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

3.18 	ARTICLE 1
3.19 	AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH 
3.20 	CARE FOR MORE MINNESOTANS

3.21 	Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.22 		Subd. 3.MinnesotaCare federal receipts. Receipts received as a result of federal 
3.23 	participation pertaining to administrative costs of the Minnesota health care reform waiver 
3.24 	shall be deposited as nondedicated revenue in the health care access fund. Receipts 
3.25 	received as a result of federal participation pertaining to grants shall be deposited in the 
3.26 	federal fund and shall offset health care access funds for payments to providers. All federal 
3.27 	funding received by Minnesota for implementation and administration of MinnesotaCare 
3.28 	as a basic health program, as authorized in section 1331 of the Affordable Care Act, 
3.29 	Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and 
3.30 	shall be deposited into the health care access fund. Federal funding that is received for 
3.31 	implementing and administering MinnesotaCare as a basic health program and deposited in 
3.32 	the fund shall be used only for that program to purchase health care coverage for enrollees 
3.33 	and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.

3.34 	EFFECTIVE DATE. This section is effective January 1, 2015.

3.35 	Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.36 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
3.37 	Regulations, title 25, part 20, persons eligible for medical assistance benefits under 
3.38 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet 
3.39 	the income standards of section 256B.056, subdivision 4, and persons eligible for general 
4.1 	assistance medical care under section 256D.03, subdivision 3, are entitled to chemical 
4.2 	dependency fund services. State money appropriated for this paragraph must be placed in 
4.3 	a separate account established for this purpose.
4.4 	Persons with dependent children who are determined to be in need of chemical 
4.5 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
4.6 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
4.7 	local agency to access needed treatment services. Treatment services must be appropriate 
4.8 	for the individual or family, which may include long-term care treatment or treatment in a 
4.9 	facility that allows the dependent children to stay in the treatment facility. The county 
4.10 	shall pay for out-of-home placement costs, if applicable.
4.11 	(b) A person not entitled to services under paragraph (a), but with family income 
4.12 	that is less than 215 percent of the federal poverty guidelines for the applicable family 
4.13 	size, shall be eligible to receive chemical dependency fund services within the limit 
4.14 	of funds appropriated for this group for the fiscal year. If notified by the state agency 
4.15 	of limited funds, a county must give preferential treatment to persons with dependent 
4.16 	children who are in need of chemical dependency treatment pursuant to an assessment 
4.17 	under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 
4.18 	6, or 260C.212. A county may spend money from its own sources to serve persons under 
4.19 	this paragraph. State money appropriated for this paragraph must be placed in a separate 
4.20 	account established for this purpose.
4.21 	(c) Persons whose income is between 215 percent and 412 percent of the federal 
4.22 	poverty guidelines for the applicable family size shall be eligible for chemical dependency 
4.23 	services on a sliding fee basis, within the limit of funds appropriated for this group for the 
4.24 	fiscal year. Persons eligible under this paragraph must contribute to the cost of services 
4.25 	according to the sliding fee scale established under subdivision 3. A county may spend 
4.26 	money from its own sources to provide services to persons under this paragraph. State 
4.27 	money appropriated for this paragraph must be placed in a separate account established 
4.28 	for this purpose.

4.29 	Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision 
4.30 	to read:
4.31 		Subd. 35.Federal approval. (a) The commissioner shall seek federal authority 
4.32 	from the U.S. Department of Health and Human Services necessary to operate a health 
4.33 	coverage program for Minnesotans with incomes up to 275 percent of the federal poverty 
4.34 	guidelines (FPG). The proposal shall seek to secure all federal funding available from at 
4.35 	least the following services:
5.1 	(1) all premium tax credits and cost sharing subsidies available under United States 
5.2 	Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals 
5.3 	with incomes above 133 percent and at or below 275 percent of the federal poverty 
5.4 	guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as 
5.5 	defined in section 62V.02;
5.6 	(2) Medicaid funding; and 
5.7 	(3) other funding sources identified by the commissioner that support coverage or 
5.8 	care redesign in Minnesota.
5.9 	(b) Funding received shall be used to design and implement a health coverage 
5.10 	program that creates a single streamlined program and meets the needs of Minnesotans with 
5.11 	incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.12 	(1) payment reform characteristics included in the health care delivery system and 
5.13 	accountable care organization payment models;
5.14 	(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee 
5.15 	needs in different income and health status situations and can provide a more seamless 
5.16 	transition from public to private health care coverage;
5.17 	(3) flexibility in co-payment or premium structures to incent patients to seek 
5.18 	high-quality, low-cost care settings; and
5.19 	(4) flexibility in premium structures to ease the transition from public to private 
5.20 	health care coverage.
5.21 	(c) The commissioner shall develop and submit a proposal consistent with the above 
5.22 	criteria and shall seek all federal authority necessary to implement the health coverage 
5.23 	program. In developing the request, the commissioner shall consult with appropriate 
5.24 	stakeholder groups and consumers.
5.25 	(d) The commissioner is authorized to seek any available waivers or federal 
5.26 	approvals to accomplish the goals under paragraph (b) prior to 2017.
5.27 	(e) The commissioner shall report to the chairs and ranking minority members of 
5.28 	the legislative committees with jurisdiction over health and human services policy and 
5.29 	financing by January 15, 2015, on the progress of receiving a federal waiver and shall 
5.30 	make recommendations on any legislative changes necessary to accomplish the project 
5.31 	in this subdivision. Any implementation of the waiver that requires a state financial 
5.32 	contribution shall be contingent on legislative action approving the contribution.
5.33 	(f) The commissioner is authorized to accept and expend federal funds that support 
5.34 	the purposes of this subdivision.

6.1 	Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision 
6.2 	to read:
6.3 		Subd. 18.Caretaker relative. "Caretaker relative" means a relative, by blood, 
6.4 	adoption, or marriage, of a child under age 19 with whom the child is living and who 
6.5 	assumes primary responsibility for the child's care.

6.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

6.7 	Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision 
6.8 	to read:
6.9 		Subd. 19.Insurance affordability program. "Insurance affordability program" 
6.10 	means one of the following programs:
6.11 	(1) medical assistance under this chapter;
6.12 	(2) a program that provides advance payments of the premium tax credits established 
6.13 	under section 36B of the Internal Revenue Code or cost-sharing reductions established 
6.14 	under section 1402 of the Affordable Care Act;
6.15 	(3) MinnesotaCare as defined in chapter 256L; and
6.16 	(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.

6.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

6.18 	Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
6.19 		Subd. 18.Applications for medical assistance. (a) The state agency may take
6.20 	 shall accept applications for medical assistance and conduct eligibility determinations for 
6.21 	MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web 
6.22 	site, and through other commonly available electronic means.
6.23 	(b) The commissioner of human services shall modify the Minnesota health care 
6.24 	programs application form to add a question asking applicants whether they have ever 
6.25 	served in the United States military.
6.26 	(c) For each individual who submits an application or whose eligibility is subject to 
6.27 	renewal or whose eligibility is being redetermined pursuant to a change in circumstances, 
6.28 	if the agency determines the individual is not eligible for medical assistance, the agency 
6.29 	shall determine potential eligibility for other insurance affordability programs.

6.30 	EFFECTIVE DATE. This section is effective January 1, 2014.

6.31 	Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.1 		Subd. 3a.Families with children. Beginning July 1, 2002, Medical assistance may 
7.2 	be paid for a person who is a child under the age of 18, or age 18 if a full-time student 
7.3 	in a secondary school, or in the equivalent level of vocational or technical training, and 
7.4 	reasonably expected to complete the program before reaching age 19; the parent or 
7.5 	stepparent of a dependent child under the age of 19, including a pregnant woman; or a 
7.6 	caretaker relative of a dependent child under the age of 19.

7.7 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
7.8 	approval, whichever is later. The commissioner of human services shall notify the revisor 
7.9 	of statutes when federal approval is obtained.

7.10 	Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
7.11 		Subd. 6.Pregnant women; needy unborn child. Medical assistance may be paid 
7.12 	for a pregnant woman who has written verification of a positive pregnancy test from a 
7.13 	physician or licensed registered nurse, who meets the other eligibility criteria of this 
7.14 	section and whose unborn child would be eligible as a needy child under subdivision 10 if 
7.15 	born and living with the woman. In accordance with Code of Federal Regulations, title 
7.16 	42, section 435.956, the commissioner must accept self-attestation of pregnancy unless 
7.17 	the agency has information that is not reasonably compatible with such attestation. For 
7.18 	purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.

7.19 	EFFECTIVE DATE. This section is effective January 1, 2014.

7.20 	Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
7.21 		Subd. 10.Infants. Medical assistance may be paid for an infant less than one year 
7.22 	of age, whose mother was eligible for and receiving medical assistance at the time of birth 
7.23 	or who is less than two years of age and is in a family with countable income that is equal 
7.24 	to or less than the income standard established under section 256B.057, subdivision 1.

7.25 	EFFECTIVE DATE. This section is effective January 1, 2014.

7.26 	Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
7.27 		Subd. 15.Adults without children. Medical assistance may be paid for a person 
7.28 	who is:
7.29 	(1) at least age 21 and under age 65;
7.30 	(2) not pregnant;
7.31 	(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII 
7.32 	of the Social Security Act;
8.1 	(4) not an adult in a family with children as defined in section 256L.01, subdivision 
8.2 	3a; and not otherwise eligible under subdivision 7 as a person who meets the categorical 
8.3 	eligibility requirements of the supplemental security income program;
8.4 	(5) not enrolled under subdivision 7 as a person who would meet the categorical 
8.5 	eligibility requirements of the supplemental security income program except for excess 
8.6 	income or assets; and
8.7 	(5) (6) not described in another subdivision of this section.

8.8 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.9 	Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a 
8.10 	subdivision to read:
8.11 		Subd. 17.Adults who were in foster care at the age of 18. Medical assistance may 
8.12 	be paid for a person under 26 years of age who was in foster care under the commissioner's 
8.13 	responsibility on the date of attaining 18 years of age, and who was enrolled in medical 
8.14 	assistance under the state plan or a waiver of the plan while in foster care, in accordance 
8.15 	with section 2004 of the Affordable Care Act.

8.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.17 	Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
8.18 		Subdivision 1.Residency. To be eligible for medical assistance, a person must 
8.19 	reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
8.20 	 in accordance with the rules of the state agency Code of Federal Regulations, title 42, 
8.21 	section 435.403.

8.22 	EFFECTIVE DATE. This section is effective January 1, 2014.

8.23 	Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
8.24 		Subd. 1c.Families with children income methodology. (a)(1) [Expired, 1Sp2003 
8.25 	c 14 art 12 s 17]
8.26 	(2) For applications processed within one calendar month prior to July 1, 2003, 
8.27 	eligibility shall be determined by applying the income standards and methodologies in 
8.28 	effect prior to July 1, 2003, for any months in the six-month budget period before July 
8.29 	1, 2003, and the income standards and methodologies in effect on July 1, 2003, for any 
8.30 	months in the six-month budget period on or after that date. The income standards for 
8.31 	each month shall be added together and compared to the applicant's total countable income 
8.32 	for the six-month budget period to determine eligibility.
9.1 	(3) For children ages one through 18 whose eligibility is determined under section 
9.2 	256B.057, subdivision 2, the following deductions shall be applied to income counted 
9.3 	toward the child's eligibility as allowed under the state's AFDC plan in effect as of July 
9.4 	16, 1996: $90 work expense, dependent care, and child support paid under court order. 
9.5 	This clause is effective October 1, 2003.
9.6 	(b) For families with children whose eligibility is determined using the standard 
9.7 	specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable 
9.8 	earned income shall be disregarded for up to four months and the following deductions 
9.9 	shall be applied to each individual's income counted toward eligibility as allowed under 
9.10 	the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid 
9.11 	under court order.
9.12 	(c) If the four-month disregard in paragraph (b) has been applied to the wage 
9.13 	earner's income for four months, the disregard shall not be applied again until the wage 
9.14 	earner's income has not been considered in determining medical assistance eligibility for 
9.15 	12 consecutive months.
9.16 	(d)(b) The commissioner shall adjust the income standards under this section each 
9.17 	July 1 by the annual update of the federal poverty guidelines following publication by the 
9.18 	United States Department of Health and Human Services except that the income standards 
9.19 	shall not go below those in effect on July 1, 2009.
9.20 	(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt 
9.21 	organization to or for the benefit of the child with a life-threatening illness must be 
9.22 	disregarded from income.

9.23 	Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
9.24 		Subd. 3.Asset limitations for certain individuals and families. (a) To be 
9.25 	eligible for medical assistance, a person must not individually own more than $3,000 in 
9.26 	assets, or if a member of a household with two family members, husband and wife, or 
9.27 	parent and child, the household must not own more than $6,000 in assets, plus $200 for 
9.28 	each additional legal dependent. In addition to these maximum amounts, an eligible 
9.29 	individual or family may accrue interest on these amounts, but they must be reduced to the 
9.30 	maximum at the time of an eligibility redetermination. The accumulation of the clothing 
9.31 	and personal needs allowance according to section 256B.35 must also be reduced to the 
9.32 	maximum at the time of the eligibility redetermination. The value of assets that are not 
9.33 	considered in determining eligibility for medical assistance is the value of those assets 
9.34 	excluded under the supplemental security income program for aged, blind, and disabled 
9.35 	persons, with the following exceptions:
10.1 	(1) household goods and personal effects are not considered;
10.2 	(2) capital and operating assets of a trade or business that the local agency determines 
10.3 	are necessary to the person's ability to earn an income are not considered;
10.4 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
10.5 	security income program;
10.6 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
10.7 	the supplemental security income program. Burial expenses funded by annuity contracts 
10.8 	or life insurance policies must irrevocably designate the individual's estate as contingent 
10.9 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
10.10 	(5) for a person who no longer qualifies as an employed person with a disability due 
10.11 	to loss of earnings, assets allowed while eligible for medical assistance under section 
10.12 	256B.057, subdivision 9, are not considered for 12 months, beginning with the first month 
10.13 	of ineligibility as an employed person with a disability, to the extent that the person's total 
10.14 	assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
10.15 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
10.16 	9, is age 65 or older and has been enrolled during each of the 24 consecutive months 
10.17 	before the person's 65th birthday, the assets owned by the person and the person's spouse 
10.18 	must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), 
10.19 	when determining eligibility for medical assistance under section 256B.055, subdivision 
10.20 	7. The income of a spouse of a person enrolled in medical assistance under section 
10.21 	256B.057, subdivision 9, during each of the 24 consecutive months before the person's 
10.22 	65th birthday must be disregarded when determining eligibility for medical assistance 
10.23 	under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to 
10.24 	the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013 
10.25 	is required to have qualified for medical assistance under section 256B.057, subdivision 9, 
10.26 	prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
10.27 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
10.28 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
10.29 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
10.30 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
10.31 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
10.32 	15.

10.33 	EFFECTIVE DATE. This section is effective January 1, 2014.

10.34 	Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by 
10.35 	Laws 2013, chapter 1, section 5, is amended to read:
11.1 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under 
11.2 	section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 
11.3 	the federal poverty guidelines. Effective January 1, 2000, and each successive January, 
11.4 	recipients of supplemental security income may have an income up to the supplemental 
11.5 	security income standard in effect on that date.
11.6 	(b) To be eligible for medical assistance, families and children may have an income 
11.7 	up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 
11.8 	AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 
11.9 	1996, shall be increased by three percent.
11.10 	(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section 
11.11 	256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133 
11.12 	percent of the federal poverty guidelines for the household size.
11.13 	(d) (c) To be eligible for medical assistance under section 256B.055, subdivision 
11.14 	15, a person may have an income up to 133 percent of federal poverty guidelines for 
11.15 	the household size.
11.16 	(e) (d) To be eligible for medical assistance under section 256B.055, subdivision 
11.17 	16, a child age 19 to 20 may have an income up to 133 percent of the federal poverty 
11.18 	guidelines for the household size.
11.19 	(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a, 
11.20 	a child under age 19 may have income up to 275 percent of the federal poverty guidelines 
11.21 	for the household size or an equivalent standard when converted using modified adjusted 
11.22 	gross income methodology as required under the Affordable Care Act. Children who are 
11.23 	enrolled in medical assistance as of December 31, 2013, and are determined ineligible 
11.24 	for medical assistance because of the elimination of income disregards under modified 
11.25 	adjusted gross income methodology as defined in subdivision 1a remain eligible for 
11.26 	medical assistance under the Children's Health Insurance Program Reauthorization Act 
11.27 	of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility 
11.28 	redetermination as required in section 256B.056, subdivision 7a.
11.29 	(f) In computing income to determine eligibility of persons under paragraphs (a) to 
11.30 	(e) who are not residents of long-term care facilities, the commissioner shall disregard 
11.31 	increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. 
11.32 	For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans 
11.33 	Administration unusual medical expense payments are considered income to the recipient.

11.34 	EFFECTIVE DATE. This section is effective January 1, 2014.

11.35 	Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
12.1 		Subd. 5c.Excess income standard. (a) The excess income standard for families 
12.2 	with children parents and caretaker relatives, pregnant women, infants, and children ages 
12.3 	two through 20 is the standard specified in subdivision 4, paragraph (b).
12.4 	(b) The excess income standard for a person whose eligibility is based on blindness, 
12.5 	disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the 
12.6 	family size. Effective July 1, 2002, the excess income standard for this paragraph shall 
12.7 	equal 75 percent of the federal poverty guidelines.

12.8 	EFFECTIVE DATE. This section is effective January 1, 2014.

12.9 	Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a 
12.10 	subdivision to read:
12.11 		Subd. 7a.Periodic renewal of eligibility. (a) The commissioner shall make an 
12.12 	annual redetermination of eligibility based on information contained in the enrollee's case 
12.13 	file and other information available to the agency, including but not limited to information 
12.14 	accessed through an electronic database, without requiring the enrollee to submit any 
12.15 	information when sufficient data is available for the agency to renew eligibility.
12.16 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), 
12.17 	the commissioner must provide the enrollee with a prepopulated renewal form containing 
12.18 	eligibility information available to the agency and permit the enrollee to submit the form 
12.19 	with any corrections or additional information to the agency and sign the renewal form via 
12.20 	any of the modes of submission specified in section 256B.04, subdivision 18.
12.21 	(c) An enrollee who is terminated for failure to complete the renewal process may 
12.22 	subsequently submit the renewal form and required information within four months after 
12.23 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
12.24 	under this chapter.
12.25 	(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be 
12.26 	required to renew eligibility every six months.

12.27 	EFFECTIVE DATE. This section is effective January 1, 2014.

12.28 	Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
12.29 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who 
12.30 	are applying for the continuation of medical assistance coverage following the end of the 
12.31 	60-day postpartum period to update their income and asset information and to submit 
12.32 	any required income or asset verification.
13.1 	(b) The commissioner shall determine the eligibility of private-sector health care 
13.2 	coverage for infants less than one year of age eligible under section 256B.055, subdivision 
13.3 	10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage 
13.4 	if this is determined to be cost-effective.
13.5 	(c) The commissioner shall verify assets and income for all applicants, and for all 
13.6 	recipients upon renewal.
13.7 	(d) The commissioner shall utilize information obtained through the electronic 
13.8 	service established by the secretary of the United States Department of Health and Human 
13.9 	Services and other available electronic data sources in Code of Federal Regulations, title 
13.10 	42, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner 
13.11 	shall establish standards to define when information obtained electronically is reasonably 
13.12 	compatible with information provided by applicants and enrollees, including use of 
13.13 	self-attestation, to accomplish real-time eligibility determinations and maintain program 
13.14 	integrity.

13.15 	EFFECTIVE DATE. This section is effective January 1, 2014.

13.16 	Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
13.17 		Subdivision 1.Infants and pregnant women. (a)(1) An infant less than one year
13.18 	 two years of age or a pregnant woman who has written verification of a positive pregnancy 
13.19 	test from a physician or licensed registered nurse is eligible for medical assistance if the 
13.20 	individual's countable family household income is equal to or less than 275 percent of the 
13.21 	federal poverty guideline for the same family household size or an equivalent standard 
13.22 	when converted using modified adjusted gross income methodology as required under 
13.23 	the Affordable Care Act. For purposes of this subdivision, "countable family income" 
13.24 	means the amount of income considered available using the methodology of the AFDC 
13.25 	program under the state's AFDC plan as of July 16, 1996, as required by the Personal 
13.26 	Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 
13.27 	Law 104-193, except for the earned income disregard and employment deductions.
13.28 	(2) For applications processed within one calendar month prior to the effective date, 
13.29 	eligibility shall be determined by applying the income standards and methodologies in 
13.30 	effect prior to the effective date for any months in the six-month budget period before 
13.31 	that date and the income standards and methodologies in effect on the effective date for 
13.32 	any months in the six-month budget period on or after that date. The income standards 
13.33 	for each month shall be added together and compared to the applicant's total countable 
13.34 	income for the six-month budget period to determine eligibility.
13.35 	(b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
14.1 	(2) For applications processed within one calendar month prior to July 1, 2003, 
14.2 	eligibility shall be determined by applying the income standards and methodologies in 
14.3 	effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 
14.4 	2003, and the income standards and methodologies in effect on the expiration date for any 
14.5 	months in the six-month budget period on or after July 1, 2003. The income standards 
14.6 	for each month shall be added together and compared to the applicant's total countable 
14.7 	income for the six-month budget period to determine eligibility.
14.8 	(3) An amount equal to the amount of earned income exceeding 275 percent of 
14.9 	the federal poverty guideline, up to a maximum of the amount by which the combined 
14.10 	total of 185 percent of the federal poverty guideline plus the earned income disregards 
14.11 	and deductions allowed under the state's AFDC plan as of July 16, 1996, as required 
14.12 	by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public 
14.13 	Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for 
14.14 	pregnant women and infants less than one year of age.
14.15 	(c) Dependent care and child support paid under court order shall be deducted from 
14.16 	the countable income of pregnant women.
14.17 	(d) (b) An infant born to a woman who was eligible for and receiving medical 
14.18 	assistance on the date of the child's birth shall continue to be eligible for medical assistance 
14.19 	without redetermination until the child's first birthday.

14.20 	EFFECTIVE DATE. This section is effective January 1, 2014.

14.21 	Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
14.22 		Subd. 10.Certain persons needing treatment for breast or cervical cancer. (a) 
14.23 	Medical assistance may be paid for a person who:
14.24 	(1) has been screened for breast or cervical cancer by the Minnesota breast and 
14.25 	cervical cancer control program, and program funds have been used to pay for the person's 
14.26 	screening;
14.27 	(2) according to the person's treating health professional, needs treatment, including 
14.28 	diagnostic services necessary to determine the extent and proper course of treatment, for 
14.29 	breast or cervical cancer, including precancerous conditions and early stage cancer;
14.30 	(3) meets the income eligibility guidelines for the Minnesota breast and cervical 
14.31 	cancer control program;
14.32 	(4) is under age 65;
14.33 	(5) is not otherwise eligible for medical assistance under United States Code, title 
14.34 	42, section 1396a(a)(10)(A)(i); and
15.1 	(6) is not otherwise covered under creditable coverage, as defined under United 
15.2 	States Code, title 42, section 1396a(aa).
15.3 	(b) Medical assistance provided for an eligible person under this subdivision shall 
15.4 	be limited to services provided during the period that the person receives treatment for 
15.5 	breast or cervical cancer.
15.6 	(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance 
15.7 	without meeting the eligibility criteria relating to income and assets in section 256B.056, 
15.8 	subdivisions 1a to 5b 5a.

15.9 	EFFECTIVE DATE. This section is effective January 1, 2014.

15.10 	Sec. 21. Minnesota Statutes 2012, section 256B.057, is amended by adding a 
15.11 	subdivision to read:
15.12 		Subd. 12.Presumptive eligibility determinations made by qualified hospitals.
 15.13 	The commissioner shall establish a process to qualify hospitals that are participating 
15.14 	providers under the medical assistance program to determine presumptive eligibility for 
15.15 	medical assistance for applicants who may have a basis of eligibility using the modified 
15.16 	adjusted gross income methodology as defined in section 256B.056, subdivision 1a, 
15.17 	paragraph (b), clause (1).

15.18 	EFFECTIVE DATE. This section is effective January 1, 2014.

15.19 	Sec. 22. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:
15.20 		Subdivision 1.Definitions. (a) For purposes of this section and sections 256B.058
15.21 	and 256B.0595, the terms defined in this subdivision have the meanings given them.
15.22 	(b) "Community spouse" means the spouse of an institutionalized spouse.
15.23 	(c) "Spousal share" means one-half of the total value of all assets, to the extent that 
15.24 	either the institutionalized spouse or the community spouse had an ownership interest at 
15.25 	the time of the first continuous period of institutionalization.
15.26 	(d) "Assets otherwise available to the community spouse" means assets individually 
15.27 	or jointly owned by the community spouse, other than assets excluded by subdivision 5, 
15.28 	paragraph (c).
15.29 	(e) "Community spouse asset allowance" is the value of assets that can be transferred 
15.30 	under subdivision 3.
15.31 	(f) "Institutionalized spouse" means a person who is:
15.32 	(1) in a hospital, nursing facility, or intermediate care facility for persons with 
15.33 	developmental disabilities, or receiving home and community-based services under section 
16.1 	256B.0915, 256B.092, or 256B.49 and is expected to remain in the facility or institution 
16.2 	or receive the home and community-based services for at least 30 consecutive days; and
16.3 	(2) married to a person who is not in a hospital, nursing facility, or intermediate 
16.4 	care facility for persons with developmental disabilities, and is not receiving home and 
16.5 	community-based services under section 256B.0915, 256B.092, or 256B.49.
16.6 	(g) "For the sole benefit of" means no other individual or entity can benefit in any 
16.7 	way from the assets or income at the time of a transfer or at any time in the future.
16.8 	(h) "Continuous period of institutionalization" means a 30-consecutive-day period 
16.9 	of time in which a person is expected to stay in a medical or long-term care facility, or 
16.10 	receive home and community-based services that would qualify for coverage under the 
16.11 	elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915, 
16.12 	256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins 
16.13 	on the date of entry into a medical or long-term care facility. For receipt of home and 
16.14 	community-based services, the 30-consecutive-day period begins on the date that the 
16.15 	following conditions are met:
16.16 	(1) the person is receiving services that meet the nursing facility level of care 
16.17 	determined by a long-term care consultation;
16.18 	(2) the person has received the long-term care consultation within the past 60 days;
16.19 	(3) the services are paid by the EW program under section 256B.0915 or the AC 
16.20 	program under section256B.0913, 256B.0915, 256B.092, or 256B.49 or would qualify 
16.21 	for payment under the EW or AC programs those sections if the person were otherwise 
16.22 	eligible for either program, and but for the receipt of such services the person would have 
16.23 	resided in a nursing facility; and
16.24 	(4) the services are provided by a licensed provider qualified to provide home and 
16.25 	community-based services.

16.26 	EFFECTIVE DATE. This section is effective January 1, 2014.

16.27 	Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
16.28 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
16.29 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
16.30 	other persons residing lawfully in the United States. Citizens or nationals of the United 
16.31 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
16.32 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
16.33 	Public Law 109-171.
16.34 	(b) "Qualified noncitizen" means a person who meets one of the following 
16.35 	immigration criteria:
17.1 	(1) admitted for lawful permanent residence according to United States Code, title 8;
17.2 	(2) admitted to the United States as a refugee according to United States Code, 
17.3 	title 8, section 1157;
17.4 	(3) granted asylum according to United States Code, title 8, section 1158;
17.5 	(4) granted withholding of deportation according to United States Code, title 8, 
17.6 	section 1253(h);
17.7 	(5) paroled for a period of at least one year according to United States Code, title 8, 
17.8 	section 1182(d)(5);
17.9 	(6) granted conditional entrant status according to United States Code, title 8, 
17.10 	section 1153(a)(7);
17.11 	(7) determined to be a battered noncitizen by the United States Attorney General 
17.12 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
17.13 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.14 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
17.15 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
17.16 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
17.17 	Public Law 104-200; or
17.18 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
17.19 	Law 96-422, the Refugee Education Assistance Act of 1980.
17.20 	(c) All qualified noncitizens who were residing in the United States before August 
17.21 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
17.22 	medical assistance with federal financial participation.
17.23 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United 
17.24 	States on or after August 22, 1996, and who otherwise meet the eligibility requirements 
17.25 	of this chapter are eligible for medical assistance with federal participation for five years 
17.26 	if they meet one of the following criteria:
17.27 	(1) refugees admitted to the United States according to United States Code, title 8, 
17.28 	section 1157;
17.29 	(2) persons granted asylum according to United States Code, title 8, section 1158;
17.30 	(3) persons granted withholding of deportation according to United States Code, 
17.31 	title 8, section 1253(h);
17.32 	(4) veterans of the United States armed forces with an honorable discharge for 
17.33 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
17.34 	children; or
17.35 	(5) persons on active duty in the United States armed forces, other than for training, 
17.36 	their spouses and unmarried minor dependent children.
18.1 	 Beginning July 1, 2010, children and pregnant women who are noncitizens 
18.2 	described in paragraph (b) or who are lawfully present in the United States as defined 
18.3 	in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet 
18.4 	eligibility requirements of this chapter, are eligible for medical assistance with federal 
18.5 	financial participation as provided by the federal Children's Health Insurance Program 
18.6 	Reauthorization Act of 2009, Public Law 111-3.
18.7 	(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
18.8 	are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this 
18.9 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
18.10 	Code, title 8, section 1101(a)(15).
18.11 	(f) Payment shall also be made for care and services that are furnished to noncitizens, 
18.12 	regardless of immigration status, who otherwise meet the eligibility requirements of 
18.13 	this chapter, if such care and services are necessary for the treatment of an emergency 
18.14 	medical condition.
18.15 	(g) For purposes of this subdivision, the term "emergency medical condition" means 
18.16 	a medical condition that meets the requirements of United States Code, title 42, section 
18.17 	1396b(v).
18.18 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment 
18.19 	of an emergency medical condition are limited to the following:
18.20 	(i) services delivered in an emergency room or by an ambulance service licensed 
18.21 	under chapter 144E that are directly related to the treatment of an emergency medical 
18.22 	condition;
18.23 	(ii) services delivered in an inpatient hospital setting following admission from an 
18.24 	emergency room or clinic for an acute emergency condition; and
18.25 	(iii) follow-up services that are directly related to the original service provided 
18.26 	to treat the emergency medical condition and are covered by the global payment made 
18.27 	to the provider.
18.28 	(2) Services for the treatment of emergency medical conditions do not include:
18.29 	(i) services delivered in an emergency room or inpatient setting to treat a 
18.30 	nonemergency condition;
18.31 	(ii) organ transplants, stem cell transplants, and related care;
18.32 	(iii) services for routine prenatal care;
18.33 	(iv) continuing care, including long-term care, nursing facility services, home health 
18.34 	care, adult day care, day training, or supportive living services;
18.35 	(v) elective surgery;
19.1 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
19.2 	part of an emergency room visit;
19.3 	(vii) preventative health care and family planning services;
19.4 	(viii) dialysis;
19.5 	(ix) chemotherapy or therapeutic radiation services;
19.6 	(x) rehabilitation services;
19.7 	(xi) physical, occupational, or speech therapy;
19.8 	(xii) transportation services;
19.9 	(xiii) case management;
19.10 	(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.11 	(xv) dental services;
19.12 	(xvi) hospice care;
19.13 	(xvii) audiology services and hearing aids;
19.14 	(xviii) podiatry services;
19.15 	(xix) chiropractic services;
19.16 	(xx) immunizations;
19.17 	(xxi) vision services and eyeglasses;
19.18 	(xxii) waiver services;
19.19 	(xxiii) individualized education programs; or
19.20 	(xxiv) chemical dependency treatment.
19.21 	(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented, 
19.22 	nonimmigrants, or lawfully present in the United States as defined in Code of Federal 
19.23 	Regulations, title 8, section 103.12, ineligible for federally funded medical assistance 
19.24 	because of immigration status are not covered by a group health plan or health insurance 
19.25 	coverage according to Code of Federal Regulations, title 42, section 457.310, and who 
19.26 	otherwise meet the eligibility requirements of this chapter, are eligible for medical 
19.27 	assistance through the period of pregnancy, including labor and delivery, and 60 days 
19.28 	postpartum, to the extent federal funds are available under title XXI of the Social Security 
19.29 	Act, and the state children's health insurance program.
19.30 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
19.31 	services from a nonprofit center established to serve victims of torture and are otherwise 
19.32 	ineligible for medical assistance under this chapter are eligible for medical assistance 
19.33 	without federal financial participation. These individuals are eligible only for the period 
19.34 	during which they are receiving services from the center. Individuals eligible under this 
19.35 	paragraph shall not be required to participate in prepaid medical assistance.

19.36 	EFFECTIVE DATE. This section is effective January 1, 2014.

20.1 	Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
20.2 		Subd. 3.Accountability. (a) Health care delivery systems must accept responsibility 
20.3 	for the quality of care based on standards established under subdivision 1, paragraph (b), 
20.4 	clause (10), and the cost of care or utilization of services provided to its enrollees under 
20.5 	subdivision 1, paragraph (b), clause (1).
20.6 	(b) A health care delivery system may contract and coordinate with providers and 
20.7 	clinics for the delivery of services and shall contract with community health clinics, 
20.8 	federally qualified health centers, community mental health centers or programs, county 
20.9 	agencies, and rural clinics to the extent practicable.
20.10 	(c) A health care delivery system must demonstrate how its services will be 
20.11 	coordinated with other services affecting its attributed patients' health, quality of care, and 
20.12 	cost of care that are provided by other providers and county agencies in the local service 
20.13 	area. The health care delivery system must document how other providers and counties, 
20.14 	including county-based purchasing plans, will provide services to attributed patients of 
20.15 	the health care delivery system, and how it will address applicable local needs, priorities, 
20.16 	and public health goals. As part of this documentation, the health care delivery system 
20.17 	must describe the involvement of local providers and counties, including county-based 
20.18 	purchasing plans, in developing the application to participate in the demonstration project.

20.19 	EFFECTIVE DATE. This section is effective July 1, 2013, and applies to health 
20.20 	care delivery system contracts entered into on or after that date.

20.21 	Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.22 	256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE 
20.23 	CONTRACT.
20.24 	(a) MS 2010 [Expired, 2008 c 364 s 10]
20.25 	(b) The commissioner shall consider, and may approve, contracting on a 
20.26 	single-health plan basis with other county-based purchasing plans, or with other qualified 
20.27 	health plans that have coordination arrangements with counties, to serve persons with a 
20.28 	disability who voluntarily enroll enrolled in state public health care programs, in order 
20.29 	to promote better coordination or integration of health care services, social services and 
20.30 	other community-based services, provided that all requirements applicable to health plan 
20.31 	purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in 
20.32 	this paragraph supersedes or modifies the requirements in paragraph (a).

21.1 	Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
21.2 	to read:
21.3 		Subd. 1b.Affordable Care Act.  "Affordable Care Act" means Public Law 111-148, 
21.4 	as amended by the federal Health Care and Education Reconciliation Act of 2010, Public 
21.5 	Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

21.6 	Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.7 		Subd. 3a.Family with children. (a) "Family with children" means:
21.8 	(1) parents and their children residing in the same household; or
21.9 	(2) grandparents, foster parents, relative caretakers as defined in the medical 
21.10 	assistance program, or legal guardians; and their wards who are children residing in the 
21.11 	same household. "Family" has the meaning given for family and family size as defined 
21.12 	in Code of Federal Regulations, title 26, section 1.36B-1.
21.13 	(b) The term includes children who are temporarily absent from the household in 
21.14 	settings such as schools, camps, or parenting time with noncustodial parents.

21.15 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
21.16 	approval, whichever is later. The commissioner of human services shall notify the revisor 
21.17 	of statutes when federal approval is obtained.

21.18 	Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.19 		Subd. 5.Income. (a) "Income" has the meaning given for earned and unearned 
21.20 	income for families and children in the medical assistance program, according to the 
21.21 	state's aid to families with dependent children plan in effect as of July 16, 1996. The 
21.22 	definition does not include medical assistance income methodologies and deeming 
21.23 	requirements. The earned income of full-time and part-time students under age 19 is 
21.24 	not counted as income. Public assistance payments and supplemental security income 
21.25 	are not excluded income modified adjusted gross income, as defined in Code of Federal 
21.26 	Regulations, title 26, section 1.36B-1.
21.27 	(b) For purposes of this subdivision, and unless otherwise specified in this section, 
21.28 	the commissioner shall use reasonable methods to calculate gross earned and unearned 
21.29 	income including, but not limited to, projecting income based on income received within 
21.30 	the past 30 days, the last 90 days, or the last 12 months.

21.31 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
21.32 	approval, whichever is later. The commissioner of human services shall notify the revisor 
21.33 	of statutes when federal approval is obtained.

22.1 	Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
22.2 	to read:
22.3 		Subd. 6.Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace" 
22.4 	means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.5 	Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision 
22.6 	to read:
22.7 		Subd. 7.Participating entity. "Participating entity" means a health carrier as 
22.8 	defined in section 62A.01, subdivision 2; a county-based purchasing plan established 
22.9 	under section 256B.692; an accountable care organization or other entity operating a 
22.10 	health care delivery systems demonstration project authorized under section 256B.0755; 
22.11 	an entity operating a county integrated health care delivery network pilot project 
22.12 	authorized under section 256B.0756; or a network of health care providers established to 
22.13 	offer services under MinnesotaCare.

22.14 	EFFECTIVE DATE. This section is effective January 1, 2015.

22.15 	Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.16 		Subd. 2.Commissioner's duties. (a) The commissioner shall establish an office 
22.17 	for the state administration of this plan. The plan shall be used to provide covered health 
22.18 	services for eligible persons. Payment for these services shall be made to all eligible 
22.19 	providers participating entities under contract with the commissioner. The commissioner 
22.20 	shall adopt rules to administer the MinnesotaCare program. The commissioner shall 
22.21 	establish marketing efforts to encourage potentially eligible persons to receive information 
22.22 	about the program and about other medical care programs administered or supervised by 
22.23 	the Department of Human Services.
22.24 	(b) A toll-free telephone number and Web site must be used to provide information 
22.25 	about medical programs and to promote access to the covered services.

22.26 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2015. Paragraph (b) is 
22.27 	effective January 1, 2014.

