pl.564.9"></a><var>564.9</var>agreement with the commissioner of <br/>
<a id="pl.564.10"></a><var>564.10</var>corrections to recover the medical assistance <br/>
<a id="pl.564.11"></a><var>564.11</var>cost attributable to medical assistance <br/>
<a id="pl.564.12"></a><var>564.12</var>eligibility for inmates of public institutions <br/>
<a id="pl.564.13"></a><var>564.13</var>admitted to hospitals on an inpatient basis. <br/>
<a id="pl.564.14"></a><var>564.14</var>The amount that must be recovered from <br/>
<a id="pl.564.15"></a><var>564.15</var>the Department of Corrections shall include <br/>
<a id="pl.564.16"></a><var>564.16</var>all state medical assistance costs, including <br/>
<a id="pl.564.17"></a><var>564.17</var>administrative costs, attributable to inmates <br/>
<a id="pl.564.18"></a><var>564.18</var>under state and county jurisdiction admitted <br/>
<a id="pl.564.19"></a><var>564.19</var>to hospitals on an inpatient basis.<br/>
<a id="pl.564.20"></a><var>564.20</var><b>Support Services for Deaf and </b><br/>
<a id="pl.564.21"></a><var>564.21</var><b>Hard-of-Hearing.</b> $121,000 in fiscal <br/>
<a id="pl.564.22"></a><var>564.22</var>year 2014 and $141,000 in fiscal year 2015; <br/>
<a id="pl.564.23"></a><var>564.23</var>and $10,000 in fiscal year 2014 and $13,000 <br/>
<a id="pl.564.24"></a><var>564.24</var>in fiscal year 2015 are from the health care <br/>
<a id="pl.564.25"></a><var>564.25</var>access fund for the hospital reimbursement <br/>
<a id="pl.564.26"></a><var>564.26</var>increase in Minnesota Statutes, section <br/>
<a id="pl.564.27"></a><var>564.27</var>256.969, subdivision 29, paragraph (b).<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.564.28"></a><var>564.28</var><br/>
</td>
<td colspan="3"><b>(h) Alternative Care</b><br/>
</td>
<td align="center"></td>
<td align="right">47,058,000<br/>
</td>
<td align="center"></td>
<td align="right">47,078,000<br/>
</td>
</tr>
</table><a id="pl.564.29"></a><var>564.29</var><b>Alternative Care Transfer. </b>Any money <br/>
<a id="pl.564.30"></a><var>564.30</var>allocated to the alternative care program that <br/>
<a id="pl.564.31"></a><var>564.31</var>is not spent for the purposes indicated does <br/>
<a id="pl.564.32"></a><var>564.32</var>not cancel but shall be transferred to the <br/>
<a id="pl.564.33"></a><var>564.33</var>medical assistance account.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.564.34"></a><var>564.34</var><br/>
</td>
<td colspan="3"><b>(i) CD Treatment Fund</b><br/>
</td>
<td align="center"></td>
<td align="right">81,440,000<br/>
</td>
<td align="center"></td>
<td align="right">74,875,000<br/>
</td>
</tr>
</table><a id="pl.565.1"></a><var>565.1</var><b>Balance Transfer. </b>The commissioner must <br/>
<a id="pl.565.2"></a><var>565.2</var>transfer $18,188,000 from the consolidated <br/>
<a id="pl.565.3"></a><var>565.3</var>chemical dependency treatment fund to the <br/>
<a id="pl.565.4"></a><var>565.4</var>general fund by September 30, 2013.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.565.5"></a><var>565.5</var><br/>
</td>
<td colspan="3">Subd. 6.<b>Grant Programs</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.565.6"></a><var>565.6</var>The amounts that may be spent from this <br/>
<a id="pl.565.7"></a><var>565.7</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.565.8"></a><var>565.8</var><br/>
</td>
<td colspan="3"><b>(a) Support Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.565.9"></a><var>565.9</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.565.10"></a><var>565.10</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">11,333,000<br/>
</td>
<td align="right">11,133,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.565.11"></a><var>565.11</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">94,611,000<br/>
</td>
<td align="right">94,611,000<br/>
</td>
</tr>
</table><a id="pl.565.12"></a><var>565.12</var><b>Paid Work Experience. </b>$1,159,000 in fiscal <br/>
<a id="pl.565.13"></a><var>565.13</var>year 2014, and $1,009,000 in fiscal year <br/>
<a id="pl.565.14"></a><var>565.14</var>2015 is from the general fund for paid work <br/>
<a id="pl.565.15"></a><var>565.15</var>experience for long-term MFIP recipients. <br/>
<a id="pl.565.16"></a><var>565.16</var>Paid work includes full and partial wage <br/>
<a id="pl.565.17"></a><var>565.17</var>subsidies and other related services such as <br/>
<a id="pl.565.18"></a><var>565.18</var>job development, marketing, preworksite <br/>
<a id="pl.565.19"></a><var>565.19</var>training, job coaching, and postplacement <br/>
<a id="pl.565.20"></a><var>565.20</var>services. Unexpended funds for fiscal year <br/>
<a id="pl.565.21"></a><var>565.21</var>2014 do not cancel but are available for this <br/>
<a id="pl.565.22"></a><var>565.22</var>purpose in fiscal year 2015.<br/>
<a id="pl.565.23"></a><var>565.23</var><b>Work Study Funding for MFIP </b><br/>
<a id="pl.565.24"></a><var>565.24</var><b>Participants. </b>$250,000 each year is from <br/>
<a id="pl.565.25"></a><var>565.25</var>the general fund to pilot work study jobs for <br/>
<a id="pl.565.26"></a><var>565.26</var>MFIP recipients in approved postsecondary <br/>
<a id="pl.565.27"></a><var>565.27</var>education programs. This is a onetime <br/>
<a id="pl.565.28"></a><var>565.28</var>appropriation. Unexpended funds for fiscal <br/>
<a id="pl.565.29"></a><var>565.29</var>year 2014 do not cancel but are available for <br/>
<a id="pl.565.30"></a><var>565.30</var>this purpose in fiscal year 2015.<br/>
<a id="pl.565.31"></a><var>565.31</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.565.32"></a><var>565.32</var>decreased by $2,418,000 in fiscal years 2016 <br/>
<a id="pl.565.33"></a><var>565.33</var>and 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.565.34"></a><var>565.34</var><br/>
<a id="pl.565.35"></a><var>565.35</var><br/>
</td>
<td colspan="3"><b>(b) Basic Sliding Fee Child Care Assistance </b><br/>
<b>Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">39,039,000<br/>
</td>
<td align="center"></td>
<td align="right">40,391,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.566.1"></a><var>566.1</var><br/>
</td>
<td colspan="3"><b>(c) Child Care Development Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
<td align="center"></td>
<td align="right">1,487,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.566.2"></a><var>566.2</var><br/>
</td>
<td colspan="3"><b>(d) Child Support Enforcement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">50,000<br/>
</td>
<td align="center"></td>
<td align="right">50,000<br/>
</td>
</tr>
</table><a id="pl.566.3"></a><var>566.3</var><b>Federal Child Support Demonstration </b><br/>
<a id="pl.566.4"></a><var>566.4</var><b>Grants. </b>Federal administrative <br/>
<a id="pl.566.5"></a><var>566.5</var>reimbursement resulting from the federal <br/>
<a id="pl.566.6"></a><var>566.6</var>child support grant expenditures authorized <br/>
<a id="pl.566.7"></a><var>566.7</var>under United States Code, title 42, section <br/>
<a id="pl.566.8"></a><var>566.8</var>1315, is appropriated to the commissioner <br/>
<a id="pl.566.9"></a><var>566.9</var>for this activity.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.566.10"></a><var>566.10</var><br/>
</td>
<td colspan="3"><b>(e) Children's Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.566.11"></a><var>566.11</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.566.12"></a><var>566.12</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">49,810,000<br/>
</td>
<td align="right">50,260,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.566.13"></a><var>566.13</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">140,000<br/>
</td>
<td align="right">140,000<br/>
</td>
</tr>
</table><a id="pl.566.14"></a><var>566.14</var><b>Adoption Assistance and Relative Custody </b><br/>
<a id="pl.566.15"></a><var>566.15</var><b>Assistance. </b>The commissioner may transfer <br/>
<a id="pl.566.16"></a><var>566.16</var>unencumbered appropriation balances for <br/>
<a id="pl.566.17"></a><var>566.17</var>adoption assistance and relative custody <br/>
<a id="pl.566.18"></a><var>566.18</var>assistance between fiscal years and between <br/>
<a id="pl.566.19"></a><var>566.19</var>programs.<br/>
<a id="pl.566.20"></a><var>566.20</var><b>Title IV-E Adoption Assistance.</b> Additional <br/>
<a id="pl.566.21"></a><var>566.21</var>federal reimbursements to the state as a result <br/>
<a id="pl.566.22"></a><var>566.22</var>of the Fostering Connections to Success <br/>
<a id="pl.566.23"></a><var>566.23</var>and Increasing Adoptions Act's expanded <br/>
<a id="pl.566.24"></a><var>566.24</var>eligibility for Title IV-E adoption assistance <br/>
<a id="pl.566.25"></a><var>566.25</var>are appropriated for postadoption services, <br/>
<a id="pl.566.26"></a><var>566.26</var>including a parent-to-parent support network.<br/>
<a id="pl.566.27"></a><var>566.27</var><b>Privatized Adoption Grants. </b>Federal <br/>
<a id="pl.566.28"></a><var>566.28</var>reimbursement for privatized adoption grant <br/>
<a id="pl.566.29"></a><var>566.29</var>and foster care recruitment grant expenditures <br/>
<a id="pl.566.30"></a><var>566.30</var>is appropriated to the commissioner for <br/>
<a id="pl.566.31"></a><var>566.31</var>adoption grants and foster care and adoption <br/>
<a id="pl.566.32"></a><var>566.32</var>administrative purposes.<br/>
<a id="pl.566.33"></a><var>566.33</var><b>Adoption Assistance Incentive Grants.</b><br/>
<a id="pl.566.34"></a><var>566.34</var> Federal funds available during fiscal years <br/>
<a id="pl.567.1"></a><var>567.1</var>2014 and 2015 for adoption incentive grants <br/>
<a id="pl.567.2"></a><var>567.2</var>are appropriated for postadoption services, <br/>
<a id="pl.567.3"></a><var>567.3</var>including a parent-to-parent support network.<br/>
<a id="pl.567.4"></a><var>567.4</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.567.5"></a><var>567.5</var>decreased by $466,000 in fiscal year 2016 <br/>
<a id="pl.567.6"></a><var>567.6</var>and by $822,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.567.7"></a><var>567.7</var><br/>
</td>
<td colspan="3"><b>(f) Child and Community Service Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">53,301,000<br/>
</td>
<td align="center"></td>
<td align="right">53,301,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.567.8"></a><var>567.8</var><br/>
</td>
<td colspan="3"><b>(g) Child and Economic Support Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">20,972,000<br/>
</td>
<td align="center"></td>
<td align="right">20,973,000<br/>
</td>
</tr>
</table><a id="pl.567.9"></a><var>567.9</var><b>Minnesota Food Assistance Program. </b><br/>
<a id="pl.567.10"></a><var>567.10</var>Unexpended funds for the Minnesota food <br/>
<a id="pl.567.11"></a><var>567.11</var>assistance program for fiscal year 2014 do <br/>
<a id="pl.567.12"></a><var>567.12</var>not cancel but are available for this purpose <br/>
<a id="pl.567.13"></a><var>567.13</var>in fiscal year 2015.<br/>