22.28 	Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision 
22.29 	to read:
22.30 		Subd. 6.Federal approval. (a) The commissioner of human services shall seek 
22.31 	federal approval to implement the MinnesotaCare program under this chapter as a basic 
22.32 	health program. In any agreement with the Centers for Medicare and Medicaid Services 
23.1 	to operate MinnesotaCare as a basic health program, the commissioner shall seek to 
23.2 	include procedures to ensure that federal funding is predictable, stable, and sufficient 
23.3 	to sustain ongoing operation of MinnesotaCare. These procedures must address issues 
23.4 	related to the timing of federal payments, payment reconciliation, enrollee risk adjustment, 
23.5 	and minimization of state financial risk. The commissioner shall consult with the 
23.6 	commissioner of management and budget, when developing the proposal for establishing 
23.7 	MinnesotaCare as a basic health program to be submitted to the Centers for Medicare 
23.8 	and Medicaid Services.
23.9 	(b) The commissioner of human services, in consultation with the commissioner 
23.10 	of management and budget, shall work with the Centers for Medicare and Medicaid 
23.11 	Services to establish a process for reconciliation and adjustment of federal payments that 
23.12 	balances state and federal liability over time. The commissioner of human services shall 
23.13 	request that the United States secretary of health and human services hold the state, and 
23.14 	enrollees, harmless in the reconciliation process for the first three years, to allow the state 
23.15 	to develop a statistically valid methodology for predicting enrollment trends and their 
23.16 	net effect on federal payments.
23.17 	(c) The commissioner of human services, through December 31, 2015, may modify 
23.18 	the MinnesotaCare program as specified in this chapter, if it is necessary to enhance 
23.19 	health benefits, expand provider access, or reduce cost-sharing and premiums in order 
23.20 	to comply with the terms and conditions of federal approval as a basic health program. 
23.21 	The commissioner may not reduce benefits, impose greater limits on access to providers, 
23.22 	or increase cost-sharing and premiums by enrollees under the authority granted by this 
23.23 	paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare 
23.24 	under this paragraph, the commissioner shall provide the legislature with notice of 
23.25 	implementation of the modifications at least ten working days before notifying enrollees 
23.26 	and participating entities. The costs of any changes to the program necessary to comply 
23.27 	with federal approval shall not become part of the program's base funding for purposes of 
23.28 	future budget forecasts.

23.29 	EFFECTIVE DATE. This section is effective the day following final enactment.

23.30 	Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision 
23.31 	to read:
23.32 		Subd. 7.Coordination with Minnesota Insurance Marketplace. MinnesotaCare 
23.33 	shall be considered a public health care program for purposes of chapter 62V.

23.34 	EFFECTIVE DATE. This section is effective January 1, 2014.

24.1 	Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
24.2 		Subdivision 1.Covered health services. (a) "Covered health services" means the 
24.3 	health services reimbursed under chapter 256B, with the exception of inpatient hospital 
24.4 	services, special education services, private duty nursing services, adult dental care 
24.5 	services other than services covered under section 256B.0625, subdivision 9, orthodontic 
24.6 	services, nonemergency medical transportation services, personal care assistance and case 
24.7 	management services, and nursing home or intermediate care facilities services, inpatient 
24.8 	mental health services, and chemical dependency services.
24.9 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare 
24.10 	except where the life of the female would be endangered or substantial and irreversible 
24.11 	impairment of a major bodily function would result if the fetus were carried to term; or 
24.12 	where the pregnancy is the result of rape or incest.
24.13 	(c) Covered health services shall be expanded as provided in this section.

24.14 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
24.15 	approval, whichever is later. The commissioner of human services shall notify the revisor 
24.16 	of statutes when federal approval is obtained.

24.17 	Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.18 		Subd. 1a.Pregnant women and Children; MinnesotaCare health care reform 
24.19 	waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage 
24.20 	of all services that are eligible for reimbursement under the medical assistance program 
24.21 	according to chapter 256B, except that abortion services under MinnesotaCare shall be 
24.22 	limited as provided under subdivision 1. Pregnant women and Children are exempt from 
24.23 	the provisions of subdivision 5, regarding co-payments. Pregnant women and Children 
24.24 	who are lawfully residing in the United States but who are not "qualified noncitizens" under 
24.25 	title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 
24.26 	Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage 
24.27 	of all services provided under the medical assistance program according to chapter 256B.

24.28 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
24.29 	approval, whichever is later. The commissioner of human services shall notify the revisor 
24.30 	of statutes when federal approval is obtained.

24.31 	Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.32 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
24.33 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
25.1 	hospital and residential chemical dependency treatment, subject to those limitations 
25.2 	necessary to coordinate the provision of these services with eligibility under the medical 
25.3 	assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 
25.4 	section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 
25.5 	2, with family gross income that exceeds 200 percent of the federal poverty guidelines or 
25.6 	215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 
25.7 	pregnant, is subject to an annual limit of $10,000.
25.8 	(b) Admissions for inpatient hospital services paid for under section 256L.11, 
25.9 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
25.10 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
25.11 	(1) all admissions must be certified, except those authorized under rules established 
25.12 	under section 254A.03, subdivision 3, or approved under Medicare; and
25.13 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
25.14 	for admissions for which certification is requested more than 30 days after the day of 
25.15 	admission. The hospital may not seek payment from the enrollee for the amount of the 
25.16 	payment reduction under this clause.

25.17 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
25.18 	approval, whichever is later. The commissioner of human services shall notify the revisor 
25.19 	of statutes when federal approval is obtained.

25.20 	Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision 
25.21 	to read:
25.22 		Subd. 4a.Loss ratio. Health coverage provided through the MinnesotaCare 
25.23 	program must have a medical loss ratio of at least 85 percent, as defined using the loss 
25.24 	ratio methodology described in section 1001 of the Affordable Care Act.

25.25 	EFFECTIVE DATE. This section is effective January 1, 2015.

25.26 	Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.27 		Subd. 5.Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.28 	 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing 
25.29 	requirements for all enrollees:
25.30 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
25.31 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.32 	(2) (1) $3 per prescription for adult enrollees;
25.33 	(3) (2) $25 for eyeglasses for adult enrollees;
26.1 	(4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means 
26.2 	an episode of service which is required because of a recipient's symptoms, diagnosis, or 
26.3 	established illness, and which is delivered in an ambulatory setting by a physician or 
26.4 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
26.5 	audiologist, optician, or optometrist;
26.6 	(5) (4) $6 for nonemergency visits to a hospital-based emergency room for services 
26.7 	provided through December 31, 2010, and $3.50 effective January 1, 2011; and
26.8 	(6) (5) a family deductible equal to the maximum amount allowed under Code of 
26.9 	Federal Regulations, title 42, part 447.54.
26.10 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
26.11 	children under the age of 21.
26.12 	(c) (b) Paragraph (a) does not apply to pregnant women and children under the 
26.13 	age of 21.
26.14 	(d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
26.15 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
26.16 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
26.17 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
26.18 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.19 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
26.20 	or changes from one prepaid health plan to another during a calendar year, any charges 
26.21 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
26.22 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
26.23 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.24 	(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to 
26.25 	managed care plans or county-based purchasing plans shall not be increased as a result of 
26.26 	the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.27 	(h) (e) The commissioner, through the contracting process under section 256L.12, 
26.28 	may allow managed care plans and county-based purchasing plans to waive the family 
26.29 	deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not 
26.30 	be included in the capitation payment to managed care plans and county-based purchasing 
26.31 	plans. Managed care plans and county-based purchasing plans shall certify annually to the 
26.32 	commissioner the dollar value of the family deductible.

26.33 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
26.34 	approval, whichever is later. The commissioner of human services shall notify the revisor 
26.35 	of statutes when federal approval is obtained.

27.1 	Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
27.2 		Subd. 6.Lien. When the state agency provides, pays for, or becomes liable for 
27.3 	covered health services, the agency shall have a lien for the cost of the covered health 
27.4 	services upon any and all causes of action accruing to the enrollee, or to the enrollee's 
27.5 	legal representatives, as a result of the occurrence that necessitated the payment for the 
27.6 	covered health services. All liens under this section shall be subject to the provisions 
27.7 	of section 256.015. For purposes of this subdivision, "state agency" includes prepaid 
27.8 	health plans participating entities, under contract with the commissioner according to 
27.9 	sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based 
27.10 	purchasing entities under section 256B.692 section 256L.121.

27.11 	EFFECTIVE DATE. This section is effective January 1, 2015.

27.12 	Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
27.13 		Subdivision 1.Families with children. (a) Families with children with family 
27.14 	income above 133 percent of the federal poverty guidelines and equal to or less than 
27.15 	275 200 percent of the federal poverty guidelines for the applicable family size shall be 
27.16 	eligible for MinnesotaCare according to this section. All other provisions of sections 
27.17 	256L.01 to 256L.18, including the insurance-related barriers to enrollment under section 
27.18 	256L.07, shall apply unless otherwise specified.
27.19 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
27.20 	if the children are eligible. Children may be enrolled separately without enrollment by 
27.21 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
27.22 	other insurance is available. If one child from a family is enrolled, all children must 
27.23 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
27.24 	the other spouse in the household must also enroll, unless other insurance is available. 
27.25 	Families cannot choose to enroll only certain uninsured members.
27.26 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
27.27 	to the MinnesotaCare program. These persons are no longer counted in the parental 
27.28 	household and may apply as a separate household.
27.29 	(d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.30 	(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision 
27.31 	8, are exempt from the eligibility requirements of this subdivision.

27.32 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
27.33 	approval, whichever is later. The commissioner of human services shall notify the revisor 
27.34 	of statutes when federal approval is obtained.

28.1 	Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision 
28.2 	to read:
28.3 		Subd. 1c.General requirements. To be eligible for coverage under MinnesotaCare, 
28.4 	a person must meet the eligibility requirements of this section. A person eligible for 
28.5 	MinnesotaCare shall not be considered a qualified individual under section 1312 of the 
28.6 	Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered 
28.7 	through the Minnesota Insurance Marketplace under chapter 62V.

28.8 	EFFECTIVE DATE. This section is effective January 1, 2014.

28.9 	Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
28.10 		Subd. 7.Single adults and households with no children. (a) The definition of 
28.11 	eligible persons includes all individuals and households families with no children who 
28.12 	have gross family incomes that are above 133 percent and equal to or less than 200 percent 
28.13 	of the federal poverty guidelines for the applicable family size.
28.14 	(b) Effective July 1, 2009, the definition of eligible persons includes all individuals 
28.15 	and households with no children who have gross family incomes that are equal to or less 
28.16 	than 250 percent of the federal poverty guidelines.

28.17 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
28.18 	approval, whichever is later. The commissioner of human services shall notify the revisor 
28.19 	of statutes when federal approval is obtained.

28.20 	Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
28.21 		Subd. 8.Applicants potentially eligible for medical assistance. (a) Individuals 
28.22 	who receive supplemental security income or retirement, survivors, or disability benefits 
28.23 	due to a disability, or other disability-based pension, who qualify under subdivision 7, but 
28.24 	who are potentially eligible for medical assistance without a spenddown shall be allowed 
28.25 	to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other 
28.26 	conditions of eligibility. The commissioner shall identify and refer the applications of 
28.27 	such individuals to their county social service agency. The county and the commissioner 
28.28 	shall cooperate to ensure that the individuals obtain medical assistance coverage for any 
28.29 	months for which they are eligible.
28.30 	(b) The enrollee must cooperate with the county social service agency in determining 
28.31 	medical assistance eligibility within the 60-day enrollment period. Enrollees who do not 
28.32 	cooperate with medical assistance within the 60-day enrollment period shall be disenrolled 
28.33 	from the plan within one calendar month. Persons disenrolled for nonapplication for 
29.1 	medical assistance may not reenroll until they have obtained a medical assistance 
29.2 	eligibility determination. Persons disenrolled for noncooperation with medical assistance 
29.3 	may not reenroll until they have cooperated with the county agency and have obtained a 
29.4 	medical assistance eligibility determination.
29.5 	(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare 
29.6 	enrollment sites shall consider MinnesotaCare applications to also be applications for 
29.7 	medical assistance. Applicants who are potentially eligible for medical assistance, except 
29.8 	for those described in paragraph (a), may choose to enroll in either MinnesotaCare or 
29.9 	medical assistance.
29.10 	(d) The commissioner shall redetermine provider payments made under 
29.11 	MinnesotaCare to the appropriate medical assistance payments for those enrollees who 
29.12 	subsequently become eligible for medical assistance.

29.13 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
29.14 	approval, whichever is later. The commissioner of human services shall notify the revisor 
29.15 	of statutes when federal approval is obtained.

29.16 	Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
29.17 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to 
29.18 	citizens or nationals of the United States, qualified noncitizens, and other persons residing
29.19 	 lawfully in the United States present noncitizens as defined in Code of Federal Regulations, 
29.20 	title 8, section 103.12. Undocumented noncitizens and nonimmigrants are ineligible for 
29.21 	MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in one 
29.22 	or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an 
29.23 	undocumented noncitizen is an individual who resides in the United States without the 
29.24 	approval or acquiescence of the United States Citizenship and Immigration Services. 
29.25 	Families with children who are citizens or nationals of the United States must cooperate in 
29.26 	obtaining satisfactory documentary evidence of citizenship or nationality according to the 
29.27 	requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
29.28 	(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and 
29.29 	individuals who are lawfully present and ineligible for medical assistance by reason of 
29.30 	immigration status and who have incomes equal to or less than 200 percent of federal 
29.31 	poverty guidelines.

29.32 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
29.33 	approval, whichever is later. The commissioner of human services shall notify the revisor 
29.34 	of statutes when federal approval is obtained.

30.1 	Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
30.2 		Subd. 12.Persons in detention. Beginning January 1, 1999, An applicant or 
30.3 	enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare, 
30.4 	unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in 
30.5 	a correctional or detention facility is not eligible at renewal of eligibility under section 
30.6 	256L.05, subdivision 3a.

30.7 	EFFECTIVE DATE. This section is effective January 1, 2014.

30.8 	Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision 
30.9 	to read:
30.10 		Subd. 14.Coordination with medical assistance. (a) Individuals eligible for 
30.11 	medical assistance under chapter 256B are not eligible for MinnesotaCare under this 
30.12 	section.
30.13 	(b) The commissioner shall coordinate eligibility and coverage to ensure that 
30.14 	individuals transitioning between medical assistance and MinnesotaCare have seamless 
30.15 	eligibility and access to health care services.

30.16 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
30.17 	approval, whichever is later. The commissioner of human services shall notify the revisor 
30.18 	of statutes when federal approval is obtained.

30.19 	Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.20 		Subdivision 1.Application assistance and information availability. (a) Applicants 
30.21 	may submit applications online, in person, by mail, or by phone in accordance with the 
30.22 	Affordable Care Act, and by any other means by which medical assistance applications 
30.23 	may be submitted. Applicants may submit applications through the Minnesota Insurance 
30.24 	Marketplace or through the MinnesotaCare program. Applications and application 
30.25 	assistance must be made available at provider offices, local human services agencies, 
30.26 	school districts, public and private elementary schools in which 25 percent or more of 
30.27 	the students receive free or reduced price lunches, community health offices, Women, 
30.28 	Infants and Children (WIC) program sites, Head Start program sites, public housing 
30.29 	councils, crisis nurseries, child care centers, early childhood education and preschool 
30.30 	program sites, legal aid offices, and libraries, and at any other locations at which medical 
30.31 	assistance applications must be made available. These sites may accept applications and 
30.32 	forward the forms to the commissioner or local county human services agencies that 
31.1 	choose to participate as an enrollment site. Otherwise, applicants may apply directly to the 
31.2 	commissioner or to participating local county human services agencies.
31.3 	(b) Application assistance must be available for applicants choosing to file an online 
31.4 	application through the Minnesota Insurance Marketplace.

31.5 	EFFECTIVE DATE. This section is effective January 1, 2014.

31.6 	Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
31.7 		Subd. 2.Commissioner's duties.  The commissioner or county agency shall use 
31.8 	electronic verification through the Minnesota Insurance Marketplace as the primary 
31.9 	method of income verification. If there is a discrepancy between reported income 
31.10 	and electronically verified income, an individual may be required to submit additional 
31.11 	verification to the extent permitted under the Affordable Care Act. In addition, the 
31.12 	commissioner shall perform random audits to verify reported income and eligibility. The 
31.13 	commissioner may execute data sharing arrangements with the Department of Revenue 
31.14 	and any other governmental agency in order to perform income verification related to 
31.15 	eligibility and premium payment under the MinnesotaCare program.

31.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

31.17 	Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.18 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the 
31.19 	first day of the month following the month in which eligibility is approved and the first 
31.20 	premium payment has been received. As provided in section 256B.057, coverage for 
31.21 	newborns is automatic from the date of birth and must be coordinated with other health 
31.22 	coverage. The effective date of coverage for eligible newly adoptive children added to a 
31.23 	family receiving covered health services is the month of placement. The effective date 
31.24 	of coverage for other new members added to the family is the first day of the month 
31.25 	following the month in which the change is reported. All eligibility criteria must be met 
31.26 	by the family at the time the new family member is added. The income of the new family 
31.27 	member is included with the family's modified adjusted gross income and the adjusted 
31.28 	premium begins in the month the new family member is added.
31.29 	(b) The initial premium must be received by the last working day of the month for 
31.30 	coverage to begin the first day of the following month.
31.31 	(c) Benefits are not available until the day following discharge if an enrollee is 
31.32 	hospitalized on the first day of coverage.
32.1 	(d) (c) Notwithstanding any other law to the contrary, benefits under sections 
32.2 	256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which 
32.3 	an eligible person may have coverage and the commissioner shall use cost avoidance 
32.4 	techniques to ensure coordination of any other health coverage for eligible persons. The 
32.5 	commissioner shall identify eligible persons who may have coverage or benefits under 
32.6 	other plans of insurance or who become eligible for medical assistance.
32.7 	(e) (d) The effective date of coverage for individuals or families who are exempt 
32.8 	from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first 
32.9 	day of the month following the month in which verification of American Indian status 
32.10 	is received or eligibility is approved, whichever is later.
32.11 	(f) (e) The effective date of coverage for children eligible under section 256L.07, 
32.12 	subdivision 8, is the first day of the month following the date of termination from foster 
32.13 	care or release from a juvenile residential correctional facility.

32.14 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
32.15 	approval, whichever is later. The commissioner of human services shall notify the revisor 
32.16 	of statutes when federal approval is obtained.

32.17 	Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.18 		Subd. 3c.Retroactive coverage. Notwithstanding subdivision 3, the effective 
32.19 	date of coverage shall be the first day of the month following termination from medical 
32.20 	assistance for families and individuals who are eligible for MinnesotaCare and who 
32.21 	submitted a written request for retroactive MinnesotaCare coverage with a completed 
32.22 	application within 30 days of the mailing of notification of termination from medical 
32.23 	assistance. The applicant must provide all required verifications within 30 days of the 
32.24 	written request for verification. For retroactive coverage, premiums must be paid in full 
32.25 	for any retroactive month, current month, and next month within 30 days of the premium 
32.26 	billing. General assistance medical care recipients may qualify for retroactive coverage 
32.27 	under this subdivision at six-month renewal.

32.28 	EFFECTIVE DATE. This section is effective January 1, 2014.

32.29 	Sec. 51. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
32.30 		Subd. 3.Commissioner's duties and payment. (a) Premiums are dedicated to the 
32.31 	commissioner for MinnesotaCare.
32.32 	(b) The commissioner shall develop and implement procedures to: (1) require 
32.33 	enrollees to report changes in income; (2) adjust sliding scale premium payments, based 
33.1 	upon both increases and decreases in enrollee income, at the time the change in income 
33.2 	is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required 
33.3 	premiums. Failure to pay includes payment with a dishonored check, a returned automatic 
33.4 	bank withdrawal, or a refused credit card or debit card payment. The commissioner may 
33.5 	demand a guaranteed form of payment, including a cashier's check or a money order, as 
33.6 	the only means to replace a dishonored, returned, or refused payment.
33.7 	(c) Premiums are calculated on a calendar month basis and may be paid on a 
33.8 	monthly, quarterly, or semiannual basis, with the first payment due upon notice from the 
33.9 	commissioner of the premium amount required. The commissioner shall inform applicants 
33.10 	and enrollees of these premium payment options. Premium payment is required before 
33.11 	enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments 
33.12 	received before noon are credited the same day. Premium payments received after noon 
33.13 	are credited on the next working day.
33.14 	(d) Nonpayment of the premium will result in disenrollment from the plan effective 
33.15 	for the calendar month for which the premium was due. Persons disenrolled for 
33.16 	nonpayment or who voluntarily terminate coverage from the program may not reenroll 
33.17 	until four calendar months have elapsed. Persons disenrolled for nonpayment who pay 
33.18 	all past due premiums as well as current premiums due, including premiums due for the 
33.19 	period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively 
33.20 	to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily 
33.21 	terminate coverage from the program may not reenroll for four calendar months unless 
33.22 	the person demonstrates good cause for nonpayment. Good cause does not exist if a 
33.23 	person chooses to pay other family expenses instead of the premium. The commissioner 
33.24 	shall define good cause in rule.

33.25 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
33.26 	approval, whichever is later. The commissioner of human services shall notify the revisor 
33.27 	of statutes when federal approval is obtained.

33.28 	Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.29 		Subdivision 1.General requirements. (a) Children enrolled in the original 
33.30 	children's health plan as of September 30, 1992, children who enrolled in the 
33.31 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
33.32 	article 4, section 17, and children who have family gross incomes that are equal to or 
33.33 	less than 200 percent of the federal poverty guidelines are eligible without meeting the 
33.34 	requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as 
33.35 	they maintain continuous coverage in the MinnesotaCare program or medical assistance.
34.1 	Parents Families and individuals enrolled in MinnesotaCare under section 256L.04, 
34.2 	subdivision 1, whose income increases above 275 200 percent of the federal poverty 
34.3 	guidelines, are no longer eligible for the program and shall be disenrolled by the 
34.4 	commissioner. Beginning January 1, 2008, Individuals enrolled in MinnesotaCare under 
34.5 	section 256L.04, subdivision 7, whose income increases above 200 percent of the federal 
34.6 	poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1, 
34.7 	2009, are no longer eligible for the program and shall be disenrolled by the commissioner.
34.8 	 For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the 
34.9 	last day of the calendar month following the month in which the commissioner determines 
34.10 	that the income of a family or individual exceeds program income limits.
34.11 	(b) Children may remain enrolled in MinnesotaCare if their gross family income as 
34.12 	defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty 
34.13 	guidelines. The premium for children remaining eligible under this paragraph shall be the 
34.14 	maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.15 	(c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if 
34.16 	gross household income exceeds $57,500 for the 12-month period of eligibility.

34.17 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
34.18 	approval, whichever is later. The commissioner of human services shall notify the revisor 
34.19 	of statutes when federal approval is obtained.

34.20 	Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.21 		Subd. 2.Must not have access to employer-subsidized minimum essential
34.22 	 coverage. (a) To be eligible, a family or individual must not have access to subsidized 
34.23 	health coverage through an employer and must not have had access to employer-subsidized 
34.24 	coverage through a current employer for 18 months prior to application or reapplication. 
34.25 	A family or individual whose employer-subsidized coverage is lost due to an employer 
34.26 	terminating health care coverage as an employee benefit during the previous 18 months is 
34.27 	not eligible that is affordable and provides minimum value as defined in Code of Federal 
34.28 	Regulations, title 26, section 1.36B-2.
34.29 	(b) This subdivision does not apply to a family or individual who was enrolled 
34.30 	in MinnesotaCare within six months or less of reapplication and who no longer has 
34.31 	employer-subsidized coverage due to the employer terminating health care coverage as an 
34.32 	employee benefit. This subdivision does not apply to children with family gross incomes 
34.33 	that are equal to or less than 200 percent of federal poverty guidelines.
34.34 	(c) For purposes of this requirement, subsidized health coverage means health 
34.35 	coverage for which the employer pays at least 50 percent of the cost of coverage for 
35.1 	the employee or dependent, or a higher percentage as specified by the commissioner. 
35.2 	Children are eligible for employer-subsidized coverage through either parent, including 
35.3 	the noncustodial parent. The commissioner must treat employer contributions to Internal 
35.4 	Revenue Code Section 125 plans and any other employer benefits intended to pay 
35.5 	health care costs as qualified employer subsidies toward the cost of health coverage for 
35.6 	employees for purposes of this subdivision.

35.7 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
35.8 	approval, whichever is later. The commissioner of human services shall notify the revisor 
35.9 	of statutes when federal approval is obtained.

35.10 	Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
35.11 		Subd. 3.Other health coverage. (a) Families and individuals enrolled in the 
35.12 	MinnesotaCare program must have no To be eligible, a family or individual must not have 
35.13 	minimum essential health coverage while enrolled, as defined by section 5000A of the 
35.14 	Internal Revenue Code. Children with family gross incomes equal to or greater than 200 
35.15 	percent of federal poverty guidelines, and adults, must have had no health coverage for 
35.16 	at least four months prior to application and renewal. Children enrolled in the original 
35.17 	children's health plan and children in families with income equal to or less than 200 
35.18 	percent of the federal poverty guidelines, who have other health insurance, are eligible if 
35.19 	the coverage:
35.20 	(1) lacks two or more of the following:
35.21 	(i) basic hospital insurance;
35.22 	(ii) medical-surgical insurance;
35.23 	(iii) prescription drug coverage;
35.24 	(iv) dental coverage; or
35.25 	(v) vision coverage;
35.26 	(2) requires a deductible of $100 or more per person per year; or
35.27 	(3) lacks coverage because the child has exceeded the maximum coverage for a 
35.28 	particular diagnosis or the policy excludes a particular diagnosis.
35.29 	The commissioner may change this eligibility criterion for sliding scale premiums 
35.30 	in order to remain within the limits of available appropriations. The requirement of no 
35.31 	health coverage does not apply to newborns.
35.32 	(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical 
35.33 	assistance, and the Civilian Health and Medical Program of the Uniformed Service, 
35.34 	CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A, 
36.1 	part II, chapter 55, are not considered insurance or health coverage for purposes of the 
36.2 	four-month requirement described in this subdivision.
36.3 	(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to 
36.4 	Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 
36.5 	Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered 
36.6 	to have minimum essential health coverage. An applicant or enrollee who is entitled to 
36.7 	premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage 
36.8 	to establish eligibility for MinnesotaCare.
36.9 	(d) Applicants who were recipients of medical assistance within one month of 
36.10 	application must meet the provisions of this subdivision and subdivision 2.
36.11 	(e) Cost-effective health insurance that was paid for by medical assistance is not 
36.12 	considered health coverage for purposes of the four-month requirement under this 
36.13 	section, except if the insurance continued after medical assistance no longer considered it 
36.14 	cost-effective or after medical assistance closed.

36.15 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
36.16 	approval, whichever is later. The commissioner of human services shall notify the revisor 
36.17 	of statutes when federal approval is obtained.

36.18 	Sec. 55. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.19 		Subd. 2.Residency requirement. To be eligible for health coverage under the 
36.20 	MinnesotaCare program, pregnant women, individuals, and families with children must 
36.21 	meet the residency requirements as provided by Code of Federal Regulations, title 42, 
36.22 	section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply 
36.23 	upon receipt of federal approval.

36.24 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
36.25 	approval, whichever is later. The commissioner of human services shall notify the revisor 
36.26 	of statutes when federal approval is obtained.

36.27 	Sec. 56. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
36.28 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers 
36.29 	under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions 
36.30 	established for medical assistance, except as provided in subdivisions 2 to 6 this section.
36.31 	(b) Effective for services provided on or after July 1, 2009, total payments for basic 
36.32 	care services shall be reduced by three percent, in accordance with section 256B.766. 
37.1 	Payments made to managed care and county-based purchasing plans shall be reduced for 
37.2 	services provided on or after October 1, 2009, to reflect this reduction.
37.3 	(c) Effective for services provided on or after July 1, 2009, payment rates for 
37.4 	physician and professional services shall be reduced as described under section 256B.76, 
37.5 	subdivision 1, paragraph (c). Payments made to managed care and county-based 
37.6 	purchasing plans shall be reduced for services provided on or after October 1, 2009, 
37.7 	to reflect this reduction.

37.8 	EFFECTIVE DATE. This section is effective January 1, 2014.

37.9 	Sec. 57. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.10 		Subd. 3.Inpatient hospital services. Inpatient hospital services provided under 
37.11 	section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the 
37.12 	medical assistance rate.

37.13 	EFFECTIVE DATE. This section is effective January 1, 2014.

37.14 	Sec. 58. [256L.121] SERVICE DELIVERY.
37.15 		Subdivision 1.Competitive process. The commissioner of human services shall 
37.16 	establish a competitive process for entering into contracts with participating entities for 
37.17 	the offering of standard health plans through MinnesotaCare. Coverage through standard 
37.18 	health plans must be available to enrollees beginning January 1, 2015. Each standard health 
37.19 	plan must cover the health services listed in, and meet the requirements of, section 256L.03. 
37.20 	The competitive process must meet the requirements of section 1331 of the Affordable 
37.21 	Care Act and be designed to ensure enrollee access to high-quality health care coverage 
37.22 	options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have 
37.23 	a choice of coverage from more than one participating entity within a geographic area.
37.24 		Subd. 2.Other requirements for participating entities. The commissioner shall 
37.25 	require participating entities, as a condition of contract, to document to the commissioner:
37.26 	(1) the provision of culturally and linguistically appropriate services, including 
37.27 	marketing materials, to MinnesotaCare enrollees; and
37.28 	(2) the inclusion in provider networks of providers designated as essential 
37.29 	community providers under section 62Q.19.
37.30 		Subd. 3.Coordination with state-administered health programs. The 
37.31 	commissioner shall coordinate the administration of the MinnesotaCare program with 
37.32 	medical assistance to maximize efficiency and improve the continuity of care. This 
37.33 	includes, but is not limited to:
38.1 	(1) establishing geographic areas for MinnesotaCare that are consistent with the 
38.2 	geographic areas of the medical assistance program, within which participating entities 
38.3 	may offer health plans;
38.4 	(2) requiring, as a condition of participation in MinnesotaCare, participating entities 
38.5 	to also participate in the medical assistance program;
38.6 	(3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and 
38.7 	256B.694 when contracting with MinnesotaCare participating entities;
38.8 	(4) providing MinnesotaCare enrollees, to the extent possible, with the option to 
38.9 	remain in the same health plan and provider network, if they later become eligible for 
38.10 	medical assistance or coverage through the Minnesota Insurance Marketplace and if, in 
38.11 	the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health 
38.12 	plan is also a medical assistance health plan in the enrollee's county of residence; and
38.13 	(5) establishing requirements and criteria for selection that ensure that covered 
38.14 	health care services will be coordinated with local public health, social services, long-term 
38.15 	care services, mental health services, and other local services affecting enrollees' health, 
38.16 	access, and quality of care.

38.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

38.18 	Sec. 59. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
38.19 		Subdivision 1.Premium determination. (a) Families with children and individuals 
38.20 	shall pay a premium determined according to subdivision 2.
38.21 	(b) Pregnant women and children under age two are exempt from the provisions 
38.22 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
38.23 	for failure to pay premiums. For pregnant women, this exemption continues until the 
38.24 	first day of the month following the 60th day postpartum. Women who remain enrolled 
38.25 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
38.26 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
38.27 	period that otherwise applies under section 256L.06, unless they begin paying premiums.
38.28 	(c) (b) Members of the military and their families who meet the eligibility criteria 
38.29 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
38.30 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
38.31 	The effective date of coverage for an individual or family who meets the criteria of this 
38.32 	paragraph shall be the first day of the month following the month in which eligibility is 
38.33 	approved. This exemption applies for 12 months.
38.34 	(d)(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and 
38.35 	their families shall have their premiums waived by the commissioner in accordance with 
39.1 	section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. 
39.2 	An individual must document status as an American Indian, as defined under Code of 
39.3 	Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.

39.4 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
39.5 	approval, whichever is later. The commissioner of human services shall notify the revisor 
39.6 	of statutes when federal approval is obtained.

39.7 	Sec. 60. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.8 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
39.9 	commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.10 	gross individual or family income that households at different income levels must pay to 
39.11 	obtain coverage through the MinnesotaCare program. The sliding fee scale must be based 
39.12 	on the enrollee's monthly gross individual or family income. The sliding fee scale must 
39.13 	contain separate tables based on enrollment of one, two, or three or more persons. Until 
39.14 	June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross 
39.15 	individual or family income for individuals or families with incomes below the limits for 
39.16 	the medical assistance program for families and children in effect on January 1, 1999, and 
39.17 	proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 
39.18 	8.8 percent. These percentages are matched to evenly spaced income steps ranging from 
39.19 	the medical assistance income limit for families and children in effect on January 1, 1999, 
39.20 	to 275200 percent of the federal poverty guidelines for the applicable family size, up to a 
39.21 	family size of five. The sliding fee scale for a family of five must be used for families of 
39.22 	more than five. The sliding fee scale and percentages are not subject to the provisions of 
39.23 	chapter 14. If a family or individual reports increased income after enrollment, premiums 
39.24 	shall be adjusted at the time the change in income is reported.
39.25 	(b) Children in families whose gross income is above 275 percent of the federal 
39.26 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
39.27 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
39.28 	cases paid the maximum premium, the total revenue would equal the total cost of 
39.29 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
39.30 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
39.31 	for pregnant women and children under age two and the enrollees in these groups shall 
39.32 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
39.33 	maximum premium for one, and the maximum premium for three or more enrollees shall 
39.34 	be three times the maximum premium for one.
40.1 	(c)Beginning July 1, 2009,(b) MinnesotaCare enrollees shall pay premiums 
40.2 	according to the premium scale specified in paragraph (d) (c), with the exception that 
40.3 	children in families with income at or below 200 percent of the federal poverty guidelines 
40.4 	shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly 
40.5 	premium of $4.
40.6 	(d) the following premium scale is established for individuals and families with 
40.7 	gross family incomes of 275 percent of the federal poverty guidelines or less:

40.8	Federal Poverty Guideline Range
	Percent of Average Gross Monthly Income
	
40.9	0-45%
	minimum
	
40.10
40.11	46-54%
	$4 or 1.1% of family income, whichever is 
greater
	
40.12	55-81%
	1.6%
	
40.13	82-109%
	2.2%
	
40.14	110-136%
	2.9%
	
40.15	137-164%
	3.6%
	
40.16	165-191%
	4.6%
	
40.17	192-219%
	5.6%
	
40.18	220-248%
	6.5%
	
40.19	249-275%
	7.2%
	
40.20 	(c) Effective January 1, 2014, the following premium scale is established for 
40.21 	individuals and families with incomes of 200 percent of federal poverty guidelines or less:

40.22	Federal Poverty Guideline Range
	Percent of Average Income
	
40.23	0-45%
	minimum
	
40.24
40.25	46-54%
	$4 or .25% of family income, whichever is 
greater
	
40.26	55-81%
	.5%
	
40.27	82-109%
	1.0%
	
40.28	110-136%
	1.5%
	
40.29	137-164%
	2.0%
	
40.30	165-191%
	2.5%
	
40.31	192-200%
	3.0%

40.32 	EFFECTIVE DATE. This section is effective January 1, 2014, or upon federal 
40.33 	approval, whichever is later. The commissioner of human services shall notify the revisor 
40.34 	of statutes when federal approval is obtained.

40.35 	Sec. 61. Laws 2013, chapter 1, section 1, the effective date, is amended to read:

40.36 	EFFECTIVE DATE. This section is effective January 1, 2014 July 1, 2013.

41.1 	Sec. 62. DETERMINATION OF FUNDING ADEQUACY FOR 
41.2 	MINNESOTACARE.
 41.3 	The commissioners of revenue and management and budget, in consultation with 
41.4 	the commissioner of human services, shall conduct an assessment of health care taxes, 
41.5 	including the gross premiums tax, the provider tax, and Medicaid surcharges, and their 
41.6 	relationship to the long-term solvency of the health care access fund, as part of the state 
41.7 	revenue and expenditure forecast in November 2013. The commissioners shall determine 
41.8 	the amount of state funding that will be required after December 31, 2019, in addition 
41.9 	to the federal payments made available under section 1331 of the Affordable Care Act, 
41.10 	for the MinnesotaCare program. The commissioners shall evaluate the stability and 
41.11 	likelihood of long-term federal funding for the MinnesotaCare program under section 
41.12 	1331. The commissioners shall report the results of this assessment to the chairs and 
41.13 	ranking minority members of the legislative committees with jurisdiction over human 
41.14 	services, finances, and taxes by January 15, 2014, along with recommendations for 
41.15 	changes to state revenue for the health care access fund, if state funding continues to 
41.16 	be required beyond December 31, 2019. 

41.17 	Sec. 63. REVISOR'S INSTRUCTION.
 41.18 	The revisor shall remove cross-references to the sections repealed in this act 
41.19 	wherever they appear in Minnesota Statutes and Minnesota Rules and make changes 
41.20 	necessary to correct the punctuation, grammar, or structure of the remaining text and 
41.21 	preserve its meaning.

41.22 	Sec. 64.  REPEALER.
 41.23 	(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.02, subdivision 
41.24 	3; 256L.031; 256L.04, subdivisions 1b, 7a, and 9; and 256L.11, subdivisions 2a, 5, and 
41.25 	6, are repealed, effective January 1, 2014.
41.26 	(b) Minnesota Statutes 2012, sections 256L.01, subdivision 3; 256L.03, subdivision 
41.27 	4; 256L.04, subdivision 2a; 256L.07, subdivisions 1, 4, 5, 8, and 9; 256L.09, subdivisions 
41.28 	1, 4, 5, 6, and 7; 256L.12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9a, and 9b; and 256L.17, 
41.29 	subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2015.
41.30 	(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b; 
41.31 	256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed.

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

42.4 	Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.5 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
42.6 	electronically submit to the commissioner of health case mix assessments that conform 
42.7 	with the assessment schedule defined by Code of Federal Regulations, title 42, section 
42.8 	483.20, and published by the United States Department of Health and Human Services, 
42.9 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
42.10 	Instrument User's Manual, version 3.0, and subsequent updates when issued by the 
42.11 	Centers for Medicare and Medicaid Services. The commissioner of health may substitute 
42.12 	successor manuals or question and answer documents published by the United States 
42.13 	Department of Health and Human Services, Centers for Medicare and Medicaid Services, 
42.14 	to replace or supplement the current version of the manual or document.
42.15 	(b) The assessments used to determine a case mix classification for reimbursement 
42.16 	include the following:
42.17 	(1) a new admission assessment must be completed by day 14 following admission;
42.18 	(2) an annual assessment which must have an assessment reference date (ARD) 
42.19 	within 366 days of the ARD of the last comprehensive assessment;
42.20 	(3) a significant change assessment must be completed within 14 days of the 
42.21 	identification of a significant change; and
42.22 	(4) all quarterly assessments must have an assessment reference date (ARD) within 
42.23 	92 days of the ARD of the previous assessment.
42.24 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
42.25 	determine nursing facility level of care include the following:
42.26 	(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a 
42.27 	county, tribe, or managed care organization under contract with the Department of Human 
42.28 	Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line 
42.29 	or other organization under contract with the Minnesota Board on Aging; and
42.30 	(2) a nursing facility level of care determination as provided for under section 
42.31 	256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment 
42.32 	completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or 
42.33 	managed care organization under contract with the Department of Human Services.

43.1 	Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.2 	144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 
43.3 	REPORT AND STUDY REQUIRED.
43.4 		Subdivision 1.Report requirements. The commissioners of health and human 
43.5 	services, with the cooperation of counties and in consultation with stakeholders, including 
43.6 	persons who need or are using long-term care services and supports, lead agencies, 
43.7 	regional entities, senior, disability, and mental health organization representatives, service 
43.8 	providers, and community members shall prepare a report to the legislature by August 15, 
43.9 	2013, and biennially thereafter, regarding the status of the full range of long-term care 
43.10 	services and supports for the elderly and children and adults with disabilities and mental 
43.11 	illnesses in Minnesota. The report shall address:
43.12 	(1) demographics and need for long-term care services and supports in Minnesota;
43.13 	(2) summary of county and regional reports on long-term care gaps, surpluses, 
43.14 	imbalances, and corrective action plans;
43.15 	(3) status of long-term care services and related mental health services, housing 
43.16 	options, and supports by county and region including:
43.17 	(i) changes in availability of the range of long-term care services and housing options;
43.18 	(ii) access problems, including access to the least restrictive and most integrated 
43.19 	services and settings, regarding long-term care services; and
43.20 	(iii) comparative measures of long-term care services availability, including serving 
43.21 	people in their home areas near family, and changes over time; and
43.22 	(4) recommendations regarding goals for the future of long-term care services and 
43.23 	supports, policy and fiscal changes, and resource development and transition needs.
43.24 		Subd. 2.Critical access study. The commissioner shall conduct a onetime study to 
43.25 	assess local capacity and availability of home and community-based services for older 
43.26 	adults, people with disabilities, and people with mental illnesses. The study must assess 
43.27 	critical access at the community level and identify potential strategies to build home and 
43.28 	community-based service capacity in critical access areas. The report shall be submitted 
43.29 	to the legislature no later than August 15, 2015.

43.30 	Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
43.31 		Subd. 4a.City, county, and state social workers. (a) Beginning July 1, 2016, the 
43.32 	licensure of city, county, and state agency social workers is voluntary, except an individual 
43.33 	who is newly employed by a city or state agency after July 1, 2016, must be licensed 
43.34 	if the individual who provides social work services, as those services are defined in 
44.1 	section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title 
44.2 	incorporating the words "social work" or "social worker."
44.3 	(b) City, county, and state agencies employing social workers and staff who are 
44.4 	designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and 
44.5 	256.01, subdivision 24, are not required to employ licensed social workers.

44.6 	Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
44.7 		Subd. 2.Specific powers. Subject to the provisions of section 241.021, subdivision 
44.8 	2, the commissioner of human services shall carry out the specific duties in paragraphs (a) 
44.9 	through (cc) (dd):
44.10 	(a) Administer and supervise all forms of public assistance provided for by state law 
44.11 	and other welfare activities or services as are vested in the commissioner. Administration 
44.12 	and supervision of human services activities or services includes, but is not limited to, 
44.13 	assuring timely and accurate distribution of benefits, completeness of service, and quality 
44.14 	program management. In addition to administering and supervising human services 
44.15 	activities vested by law in the department, the commissioner shall have the authority to:
44.16 	(1) require county agency participation in training and technical assistance programs 
44.17 	to promote compliance with statutes, rules, federal laws, regulations, and policies 
44.18 	governing human services;
44.19 	(2) monitor, on an ongoing basis, the performance of county agencies in the 
44.20 	operation and administration of human services, enforce compliance with statutes, rules, 
44.21 	federal laws, regulations, and policies governing welfare services and promote excellence 
44.22 	of administration and program operation;
44.23 	(3) develop a quality control program or other monitoring program to review county 
44.24 	performance and accuracy of benefit determinations;
44.25 	(4) require county agencies to make an adjustment to the public assistance benefits 
44.26 	issued to any individual consistent with federal law and regulation and state law and rule 
44.27 	and to issue or recover benefits as appropriate;
44.28 	(5) delay or deny payment of all or part of the state and federal share of benefits and 
44.29 	administrative reimbursement according to the procedures set forth in section 256.017;
44.30 	(6) make contracts with and grants to public and private agencies and organizations, 
44.31 	both profit and nonprofit, and individuals, using appropriated funds; and
44.32 	(7) enter into contractual agreements with federally recognized Indian tribes with 
44.33 	a reservation in Minnesota to the extent necessary for the tribe to operate a federally 
44.34 	approved family assistance program or any other program under the supervision of the 
44.35 	commissioner. The commissioner shall consult with the affected county or counties in 
45.1 	the contractual agreement negotiations, if the county or counties wish to be included, 
45.2 	in order to avoid the duplication of county and tribal assistance program services. The 
45.3 	commissioner may establish necessary accounts for the purposes of receiving and 
45.4 	disbursing funds as necessary for the operation of the programs.
45.5 	(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, 
45.6 	regulation, and policy necessary to county agency administration of the programs.
45.7 	(c) Administer and supervise all child welfare activities; promote the enforcement of 
45.8 	laws protecting disabled, dependent, neglected and delinquent children, and children born 
45.9 	to mothers who were not married to the children's fathers at the times of the conception 
45.10 	nor at the births of the children; license and supervise child-caring and child-placing 
45.11 	agencies and institutions; supervise the care of children in boarding and foster homes or 
45.12 	in private institutions; and generally perform all functions relating to the field of child 
45.13 	welfare now vested in the State Board of Control.
45.14 	(d) Administer and supervise all noninstitutional service to disabled persons, 
45.15 	including those who are visually impaired, hearing impaired, or physically impaired 
45.16 	or otherwise disabled. The commissioner may provide and contract for the care and 
45.17 	treatment of qualified indigent children in facilities other than those located and available 
45.18 	at state hospitals when it is not feasible to provide the service in state hospitals.
45.19 	(e) Assist and actively cooperate with other departments, agencies and institutions, 
45.20 	local, state, and federal, by performing services in conformity with the purposes of Laws 
45.21 	1939, chapter 431.
45.22 	(f) Act as the agent of and cooperate with the federal government in matters of 
45.23 	mutual concern relative to and in conformity with the provisions of Laws 1939, chapter 
45.24 	431, including the administration of any federal funds granted to the state to aid in the 
45.25 	performance of any functions of the commissioner as specified in Laws 1939, chapter 431, 
45.26 	and including the promulgation of rules making uniformly available medical care benefits 
45.27 	to all recipients of public assistance, at such times as the federal government increases its 
45.28 	participation in assistance expenditures for medical care to recipients of public assistance, 
45.29 	the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
45.30 	(g) Establish and maintain any administrative units reasonably necessary for the 
45.31 	performance of administrative functions common to all divisions of the department.
45.32 	(h) Act as designated guardian of both the estate and the person of all the wards of 
45.33 	the state of Minnesota, whether by operation of law or by an order of court, without any 
45.34 	further act or proceeding whatever, except as to persons committed as developmentally 
45.35 	disabled. For children under the guardianship of the commissioner or a tribe in Minnesota 
45.36 	recognized by the Secretary of the Interior whose interests would be best served by 
46.1 	adoptive placement, the commissioner may contract with a licensed child-placing agency 
46.2 	or a Minnesota tribal social services agency to provide adoption services. A contract 
46.3 	with a licensed child-placing agency must be designed to supplement existing county 
46.4 	efforts and may not replace existing county programs or tribal social services, unless the 
46.5 	replacement is agreed to by the county board and the appropriate exclusive bargaining 
46.6 	representative, tribal governing body, or the commissioner has evidence that child 
46.7 	placements of the county continue to be substantially below that of other counties. Funds 
46.8 	encumbered and obligated under an agreement for a specific child shall remain available 
46.9 	until the terms of the agreement are fulfilled or the agreement is terminated.
46.10 	(i) Act as coordinating referral and informational center on requests for service for 
46.11 	newly arrived immigrants coming to Minnesota.
46.12 	(j) The specific enumeration of powers and duties as hereinabove set forth shall in no 
46.13 	way be construed to be a limitation upon the general transfer of powers herein contained.
46.14 	(k) Establish county, regional, or statewide schedules of maximum fees and charges 
46.15 	which may be paid by county agencies for medical, dental, surgical, hospital, nursing and 
46.16 	nursing home care and medicine and medical supplies under all programs of medical 
46.17 	care provided by the state and for congregate living care under the income maintenance 
46.18 	programs.
46.19 	(l) Have the authority to conduct and administer experimental projects to test methods 
46.20 	and procedures of administering assistance and services to recipients or potential recipients 
46.21 	of public welfare. To carry out such experimental projects, it is further provided that the 
46.22 	commissioner of human services is authorized to waive the enforcement of existing specific 
46.23 	statutory program requirements, rules, and standards in one or more counties. The order 
46.24 	establishing the waiver shall provide alternative methods and procedures of administration, 
46.25 	shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and 
46.26 	in no event shall the duration of a project exceed four years. It is further provided that no 
46.27 	order establishing an experimental project as authorized by the provisions of this section 
46.28 	shall become effective until the following conditions have been met:
46.29 	(1) the secretary of health and human services of the United States has agreed, for 
46.30 	the same project, to waive state plan requirements relative to statewide uniformity; and
46.31 	(2) a comprehensive plan, including estimated project costs, shall be approved by 
46.32 	the Legislative Advisory Commission and filed with the commissioner of administration.
46.33 	(m) According to federal requirements, establish procedures to be followed by 
46.34 	local welfare boards in creating citizen advisory committees, including procedures for 
46.35 	selection of committee members.
47.1 	(n) Allocate federal fiscal disallowances or sanctions which are based on quality 
47.2 	control error rates for the aid to families with dependent children program formerly 
47.3 	codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the 
47.4 	following manner:
47.5 	(1) one-half of the total amount of the disallowance shall be borne by the county 
47.6 	boards responsible for administering the programs. For the medical assistance and the 
47.7 	AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be 
47.8 	shared by each county board in the same proportion as that county's expenditures for the 
47.9 	sanctioned program are to the total of all counties' expenditures for the AFDC program 
47.10 	formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the 
47.11 	food stamp program, sanctions shall be shared by each county board, with 50 percent of 
47.12 	the sanction being distributed to each county in the same proportion as that county's 
47.13 	administrative costs for food stamps are to the total of all food stamp administrative costs 
47.14 	for all counties, and 50 percent of the sanctions being distributed to each county in the 
47.15 	same proportion as that county's value of food stamp benefits issued are to the total of 
47.16 	all benefits issued for all counties. Each county shall pay its share of the disallowance 
47.17 	to the state of Minnesota. When a county fails to pay the amount due hereunder, the 
47.18 	commissioner may deduct the amount from reimbursement otherwise due the county, or 
47.19 	the attorney general, upon the request of the commissioner, may institute civil action 
47.20 	to recover the amount due; and
47.21 	(2) notwithstanding the provisions of clause (1), if the disallowance results from 
47.22 	knowing noncompliance by one or more counties with a specific program instruction, and 
47.23 	that knowing noncompliance is a matter of official county board record, the commissioner 
47.24 	may require payment or recover from the county or counties, in the manner prescribed in 
47.25 	clause (1), an amount equal to the portion of the total disallowance which resulted from the 
47.26 	noncompliance, and may distribute the balance of the disallowance according to clause (1).
47.27 	(o) Develop and implement special projects that maximize reimbursements and 
47.28 	result in the recovery of money to the state. For the purpose of recovering state money, 
47.29 	the commissioner may enter into contracts with third parties. Any recoveries that result 
47.30 	from projects or contracts entered into under this paragraph shall be deposited in the 
47.31 	state treasury and credited to a special account until the balance in the account reaches 
47.32 	$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be 
47.33 	transferred and credited to the general fund. All money in the account is appropriated to 
47.34 	the commissioner for the purposes of this paragraph.
47.35 	(p) Have the authority to make direct payments to facilities providing shelter 
47.36 	to women and their children according to section 256D.05, subdivision 3. Upon 
48.1 	the written request of a shelter facility that has been denied payments under section 
48.2 	256D.05, subdivision 3, the commissioner shall review all relevant evidence and make 
48.3 	a determination within 30 days of the request for review regarding issuance of direct 
48.4 	payments to the shelter facility. Failure to act within 30 days shall be considered a 
48.5 	determination not to issue direct payments.
48.6 	(q) Have the authority to establish and enforce the following county reporting 
48.7 	requirements:
48.8 	(1) the commissioner shall establish fiscal and statistical reporting requirements 
48.9 	necessary to account for the expenditure of funds allocated to counties for human 
48.10 	services programs. When establishing financial and statistical reporting requirements, the 
48.11 	commissioner shall evaluate all reports, in consultation with the counties, to determine if 
48.12 	the reports can be simplified or the number of reports can be reduced;
48.13 	(2) the county board shall submit monthly or quarterly reports to the department 
48.14 	as required by the commissioner. Monthly reports are due no later than 15 working days 
48.15 	after the end of the month. Quarterly reports are due no later than 30 calendar days after 
48.16 	the end of the quarter, unless the commissioner determines that the deadline must be 
48.17 	shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines 
48.18 	or risking a loss of federal funding. Only reports that are complete, legible, and in the 
48.19 	required format shall be accepted by the commissioner;
48.20 	(3) if the required reports are not received by the deadlines established in clause (2), 
48.21 	the commissioner may delay payments and withhold funds from the county board until 
48.22 	the next reporting period. When the report is needed to account for the use of federal 
48.23 	funds and the late report results in a reduction in federal funding, the commissioner shall 
48.24 	withhold from the county boards with late reports an amount equal to the reduction in 
48.25 	federal funding until full federal funding is received;
48.26 	(4) a county board that submits reports that are late, illegible, incomplete, or not 
48.27 	in the required format for two out of three consecutive reporting periods is considered 
48.28 	noncompliant. When a county board is found to be noncompliant, the commissioner 
48.29 	shall notify the county board of the reason the county board is considered noncompliant 
48.30 	and request that the county board develop a corrective action plan stating how the 
48.31 	county board plans to correct the problem. The corrective action plan must be submitted 
48.32 	to the commissioner within 45 days after the date the county board received notice 
48.33 	of noncompliance;
48.34 	(5) the final deadline for fiscal reports or amendments to fiscal reports is one year 
48.35 	after the date the report was originally due. If the commissioner does not receive a report 
48.36 	by the final deadline, the county board forfeits the funding associated with the report for 
49.1 	that reporting period and the county board must repay any funds associated with the 
49.2 	report received for that reporting period;
49.3 	(6) the commissioner may not delay payments, withhold funds, or require repayment 
49.4 	under clause (3) or (5) if the county demonstrates that the commissioner failed to 
49.5 	provide appropriate forms, guidelines, and technical assistance to enable the county to 
49.6 	comply with the requirements. If the county board disagrees with an action taken by the 
49.7 	commissioner under clause (3) or (5), the county board may appeal the action according 
49.8 	to sections 14.57 to 14.69; and
49.9 	(7) counties subject to withholding of funds under clause (3) or forfeiture or 
49.10 	repayment of funds under clause (5) shall not reduce or withhold benefits or services to 
49.11 	clients to cover costs incurred due to actions taken by the commissioner under clause 
49.12 	(3) or (5).
49.13 	(r) Allocate federal fiscal disallowances or sanctions for audit exceptions when 
49.14 	federal fiscal disallowances or sanctions are based on a statewide random sample in direct 
49.15 	proportion to each county's claim for that period.
49.16 	(s) Be responsible for ensuring the detection, prevention, investigation, and 
49.17 	resolution of fraudulent activities or behavior by applicants, recipients, and other 
49.18 	participants in the human services programs administered by the department.
49.19 	(t) Require county agencies to identify overpayments, establish claims, and utilize 
49.20 	all available and cost-beneficial methodologies to collect and recover these overpayments 
49.21 	in the human services programs administered by the department.
49.22 	(u) Have the authority to administer a drug rebate program for drugs purchased 
49.23 	pursuant to the prescription drug program established under section 256.955 after the 
49.24 	beneficiary's satisfaction of any deductible established in the program. The commissioner 
49.25 	shall require a rebate agreement from all manufacturers of covered drugs as defined in 
49.26 	section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on 
49.27 	or after July 1, 2002, must include rebates for individuals covered under the prescription 
49.28 	drug program who are under 65 years of age. For each drug, the amount of the rebate shall 
49.29 	be equal to the rebate as defined for purposes of the federal rebate program in United 
49.30 	States Code, title 42, section 1396r-8. The manufacturers must provide full payment 
49.31 	within 30 days of receipt of the state invoice for the rebate within the terms and conditions 
49.32 	used for the federal rebate program established pursuant to section 1927 of title XIX of 
49.33 	the Social Security Act. The manufacturers must provide the commissioner with any 
49.34 	information necessary to verify the rebate determined per drug. The rebate program shall 
49.35 	utilize the terms and conditions used for the federal rebate program established pursuant to 
49.36 	section 1927 of title XIX of the Social Security Act.
50.1 	(v) Have the authority to administer the federal drug rebate program for drugs 
50.2 	purchased under the medical assistance program as allowed by section 1927 of title XIX 
50.3 	of the Social Security Act and according to the terms and conditions of section 1927. 
50.4 	Rebates shall be collected for all drugs that have been dispensed or administered in an 
50.5 	outpatient setting and that are from manufacturers who have signed a rebate agreement 
50.6 	with the United States Department of Health and Human Services.
50.7 	(w) Have the authority to administer a supplemental drug rebate program for drugs 
50.8 	purchased under the medical assistance program. The commissioner may enter into 
50.9 	supplemental rebate contracts with pharmaceutical manufacturers and may require prior 
50.10 	authorization for drugs that are from manufacturers that have not signed a supplemental 
50.11 	rebate contract. Prior authorization of drugs shall be subject to the provisions of section 
50.12 	256B.0625, subdivision 13.
50.13 	(x) Operate the department's communication systems account established in Laws 
50.14 	1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared 
50.15 	communication costs necessary for the operation of the programs the commissioner 
50.16 	supervises. A communications account may also be established for each regional 
50.17 	treatment center which operates communications systems. Each account must be used 
50.18 	to manage shared communication costs necessary for the operations of the programs the 
50.19 	commissioner supervises. The commissioner may distribute the costs of operating and 
50.20 	maintaining communication systems to participants in a manner that reflects actual usage. 
50.21 	Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and 
50.22 	other costs as determined by the commissioner. Nonprofit organizations and state, county, 
50.23 	and local government agencies involved in the operation of programs the commissioner 
50.24 	supervises may participate in the use of the department's communications technology and 
50.25 	share in the cost of operation. The commissioner may accept on behalf of the state any 
50.26 	gift, bequest, devise or personal property of any kind, or money tendered to the state for 
50.27 	any lawful purpose pertaining to the communication activities of the department. Any 
50.28 	money received for this purpose must be deposited in the department's communication 
50.29 	systems accounts. Money collected by the commissioner for the use of communication 
50.30 	systems must be deposited in the state communication systems account and is appropriated 
50.31 	to the commissioner for purposes of this section.
50.32 	(y) Receive any federal matching money that is made available through the medical 
50.33 	assistance program for the consumer satisfaction survey. Any federal money received for 
50.34 	the survey is appropriated to the commissioner for this purpose. The commissioner may 
50.35 	expend the federal money received for the consumer satisfaction survey in either year of 
50.36 	the biennium.
51.1 	(z) Designate community information and referral call centers and incorporate 
51.2 	cost reimbursement claims from the designated community information and referral 
51.3 	call centers into the federal cost reimbursement claiming processes of the department 
51.4 	according to federal law, rule, and regulations. Existing information and referral centers 
51.5 	provided by Greater Twin Cities United Way or existing call centers for which Greater 
51.6 	Twin Cities United Way has legal authority to represent, shall be included in these 
51.7 	designations upon review by the commissioner and assurance that these services are 
51.8 	accredited and in compliance with national standards. Any reimbursement is appropriated 
51.9 	to the commissioner and all designated information and referral centers shall receive 
51.10 	payments according to normal department schedules established by the commissioner 
51.11 	upon final approval of allocation methodologies from the United States Department of 
51.12 	Health and Human Services Division of Cost Allocation or other appropriate authorities.
51.13 	(aa) Develop recommended standards for foster care homes that address the 
51.14 	components of specialized therapeutic services to be provided by foster care homes with 
51.15 	those services.
51.16 	(bb) Authorize the method of payment to or from the department as part of the 
51.17 	human services programs administered by the department. This authorization includes the 
51.18 	receipt or disbursement of funds held by the department in a fiduciary capacity as part of 
51.19 	the human services programs administered by the department.
51.20 	(cc) Have the authority to administer a drug rebate program for drugs purchased for 
51.21 	persons eligible for general assistance medical care under section 256D.03, subdivision 3. 
51.22 	For manufacturers that agree to participate in the general assistance medical care rebate 
51.23 	program, the commissioner shall enter into a rebate agreement for covered drugs as 
51.24 	defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the 
51.25 	rebate shall be equal to the rebate as defined for purposes of the federal rebate program in 
51.26 	United States Code, title 42, section 1396r-8. The manufacturers must provide payment 
51.27 	within the terms and conditions used for the federal rebate program established under 
51.28 	section 1927 of title XIX of the Social Security Act. The rebate program shall utilize 
51.29 	the terms and conditions used for the federal rebate program established under section 
51.30 	1927 of title XIX of the Social Security Act.
51.31 	Effective January 1, 2006, drug coverage under general assistance medical care shall 
51.32 	be limited to those prescription drugs that:
51.33 	(1) are covered under the medical assistance program as described in section 
51.34 	256B.0625, subdivisions 13 and 13d; and
51.35 	(2) are provided by manufacturers that have fully executed general assistance 
51.36 	medical care rebate agreements with the commissioner and comply with such agreements. 
52.1 	Prescription drug coverage under general assistance medical care shall conform to 
52.2 	coverage under the medical assistance program according to section 256B.0625, 
52.3 	subdivisions 13 to 13g.
52.4 	The rebate revenues collected under the drug rebate program are deposited in the 
52.5 	general fund.
52.6 	(dd) Designate the agencies that operate the Senior LinkAge Line under section 
52.7 	256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state 
52.8 	of Minnesota Aging and the Disability Resource Centers under United States Code, title 
52.9 	42, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost 
52.10 	reimbursement claims from the designated centers into the federal cost reimbursement 
52.11 	claiming processes of the department according to federal law, rule, and regulations. Any 
52.12 	reimbursement must be appropriated to the commissioner and all Aging and Disability 
52.13 	Resource Center designated agencies shall receive payments of grant funding that supports 
52.14 	the activity and generates the federal financial participation according to Board on Aging 
52.15 	administrative granting mechanisms.

52.16 	Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
52.17 		Subd. 24.Disability Linkage Line. The commissioner shall establish the Disability 
52.18 	Linkage Line, towhich shall serve people with disabilities as the designated Aging and 
52.19 	Disability Resource Center under United States Code, title 42, section 3001, the Older 
52.20 	Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and 
52.21 	shall serve as Minnesota's neutral access point for statewide disability information and 
52.22 	assistance and must be available during business hours through a statewide toll-free 
52.23 	number and the Internet. The Disability Linkage Line shall:
52.24 	(1) deliver information and assistance based on national and state standards;
52.25 	(2) provide information about state and federal eligibility requirements, benefits, 
52.26 	and service options;
52.27 	(3) provide benefits and options counseling;
52.28 	(4) make referrals to appropriate support entities;
52.29 	(5) educate people on their options so they can make well-informed choices and link 
52.30 	them to quality profiles;
52.31 	(6) help support the timely resolution of service access and benefit issues;
52.32 	(7) inform people of their long-term community services and supports;
52.33 	(8) provide necessary resources and supports that can lead to employment and 
52.34 	increased economic stability of people with disabilities; and
53.1 	(9) serve as the technical assistance and help center for the Web-based tool, 
53.2 	Minnesota's Disability Benefits 101.org.; and
53.3 	(10) provide preadmission screening for individuals under 60 years of age using 
53.4 	the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911, 
53.5 	subdivision 4d.

53.6 	Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
53.7 		Subd. 7.Consumer information and assistance and long-term care options 
53.8 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
53.9 	statewide service to aid older Minnesotans and their families in making informed choices 
53.10 	about long-term care options and health care benefits. Language services to persons 
53.11 	with limited English language skills may be made available. The service, known as 
53.12 	Senior LinkAge Line, shall serve older adults as the designated Aging and Disability 
53.13 	Resource Center under United States Code, title 42, section 3001, the Older Americans 
53.14 	Act Amendments of 2006, in partnership with the Disability LinkAge Line under section 
53.15 	256.01, subdivision 24, and must be available during business hours through a statewide 
53.16 	toll-free number and must also be available through the Internet. The Minnesota Board 
53.17 	on Aging shall consult with, and when appropriate work through, the area agencies on 
53.18 	aging to provide and maintain the telephone infrastructure and related support for the 
53.19 	Aging and Disability Resource Center partners that agree by memorandum to access the 
53.20 	infrastructure, including the designated providers of the Senior LinkAge Line and the 
53.21 	Disability Linkage Line.
53.22 	(b) The service must provide long-term care options counseling by assisting older 
53.23 	adults, caregivers, and providers in accessing information and options counseling about 
53.24 	choices in long-term care services that are purchased through private providers or available 
53.25 	through public options. The service must:
53.26 	(1) develop a comprehensive database that includes detailed listings in both 
53.27 	consumer- and provider-oriented formats;
53.28 	(2) make the database accessible on the Internet and through other telecommunication 
53.29 	and media-related tools;
53.30 	(3) link callers to interactive long-term care screening tools and make these tools 
53.31 	available through the Internet by integrating the tools with the database;
53.32 	(4) develop community education materials with a focus on planning for long-term 
53.33 	care and evaluating independent living, housing, and service options;
53.34 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
53.35 	finding information on the Internet and through other means of communication;
54.1 	(6) implement a messaging system for overflow callers and respond to these callers 
54.2 	by the next business day;
54.3 	(7) link callers with county human services and other providers to receive more 
54.4 	in-depth assistance and consultation related to long-term care options;
54.5 	(8) link callers with quality profiles for nursing facilities and other home and 
54.6 	community-based services providers developed by the commissioner commissioners of 
54.7 	health and human services;
54.8 	(9) incorporate information about the availability of housing options, as well as 
54.9 	registered housing with services and consumer rights within the MinnesotaHelp.info 
54.10 	network long-term care database to facilitate consumer comparison of services and costs 
54.11 	among housing with services establishments and with other in-home services and to 
54.12 	support financial self-sufficiency as long as possible. Housing with services establishments 
54.13 	and their arranged home care providers shall provide information that will facilitate price 
54.14 	comparisons, including delineation of charges for rent and for services available. The 
54.15 	commissioners of health and human services shall align the data elements required by 
54.16 	section 144G.06, the Uniform Consumer Information Guide, and this section to provide 
54.17 	consumers standardized information and ease of comparison of long-term care options. 
54.18 	The commissioner of human services shall provide the data to the Minnesota Board on 
54.19 	Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.20 	(10) provide long-term care options counseling. Long-term care options counselors 
54.21 	shall:
54.22 	(i) for individuals not eligible for case management under a public program or public 
54.23 	funding source, provide interactive decision support under which consumers, family 
54.24 	members, or other helpers are supported in their deliberations to determine appropriate 
54.25 	long-term care choices in the context of the consumer's needs, preferences, values, and 
54.26 	individual circumstances, including implementing a community support plan;
54.27 	(ii) provide Web-based educational information and collateral written materials to 
54.28 	familiarize consumers, family members, or other helpers with the long-term care basics, 
54.29 	issues to be considered, and the range of options available in the community;
54.30 	(iii) provide long-term care futures planning, which means providing assistance to 
54.31 	individuals who anticipate having long-term care needs to develop a plan for the more 
54.32 	distant future; and
54.33 	(iv) provide expertise in benefits and financing options for long-term care, including 
54.34 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
54.35 	private pay options, and ways to access low or no-cost services or benefits through 
54.36 	volunteer-based or charitable programs;
55.1 	(11) using risk management and support planning protocols, provide long-term care 
55.2 	options counseling to current residents of nursing homes deemed appropriate for discharge 
55.3 	by the commissioner and older adults who request service after consultation with the 
55.4 	Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior 
55.5 	LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The 
55.6 	Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge 
55.7 	by developing targeting criteria in consultation with the commissioner who shall provide 
55.8 	designated Senior LinkAge Line contact centers with a list of nursing home residents that 
55.9 	meet the criteria as being appropriate for discharge planning via a secure Web portal. 
55.10 	Senior LinkAge Line shall provide these residents, if they indicate a preference to 
55.11 	receive long-term care options counseling, with initial assessment, review of risk factors, 
55.12 	independent living support consultation, or and, if appropriate, a referral to:
55.13 	(i) long-term care consultation services under section 256B.0911;
55.14 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
55.15 	persons who are enrolled in a managed care plan; or
55.16 	(iii) the long-term care consultation team for those who are appropriate eligible
55.17 	 for relocation service coordination due to high-risk factors or psychological or physical 
55.18 	disability; and
55.19 	(12) develop referral protocols and processes that will assist certified health care 
55.20 	homes and hospitals to identify at-risk older adults and determine when to refer these 
55.21 	individuals to the Senior LinkAge Line for long-term care options counseling under this 
55.22 	section. The commissioner is directed to work with the commissioner of health to develop 
55.23 	protocols that would comply with the health care home designation criteria and protocols 
55.24 	available at the time of hospital discharge. The commissioner shall keep a record of the 
55.25 	number of people who choose long-term care options counseling as a result of this section.

55.26 	Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
55.27 	to read:
55.28 		Subd. 7a.Preadmission screening activities related to nursing facility 
55.29 	admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities, 
55.30 	including certified boarding care facilities, must be screened prior to admission regardless 
55.31 	of income, assets, or funding sources for nursing facility care, except as described in 
55.32 	subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the 
55.33 	need for nursing facility level of care as described in section 256B.0911, subdivision 
55.34 	4e, and to complete activities required under federal law related to mental illness and 
55.35 	developmental disability as outlined in paragraph (b).
56.1 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
56.2 	developmental disability must receive a preadmission screening before admission 
56.3 	regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify 
56.4 	the need for further evaluation and specialized services, unless the admission prior to 
56.5 	screening is authorized by the local mental health authority or the local developmental 
56.6 	disabilities case manager, or unless authorized by the county agency according to Public 
56.7 	Law 101-508.
56.8 	(c) The following criteria apply to the preadmission screening:
56.9 	(1) requests for preadmission screenings must be submitted via an online form 
56.10 	developed by the commissioner;
56.11 	(2) the Senior LinkAge Line must use forms and criteria developed by the 
56.12 	commissioner to identify persons who require referral for further evaluation and 
56.13 	determination of the need for specialized services; and
56.14 	(3) the evaluation and determination of the need for specialized services must be 
56.15 	done by:
56.16 	(i) a qualified independent mental health professional, for persons with a primary or 
56.17 	secondary diagnosis of a serious mental illness; or
56.18 	(ii) a qualified developmental disability professional, for persons with a primary or 
56.19 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
56.20 	qualified developmental disability professional must meet the standards for a qualified 
56.21 	developmental disability professional under Code of Federal Regulations, title 42, section 
56.22 	483.430.
56.23 	(d) The local county mental health authority or the state developmental disability 
56.24 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
56.25 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
56.26 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
56.27 	purposes of this section, "specialized services" for a person with developmental disability 
56.28 	means active treatment as that term is defined under Code of Federal Regulations, title 
56.29 	42, section 483.440(a)(1).
56.30 	(e) In assessing a person's needs, the screener shall:
56.31 	(1) use an automated system designated by the commissioner;
56.32 	(2) consult with care transitions coordinators or physician; and
56.33 	(3) consider the assessment of the individual's physician.
56.34 	Other personnel may be included in the level of care determination as deemed 
56.35 	necessary by the screener.

56.36 	EFFECTIVE DATE. This section is effective October 1, 2013.

57.1 	Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
57.2 	to read:
57.3 		Subd. 7b.Exemptions and emergency admissions. (a) Exemptions from the federal 
57.4 	screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
57.5 	(1) a person who, having entered an acute care facility from a certified nursing 
57.6 	facility, is returning to a certified nursing facility; or
57.7 	(2) a person transferring from one certified nursing facility in Minnesota to another 
57.8 	certified nursing facility in Minnesota.
57.9 	(b) Persons who are exempt from preadmission screening for purposes of level of 
57.10 	care determination include:
57.11 	(1) persons described in paragraph (a);
57.12 	(2) an individual who has a contractual right to have nursing facility care paid for 
57.13 	indefinitely by the Veterans' Administration;
57.14 	(3) an individual enrolled in a demonstration project under section 256B.69, 
57.15 	subdivision 8, at the time of application to a nursing facility; and
57.16 	(4) an individual currently being served under the alternative care program or under 
57.17 	a home and community-based services waiver authorized under section 1915(c) of the 
57.18 	federal Social Security Act.
57.19 	(c) Persons admitted to a Medicaid-certified nursing facility from the community 
57.20 	on an emergency basis as described in paragraph (d) or from an acute care facility on a 
57.21 	nonworking day must be screened the first working day after admission.
57.22 	(d) Emergency admission to a nursing facility prior to screening is permitted when 
57.23 	all of the following conditions are met:
57.24 	(1) a person is admitted from the community to a certified nursing or certified 
57.25 	boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and 
57.26 	older and Disability Linkage Line nonworking hours for under age 60;
57.27 	(2) a physician has determined that delaying admission until preadmission screening 
57.28 	is completed would adversely affect the person's health and safety;
57.29 	(3) there is a recent precipitating event that precludes the client from living safely in 
57.30 	the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 
57.31 	inability to continue to provide care;
57.32 	(4) the attending physician has authorized the emergency placement and has 
57.33 	documented the reason that the emergency placement is recommended; and
57.34 	(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first 
57.35 	working day following the emergency admission.
58.1 	Transfer of a patient from an acute care hospital to a nursing facility is not considered 
58.2 	an emergency except for a person who has received hospital services in the following 
58.3 	situations: hospital admission for observation, care in an emergency room without hospital 
58.4 	admission, or following hospital 24-hour bed care and from whom admission is being 
58.5 	sought on a nonworking day.
58.6 	(e) A nursing facility must provide written information to all persons admitted 
58.7 	regarding the person's right to request and receive long-term care consultation services as 
58.8 	defined in section 256B.0911, subdivision 1a. The information must be provided prior to 
58.9 	the person's discharge from the facility and in a format specified by the commissioner.

58.10 	EFFECTIVE DATE. This section is effective October 1, 2013.

58.11 	Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
58.12 	to read:
58.13 		Subd. 7c.Screening requirements. (a) A person may be screened for nursing 
58.14 	facility admission by telephone or in a face-to-face screening interview. The Senior 
58.15 	LinkAge Line shall identify each individual's needs using the following categories:
58.16 	(1) the person needs no face-to-face long-term care consultation assessment 
58.17 	completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or 
58.18 	managed care organization under contract with the Department of Human Services to 
58.19 	determine the need for nursing facility level of care based on information obtained from 
58.20 	other health care professionals;
58.21 	(2) the person needs an immediate face-to-face long-term care consultation 
58.22 	assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, 
58.23 	tribe, or managed care organization under contract with the Department of Human 
58.24 	Services to determine the need for nursing facility level of care and complete activities 
58.25 	required under subdivision 7a; or
58.26 	(3) the person may be exempt from screening requirements as outlined in subdivision 
58.27 	7b, but will need transitional assistance after admission or in-person follow-along after 
58.28 	a return home.
58.29 	(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities 
58.30 	with only a telephone screening must receive a face-to-face assessment from the long-term 
58.31 	care consultation team member of the county in which the facility is located or from the 
58.32 	recipient's county case manager within 40 calendar days of admission as described in 
58.33 	section 256B.0911, subdivision 4d, paragraph (c).
58.34 	(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 
58.35 	facility must be screened prior to admission.
59.1 	(d) Screenings provided by the Senior LinkAge Line must include processes 
59.2 	to identify persons who may require transition assistance described in subdivision 7, 
59.3 	paragraph (b), clause (12), and section 256B.0911, subdivision 3b.

59.4 	EFFECTIVE DATE. This section is effective October 1, 2013.

59.5 	Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
59.6 	to read:
59.7 		Subd. 7d.Payment for preadmission screening. Funding for preadmission 
59.8 	screening shall be provided to the Minnesota Board on Aging for the population 60 
59.9 	years of age and older by the Department of Human Services to cover screener salaries 
59.10 	and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota 
59.11 	Board on Aging shall employ, or contract with other agencies to employ, within the limits 
59.12 	of available funding, sufficient personnel to provide preadmission screening and level of 
59.13 	care determination services and shall seek to maximize federal funding for the service as 
59.14 	provided under section 256.01, subdivision 2, paragraph (dd).

59.15 	EFFECTIVE DATE. This section is effective October 1, 2013.

59.16 	Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a 
59.17 	subdivision to read:
59.18 		Subd. 3a.Priority for other grants. The commissioner of health shall give 
59.19 	priority to a grantee selected under subdivision 3 when awarding technology-related 
59.20 	grants, if the grantee is using technology as a part of a proposal, unless that priority 
59.21 	conflicts with existing state or federal guidance related to grant awards by the Department 
59.22 	of Health. The commissioner of transportation shall give priority to a grantee selected 
59.23 	under subdivision 3 when distributing transportation-related funds to create transportation 
59.24 	options for older adults.