<a id="pl.567.14"></a><var>567.14</var><b>Family Assets for Independence.</b> $250,000 <br/>
<a id="pl.567.15"></a><var>567.15</var>each year is for the Family Assets for <br/>
<a id="pl.567.16"></a><var>567.16</var>Independence Minnesota program. This <br/>
<a id="pl.567.17"></a><var>567.17</var>appropriation is available in either year of the <br/>
<a id="pl.567.18"></a><var>567.18</var>biennium and may be transferred between <br/>
<a id="pl.567.19"></a><var>567.19</var>fiscal years. <br/>
<a id="pl.567.20"></a><var>567.20</var><b>Food Shelf Programs.</b> $500,000 in fiscal <br/>
<a id="pl.567.21"></a><var>567.21</var>year 2014 and $500,000 in fiscal year <br/>
<a id="pl.567.22"></a><var>567.22</var>2015 are for food shelf programs under <br/>
<a id="pl.567.23"></a><var>567.23</var>Minnesota Statutes, section 256E.34. If the <br/>
<a id="pl.567.24"></a><var>567.24</var>appropriation for either year is insufficient, <br/>
<a id="pl.567.25"></a><var>567.25</var>the appropriation for the other year is <br/>
<a id="pl.567.26"></a><var>567.26</var>available for it.<br/>
<a id="pl.567.27"></a><var>567.27</var><b>Homeless Youth Act.</b> $4,000,000 is for <br/>
<a id="pl.567.28"></a><var>567.28</var>purposes of Minnesota Statutes, section <br/>
<a id="pl.567.29"></a><var>567.29</var>256K.45.<br/>
<a id="pl.567.30"></a><var>567.30</var><b>Safe Harbor Shelter and Housing. </b><br/>
<a id="pl.567.31"></a><var>567.31</var>$2,000,000 in fiscal year 2014 and <br/>
<a id="pl.567.32"></a><var>567.32</var>$2,000,000 in fiscal year 2015 is for a safe <br/>
<a id="pl.567.33"></a><var>567.33</var>harbor shelter and housing fund for housing <br/>
<a id="pl.568.1"></a><var>568.1</var>and supportive services for youth who are <br/>
<a id="pl.568.2"></a><var>568.2</var>sexually exploited. <br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.568.3"></a><var>568.3</var><br/>
</td>
<td colspan="3"><b>(h) Health Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.568.4"></a><var>568.4</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.568.5"></a><var>568.5</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">190,000<br/>
</td>
<td align="right">190,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.568.6"></a><var>568.6</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right"> 2,228,000<br/>
</td>
<td align="right">1,413,000<br/>
</td>
</tr>
</table><a id="pl.568.7"></a><var>568.7</var><b>Emergency Medical Assistance Referral </b><br/>
<a id="pl.568.8"></a><var>568.8</var><b>and Assistance Grants.</b> (a) The <br/>
<a id="pl.568.9"></a><var>568.9</var>commissioner of human services shall <br/>
<a id="pl.568.10"></a><var>568.10</var>award grants to nonprofit programs that <br/>
<a id="pl.568.11"></a><var>568.11</var>provide immigration legal services based <br/>
<a id="pl.568.12"></a><var>568.12</var>on indigency to provide legal services for <br/>
<a id="pl.568.13"></a><var>568.13</var>immigration assistance to individuals with <br/>
<a id="pl.568.14"></a><var>568.14</var>emergency medical conditions or complex <br/>
<a id="pl.568.15"></a><var>568.15</var>and chronic health conditions who are not <br/>
<a id="pl.568.16"></a><var>568.16</var>currently eligible for medical assistance <br/>
<a id="pl.568.17"></a><var>568.17</var>or other public health care programs, but <br/>
<a id="pl.568.18"></a><var>568.18</var>who may meet eligibility requirements with <br/>
<a id="pl.568.19"></a><var>568.19</var>immigration assistance.<br/>
<a id="pl.568.20"></a><var>568.20</var>(b) The grantees, in collaboration with <br/>
<a id="pl.568.21"></a><var>568.21</var>hospitals and safety net providers, shall <br/>
<a id="pl.568.22"></a><var>568.22</var>provide referral assistance to connect <br/>
<a id="pl.568.23"></a><var>568.23</var>individuals identified in paragraph (a) with <br/>
<a id="pl.568.24"></a><var>568.24</var>alternative resources and services to assist in <br/>
<a id="pl.568.25"></a><var>568.25</var>meeting their health care needs. $100,000 <br/>
<a id="pl.568.26"></a><var>568.26</var>is appropriated in fiscal year 2014 and <br/>
<a id="pl.568.27"></a><var>568.27</var>$100,000 in fiscal year 2015. This is a <br/>
<a id="pl.568.28"></a><var>568.28</var>onetime appropriation.<br/>
<a id="pl.568.29"></a><var>568.29</var>(c) The programs receiving grants under <br/>
<a id="pl.568.30"></a><var>568.30</var>paragraph (a) must report to the commissioner <br/>
<a id="pl.568.31"></a><var>568.31</var>of human services the number of individuals <br/>
<a id="pl.568.32"></a><var>568.32</var>who were provided immigration assistance <br/>
<a id="pl.568.33"></a><var>568.33</var>under the grants and who were eventually <br/>
<a id="pl.568.34"></a><var>568.34</var>determined to be eligible for medical <br/>
<a id="pl.568.35"></a><var>568.35</var>assistance or another public health care <br/>
<a id="pl.569.1"></a><var>569.1</var>program due to this assistance. The <br/>
<a id="pl.569.2"></a><var>569.2</var>commissioner shall report this information to <br/>
<a id="pl.569.3"></a><var>569.3</var>the chairs and ranking minority members of <br/>
<a id="pl.569.4"></a><var>569.4</var>the legislative committees with jurisdiction <br/>
<a id="pl.569.5"></a><var>569.5</var>over human services policy and finance by <br/>
<a id="pl.569.6"></a><var>569.6</var>January 1, 2015.<br/>
<a id="pl.569.7"></a><var>569.7</var><b>Base Adjustment.</b> The general fund is <br/>
<a id="pl.569.8"></a><var>569.8</var>decreased by $100,000 in fiscal year 2016 <br/>
<a id="pl.569.9"></a><var>569.9</var>and $100,000 in fiscal year 2017. The health <br/>
<a id="pl.569.10"></a><var>569.10</var>care access fund is decreased by $1,223,000 <br/>
<a id="pl.569.11"></a><var>569.11</var>in fiscal years 2016 and 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.569.12"></a><var>569.12</var><br/>
</td>
<td colspan="3"><b>(i) Aging and Adult Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">22,043,000<br/>
</td>
<td align="center"></td>
<td align="right">22,910,000<br/>
</td>
</tr>
</table><a id="pl.569.13"></a><var>569.13</var><b>Base Adjustment.</b> The general fund is <br/>
<a id="pl.569.14"></a><var>569.14</var>increased by $5,000 in fiscal year 2016 and <br/>
<a id="pl.569.15"></a><var>569.15</var>$5,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.569.16"></a><var>569.16</var><br/>
</td>
<td colspan="3"><b>(j) Deaf and Hard-of-Hearing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,767,000<br/>
</td>
<td align="center"></td>
<td align="right">1,767,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.569.17"></a><var>569.17</var><br/>
</td>
<td colspan="3"><b>(k) Disabilities Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">17,844,000<br/>
</td>
<td align="center"></td>
<td align="right">17,426,000<br/>
</td>
</tr>
</table><a id="pl.569.18"></a><var>569.18</var><b>Advocating Change Together.</b> $310,000 in <br/>
<a id="pl.569.19"></a><var>569.19</var>fiscal year 2014 is for a grant to Advocating <br/>
<a id="pl.569.20"></a><var>569.20</var>Change Together (ACT) to maintain and <br/>
<a id="pl.569.21"></a><var>569.21</var>promote services for persons with intellectual <br/>
<a id="pl.569.22"></a><var>569.22</var>and developmental disabilities throughout <br/>
<a id="pl.569.23"></a><var>569.23</var>the state. Of this appropriation:<br/>
<a id="pl.569.24"></a><var>569.24</var>(1) $120,000 is for direct costs associated <br/>
<a id="pl.569.25"></a><var>569.25</var>with the delivery and evaluation of <br/>
<a id="pl.569.26"></a><var>569.26</var>peer-to-peer training programs administered <br/>
<a id="pl.569.27"></a><var>569.27</var>throughout the state, focusing on education, <br/>
<a id="pl.569.28"></a><var>569.28</var>employment, housing, transportation, and <br/>
<a id="pl.569.29"></a><var>569.29</var>voting;<br/>
<a id="pl.569.30"></a><var>569.30</var>(2) $100,000 is for delivery of statewide <br/>
<a id="pl.569.31"></a><var>569.31</var>conferences focusing on leadership and <br/>
<a id="pl.569.32"></a><var>569.32</var>skill development within the disability <br/>
<a id="pl.569.33"></a><var>569.33</var>community; and<br/>
<a id="pl.570.1"></a><var>570.1</var>(3) $90,000 is for administrative and general <br/>
<a id="pl.570.2"></a><var>570.2</var>operating costs associated with managing <br/>
<a id="pl.570.3"></a><var>570.3</var>or maintaining facilities, program delivery, <br/>
<a id="pl.570.4"></a><var>570.4</var>staff, and technology. This is a onetime <br/>
<a id="pl.570.5"></a><var>570.5</var>appropriation.<br/>
<a id="pl.570.6"></a><var>570.6</var><b>Base Adjustment. </b>The general fund base <br/>
<a id="pl.570.7"></a><var>570.7</var>is increased by $448,000 in fiscal year 2016 <br/>
<a id="pl.570.8"></a><var>570.8</var>and by $470,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.570.9"></a><var>570.9</var><br/>
</td>
<td colspan="3"><b>(l) Adult Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.570.10"></a><var>570.10</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.570.11"></a><var>570.11</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">70,777,000<br/>
</td>
<td align="right">69,108,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.570.12"></a><var>570.12</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">750,000<br/>
</td>
<td align="right">750,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.570.13"></a><var>570.13</var><br/>
</td>
<td>Lottery Prize<br/>
</td>
<td align="right">1,733,000<br/>
</td>
<td align="right">1,733,000<br/>
</td>
</tr>
</table><a id="pl.570.14"></a><var>570.14</var><b>Problem Gambling.</b> $225,000 in fiscal year <br/>
<a id="pl.570.15"></a><var>570.15</var>2014 and $225,000 in fiscal year 2015 is <br/>
<a id="pl.570.16"></a><var>570.16</var>appropriated from the lottery prize fund for a <br/>
<a id="pl.570.17"></a><var>570.17</var>grant to the state affiliate recognized by the <br/>
<a id="pl.570.18"></a><var>570.18</var>National Council on Problem Gambling. The <br/>
<a id="pl.570.19"></a><var>570.19</var>affiliate must provide services to increase <br/>
<a id="pl.570.20"></a><var>570.20</var>public awareness of problem gambling, <br/>
<a id="pl.570.21"></a><var>570.21</var>education and training for individuals and <br/>
<a id="pl.570.22"></a><var>570.22</var>organizations providing effective treatment <br/>
<a id="pl.570.23"></a><var>570.23</var>services to problem gamblers and their <br/>
<a id="pl.570.24"></a><var>570.24</var>families, and research relating to problem <br/>
<a id="pl.570.25"></a><var>570.25</var>gambling. <br/>
<a id="pl.570.26"></a><var>570.26</var><b>Funding Usage. </b>Up to 75 percent of a fiscal <br/>
<a id="pl.570.27"></a><var>570.27</var>year's appropriations for adult mental health <br/>
<a id="pl.570.28"></a><var>570.28</var>grants may be used to fund allocations in that <br/>
<a id="pl.570.29"></a><var>570.29</var>portion of the fiscal year ending December <br/>
<a id="pl.570.30"></a><var>570.30</var>31.<br/>
<a id="pl.570.31"></a><var>570.31</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.570.32"></a><var>570.32</var>decreased by $4,197,000 in fiscal year 2016 <br/>
<a id="pl.570.33"></a><var>570.33</var>and by $4,197,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.570.34"></a><var>570.34</var><br/>
</td>
<td colspan="3"><b>(m) Child Mental Health Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">15,233,000<br/>
</td>
<td align="center"></td>
<td align="right">15,234,000<br/>
</td>
</tr>
</table><a id="pl.571.1"></a><var>571.1</var><b>Mental Health First Aid Training.</b> $45,000 <br/>
<a id="pl.571.2"></a><var>571.2</var>for the biennium ending June 30, 2015, is <br/>
<a id="pl.571.3"></a><var>571.3</var>to train teachers, social service personnel, <br/>
<a id="pl.571.4"></a><var>571.4</var>law enforcement, and others who come into <br/>
<a id="pl.571.5"></a><var>571.5</var>contact with children with mental illnesses, <br/>
<a id="pl.571.6"></a><var>571.6</var>in children and adolescents mental health <br/>
<a id="pl.571.7"></a><var>571.7</var>first aid training.<br/>
<a id="pl.571.8"></a><var>571.8</var><b>Funding Usage. </b>Up to 75 percent of a fiscal <br/>
<a id="pl.571.9"></a><var>571.9</var>year's appropriation for child mental health <br/>
<a id="pl.571.10"></a><var>571.10</var>grants may be used to fund allocations in that <br/>
<a id="pl.571.11"></a><var>571.11</var>portion of the fiscal year ending December <br/>
<a id="pl.571.12"></a><var>571.12</var>31.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.571.13"></a><var>571.13</var><br/>
</td>
<td colspan="3"><b>(n) CD Treatment Support Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,996,000<br/>
</td>
<td align="center"></td>
<td align="right">1,636,000<br/>
</td>
</tr>
</table><a id="pl.571.14"></a><var>571.14</var><b>SBIRT Training. </b>$300,000 each year is <br/>
<a id="pl.571.15"></a><var>571.15</var>for grants to train primary care clinicians to <br/>
<a id="pl.571.16"></a><var>571.16</var>provide substance abuse brief intervention <br/>
<a id="pl.571.17"></a><var>571.17</var>and referral to treatment (SBIRT). This is a <br/>
<a id="pl.571.18"></a><var>571.18</var>onetime appropriation.<br/>
<a id="pl.571.19"></a><var>571.19</var><b>Fetal Alcohol Syndrome Grant.</b> (a) <br/>
<a id="pl.571.20"></a><var>571.20</var>$360,000 is appropriated in fiscal year 2014 <br/>
<a id="pl.571.21"></a><var>571.21</var>to the commissioner of human services for <br/>
<a id="pl.571.22"></a><var>571.22</var>a grant to the Minnesota Organization on <br/>
<a id="pl.571.23"></a><var>571.23</var>Fetal Alcohol Syndrome (MOFAS). This is a <br/>
<a id="pl.571.24"></a><var>571.24</var>onetime appropriation.<br/>
<a id="pl.571.25"></a><var>571.25</var>(b) Grant money must be used to reduce the <br/>
<a id="pl.571.26"></a><var>571.26</var>incidence of FASD and other prenatal drug <br/>
<a id="pl.571.27"></a><var>571.27</var>related effects in children in Minnesota by <br/>
<a id="pl.571.28"></a><var>571.28</var>identifying and serving pregnant women <br/>
<a id="pl.571.29"></a><var>571.29</var>suspected of or known to use or abuse <br/>
<a id="pl.571.30"></a><var>571.30</var>alcohol or other drugs. The grant recipient <br/>
<a id="pl.571.31"></a><var>571.31</var>must provide intensive services to chemically <br/>
<a id="pl.571.32"></a><var>571.32</var>dependent women in order to increase <br/>
<a id="pl.571.33"></a><var>571.33</var>positive birth outcomes and report to the <br/>
<a id="pl.571.34"></a><var>571.34</var>commissioner necessary data to prepare <br/>
<a id="pl.571.35"></a><var>571.35</var>the required report to the legislature. The <br/>
<a id="pl.572.1"></a><var>572.1</var>organization may retain two percent of the <br/>
<a id="pl.572.2"></a><var>572.2</var>grant money for administrative costs. <br/>
<a id="pl.572.3"></a><var>572.3</var>(c) A grant recipient must report to the <br/>
<a id="pl.572.4"></a><var>572.4</var>commissioner of human services annually <br/>
<a id="pl.572.5"></a><var>572.5</var>by January 15 on the services and programs <br/>
<a id="pl.572.6"></a><var>572.6</var>funded by the appropriation. The report must <br/>
<a id="pl.572.7"></a><var>572.7</var>include measurable outcomes, including <br/>
<a id="pl.572.8"></a><var>572.8</var>the number of pregnant women served and <br/>
<a id="pl.572.9"></a><var>572.9</var>toxic-free babies born in the previous year.<br/>
<a id="pl.572.10"></a><var>572.10</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.572.11"></a><var>572.11</var>decreased by $300,000 in fiscal year 2016 <br/>
<a id="pl.572.12"></a><var>572.12</var>and $300,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.572.13"></a><var>572.13</var><br/>
</td>
<td colspan="3">Subd. 7.<b>State-Operated Services</b><br/>
</td>
<td align="center"></td>
<td align="center"></td>
<td></td>
<td></td>
</tr>
</table><a id="pl.572.14"></a><var>572.14</var><b>Transfer Authority Related to </b><br/>
<a id="pl.572.15"></a><var>572.15</var><b>State-Operated Services. </b>Money <br/>
<a id="pl.572.16"></a><var>572.16</var>appropriated for state-operated services <br/>
<a id="pl.572.17"></a><var>572.17</var>may be transferred between fiscal years <br/>
<a id="pl.572.18"></a><var>572.18</var>of the biennium with the approval of the <br/>
<a id="pl.572.19"></a><var>572.19</var>commissioner of management and budget.<br/>
<a id="pl.572.20"></a><var>572.20</var>The amounts that may be spent from the <br/>
<a id="pl.572.21"></a><var>572.21</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.572.22"></a><var>572.22</var><br/>
</td>
<td colspan="3"><b>(a) SOS Mental Health</b><br/>
</td>
<td align="center"></td>
<td align="right">115,738,000<br/>
</td>
<td align="center"></td>
<td align="right">115,738,000<br/>
</td>
</tr>
</table><a id="pl.572.23"></a><var>572.23</var><b>Dedicated Receipts Available. </b>Of the <br/>
<a id="pl.572.24"></a><var>572.24</var>revenue received under Minnesota Statutes, <br/>
<a id="pl.572.25"></a><var>572.25</var>section 246.18, subdivision 8, paragraph <br/>
<a id="pl.572.26"></a><var>572.26</var>(a), $1,000,000 each year is available for <br/>
<a id="pl.572.27"></a><var>572.27</var>the purposes of paragraph (b), clause (1), <br/>
<a id="pl.572.28"></a><var>572.28</var>of that subdivision, $1,000,000 each year <br/>
<a id="pl.572.29"></a><var>572.29</var>is available to transfer to the adult mental <br/>
<a id="pl.572.30"></a><var>572.30</var>health budget activity for the purposes of <br/>
<a id="pl.572.31"></a><var>572.31</var>paragraph (b), clause (2), of that subdivision, <br/>
<a id="pl.572.32"></a><var>572.32</var>and up to $2,713,000 each year is available <br/>
<a id="pl.572.33"></a><var>572.33</var>for the purposes of paragraph (b), clause (3), <br/>
<a id="pl.572.34"></a><var>572.34</var>of that subdivision.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.1"></a><var>573.1</var><br/>
</td>
<td colspan="3"><b>(b) SOS MN Security Hospital</b><br/>
</td>
<td align="center"></td>
<td align="right">69,582,000<br/>
</td>
<td align="center"></td>
<td align="right">69,582,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.2"></a><var>573.2</var><br/>
</td>
<td colspan="3">Subd. 8.<b>Sex Offender Program</b><br/>
</td>
<td align="center"></td>
<td align="right">76,769,000<br/>
</td>
<td align="center"></td>
<td align="right">79,745,000<br/>
</td>
</tr>
</table><a id="pl.573.3"></a><var>573.3</var><b>Transfer Authority Related to Minnesota </b><br/>
<a id="pl.573.4"></a><var>573.4</var><b>Sex Offender Program. </b>Money <br/>
<a id="pl.573.5"></a><var>573.5</var>appropriated for the Minnesota sex offender <br/>
<a id="pl.573.6"></a><var>573.6</var>program may be transferred between fiscal <br/>
<a id="pl.573.7"></a><var>573.7</var>years of the biennium with the approval of the <br/>
<a id="pl.573.8"></a><var>573.8</var>commissioner of management and budget.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.9"></a><var>573.9</var><br/>
</td>
<td colspan="3">Subd. 9.<b>Technical Activities</b><br/>
</td>
<td align="center"></td>
<td align="right">80,440,000<br/>
</td>
<td align="center"></td>
<td align="right">80,829,000<br/>
</td>
</tr>
</table><a id="pl.573.10"></a><var>573.10</var>This appropriation is from the federal TANF <br/>
<a id="pl.573.11"></a><var>573.11</var>fund.<br/>
<a id="pl.573.12"></a><var>573.12</var><b>Base Adjustment. </b>The federal TANF fund <br/>
<a id="pl.573.13"></a><var>573.13</var>base is increased by $278,000 in fiscal year <br/>
<a id="pl.573.14"></a><var>573.14</var>2016 and increased by $651,000 in fiscal <br/>
<a id="pl.573.15"></a><var>573.15</var>year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.16"></a><var>573.16</var><br/>
</td>
<td colspan="3">Subd. 10.<b>Transfer.</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><br/>
<a id="bill.14.3.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.17"></a><var>573.17</var><br/>
</td>
<td colspan="3">Sec. 3. <b>COMMISSIONER OF HEALTH</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.18"></a><var>573.18</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 158,912,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 155,115,000</b><br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.573.19"></a><var>573.19</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.20"></a><var>573.20</var><br/>
</td>
<td></td>
<td align="center">2014<br/>
</td>
<td align="center">2015<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.21"></a><var>573.21</var><br/>
</td>
<td>General<br/>
</td>
<td align="right"> 79,476,000<br/>
</td>
<td align="right"> 74,256,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.22"></a><var>573.22</var><br/>
<a id="pl.573.23"></a><var>573.23</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">48,680,000<br/>
</td>
<td align="right">50,703,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.24"></a><var>573.24</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">18,743,000<br/>
</td>
<td align="right">18,143,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.25"></a><var>573.25</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">11,713,000<br/>
</td>
<td align="right">11,713,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.26"></a><var>573.26</var><br/>
</td>
<td>Special Revenue<br/>
</td>
<td align="right">300,000<br/>
</td>
<td align="right">300,000<br/>
</td>
</tr>
</table><a id="pl.573.27"></a><var>573.27</var>The amounts that may be spent for each <br/>
<a id="pl.573.28"></a><var>573.28</var>purpose are specified in the following <br/>
<a id="pl.573.29"></a><var>573.29</var>subdivisions.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.573.30"></a><var>573.30</var><br/>
</td>
<td colspan="3">Subd. 2.<b>Health Improvement</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.573.31"></a><var>573.31</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.32"></a><var>573.32</var><br/>
</td>
<td>General<br/>
</td>
<td align="right"> 52,864,000<br/>
</td>
<td align="right"> 47,644,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.573.33"></a><var>573.33</var><br/>
<a id="pl.573.34"></a><var>573.34</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">1,033,000<br/>