59.25 	Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a 
59.26 	subdivision to read:
59.27 		Subd. 3b.State waivers. The commissioner of health may waive applicable state 
59.28 	laws and rules on a time-limited basis if the commissioner of health determines that a 
59.29 	participating grantee requires a waiver in order to achieve demonstration project goals.

59.30 	Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.1 		Subd. 5.Grant preference. The commissioner of human services shall give 
60.2 	preference when awarding grants under this section to areas where nursing facility 
60.3 	closures have occurred or are occurring or areas with service needs identified by section 
60.4 	144A.351. The commissioner may award grants to the extent grant funds are available 
60.5 	and to the extent applications are approved by the commissioner. Denial of approval of an 
60.6 	application in one year does not preclude submission of an application in a subsequent 
60.7 	year. The maximum grant amount is limited to $750,000.

60.8 	Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a 
60.9 	subdivision to read:
60.10 		Subd. 4a.Evaluation. The commissioner shall evaluate the projects contained in 
60.11 	subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
60.12 	(1) an impact assessment focusing on program outcomes, especially those 
60.13 	experienced directly by the person receiving services;
60.14 	(2) study samples drawn from the population of interest for each project; and
60.15 	(3) a time series analysis to examine aggregate trends in average monthly 
60.16 	utilization, expenditures, and other outcomes in the targeted populations before and after 
60.17 	implementation of the initiatives.

60.18 	Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a 
60.19 	subdivision to read:
60.20 		Subd. 6.Work, empower, and encourage independence. As provided under 
60.21 	subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a 
60.22 	demonstration project to provide navigation, employment supports, and benefits planning 
60.23 	services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014. 
60.24 	This demonstration shall promote economic stability, increase independence, and reduce 
60.25 	applications for disability benefits while providing a positive impact on the health and 
60.26 	future of participants.

60.27 	Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a 
60.28 	subdivision to read:
60.29 		Subd. 7.Housing stabilization. As provided under subdivision 4, paragraph (e), 
60.30 	upon federal approval, the commissioner shall establish a demonstration project to provide 
60.31 	service coordination, outreach, in-reach, tenancy support, and community living assistance 
60.32 	to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This 
61.1 	demonstration shall promote housing stability, reduce costly medical interventions, and 
61.2 	increase opportunities for independent community living.

61.3 	Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
61.4 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation 
61.5 	services is to assist persons with long-term or chronic care needs in making care 
61.6 	decisions and selecting support and service options that meet their needs and reflect 
61.7 	their preferences. The availability of, and access to, information and other types of 
61.8 	assistance, including assessment and support planning, is also intended to prevent or delay 
61.9 	institutional placements and to provide access to transition assistance after admission. 
61.10 	Further, the goal of these services is to contain costs associated with unnecessary 
61.11 	institutional admissions. Long-term consultation services must be available to any person 
61.12 	regardless of public program eligibility. The commissioner of human services shall seek 
61.13 	to maximize use of available federal and state funds and establish the broadest program 
61.14 	possible within the funding available.
61.15 	(b) These services must be coordinated with long-term care options counseling 
61.16 	provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and 
61.17 	section 256.01, subdivision 24. The lead agency providing long-term care consultation 
61.18 	services shall encourage the use of volunteers from families, religious organizations, social 
61.19 	clubs, and similar civic and service organizations to provide community-based services.

61.20 	Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to 
61.21 	read:
61.22 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
61.23 	(a) Until additional requirements apply under paragraph (b), "long-term care 
61.24 	consultation services" means:
61.25 	(1) intake for and access to assistance in identifying services needed to maintain an 
61.26 	individual in the most inclusive environment;
61.27 	(2) providing recommendations for and referrals to cost-effective community 
61.28 	services that are available to the individual;
61.29 	(3) development of an individual's person-centered community support plan;
61.30 	(4) providing information regarding eligibility for Minnesota health care programs;
61.31 	(5) face-to-face long-term care consultation assessments, which may be completed 
61.32 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
61.33 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
61.34 	residence;
62.1 	(6) federally mandated preadmission screening activities described under 
62.2 	subdivisions 4a and 4b;
62.3 	(7) (6) determination of home and community-based waiver and other service 
62.4 	eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level 
62.5 	of care determination for individuals who need an institutional level of care as determined 
62.6 	under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and 
62.7 	community support plan development, appropriate referrals to obtain necessary diagnostic 
62.8 	information, and including an eligibility determination for consumer-directed community 
62.9 	supports;
62.10 	(8) (7) providing recommendations for institutional placement when there are no 
62.11 	cost-effective community services available;
62.12 	(9) (8) providing access to assistance to transition people back to community settings 
62.13 	after institutional admission; and
62.14 	(10) (9) providing information about competitive employment, with or without 
62.15 	supports, for school-age youth and working-age adults and referrals to the Disability 
62.16 	Linkage Line and Disability Benefits 101 to ensure that an informed choice about 
62.17 	competitive employment can be made. For the purposes of this subdivision, "competitive 
62.18 	employment" means work in the competitive labor market that is performed on a full-time 
62.19 	or part-time basis in an integrated setting, and for which an individual is compensated at or 
62.20 	above the minimum wage, but not less than the customary wage and level of benefits paid 
62.21 	by the employer for the same or similar work performed by individuals without disabilities.
62.22 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 
62.23 	2c, and 3a, "long-term care consultation services" also means:
62.24 	(1) service eligibility determination for state plan home care services identified in:
62.25 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
62.26 	(ii) section 256B.0657; or
62.27 	(iii) consumer support grants under section 256.476;
62.28 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
62.29 	determination of eligibility for case management services available under sections 
62.30 	256B.0621, subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, part 
62.31 	9525.0016;
62.32 	(3) determination of institutional level of care, home and community-based service 
62.33 	waiver, and other service eligibility as required under section 256B.092, determination 
62.34 	of eligibility for family support grants under section 252.32, semi-independent living 
62.35 	services under section 252.275, and day training and habilitation services under section 
62.36 	256B.092; and
63.1 	(4) obtaining necessary diagnostic information to determine eligibility under clauses 
63.2 	(2) and (3).
63.3 	(c) "Long-term care options counseling" means the services provided by the linkage 
63.4 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and 
63.5 	also includes telephone assistance and follow up once a long-term care consultation 
63.6 	assessment has been completed.
63.7 	(d) "Minnesota health care programs" means the medical assistance program under 
63.8 	chapter 256B and the alternative care program under section 256B.0913.
63.9 	(e) "Lead agencies" means counties administering or tribes and health plans under 
63.10 	contract with the commissioner to administer long-term care consultation assessment and 
63.11 	support planning services.

63.12 	Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to 
63.13 	read:
63.14 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
63.15 	services planning, or other assistance intended to support community-based living, 
63.16 	including persons who need assessment in order to determine waiver or alternative care 
63.17 	program eligibility, must be visited by a long-term care consultation team within 20 
63.18 	calendar days after the date on which an assessment was requested or recommended. 
63.19 	Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also 
63.20 	applies to an assessment of a person requesting personal care assistance services and 
63.21 	private duty nursing. The commissioner shall provide at least a 90-day notice to lead 
63.22 	agencies prior to the effective date of this requirement. Face-to-face assessments must be 
63.23 	conducted according to paragraphs (b) to (i).
63.24 	(b) The lead agency may utilize a team of either the social worker or public health 
63.25 	nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall 
63.26 	use certified assessors to conduct the assessment. The consultation team members must 
63.27 	confer regarding the most appropriate care for each individual screened or assessed. For 
63.28 	a person with complex health care needs, a public health or registered nurse from the 
63.29 	team must be consulted.
63.30 	(c) The assessment must be comprehensive and include a person-centered assessment 
63.31 	of the health, psychological, functional, environmental, and social needs of referred 
63.32 	individuals and provide information necessary to develop a community support plan that 
63.33 	meets the consumers needs, using an assessment form provided by the commissioner.
63.34 	(d) The assessment must be conducted in a face-to-face interview with the person 
63.35 	being assessed and the person's legal representative, and other individuals as requested by 
64.1 	the person, who can provide information on the needs, strengths, and preferences of the 
64.2 	person necessary to develop a community support plan that ensures the person's health and 
64.3 	safety, but who is not a provider of service or has any financial interest in the provision 
64.4 	of services. For persons who are to be assessed for elderly waiver customized living 
64.5 	services under section 256B.0915, with the permission of the person being assessed or 
64.6 	the person's designated or legal representative, the client's current or proposed provider 
64.7 	of services may submit a copy of the provider's nursing assessment or written report 
64.8 	outlining its recommendations regarding the client's care needs. The person conducting 
64.9 	the assessment will notify the provider of the date by which this information is to be 
64.10 	submitted. This information shall be provided to the person conducting the assessment 
64.11 	prior to the assessment.
64.12 	(e) If the person chooses to use community-based services, the person or the person's 
64.13 	legal representative must be provided with a written community support plan within 40 
64.14 	calendar days of the assessment visit, regardless of whether the individual is eligible for 
64.15 	Minnesota health care programs. The written community support plan must include:
64.16 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
64.17 	(2) the individual's options and choices to meet identified needs, including all 
64.18 	available options for case management services and providers;
64.19 	(3) identification of health and safety risks and how those risks will be addressed, 
64.20 	including personal risk management strategies;
64.21 	(4) referral information; and
64.22 	(5) informal caregiver supports, if applicable.
64.23 	For a person determined eligible for state plan home care under subdivision 1a, 
64.24 	paragraph (b), clause (1), the person or person's representative must also receive a copy of 
64.25 	the home care service plan developed by the certified assessor.
64.26 	(f) A person may request assistance in identifying community supports without 
64.27 	participating in a complete assessment. Upon a request for assistance identifying 
64.28 	community support, the person must be transferred or referred to long-term care options 
64.29 	counseling services available under sections 256.975, subdivision 7, and 256.01, 
64.30 	subdivision 24, for telephone assistance and follow up.
64.31 	(g) The person has the right to make the final decision between institutional 
64.32 	placement and community placement after the recommendations have been provided, 
64.33 	except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
64.34 	(h) The lead agency must give the person receiving assessment or support planning, 
64.35 	or the person's legal representative, materials, and forms supplied by the commissioner 
64.36 	containing the following information:
65.1 	(1) written recommendations for community-based services and consumer-directed 
65.2 	options;
65.3 	(2) documentation that the most cost-effective alternatives available were offered to 
65.4 	the individual. For purposes of this clause, "cost-effective" means community services and 
65.5 	living arrangements that cost the same as or less than institutional care. For an individual 
65.6 	found to meet eligibility criteria for home and community-based service programs under 
65.7 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
65.8 	approved waiver plan for each program;
65.9 	(3) the need for and purpose of preadmission screening conducted by long-term care 
65.10 	options counselors according to sections 256.975, subdivisions 7a to 7c, and 256.01, 
65.11 	subdivision 24, if the person selects nursing facility placement. If the individual selects 
65.12 	nursing facility placement, the lead agency shall forward information needed to complete 
65.13 	the level of care determinations and screening for developmental disability and mental 
65.14 	illness collected during the assessment to the long-term care options counselor using forms 
65.15 	provided by the commissioner;
65.16 	(4) the role of long-term care consultation assessment and support planning in 
65.17 	eligibility determination for waiver and alternative care programs, and state plan home 
65.18 	care, case management, and other services as defined in subdivision 1a, paragraphs (a), 
65.19 	clause (7), and (b);
65.20 	(5) information about Minnesota health care programs;
65.21 	(6) the person's freedom to accept or reject the recommendations of the team;
65.22 	(7) the person's right to confidentiality under the Minnesota Government Data 
65.23 	Practices Act, chapter 13;
65.24 	(8) the certified assessor's decision regarding the person's need for institutional level 
65.25 	of care as determined under criteria established in section 256B.0911, subdivision 4a, 
65.26 	paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services 
65.27 	and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
65.28 	(9) the person's right to appeal the certified assessor's decision regarding eligibility 
65.29 	for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and 
65.30 	(b), and incorporating the decision regarding the need for institutional level of care or the 
65.31 	lead agency's final decisions regarding public programs eligibility according to section 
65.32 	256.045, subdivision 3.
65.33 	(i) Face-to-face assessment completed as part of eligibility determination for 
65.34 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
65.35 	community alternative care, and brain injury waiver programs under sections 256B.0913, 
66.1 	256B.0915, and 256B.49 is valid to establish service eligibility for no more than 60 
66.2 	calendar days after the date of assessment.
66.3 	(j) The effective eligibility start date for programs in paragraph (i) can never be 
66.4 	prior to the date of assessment. If an assessment was completed more than 60 days 
66.5 	before the effective waiver or alternative care program eligibility start date, assessment 
66.6 	and support plan information must be updated in a face-to-face visit and documented in 
66.7 	the department's Medicaid Management Information System (MMIS). Notwithstanding 
66.8 	retroactive medical assistance coverage of state plan services, the effective date of 
66.9 	eligibility for programs included in paragraph (i) cannot be prior to the date the most 
66.10 	recent updated assessment is completed.

66.11 	Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to 
66.12 	read:
66.13 		Subd. 4d.Preadmission screening of individuals under 65 60 years of age. (a) 
66.14 	It is the policy of the state of Minnesota to ensure that individuals with disabilities or 
66.15 	chronic illness are served in the most integrated setting appropriate to their needs and have 
66.16 	the necessary information to make informed choices about home and community-based 
66.17 	service options.
66.18 	(b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
66.19 	 nursing facility from a hospital must be screened prior to admission as outlined in 
66.20 	subdivisions 4a through 4c according to the requirements outlined in section 256.975, 
66.21 	subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required 
66.22 	under section 256.01, subdivision 24.
66.23 	(c) Individuals under 65 years of age who are admitted to nursing facilities with 
66.24 	only a telephone screening must receive a face-to-face assessment from the long-term 
66.25 	care consultation team member of the county in which the facility is located or from the 
66.26 	recipient's county case manager within 40 calendar days of admission.
66.27 	(d) Individuals under 65 years of age who are admitted to a nursing facility 
66.28 	without preadmission screening according to the exemption described in subdivision 4b, 
66.29 	paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive 
66.30 	a face-to-face assessment within 40 days of admission.
66.31 	(e) (d) At the face-to-face assessment, the long-term care consultation team member 
66.32 	or county case manager must perform the activities required under subdivision 3b.
66.33 	(f) (e) For individuals under 21 years of age, a screening interview which 
66.34 	recommends nursing facility admission must be face-to-face and approved by the 
66.35 	commissioner before the individual is admitted to the nursing facility.
67.1 	(g) (f) In the event that an individual under 65 60 years of age is admitted to a 
67.2 	nursing facility on an emergency basis, the county Disability Linkage Line must be 
67.3 	notified of the admission on the next working day, and a face-to-face assessment as 
67.4 	described in paragraph (c) must be conducted within 40 calendar days of admission.
67.5 	(h) (g) At the face-to-face assessment, the long-term care consultation team member 
67.6 	or the case manager must present information about home and community-based options, 
67.7 	including consumer-directed options, so the individual can make informed choices. If the 
67.8 	individual chooses home and community-based services, the long-term care consultation 
67.9 	team member or case manager must complete a written relocation plan within 20 working 
67.10 	days of the visit. The plan shall describe the services needed to move out of the facility 
67.11 	and a time line for the move which is designed to ensure a smooth transition to the 
67.12 	individual's home and community.
67.13 	(i) (h) An individual under 65 years of age residing in a nursing facility shall receive 
67.14 	a face-to-face assessment at least every 12 months to review the person's service choices 
67.15 	and available alternatives unless the individual indicates, in writing, that annual visits are 
67.16 	not desired. In this case, the individual must receive a face-to-face assessment at least 
67.17 	once every 36 months for the same purposes.
67.18 	(j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay 
67.19 	county agencies directly for face-to-face assessments for individuals under 65 years of age 
67.20 	who are being considered for placement or residing in a nursing facility.
67.21 	(j) Funding for preadmission screening shall be provided to the Disability Linkage 
67.22 	Line for the under 60 population by the Department of Human Services to cover screener 
67.23 	salaries and expenses to provide the services described in subdivisions 7a to 7c. The 
67.24 	Disability Linkage Line shall employ, or contract with other agencies to employ, within 
67.25 	the limits of available funding, sufficient personnel to provide preadmission screening and 
67.26 	level of care determination services and shall seek to maximize federal funding for the 
67.27 	service as provided under section 256.01, subdivision 2, paragraph (dd).

67.28 	EFFECTIVE DATE. This section is effective October 1, 2013.

67.29 	Sec. 21. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to 
67.30 	read:
67.31 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) 
67.32 	It is the policy of the state of Minnesota to ensure that individuals with disabilities or 
67.33 	chronic illness are served in the most integrated setting appropriate to their needs and have 
67.34 	the necessary information to make informed choices about home and community-based 
67.35 	service options.
68.1 	(b) Individuals under 65 years of age who are admitted to a nursing facility from a 
68.2 	hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
68.3 	(c) Individuals under 65 years of age who are admitted to nursing facilities with 
68.4 	only a telephone screening must receive a face-to-face assessment from the long-term 
68.5 	care consultation team member of the county in which the facility is located or from the 
68.6 	recipient's county case manager within 40 calendar days of admission.
68.7 	(d) Individuals under 65 years of age who are admitted to a nursing facility 
68.8 	without preadmission screening according to the exemption described in subdivision 4b, 
68.9 	paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive 
68.10 	a face-to-face assessment within 40 days of admission.
68.11 	(e) At the face-to-face assessment, the long-term care consultation team member or 
68.12 	county case manager must perform the activities required under subdivision 3b.
68.13 	(f) For individuals under 21 years of age, a screening interview which recommends 
68.14 	nursing facility admission must be face-to-face and approved by the commissioner before 
68.15 	the individual is admitted to the nursing facility.
68.16 	(g) In the event that an individual under 65 years of age is admitted to a nursing 
68.17 	facility on an emergency basis, the county must be notified of the admission on the 
68.18 	next working day, and a face-to-face assessment as described in paragraph (c) must be 
68.19 	conducted within 40 calendar days of admission.
68.20 	(h) At the face-to-face assessment, the long-term care consultation team member or 
68.21 	the case manager must present information about home and community-based options, 
68.22 	including consumer-directed options, so the individual can make informed choices. If the 
68.23 	individual chooses home and community-based services, the long-term care consultation 
68.24 	team member or case manager must complete a written relocation plan within 20 working 
68.25 	days of the visit. The plan shall describe the services needed to move out of the facility 
68.26 	and a time line for the move which is designed to ensure a smooth transition to the 
68.27 	individual's home and community.
68.28 	(i) An individual under 65 years of age residing in a nursing facility shall receive a 
68.29 	face-to-face assessment at least every 12 months to review the person's service choices 
68.30 	and available alternatives unless the individual indicates, in writing, that annual visits are 
68.31 	not desired. In this case, the individual must receive a face-to-face assessment at least 
68.32 	once every 36 months for the same purposes.
68.33 	(j) Notwithstanding the provisions of subdivision 6, the commissioner may pay 
68.34 	county agencies directly for face-to-face assessments for individuals under 65 years of age 
68.35 	who are being considered for placement or residing in a nursing facility. Until September 
69.1 	30, 2013, payments for individuals under 65 years of age shall be made as described 
69.2 	in this subdivision.

69.3 	Sec. 22. Minnesota Statutes 2012, section 256B.0911, is amended by adding a 
69.4 	subdivision to read:
69.5 		Subd. 4e.Determination of institutional level of care. The determination of the 
69.6 	need for nursing facility, hospital, and intermediate care facility levels of care must be 
69.7 	made according to criteria developed by the commissioner, and in section 256B.092, 
69.8 	using forms developed by the commissioner. Effective January 1, 2014, for individuals 
69.9 	age 21 and older, the determination of need for nursing facility level of care shall be 
69.10 	based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the 
69.11 	determination of the need for nursing facility level of care must be made according to 
69.12 	criteria developed by the commissioner until criteria in section 144.0724, subdivision 11, 
69.13 	becomes effective on or after October 1, 2019.

69.14 	Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
69.15 		Subd. 6.Payment for long-term care consultation services. (a) Until September 
69.16 	30, 2013, payment for long-term care consultation face-to-face assessment shall be made 
69.17 	as described in this subdivision.
69.18 	(b) The total payment for each county must be paid monthly by certified nursing 
69.19 	facilities in the county. The monthly amount to be paid by each nursing facility for each 
69.20 	fiscal year must be determined by dividing the county's annual allocation for long-term 
69.21 	care consultation services by 12 to determine the monthly payment and allocating the 
69.22 	monthly payment to each nursing facility based on the number of licensed beds in the 
69.23 	nursing facility. Payments to counties in which there is no certified nursing facility must be 
69.24 	made by increasing the payment rate of the two facilities located nearest to the county seat.
69.25 	(b) (c) The commissioner shall include the total annual payment determined under 
69.26 	paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434, 
69.27 	or 256B.441.
69.28 	(c) (d) In the event of the layaway, delicensure and decertification, or removal 
69.29 	from layaway of 25 percent or more of the beds in a facility, the commissioner may 
69.30 	adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly 
69.31 	payment amount in paragraph (a) (b). The effective date of an adjustment made under this 
69.32 	paragraph shall be on or after the first day of the month following the effective date of the 
69.33 	layaway, delicensure and decertification, or removal from layaway.
70.1 	(d) (e) Payments for long-term care consultation services are available to the county 
70.2 	or counties to cover staff salaries and expenses to provide the services described in 
70.3 	subdivision 1a. The county shall employ, or contract with other agencies to employ, 
70.4 	within the limits of available funding, sufficient personnel to provide long-term care 
70.5 	consultation services while meeting the state's long-term care outcomes and objectives as 
70.6 	defined in subdivision 1. The county shall be accountable for meeting local objectives 
70.7 	as approved by the commissioner in the biennial home and community-based services 
70.8 	quality assurance plan on a form provided by the commissioner.
70.9 	(e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment 
70.10 	of the screening costs under the medical assistance program may not be recovered from 
70.11 	a facility.
70.12 	(f) (g) The commissioner of human services shall amend the Minnesota medical 
70.13 	assistance plan to include reimbursement for the local consultation teams.
70.14 	(g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented, 
70.15 	the county may bill, as case management services, assessments, support planning, and 
70.16 	follow-along provided to persons determined to be eligible for case management under 
70.17 	Minnesota health care programs. No individual or family member shall be charged for an 
70.18 	initial assessment or initial support plan development provided under subdivision 3a or 3b.
70.19 	(h) (i) The commissioner shall develop an alternative payment methodology, 
70.20 	effective on October 1, 2013, for long-term care consultation services that includes 
70.21 	the funding available under this subdivision, and for assessments authorized under 
70.22 	sections 256B.092 and 256B.0659. In developing the new payment methodology, the 
70.23 	commissioner shall consider the maximization of other funding sources, including federal 
70.24 	administrative reimbursement through federal financial participation funding, for all 
70.25 	long-term care consultation and preadmission screening activity. The alternative payment 
70.26 	methodology shall include the use of the appropriate time studies and the state financing 
70.27 	of nonfederal share as part of the state's medical assistance program.

70.28 	Sec. 24. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
70.29 		Subd. 7.Reimbursement for certified nursing facilities. (a) Medical assistance 
70.30 	reimbursement for nursing facilities shall be authorized for a medical assistance recipient 
70.31 	only if a preadmission screening has been conducted prior to admission or the county has 
70.32 	authorized an exemption. Medical assistance reimbursement for nursing facilities shall 
70.33 	not be provided for any recipient who the local screener has determined does not meet the 
70.34 	level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, 
70.35 	if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 
71.1 	Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 
71.2 	mental illness is approved by the local mental health authority or an admission for a 
71.3 	recipient with developmental disability is approved by the state developmental disability 
71.4 	authority.
71.5 	(b) The nursing facility must not bill a person who is not a medical assistance 
71.6 	recipient for resident days that preceded the date of completion of screening activities 
71.7 	as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing 
71.8 	facility must include unreimbursed resident days in the nursing facility resident day totals 
71.9 	reported to the commissioner.

71.10 	Sec. 25. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
71.11 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 71.12 	(a) Funding for services under the alternative care program is available to persons who 
71.13 	meet the following criteria:
71.14 	(1) the person has been determined by a community assessment under section 
71.15 	256B.0911 to be a person who would require the level of care provided in a nursing 
71.16 	facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for 
71.17 	the provision of services under the alternative care program;
71.18 	(2) the person is age 65 or older;
71.19 	(3) the person would be eligible for medical assistance within 135 days of admission 
71.20 	to a nursing facility;
71.21 	(4) the person is not ineligible for the payment of long-term care services by the 
71.22 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
71.23 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
71.24 	(5) the person needs long-term care services that are not funded through other 
71.25 	state or federal funding, or other health insurance or other third-party insurance such as 
71.26 	long-term care insurance;
71.27 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
71.28 	care services funded by the program for this person does not exceed 75 percent of the 
71.29 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
71.30 	does not prohibit the alternative care client from payment for additional services, but in no 
71.31 	case may the cost of additional services purchased under this section exceed the difference 
71.32 	between the client's monthly service limit defined under section 256B.0915, subdivision 
71.33 	3, and the alternative care program monthly service limit defined in this paragraph. If 
71.34 	care-related supplies and equipment or environmental modifications and adaptations are or 
71.35 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
72.1 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
72.2 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
72.3 	limit established in this paragraph, the annual cost of the alternative care services shall be 
72.4 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
72.5 	times the monthly limit described in this paragraph;
72.6 	(7) for individuals assigned a case mix classification A as described under section 
72.7 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
72.8 	living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating 
72.9 	when the dependency score in eating is three or greater as determined by an assessment 
72.10 	performed under section 256B.0911, the monthly cost of alternative care services funded 
72.11 	by the program cannot exceed $593 per month for all new participants enrolled in 
72.12 	the program on or after July 1, 2011. This monthly limit shall be applied to all other 
72.13 	participants who meet this criteria at reassessment. This monthly limit shall be increased 
72.14 	annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly 
72.15 	limit does not prohibit the alternative care client from payment for additional services, but 
72.16 	in no case may the cost of additional services purchased exceed the difference between the 
72.17 	client's monthly service limit defined in this clause and the limit described in clause (6) 
72.18 	for case mix classification A; and
72.19 	(8) the person is making timely payments of the assessed monthly fee.
72.20 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
72.21 	agrees to:
72.22 	(i) the appointment of a representative payee;
72.23 	(ii) automatic payment from a financial account;
72.24 	(iii) the establishment of greater family involvement in the financial management of 
72.25 	payments; or
72.26 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
72.27 	The lead agency may extend the client's eligibility as necessary while making 
72.28 	arrangements to facilitate payment of past-due amounts and future premium payments. 
72.29 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
72.30 	reinstated for a period of 30 days.
72.31 	(b) Alternative care funding under this subdivision is not available for a person who 
72.32 	is a medical assistance recipient or who would be eligible for medical assistance without a 
72.33 	spenddown or waiver obligation. A person whose initial application for medical assistance 
72.34 	and the elderly waiver program is being processed may be served under the alternative care 
72.35 	program for a period up to 60 days. If the individual is found to be eligible for medical 
72.36 	assistance, medical assistance must be billed for services payable under the federally 
73.1 	approved elderly waiver plan and delivered from the date the individual was found eligible 
73.2 	for the federally approved elderly waiver plan. Notwithstanding this provision, alternative 
73.3 	care funds may not be used to pay for any service the cost of which: (i) is payable by 
73.4 	medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to 
73.5 	pay a medical assistance income spenddown for a person who is eligible to participate in the 
73.6 	federally approved elderly waiver program under the special income standard provision.
73.7 	(c) Alternative care funding is not available for a person who resides in a licensed 
73.8 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
73.9 	for case management services which are provided in support of the discharge planning 
73.10 	process for a nursing home resident or certified boarding care home resident to assist with 
73.11 	a relocation process to a community-based setting.
73.12 	(d) Alternative care funding is not available for a person whose income is greater 
73.13 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
73.14 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
73.15 	year for which alternative care eligibility is determined, who would be eligible for the 
73.16 	elderly waiver with a waiver obligation.

73.17 	Sec. 26. Minnesota Statutes 2012, section 256B.0913, is amended by adding a 
73.18 	subdivision to read:
73.19 		Subd. 17.Essential community supports grants. (a) Notwithstanding subdivisions 
73.20 	1 to 14, the purpose of the essential community supports grant program is to provide 
73.21 	targeted services to persons age 65 and older who need essential community support, but 
73.22 	whose needs do not meet the level of care required for nursing facility placement under 
73.23 	section 144.0724, subdivision 11.
73.24 	(b) Essential community supports grants are available not to exceed $400 per person 
73.25 	per month. Essential community supports service grants may be used as authorized within 
73.26 	an authorization period not to exceed 12 months. Grants must be available to a person who:
73.27 	(1) is age 65 or older;
73.28 	(2) is not eligible for medical assistance;
73.29 	(3) would otherwise be financially eligible for the alternative care program under 
73.30 	subdivision 4;
73.31 	(4) has received a community assessment under section 256B.0911, subdivision 3a 
73.32 	or 3b, and does not require the level of care provided in a nursing facility;
73.33 	(5) has a community support plan; and
73.34 	(6) has been determined by a community assessment under section 256B.0911, 
73.35 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
74.1 	following services, as defined in the approved elderly waiver plan, in order to maintain 
74.2 	their community residence:
74.3 	(i) caregiver support;
74.4 	(ii) homemaker support;
74.5 	(iii) chores; or
74.6 	(iv) a personal emergency response device or system.
74.7 	(c) The person receiving any of the essential community supports in this subdivision 
74.8 	must also receive service coordination, not to exceed $600 in a 12-month authorization 
74.9 	period, as part of their community support plan.
74.10 	(d) A person who has been determined to be eligible for an essential community 
74.11 	supports grant must be reassessed at least annually and continue to meet the criteria in 
74.12 	paragraph (b) to remain eligible for an essential community supports grant.
74.13 	(e) The commissioner is authorized to use federal matching funds for essential 
74.14 	community supports as necessary and to meet demand for essential community supports 
74.15 	grants as outlined in paragraphs (f) and (g), and that amount of federal funds is 
74.16 	appropriated to the commissioner for this purpose.
74.17 	(f) Upon federal approval and following a reasonable implementation period 
74.18 	determined by the commissioner, essential community supports are available to an 
74.19 	individual who:
74.20 	(1) is receiving nursing facility services or home and community-based long-term 
74.21 	services and supports under section 256B.0915 or 256B.49 on the effective date of 
74.22 	implementation of the revised nursing facility level of care under section 144.0724, 
74.23 	subdivision 11;
74.24 	(2) meets one of the following criteria:
74.25 	(i) due to the implementation of the revised nursing facility level of care, loses 
74.26 	eligibility for continuing medical assistance payment of nursing facility services at the 
74.27 	first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or 
74.28 	after the effective date of the revised nursing facility level of care criteria under section 
74.29 	144.0724, subdivision 11; or
74.30 	(ii) due to the implementation of the revised nursing facility level of care, loses 
74.31 	eligibility for continuing medical assistance payment of home and community-based 
74.32 	long-term services and supports under section 256B.0915 or 256B.49 at the first 
74.33 	reassessment required under those sections that occurs on or after the effective date of 
74.34 	implementation of the revised nursing facility level of care under section 144.0724, 
74.35 	subdivision 11;
74.36 	(3) is not eligible for personal care attendant services; and
75.1 	(4) has an assessed need for one or more of the supportive services offered under 
75.2 	essential community supports.
75.3 	Individuals eligible under this paragraph includes individuals who continue to be 
75.4 	eligible for medical assistance state plan benefits and those who are not or are no longer 
75.5 	financially eligible for medical assistance.
75.6 	(g) Upon federal approval and following a reasonable implementation period 
75.7 	determined by the commissioner, the services available through essential community 
75.8 	supports include the services and grants provided in paragraphs (b) and (c), home-delivered 
75.9 	meals, and community living assistance as defined by the commissioner. These services 
75.10 	are available to all eligible recipients including those outlined in paragraphs (b) and (f). 
75.11 	Recipients are eligible if they have a need for any of these services and meet all other 
75.12 	eligibility criteria.

75.13 	Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.14 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
75.15 	shall receive an initial assessment of strengths, informal supports, and need for services 
75.16 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
75.17 	client served under the elderly waiver must be conducted at least every 12 months and at 
75.18 	other times when the case manager determines that there has been significant change in 
75.19 	the client's functioning. This may include instances where the client is discharged from 
75.20 	the hospital. There must be a determination that the client requires nursing facility level 
75.21 	of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and 
75.22 	subsequent assessments to initiate and maintain participation in the waiver program.
75.23 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
75.24 	4, as appropriate to determine nursing facility level of care for purposes of medical 
75.25 	assistance payment for nursing facility services, only face-to-face assessments conducted 
75.26 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
75.27 	level of care determination will be accepted for purposes of initial and ongoing access to 
75.28 	waiver service payment.

75.29 	Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
75.30 	subdivision to read:
75.31 		Subd. 1a.Home and community-based services for older adults. (a) The purpose 
75.32 	of projects selected by the commissioner of human services under this section is to 
75.33 	make strategic changes in the long-term services and supports system for older adults 
75.34 	including statewide capacity for local service development and technical assistance, and 
76.1 	statewide availability of home and community-based services for older adult services, 
76.2 	caregiver support and respite care services, and other supports in the state of Minnesota. 
76.3 	These projects are intended to create incentives for new and expanded home and 
76.4 	community-based services in Minnesota in order to:
76.5 	(1) reach older adults early in the progression of their need for long-term services 
76.6 	and supports, providing them with low-cost, high-impact services that will prevent or 
76.7 	delay the use of more costly services;
76.8 	(2) support older adults to live in the most integrated, least restrictive community 
76.9 	setting;
76.10 	(3) support the informal caregivers of older adults;
76.11 	(4) develop and implement strategies to integrate long-term services and supports 
76.12 	with health care services, in order to improve the quality of care and enhance the quality 
76.13 	of life of older adults and their informal caregivers;
76.14 	(5) ensure cost-effective use of financial and human resources;
76.15 	(6) build community-based approaches and community commitment to delivering 
76.16 	long-term services and supports for older adults in their own homes;
76.17 	(7) achieve a broad awareness and use of lower-cost in-home services as an 
76.18 	alternative to nursing homes and other residential services;
76.19 	(8) strengthen and develop additional home and community-based services and 
76.20 	alternatives to nursing homes and other residential services; and
76.21 	(9) strengthen programs that use volunteers.
76.22 	(b) The services provided by these projects are available to older adults who are 
76.23 	eligible for medical assistance and the elderly waiver under section 256B.0915, the 
76.24 	alternative care program under section 256B.0913, or essential community supports grant 
76.25 	under subdivision 14, paragraph (b), and to persons who have their own funds to pay for 
76.26 	services.

76.27 	Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
76.28 	subdivision to read:
76.29 		Subd. 1b.Definitions. (a) For purposes of this section, the following terms have 
76.30 	the meanings given.
76.31 	(b) "Community" means a town; township; city; or targeted neighborhood within a 
76.32 	city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
76.33 	(c) "Core home and community-based services provider" means a Faith in Action, 
76.34 	Living at Home Block Nurse, Congregational Nurse, or similar community-based 
76.35 	program governed by a board, the majority of whose members reside within the program's 
77.1 	service area, that organizes and uses volunteers and paid staff to deliver nonmedical 
77.2 	services intended to assist older adults to identify and manage risks and to maintain their 
77.3 	community living and integration in the community.
77.4 	(d) "Eldercare development partnership" means a team of representatives of county 
77.5 	social service and public health agencies, the area agency on aging, local nursing home 
77.6 	providers, local home care providers, and other appropriate home and community-based 
77.7 	providers in the area agency's planning and service area.
77.8 	(e) "Long-term services and supports" means any service available under the 
77.9 	elderly waiver program or alternative care grant programs, nursing facility services, 
77.10 	transportation services, caregiver support and respite care services, and other home and 
77.11 	community-based services identified as necessary either to maintain lifestyle choices for 
77.12 	older adults or to support them to remain in their own home.
77.13 	(f) "Older adult" refers to an individual who is 65 years of age or older.

77.14 	Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
77.15 	subdivision to read:
77.16 		Subd. 1c.Eldercare development partnerships. The commissioner of human 
77.17 	services shall select and contract with eldercare development partnerships sufficient to 
77.18 	provide statewide availability of service development and technical assistance using a 
77.19 	request for proposals process. Eldercare development partnerships shall:
77.20 	(1) develop a local long-term services and supports strategy consistent with state 
77.21 	goals and objectives;
77.22 	(2) identify and use existing local skills, knowledge, and relationships, and build 
77.23 	on these assets;
77.24 	(3) coordinate planning for funds to provide services to older adults, including funds 
77.25 	received under Title III of the Older Americans Act, Title XX of the Social Security Act, 
77.26 	and the Local Public Health Act;
77.27 	(4) target service development and technical assistance where nursing facility 
77.28 	closures have occurred or are occurring or in areas where service needs have been 
77.29 	identified through activities under section 144A.351;
77.30 	(5) provide sufficient staff for development and technical support in its designated 
77.31 	area; and
77.32 	(6) designate a single public or nonprofit member of the eldercare development 
77.33 	partnerships to apply grant funding and manage the project.

77.34 	Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
78.1 		Subd. 6.Caregiver support and respite care projects. (a) The commissioner 
78.2 	shall establish up to 36 projects to expand the respite care network in the state and to 
78.3 	support caregivers in their responsibilities for care. The purpose of each project shall 
78.4 	be to availability of caregiver support and respite care services for family and other 
78.5 	caregivers. The commissioner shall use a request for proposals to select nonprofit entities 
78.6 	to administer the projects. Projects shall:
78.7 	(1) establish a local coordinated network of volunteer and paid respite workers;
78.8 	(2) coordinate assignment of respite workers care services to clients and care 
78.9 	receivers and assure the health and safety of the client; and caregivers of older adults;
78.10 	(3) provide training for caregivers and ensure that support groups are available 
78.11 	in the community.
78.12 	(b) The caregiver support and respite care funds shall be available to the four to six 
78.13 	local long-term care strategy projects designated in subdivisions 1 to 5.
78.14 	(c) The commissioner shall publish a notice in the State Register to solicit proposals 
78.15 	from public or private nonprofit agencies for the projects not included in the four to six 
78.16 	local long-term care strategy projects defined in subdivision 2. A county agency may, 
78.17 	alone or in combination with other county agencies, apply for caregiver support and 
78.18 	respite care project funds. A public or nonprofit agency within a designated SAIL project 
78.19 	area may apply for project funds if the agency has a letter of agreement with the county 
78.20 	or counties in which services will be developed, stating the intention of the county or 
78.21 	counties to coordinate their activities with the agency requesting a grant.
78.22 	(d) The commissioner shall select grantees based on the following criteria:
78.23 	(1) the ability of the proposal to demonstrate need in the area served, as evidenced 
78.24 	by a community needs assessment or other demographic data;
78.25 	(2) the ability of the proposal to clearly describe how the project
78.26 	(3) assure the health and safety of the older adults;
78.27 	(4) identify at-risk caregivers;
78.28 	(5) provide information, education, and training for caregivers in the designated 
78.29 	community; and
78.30 	(6) demonstrate the need in the proposed service area particularly where nursing 
78.31 	facility closures have occurred or are occurring or areas with service needs identified 
78.32 	by section 144A.351. Preference must be given for projects that reach underserved 
78.33 	populations.
78.34 	(b) Projects must clearly describe:
78.35 	(1) how they will achieve the their purpose defined in paragraph (b);
78.36 	(3) the ability of the proposal to reach underserved populations;
79.1 	(4) the ability of the proposal to demonstrate community commitment to the project, 
79.2 	as evidenced by letters of support and cooperation as well as formation of a community 
79.3 	task force;
79.4 	(5) the ability of the proposal to clearly describe (2) the process for recruiting, 
79.5 	training, and retraining volunteers; and
79.6 	(6) the inclusion in the proposal of the (3) a plan to promote the project in the 
79.7 	designated community, including outreach to persons needing the services.
79.8 	(e) (c) Funds for all projects under this subdivision may be used to:
79.9 	(1) hire a coordinator to develop a coordinated network of volunteer and paid respite 
79.10 	care services and assign workers to clients;
79.11 	(2) recruit and train volunteer providers;
79.12 	(3) train provide information, training, and education to caregivers;
79.13 	(4) ensure the development of support groups for caregivers;
79.14 	(5) (4) advertise the availability of the caregiver support and respite care project; and
79.15 	(6) (5) purchase equipment to maintain a system of assigning workers to clients.
79.16 	(f) (d) Project funds may not be used to supplant existing funding sources.

79.17 	Sec. 32. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
79.18 	subdivision to read:
79.19 		Subd. 7a.Core home and community-based services. The commissioner shall 
79.20 	select and contract with core home and community-based services providers for projects 
79.21 	to provide services and supports to older adults both with and without family and other 
79.22 	informal caregivers using a request for proposals process. Projects must:
79.23 	(1) have a credible, public, or private nonprofit sponsor providing ongoing financial 
79.24 	support;
79.25 	(2) have a specific, clearly defined geographic service area;
79.26 	(3) use a practice framework designed to identify high-risk older adults and help them 
79.27 	take action to better manage their chronic conditions and maintain their community living;
79.28 	(4) have a team approach to coordination and care, ensuring that the older adult 
79.29 	participants, their families, and the formal and informal providers are all part of planning 
79.30 	and providing services;
79.31 	(5) provide information, support services, homemaking services, counseling, and 
79.32 	training for the older adults and family caregivers;
79.33 	(6) encourage service area or neighborhood residents and local organizations to 
79.34 	collaborate in meeting the needs of older adults in their geographic service areas;
80.1 	(7) recruit, train, and direct the use of volunteers to provide informal services and 
80.2 	other appropriate support to older adults and their caregivers; and
80.3 	(8) provide coordination and management of formal and informal services to older 
80.4 	adults and their families using less expensive alternatives.

80.5 	Sec. 33. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to 
80.6 	read:
80.7 		Subd. 13.Community service grants. The commissioner shall award contracts 
80.8 	for grants to public and private nonprofit agencies to establish services that strengthen 
80.9 	a community's ability to provide a system of home and community-based services 
80.10 	for elderly persons. The commissioner shall use a request for proposal process. The 
80.11 	commissioner shall give preference when awarding grants under this section to areas 
80.12 	where nursing facility closures have occurred or are occurring or to areas with service 
80.13 	needs identified under section 144A.351. The commissioner shall consider grants for:
80.14 	(1) caregiver support and respite care projects under subdivision 6;
80.15 	(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
80.16 	(3) services identified as needed for community transition.

80.17 	Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
80.18 		Subdivision 1.Development and implementation of quality profiles. (a) The 
80.19 	commissioner of human services, in cooperation with the commissioner of health, 
80.20 	shall develop and implement a quality profile system profiles for nursing facilities and, 
80.21 	beginning not later than July 1, 2004 2014, other providers of long-term care services, 
80.22 	except when the quality profile system would duplicate requirements under section 
80.23 	256B.5011, 256B.5012, or 256B.5013. The system quality profiles  must be developed 
80.24 	and implemented to the extent possible without the collection of significant amounts of 
80.25 	new data. To the extent possible, the system using existing data sets maintained by the 
80.26 	commissioners of health and human services to the extent possible. The profiles  must 
80.27 	incorporate or be coordinated with information on quality maintained by area agencies on 
80.28 	aging, long-term care trade associations, the ombudsman offices, counties, tribes, health 
80.29 	plans, and other entities and the long-term care database maintained under section 256.975, 
80.30 	subdivision 7. The system profiles must be designed to provide information on quality to:
80.31 	(1) consumers and their families to facilitate informed choices of service providers;
80.32 	(2) providers to enable them to measure the results of their quality improvement 
80.33 	efforts and compare quality achievements with other service providers; and
81.1 	(3) public and private purchasers of long-term care services to enable them to 
81.2 	purchase high-quality care.
81.3 	(b) The system profiles must be developed in consultation with the long-term care 
81.4 	task force, area agencies on aging, and representatives of consumers, providers, and labor 
81.5 	unions. Within the limits of available appropriations, the commissioners may employ 
81.6 	consultants to assist with this project.

81.7 	Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
81.8 		Subd. 2.Quality measurement tools. The commissioners shall identify and apply 
81.9 	existing quality measurement tools to:
81.10 	(1) emphasize quality of care and its relationship to quality of life; and
81.11 	(2) address the needs of various users of long-term care services, including, but not 
81.12 	limited to, short-stay residents, persons with behavioral problems, persons with dementia, 
81.13 	and persons who are members of minority groups.
81.14 	The tools must be identified and applied, to the extent possible, without requiring 
81.15 	providers to supply information beyond current state and federal requirements.

81.16 	Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
81.17 		Subd. 3.Consumer surveys of nursing facilities residents. Following 
81.18 	identification of the quality measurement tool, the commissioners shall conduct surveys 
81.19 	of long-term care service consumers of nursing facilities to develop quality profiles 
81.20 	of providers. To the extent possible, surveys must be conducted face-to-face by state 
81.21 	employees or contractors. At the discretion of the commissioners, surveys may be 
81.22 	conducted by telephone or by provider staff. Surveys must be conducted periodically to 
81.23 	update quality profiles of individual service nursing facilities providers.

81.24 	Sec. 37. Minnesota Statutes 2012, section 256B.439, is amended by adding a 
81.25 	subdivision to read:
81.26 		Subd. 3a.Home and community-based services report card in cooperation with 
81.27 	the commissioner of health. The profiles developed for home and community-based 
81.28 	services providers under this section shall be incorporated into a report card and 
81.29 	maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision 
81.30 	7, paragraph (b), clause (2), as data becomes available. The commissioner, in 
81.31 	cooperation with the commissioner of health, shall use consumer choice, quality of life, 
81.32 	care approaches, and cost or flexible purchasing categories to organize the consumer 
81.33 	information in the profiles. The final categories used shall include consumer input and 
82.1 	survey data to the extent that it is available through the state agencies. The commissioner 
82.2 	shall develop and disseminate the qualify profiles for a limited number of provider types 
82.3 	initially, and develop quality profiles for additional provider types as measurement tools 
82.4 	are developed and data becomes available. This includes providers of services to older 
82.5 	adults and people with disabilities, regardless of payor source.

82.6 	Sec. 38. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
82.7 		Subd. 4.Dissemination of quality profiles. By July 1, 2003 2014, the 
82.8 	commissioners shall implement a system public awareness effort to disseminate the quality 
82.9 	profiles developed from consumer surveys using the quality measurement tool. Profiles 
82.10 	may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and 
82.11 	to consumers, providers, and purchasers of long-term care services through all feasible 
82.12 	printed and electronic outlets. The commissioners may conduct a public awareness 
82.13 	campaign to inform potential users regarding profile contents and potential uses.

82.14 	Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
82.15 		Subd. 13.External fixed costs. "External fixed costs" means costs related to the 
82.16 	nursing home surcharge under section 256.9657, subdivision 1; licensure fees under 
82.17 	section 144.122; until September 30, 2013, long-term care consultation fees under 
82.18 	section 256B.0911, subdivision 6; family advisory council fee under section 144A.33; 
82.19 	scholarships under section 256B.431, subdivision 36; planned closure rate adjustments 
82.20 	under section 256B.437; or single bed room incentives under section 256B.431, 
82.21 	subdivision 42; property taxes and property insurance; and PERA.

82.22 	Sec. 40. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
82.23 		Subd. 53.Calculation of payment rate for external fixed costs. The commissioner 
82.24 	shall calculate a payment rate for external fixed costs.
82.25 	(a) For a facility licensed as a nursing home, the portion related to section 256.9657 
82.26 	shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 
82.27 	home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 
82.28 	result of its number of nursing home beds divided by its total number of licensed beds.
82.29 	(b) The portion related to the licensure fee under section 144.122, paragraph (d), 
82.30 	shall be the amount of the fee divided by actual resident days.
82.31 	(c) The portion related to scholarships shall be determined under section 256B.431, 
82.32 	subdivision 36.
83.1 	(d)  Until September 30, 2013, the portion related to long-term care consultation shall 
83.2 	be determined according to section 256B.0911, subdivision 6.
83.3 	(e) The portion related to development and education of resident and family advisory 
83.4 	councils under section 144A.33 shall be $5 divided by 365.
83.5 	(f) The portion related to planned closure rate adjustments shall be as determined 
83.6 	under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436. 
83.7 	Planned closure rate adjustments that take effect before October 1, 2014, shall no longer 
83.8 	be included in the payment rate for external fixed costs beginning October 1, 2016. 
83.9 	Planned closure rate adjustments that take effect on or after October 1, 2014, shall no 
83.10 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
83.11 	the first year not less than two years after their effective date.
83.12 	(g) The portions related to property insurance, real estate taxes, special assessments, 
83.13 	and payments made in lieu of real estate taxes directly identified or allocated to the nursing 
83.14 	facility shall be the actual amounts divided by actual resident days.
83.15 	(h) The portion related to the Public Employees Retirement Association shall be 
83.16 	actual costs divided by resident days.
83.17 	(i) The single bed room incentives shall be as determined under section 256B.431, 
83.18 	subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall 
83.19 	no longer be included in the payment rate for external fixed costs beginning October 1, 
83.20 	2016. Single bed room incentives that take effect on or after October 1, 2014, shall no 
83.21 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
83.22 	the first year not less than two years after their effective date.
83.23 	(j) The payment rate for external fixed costs shall be the sum of the amounts in 
83.24 	paragraphs (a) to (i).

83.25 	Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
83.26 		Subd. 12.Informed choice. Persons who are determined likely to require the level 
83.27 	of care provided in a nursing facility as determined under section 256B.0911, subdivision 
83.28 	4e, or a hospital shall be informed of the home and community-based support alternatives 
83.29 	to the provision of inpatient hospital services or nursing facility services. Each person 
83.30 	must be given the choice of either institutional or home and community-based services 
83.31 	using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.32 	Sec. 42. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.33 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments 
83.34 	shall be conducted by certified assessors according to section 256B.0911, subdivision 2b. 
84.1 	With the permission of the recipient or the recipient's designated legal representative, 
84.2 	the recipient's current provider of services may submit a written report outlining their 
84.3 	recommendations regarding the recipient's care needs prepared by a direct service 
84.4 	employee with at least 20 hours of service to that client. The person conducting the 
84.5 	assessment or reassessment must notify the provider of the date by which this information 
84.6 	is to be submitted. This information shall be provided to the person conducting the 
84.7 	assessment and the person or the person's legal representative and must be considered 
84.8 	prior to the finalization of the assessment or reassessment.
84.9 	(b) There must be a determination that the client requires a hospital level of care or a 
84.10 	nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph 
84.11 	(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the 
84.12 	waiver program.
84.13 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
84.14 	appropriate to determine nursing facility level of care for purposes of medical assistance 
84.15 	payment for nursing facility services, only face-to-face assessments conducted according 
84.16 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
84.17 	determination or a nursing facility level of care determination must be accepted for 
84.18 	purposes of initial and ongoing access to waiver services payment.
84.19 	(d) Recipients who are found eligible for home and community-based services under 
84.20 	this section before their 65th birthday may remain eligible for these services after their 
84.21 	65th birthday if they continue to meet all other eligibility factors.
84.22 	(e) The commissioner shall develop criteria to identify recipients whose level of 
84.23 	functioning is reasonably expected to improve and reassess these recipients to establish 
84.24 	a baseline assessment. Recipients who meet these criteria must have a comprehensive 
84.25 	transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 
84.26 	reassessed every six months until there has been no significant change in the recipient's 
84.27 	functioning for at least 12 months. After there has been no significant change in the 
84.28 	recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 
84.29 	informal support systems, and need for services shall be conducted at least every 12 
84.30 	months and at other times when there has been a significant change in the recipient's 
84.31 	functioning. Counties, case managers, and service providers are responsible for 
84.32 	conducting these reassessments and shall complete the reassessments out of existing funds.

84.33 	Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
84.34 		Subdivision 1.Basis and scope. (a) Upon federal approval, the commissioner 
84.35 	shall establish a medical assistance state plan option for the provision of home and 
85.1 	community-based personal assistance service and supports called "community first 
85.2 	services and supports (CFSS)."
85.3 	(b) CFSS is a participant-controlled method of selecting and providing services 
85.4 	and supports that allows the participant maximum control of the services and supports. 
85.5 	Participants may choose the degree to which they direct and manage their supports by 
85.6 	choosing to have a significant and meaningful role in the management of services and 
85.7 	supports including by directly employing support workers with the necessary supports 
85.8 	to perform that function.
85.9 	(c) CFSS is available statewide to eligible individuals to assist with accomplishing 
85.10 	activities of daily living (ADLs), instrumental activities of daily living (IADLs), and 
85.11 	health-related procedures and tasks through hands-on assistance to accomplish the task 
85.12 	or constant supervision and cueing to accomplish the task; and to assist with acquiring, 
85.13 	maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and 
85.14 	health-related procedures and tasks. CFSS allows payment for certain supports and goods 
85.15 	such as environmental modifications and technology that are intended to replace or 
85.16 	decrease the need for human assistance.
85.17 	(d) Upon federal approval, CFSS will replace the personal care assistance program 
85.18 	under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
85.19 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in 
85.20 	this subdivision have the meanings given.
85.21 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, 
85.22 	dressing, bathing, mobility, positioning, and transferring.
85.23 	(c) "Agency-provider model" means a method of CFSS under which a qualified 
85.24 	agency provides services and supports through the agency's own employees and policies. 
85.25 	The agency must allow the participant to have a significant role in the selection and 
85.26 	dismissal of support workers of their choice for the delivery of their specific services 
85.27 	and supports.
85.28 	(d) "Behavior" means a description of a need for services and supports used to 
85.29 	determine the home care rating and additional service units. The presence of Level I 
85.30 	behavior is used to determine the home care rating. "Level I behavior" means physical 
85.31 	aggression towards self or others or destruction of property that requires the immediate 
85.32 	response of another person. If qualified for a home care rating as described in subdivision 
85.33 	8, additional service units can be added as described in subdivision 8, paragraph (f), for 
85.34 	the following behaviors:
85.35 	(1) Level I behavior;
86.1 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
86.2 	behavior; or
86.3 	(3) increased need for assistance for recipients who are verbally aggressive or 
86.4 	resistive to care so that time needed to perform activities of daily living is increased.
86.5 	(e) "Complex health-related needs" means an intervention listed in clauses (1) to 
86.6 	(8) that has been ordered by a physician, and is specified in a community support plan, 
86.7 	including:
86.8 	(1) tube feedings requiring:
86.9 	(i) a gastrojejunostomy tube; or
86.10 	(ii) continuous tube feeding lasting longer than 12 hours per day;
86.11 	(2) wounds described as:
86.12 	(i) stage III or stage IV; 
86.13 	(ii) multiple wounds;
86.14 	(iii) requiring sterile or clean dressing changes or a wound vac; or
86.15 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
86.16 	specialized  care;
86.17 	(3) parenteral therapy described as:
86.18 	(i) IV therapy more than two times per week lasting longer than four hours for 
86.19 	each  treatment; or
86.20 	(ii) total parenteral nutrition (TPN) daily; 
86.21 	(4) respiratory interventions, including:
86.22 	(i) oxygen required more than eight hours per day;
86.23 	(ii) respiratory vest more than one time per day;  
86.24 	(iii) bronchial drainage treatments more than two times per day;
86.25 	(iv) sterile or clean suctioning more than six times per day;
86.26 	(v) dependence on another to apply respiratory ventilation augmentation devices 
86.27 	such as  BiPAP and CPAP; and
86.28 	(vi) ventilator dependence under section 256B.0652;
86.29 	(5) insertion and maintenance of catheter, including: 
86.30 	(i) sterile catheter changes more than one time per month;
86.31 	(ii) clean intermittent catheterization, and including self-catheterization more than 
86.32 	six times  per day; or
86.33 	(iii) bladder irrigations;
86.34 	(6) bowel program more than two times per week requiring more than 30 minutes to 
86.35 	perform  each time;
86.36 	(7) neurological intervention, including: 
87.1 	(i) seizures more than two times per week and requiring significant physical 
87.2 	assistance  to maintain safety; or
87.3 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
87.4 	assistance  from another on a daily basis; and
87.5 	(8) other congenital or acquired diseases creating a need for significantly increased 
87.6 	direct  hands-on assistance and interventions in six to eight activities of daily living.
87.7 	(f) "Community first services and supports" or "CFSS" means the assistance and 
87.8 	supports program under this section needed for accomplishing activities of daily living, 
87.9 	instrumental activities of daily living, and health-related tasks through hands-on assistance 
87.10 	to complete the task or supervision and cueing to complete the task, or the purchase of 
87.11 	goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for 
87.12 	human assistance.
87.13 	(g) "Community first services and supports service delivery plan" or "service delivery 
87.14 	plan" means a written summary of the services and supports, that is based on the community 
87.15 	support plan identified in section 256B.0911 and coordinated services and support plan 
87.16 	and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined 
87.17 	by the participant to meet the assessed needs, using a person-centered planning process.
87.18 	(h) "Critical activities of daily living" means transferring, mobility, eating, and 
87.19 	toileting.
87.20 	(i) "Dependency" in activities of daily living means a person requires hands-on 
87.21 	assistance or constant supervision and cueing to accomplish  one or more of the activities 
87.22 	of daily living every day or on the days during the week that the activity is performed; 
87.23 	however, a child may not be found to be dependent in an activity of daily living if, 
87.24 	because of the child's age, an adult would either perform the activity for the child or assist 
87.25 	the child with the activity. Assistance needed is the assistance appropriate for a typical 
87.26 	child of the same age.
87.27 	(j) "Extended CFSS" means CFSS services and supports under the agencyâ€“provider 
87.28 	model included in a service plan through one of the home and community-based services 
87.29 	waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49, 
87.30 	which exceed the amount, duration, and frequency of the state plan CFSS services for 
87.31 	participants.
87.32 	(k) "Financial management services contractor or vendor" means a qualified 
87.33 	organization having a written contract with the department to provide services necessary to 
87.34 	use the budget model under subdivision 13, that include but are not limited to: participant 
87.35 	education and technical assistance; CFSS service delivery planning and budgeting; billing, 
87.36 	making payments, and monitoring of spending; and assisting the participant in fulfilling 
88.1 	employer-related requirements in accordance with Section 3504 of the IRS code and 
88.2 	the IRS Revenue Procedure 70-6.
88.3 	(l) "Budget model" means a service delivery method of CFSS that uses an 
88.4 	individualized CFSS service delivery plan and service budget and assistance from the 
88.5 	financial management services contractor to facilitate participant employment of support 
88.6 	workers and the acquisition of supports and goods.
88.7 	(m) "Health-related procedures and tasks" means procedures and tasks related to 
88.8 	the specific needs of an individual that can be delegated or assigned by a state-licensed 
88.9 	healthcare or behavioral health professional and performed by a support worker.
88.10 	(n) "Instrumental activities of daily living" means activities related to living 
88.11 	independently in the community, including but not limited to: meal planning, preparation, 
88.12 	and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning; 
88.13 	assistance with medications; managing money; communicating needs, preferences, and 
88.14 	activities; arranging supports; and assistance with traveling around and participating 
88.15 	in the community.
88.16 	(o) "Legal representative" means parent of a minor, a court-appointed guardian, or 
88.17 	another representative with legal authority to make decisions about services and supports 
88.18 	for the participant. Other representatives with legal authority to make decisions include 
88.19 	but are not limited to a health care agent or an attorney-in-fact authorized through a health 
88.20 	care directive or power of attorney.
88.21 	(p) "Medication assistance" means providing verbal or visual reminders to take  
88.22 	regularly scheduled medication, and includes any of the following supports listed in clauses 
88.23 	(1) to (3) and other types of assistance, except that a support worker may not determine 
88.24 	medication dose or time for medication or inject medications into veins, muscles, or skin:
88.25 	(1) under the direction of the participant or the participant's representative, bringing  
88.26 	medications to the participant including medications given through a nebulizer, opening a  
88.27 	container of previously set-up medications, emptying the container into the participant's  
88.28 	hand, opening and giving the medication in the original container to the participant, or  
88.29 	bringing to the participant liquids or food to accompany the medication;
88.30 	(2) organizing medications as directed by the participant or the participant's  
88.31 	representative; and
88.32 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
88.33 	(q) "Participant's representative" means a parent, family member, advocate, or 
88.34 	other adult authorized by the participant to serve as a representative in connection with 
88.35 	the provision of CFSS. This authorization must be in writing or by another method 
88.36 	that clearly indicates the participant's free choice. The participant's representative must 
89.1 	have no financial interest in the provision of any services included in the participant's 
89.2 	service delivery plan and must be capable of providing the support necessary to assist 
89.3 	the participant in the use of CFSS. If through the assessment process described in 
89.4 	subdivision 5 a participant is determined to be in need of a participant's representative, one 
89.5 	must be selected. If the participant is unable to assist in the selection of a participant's 
89.6 	representative, the legal representative shall appoint one. Two persons may be designated 
89.7 	as a participant's representative for reasons such as divided households and court-ordered 
89.8 	custodies. Duties of a participant's representatives may include:
89.9 	(1) being available while care is provided in a method agreed upon by the participant 
89.10 	or the participant's legal representative and documented in the participant's CFSS service 
89.11 	delivery plan;
89.12 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery 
89.13 	plan is being followed; and
89.14 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
89.15 	verification of the CFSS services.
89.16 	(r) "Person-centered planning process" means a process that is driven by the 
89.17 	participant for discovering and planning services and supports that ensures the participant 
89.18 	makes informed choices and decisions. The person-centered planning process must:
89.19 	(1) include people chosen by the participant;
89.20 	(2) provide necessary information and support to ensure that the participant directs 
89.21 	the process to the maximum extent possible, and is enabled to make informed choices 
89.22 	and decisions;
89.23 	(3) be timely and occur at time and locations of convenience to the participant;
89.24 	(4) reflect cultural considerations of the participant;
89.25 	(5) include strategies for solving conflict or disagreement within the process, 
89.26 	including clear conflict-of-interest guidelines for all planning;
89.27 	(6) offer choices to the participant regarding the services and supports they receive 
89.28 	and from whom;
89.29 	(7) include a method for the participant to request updates to the plan; and
89.30 	(8) record the alternative home and community-based settings that were considered 
89.31 	by the participant.
89.32 	(s) "Shared services" means the provision of CFSS services by the same CFSS 
89.33 	support worker to two or three participants who voluntarily enter into an agreement to 
89.34 	receive services at the same time and in the same setting by the same provider.
89.35 	(t) "Support specialist" means a professional with the skills and ability to assist the 
89.36 	participant using either the agency provider model under subdivision 11 or the flexible 
90.1 	spending model under subdivision 13, in services including but not limited to assistance 
90.2 	regarding:
90.3 	(1) the development, implementation, and evaluation of the CFSS service delivery 
90.4 	plan under subdivision 6;
90.5 	(2) recruitment, training, or supervision, including supervision of health-related 
90.6 	tasks or behavioral supports appropriately delegated by a health care professional, and 
90.7 	evaluation of support workers; and
90.8 	(3) facilitating the use of informal and community supports, goods, or resources.
90.9 	(u) "Support worker" means an employee of the agency provider or of the participant 
90.10 	who has direct contact with the participant and provides services as specified within the 
90.11 	participant's service delivery plan.
90.12 	(v) "Wages and benefits" means the hourly wages and salaries, the employer's 
90.13 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' 
90.14 	compensation, mileage reimbursement, health and dental insurance, life insurance, 
90.15 	disability insurance, long-term care insurance, uniform allowance, contributions to 
90.16 	employee retirement accounts, or other forms of employee compensation and benefits.
90.17 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the 
90.18 	following:
90.19 	(1) is a recipient of medical assistance as determined under section 256B.055, 
90.20 	256B.056, or 256B.057, subdivisions 5 and 9;
90.21 	(2) is a recipient of the alternative care program under section 256B.0913;
90.22 	(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093, 
90.23 	or 256B.49; or
90.24 	(4) has medical services identified in a participant's individualized education 
90.25 	program and is eligible for services as determined in section 256B.0625, subdivision 26.
90.26 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
90.27 	meet all of the following:
90.28 	(1) require assistance and be determined dependent in one activity of daily living or 
90.29 	Level I behavior based on assessment under section 256B.0911;
90.30 	(2) is not a recipient under the family support grant under section 252.32;
90.31 	(3) lives in the person's own apartment or home including a family foster care setting 
90.32 	licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a 
90.33 	noncertified boarding care or boarding and lodging establishments under chapter 157. 
90.34 		Subd. 4.Eligibility for other services. Selection of CFSS by a participant must not 
90.35 	restrict access to other medically necessary care and services furnished under the state 
90.36 	plan medical assistance benefit or other services available through alternative care.
91.1 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
91.2 	(1) be conducted by a certified assessor according to the criteria established in 
91.3 	section 256B.0911, subdivision 3a;
91.4 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there 
91.5 	is a significant change in the participant's condition or a change in the need for services 
91.6 	and supports; and
91.7 	(3) be completed using the format established by the commissioner.
91.8 	(b) A participant who is residing in a facility may be assessed and choose CFSS for 
91.9 	the purpose of using CFSS to return to the community as described in subdivisions 3 
91.10 	and 7, paragraph (a), clause (5).
91.11 	(c) The results of the assessment and any recommendations and authorizations for 
91.12 	CFSS must be determined and communicated in writing by the lead agency's certified 
91.13 	assessor as defined in section 256B.0911 to the participant and the agency-provider or 
91.14 	financial management services provider chosen by the participant within 40 calendar days 
91.15 	and must include the participant's right to appeal under section 256.045, subdivision 3.
91.16 	(d)  The lead agency assessor may request a temporary authorization for CFSS 
91.17 	services. Authorization for a temporary level of CFSS services is limited to the time 
91.18 	specified by the commissioner, but shall not exceed 45 days. The level of services 
91.19 	authorized under this provision shall have no bearing on a future authorization.
91.20 		Subd. 6.Community first services and support service delivery plan. (a) The 
91.21 	CFSS service delivery plan must be developed, implemented, and evaluated through a 
91.22 	person-centered planning process by the participant, or the participant's representative 
91.23 	or legal representative who may be assisted by a support specialist. The CFSS service 
91.24 	delivery plan must reflect the services and supports that are important to the participant 
91.25 	and for the participant to meet the needs assessed by the certified assessor and identified 
91.26 	in the community support plan under section 256B.0911 or the coordinated services and 
91.27 	support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS 
91.28 	service delivery plan must be reviewed by the participant and the agency-provider or 
91.29 	financial management services contractor at least annually upon reassessment, or when 
91.30 	there is a significant change in the participant's condition, or a change in the need for 
91.31 	services and supports.
91.32 	(b) The commissioner shall establish the format and criteria for the CFSS service 
91.33 	delivery plan.
91.34 	(c) The CFSS service delivery plan must be person-centered and:
91.35 	(1) specify the agency-provider or financial management services contractor selected 
91.36 	by the participant;
92.1 	(2) reflect the setting in which the participant resides that is chosen by the participant;
92.2 	(3) reflect the participant's strengths and preferences;
92.3 	(4) include the means to address the clinical and support needs as identified through 
92.4 	an assessment of functional needs;
92.5 	(5) include individually identified goals and desired outcomes;
92.6 	(6) reflect the services and supports, paid and unpaid, that will assist the participant 
92.7 	to achieve identified goals, and the providers of those services and supports, including 
92.8 	natural supports;
92.9 	(7) identify the amount and frequency of face-to-face supports and amount and 
92.10 	frequency of remote supports and technology that will be used;
92.11 	(8) identify risk factors and measures in place to minimize them, including 
92.12 	individualized backup plans;
92.13 	(9) be understandable to the participant and the individuals providing support;
92.14 	(10) identify the individual or entity responsible for monitoring the plan;
92.15 	(11) be finalized and agreed to in writing by the participant and signed by all 
92.16 	individuals and providers responsible for its implementation;
92.17 	(12) be distributed to the participant and other people involved in the plan; and
92.18 	(13) prevent the provision of unnecessary or inappropriate care.
92.19 	(d) The total units of agency-provider services or the budget allocation amount for 
92.20 	the budget model include both annual totals and a monthly average amount that cover 
92.21 	the number of months of the service authorization. The amount used each month may 
92.22 	vary, but additional funds must not be provided above the annual service authorization 
92.23 	amount unless a change in condition is assessed and authorized by the certified assessor 
92.24 	and documented in the community support plan, coordinated services and supports plan, 
92.25 	and service delivery plan.
92.26 		Subd. 7.Community first services and supports; covered services.  Services 
92.27 	and supports covered under CFSS include:
92.28 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities 
92.29 	of daily living (IADLs), and health-related procedures and tasks through hands-on 
92.30 	assistance to complete the task or supervision and cueing to complete the task;
92.31 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant 
92.32 	to accomplish activities of daily living, instrumental activities of daily living, or 
92.33 	health-related tasks;
92.34 	(3) expenditures for items, services, supports, environmental modifications, or 
92.35 	goods, including assistive technology. These expenditures must:
92.36 	(i) relate to a need identified in a participant's CFSS service delivery plan; 
93.1 	(ii) increase independence or substitute for human assistance to the extent that 
93.2 	expenditures would otherwise be made for human assistance for the participant's assessed 
93.3 	needs; 
93.4 	(4) observation and redirection for behavior or symptoms where there is a need for 
93.5 	assistance. A recipient qualifies as having a need for assistance due to behaviors if the 
93.6 	recipient's behavior requires assistance at least four times per week and shows one or 
93.7 	more of the following behaviors:
93.8 	(i) physical aggression towards self or others, or destruction of property that requires 
93.9 	the immediate response of another person;
93.10 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate 
93.11 	behavior; or
93.12 	(iii) increased need for assistance for recipients who are verbally aggressive or 
93.13 	resistive to care so that time needed to perform activities of daily living is increased;
93.14 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic 
93.15 	devices, to ensure continuity of the participant's services and supports;
93.16 	(6) transition costs, including:
93.17 	(i) deposits for rent and utilities;
93.18 	(ii) first month's rent and utilities;
93.19 	(iii) bedding;
93.20 	(iv) basic kitchen supplies;
93.21 	(v) other necessities, to the extent that these necessities are not otherwise covered 
93.22 	under any other funding that the participant is eligible to receive; and
93.23 	(vi) other required necessities for an individual to make the transition from a nursing 
93.24 	facility, institution for mental diseases, or intermediate care facility for persons with 
93.25 	developmental disabilities to a community-based home setting where the participant 
93.26 	resides; and
93.27 	(7) services by a support specialist defined under subdivision 2 that are chosen 
93.28 	by the participant.
93.29 		Subd. 8.Determination of CFSS service methodology. (a) All community first 
93.30 	services and supports must be authorized by the commissioner or the commissioner's  
93.31 	designee before services begin, except for the assessments established in section  
93.32 	256B.0911. The authorization for CFSS must be completed as soon as possible following 
93.33 	an assessment but no later than 40 calendar days from the date of the assessment.
93.34 	(b) The amount of CFSS authorized must be based on the recipient's home  care 
93.35 	rating described in subdivision 8, paragraphs (d) and (e), and any additional service units 
93.36 	for which the person qualifies as described in subdivision 8, paragraph (f). 
94.1 	(c) The home care rating shall be determined by the commissioner or the  
94.2 	commissioner's designee based on information submitted to the commissioner identifying  
94.3 	the following for a recipient:
94.4 	(1) the total number of dependencies of activities of daily living as defined in  
94.5 	subdivision 2, paragraph (b);
94.6 	(2) the presence of complex health-related needs as defined in subdivision 2, 
94.7 	paragraph (e); and
94.8 	(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d), 
94.9 	clause (1).
94.10 	(d) The methodology to determine  the total service units for CFSS for each home 
94.11 	care rating is based on the median paid units  per day for each home care rating from 
94.12 	fiscal year 2007 data for the PCA program.
94.13 	(e) Each  home care rating is designated by the letters P through Z and EN and  has 
94.14 	the following base number of service units assigned:
94.15 	(i) P home care rating requires Level 1 behavior or one to three dependencies in 
94.16 	ADLs and qualifies one for five service units;
94.17 	(ii) Q home care rating requires Level 1 behavior and one to three dependencies in 
94.18 	ADLs and qualifies one for six service units;  
94.19 	(iii) R home care rating requires complex health-related needs and one to three 
94.20 	dependencies in ADLs and qualifies one for seven service units; 
94.21 	(iv) S home care rating requires four to six dependencies in ADLs and qualifies 
94.22 	one for ten service units;
94.23 	(v) T home care rating requires four to six dependencies in ADLs and Level 1 
94.24 	behavior and qualifies one for 11 service units;
94.25 	(vi) U home care rating requires four to six dependencies in ADLs and a complex 
94.26 	health need and qualifies one for 14 service units;
94.27 	(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies 
94.28 	one for 17 service units; 
94.29 	(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1 
94.30 	behavior and qualifies one for 20 service units;
94.31 	(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex 
94.32 	health related need and qualifies one for 30 service units; and
94.33 	(x) EN home care rating includes ventilator dependency as defined in section 
94.34 	256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of 
94.35 	ventilator-dependent and the EN home care rating and utilize a combination of CFSS 
94.36 	and other home care services are limited to a total of 96 service units per day for those 
95.1 	services in combination. Additional units may be authorized when a recipient's assessment 
95.2 	indicates a need for two staff to perform activities. Additional time is limited to 16 service 
95.3 	units per day.
95.4 	(f) Additional service units are provided  through the assessment and identification of 
95.5 	the following:
95.6 	(1) 30 additional minutes per day for a dependency in each critical activity of daily  
95.7 	living as defined in subdivision 2, paragraph (h);
95.8 	(2) 30 additional minutes per day for each complex health-related function as  
95.9 	defined in subdivision 2, paragraph (e); and   
95.10 	(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2, 
95.11 	paragraph (d). 
95.12 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for 
95.13 	payment under this section include those that:
95.14 	(1) are not authorized by the certified assessor or included in the written service 
95.15 	delivery plan;
95.16 	(2) are provided prior to the authorization of services and the approval of the written 
95.17 	CFSS service delivery plan;
95.18 	(3) are duplicative of other paid services in the written service delivery plan;
95.19 	(4) supplant natural unpaid supports that appropriately meet a need in the service 
95.20 	plan, are provided voluntarily to the participant and are selected by the participant in lieu 
95.21 	of other services and supports;
95.22 	(5) are not effective means to meet the participant's needs; and
95.23 	(6) are available through other funding sources, including, but not limited to, funding 
95.24 	through Title IV-E of the Social Security Act.
95.25 	(b) Additional services, goods, or supports that are not covered include:
95.26 	(1) those that are not for the direct benefit of the participant, except that services for 
95.27 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
95.28 	benefit the participant if chosen by the participant and approved in the support plan;
95.29 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
95.30 	and co-pays, legal fees, or costs related to advocate agencies;
95.31 	(3) insurance, except for insurance costs related to employee coverage;
95.32 	(4) room and board costs for the participant with the exception of allowable 
95.33 	transition costs in subdivision 7, clause (6);
95.34 	(5) services, supports, or goods that are not related to the assessed needs;
96.1 	(6) special education and related services provided under the Individuals with 
96.2 	Disabilities Education Act and vocational rehabilitation services provided under the 
96.3 	Rehabilitation Act of 1973;
96.4 	(7) assistive technology devices and assistive technology services other than those 
96.5 	for back-up systems or mechanisms to ensure continuity of service and supports listed in 
96.6 	subdivision 7;
96.7 	(8) medical supplies and equipment;
96.8 	(9) environmental modifications, except as specified in subdivision 7;
96.9 	(10) expenses for travel, lodging, or meals related to training the participant, the 
96.10 	participant's representative, legal representative, or paid or unpaid caregivers that exceed 
96.11 	$500 in a 12-month period;
96.12 	(11) experimental treatments;
96.13 	(12) any service or good covered by other medical assistance state plan services, 
96.14 	including prescription and over-the-counter medications, compounds, and solutions and 
96.15 	related fees, including premiums and co-payments;
96.16 	(13) membership dues or costs, except when the service is necessary and appropriate 
96.17 	to treat a physical condition or to improve or maintain the participant's physical condition. 
96.18 	The condition must be identified in the participant's CFSS plan and monitored by a 
96.19 	physician enrolled in a Minnesota health care program;
96.20 	(14) vacation expenses other than the cost of direct services;
96.21 	(15) vehicle maintenance or modifications not related to the disability, health 
96.22 	condition, or physical need; and
96.23 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
96.24 	events.
96.25 		Subd. 10.Provider qualifications and general requirements. (a) 
96.26 	Agency-providers delivering services under the agency-provider model under subdivision 
96.27 	11 or financial management service (FMS) contractors under subdivision 13 shall:
96.28 	(1) enroll as a medical assistance Minnesota health care programs provider and meet 
96.29 	all applicable provider standards;
96.30 	(2) comply with medical assistance provider enrollment requirements;
96.31 	(3) demonstrate compliance with law and policies of CFSS as determined by the 
96.32 	commissioner;
96.33 	(4) comply with background study requirements under chapter 245C;
96.34 	(5) verify and maintain records of all services and expenditures by the participant, 
96.35 	including hours worked by support workers and support specialists;
97.1 	(6) not engage in any agency-initiated direct contact or marketing in person, by 
97.2 	telephone, or other electronic means to potential participants, guardians, family member, 
97.3 	or participants' representatives;
97.4 	(7) pay support workers and support specialists based upon actual hours of services 
97.5 	provided;
97.6 	(8) withhold and pay all applicable federal and state payroll taxes;
97.7 	(9) make arrangements and pay unemployment insurance, taxes, workers' 
97.8 	compensation, liability insurance, and other benefits, if any;
97.9 	(10) enter into a written agreement with the participant, participant's representative, 
97.10 	or legal representative that assigns roles and responsibilities to be performed before 
97.11 	services, supports, or goods are provided using a format established by the commissioner;
97.12 	(11) report maltreatment as required under sections 626.556 and 626.557; and
97.13 	(12) provide the participant with a copy of the service-related rights under 
97.14 	subdivision 19 at the start of services and supports.
97.15 	(b) The commissioner shall develop policies and procedures designed to ensure 
97.16 	program integrity and fiscal accountability for goods and services provided in this section 
97.17 	in consultation with the implementation council described in subdivision 21.
97.18 		Subd. 11.Agency-provider model. (a) The agency-provider model is limited to  
97.19 	the services provided by support workers and support specialists who are employed by 
97.20 	an agency-provider that is licensed according to chapter 245A or meets other criteria 
97.21 	established by the commissioner, including required training.
97.22 	(b) The agency-provider shall allow the participant to have a significant role in the 
97.23 	selection and dismissal of the support workers for the delivery of the   services and supports 
97.24 	specified in the participant's service delivery plan.
97.25 	(c) A participant may use authorized units of CFSS services as needed within  a 
97.26 	service authorization that is not greater than 12 months. Using authorized units in a 
97.27 	flexible manner in either the agency-provider model or the budget model  does not increase 
97.28 	the total amount of services and supports authorized for a  participant or included in the 
97.29 	participant's service delivery plan.
97.30 	(d) A participant may share CFSS services. Two or three CFSS participants may  
97.31 	share services at the same time provided by the same support worker.
97.32 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue  
97.33 	generated by the medical assistance payment for CFSS for support worker wages and 
97.34 	benefits. The agency-provider must document how this requirement is being met. The 
97.35 	revenue generated by the support specialist and the reasonable costs associated with the 
97.36 	support specialist must not be used in making this calculation.
98.1 	(f) The agency-provider model must be used by individuals who have been restricted 
98.2 	by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 
98.3 	to 9505.2245.
98.4 		Subd. 12.Requirements for initial enrollment of CFSS provider agencies.  (a)  
98.5 	All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider  
98.6 	agency in a format determined by the commissioner, information and documentation that  
98.7 	includes, but is not limited to, the following:
98.8 	(1) the CFSS provider agency's current contact information including address,  
98.9 	telephone number, and e-mail address;
98.10 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the  
98.11 	provider's payments from Medicaid in the previous year, whichever is less;
98.12 	(3) proof of fidelity bond coverage in the amount of $20,000;
98.13 	(4) proof of workers' compensation insurance coverage;
98.14 	(5) proof of liability insurance;
98.15 	(6) a description of the CFSS provider agency's organization identifying the names  
98.16 	or all owners, managing employees, staff, board of directors, and the affiliations of the  
98.17 	directors, owners, or staff to other service providers;
98.18 	(7) a copy of the CFSS provider agency's written policies and procedures including:  
98.19 	hiring of employees; training requirements; service delivery; and employee and consumer  
98.20 	safety including process for notification and resolution of consumer grievances,  
98.21 	identification and prevention of communicable diseases, and employee misconduct;
98.22 	(8) copies of all other forms the CFSS provider agency uses in the course of daily  
98.23 	business including, but not limited to:
98.24 	(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from  
98.25 	the standard time sheet for CFSS services approved by the commissioner, and a letter  
98.26 	requesting approval of the CFSS provider agency's nonstandard time sheet;
98.27 	(ii) the CFSS provider agency's template for the CFSS care plan; and
98.28 	(iii) the CFSS provider agency's template for the written agreement in subdivision 
98.29 	21 for recipients using the CFSS choice option, if applicable;
98.30 	(9) a list of all training and classes that the CFSS provider agency requires of its  
98.31 	staff providing CFSS services;
98.32 	(10) documentation that the CFSS provider agency and staff have successfully  
98.33 	completed all the training required by this section;
98.34 	(11) documentation of the agency's marketing practices;
98.35 	(12) disclosure of ownership, leasing, or management of all residential properties   
98.36 	that is used or could be used for providing home care services;
99.1 	(13) documentation that the agency will use the following percentages of revenue  
99.2 	generated from the medical assistance rate paid for CFSS services for employee personal  
99.3 	care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The  
99.4 	revenue generated by the support specialist and the reasonable costs associated with the  
99.5 	support specialist shall not be used in making this calculation; and 
99.6 	(14) documentation that the agency does not burden recipients' free exercise of their  
99.7 	right to choose service providers by requiring personal care assistants to sign an agreement  
99.8 	not to work with any particular CFSS recipient or for another CFSS provider agency after  
99.9 	leaving the agency and that the agency is not taking action on any such agreements or 
99.10 	requirements regardless of the date signed.
99.11 	(b) CFSS provider agencies shall provide to the commissioner the information 
99.12 	specified in paragraph (a).
99.13 	(c) All CFSS provider agencies shall require all employees in management and 
99.14 	supervisory positions and owners of the agency who are active in the day-to-day 
99.15 	management and operations of the agency to complete mandatory training as determined 
99.16 	by the commissioner. Employees in management and supervisory positions and owners 
99.17 	who are active in the day-to-day operations of an agency who have completed the required  
99.18 	training as an employee with a CFSS provider agency do not need to repeat the required 
99.19 	training if they are hired by another agency, if they have completed the training within 
99.20 	the past three years. CFSS provider agency billing staff shall complete training about 
99.21 	CFSS program financial management. Any new owners or employees in management 
99.22 	and supervisory positions involved in the day-to-day operations are required to complete 
99.23 	mandatory training as a requisite of working for the agency. CFSS provider agencies 
99.24 	certified for participation in Medicare as home health agencies are exempt from the 
99.25 	training required in this subdivision. 
99.26 		Subd. 13.Budget model.  (a) Under the budget model participants can exercise 
99.27 	more responsibility and control over the services and supports described and budgeted 
99.28 	within the CFSS service delivery plan. Under this model, participants may use their 
99.29 	budget allocation to:
99.30 	(1) directly employ support workers;
99.31 	(2) obtain supports and goods as defined in subdivision 7; and
99.32 	(3) choose a range of support assistance services from the financial management 
99.33 	services (FMS) contractor related to:
99.34 	(i) assistance in managing the budget to meet the service delivery plan needs, 
99.35 	consistent with federal and state laws and regulations;
100.1 	(ii) the employment, training, supervision, and evaluation of workers by the 
100.2 	participant;
100.3 	(iii) acquisition and payment for supports and goods; and
100.4 	(iv) evaluation of individual service outcomes as needed for the scope of the  
100.5 	participant's degree of control and responsibility.
100.6 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) 
100.7 	may authorize a legal representative or participant's representative to do so on their behalf.
100.8 	(c) The FMS contractor shall not provide CFSS services and supports under the  
100.9 	agency-provider service model. The FMS contractor shall provide service functions as 
100.10 	determined by the commissioner that include but are not limited to:
100.11 	(1) information and consultation about CFSS;
100.12 	(2) assistance with the development of the service delivery plan and budget model 
100.13 	as requested by the participant;
100.14 	(3) billing and making payments for budget model expenditures;
100.15 	(4) assisting participants in fulfilling employer-related requirements according to 
100.16 	Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,  
100.17 	regulation 137036-08, which includes assistance with filing and paying payroll taxes, and 
100.18 	obtaining worker compensation coverage;
100.19 	(5) data recording and reporting of participant spending; and
100.20 	(6) other duties established in the contract with the department.
100.21 	(d) A participant who requests to purchase goods and supports along with support  
100.22 	worker services under the agency-provider model must use the budget model  with 
100.23 	a service delivery plan that specifies the amount of services to be authorized to the 
100.24 	agency-provider and the expenditures to be paid by the FMS contractor.
100.25 	(e) The FMS contractor shall:
100.26 	(1) not limit or restrict the participant's choice of service or support providers or  
100.27 	service delivery models consistent with any applicable state and federal requirements;
100.28 	(2) provide the participant and the targeted case manager, if applicable, with a 
100.29 	monthly written summary of the spending for services and supports that were billed 
100.30 	against the spending budget;
100.31 	(3) be knowledgeable of state and federal employment regulations under the Fair 
100.32 	Labor Standards Act of 1938, and comply with the requirements under the Internal 
100.33 	Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax 
100.34 	Liability for vendor or fiscal employer agent, and any requirements necessary to process 
100.35 	employer and employee deductions, provide appropriate and timely submission of 
100.36 	employer tax liabilities, and maintain documentation to support medical assistance claims;
101.1 	(4) have current and adequate liability insurance and bonding and sufficient cash 
101.2 	flow as determined by the commissioner and have on staff or under contract a certified 
101.3 	public accountant or an individual with a baccalaureate degree in accounting;
101.4 	(5) assume fiscal accountability for state funds designated for the program; and
101.5 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
101.6 	supports expenditures for any goods purchased and maintain time records of support 
101.7 	workers. The documentation and time records must be maintained for a minimum of 
101.8 	five years from the claim date and be available for audit or review upon request by the 
101.9 	commissioner. Claims submitted by the FMS contractor to the commissioner for payment 
101.10 	must correspond with services, amounts, and time periods as authorized in the participant's 
101.11 	spending budget and service plan.
101.12 	(f) The commissioner of human services shall:
101.13 	(1) establish rates and payment methodology for the FMS contractor;
101.14 	(2) identify a process to ensure quality and performance standards for the FMS 
101.15 	contractor and ensure statewide access to FMS contractors; and 
101.16 	(3) establish a uniform protocol for delivering and administering CFSS services 
101.17 	to be used by eligible FMS contractors.
101.18 	(g) The commissioner of human services shall disenroll or exclude participants from 
101.19 	the budget model and transfer them to the agency-provider model under the following 
101.20 	circumstances that include but are not limited to:
101.21 	(1) when a participant has been restricted by the Minnesota restricted recipient 
101.22 	program, the participant may be excluded for a specified time period under Minnesota 
101.23 	Rules, parts 9505.2160 to 9505.2245;
101.24 	(2) when a participant exits the budget model during the participant's service plan 
101.25 	year. Upon transfer, the participant shall not access the budget  model for the remainder of 
101.26 	that service plan year; or 
101.27 	(3) when the department determines that the participant or participant's representative 
101.28 	or legal representative cannot manage participant responsibilities under the budget model. 
101.29 	The commissioner must develop policies for determining if a participant  is unable to 
101.30 	manage responsibilities under a budget model.
101.31 	(h) A participant may appeal under section 256.045, subdivision 3, in writing to the 
101.32 	department to contest the department's decision under paragraph (c), clause (3), to remove 
101.33 	or exclude the participant from the budget model.
101.34 		Subd. 14.Participant's responsibilities under budget model. (a) A  participant 
101.35 	using the budget model must use an FMS contractor or vendor that is  under contract with 
101.36 	the department. Upon a determination of eligibility and completion of the assessment and 
102.1 	community support plan, the participant shall choose a FMS contractor from a list of 
102.2 	eligible vendors maintained by the department.
102.3 	(b) When the participant, participant's representative, or legal representative chooses 
102.4 	to be the employer of the support worker, they are responsible for the hiring and supervision 
102.5 	of the support worker, including, but not limited to, recruiting, interviewing, training, and 
102.6 	discharging the support worker consistent with federal  and state laws and regulations.
102.7 	(c) In addition to the employer responsibilities in paragraph (b), the participant,  
102.8 	participant's representative, or legal representative is responsible for:
102.9 	(1) tracking the services provided and all expenditures for goods or other supports;
102.10 	(2) preparing and submitting time sheets, signed by both the participant and support 
102.11 	worker, to the FMS contractor on a regular basis and in a timely manner according to 
102.12 	the FMS contractor's procedures;  
102.13 	(3) notifying the FMS contractor within ten days of any changes in circumstances  
102.14 	affecting the CFSS service plan or in the participant's place of residence including, but  
102.15 	not limited to, any hospitalization of the participant or change in the participant's address,  
102.16 	telephone number, or employment;
102.17 	(4) notifying the FMS contractor of any changes in the employment status of each 
102.18 	participant support worker; and  
102.19 	(5) reporting any problems resulting from the quality of services rendered by the  
102.20 	support worker to the FMS contractor. If the participant is unable to resolve any problems  
102.21 	resulting from the quality of service rendered by the support worker with the assistance of  
102.22 	the FMS contractor, the participant shall report the situation to the department.  
102.23 		Subd. 15.Documentation of support services provided. (a) Support services 
102.24 	provided to a participant by a support worker employed by either an agency-provider 
102.25 	or the participant acting as the employer must be documented daily by each support 
102.26 	worker, on a time sheet form approved by the commissioner. All documentation may be 
102.27 	Web-based, electronic, or paper documentation. The completed form must be submitted 
102.28 	on a monthly basis to the provider or the participant and the FMS contractor selected by 
102.29 	the participant to provide assistance with meeting the participant's employer obligations 
102.30 	and kept in the recipient's health record.
102.31 	(b) The activity documentation must correspond to the written service delivery plan 
102.32 	and be reviewed by the agency provider or the participant and the FMS contractor when 
102.33 	the participant is acting as the employer of the support worker.
102.34 	(c) The time sheet must be on a form approved by the commissioner documenting 
102.35 	time the support worker provides services in the home. The following criteria must be 
102.36 	included in the time sheet:
103.1 	(1) full name of the support worker and individual provider number;
103.2 	(2) provider name and telephone numbers, if an agency-provider is responsible for 
103.3 	delivery services under the written service plan;
103.4 	(3) full name of the participant;
103.5 	(4) consecutive dates, including month, day, and year, and arrival and departure 
103.6 	times with a.m. or p.m. notations;
103.7 	(5) signatures of the participant or the participant's representative;
103.8 	(6) personal signature of the support worker;
103.9 	(7) any shared care provided, if applicable;
103.10 	(8) a statement that it is a federal crime to provide false information on CFSS 
103.11 	billings for medical assistance payments; and
103.12 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
103.13 		Subd. 16.Support workers requirements. (a) Support workers shall:
103.14 	(1) enroll with the department as a support worker after a background study under 
103.15 	chapter 245C has been completed and the support worker has received a notice from the 
103.16 	commissioner that:
103.17 	(i) the support worker is not disqualified under section 245C.14; or
103.18 	(ii) is disqualified, but the support worker has received a set-aside of the 
103.19 	disqualification under section 245C.22; 
103.20 	(2) have the ability to effectively communicate with the participant or the  
103.21 	participant's representative;
103.22 	(3) have the skills and ability to provide the services and supports according to the 
103.23 	person's CFSS service delivery plan and respond appropriately to the participant's needs;
103.24 	(4) not be a participant of CFSS, unless the support services provided by the support 
103.25 	worker differ from those provided to the support worker;
103.26 	(5) complete the basic standardized training as determined by the commissioner 
103.27 	before completing enrollment. The training must be available in languages other than 
103.28 	English and to those who need accommodations due to disabilities. Support worker 
103.29 	training must include successful completion of the following training components: basic 
103.30 	first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles 
103.31 	and responsibilities of support workers including information about basic body mechanics,  
103.32 	emergency preparedness, orientation to positive behavioral practices, orientation to 
103.33 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
103.34 	overview of person-centered planning and self-direction. Upon completion of the training 
103.35 	components, the support worker must pass the certification test to provide assistance 
103.36 	to participants;
104.1 	(6) complete training and orientation on the participant's individual needs; and
104.2 	(7) maintain the privacy and confidentiality of the participant, and not independently 
104.3 	determine the medication dose or time for medications for the participant.
104.4 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
104.5 	and provider number if the support worker:
104.6 	(1) lacks the skills, knowledge, or ability to adequately or safely perform the  
104.7 	required work;
104.8 	(2) fails to provide the authorized services required by the participant employer;
104.9 	(3) has been intoxicated by alcohol or drugs while providing authorized services to  
104.10 	the participant or while in the participant's home;
104.11 	(4) has manufactured or distributed drugs while providing authorized services to the  
104.12 	participant or while in the participant's home; or
104.13 	(5) has been excluded as a provider by the commissioner of human services, or the  
104.14 	United States Department of Health and Human Services, Office of Inspector General,  
104.15 	from participation in Medicaid, Medicare, or any other federal health care program.
104.16 	(c) A support worker may appeal in writing to the commissioner to contest the 
104.17 	decision to terminate the support worker's provider enrollment and provider number.
104.18 		Subd. 17.Support specialist requirements and payments. The commissioner 
104.19 	shall develop qualifications, scope of functions, and payment rates and service limits for a 
104.20 	support specialist that may provide additional or specialized assistance necessary to plan, 
104.21 	implement, arrange, augment, or evaluate services and supports.
104.22 		Subd. 18.Service unit and budget allocation requirements and limits. (a) For the  
104.23 	agency-provider model, services will be authorized in units of service. The total service  
104.24 	unit amount must be established based upon the assessed need for CFSS services, and  must 
104.25 	not exceed the maximum number of units available as determined under  subdivision 8.
104.26 	(b) For the budget model, the budget allocation allowed for services and supports 
104.27 	is established by multiplying the number of units authorized under subdivision 8 by the 
104.28 	payment rate established by the commissioner.
104.29 		Subd. 19.Support system. (a) The commissioner shall provide information, 
104.30 	consultation, training, and assistance to ensure the participant is able to manage the   
104.31 	services and supports and budgets, if applicable. This support shall include individual 
104.32 	consultation on how to select and employ workers, manage responsibilities under CFSS, 
104.33 	and evaluate personal outcomes.
104.34 	(b) The commissioner shall provide assistance with the development of risk   
104.35 	management agreements.
105.1 		Subd. 20.Service-related rights. (a) Participants must be provided with adequate 
105.2 	information, counseling, training, and assistance, as needed, to ensure that the participant 
105.3 	is able to choose and manage services, models, and budgets. This support shall include  
105.4 	information regarding:
105.5 	(1) person-centered planning;
105.6 	(2) the range and scope of individual choices;
105.7 	(3) the process for changing plans, services and budgets;
105.8 	(4) the grievance  process;
105.9 	(5) individual rights;
105.10 	(6) identifying and assessing appropriate services;
105.11 	(7) risks and responsibilities; and
105.12 	(8) risk management.
105.13 	(b) The commissioner must ensure that the participant has a copy of the most recent 
105.14 	community support plan and service delivery plan.
105.15 	(c) A participant who appeals a reduction in previously authorized CFSS services 
105.16 	may continue previously authorized services pending an appeal in accordance with section 
105.17 	256.045.
105.18 	(d) If the units of service or budget allocation for CFSS are reduced, denied, or 
105.19 	terminated, the commissioner must provide notice of the reasons for the reduction in the 
105.20 	participant's notice of denial, termination, or reduction.
105.21 	(e) If all or part of a service delivery plan is denied approval, the commissioner must 
105.22 	provide a notice that describes the basis of the denial.
105.23 		Subd. 21.Development and Implementation Council. The commissioner 
105.24 	shall establish a Development and Implementation Council of which the majority of  
105.25 	members are individuals with disabilities, elderly individuals, and their representatives. 
105.26 	The commissioner shall consult and collaborate with the council when developing and 
105.27 	implementing this section for at least the first five years of operation. The commissioner, 
105.28 	in consultation with the council, shall provide recommendations on how to improve the 
105.29 	quality and integrity of CFSS, reduce the paper documentation required in subdivisions 
105.30 	10, 12, and 15, make use of electronic means of documentation and online reporting in 
105.31 	order to reduce administrative costs and improve training to the legislative chairs of the 
105.32 	health and human services policy and finance committees by February 1, 2014.
105.33 		Subd. 22.Quality assurance and risk management system. (a) The commissioner 
105.34 	shall establish quality assurance and risk management measures for use in developing and 
105.35 	implementing CFSS, including those that (1) recognize the roles and responsibilities of 
105.36 	those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and 
106.1 	budgets based upon a recipient's resources and capabilities. Risk management measures 
106.2 	must include background studies, and backup and emergency plans, including disaster 
106.3 	planning.
106.4 	(b) The commissioner shall provide ongoing technical assistance and resource and  
106.5 	educational materials for CFSS participants. 
106.6 	(c) Performance assessment measures, such as a participant's satisfaction with the 
106.7 	services and supports, and ongoing monitoring of health and well-being shall be identified 
106.8 	in consultation with the council established in subdivision 21.
106.9 	(d) Data reporting requirements will be developed in consultation with the council 
106.10 	established in subdivision 21.
106.11 		Subd. 23.Commissioner's access. When the commissioner is investigating a  
106.12 	possible overpayment of Medicaid funds, the commissioner must be given immediate 
106.13 	access without prior notice to the agency provider or FMS contractor's office during  
106.14 	regular business hours and to documentation and records related to services provided and 
106.15 	submission of claims for services provided. Denying the commissioner access to records 
106.16 	is cause for immediate suspension of payment and terminating the agency provider's  
106.17 	enrollment according to section 256B.064 or terminating the FMS contract.
106.18 		Subd. 24.CFSS agency-providers; background studies. CFSS agency-providers 
106.19 	enrolled to provide personal care assistance services under the medical assistance program 
106.20 	shall comply with the following:
106.21 	(1) owners who have a five percent interest or more and all managing employees 
106.22 	are subject to a background study as provided in chapter 245C. This applies to currently 
106.23 	enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS 
106.24 	agency-provider. "Managing employee" has the same meaning as Code of Federal  
106.25 	Regulations, title 42, section 455. An organization is barred from enrollment if:
106.26 	(i) the organization has not initiated background studies on owners managing 
106.27 	employees; or
106.28 	(ii) the organization has initiated background studies on owners and managing 
106.29 	employees, but the commissioner has sent the organization a notice that an owner or 
106.30 	managing employee of the organization has been disqualified under section 245C.14, and 
106.31 	the owner or managing employee has not received a set-aside of the disqualification 
106.32 	under section 245C.22;
106.33 	(2) a background study must be initiated and completed for all support specialists; and
106.34 	(3) a background study must be initiated and completed for all support workers.