</td>
<td align="right">1,033,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.574.1"></a><var>574.1</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">9,219,000<br/>
</td>
<td align="right">9,219,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.574.2"></a><var>574.2</var><br/>
</td>
<td>Federal TANF<br/>
</td>
<td align="right">11,713,000<br/>
</td>
<td align="right">11,713,000<br/>
</td>
</tr>
</table><a id="pl.574.3"></a><var>574.3</var><b>Statewide Health Improvement Program. </b><br/>
<a id="pl.574.4"></a><var>574.4</var>$7,500,000 in fiscal year 2014 and <br/>
<a id="pl.574.5"></a><var>574.5</var>$7,500,000 in fiscal year 2015 is from the <br/>
<a id="pl.574.6"></a><var>574.6</var>health care access fund for the statewide <br/>
<a id="pl.574.7"></a><var>574.7</var>health improvement program under <br/>
<a id="pl.574.8"></a><var>574.8</var>Minnesota Statutes, section 145.986.<br/>
<a id="pl.574.9"></a><var>574.9</var>Of the appropriation in fiscal year 2014, <br/>
<a id="pl.574.10"></a><var>574.10</var>$10,000 is for the commissioner of <br/>
<a id="pl.574.11"></a><var>574.11</var>management and budget to develop and <br/>
<a id="pl.574.12"></a><var>574.12</var>implement a return on taxpayer investment <br/>
<a id="pl.574.13"></a><var>574.13</var>(ROTI) methodology and practice related <br/>
<a id="pl.574.14"></a><var>574.14</var>to the state health improvement program. <br/>
<a id="pl.574.15"></a><var>574.15</var>In developing the methodology, the <br/>
<a id="pl.574.16"></a><var>574.16</var>commissioner shall assess ROTI initiatives <br/>
<a id="pl.574.17"></a><var>574.17</var>in other states, design implications for <br/>
<a id="pl.574.18"></a><var>574.18</var>Minnesota, and identify one or more <br/>
<a id="pl.574.19"></a><var>574.19</var>Minnesota institutions of higher education <br/>
<a id="pl.574.20"></a><var>574.20</var>capable of providing rigorous and consistent <br/>
<a id="pl.574.21"></a><var>574.21</var>nonpartisan institutional support for ROTI. <br/>
<a id="pl.574.22"></a><var>574.22</var>The commissioner shall consult with <br/>
<a id="pl.574.23"></a><var>574.23</var>representatives of other state agencies, <br/>
<a id="pl.574.24"></a><var>574.24</var>counties, legislative staff, Minnesota <br/>
<a id="pl.574.25"></a><var>574.25</var>institutions of higher education, and other <br/>
<a id="pl.574.26"></a><var>574.26</var>stakeholders in developing the methodology. <br/>
<a id="pl.574.27"></a><var>574.27</var>The commissioner shall report the results to <br/>
<a id="pl.574.28"></a><var>574.28</var>the chairs and ranking minority members of <br/>
<a id="pl.574.29"></a><var>574.29</var>the legislative committees and divisions with <br/>
<a id="pl.574.30"></a><var>574.30</var>jurisdiction over health and human services, <br/>
<a id="pl.574.31"></a><var>574.31</var>taxes, and finance by March 15, 2015.<br/>
<a id="pl.574.32"></a><var>574.32</var><b>Statewide Cancer Surveillance System.</b> Of <br/>
<a id="pl.574.33"></a><var>574.33</var>the general fund appropriation, $350,000 in <br/>
<a id="pl.574.34"></a><var>574.34</var>fiscal year 2014 and $350,000 in fiscal year <br/>
<a id="pl.574.35"></a><var>574.35</var>2015 is to develop and implement a new <br/>
<a id="pl.575.1"></a><var>575.1</var>cancer reporting system under Minnesota <br/>
<a id="pl.575.2"></a><var>575.2</var>Statutes, sections 144.671 to 144.69. Any <br/>
<a id="pl.575.3"></a><var>575.3</var>information technology development or <br/>
<a id="pl.575.4"></a><var>575.4</var>support costs necessary for the cancer <br/>
<a id="pl.575.5"></a><var>575.5</var>surveillance system must be incorporated <br/>
<a id="pl.575.6"></a><var>575.6</var>into the agency's service level agreement and <br/>
<a id="pl.575.7"></a><var>575.7</var>paid to the Office of Enterprise Technology.<br/>
<a id="pl.575.8"></a><var>575.8</var><b>Minnesota Poison Information Center.</b><br/>
<a id="pl.575.9"></a><var>575.9</var> $250,000 in fiscal year 2014 and $250,000 <br/>
<a id="pl.575.10"></a><var>575.10</var>in fiscal year 2015 from the general fund <br/>
<a id="pl.575.11"></a><var>575.11</var>is for regional poison information centers <br/>
<a id="pl.575.12"></a><var>575.12</var>according to Minnesota Statutes, section <br/>
<a id="pl.575.13"></a><var>575.13</var>145.93.<br/>
<a id="pl.575.14"></a><var>575.14</var><b>Text Message Suicide Prevention Program.</b><br/>
<a id="pl.575.15"></a><var>575.15</var> $1,500,000 for the biennium ending June 30, <br/>
<a id="pl.575.16"></a><var>575.16</var>2015, is for a grant to a nonprofit organization <br/>
<a id="pl.575.17"></a><var>575.17</var>to establish and implement a statewide text <br/>
<a id="pl.575.18"></a><var>575.18</var>message suicide prevention program. The <br/>
<a id="pl.575.19"></a><var>575.19</var>program shall implement a suicide prevention <br/>
<a id="pl.575.20"></a><var>575.20</var>counseling text line designed to use text <br/>
<a id="pl.575.21"></a><var>575.21</var>messaging to connect with crisis counselors <br/>
<a id="pl.575.22"></a><var>575.22</var>and to obtain emergency information and <br/>
<a id="pl.575.23"></a><var>575.23</var>referrals to local resources in the local <br/>
<a id="pl.575.24"></a><var>575.24</var>community. The program shall include <br/>
<a id="pl.575.25"></a><var>575.25</var>training within schools and communities to <br/>
<a id="pl.575.26"></a><var>575.26</var>encourage the use of the program.<br/>
<a id="pl.575.27"></a><var>575.27</var><b>Support Services for Deaf and </b><br/>
<a id="pl.575.28"></a><var>575.28</var><b>Hard-of-Hearing.</b> (a) $365,000 in fiscal <br/>
<a id="pl.575.29"></a><var>575.29</var>year 2014 and $349,000 in fiscal year 2015 <br/>
<a id="pl.575.30"></a><var>575.30</var>are for providing support services to families <br/>
<a id="pl.575.31"></a><var>575.31</var>as required under Minnesota Statutes, section <br/>
<a id="pl.575.32"></a><var>575.32</var>144.966, subdivision 3a.<br/>
<a id="pl.575.33"></a><var>575.33</var>(b) $164,000 in fiscal year 2014 and $156,000 <br/>
<a id="pl.575.34"></a><var>575.34</var>in fiscal year 2015 are for home-based <br/>
<a id="pl.575.35"></a><var>575.35</var>education in American Sign Language for <br/>
<a id="pl.576.1"></a><var>576.1</var>families with children who are deaf or have <br/>
<a id="pl.576.2"></a><var>576.2</var>hearing loss, as required under Minnesota <br/>
<a id="pl.576.3"></a><var>576.3</var>Statutes, section 144.966, subdivision 3a.<br/>
<a id="pl.576.4"></a><var>576.4</var><b>Reproductive Health Strategic Plan to </b><br/>
<a id="pl.576.5"></a><var>576.5</var><b>Reduce Health Disparities for Somali </b><br/>
<a id="pl.576.6"></a><var>576.6</var><b>Women.</b> To the extent funds are available <br/>
<a id="pl.576.7"></a><var>576.7</var>for fiscal years 2014 and 2015 for grants <br/>
<a id="pl.576.8"></a><var>576.8</var>provided pursuant to Minnesota Statutes, <br/>
<a id="pl.576.9"></a><var>576.9</var>section 145.928, the commissioner <br/>
<a id="pl.576.10"></a><var>576.10</var>shall provide a grant to a Somali-based <br/>
<a id="pl.576.11"></a><var>576.11</var>organization located in the metropolitan area <br/>
<a id="pl.576.12"></a><var>576.12</var>to develop a reproductive health strategic <br/>
<a id="pl.576.13"></a><var>576.13</var>plan to eliminate reproductive health <br/>
<a id="pl.576.14"></a><var>576.14</var>disparities for Somali women. The plan shall <br/>
<a id="pl.576.15"></a><var>576.15</var>develop initiatives to provide educational <br/>
<a id="pl.576.16"></a><var>576.16</var>and information resources to health care <br/>
<a id="pl.576.17"></a><var>576.17</var>providers, community organizations, and <br/>
<a id="pl.576.18"></a><var>576.18</var>Somali women to ensure effective interaction <br/>
<a id="pl.576.19"></a><var>576.19</var>with Somali culture and western medicine <br/>
<a id="pl.576.20"></a><var>576.20</var>and the delivery of appropriate health care <br/>
<a id="pl.576.21"></a><var>576.21</var>services, and the achievement of better health <br/>
<a id="pl.576.22"></a><var>576.22</var>outcomes for Somali women. The plan must <br/>
<a id="pl.576.23"></a><var>576.23</var>engage health care providers, the Somali <br/>
<a id="pl.576.24"></a><var>576.24</var>community, and Somali health-centered <br/>
<a id="pl.576.25"></a><var>576.25</var>organizations. The commissioner shall <br/>
<a id="pl.576.26"></a><var>576.26</var>submit a report to the chairs and ranking <br/>
<a id="pl.576.27"></a><var>576.27</var>minority members of the senate and house <br/>
<a id="pl.576.28"></a><var>576.28</var>committees with jurisdiction over health <br/>
<a id="pl.576.29"></a><var>576.29</var>policy on the strategic plan developed under <br/>
<a id="pl.576.30"></a><var>576.30</var>this grant for eliminating reproductive health <br/>
<a id="pl.576.31"></a><var>576.31</var>disparities for Somali women. The report <br/>
<a id="pl.576.32"></a><var>576.32</var>must be submitted by February 15, 2014.<br/>
<a id="pl.576.33"></a><var>576.33</var><b>TANF Appropriations.</b> (1) $1,156,000 of <br/>
<a id="pl.576.34"></a><var>576.34</var>the TANF funds is appropriated each year of <br/>
<a id="pl.576.35"></a><var>576.35</var>the biennium to the commissioner for family <br/>
<a id="pl.577.1"></a><var>577.1</var>planning grants under Minnesota Statutes, <br/>
<a id="pl.577.2"></a><var>577.2</var>section 145.925.<br/>
<a id="pl.577.3"></a><var>577.3</var>(2) $3,579,000 of the TANF funds is <br/>
<a id="pl.577.4"></a><var>577.4</var>appropriated each year of the biennium to <br/>
<a id="pl.577.5"></a><var>577.5</var>the commissioner for home visiting and <br/>
<a id="pl.577.6"></a><var>577.6</var>nutritional services listed under Minnesota <br/>
<a id="pl.577.7"></a><var>577.7</var>Statutes, section 145.882, subdivision 7, <br/>
<a id="pl.577.8"></a><var>577.8</var>clauses (6) and (7). Funds must be distributed <br/>
<a id="pl.577.9"></a><var>577.9</var>to community health boards according to <br/>
<a id="pl.577.10"></a><var>577.10</var>Minnesota Statutes, section 145A.131, <br/>
<a id="pl.577.11"></a><var>577.11</var>subdivision 1.<br/>
<a id="pl.577.12"></a><var>577.12</var>(3) $2,000,000 of the TANF funds is <br/>
<a id="pl.577.13"></a><var>577.13</var>appropriated each year of the biennium to <br/>
<a id="pl.577.14"></a><var>577.14</var>the commissioner for decreasing racial and <br/>
<a id="pl.577.15"></a><var>577.15</var>ethnic disparities in infant mortality rates <br/>
<a id="pl.577.16"></a><var>577.16</var>under Minnesota Statutes, section 145.928, <br/>
<a id="pl.577.17"></a><var>577.17</var>subdivision 7.<br/>
<a id="pl.577.18"></a><var>577.18</var>(4) $4,978,000 of the TANF funds is <br/>
<a id="pl.577.19"></a><var>577.19</var>appropriated each year of the biennium to the <br/>
<a id="pl.577.20"></a><var>577.20</var>commissioner for the family home visiting <br/>
<a id="pl.577.21"></a><var>577.21</var>grant program according to Minnesota <br/>
<a id="pl.577.22"></a><var>577.22</var>Statutes, section 145A.17. $4,000,000 of the <br/>