106.35 	EFFECTIVE DATE. This section is effective upon federal approval but no earlier 
106.36 	than January 1, 2014. The service will begin 90 days after federal approval or January 1, 
107.1 	2014, whichever is later. The commissioner of human services shall notify the revisor of 
107.2 	statutes when this occurs.

107.3 	Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision 
107.4 	to read:
107.5 		Subd. 1o.Supplementary service rate; exemptions. A county agency shall not 
107.6 	negotiate a supplementary service rate under this section for any individual that has been 
107.7 	determined to be eligible for Housing Stability Services as approved by the Centers 
107.8 	for Medicare and Medicaid Services, and who resides in an establishment voluntarily 
107.9 	registered under section 144D.025, as a supportive housing establishment or participates 
107.10 	in the Minnesota supportive housing demonstration program under section 256I.04, 
107.11 	subdivision 3, paragraph (a), clause (4).

107.12 	Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
107.13 		Subd. 4.Reporting. (a) Except as provided in paragraph (b), a mandated reporter 
107.14 	shall immediately make an oral report to the common entry point. The common entry 
107.15 	point may accept electronic reports submitted through a Web-based reporting system 
107.16 	established by the commissioner. Use of a telecommunications device for the deaf or other 
107.17 	similar device shall be considered an oral report. The common entry point may not require 
107.18 	written reports. To the extent possible, the report must be of sufficient content to identify 
107.19 	the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, 
107.20 	any evidence of previous maltreatment, the name and address of the reporter, the time, 
107.21 	date, and location of the incident, and any other information that the reporter believes 
107.22 	might be helpful in investigating the suspected maltreatment. A mandated reporter may 
107.23 	disclose not public data, as defined in section 13.02, and medical records under sections 
107.24 	144.291 to 144.298, to the extent necessary to comply with this subdivision.
107.25 	(b) A boarding care home that is licensed under sections 144.50 to 144.58 and 
107.26 	certified under Title 19 of the Social Security Act, a nursing home that is licensed under 
107.27 	section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a 
107.28 	hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under 
107.29 	Code of Federal Regulations, title 42, section 482.66, may submit a report electronically 
107.30 	to the common entry point instead of submitting an oral report. The report may be a 
107.31 	duplicate of the initial report the facility submits electronically to the commissioner of 
107.32 	health to comply with the reporting requirements under Code of Federal Regulations, title 
107.33 	42, section 483.13. The commissioner of health may modify these reporting requirements 
108.1 	to include items required under paragraph (a) that are not currently included in the 
108.2 	electronic reporting form.

108.3 	EFFECTIVE DATE. This section is effective July 1, 2014.

108.4 	Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
108.5 		Subd. 9.Common entry point designation. (a) Each county board shall designate 
108.6 	a common entry point for reports of suspected maltreatment. Two or more county boards 
108.7 	may jointly designate a single The commissioner of human services shall establish a
108.8 	 common entry point effective July 1, 2014. The common entry point is the unit responsible 
108.9 	for receiving the report of suspected maltreatment under this section.
108.10 	(b) The common entry point must be available 24 hours per day to take calls from 
108.11 	reporters of suspected maltreatment. The common entry point shall use a standard intake 
108.12 	form that includes:
108.13 	(1) the time and date of the report;
108.14 	(2) the name, address, and telephone number of the person reporting;
108.15 	(3) the time, date, and location of the incident;
108.16 	(4) the names of the persons involved, including but not limited to, perpetrators, 
108.17 	alleged victims, and witnesses;
108.18 	(5) whether there was a risk of imminent danger to the alleged victim;
108.19 	(6) a description of the suspected maltreatment;
108.20 	(7) the disability, if any, of the alleged victim;
108.21 	(8) the relationship of the alleged perpetrator to the alleged victim;
108.22 	(9) whether a facility was involved and, if so, which agency licenses the facility;
108.23 	(10) any action taken by the common entry point;
108.24 	(11) whether law enforcement has been notified;
108.25 	(12) whether the reporter wishes to receive notification of the initial and final 
108.26 	reports; and
108.27 	(13) if the report is from a facility with an internal reporting procedure, the name, 
108.28 	mailing address, and telephone number of the person who initiated the report internally.
108.29 	(c) The common entry point is not required to complete each item on the form prior 
108.30 	to dispatching the report to the appropriate lead investigative agency.
108.31 	(d) The common entry point shall immediately report to a law enforcement agency 
108.32 	any incident in which there is reason to believe a crime has been committed.
108.33 	(e) If a report is initially made to a law enforcement agency or a lead investigative 
108.34 	agency, those agencies shall take the report on the appropriate common entry point intake 
108.35 	forms and immediately forward a copy to the common entry point.
109.1 	(f) The common entry point staff must receive training on how to screen and 
109.2 	dispatch reports efficiently and in accordance with this section.
109.3 	(g) The commissioner of human services shall maintain a centralized database 
109.4 	for the collection of common entry point data, lead investigative agency data including 
109.5 	maltreatment report disposition, and appeals data. The common entry point shall 
109.6 	have access to the centralized database and must log the reports into the database and 
109.7 	immediately identify and locate prior reports of abuse, neglect, or exploitation.
109.8 	(h) When appropriate, the common entry point staff must refer calls that do not 
109.9 	allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations 
109.10 	that might resolve the reporter's concerns.
109.11 	(i) a common entry point must be operated in a manner that enables the 
109.12 	commissioner of human services to:
109.13 	(1) track critical steps in the reporting, evaluation, referral, response, disposition, 
109.14 	and investigative process to ensure compliance with all requirements for all reports;
109.15 	(2) maintain data to facilitate the production of aggregate statistical reports for 
109.16 	monitoring patterns of abuse, neglect, or exploitation;
109.17 	(3) serve as a resource for the evaluation, management, and planning of preventative 
109.18 	and remedial services for vulnerable adults who have been subject to abuse, neglect, 
109.19 	or exploitation;
109.20 	(4) set standards, priorities, and policies to maximize the efficiency and effectiveness 
109.21 	of the common entry point; and
109.22 	(5) track and manage consumer complaints related to the common entry point.
109.23 	(j) The commissioners of human services and health shall collaborate on the 
109.24 	creation of a system for referring reports to the lead investigative agencies. This system 
109.25 	shall enable the commissioner of human services to track critical steps in the reporting, 
109.26 	evaluation, referral, response, disposition, investigation, notification, determination, and 
109.27 	appeal processes.

109.28 	Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
109.29 		Subd. 9e.Education requirements. (a) The commissioners of health, human 
109.30 	services, and public safety shall cooperate in the development of a joint program for 
109.31 	education of lead investigative agency investigators in the appropriate techniques for 
109.32 	investigation of complaints of maltreatment. This program must be developed by July 
109.33 	1, 1996. The program must include but need not be limited to the following areas: (1) 
109.34 	information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4) 
109.35 	conclusions based on evidence; (5) interviewing skills, including specialized training to 
110.1 	interview people with unique needs; (6) report writing; (7) coordination and referral 
110.2 	to other necessary agencies such as law enforcement and judicial agencies; (8) human 
110.3 	relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family 
110.4 	systems and the appropriate methods for interviewing relatives in the course of the 
110.5 	assessment or investigation; (10) the protective social services that are available to protect 
110.6 	alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by 
110.7 	which lead investigative agency investigators and law enforcement workers cooperate in 
110.8 	conducting assessments and investigations in order to avoid duplication of efforts; and 
110.9 	(12) data practices laws and procedures, including provisions for sharing data.
110.10 	(b) The commissioner of human services shall conduct an outreach campaign to 
110.11 	promote the common entry point for reporting vulnerable adult maltreatment. This 
110.12 	campaign shall use the Internet and other means of communication.
110.13 	(b) (c) The commissioners of health, human services, and public safety shall offer at 
110.14 	least annual education to others on the requirements of this section, on how this section is 
110.15 	implemented, and investigation techniques.
110.16 	(c) (d) The commissioner of human services, in coordination with the commissioner 
110.17 	of public safety shall provide training for the common entry point staff as required in this 
110.18 	subdivision and the program courses described in this subdivision, at least four times 
110.19 	per year. At a minimum, the training shall be held twice annually in the seven-county 
110.20 	metropolitan area and twice annually outside the seven-county metropolitan area. The 
110.21 	commissioners shall give priority in the program areas cited in paragraph (a) to persons 
110.22 	currently performing assessments and investigations pursuant to this section.
110.23 	(d) (e) The commissioner of public safety shall notify in writing law enforcement 
110.24 	personnel of any new requirements under this section. The commissioner of public 
110.25 	safety shall conduct regional training for law enforcement personnel regarding their 
110.26 	responsibility under this section.
110.27 	(e) (f) Each lead investigative agency investigator must complete the education 
110.28 	program specified by this subdivision within the first 12 months of work as a lead 
110.29 	investigative agency investigator.
110.30 	A lead investigative agency investigator employed when these requirements take 
110.31 	effect must complete the program within the first year after training is available or as soon 
110.32 	as training is available.
110.33 	All lead investigative agency investigators having responsibility for investigation 
110.34 	duties under this section must receive a minimum of eight hours of continuing education 
110.35 	or in-service training each year specific to their duties under this section.

111.1 	Sec. 48. FEDERAL APPROVAL.
 111.2 	This article is contingent on federal approval.

111.3 	Sec. 49.  REPEALER.
 111.4 	(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2, 
111.5 	3, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
111.6 	(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are 
111.7 	repealed effective October 1, 2013.

111.8 	ARTICLE 3
111.9 	SAFE AND HEALTHY DEVELOPMENT OF CHILDREN, 
111.10 	YOUTH, AND FAMILIES

111.11 	Section 1. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
111.12 		Subdivision 1.Eligible participants. Families eligible for child care assistance 
111.13 	under the MFIP child care program are:
111.14 	(1) MFIP participants who are employed or in job search and meet the requirements 
111.15 	of section 119B.10;
111.16 	(2) persons who are members of transition year families under section 119B.011, 
111.17 	subdivision 20, and meet the requirements of section 119B.10;
111.18 	(3) families who are participating in employment orientation or job search, or 
111.19 	other employment or training activities that are included in an approved employability 
111.20 	development plan under section 256J.95;
111.21 	(4) MFIP families who are participating in work job search, job support, 
111.22 	employment, or training activities as required in their employment plan, or in appeals, 
111.23 	hearings, assessments, or orientations according to chapter 256J;
111.24 	(5) MFIP families who are participating in social services activities under chapter 
111.25 	256J or mental health treatment as required in their employment plan approved according 
111.26 	to chapter 256J;
111.27 	(6) families who are participating in services or activities that are included in an 
111.28 	approved family stabilization plan under section 256J.575;
111.29 	(7) MFIP child-only cases under section 256J.88, for up to 20 hours of child care 
111.30 	per child per week under the following conditions: (i) child care will be authorized if the 
111.31 	child's primary caregiver is receiving SSI for a disability related to depression or other 
111.32 	serious mental illness; and (ii) child care will only be authorized for children five years 
111.33 	of age or younger. The child's authorized care under this clause is not conditional based 
111.34 	on the primary caregiver participating in an authorized activity under section 119B.07 or 
112.1 	119B.11. Medical appointments, treatment, or therapy are considered authorized activities 
112.2 	for participants in this category;
112.3 	(8) families who are participating in programs as required in tribal contracts under 
112.4 	section 119B.02, subdivision 2, or 256.01, subdivision 2; and
112.5 	(8)(9) families who are participating in the transition year extension under section 
112.6 	119B.011, subdivision 20a.

112.7 	Sec. 2. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
112.8 		Subdivision 1.Subsidy restrictions. (a) Beginning October 31, 2011 July 1, 2014, 
112.9 	the maximum rate paid for child care assistance in any county or multicounty region under 
112.10 	the child care fund shall be the rate for like-care arrangements in the county effective July 
112.11 	1, 2006 2012, decreased increased  by 2.5 two percent.
112.12 	(b) Biennially, beginning in 2012, the commissioner shall survey rates charged 
112.13 	by child care providers in Minnesota to determine the 75th percentile for like-care 
112.14 	arrangements in counties. When the commissioner determines that, using the 
112.15 	commissioner's established protocol, the number of providers responding to the survey is 
112.16 	too small to determine the 75th percentile rate for like-care arrangements in a county or 
112.17 	multicounty region, the commissioner may establish the 75th percentile maximum rate 
112.18 	based on like-care arrangements in a county, region, or category that the commissioner 
112.19 	deems to be similar.
112.20 	(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
112.21 	school readiness service agreement paid under section 119B.231, may be in excess of the 
112.22 	maximum rate allowed under this subdivision.
112.23 	(d) The department shall monitor the effect of this paragraph on provider rates. The 
112.24 	county shall pay the provider's full charges for every child in care up to the maximum 
112.25 	established. The commissioner shall determine the maximum rate for each type of care 
112.26 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
112.27 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
112.28 	maximum payment to a provider for one week of care must not exceed the weekly rate.
112.29 	(e) Child care providers receiving reimbursement under this chapter must not be 
112.30 	paid activity fees or an additional amount above the maximum rates for care provided 
112.31 	during nonstandard hours for families receiving assistance.
112.32 	(f) When the provider charge is greater than the maximum provider rate allowed, 
112.33 	the parent is responsible for payment of the difference in the rates in addition to any 
112.34 	family co-payment fee.
113.1 	(g) All maximum provider rates changes shall be implemented on the Monday 
113.2 	following the effective date of the maximum provider rate.

113.3 	Sec. 3. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
113.4 		Subd. 7.Absent days. (a) Licensed child care providers and license-exempt centers 
113.5 	must not be reimbursed for more than ten 25 full-day absent days per child, excluding 
113.6 	holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal 
113.7 	nonlicensed family child care providers must not be reimbursed for absent days. If a child 
113.8 	attends for part of the time authorized to be in care in a day, but is absent for part of the 
113.9 	time authorized to be in care in that same day, the absent time must be reimbursed but the 
113.10 	time must not count toward the ten 25 absent day days limit. Child care providers must 
113.11 	only be reimbursed for absent days if the provider has a written policy for child absences 
113.12 	and charges all other families in care for similar absences.
113.13 	(b) Notwithstanding paragraph (a), children in families may exceed the ten 25 absent 
113.14 	days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school 
113.15 	or general equivalency diploma; and (3) is a student in a school district or another similar 
113.16 	program that provides or arranges for child care, parenting support, social services, career 
113.17 	and employment supports, and academic support to achieve high school graduation, upon 
113.18 	request of the program and approval of the county. If a child attends part of an authorized 
113.19 	day, payment to the provider must be for the full amount of care authorized for that day.
113.20 	(c) Child care providers must be reimbursed for up to ten federal or state holidays or 
113.21 	designated holidays per year when the provider charges all families for these days and the 
113.22 	holiday or designated holiday falls on a day when the child is authorized to be in attendance. 
113.23 	Parents may substitute other cultural or religious holidays for the ten recognized state and 
113.24 	federal holidays. Holidays do not count toward the ten 25 absent day days limit.
113.25 	(d) A family or child care provider must not be assessed an overpayment for an 
113.26 	absent day payment unless (1) there was an error in the amount of care authorized for the 
113.27 	family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 
113.28 	the family or provider did not timely report a change as required under law.
113.29 	(e) The provider and family shall receive notification of the number of absent days 
113.30 	used upon initial provider authorization for a family and ongoing notification of the 
113.31 	number of absent days used as of the date of the notification.

113.32 	Sec. 4. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
113.33 		Subd. 2a.Immediate suspension expedited hearing. (a) Within five working days 
113.34 	of receipt of the license holder's timely appeal, the commissioner shall request assignment 
114.1 	of an administrative law judge. The request must include a proposed date, time, and place 
114.2 	of a hearing. A hearing must be conducted by an administrative law judge within 30 
114.3 	calendar days of the request for assignment, unless an extension is requested by either 
114.4 	party and granted by the administrative law judge for good cause. The commissioner shall 
114.5 	issue a notice of hearing by certified mail or personal service at least ten working days 
114.6 	before the hearing. The scope of the hearing shall be limited solely to the issue of whether 
114.7 	the temporary immediate suspension should remain in effect pending the commissioner's 
114.8 	final order under section 245A.08, regarding a licensing sanction issued under subdivision 
114.9 	3 following the immediate suspension. The burden of proof in expedited hearings under 
114.10 	this subdivision shall be limited to the commissioner's demonstration that reasonable 
114.11 	cause exists to believe that the license holder's actions or failure to comply with applicable 
114.12 	law or rule poses, or if the actions of other individuals or conditions in the program 
114.13 	poses an imminent risk of harm to the health, safety, or rights of persons served by the 
114.14 	program. "Reasonable cause" means there exist specific articulable facts or circumstances 
114.15 	which provide the commissioner with a reasonable suspicion that there is an imminent 
114.16 	risk of harm to the health, safety, or rights of persons served by the program. When the 
114.17 	commissioner has determined there is reasonable cause to order the temporary immediate 
114.18 	suspension of a license based on a violation of safe sleep requirements, as defined in 
114.19 	section 245A.1435, the commissioner is not required to demonstrate that an infant died or 
114.20 	was injured as a result of the safe sleep violations.
114.21 	(b) The administrative law judge shall issue findings of fact, conclusions, and a 
114.22 	recommendation within ten working days from the date of hearing. The parties shall have 
114.23 	ten calendar days to submit exceptions to the administrative law judge's report. The 
114.24 	record shall close at the end of the ten-day period for submission of exceptions. The 
114.25 	commissioner's final order shall be issued within ten working days from the close of the 
114.26 	record. Within 90 calendar days after a final order affirming an immediate suspension, the 
114.27 	commissioner shall make a determination regarding whether a final licensing sanction 
114.28 	shall be issued under subdivision 3. The license holder shall continue to be prohibited 
114.29 	from operation of the program during this 90-day period.
114.30 	(c) When the final order under paragraph (b) affirms an immediate suspension, and a 
114.31 	final licensing sanction is issued under subdivision 3 and the license holder appeals that 
114.32 	sanction, the license holder continues to be prohibited from operation of the program 
114.33 	pending a final commissioner's order under section 245A.08, subdivision 5, regarding the 
114.34 	final licensing sanction.

115.1 	Sec. 5. Minnesota Statutes 2012, section 245A.1435, is amended to read:
115.2 	245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT 
115.3 	DEATH SYNDROME IN LICENSED PROGRAMS.
115.4 	(a) When a license holder is placing an infant to sleep, the license holder must 
115.5 	place the infant on the infant's back, unless the license holder has documentation from 
115.6 	the infant's parent physician directing an alternative sleeping position for the infant. The 
115.7 	parent physician directive must be on a form approved by the commissioner and must 
115.8 	include a statement that the parent or legal guardian has read the information provided by 
115.9 	the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance 
115.10 	of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file 
115.11 	at the licensed location. An infant who independently rolls onto its stomach after being 
115.12 	placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant 
115.13 	is at least six months of age or the license holder has a signed statement from the parent 
115.14 	indicating that the infant regularly rolls over at home.
115.15 	(b) The license holder must place the infant in a crib directly on a firm mattress with 
115.16 	a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be 
115.17 	dislodged by pulling on the corner of the sheet. The license holder must not place pillows, 
115.18 	quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib 
115.19 	with the infant The license holder must place the infant in a crib directly on a firm mattress 
115.20 	with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, 
115.21 	and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner 
115.22 	of the sheet with reasonable effort. The license holder must not place anything in the crib 
115.23 	with the infant except for the infant's pacifier. The requirements of this section apply to 
115.24 	license holders serving infants up to and including 12 months younger than one year of age. 
115.25 	Licensed child care providers must meet the crib requirements under section 245A.146.
115.26 	(c) If an infant falls asleep before being placed in a crib, the license holder must 
115.27 	move the infant to a crib as soon as practicable, and must keep the infant within sight of 
115.28 	the license holder until the infant is placed in a crib. When an infant falls asleep while 
115.29 	being held, the license holder must consider the supervision needs of other children in 
115.30 	care when determining how long to hold the infant before placing the infant in a crib to 
115.31 	sleep. The sleeping infant must not be in a position where the airway may be blocked or 
115.32 	with anything covering the infant's face.
115.33 	(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended 
115.34 	for an infant of any age and is prohibited for any infant who has begun to roll over 
115.35 	independently. However, with the written consent of a parent or guardian according to this 
115.36 	paragraph, a license holder may place the infant who has not yet begun to roll over on its 
116.1 	own down to sleep in a one-piece sleeper equipped with an attached system that fastens 
116.2 	securely only across the upper torso, with no constriction of the hips or legs, to create a 
116.3 	swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter, 
116.4 	the license holder must obtain informed written consent for the use of swaddling from the 
116.5 	parent or guardian of the infant on a form provided by the commissioner and prepared in 
116.6 	partnership with the Minnesota Sudden Infant Death Center.

116.7 	Sec. 6. Minnesota Statutes 2012, section 245A.144, is amended to read:
116.8 	245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT 
116.9 	DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR 
116.10 	CHILD FOSTER CARE PROVIDERS.
116.11 	(a) Licensed child foster care providers that care for infants or children through five 
116.12 	years of age must document that before staff persons and caregivers assist in the care 
116.13 	of infants or children through five years of age, they are instructed on the standards in 
116.14 	section 245A.1435 and receive training on reducing the risk of sudden unexpected infant 
116.15 	death syndrome and shaken baby syndrome for abusive head trauma from shaking infants 
116.16 	and young children. This section does not apply to emergency relative placement under 
116.17 	section 245A.035. The training on reducing the risk of sudden unexpected infant death 
116.18 	syndrome and shaken baby syndrome abusive head trauma may be provided as:
116.19 	(1) orientation training to child foster care providers, who care for infants or children 
116.20 	through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
116.21 	(2) in-service training to child foster care providers, who care for infants or children 
116.22 	through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
116.23 	(b) Training required under this section must be at least one hour in length and must 
116.24 	be completed at least once every five years. At a minimum, the training must address 
116.25 	the risk factors related to sudden unexpected infant death syndrome and shaken baby 
116.26 	syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant 
116.27 	death syndrome and shaken baby syndrome abusive head trauma, and license holder 
116.28 	communication with parents regarding reducing the risk of sudden unexpected infant 
116.29 	death syndrome and shaken baby syndrome abusive head trauma.
116.30 	(c) Training for child foster care providers must be approved by the county or 
116.31 	private licensing agency that is responsible for monitoring the child foster care provider 
116.32 	under section 245A.16. The approved training fulfills, in part, training required under 
116.33 	Minnesota Rules, part 2960.3070.

117.1 	Sec. 7. Minnesota Statutes 2012, section 245A.1444, is amended to read:
117.2 	245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT 
117.3 	DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD 
117.4 	TRAUMA BY OTHER PROGRAMS.
117.5 	A licensed chemical dependency treatment program that serves clients with infants 
117.6 	or children through five years of age, who sleep at the program and a licensed children's 
117.7 	residential facility that serves infants or children through five years of age, must document 
117.8 	that before program staff persons or volunteers assist in the care of infants or children 
117.9 	through five years of age, they are instructed on the standards in section 245A.1435 and 
117.10 	receive training on reducing the risk of sudden unexpected infant death syndrome and 
117.11 	shaken baby syndrome abusive head trauma from shaking infants and young children. The 
117.12 	training conducted under this section may be used to fulfill training requirements under 
117.13 	Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
117.14 	This section does not apply to child care centers or family child care programs 
117.15 	governed by sections 245A.40 and 245A.50.

117.16 	Sec. 8. [245A.1446] FAMILY CHILD CARE DIAPERING AREA 
117.17 	DISINFECTION.
117.18 	Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may 
117.19 	disinfect the diaper changing surface with either a solution of at least two teaspoons 
117.20 	of chlorine bleach to one quart of water or with a surface disinfectant that meets the 
117.21 	following criteria:
117.22 	(1) the manufacturer's label or instructions state that the product is registered with 
117.23 	the United States Environmental Protection Agency;
117.24 	(2) the manufacturer's label or instructions state that the disinfectant is effective 
117.25 	against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
117.26 	(3) the manufacturer's label or instructions state that the disinfectant is effective with 
117.27 	a ten minute or less contact time;
117.28 	(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing 
117.29 	and use;
117.30 	(5) the disinfectant is used only in accordance with the manufacturer's directions; and
117.31 	(6) the product does not include triclosan or derivatives of triclosan.

117.32 	Sec. 9. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION 
117.33 	REQUIREMENTS.
118.1 		Subdivision 1.In-person checks on infants. (a) License holders that serve infants 
118.2 	are encouraged to monitor sleeping infants by conducting in-person checks on each infant 
118.3 	in their care every 30 minutes.
118.4 	(b) Upon enrollment of an infant in a family child care program, the license holder is 
118.5 	encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during 
118.6 	the first four months of care.
118.7 	(c) When an infant has an upper respiratory infection, the license holder is 
118.8 	encouraged to conduct in-person checks on the sleeping infant every 15 minutes 
118.9 	throughout the hours of sleep.
118.10 		Subd. 2.Use of audio or visual monitoring devices. In addition to conducting 
118.11 	the in-person checks encouraged under subdivision 1, license holders serving infants are 
118.12 	encouraged to use and maintain an audio or visual monitoring device to monitor each 
118.13 	sleeping infant in care during all hours of sleep.

118.14 	Sec. 10. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
118.15 	(a) A license holder must provide a written notice to all parents or guardians of all 
118.16 	children to be accepted for care prior to admission stating whether the license holder has 
118.17 	liability insurance. This notice may be incorporated into and provided on the admission 
118.18 	form used by the license holder.
118.19 	(b) If the license holder has liability insurance:
118.20 	(1) the license holder shall inform parents in writing that a current certificate of 
118.21 	coverage for insurance is available for inspection to all parents or guardians of children 
118.22 	receiving services and to all parents seeking services from the family child care program;
118.23 	(2) the notice must provide the parent or guardian with the date of expiration or 
118.24 	next renewal of the policy; and
118.25 	(3) upon the expiration date of the policy, the license holder must provide a new 
118.26 	written notice indicating whether the insurance policy has lapsed or whether the license 
118.27 	holder has renewed the policy.
118.28 	If the policy was renewed, the license holder must provide the new expiration date of the 
118.29 	policy in writing to the parents or guardians.
118.30 	(c) If the license holder does not have liability insurance, the license holder must 
118.31 	provide an annual notice on a form developed and made available by the commissioner, 
118.32 	to the parents or guardians of children in care indicating that the license holder does not 
118.33 	carry liability insurance.
118.34 	(d) The license holder must notify all parents and guardians in writing immediately 
118.35 	of any change in insurance status.
119.1 	(e) The license holder must make available upon request the certificate of liability 
119.2 	insurance to the parents of children in care, to the commissioner, and to county licensing 
119.3 	agents.
119.4 	(f) The license holder must document, with the signature of the parent or guardian, 
119.5 	that the parent or guardian received the notices required by this section.

119.6 	Sec. 11. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
119.7 		Subd. 5.Sudden unexpected infant death syndrome and shaken baby syndrome
119.8 	abusive head trauma training. (a) License holders must document that before staff 
119.9 	persons and volunteers care for infants, they are instructed on the standards in section 
119.10 	245A.1435 and receive training on reducing the risk of sudden unexpected infant death 
119.11 	syndrome. In addition, license holders must document that before staff persons care for 
119.12 	infants or children under school age, they receive training on the risk of shaken baby 
119.13 	syndrome abusive head trauma from shaking infants and young children. The training 
119.14 	in this subdivision may be provided as orientation training under subdivision 1 and 
119.15 	in-service training under subdivision 7.
119.16 	(b) Sudden unexpected infant death syndrome reduction training required under 
119.17 	this subdivision must be at least one-half hour in length and must be completed at least 
119.18 	once every five years year. At a minimum, the training must address the risk factors 
119.19 	related to sudden unexpected infant death syndrome, means of reducing the risk of sudden 
119.20 	unexpected infant death syndrome in child care, and license holder communication with 
119.21 	parents regarding reducing the risk of sudden unexpected infant death syndrome.
119.22 	(c) Shaken baby syndrome Abusive head trauma training under this subdivision 
119.23 	must be at least one-half hour in length and must be completed at least once every five 
119.24 	years year. At a minimum, the training must address the risk factors related to shaken 
119.25 	baby syndrome for shaking infants and young children, means to reduce the risk of shaken 
119.26 	baby syndrome abusive head trauma in child care, and license holder communication with 
119.27 	parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
119.28 	(d) The commissioner shall make available for viewing a video presentation on the 
119.29 	dangers associated with shaking infants and young children. The video presentation must 
119.30 	be part of the orientation and annual in-service training of licensed child care center 
119.31 	staff persons caring for children under school age. The commissioner shall provide to 
119.32 	child care providers and interested individuals, at cost, copies of a video approved by the 
119.33 	commissioner of health under section 144.574 on the dangers associated with shaking 
119.34 	infants and young children.

120.1 	Sec. 12. Minnesota Statutes 2012, section 245A.50, is amended to read:
120.2 	245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
120.3 		Subdivision 1.Initial training. (a) License holders, caregivers, and substitutes must 
120.4 	comply with the training requirements in this section.
120.5 	(b) Helpers who assist with care on a regular basis must complete six hours of 
120.6 	training within one year after the date of initial employment.
120.7 		Subd. 2.Child growth and development and behavior guidance training. (a) For 
120.8 	purposes of family and group family child care, the license holder and each adult caregiver 
120.9 	who provides care in the licensed setting for more than 30 days in any 12-month period 
120.10 	shall complete and document at least two four hours of child growth and development 
120.11 	and behavior guidance training within the first year of prior to initial licensure, and before 
120.12 	caring for children. For purposes of this subdivision, "child growth and development 
120.13 	training" means training in understanding how children acquire language and develop 
120.14 	physically, cognitively, emotionally, and socially. "Behavior guidance training" means 
120.15 	training in the understanding of the functions of child behavior and strategies for managing 
120.16 	challenging situations. Child growth and development and behavior guidance training 
120.17 	must be repeated annually. Training curriculum shall be developed or approved by the 
120.18 	commissioner of human services by January 1, 2014.
120.19 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if 
120.20 	they:
120.21 	(1) have taken a three-credit course on early childhood development within the 
120.22 	past five years;
120.23 	(2) have received a baccalaureate or master's degree in early childhood education or 
120.24 	school-age child care within the past five years;
120.25 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood 
120.26 	educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early 
120.27 	childhood special education teacher, or an elementary teacher with a kindergarten 
120.28 	endorsement; or
120.29 	(4) have received a baccalaureate degree with a Montessori certificate within the 
120.30 	past five years.
120.31 		Subd. 3.First aid. (a) When children are present in a family child care home 
120.32 	governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person 
120.33 	must be present in the home who has been trained in first aid. The first aid training must 
120.34 	have been provided by an individual approved to provide first aid instruction. First aid 
120.35 	training may be less than eight hours and persons qualified to provide first aid training 
121.1 	include individuals approved as first aid instructors. First aid training must be repeated 
121.2 	every two years.
121.3 	(b) A family child care provider is exempt from the first aid training requirements 
121.4 	under this subdivision related to any substitute caregiver who provides less than 30 hours 
121.5 	of care during any 12-month period.
121.6 	(c) Video training reviewed and approved by the county licensing agency satisfies 
121.7 	the training requirement of this subdivision.
121.8 		Subd. 4.Cardiopulmonary resuscitation. (a) When children are present in a family 
121.9 	child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least 
121.10 	one staff person must be present in the home who has been trained in cardiopulmonary 
121.11 	resuscitation (CPR) and in the treatment of obstructed airways that includes CPR 
121.12 	techniques for infants and children. The CPR training must have been provided by an 
121.13 	individual approved to provide CPR instruction, must be repeated at least once every three
121.14 	 two years, and must be documented in the staff person's records.
121.15 	(b) A family child care provider is exempt from the CPR training requirement in 
121.16 	this subdivision related to any substitute caregiver who provides less than 30 hours of 
121.17 	care during any 12-month period.
121.18 	(c) Video training reviewed and approved by the county licensing agency satisfies 
121.19 	the training requirement of this subdivision. Persons providing CPR training must use 
121.20 	CPR training that has been developed:
121.21 	(1) by the American Heart Association or the American Red Cross and incorporates 
121.22 	psychomotor skills to support the instruction; or
121.23 	(2) using nationally recognized, evidence-based guidelines for CPR training and 
121.24 	incorporates psychomotor skills to support the instruction.
121.25 		Subd. 5.Sudden unexpected infant death syndrome and shaken baby syndrome
121.26 	 abusive head trauma training. (a) License holders must document that before staff 
121.27 	persons, caregivers, and helpers assist in the care of infants, they are instructed on the 
121.28 	standards in section 245A.1435 and receive training on reducing the risk of sudden 
121.29 	unexpected infant death syndrome. In addition, license holders must document that before 
121.30 	staff persons, caregivers, and helpers assist in the care of infants and children under 
121.31 	school age, they receive training on reducing the risk of shaken baby syndrome abusive 
121.32 	head trauma from shaking infants and young children. The training in this subdivision 
121.33 	may be provided as initial training under subdivision 1 or ongoing annual training under 
121.34 	subdivision 7.
121.35 	(b) Sudden unexpected infant death syndrome reduction training required under this 
121.36 	subdivision must be at least one-half hour in length and must be completed in person
122.1 	 at least once every five years two years. On the years when the license holder is not 
122.2 	receiving the in-person training on sudden unexpected infant death reduction, the license 
122.3 	holder must receive sudden unexpected infant death reduction training through a video 
122.4 	of no more than one hour in length developed or approved by the commissioner. At a 
122.5 	minimum, the training must address the risk factors related to sudden unexpected infant 
122.6 	death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
122.7 	 in child care, and license holder communication with parents regarding reducing the risk 
122.8 	of sudden unexpected infant death syndrome.
122.9 	(c) Shaken baby syndrome Abusive head trauma training required under this 
122.10 	subdivision must be at least one-half hour in length and must be completed at least once 
122.11 	every five years year. At a minimum, the training must address the risk factors related 
122.12 	to shaken baby syndrome shaking infants and young children, means of reducing the 
122.13 	risk of shaken baby syndrome abusive head trauma in child care, and license holder 
122.14 	communication with parents regarding reducing the risk of shaken baby syndrome abusive 
122.15 	head trauma.
122.16 	(d) Training for family and group family child care providers must be developed 
122.17 	by the commissioner in conjunction with the Minnesota Sudden Infant Death Center 
122.18 	and approved by the county licensing agency by the Minnesota Center for Professional 
122.19 	Development.
122.20 	(e) The commissioner shall make available for viewing by all licensed child care 
122.21 	providers a video presentation on the dangers associated with shaking infants and young 
122.22 	children. The video presentation shall be part of the initial and ongoing annual training of 
122.23 	licensed child care providers, caregivers, and helpers caring for children under school age. 
122.24 	The commissioner shall provide to child care providers and interested individuals, at cost, 
122.25 	copies of a video approved by the commissioner of health under section 144.574 on the 
122.26 	dangers associated with shaking infants and young children.
122.27 		Subd. 6.Child passenger restraint systems; training requirement. (a) A license 
122.28 	holder must comply with all seat belt and child passenger restraint system requirements 
122.29 	under section 169.685.
122.30 	(b) Family and group family child care programs licensed by the Department of 
122.31 	Human Services that serve a child or children under nine years of age must document 
122.32 	training that fulfills the requirements in this subdivision.
122.33 	(1) Before a license holder, staff person, caregiver, or helper transports a child or 
122.34 	children under age nine in a motor vehicle, the person placing the child or children in a 
122.35 	passenger restraint must satisfactorily complete training on the proper use and installation 
123.1 	of child restraint systems in motor vehicles. Training completed under this subdivision may 
123.2 	be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
123.3 	(2) Training required under this subdivision must be at least one hour in length, 
123.4 	completed at initial training, and repeated at least once every five years. At a minimum, 
123.5 	the training must address the proper use of child restraint systems based on the child's 
123.6 	size, weight, and age, and the proper installation of a car seat or booster seat in the motor 
123.7 	vehicle used by the license holder to transport the child or children.
123.8 	(3) Training under this subdivision must be provided by individuals who are certified 
123.9 	and approved by the Department of Public Safety, Office of Traffic Safety. License holders 
123.10 	may obtain a list of certified and approved trainers through the Department of Public 
123.11 	Safety Web site or by contacting the agency.
123.12 	(c) Child care providers that only transport school-age children as defined in section 
123.13 	245A.02, subdivision 19, paragraph (f), in child care buses as defined in section 169.448, 
123.14 	subdivision 1, paragraph (e), are exempt from this subdivision.
123.15 		Subd. 7.Training requirements for family and group family child care. For 
123.16 	purposes of family and group family child care, the license holder and each primary 
123.17 	caregiver must complete eight 16 hours of ongoing training each year. For purposes 
123.18 	of this subdivision, a primary caregiver is an adult caregiver who provides services in 
123.19 	the licensed setting for more than 30 days in any 12-month period. Repeat of topical 
123.20 	training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training 
123.21 	requirement. Additional ongoing training subjects to meet the annual 16-hour training 
123.22 	requirement must be selected from the following areas:
123.23 	(1) "child growth and development training" has the meaning given in under
123.24 	 subdivision 2, paragraph (a);
123.25 	(2) "learning environment and curriculum" includes, including training in 
123.26 	establishing an environment and providing activities that provide learning experiences to 
123.27 	meet each child's needs, capabilities, and interests;
123.28 	(3) "assessment and planning for individual needs" includes, including training in 
123.29 	observing and assessing what children know and can do in order to provide curriculum 
123.30 	and instruction that addresses their developmental and learning needs, including children 
123.31 	with special needs and bilingual children or children for whom English is not their 
123.32 	primary language;
123.33 	(4) "interactions with children" includes, including training in establishing 
123.34 	supportive relationships with children, guiding them as individuals and as part of a group;
124.1 	(5) "families and communities" includes, including training in working 
124.2 	collaboratively with families and agencies or organizations to meet children's needs and to 
124.3 	encourage the community's involvement;
124.4 	(6) "health, safety, and nutrition" includes, including training in establishing and 
124.5 	maintaining an environment that ensures children's health, safety, and nourishment, 
124.6 	including child abuse, maltreatment, prevention, and reporting; home and fire safety; child 
124.7 	injury prevention; communicable disease prevention and control; first aid; and CPR; and
124.8 	(7) "program planning and evaluation" includes, including training in establishing, 
124.9 	implementing, evaluating, and enhancing program operations.; and
124.10 	(8) behavior guidance, including training in the understanding of the functions of 
124.11 	child behavior and strategies for managing behavior.
124.12 		Subd. 8.Other required training requirements. (a) The training required of 
124.13 	family and group family child care providers and staff must include training in the cultural 
124.14 	dynamics of early childhood development and child care. The cultural dynamics and 
124.15 	disabilities training and skills development of child care providers must be designed to 
124.16 	achieve outcomes for providers of child care that include, but are not limited to:
124.17 	(1) an understanding and support of the importance of culture and differences in 
124.18 	ability in children's identity development;
124.19 	(2) understanding the importance of awareness of cultural differences and 
124.20 	similarities in working with children and their families;
124.21 	(3) understanding and support of the needs of families and children with differences 
124.22 	in ability;
124.23 	(4) developing skills to help children develop unbiased attitudes about cultural 
124.24 	differences and differences in ability;
124.25 	(5) developing skills in culturally appropriate caregiving; and
124.26 	(6) developing skills in appropriate caregiving for children of different abilities.
124.27 	The commissioner shall approve the curriculum for cultural dynamics and disability 
124.28 	training.
124.29 	(b) The provider must meet the training requirement in section 245A.14, subdivision 
124.30 	11, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child 
124.31 	care or group family child care home to use the swimming pool located at the home.
124.32 		Subd. 9.Supervising for safety; training requirement. Effective July 1, 2014, 
124.33 	all family child care license holders and each adult caregiver who provides care in the 
124.34 	licensed family child care home for more than 30 days in any 12-month period shall 
124.35 	complete and document at least six hours approved training on supervising for safety 
124.36 	prior to initial licensure, and before caring for children. At least two hours of training 
125.1 	on supervising for safety must be repeated annually. For purposes of this subdivision, 
125.2 	"supervising for safety" includes supervision basics, supervision outdoors, equipment and 
125.3 	materials, illness, injuries, and disaster preparedness. The commissioner shall develop 
125.4 	the supervising for safety curriculum by January 1, 2014.
125.5 		Subd. 10.Approved training. (a) County licensing staff must accept training 
125.6 	approved by the Minnesota Center for Professional Development, including:
125.7 	(1) face-to-face or classroom training;
125.8 	(2) online training; and
125.9 	(3) relationship-based professional development, such as mentoring, coaching, 
125.10 	and consulting.
125.11 	(b) New and increased training requirements under this section must not be imposed 
125.12 	on providers until the commissioner establishes statewide accessibility to the required 
125.13 	provider training.

125.14 	Sec. 13. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
125.15 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
125.16 	child, including a child determined eligible for medical assistance without consideration of 
125.17 	parental income, must contribute to the cost of services used by making monthly payments 
125.18 	on a sliding scale based on income, unless the child is married or has been married, parental 
125.19 	rights have been terminated, or the child's adoption is subsidized according to section 
125.20 	259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial 
125.21 	or full payment for medical services provided for diagnostic, therapeutic, curing, treating, 
125.22 	mitigating, rehabilitation, maintenance, and personal care services as defined in United 
125.23 	States Code, title 26, section 213, needed by the child with a chronic illness or disability.
125.24 	(b) For households with adjusted gross income equal to or greater than 100 percent 
125.25 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
125.26 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
125.27 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
125.28 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
125.29 	contribution is $4 per month;
125.30 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
125.31 	poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 
125.32 	the parental contribution shall be determined using a sliding fee scale established by the 
125.33 	commissioner of human services which begins at one percent of adjusted gross income 
125.34 	at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 
126.1 	gross income for those with adjusted gross income up to 545 percent of federal poverty 
126.2 	guidelines;
126.3 	(3) if the adjusted gross income is greater than 545 percent of federal poverty 
126.4 	guidelines and less than 675 percent of federal poverty guidelines, the parental 
126.5 	contribution shall be 7.5 percent of adjusted gross income;
126.6 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
126.7 	poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 
126.8 	contribution shall be determined using a sliding fee scale established by the commissioner 
126.9 	of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 
126.10 	federal poverty guidelines and increases to ten percent of adjusted gross income for those 
126.11 	with adjusted gross income up to 975 percent of federal poverty guidelines; and
126.12 	(5) if the adjusted gross income is equal to or greater than 975 percent of federal 
126.13 	poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
126.14 	If the child lives with the parent, the annual adjusted gross income is reduced by 
126.15 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
126.16 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
126.17 	specified under that section in addition to the parental contribution determined under this 
126.18 	section. The parental contribution is reduced by any amount required to be paid directly to 
126.19 	the child pursuant to a court order, but only if actually paid.
126.20 	(c) The household size to be used in determining the amount of contribution under 
126.21 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
126.22 	child receiving services. Adjustments in the contribution amount due to annual changes 
126.23 	in the federal poverty guidelines shall be implemented on the first day of July following 
126.24 	publication of the changes.
126.25 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
126.26 	natural or adoptive parents determined according to the previous year's federal tax form, 
126.27 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
126.28 	have been used to purchase a home shall not be counted as income.
126.29 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
126.30 	for services is being determined. The contribution shall be made on a monthly basis 
126.31 	effective with the first month in which the child receives services. Annually upon 
126.32 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
126.33 	services provided, the local agency or the state shall reimburse that excess amount to 
126.34 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
126.35 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
126.36 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
127.1 	taxable income if the parent paid for the parent's fees through an employer's health care 
127.2 	flexible spending account under the Internal Revenue Code, section 125, and that the 
127.3 	parent is responsible for paying the taxes owed on the amount reimbursed.
127.4 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
127.5 	when there is a change in household size; and when there is a loss of or gain in income 
127.6 	from one month to another in excess of ten percent. The local agency shall mail a written 
127.7 	notice 30 days in advance of the effective date of a change in the contribution amount. 
127.8 	A decrease in the contribution amount is effective in the month that the parent verifies a 
127.9 	reduction in income or change in household size.
127.10 	(g) Parents of a minor child who do not live with each other shall each pay the 
127.11 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
127.12 	child support payment actually paid on behalf of the child receiving services shall be 
127.13 	deducted from the adjusted gross income of the parent making the payment prior to 
127.14 	calculating the parental contribution under paragraph (b).
127.15 	(h) The contribution under paragraph (b) shall be increased by an additional five 
127.16 	percent if the local agency determines that insurance coverage is available but not 
127.17 	obtained for the child. For purposes of this section, "available" means the insurance is a 
127.18 	benefit of employment for a family member at an annual cost of no more than five percent 
127.19 	of the family's annual income. For purposes of this section, "insurance" means health 
127.20 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
127.21 	maintenance organization, self-insured plan, or preferred provider organization.
127.22 	Parents who have more than one child receiving services shall not be required 
127.23 	to pay more than the amount for the child with the highest expenditures. There shall 
127.24 	be no resource contribution from the parents. The parent shall not be required to pay 
127.25 	a contribution in excess of the cost of the services provided to the child, not counting 
127.26 	payments made to school districts for education-related services. Notice of an increase in 
127.27 	fee payment must be given at least 30 days before the increased fee is due.
127.28 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
127.29 	in the 12 months prior to July 1:
127.30 	(1) the parent applied for insurance for the child;
127.31 	(2) the insurer denied insurance;
127.32 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
127.33 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
127.34 	commerce, or litigated the complaint or appeal; and
127.35 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
127.36 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
128.1 	A parent who has requested a reduction in the contribution amount under this 
128.2 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
128.3 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
128.4 	letter or complaint of the parents, court documents, and the written response of the insurer 
128.5 	approving insurance. The determinations of the commissioner or county agency under this 
128.6 	paragraph are not rules subject to chapter 14.
128.7 	(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 
128.8 	2015, the parental contribution shall be computed by applying the following contribution 
128.9 	schedule to the adjusted gross income of the natural or adoptive parents:
128.10 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
128.11 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
128.12 	contribution is $4 per month;
128.13 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
128.14 	poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 
128.15 	the parental contribution shall be determined using a sliding fee scale established by the 
128.16 	commissioner of human services which begins at one percent of adjusted gross income 
128.17 	at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 
128.18 	gross income for those with adjusted gross income up to 525 percent of federal poverty 
128.19 	guidelines;
128.20 	(3) if the adjusted gross income is greater than 525 percent of federal poverty 
128.21 	guidelines and less than 675 percent of federal poverty guidelines, the parental 
128.22 	contribution shall be 9.5 percent of adjusted gross income;
128.23 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
128.24 	poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 
128.25 	contribution shall be determined using a sliding fee scale established by the commissioner 
128.26 	of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 
128.27 	federal poverty guidelines and increases to 12 percent of adjusted gross income for those 
128.28 	with adjusted gross income up to 900 percent of federal poverty guidelines; and
128.29 	(5) if the adjusted gross income is equal to or greater than 900 percent of federal 
128.30 	poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 
128.31 	income. If the child lives with the parent, the annual adjusted gross income is reduced by 
128.32 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
128.33 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
128.34 	specified under that section in addition to the parental contribution determined under this 
128.35 	section. The parental contribution is reduced by any amount required to be paid directly to 
128.36 	the child pursuant to a court order, but only if actually paid.

129.1 	Sec. 14. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:
129.2 		Subd. 3.Setting foster care standard rates. The commissioner shall annually 
129.3 	establish minimum standard maintenance rates for foster care maintenance and difficulty 
129.4 	of care payments for all children in foster care. Any increase in rates shall in no case 
129.5 	exceed three percent per annum. The foster care rates in effect on January 1, 2013, shall 
129.6 	remain in effect until December 13, 2015.

129.7 	Sec. 15. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
129.8 		Subd. 24.Disregard. "Disregard" means earned income that is not counted when 
129.9 	determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
129.10 	 or income that is not counted when determining ongoing eligibility and calculating the 
129.11 	amount of the assistance payment for participants. The commissioner shall determine 
129.12 	the amount of the disregard according to section 256J.24, subdivision 10 for ongoing 
129.13 	eligibility shall be 50 percent of gross earned income.

129.14 	EFFECTIVE DATE. This section is effective October 1, 2013, or upon approval 
129.15 	from the United States Department of Agriculture, whichever is later.

129.16 	Sec. 16. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
129.17 		Subd. 3.Initial income test. The county agency shall determine initial eligibility 
129.18 	by considering all earned and unearned income that is not excluded under subdivision 2. 
129.19 	To be eligible for MFIP, the assistance unit's countable income minus the disregards in 
129.20 	paragraphs (a) and (b) must be below the transitional standard of assistance family wage 
129.21 	level according to section 256J.24 for that size assistance unit.
129.22 	(a) The initial eligibility determination must disregard the following items:
129.23 	(1) the employment disregard is 18 percent of the gross earned income whether or 
129.24 	not the member is working full time or part time;
129.25 	(2) dependent care costs must be deducted from gross earned income for the actual 
129.26 	amount paid for dependent care up to a maximum of $200 per month for each child less 
129.27 	than two years of age, and $175 per month for each child two years of age and older under 
129.28 	this chapter and chapter 119B;
129.29 	(3) all payments made according to a court order for spousal support or the support 
129.30 	of children not living in the assistance unit's household shall be disregarded from the 
129.31 	income of the person with the legal obligation to pay support, provided that, if there has 
129.32 	been a change in the financial circumstances of the person with the legal obligation to pay 
129.33 	support since the support order was entered, the person with the legal obligation to pay 
129.34 	support has petitioned for a modification of the support order; and
130.1 	(4) an allocation for the unmet need of an ineligible spouse or an ineligible child 
130.2 	under the age of 21 for whom the caregiver is financially responsible and who lives with 
130.3 	the caregiver according to section 256J.36.
130.4 	(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant 
130.5 	units when at least one member has received MFIP in this state within four months of 
130.6 	the most recent application for MFIP, apply the disregard as defined in section 256J.08, 
130.7 	subdivision 24, for all unit members.
130.8 	After initial eligibility is established, the assistance payment calculation is based on 
130.9 	the monthly income test.

130.10 	EFFECTIVE DATE. This section is effective October 1, 2013, or upon approval 
130.11 	from the United States Department of Agriculture, whichever is later.

130.12 	Sec. 17. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
130.13 		Subd. 5.MFIP transitional standard. The MFIP transitional standard is based 
130.14 	on the number of persons in the assistance unit eligible for both food and cash assistance 
130.15 	unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the 
130.16 	transitional standard is published annually by the Department of Human Services.

130.17 	EFFECTIVE DATE. This section is effective July 1, 2014.

130.18 	Sec. 18. Minnesota Statutes 2012, section 256J.24, subdivision 5a, is amended to read:
130.19 		Subd. 5a.Food portion ofAdjustments to the MFIP transitional standard. (a) 
130.20 	Effective October 1, 2015, the commissioner shall adjust the MFIP transitional standard as 
130.21 	needed to reflect a onetime increase in the cash portion of 16 percent.
130.22 	(b) When any adjustments are made in the Supplemental Nutrition Assistance 
130.23 	Program, the commissioner shall adjust the food portion of the MFIP transitional standard 
130.24 	as needed to reflect adjustments to the Supplemental Nutrition Assistance Program. The 
130.25 	commissioner shall publish the transitional standard including a breakdown of the cash 
130.26 	and food portions for an assistance unit of sizes one to ten in the State Register whenever 
130.27 	an adjustment is made.

130.28 	Sec. 19. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
130.29 		Subd. 7.Family wage level. The family wage level is 110 percent of the transitional 
130.30 	standard under subdivision 5 or 6, when applicable, and is the standard used when there is 
130.31 	earned income in the assistance unit. As specified in section 256J.21. If there is earned 
130.32 	income in the assistance unit, earned income is subtracted from the family wage level to 
131.1 	determine the amount of the assistance payment, as specified in section 256J.21. The 
131.2 	assistance payment may not exceed the transitional standard under subdivision 5 or 6, 
131.3 	or the shared household standard under subdivision 9, whichever is applicable, for the 
131.4 	assistance unit.

131.5 	EFFECTIVE DATE. This section is effective October 1, 2013, or upon approval 
131.6 	from the United States Department of Agriculture, whichever is later.