<a id="pl.577.23"></a><var>577.23</var>funding must be distributed to community <br/>
<a id="pl.577.24"></a><var>577.24</var>health boards according to Minnesota <br/>
<a id="pl.577.25"></a><var>577.25</var>Statutes, section 145A.131, subdivision 1. <br/>
<a id="pl.577.26"></a><var>577.26</var>$978,000 of the funding must be distributed <br/>
<a id="pl.577.27"></a><var>577.27</var>to tribal governments based on Minnesota <br/>
<a id="pl.577.28"></a><var>577.28</var>Statutes, section 145A.14, subdivision 2a.<br/>
<a id="pl.577.29"></a><var>577.29</var>(5) The commissioner may use up to 6.23 <br/>
<a id="pl.577.30"></a><var>577.30</var>percent of the funds appropriated each fiscal <br/>
<a id="pl.577.31"></a><var>577.31</var>year to conduct the ongoing evaluations <br/>
<a id="pl.577.32"></a><var>577.32</var>required under Minnesota Statutes, section <br/>
<a id="pl.577.33"></a><var>577.33</var>145A.17, subdivision 7, and training and <br/>
<a id="pl.577.34"></a><var>577.34</var>technical assistance as required under <br/>
<a id="pl.578.1"></a><var>578.1</var>Minnesota Statutes, section 145A.17, <br/>
<a id="pl.578.2"></a><var>578.2</var>subdivisions 4 and 5.<br/>
<a id="pl.578.3"></a><var>578.3</var><b>TANF Carryforward.</b> Any unexpended <br/>
<a id="pl.578.4"></a><var>578.4</var>balance of the TANF appropriation in the <br/>
<a id="pl.578.5"></a><var>578.5</var>first year of the biennium does not cancel but <br/>
<a id="pl.578.6"></a><var>578.6</var>is available for the second year.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.578.7"></a><var>578.7</var><br/>
</td>
<td colspan="3">Subd. 3.<b>Policy Quality and Compliance</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.578.8"></a><var>578.8</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.9"></a><var>578.9</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">9,391,000<br/>
</td>
<td align="right">9,391,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.10"></a><var>578.10</var><br/>
<a id="pl.578.11"></a><var>578.11</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">14,434,000<br/>
</td>
<td align="right">16,454,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.12"></a><var>578.12</var><br/>
</td>
<td>Health Care Access<br/>
</td>
<td align="right">9,524,000<br/>
</td>
<td align="right">8,924,000<br/>
</td>
</tr>
</table><a id="pl.578.13"></a><var>578.13</var><b>Base Level Adjustment.</b> The state <br/>
<a id="pl.578.14"></a><var>578.14</var>government special revenue fund base shall <br/>
<a id="pl.578.15"></a><var>578.15</var>be reduced by $2,000 in fiscal year 2017. The <br/>
<a id="pl.578.16"></a><var>578.16</var>health care access base shall be increased by <br/>
<a id="pl.578.17"></a><var>578.17</var>$600,000 in fiscal year 2016 and decreased <br/>
<a id="pl.578.18"></a><var>578.18</var>by $600,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.578.19"></a><var>578.19</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Health Protection</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.578.20"></a><var>578.20</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.21"></a><var>578.21</var><br/>
</td>
<td>General<br/>
</td>
<td align="right">9,449,000<br/>
</td>
<td align="right">9,449,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.22"></a><var>578.22</var><br/>
<a id="pl.578.23"></a><var>578.23</var><br/>
</td>
<td>State Government <br/>
Special Revenue<br/>
</td>
<td align="right">33,213,000<br/>
</td>
<td align="right">33,216,000<br/>
</td>
</tr>
<tr>
<td><a id="pl.578.24"></a><var>578.24</var><br/>
</td>
<td>Special Revenue<br/>
</td>
<td align="right">300,000<br/>
</td>
<td align="right">300,000<br/>
</td>
</tr>
</table><a id="pl.578.25"></a><var>578.25</var><b>Infectious Disease Laboratory.</b> Of the <br/>
<a id="pl.578.26"></a><var>578.26</var>general fund appropriation, $200,000 in <br/>
<a id="pl.578.27"></a><var>578.27</var>fiscal year 2014 and $200,000 in fiscal year <br/>
<a id="pl.578.28"></a><var>578.28</var>2015 are to monitor infectious disease trends <br/>
<a id="pl.578.29"></a><var>578.29</var>and investigate infectious disease outbreaks.<br/>
<a id="pl.578.30"></a><var>578.30</var><b>Surveillance for Elevated Blood Lead </b><br/>
<a id="pl.578.31"></a><var>578.31</var><b>Levels.</b> Of the general fund appropriation, <br/>
<a id="pl.578.32"></a><var>578.32</var>$100,000 in fiscal year 2014 and $100,000 <br/>
<a id="pl.578.33"></a><var>578.33</var>in fiscal year 2015 are for the blood lead <br/>
<a id="pl.578.34"></a><var>578.34</var>surveillance system under Minnesota <br/>
<a id="pl.578.35"></a><var>578.35</var>Statutes, section 144.9502.<br/>
<a id="pl.579.1"></a><var>579.1</var><b>Base Level Adjustment.</b> The state <br/>
<a id="pl.579.2"></a><var>579.2</var>government special revenue base is increased <br/>
<a id="pl.579.3"></a><var>579.3</var>by $6,000 in fiscal year 2016 and by $13,000 <br/>
<a id="pl.579.4"></a><var>579.4</var>in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.5"></a><var>579.5</var><br/>
</td>
<td colspan="3">Subd. 5.<b>Administrative Support Services</b><br/>
</td>
<td align="center"></td>
<td align="right">7,772,000<br/>
</td>
<td align="center"></td>
<td align="right">7,772,000<br/>
</td>
</tr>
</table><a id="pl.579.6"></a><var>579.6</var><b>Regional Support for Local Public Health </b><br/>
<a id="pl.579.7"></a><var>579.7</var><b>Departments.</b> $350,000 in fiscal year <br/>
<a id="pl.579.8"></a><var>579.8</var>2014 and $350,000 in fiscal year 2015 is <br/>
<a id="pl.579.9"></a><var>579.9</var>for regional staff who provide specialized <br/>
<a id="pl.579.10"></a><var>579.10</var>expertise to local public health departments.<br/>
<br/>
<a id="bill.14.4.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.11"></a><var>579.11</var><br/>
</td>
<td colspan="3">Sec. 4.  <b>HEALTH-RELATED BOARDS</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.12"></a><var>579.12</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 17,335,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b> 17,285,000</b><br/>
</td>
</tr>
</table><a id="pl.579.13"></a><var>579.13</var>This appropriation is from the state <br/>
<a id="pl.579.14"></a><var>579.14</var>government special revenue fund.<br/>
<a id="pl.579.15"></a><var>579.15</var>The amounts that may be spent for each <br/>
<a id="pl.579.16"></a><var>579.16</var>purpose are specified in the following <br/>
<a id="pl.579.17"></a><var>579.17</var>subdivisions.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.18"></a><var>579.18</var><br/>
</td>
<td colspan="3">Subd. 2.<b><b>Board of Chiropractic Examiners</b></b><br/>
</td>
<td align="center"></td>
<td align="right">470,000<br/>
</td>
<td align="center"></td>
<td align="right">470,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.19"></a><var>579.19</var><br/>
</td>
<td colspan="3">Subd. 3.<b>Board of Dentistry</b><br/>
</td>
<td align="center"></td>
<td align="right">1,820,000<br/>
</td>
<td align="center"></td>
<td align="right">1,820,000<br/>
</td>
</tr>
</table><a id="pl.579.20"></a><var>579.20</var><b>Health Professional Services Program.</b> Of <br/>
<a id="pl.579.21"></a><var>579.21</var>this appropriation, $704,000 in fiscal year <br/>
<a id="pl.579.22"></a><var>579.22</var>2014 and $704,000 in fiscal year 2015 from <br/>
<a id="pl.579.23"></a><var>579.23</var>the state government special revenue fund are <br/>
<a id="pl.579.24"></a><var>579.24</var>for the health professional services program.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.25"></a><var>579.25</var><br/>
<a id="pl.579.26"></a><var>579.26</var><br/>
</td>
<td colspan="3">Subd. 4.<b>Board of Dietetic and Nutrition </b><br/>
<b>Practice</b><br/>
</td>
<td align="center"></td>
<td align="right">111,000<br/>
</td>
<td align="center"></td>
<td align="right">111,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.27"></a><var>579.27</var><br/>
<a id="pl.579.28"></a><var>579.28</var><br/>
</td>
<td colspan="3">Subd. 5.<b>Board of Marriage and Family </b><br/>
<b>Therapy</b><br/>
</td>
<td align="center"></td>
<td align="right">168,000<br/>
</td>
<td align="center"></td>
<td align="right">168,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.29"></a><var>579.29</var><br/>
</td>
<td colspan="3">Subd. 6.<b>Board of Medical Practice</b><br/>
</td>
<td align="center"></td>
<td align="right">3,867,000<br/>
</td>
<td align="center"></td>
<td align="right">3,867,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.30"></a><var>579.30</var><br/>
</td>
<td colspan="3">Subd. 7.<b>Board of Nursing</b><br/>
</td>
<td align="center"></td>
<td align="right">3,637,000<br/>
</td>
<td align="center"></td>
<td align="right">3,637,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.579.31"></a><var>579.31</var><br/>
<a id="pl.579.32"></a><var>579.32</var><br/>
</td>
<td colspan="3">Subd. 8.<b>Board of Nursing Home </b><br/>
<b>Administrators</b><br/>
</td>
<td align="center"></td>
<td align="right"> 1,632,000<br/>
</td>
<td align="center"></td>
<td align="right"> 1,582,000<br/>
</td>
</tr>
</table><a id="pl.580.1"></a><var>580.1</var><b>Administrative Services Unit - Operating </b><br/>
<a id="pl.580.2"></a><var>580.2</var><b>Costs.</b> Of this appropriation, $676,000 <br/>
<a id="pl.580.3"></a><var>580.3</var>in fiscal year 2014 and $626,000 in <br/>
<a id="pl.580.4"></a><var>580.4</var>fiscal year 2015 are for operating costs <br/>
<a id="pl.580.5"></a><var>580.5</var>of the administrative services unit. The <br/>
<a id="pl.580.6"></a><var>580.6</var>administrative services unit may receive <br/>
<a id="pl.580.7"></a><var>580.7</var>and expend reimbursements for services <br/>
<a id="pl.580.8"></a><var>580.8</var>performed by other agencies.<br/>
<a id="pl.580.9"></a><var>580.9</var><b>Administrative Services Unit - Volunteer </b><br/>
<a id="pl.580.10"></a><var>580.10</var><b>Health Care Provider Program.</b> Of this <br/>
<a id="pl.580.11"></a><var>580.11</var>appropriation, $150,000 in fiscal year 2014 <br/>
<a id="pl.580.12"></a><var>580.12</var>and $150,000 in fiscal year 2015 are to pay <br/>
<a id="pl.580.13"></a><var>580.13</var>for medical professional liability coverage <br/>
<a id="pl.580.14"></a><var>580.14</var>required under Minnesota Statutes, section <br/>
<a id="pl.580.15"></a><var>580.15</var>214.40.<br/>
<a id="pl.580.16"></a><var>580.16</var><b>Administrative Services Unit - Contested </b><br/>
<a id="pl.580.17"></a><var>580.17</var><b>Cases and Other Legal Proceedings.</b> Of <br/>
<a id="pl.580.18"></a><var>580.18</var>this appropriation, $200,000 in fiscal year <br/>
<a id="pl.580.19"></a><var>580.19</var>2014 and $200,000 in fiscal year 2015 are <br/>
<a id="pl.580.20"></a><var>580.20</var>for costs of contested case hearings and other <br/>
<a id="pl.580.21"></a><var>580.21</var>unanticipated costs of legal proceedings <br/>
<a id="pl.580.22"></a><var>580.22</var>involving health-related boards funded <br/>
<a id="pl.580.23"></a><var>580.23</var>under this section. Upon certification of a <br/>
<a id="pl.580.24"></a><var>580.24</var>health-related board to the administrative <br/>
<a id="pl.580.25"></a><var>580.25</var>services unit that the costs will be incurred <br/>
<a id="pl.580.26"></a><var>580.26</var>and that there is insufficient money available <br/>
<a id="pl.580.27"></a><var>580.27</var>to pay for the costs out of money currently <br/>
<a id="pl.580.28"></a><var>580.28</var>available to that board, the administrative <br/>
<a id="pl.580.29"></a><var>580.29</var>services unit is authorized to transfer money <br/>
<a id="pl.580.30"></a><var>580.30</var>from this appropriation to the board for <br/>
<a id="pl.580.31"></a><var>580.31</var>payment of those costs with the approval <br/>
<a id="pl.580.32"></a><var>580.32</var>of the commissioner of management and <br/>
<a id="pl.580.33"></a><var>580.33</var>budget.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.580.34"></a><var>580.34</var><br/>
</td>
<td colspan="3">Subd. 9.<b>Board of Optometry</b><br/>
</td>
<td align="center"></td>
<td align="right">107,000<br/>
</td>
<td align="center"></td>
<td align="right">107,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.580.35"></a><var>580.35</var><br/>
</td>
<td colspan="3">Subd. 10.<b>Board of Pharmacy</b><br/>
</td>
<td align="center"></td>
<td align="right">2,555,000<br/>
</td>
<td align="center"></td>
<td align="right">2,555,000<br/>
</td>
</tr>
</table><a id="pl.581.1"></a><var>581.1</var><b>Prescription Electronic Reporting.</b> Of <br/>
<a id="pl.581.2"></a><var>581.2</var>this appropriation, $356,000 in fiscal year <br/>
<a id="pl.581.3"></a><var>581.3</var>2014 and $356,000 in fiscal year 2015 from <br/>
<a id="pl.581.4"></a><var>581.4</var>the state government special revenue fund <br/>
<a id="pl.581.5"></a><var>581.5</var>are to the board to operate the prescription <br/>
<a id="pl.581.6"></a><var>581.6</var>monitoring program in Minnesota Statutes, <br/>
<a id="pl.581.7"></a><var>581.7</var>section 152.126.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.8"></a><var>581.8</var><br/>
</td>
<td colspan="3">Subd. 11.<b>Board of Physical Therapy</b><br/>
</td>
<td align="center"></td>
<td align="right">346,000<br/>
</td>
<td align="center"></td>
<td align="right">346,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.9"></a><var>581.9</var><br/>
</td>
<td colspan="3">Subd. 12.<b>Board of Podiatry</b><br/>
</td>
<td align="center"></td>
<td align="right">76,000<br/>
</td>
<td align="center"></td>
<td align="right">76,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.10"></a><var>581.10</var><br/>
</td>
<td colspan="3">Subd. 13.<b>Board of Psychology</b><br/>
</td>
<td align="center"></td>
<td align="right">847,000<br/>
</td>
<td align="center"></td>
<td align="right">847,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.11"></a><var>581.11</var><br/>
</td>
<td colspan="3">Subd. 14.<b>Board of Social Work</b><br/>
</td>
<td align="center"></td>
<td align="right">1,054,000<br/>
</td>
<td align="center"></td>
<td align="right">1,054,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.12"></a><var>581.12</var><br/>
</td>
<td colspan="3">Subd. 15.<b>Board of Veterinary Medicine</b><br/>
</td>
<td align="center"></td>
<td align="right">230,000<br/>
</td>
<td align="center"></td>
<td align="right">230,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.13"></a><var>581.13</var><br/>
<a id="pl.581.14"></a><var>581.14</var><br/>
</td>
<td colspan="3">Subd. 16.<b>Board of Behavioral Health and </b><br/>
<b>Therapy</b><br/>
</td>
<td align="center"></td>
<td align="right">415,000<br/>
</td>
<td align="center"></td>
<td align="right">415,000<br/>
</td>
</tr>
</table><br/>
<a id="bill.14.5.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.581.15"></a><var>581.15</var><br/>
<a id="pl.581.16"></a><var>581.16</var><br/>
</td>
<td colspan="3">Sec. 5. <b>EMERGENCY MEDICAL SERVICES </b><br/>
<b>REGULATORY BOARD</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>2,741,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>2,741,000</b><br/>
</td>
</tr>
</table><a id="pl.581.17"></a><var>581.17</var><b>Regional Grants.</b> $585,000 in fiscal year <br/>
<a id="pl.581.18"></a><var>581.18</var>2014 and $585,000 in fiscal year 2015 are <br/>
<a id="pl.581.19"></a><var>581.19</var>for regional emergency medical services <br/>
<a id="pl.581.20"></a><var>581.20</var>programs, to be distributed equally to the <br/>
<a id="pl.581.21"></a><var>581.21</var>eight emergency medical service regions.<br/>
<a id="pl.581.22"></a><var>581.22</var><b>Cooper/Sams Volunteer Ambulance </b><br/>
<a id="pl.581.23"></a><var>581.23</var><b>Program.</b> $700,000 in fiscal year 2014 and <br/>
<a id="pl.581.24"></a><var>581.24</var>$700,000 in fiscal year 2015 are for the <br/>
<a id="pl.581.25"></a><var>581.25</var>Cooper/Sams volunteer ambulance program <br/>
<a id="pl.581.26"></a><var>581.26</var>under Minnesota Statutes, section 144E.40.<br/>
<a id="pl.581.27"></a><var>581.27</var>(a) Of this amount, $611,000 in fiscal year <br/>
<a id="pl.581.28"></a><var>581.28</var>2014 and $611,000 in fiscal year 2015 <br/>
<a id="pl.581.29"></a><var>581.29</var>are for the ambulance service personnel <br/>
<a id="pl.581.30"></a><var>581.30</var>longevity award and incentive program under <br/>
<a id="pl.581.31"></a><var>581.31</var>Minnesota Statutes, section 144E.40.<br/>
<a id="pl.581.32"></a><var>581.32</var>(b) Of this amount, $89,000 in fiscal year <br/>
<a id="pl.581.33"></a><var>581.33</var>2014 and $89,000 in fiscal year 2015 are <br/>
<a id="pl.582.1"></a><var>582.1</var>for the operations of the ambulance service <br/>
<a id="pl.582.2"></a><var>582.2</var>personnel longevity award and incentive <br/>
<a id="pl.582.3"></a><var>582.3</var>program under Minnesota Statutes, section <br/>
<a id="pl.582.4"></a><var>582.4</var>144E.40.<br/>
<a id="pl.582.5"></a><var>582.5</var><b>Ambulance Training Grant.</b> $361,000 in <br/>
<a id="pl.582.6"></a><var>582.6</var>fiscal year 2014 and $361,000 in fiscal year <br/>
<a id="pl.582.7"></a><var>582.7</var>2015 are for training grants.<br/>
<a id="pl.582.8"></a><var>582.8</var><b>EMSRB Board Operations.</b> $1,095,000 in <br/>
<a id="pl.582.9"></a><var>582.9</var>fiscal year 2014 and $1,095,000 in fiscal year <br/>
<a id="pl.582.10"></a><var>582.10</var>2015 are for operations.<br/>
<br/>
<a id="bill.14.6.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.582.11"></a><var>582.11</var><br/>
</td>
<td colspan="3">Sec. 6. <b>COUNCIL ON DISABILITY</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>614,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>614,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.14.7.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.582.12"></a><var>582.12</var><br/>
<a id="pl.582.13"></a><var>582.13</var><br/>
<a id="pl.582.14"></a><var>582.14</var><br/>
</td>
<td colspan="3">Sec. 7. <b>OMBUDSMAN FOR MENTAL </b><br/>
<b>HEALTH AND DEVELOPMENTAL </b><br/>
<b>DISABILITIES</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>1,654,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>1,654,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.14.8.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.582.15"></a><var>582.15</var><br/>
</td>
<td colspan="3">Sec. 8. <b>OMBUDSPERSON FOR FAMILIES</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>333,000</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>334,000</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.14.9.0"></a><a id="pl.582.16"></a><var>582.16</var>    Sec. 9. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:<br/>
<a id="pl.582.17"></a><var>582.17</var>    Subd. 34. <b>Federal administrative reimbursement dedicated.</b> Federal <br/>
<a id="pl.582.18"></a><var>582.18</var>administrative reimbursement resulting from the following activities is appropriated to the <br/>
<a id="pl.582.19"></a><var>582.19</var>commissioner for the designated purposes:<br/>
<a id="pl.582.20"></a><var>582.20</var>(1) reimbursement for the Minnesota senior health options project; and<br/>
<a id="pl.582.21"></a><var>582.21</var>(2) reimbursement related to prior authorization and inpatient admission certification <br/>
<a id="pl.582.22"></a><var>582.22</var>by a professional review organization. A portion of these funds must be used for activities <br/>
<a id="pl.582.23"></a><var>582.23</var>to decrease unnecessary pharmaceutical costs in medical assistance.; and<br/>
<a id="pl.582.24"></a><var>582.24</var>(3) reimbursement resulting from the federal child support grant expenditures <br/>
<a id="pl.582.25"></a><var>582.25</var>authorized under United States Code, title 42, section 1315.<br/>
<br/>
<a id="bill.14.10.0"></a><a id="pl.582.26"></a><var>582.26</var>    Sec. 10. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.582.27"></a><var>582.27</var>to read:<br/>
<a id="pl.582.28"></a><var>582.28</var>    Subd. 35. <b>Federal reimbursement for privatized adoption grants.</b> Federal <br/>
<a id="pl.582.29"></a><var>582.29</var>reimbursement for privatized adoption grant and foster care recruitment grant expenditures <br/>
<a id="pl.582.30"></a><var>582.30</var>is appropriated to the commissioner for adoption grants and foster care and adoption <br/>
<a id="pl.582.31"></a><var>582.31</var>administrative purposes.<br/>
<br/>
<a id="bill.14.11.0"></a><a id="pl.583.1"></a><var>583.1</var>    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision <br/>
<a id="pl.583.2"></a><var>583.2</var>to read:<br/>
<a id="pl.583.3"></a><var>583.3</var>    Subd. 36. <b>DHS receipt center accounting.</b> The commissioner may transfer <br/>
<a id="pl.583.4"></a><var>583.4</var>appropriations to, and account for DHS receipt center operations in, the special revenue <br/>
<a id="pl.583.5"></a><var>583.5</var>fund.<br/>
<br/>
<a id="bill.14.12.0"></a><a id="pl.583.6"></a><var>583.6</var>    Sec. 12. <b>TRANSFERS AND ADJUSTMENTS.</b><br/>
<a id="pl.583.7"></a><var>583.7</var>(a) The appropriation in subdivision 5, paragraph (g), includes up to $53,391,000 <br/>
<a id="pl.583.8"></a><var>583.8</var>in fiscal year 2014; $216,637,000 in fiscal year 2015; $261,660,000 in fiscal year 2016; <br/>
<a id="pl.583.9"></a><var>583.9</var>and $279,984,000 in fiscal year 2017, for medical assistance eligibility and administration <br/>
<a id="pl.583.10"></a><var>583.10</var>changes related to:<br/>
<a id="pl.583.11"></a><var>583.11</var>(1) eligibility for children age two to 18 with income up to 275 percent of the federal <br/>
<a id="pl.583.12"></a><var>583.12</var>poverty guidelines;<br/>
<a id="pl.583.13"></a><var>583.13</var>(2) eligibility for pregnant women with income up to 275 percent of the federal <br/>
<a id="pl.583.14"></a><var>583.14</var>poverty guidelines;<br/>
<a id="pl.583.15"></a><var>583.15</var>(3) Affordable Care Act enrollment and renewal processes, including elimination <br/>
<a id="pl.583.16"></a><var>583.16</var>of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes <br/>
<a id="pl.583.17"></a><var>583.17</var>in verification requirements, and other changes in the eligibility determination and <br/>
<a id="pl.583.18"></a><var>583.18</var>enrollment and renewal process;<br/>
<a id="pl.583.19"></a><var>583.19</var>(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;<br/>
<a id="pl.583.20"></a><var>583.20</var>(5) eligibility related to spousal impoverishment provisions for waiver recipients; and<br/>
<a id="pl.583.21"></a><var>583.21</var>(6) presumptive eligibility determinations by hospitals.<br/>
<a id="pl.583.22"></a><var>583.22</var>(b) The commissioner of the Department of Human Services shall determine the <br/>
<a id="pl.583.23"></a><var>583.23</var>difference between the actual costs to the medical assistance program attributable to <br/>
<a id="pl.583.24"></a><var>583.24</var>the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a), <br/>
<a id="pl.583.25"></a><var>583.25</var>clauses (1) to (6), that were estimated during the 2013 legislative session based on data <br/>
<a id="pl.583.26"></a><var>583.26</var>from the 2013 February forecast. The costs in this paragraph must be calculated between <br/>
<a id="pl.583.27"></a><var>583.27</var>beginning January 1, 2014, and June 30, 2017.<br/>
<a id="pl.583.28"></a><var>583.28</var>(c) For each fiscal year from 2014 to 2017, the commissioner of human services <br/>
<a id="pl.583.29"></a><var>583.29</var>shall certify the actual cost differences to the medical assistance program determined <br/>
<a id="pl.583.30"></a><var>583.30</var>under paragraph (b), and report the costs to the commissioner of management and budget <br/>
<a id="pl.583.31"></a><var>583.31</var>by June 30 of each fiscal year. In each fiscal year, the commissioner of management <br/>
<a id="pl.583.32"></a><var>583.32</var>and budget shall reduce the transfer from the health care access fund under section 3 <br/>
<a id="pl.583.33"></a><var>583.33</var>by the amounts determined in paragraph (b). If for any fiscal year the amount of the <br/>
<a id="pl.583.34"></a><var>583.34</var>cost difference determined under paragraph (b) exceeds the amount of the transfer under <br/>
<a id="pl.583.35"></a><var>583.35</var>section 14, the transfer for that year must be zero.<br/>
<a id="pl.584.1"></a><var>584.1</var>(d) This section expires on January 1, 2018.<br/>
<br/>
<a id="bill.14.13.0"></a><a id="pl.584.2"></a><var>584.2</var>    Sec. 13. <b>HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND </b><br/>
<a id="pl.584.3"></a><var>584.3</var><b>FOR MINNESOTACARE POPULATIONS.</b><br/>
<a id="pl.584.4"></a><var>584.4</var>(a) The commissioner of Minnesota management and budget shall transfer from the <br/>
<a id="pl.584.5"></a><var>584.5</var>health care access fund to the general fund $53,391,000 in fiscal year 2014; $216,637,000 <br/>
<a id="pl.584.6"></a><var>584.6</var>in fiscal year 2015; $261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year <br/>
<a id="pl.584.7"></a><var>584.7</var>2017, for medical assistance changes in section 12.<br/>
<a id="pl.584.8"></a><var>584.8</var>(b) This section expires on January 1, 2018.<br/>
<br/>
<a id="bill.14.14.0"></a><a id="pl.584.9"></a><var>584.9</var>    Sec. 14. <b>HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND.</b><br/>
<a id="pl.584.10"></a><var>584.10</var>(a) The commissioner of Minnesota management and budget shall transfer from the <br/>
<a id="pl.584.11"></a><var>584.11</var>health care access fund to the general fund $133,765,000 in fiscal year 2014; $23,893,000 <br/>
<a id="pl.584.12"></a><var>584.12</var>in fiscal year 2015; $48,371,000 in fiscal year 2016; and $32,325,000 in fiscal year 2017. <br/>
<a id="pl.584.13"></a><var>584.13</var>For each fiscal year, the commissioner must reduce the amount of the transfer under this <br/>
<a id="pl.584.14"></a><var>584.14</var>section according to section 12, paragraph (c).<br/>
<a id="pl.584.15"></a><var>584.15</var>(b) This section expires on January 1, 2018.<br/>
<br/>
<a id="bill.14.15.0"></a><a id="pl.584.16"></a><var>584.16</var>    Sec. 15. <b>TRANSFERS.</b><br/>
<a id="pl.584.17"></a><var>584.17</var>    Subdivision 1. <b>Grants.</b> The commissioner of human services, with the approval of <br/>
<a id="pl.584.18"></a><var>584.18</var>the commissioner of management and budget, may transfer unencumbered appropriation <br/>
<a id="pl.584.19"></a><var>584.19</var>balances for the biennium ending June 30, 2015, within fiscal years among the MFIP, <br/>
<a id="pl.584.20"></a><var>584.20</var>general assistance, general assistance medical care under Minnesota Statutes 2009 <br/>
<a id="pl.584.21"></a><var>584.21</var>Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP <br/>
<a id="pl.584.22"></a><var>584.22</var>child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental <br/>
<a id="pl.584.23"></a><var>584.23</var>aid, group residential housing programs, the entitlement portion of the chemical <br/>
<a id="pl.584.24"></a><var>584.24</var>dependency consolidated treatment fund, and between fiscal years of the biennium. The <br/>
<a id="pl.584.25"></a><var>584.25</var>commissioner shall inform the chairs and ranking minority members of the senate Health <br/>
<a id="pl.584.26"></a><var>584.26</var>and Human Services Finance Division and the house of representatives Health and Human <br/>
<a id="pl.584.27"></a><var>584.27</var>Services Finance Committee quarterly about transfers made under this provision.<br/>
<a id="pl.584.28"></a><var>584.28</var>    Subd. 2. <b>Administration.</b> Positions, salary money, and nonsalary administrative <br/>
<a id="pl.584.29"></a><var>584.29</var>money may be transferred within the Departments of Human Services and Health as the <br/>
<a id="pl.584.30"></a><var>584.30</var>commissioners consider necessary, with the advance approval of the commissioner of <br/>
<a id="pl.584.31"></a><var>584.31</var>management and budget. The commissioner shall inform the chairs and ranking minority <br/>
<a id="pl.584.32"></a><var>584.32</var>members of the senate Health and Human Services Finance Division and the house of <br/>
<a id="pl.585.1"></a><var>585.1</var>representatives Health and Human Services Finance Committee quarterly about transfers <br/>
<a id="pl.585.2"></a><var>585.2</var>made under this provision.<br/>
<br/>
<a id="bill.14.16.0"></a><a id="pl.585.3"></a><var>585.3</var>    Sec. 16. <b>INDIRECT COSTS NOT TO FUND PROGRAMS.</b><br/>
<a id="pl.585.4"></a><var>585.4</var>The commissioners of health and human services shall not use indirect cost <br/>
<a id="pl.585.5"></a><var>585.5</var>allocations to pay for the operational costs of any program for which they are responsible.<br/>
<br/>
<a id="bill.14.17.0"></a><a id="pl.585.6"></a><var>585.6</var>    Sec. 17. <b>EXPIRATION OF UNCODIFIED LANGUAGE.</b><br/>
<a id="pl.585.7"></a><var>585.7</var>All uncodified language contained in this article expires on June 30, 2015, unless a <br/>
<a id="pl.585.8"></a><var>585.8</var>different expiration date is explicit.<br/>
<br/>
<a id="bill.14.18.0"></a><a id="pl.585.9"></a><var>585.9</var>    Sec. 18. <b>EFFECTIVE DATE.</b><br/>
<a id="pl.585.10"></a><var>585.10</var>This article is effective July 1, 2013, unless a different effective date is specified.<br/>
<br/>
<a id="bill.15.0.0"></a>

<a id="bill.15.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.13"></a><var>585.13</var><br/>
</td>
<td colspan="7">Section 1. <b>HEALTH AND HUMAN SERVICES APPROPRIATIONS.</b><b> </b><br/>
</td>
</tr>
</table><a id="pl.585.14"></a><var>585.14</var>The sums shown in the columns marked "Appropriations" are appropriated to the <br/>
<a id="pl.585.15"></a><var>585.15</var>agencies and for the purposes specified in this article. The appropriations are from the <br/>
<a id="pl.585.16"></a><var>585.16</var>general fund, or another named fund, and are available for the fiscal years indicated <br/>
<a id="pl.585.17"></a><var>585.17</var>for each purpose. The figures "2014" and "2015" used in this article mean that the <br/>
<a id="pl.585.18"></a><var>585.18</var>appropriations listed under them are available for the fiscal year ending June 30, 2014, or <br/>
<a id="pl.585.19"></a><var>585.19</var>June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal <br/>
<a id="pl.585.20"></a><var>585.20</var>year 2015. "The biennium" is fiscal years 2014 and 2015.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.21"></a><var>585.21</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>APPROPRIATIONS</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.585.22"></a><var>585.22</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Available for the Year</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.585.23"></a><var>585.23</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td align="center" colspan="4"><b>Ending June 30</b><br/>
</td>
</tr>
<tr>
<td><a id="pl.585.24"></a><var>585.24</var><br/>
</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td align="center"><b>2014</b><br/>
</td>
<td></td>
<td align="center"><b>2015</b><br/>
</td>
</tr>
</table><br/>
<a id="bill.15.2.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.25"></a><var>585.25</var><br/>
<a id="pl.585.26"></a><var>585.26</var><br/>
</td>
<td colspan="3">Sec. 2. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.27"></a><var>585.27</var><br/>
</td>
<td colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"></td>
<td align="right">817,000<br/>
</td>
<td align="center"></td>
<td align="right">895,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.28"></a><var>585.28</var><br/>
</td>
<td colspan="3">Subd. 2.<b>Central Office</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.585.29"></a><var>585.29</var>The amounts that may be spent from this <br/>
<a id="pl.585.30"></a><var>585.30</var>appropriation for each purpose are as follows:<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.585.31"></a><var>585.31</var><br/>
</td>
<td colspan="3"><b>(a) Operations</b><br/>
</td>
<td align="center"></td>
<td align="right">4,688,000<br/>
</td>
<td align="center"></td>
<td align="right">11,643,000<br/>
</td>
</tr>
</table><a id="pl.586.1"></a><var>586.1</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.586.2"></a><var>586.2</var>decreased by $11,056,000 in fiscal year 2016 <br/>
<a id="pl.586.3"></a><var>586.3</var>and $11,056,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.4"></a><var>586.4</var><br/>
</td>
<td colspan="3"><b>(b) Continuing Care</b><br/>
</td>
<td align="center"></td>
<td align="right">2,334,000<br/>
</td>
<td align="center"></td>
<td align="right">2,556,000<br/>
</td>
</tr>
</table><a id="pl.586.5"></a><var>586.5</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.586.6"></a><var>586.6</var>decreased by $2,000 in fiscal year 2016 and <br/>
<a id="pl.586.7"></a><var>586.7</var>by $27,000,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.8"></a><var>586.8</var><br/>
</td>
<td colspan="3"><b>(c) Group Residential Housing</b><br/>
</td>
<td align="center"></td>
<td align="right">(1,166,000)<br/>
</td>
<td align="center"></td>
<td align="right">(8,602,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.9"></a><var>586.9</var><br/>
</td>
<td colspan="3"><b>(d) Medical Assistance</b><br/>
</td>
<td align="center"></td>
<td align="right">(2,647,000)<br/>
</td>
<td align="center"></td>
<td align="right">(2,627,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.10"></a><var>586.10</var><br/>
</td>
<td colspan="3"><b>(e) Alternative Care</b><br/>
</td>
<td align="center"></td>
<td align="right">(7,386,000)<br/>
</td>
<td align="center"></td>
<td align="right">(6,851,000)<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.11"></a><var>586.11</var><br/>
</td>
<td colspan="3"><b>(f) Child and Community Service Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">3,000,000<br/>
</td>
<td align="center"></td>
<td align="right">3,000,000<br/>
</td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.12"></a><var>586.12</var><br/>
</td>
<td colspan="3"><b>(g) Aging and Adult Services Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">1,430,000<br/>
</td>
<td align="center"></td>
<td align="right">1,237,000<br/>
</td>
</tr>
</table><a id="pl.586.13"></a><var>586.13</var><b>Gaps Analysis. </b>In fiscal year 2014, and <br/>
<a id="pl.586.14"></a><var>586.14</var>in each even-numbered year thereafter, <br/>
<a id="pl.586.15"></a><var>586.15</var>$435,000 is appropriated to conduct an <br/>
<a id="pl.586.16"></a><var>586.16</var>analysis of gaps in long-term care services <br/>
<a id="pl.586.17"></a><var>586.17</var>under Minnesota Statutes, section 144A.351. <br/>
<a id="pl.586.18"></a><var>586.18</var>This is a biennial appropriation. The base is <br/>
<a id="pl.586.19"></a><var>586.19</var>increased by $435,000 in fiscal year 2016. <br/>
<a id="pl.586.20"></a><var>586.20</var>Notwithstanding any contrary provisions in <br/>
<a id="pl.586.21"></a><var>586.21</var>this article, this provision does not expire.<br/>
<a id="pl.586.22"></a><var>586.22</var><b>Base Adjustment.</b> The general fund base is <br/>
<a id="pl.586.23"></a><var>586.23</var>increased by $597,000 in fiscal year 2016, <br/>
<a id="pl.586.24"></a><var>586.24</var>and by $100,000 in fiscal year 2017.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.586.25"></a><var>586.25</var><br/>
</td>
<td colspan="3"><b>(h) Disabilities Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(564,000)<br/>
</td>
<td align="center"></td>
<td align="right">(539,000)<br/>
</td>
</tr>
</table><a id="pl.586.26"></a><var>586.26</var><b>Base Adjustment. </b>The general fund base is <br/>
<a id="pl.586.27"></a><var>586.27</var>increased by $25,000 in fiscal year 2016 and <br/>
<a id="pl.586.28"></a><var>586.28</var>by $25,000 in fiscal year 2017.<br/>
<br/>
<a id="bill.15.3.0"></a><a id="pl.586.29"></a><var>586.29</var>    Sec. 3. <b>FEDERAL APPROVAL.</b><br/>
<a id="pl.586.30"></a><var>586.30</var>(a) The implementation of this article is contingent on federal approval.<br/>
<a id="pl.586.31"></a><var>586.31</var>(b) Upon full or partial approval of the waiver application, the commissioner of <br/>
<a id="pl.586.32"></a><var>586.32</var>human services shall submit to the commissioner of management and budget a plan for <br/>
<a id="pl.587.1"></a><var>587.1</var>implementing the provisions in this article that received federal approval as well as any <br/>
<a id="pl.587.2"></a><var>587.2</var>provisions that do not require federal approval. The plan must:<br/>
<a id="pl.587.3"></a><var>587.3</var>(1) include fiscal estimates that, with federal administrative reimbursement, do <br/>
<a id="pl.587.4"></a><var>587.4</var>not increase the general fund appropriations to the commissioner of human services in <br/>
<a id="pl.587.5"></a><var>587.5</var>fiscal years 2014 and 2015; and<br/>
<a id="pl.587.6"></a><var>587.6</var>(2) include a fiscal estimate for the systems modernization appropriation, which <br/>
<a id="pl.587.7"></a><var>587.7</var>cannot exceed $15,463,000 for the biennium ending June 30, 2015.<br/>
<a id="pl.587.8"></a><var>587.8</var>(c) Upon approval by the commissioner of management and budget, the <br/>
<a id="pl.587.9"></a><var>587.9</var>commissioner of human services may implement the plan.<br/>
<a id="pl.587.10"></a><var>587.10</var>(d) The commissioner of management and budget must notify the chairs and ranking <br/>
<a id="pl.587.11"></a><var>587.11</var>minority members of the legislative committees with jurisdiction over health and human <br/>
<a id="pl.587.12"></a><var>587.12</var>services finance when the plan is approved. The plan must be made publicly available.<br/>
<br/>
<a id="bill.15.4.0"></a><a id="pl.587.13"></a><var>587.13</var>    Sec. 4. <b>IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS </b><br/>
<a id="pl.587.14"></a><var>587.14</var><b>AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES.</b><br/>
<a id="pl.587.15"></a><var>587.15</var>Upon approval of the plan in section 3, the commissioner of management and <br/>
<a id="pl.587.16"></a><var>587.16</var>budget shall make necessary adjustments to the appropriations in this article to reflect the <br/>
<a id="pl.587.17"></a><var>587.17</var>effective date of federal approval. The adjustments must include the nondedicated revenue <br/>
<a id="pl.587.18"></a><var>587.18</var>attributable to the provisions of this article and the related planning estimates for fiscal <br/>
<a id="pl.587.19"></a><var>587.19</var>years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions <br/>
<a id="pl.587.20"></a><var>587.20</var>in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included <br/>
<a id="pl.587.21"></a><var>587.21</var>in the forecast and must not increase the appropriations to the commissioner of human <br/>
<a id="pl.587.22"></a><var>587.22</var>services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for <br/>
<a id="pl.587.23"></a><var>587.23</var>fiscal years 2016 and 2017 result in increased general fund expenditure estimates for <br/>
<a id="pl.587.24"></a><var>587.24</var>the commissioner of human services attributable to the provisions in this article, when <br/>
<a id="pl.587.25"></a><var>587.25</var>compared to the planning estimates attributable to the provision in this article made in the <br/>
<a id="pl.587.26"></a><var>587.26</var>February 2013 forecast, none of the provisions in this article shall be implemented.<br/>
<br/>
<a id="bill.16.0.0"></a>

<a id="bill.16.1.0"></a><table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.587.29"></a><var>587.29</var><br/>
<a id="pl.587.30"></a><var>587.30</var><br/>
</td>
<td align="left" colspan="3">Section 1. <b>COMMISSIONER OF HUMAN </b><br/>
<b>SERVICES</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.587.31"></a><var>587.31</var><br/>
</td>
<td align="left" colspan="3">Subdivision 1.<b>Total Appropriation</b><br/>
</td>
<td align="center"><b>$</b><br/>
</td>
<td align="right"><b>(161,031,000)</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="95px"/>
<col width="96px"/>
<tr>
<td><a id="pl.587.32"></a><var>587.32</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.587.33"></a><var>587.33</var><br/>
</td>
<td align="left"></td>
<td align="center">2013<br/>
</td>
<td align="center"></td>
</tr>
<tr>
<td><a id="pl.587.34"></a><var>587.34</var><br/>
</td>
<td align="left">General Fund<br/>
</td>
<td align="right">(158,668,000)<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.588.1"></a><var>588.1</var><br/>
</td>
<td align="left">Health Care Access<br/>
</td>
<td align="right">(7,179,000)<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.588.2"></a><var>588.2</var><br/>
</td>
<td align="left">TANF<br/>
</td>
<td align="right">4,816,000<br/>
</td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.3"></a><var>588.3</var><br/>
</td>
<td align="left" colspan="2">Subd. 2.<b>Forecasted Programs</b><br/>
</td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.588.4"></a><var>588.4</var><br/>
</td>
<td align="left">(a) <b>MFIP/DWP Grants</b><br/>
</td>
<td align="left"></td>
<td align="center"></td>
<td align="right"></td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="126px"/>
<col width="96px"/>
<col width="96px"/>
<tr>
<td><a id="pl.588.5"></a><var>588.5</var><br/>
</td>
<td align="center" colspan="3">Appropriations by Fund<br/>
</td>
</tr>
<tr>
<td><a id="pl.588.6"></a><var>588.6</var><br/>
</td>
<td align="left">General Fund<br/>
</td>
<td align="right">(8,211,000)<br/>
</td>
<td align="right"></td>
</tr>
<tr>
<td><a id="pl.588.7"></a><var>588.7</var><br/>
</td>
<td align="left">TANF<br/>
</td>
<td align="right">4,399,000<br/>
</td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.8"></a><var>588.8</var><br/>
</td>
<td align="left" colspan="3">(b) <b>MFIP Child Care Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">10,113,000<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.9"></a><var>588.9</var><br/>
</td>
<td align="left" colspan="3">(c) <b>General Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">3,230,000<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.10"></a><var>588.10</var><br/>
</td>
<td align="left" colspan="3">(d) <b>Minnesota Supplemental Aid Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(1,008,000)<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.11"></a><var>588.11</var><br/>
</td>
<td align="left" colspan="3">(e) <b>Group Residential Housing Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(5,423,000)<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.12"></a><var>588.12</var><br/>
</td>
<td align="left" colspan="3">(f) <b>MinnesotaCare Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(7,179,000)<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.588.13"></a><var>588.13</var>This appropriation is from the health care <br/>
<a id="pl.588.14"></a><var>588.14</var>access fund.<br/>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.15"></a><var>588.15</var><br/>
</td>
<td align="left" colspan="3">(g) <b>Medical Assistance Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">(159,733,000)<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.16"></a><var>588.16</var><br/>
</td>
<td align="left" colspan="3">(h) <b>Alternative Care Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">-0-<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.17"></a><var>588.17</var><br/>
</td>
<td align="left" colspan="3">(i) <b>CD Entitlement Grants</b><br/>
</td>
<td align="center"></td>
<td align="right">2,364,000<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table>
<table>
<col width="50px"/>
<col width="21.5"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<col width="2.5"/>
<col width="12"/>
<tr>
<td><a id="pl.588.18"></a><var>588.18</var><br/>
</td>
<td align="left" colspan="3">Subd. 3.<b>Technical Activities</b><br/>
</td>
<td align="center"></td>
<td align="right">417,000<br/>
</td>
<td align="center"></td>
<td align="right"></td>
</tr>
</table><a id="pl.588.19"></a><var>588.19</var>This appropriation is from the TANF fund.<br/>
<a id="pl.588.20"></a><var>588.20</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br/>