131.7 	Sec. 20. Minnesota Statutes 2012, section 256J.621, is amended to read:
131.8 	256J.621 WORK PARTICIPATION CASH BENEFITS.
131.9 		Subdivision 1.Program characteristics. (a) Effective October 1, 2009, upon 
131.10 	exiting the diversionary work program (DWP) or upon terminating the Minnesota family 
131.11 	investment program with earnings, a participant who is employed may be eligible for work 
131.12 	participation cash benefits of $25 per month to assist in meeting the family's basic needs 
131.13 	as the participant continues to move toward self-sufficiency.
131.14 	(b) To be eligible for work participation cash benefits, the participant shall not 
131.15 	receive MFIP or diversionary work program assistance during the month and the 
131.16 	participant or participants must meet the following work requirements:
131.17 	(1) if the participant is a single caregiver and has a child under six years of age, the 
131.18 	participant must be employed at least 87 hours per month;
131.19 	(2) if the participant is a single caregiver and does not have a child under six years of 
131.20 	age, the participant must be employed at least 130 hours per month; or
131.21 	(3) if the household is a two-parent family, at least one of the parents must be 
131.22 	employed 130 hours per month.
131.23 	Whenever a participant exits the diversionary work program or is terminated from 
131.24 	MFIP and meets the other criteria in this section, work participation cash benefits are 
131.25 	available for up to 24 consecutive months.
131.26 	(c) Expenditures on the program are maintenance of effort state funds under 
131.27 	a separate state program for participants under paragraph (b), clauses (1) and (2). 
131.28 	Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort 
131.29 	funds. Months in which a participant receives work participation cash benefits under this 
131.30 	section do not count toward the participant's MFIP 60-month time limit.
131.31 		Subd. 2.Program suspension. (a) Effective December 1, 2013, the work 
131.32 	participation cash benefits program shall be suspended.
131.33 	(b) The commissioner of human services may reinstate the work participation cash 
131.34 	benefits program if the United States Department of Human Services determines that the 
132.1 	state of Minnesota did not meet the federal TANF work participation rate and sends a 
132.2 	notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I 
132.3 	of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation 
132.4 	Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
132.5 	(c) The commissioner shall notify the chairs and ranking minority members of the 
132.6 	legislative committees with jurisdiction over human services policy and finance of the 
132.7 	potential penalty and the commissioner's plans to reinstate the work participation cash 
132.8 	benefit program within 30 days of the date the commissioner receives notification that 
132.9 	the state failed to meet the federal work participation rate.

132.10 	Sec. 21. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
132.11 		Subd. 7.Performance base funds. (a) For the purpose of this section, the following 
132.12 	terms have the meanings given.
132.13 	(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota 
132.14 	TANF and separate state program caseload has fallen relative to federal fiscal year 2005 
132.15 	based on caseload data from October 1 to September 30.
132.16 	(2) "TANF participation rate target" means a 50 percent participation rate reduced by 
132.17 	the CRC for the previous year.
132.18 	(b)(a) For calendar year 20102016 and yearly thereafter, each county and tribe will
132.19 	must be allocated 95 percent of their initial calendar year allocation. Allocations for 
132.20 	counties and tribes will must be allocated additional fundsadjusted based on performance 
132.21 	as follows:
132.22 	(1) a county or tribe that achieves the TANF participation rate target or a five 
132.23 	percentage point improvement over the previous year's TANF participation rate under 
132.24 	section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for 
132.25 	the most recent year for which the measurements are available, will receive an additional 
132.26 	allocation equal to 2.5 percent of its initial allocation;
132.27 	(2)(1) a county or tribe that performs within or above its range of expected 
132.28 	performance on the annualized three-year self-support index under section 256J.751, 
132.29 	subdivision 2, clause (6), willmust receive an additional allocation equal to 2.5five 
132.30 	percent of its initial allocation; and
132.31 	(3) a county or tribe that does not achieve the TANF participation rate target or 
132.32 	a five percentage point improvement over the previous year's TANF participation rate 
132.33 	under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive 
132.34 	months for the most recent year for which the measurements are available, will not 
133.1 	receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear 
133.2 	improvement plan with the commissioner; or
133.3 	(4)(2) a county or tribe that does not perform within or aboveperforms below its 
133.4 	range of expected performance on the annualized three-year self-support index under 
133.5 	section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal 
133.6 	to 2.5 percent of its initial allocation until after negotiating for a single year, may receive 
133.7 	an additional allocation of up to five percent of its initial allocation. A county or tribe that 
133.8 	continues to perform below its range of expected performance for two consecutive years 
133.9 	must negotiate  a multiyear improvement plan with the commissioner. If no improvement 
133.10 	is shown by the end of the multiyear plan, the commissioner may decrease the county's or 
133.11 	tribe's performance-based funds by up to five percent. The decrease must remain in effect 
133.12 	until the county or tribe performs within or above its range of expected performance.
133.13 	(c) (b) For calendar year 20092016 and yearly thereafter, performance-based funds 
133.14 	for a federally approved tribal TANF program in which the state and tribe have in place a 
133.15 	contract under section 256.01, addressing consolidated funding, willmust be allocated 
133.16 	as follows:
133.17 	(1) a tribe that achieves the participation rate approved in its federal TANF plan 
133.18 	using the average of 12 consecutive months for the most recent year for which the 
133.19 	measurements are available, will receive an additional allocation equal to 2.5 percent of 
133.20 	its initial allocation; and
133.21 	(2)(1) a tribe that performs within or above its range of expected performance on the 
133.22 	annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), 
133.23 	willmust receive an additional allocation equal to 2.5 percent of its initial allocation; or
133.24 	(3) a tribe that does not achieve the participation rate approved in its federal TANF 
133.25 	plan using the average of 12 consecutive months for the most recent year for which the 
133.26 	measurements are available, will not receive an additional allocation equal to 2.5 percent 
133.27 	of its initial allocation until after negotiating a multiyear improvement plan with the 
133.28 	commissioner; or
133.29 	(4)(2) a tribe that does not perform within or aboveperforms below its range of 
133.30 	expected performance on the annualized three-year self-support index under section 
133.31 	256J.751, subdivision 2, clause (6), will not receive an additional allocation equal to 2.5 
133.32 	percent until after negotiating for a single year may receive an additional allocation of up 
133.33 	to five percent of its initial allocation. A county or tribe that continues to perform below 
133.34 	its range of expected performance for two consecutive years must negotiate  a multiyear 
133.35 	improvement plan with the commissioner. If no improvement is shown by the end of the 
133.36 	multiyear plan, the commissioner may decrease the tribe's performance-based funds by 
134.1 	up to five percent. The decrease must remain in effect until the tribe performs within or 
134.2 	above its range of expected performance.
134.3 	(d)(c) Funds remaining unallocated after the performance-based allocations in 
134.4 	paragraphparagraphs (a) and (b) are available to the commissioner for innovation projects 
134.5 	under subdivision 5.
134.6 	(1)(d) If available funds are insufficient to meet county and tribal allocations under 
134.7 	paragraphparagraphs (a) and (b), the commissioner may make available for allocation 
134.8 	funds that are unobligated and available from the innovation projects through the end of 
134.9 	the current biennium shall proportionally prorate funds to counties and tribes that qualify 
134.10 	for an additional allocation under paragraphs (a), clause (1), and (b), clause (1).
134.11 	(2) If after the application of clause (1) funds remain insufficient to meet county and 
134.12 	tribal allocations under paragraph (b), the commissioner must proportionally reduce the 
134.13 	allocation of each county and tribe with respect to their maximum allocation available 
134.14 	under paragraph (b).

134.15 	Sec. 22. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM 
134.16 	FEDERAL RULES AND REGULATIONS.
134.17 		Subdivision 1.Duties of the commissioner. The commissioner of human services 
134.18 	may pursue TANF demonstration projects or waivers of TANF requirements from the 
134.19 	United States Department of Health and Human Services as needed to allow the state to 
134.20 	build a more results-oriented Minnesota Family Investment Program to better meet the 
134.21 	needs of Minnesota families.
134.22 		Subd. 2.Purpose. The purpose of the TANF demonstration projects or waivers is to:
134.23 	(1) replace the federal TANF process measure and its complex administrative 
134.24 	requirements with state-developed outcomes measures that track adult employment and 
134.25 	exits from MFIP cash assistance;
134.26 	(2) simplify programmatic and administrative requirements; and
134.27 	(3) make other policy or programmatic changes that improve the performance of the 
134.28 	program and the outcomes for participants.
134.29 		Subd. 3.Report to legislature. The commissioner shall report to the members of 
134.30 	the legislative committees having jurisdiction over human services issues by March 1, 
134.31 	2014, regarding the progress of this waiver or demonstration project.

134.32 	EFFECTIVE DATE. This section is effective the day following final enactment.

135.1 	Sec. 23. Minnesota Statutes 2012, section 256K.45, is amended to read:
135.2 	256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
135.3 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this 
135.4 	section.
135.5 	(b) "Commissioner" means the commissioner of human services.
135.6 	(c) "Homeless youth" means a person 21 years of age or younger who is 
135.7 	unaccompanied by a parent or guardian and is without shelter where appropriate care and 
135.8 	supervision are available, whose parent or legal guardian is unable or unwilling to provide 
135.9 	shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The 
135.10 	following are not fixed, regular, or adequate nighttime residences:
135.11 	(1) a supervised publicly or privately operated shelter designed to provide temporary 
135.12 	living accommodations;
135.13 	(2) an institution or a publicly or privately operated shelter designed to provide 
135.14 	temporary living accommodations;
135.15 	(3) transitional housing;
135.16 	(4) a temporary placement with a peer, friend, or family member that has not offered 
135.17 	permanent residence, a residential lease, or temporary lodging for more than 30 days; or
135.18 	(5) a public or private place not designed for, nor ordinarily used as, a regular 
135.19 	sleeping accommodation for human beings.
135.20 	Homeless youth does not include persons incarcerated or otherwise detained under 
135.21 	federal or state law.
135.22 	(d) "Youth at risk of homelessness" means a person 21 years of age or younger 
135.23 	whose status or circumstances indicate a significant danger of experiencing homelessness 
135.24 	in the near future. Status or circumstances that indicate a significant danger may include: 
135.25 	(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3) 
135.26 	youth whose parents or primary caregivers are or were previously homeless; (4) youth 
135.27 	who are exposed to abuse and neglect in their homes; (5) youth who experience conflict 
135.28 	with parents due to chemical or alcohol dependency, mental health disabilities, or other 
135.29 	disabilities; and (6) runaways.
135.30 	(e) "Runaway" means an unmarried child under the age of 18 years who is absent 
135.31 	from the home of a parent or guardian or other lawful placement without the consent of 
135.32 	the parent, guardian, or lawful custodian.
135.33 		Subd. 2.Homeless and runaway youth report. The commissioner shall develop a
135.34 	report for homeless youth, youth at risk of homelessness, and runaways. The report shall 
135.35 	include coordination of services as defined under subdivisions 3 to 5 prepare a biennial 
135.36 	report, beginning in February 2015, which provides meaningful information to the 
136.1 	legislative committees having jurisdiction over the issue of homeless youth, that includes, 
136.2 	but is not limited to: (1) a list of the areas of the state with the greatest need for services 
136.3 	and housing for homeless youth, and the level and nature of the needs identified; (2) details 
136.4 	about grants made; (3) the distribution of funds throughout the state based on population 
136.5 	need; (4) follow-up information, if available, on the status of homeless youth and whether 
136.6 	they have stable housing two years after services are provided; and (5) any other outcomes 
136.7 	for populations served to determine the effectiveness of the programs and use of funding.
136.8 		Subd. 3.Street and community outreach and drop-in program. Youth drop-in 
136.9 	centers must provide walk-in access to crisis intervention and ongoing supportive services 
136.10 	including one-to-one case management services on a self-referral basis. Street and 
136.11 	community outreach programs must locate, contact, and provide information, referrals, 
136.12 	and services to homeless youth, youth at risk of homelessness, and runaways. Information, 
136.13 	referrals, and services provided may include, but are not limited to:
136.14 	(1) family reunification services;
136.15 	(2) conflict resolution or mediation counseling;
136.16 	(3) assistance in obtaining temporary emergency shelter;
136.17 	(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
136.18 	(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted 
136.19 	diseases, and pregnancy;
136.20 	(6) referrals to other agencies that provide support services to homeless youth, 
136.21 	youth at risk of homelessness, and runaways;
136.22 	(7) assistance with education, employment, and independent living skills;
136.23 	(8) aftercare services;
136.24 	(9) specialized services for highly vulnerable runaways and homeless youth, 
136.25 	including teen parents, emotionally disturbed and mentally ill youth, and sexually 
136.26 	exploited youth; and
136.27 	(10) homelessness prevention.
136.28 		Subd. 4.Emergency shelter program. (a) Emergency shelter programs must 
136.29 	provide homeless youth and runaways with referral and walk-in access to emergency, 
136.30 	short-term residential care. The program shall provide homeless youth and runaways with 
136.31 	safe, dignified shelter, including private shower facilities, beds, and at least one meal each 
136.32 	day; and shall assist a runaway and homeless youth with reunification with the family or 
136.33 	legal guardian when required or appropriate.
136.34 	(b) The services provided at emergency shelters may include, but are not limited to:
136.35 	(1) family reunification services;
136.36 	(2) individual, family, and group counseling;
137.1 	(3) assistance obtaining clothing;
137.2 	(4) access to medical and dental care and mental health counseling;
137.3 	(5) education and employment services;
137.4 	(6) recreational activities;
137.5 	(7) advocacy and referral services;
137.6 	(8) independent living skills training;
137.7 	(9) aftercare and follow-up services;
137.8 	(10) transportation; and
137.9 	(11) homelessness prevention.
137.10 		Subd. 5.Supportive housing and transitional living programs. Transitional 
137.11 	living programs must help homeless youth and youth at risk of homelessness to find and 
137.12 	maintain safe, dignified housing. The program may also provide rental assistance and 
137.13 	related supportive services, or refer youth to other organizations or agencies that provide 
137.14 	such services. Services provided may include, but are not limited to:
137.15 	(1) educational assessment and referrals to educational programs;
137.16 	(2) career planning, employment, work skill training, and independent living skills 
137.17 	training;
137.18 	(3) job placement;
137.19 	(4) budgeting and money management;
137.20 	(5) assistance in securing housing appropriate to needs and income;
137.21 	(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted 
137.22 	diseases, and pregnancy;
137.23 	(7) referral for medical services or chemical dependency treatment;
137.24 	(8) parenting skills;
137.25 	(9) self-sufficiency support services or life skill training;
137.26 	(10) aftercare and follow-up services; and
137.27 	(11) homelessness prevention.
137.28 		Subd. 6.Funding. Any Funds appropriated for this section may be expended on 
137.29 	programs described under subdivisions 3 to 5, technical assistance, and capacity building. 
137.30 	Up to four percent of funds appropriated may be used for the purpose of monitoring and 
137.31 	evaluating runaway and homeless youth programs receiving funding under this section. 
137.32 	Funding shall be directed to meet the greatest need, with a significant share of the funding 
137.33 	focused on homeless youth providers in greater Minnesota to meet the greatest need 
137.34 	on a statewide basis.

137.35 	Sec. 24. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
138.1 		Subdivision 1.Formula. The commissioner shall allocate state funds appropriated 
138.2 	under this chapter to each county board on a calendar year basis in an amount determined 
138.3 	according to the formula in paragraphs (a) to (e).
138.4 	(a) For calendar years 2011 and 2012, the commissioner shall allocate available 
138.5 	funds to each county in proportion to that county's share in calendar year 2010.
138.6 	(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall 
138.7 	allocate available funds to each county as follows:
138.8 	(1) 75 percent must be distributed on the basis of the county share in calendar year 
138.9 	2012;
138.10 	(2) five percent must be distributed on the basis of the number of persons residing in 
138.11 	the county as determined by the most recent data of the state demographer;
138.12 	(3) ten percent must be distributed on the basis of the number of vulnerable children 
138.13 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in 
138.14 	the county as determined by the most recent data of the commissioner; and
138.15 	(4) ten percent must be distributed on the basis of the number of vulnerable adults 
138.16 	that are subjects of reports under section 626.557 in the county as determined by the most 
138.17 	recent data of the commissioner.
138.18 	(c) For calendar year 2014, the commissioner shall allocate available funds to each 
138.19 	county as follows:
138.20 	(1) 50 percent must be distributed on the basis of the county share in calendar year 
138.21 	2012;
138.22 	(2) Ten percent must be distributed on the basis of the number of persons residing in 
138.23 	the county as determined by the most recent data of the state demographer;
138.24 	(3) 20 percent must be distributed on the basis of the number of vulnerable children 
138.25 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
138.26 	county as determined by the most recent data of the commissioner; and
138.27 	(4) 20 percent must be distributed on the basis of the number of vulnerable adults 
138.28 	that are subjects of reports under section 626.557 in the county as determined by the 
138.29 	most recent data of the commissioner The commissioner is precluded from changing the 
138.30 	formula under this subdivision or recommending a change to the legislature without 
138.31 	public review and input.
138.32 	(d) For calendar year 2015, the commissioner shall allocate available funds to each 
138.33 	county as follows:
138.34 	(1) 25 percent must be distributed on the basis of the county share in calendar year 
138.35 	2012;
139.1 	(2) 15 percent must be distributed on the basis of the number of persons residing in 
139.2 	the county as determined by the most recent data of the state demographer;
139.3 	(3) 30 percent must be distributed on the basis of the number of vulnerable children 
139.4 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
139.5 	county as determined by the most recent data of the commissioner; and
139.6 	(4) 30 percent must be distributed on the basis of the number of vulnerable adults 
139.7 	that are subjects of reports under section 626.557 in the county as determined by the most 
139.8 	recent data of the commissioner.
139.9 	(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall 
139.10 	allocate available funds to each county as follows:
139.11 	(1) 20 percent must be distributed on the basis of the number of persons residing in 
139.12 	the county as determined by the most recent data of the state demographer;
139.13 	(2) 40 percent must be distributed on the basis of the number of vulnerable children 
139.14 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
139.15 	county as determined by the most recent data of the commissioner; and
139.16 	(3) 40 percent must be distributed on the basis of the number of vulnerable adults 
139.17 	that are subjects of reports under section 626.557 in the county as determined by the most 
139.18 	recent data of the commissioner.

139.19 	Sec. 25. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
139.20 		Subd. 11.Financial considerations. (a) Payment of relative custody assistance 
139.21 	under a relative custody assistance agreement is subject to the availability of state funds 
139.22 	and payments may be reduced or suspended on order of the commissioner if insufficient 
139.23 	funds are available Beginning July 1, 2013, relative custody assistance shall be a forecasted 
139.24 	program, and the commissioner, with the approval of the commissioner of management 
139.25 	and budget, may transfer unencumbered appropriation balances within fiscal years of 
139.26 	each biennium to other forecasted programs of the Department of Human Services. The 
139.27 	commissioner shall inform the chairs and ranking minority members of the senate Health 
139.28 	and Human Services Finance Division and the house of representatives Health and Human 
139.29 	Services Finance Committee quarterly about transfers made under this provision.
139.30 	(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner 
139.31 	shall reimburse the local agency in an amount equal to 100 percent of the relative custody 
139.32 	assistance payments provided to relative custodians. The local agency may not seek and 
139.33 	the commissioner shall not provide reimbursement for the administrative costs associated 
139.34 	with performing the duties described in subdivision 4.
140.1 	(c) For the purposes of determining eligibility or payment amounts under MFIP, 
140.2 	relative custody assistance payments shall be excluded in determining the family's 
140.3 	available income.

140.4 	Sec. 26. Minnesota Statutes 2012, section 259A.05, subdivision 5, is amended to read:
140.5 		Subd. 5.Transfer of funds. The commissioner of human services may transfer 
140.6 	funds into the adoption assistance account when a deficit in the adoption assistance 
140.7 	program occurs Beginning July 1, 2013, adoption assistance shall be a forecasted program 
140.8 	and the commissioner, with the approval of the commissioner of management and budget, 
140.9 	may transfer unencumbered appropriation balances within fiscal years of each biennium to 
140.10 	other forecasted programs of the Department of Human Services. The commissioner shall 
140.11 	inform the chairs and ranking minority members of the senate Health and Human Services 
140.12 	Finance Division and the house of representatives Health and Human Services Finance 
140.13 	Committee quarterly about transfers made under this provision.

140.14 	Sec. 27. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
140.15 		Subd. 4.Reimbursement for special nonmedical expenses. (a) Reimbursement 
140.16 	for special nonmedical expenses is available to children, except those eligible for adoption 
140.17 	assistance based on being an at-risk child.
140.18 	(b) Reimbursements under this paragraph shall be made only after the adoptive 
140.19 	parent documents that the requested service was denied by the local social service agency, 
140.20 	community agencies, the local school district, the local public health department, the 
140.21 	parent's insurance provider, or the child's program. The denial must be for an eligible 
140.22 	service or qualified item under the program requirements of the applicable agency or 
140.23 	organization.
140.24 	(c) Reimbursements must be previously authorized, adhere to the requirements and 
140.25 	procedures prescribed by the commissioner, and be limited to:
140.26 	(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a 
140.27 	documented disability that requires special instruction for and services by the child care 
140.28 	provider. Child care reimbursements may be made if all available adult caregivers are 
140.29 	employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
140.30 	 or attending educational or vocational training programs. Documentation from a qualified 
140.31 	expert that is dated within the last 12 months must be provided to verify the disability. If a 
140.32 	parent is attending an educational or vocational training program, child care reimbursement 
140.33 	is limited to no more than the time necessary to complete the credit requirements for an 
140.34 	associate or baccalaureate degree as determined by the educational institution. Child 
141.1 	care reimbursement is not limited for an adoptive parent completing basic or remedial 
141.2 	education programs needed to prepare for postsecondary education or employment;
141.3 	(2) respite care provided for the relief of the child's parent up to 504 hours of respite 
141.4 	care annually;
141.5 	(3) camping up to 14 days per state fiscal year for a child to attend a special needs 
141.6 	camp. The camp must be accredited by the American Camp Association as a special needs 
141.7 	camp in order to be eligible for camp reimbursement;
141.8 	(4) postadoption counseling to promote the child's integration into the adoptive 
141.9 	family that is provided by the placing agency during the first year following the date of the 
141.10 	adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
141.11 	(5) family counseling that is required to meet the child's special needs. 
141.12 	Reimbursement is limited to the prorated portion of the counseling fees allotted to the 
141.13 	family when the adoptive parent's health insurance or Medicaid pays for the child's 
141.14 	counseling but does not cover counseling for the rest of the family members;
141.15 	(6) home modifications to accommodate the child's special needs upon which 
141.16 	eligibility for adoption assistance was approved. Reimbursement is limited to once every 
141.17 	five years per child;
141.18 	(7) vehicle modifications to accommodate the child's special needs upon which 
141.19 	eligibility for adoption assistance was approved. Reimbursement is limited to once every 
141.20 	five years per family; and
141.21 	(8) burial expenses up to $1,000, if the special needs, upon which eligibility for 
141.22 	adoption assistance was approved, resulted in the death of the child.
141.23 	(d) The adoptive parent shall submit statements for expenses incurred between July 
141.24 	1 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days 
141.25 	after the end of the fiscal year in order for reimbursement to occur.

141.26 	Sec. 28. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
141.27 		Subd. 6.Delinquent child. (a) Except as otherwise provided in paragraphs (b) 
141.28 	and (c), "delinquent child" means a child:
141.29 	(1) who has violated any state or local law, except as provided in section 260B.225, 
141.30 	subdivision 1, and except for juvenile offenders as described in subdivisions 16 to 18;
141.31 	(2) who has violated a federal law or a law of another state and whose case has been 
141.32 	referred to the juvenile court if the violation would be an act of delinquency if committed 
141.33 	in this state or a crime or offense if committed by an adult;
141.34 	(3) who has escaped from confinement to a state juvenile correctional facility after 
141.35 	being committed to the custody of the commissioner of corrections; or
142.1 	(4) who has escaped from confinement to a local juvenile correctional facility after 
142.2 	being committed to the facility by the court.
142.3 	(b) The term delinquent child does not include a child alleged to have committed 
142.4 	murder in the first degree after becoming 16 years of age, but the term delinquent child 
142.5 	does include a child alleged to have committed attempted murder in the first degree.
142.6 	(c) The term delinquent child does not include a child under the age of 16 years
142.7 	 alleged to have engaged in conduct which would, if committed by an adult, violate any 
142.8 	federal, state, or local law relating to being hired, offering to be hired, or agreeing to be 
142.9 	hired by another individual to engage in sexual penetration or sexual conduct.

142.10 	EFFECTIVE DATE. This section is effective August 1, 2014, and applies to 
142.11 	offenses committed on or after that date.

142.12 	Sec. 29. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
142.13 		Subd. 16.Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty 
142.14 	offense" includes a juvenile alcohol offense, a juvenile controlled substance offense, 
142.15 	a violation of section 609.685, or a violation of a local ordinance, which by its terms 
142.16 	prohibits conduct by a child under the age of 18 years which would be lawful conduct if 
142.17 	committed by an adult.
142.18 	(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also 
142.19 	includes an offense that would be a misdemeanor if committed by an adult.
142.20 	(c) "Juvenile petty offense" does not include any of the following:
142.21 	(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242, 
142.22 	609.324, subdivision 2 or 3,609.5632, 609.576, 609.66, 609.746, 609.748, 609.79, 
142.23 	or 617.23;
142.24 	(2) a major traffic offense or an adult court traffic offense, as described in section 
142.25 	260B.225;
142.26 	(3) a misdemeanor-level offense committed by a child whom the juvenile court 
142.27 	previously has found to have committed a misdemeanor, gross misdemeanor, or felony 
142.28 	offense; or
142.29 	(4) a misdemeanor-level offense committed by a child whom the juvenile court 
142.30 	has found to have committed a misdemeanor-level juvenile petty offense on two or 
142.31 	more prior occasions, unless the county attorney designates the child on the petition 
142.32 	as a juvenile petty offender notwithstanding this prior record. As used in this clause, 
142.33 	"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that 
142.34 	would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
143.1 	(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The 
143.2 	term juvenile petty offender does not include a child under the age of 16 years alleged 
143.3 	to have violated any law relating to being hired, offering to be hired, or agreeing to be 
143.4 	hired by another individual to engage in sexual penetration or sexual conduct which, if 
143.5 	committed by an adult, would be a misdemeanor.

143.6 	EFFECTIVE DATE. This section is effective August 1, 2014, and applies to 
143.7 	offenses committed on or after that date.

143.8 	Sec. 30. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
143.9 		Subd. 6.Child in need of protection or services. "Child in need of protection or 
143.10 	services" means a child who is in need of protection or services because the child:
143.11 	(1) is abandoned or without parent, guardian, or custodian;
143.12 	(2)(i) has been a victim of physical or sexual abuse as defined in section 626.556, 
143.13 	subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in 
143.14 	subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or 
143.15 	would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or 
143.16 	child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment 
143.17 	as defined in subdivision 15;
143.18 	(3) is without necessary food, clothing, shelter, education, or other required care 
143.19 	for the child's physical or mental health or morals because the child's parent, guardian, 
143.20 	or custodian is unable or unwilling to provide that care;
143.21 	(4) is without the special care made necessary by a physical, mental, or emotional 
143.22 	condition because the child's parent, guardian, or custodian is unable or unwilling to 
143.23 	provide that care;
143.24 	(5) is medically neglected, which includes, but is not limited to, the withholding of 
143.25 	medically indicated treatment from a disabled infant with a life-threatening condition. The 
143.26 	term "withholding of medically indicated treatment" means the failure to respond to the 
143.27 	infant's life-threatening conditions by providing treatment, including appropriate nutrition, 
143.28 	hydration, and medication which, in the treating physician's or physicians' reasonable 
143.29 	medical judgment, will be most likely to be effective in ameliorating or correcting all 
143.30 	conditions, except that the term does not include the failure to provide treatment other 
143.31 	than appropriate nutrition, hydration, or medication to an infant when, in the treating 
143.32 	physician's or physicians' reasonable medical judgment:
143.33 	(i) the infant is chronically and irreversibly comatose;
144.1 	(ii) the provision of the treatment would merely prolong dying, not be effective in 
144.2 	ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be 
144.3 	futile in terms of the survival of the infant; or
144.4 	(iii) the provision of the treatment would be virtually futile in terms of the survival 
144.5 	of the infant and the treatment itself under the circumstances would be inhumane;
144.6 	(6) is one whose parent, guardian, or other custodian for good cause desires to be 
144.7 	relieved of the child's care and custody, including a child who entered foster care under a 
144.8 	voluntary placement agreement between the parent and the responsible social services 
144.9 	agency under section 260C.227;
144.10 	(7) has been placed for adoption or care in violation of law;
144.11 	(8) is without proper parental care because of the emotional, mental, or physical 
144.12 	disability, or state of immaturity of the child's parent, guardian, or other custodian;
144.13 	(9) is one whose behavior, condition, or environment is such as to be injurious or 
144.14 	dangerous to the child or others. An injurious or dangerous environment may include, but 
144.15 	is not limited to, the exposure of a child to criminal activity in the child's home;
144.16 	(10) is experiencing growth delays, which may be referred to as failure to thrive, that 
144.17 	have been diagnosed by a physician and are due to parental neglect;
144.18 	(11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a 
144.19 	sexually exploited youth;
144.20 	(12) has committed a delinquent act or a juvenile petty offense before becoming 
144.21 	ten years old;
144.22 	(13) is a runaway;
144.23 	(14) is a habitual truant;
144.24 	(15) has been found incompetent to proceed or has been found not guilty by reason 
144.25 	of mental illness or mental deficiency in connection with a delinquency proceeding, a 
144.26 	certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a 
144.27 	proceeding involving a juvenile petty offense; or
144.28 	(16) has a parent whose parental rights to one or more other children were 
144.29 	involuntarily terminated or whose custodial rights to another child have been involuntarily 
144.30 	transferred to a relative and there is a case plan prepared by the responsible social services 
144.31 	agency documenting a compelling reason why filing the termination of parental rights 
144.32 	petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
144.33 	(17) is a sexually exploited youth.

144.34 	EFFECTIVE DATE. This section is effective August 1, 2014.

144.35 	Sec. 31. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
145.1 		Subd. 31.Sexually exploited youth. "Sexually exploited youth" means an 
145.2 	individual who:
145.3 	(1) is alleged to have engaged in conduct which would, if committed by an adult, 
145.4 	violate any federal, state, or local law relating to being hired, offering to be hired, or 
145.5 	agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
145.6 	(2) is a victim of a crime described in section 609.342, 609.343, 609.344,609.345, 
145.7 	609.3451, 609.3453, 609.352, 617.246, or 617.247;
145.8 	(3) is a victim of a crime described in United States Code, title 18, section 2260; 
145.9 	2421; 2422; 2423; 2425; 2425A; or 2256; or
145.10 	(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.

145.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

145.12 	Sec. 32. Minnesota Statutes 2012, section 518A.60, is amended to read:
145.13 	518A.60 COLLECTION; ARREARS ONLY.
145.14 	(a) Remedies available for the collection and enforcement of support in this chapter 
145.15 	and chapters 256, 257, 518, and 518C also apply to cases in which the child or children 
145.16 	for whom support is owed are emancipated and the obligor owes past support or has an 
145.17 	accumulated arrearage as of the date of the youngest child's emancipation. Child support 
145.18 	arrearages under this section include arrearages for child support, medical support, child 
145.19 	care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in 
145.20 	section 518A.41, subdivision 1, paragraph (h).
145.21 	(b) This section applies retroactively to any support arrearage that accrued on or 
145.22 	before June 3, 1997, and to all arrearages accruing after June 3, 1997.
145.23 	(c) Past support or pregnancy and confinement expenses ordered for which the 
145.24 	obligor has specific court ordered terms for repayment may not be enforced using 
145.25 	drivers' and occupational or professional license suspension, credit bureau reporting, and 
145.26 	additional income withholding under section 518A.53, subdivision 10, paragraph (a), 
145.27 	unless the obligor fails to comply with the terms of the court order for repayment.
145.28 	(d) If an arrearage exists at the time a support order would otherwise terminate 
145.29 	and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the 
145.30 	arrearage shall be repaid in an amount equal to the current support order until all arrears 
145.31 	have been paid in full, absent a court order to the contrary.
145.32 	(e) If an arrearage exists according to a support order which fails to establish a 
145.33 	monthly support obligation in a specific dollar amount, the public authority, if it provides 
145.34 	child support services, or the obligee, may establish a payment agreement which shall 
146.1 	equal what the obligor would pay for current support after application of section 518A.34, 
146.2 	plus an additional 20 percent of the current support obligation, until all arrears have been 
146.3 	paid in full. If the obligor fails to enter into or comply with a payment agreement, the 
146.4 	public authority, if it provides child support services, or the obligee, may move the district 
146.5 	court or child support magistrate, if section 484.702 applies, for an order establishing 
146.6 	repayment terms.
146.7 	(f) If there is no longer a current support order because all of the children of the 
146.8 	order are emancipated, the public authority may discontinue child support services and 
146.9 	close its case under title IV-D of the Social Security Act if:
146.10 	(1) the arrearage is under $500; or
146.11 	(2) the arrearage is considered unenforceable by the public authority because there 
146.12 	have been no collections for three years, and all administrative and legal remedies have 
146.13 	been attempted or are determined by the public authority to be ineffective because the 
146.14 	obligor is unable to pay, the obligor has no known income or assets, and there is no 
146.15 	reasonable prospect that the obligor will be able to pay in the foreseeable future.
146.16 	(g) At least 60 calendar days before the discontinuation of services under paragraph 
146.17 	(f), the public authority must mail a written notice to the obligee and obligor at the 
146.18 	obligee's and obligor's last known addresses that the public authority intends to close the 
146.19 	child support enforcement case and explaining each party's rights. Seven calendar days 
146.20 	after the first notice is mailed, the public authority must mail a second notice under this 
146.21 	paragraph to the obligee.
146.22 	(h) The case must be kept open if the obligee responds before case closure and 
146.23 	provides information that could reasonably lead to collection of arrears. If the case is 
146.24 	closed, the obligee may later request that the case be reopened by completing a new 
146.25 	application for services, if there is a change in circumstances that could reasonably lead to 
146.26 	the collection of arrears.

146.27 	Sec. 33. Laws 1998, chapter 407, article 6, section 116, is amended to read:
146.28 	Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
 146.29 	The commissioner of human services shall request and receive approval from the 
146.30 	legislature before adjusting the payment todiscontinue the state subsidy to retailers for 
146.31 	electronic benefit transfer transaction costs Supplemental Nutrition Assistance Program 
146.32 	transactions when the federal government discontinues the federal subsidy to the same.

146.33 	Sec. 34. DIRECTION TO COMMISSIONERS; INCOME AND ASSET 
146.34 	EXCLUSION.
 147.1 	(a) The commissioner of human services shall not count conditional cash transfers 
147.2 	made to families participating in a family independence demonstration as income or 
147.3 	assets for purposes of determining or redetermining eligibility for child care assistance 
147.4 	programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota 
147.5 	Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I; 
147.6 	the Minnesota family investment program, work benefit program, or diversionary work 
147.7 	program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
147.8 	(b) The commissioner of human services shall not count conditional cash transfers 
147.9 	made to families participating in a family independence demonstration as income or assets 
147.10 	for purposes of determining or redetermining eligibility for medical assistance under 
147.11 	Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter 
147.12 	256L, except that for enrollees subject to a modified adjusted gross income calculation to 
147.13 	determine eligibility, the conditional cash transfer payments shall be counted as income if 
147.14 	they are included on the enrollee's federal tax return as income, or if the payments can be 
147.15 	taken into account in the month of receipt as a lump sum payment.
147.16 	(c) The commissioner of the Minnesota Housing Finance Agency shall not count 
147.17 	conditional cash transfers made to families participating in a family independence 
147.18 	demonstration as income or assets for purposes of determining or redetermining eligibility 
147.19 	for housing assistance programs under Minnesota Statutes, section 462A.201, during 
147.20 	the duration of the demonstration.
147.21 	(d) For the purposes of this section:
147.22 	(1) "conditional cash transfer" means a payment made to a participant in a family 
147.23 	independence demonstration by a sponsoring organization to incent, support, or facilitate 
147.24 	participation; and 
147.25 	(2) "family independence demonstration" means an initiative sponsored or 
147.26 	cosponsored by a governmental or nongovernmental organization, the goal of which is 
147.27 	to facilitate individualized goal-setting and peer support for cohorts of no more than 12 
147.28 	families each toward the development of financial and nonfinancial assets that enable the 
147.29 	participating families to achieve financial independence.
147.30 	(e) The citizens league shall provide a report to the legislative committees having 
147.31 	jurisdiction over human services issues by July 1, 2016, informing the legislature on the 
147.32 	progress and outcomes of the demonstration under this section.

147.33 	Sec. 35. UNIFORM BENEFITS FOR CHILDREN IN FOSTER CARE, 
147.34 	PERMANENT RELATIVE CARE, AND ADOPTION ASSISTANCE.
 148.1 	Using available resources, the commissioner of human services, in consultation with 
148.2 	representatives of the judicial branch, county human services, and tribes participating in 
148.3 	the American Indian child welfare initiative under Minnesota Statutes, section 256.01, 
148.4 	subdivision 14b, together with other appropriate stakeholders, which might include 
148.5 	communities of color; youth in foster care or those who have aged out of care; kinship 
148.6 	caregivers, foster parents, adoptive parents, foster and adoptive agencies; guardians ad 
148.7 	litem; and experts in permanency, adoption, child development, and the effects of trauma, 
148.8 	and the use of medical assistance home and community-based waivers for persons with 
148.9 	disabilities, shall analyze benefits and services available to children in family foster care 
148.10 	under Minnesota Rules, parts 9560.0650 to 9560.0656, relative custody assistance under 
148.11 	Minnesota Statutes, section 257.85, and adoption assistance under Minnesota Statutes, 
148.12 	chapter 259A. The goal of the analysis is to establish a uniform set of benefits available 
148.13 	to children in foster care, permanent relative care, and adoption so that the benefits 
148.14 	can follow the child rather than being tied to the child's legal status. Included in the 
148.15 	analysis is possible accessing of federal title IV-E through guardianship assistance. The 
148.16 	commissioner shall report findings and conclusions to the chairs and ranking minority 
148.17 	members of the legislative committees and divisions with jurisdiction over health and 
148.18 	human services policy and finance by January 15, 2014, and include draft legislation 
148.19 	establishing uniform benefits.

148.20 	Sec. 36.  REPEALER.
 148.21 	(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed effective 
148.22 	July 1, 2014.
148.23 	(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following 
148.24 	final enactment.

148.25 	ARTICLE 4
148.26 	STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

148.27 	Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
148.28 		Subd. 20.Mental illness. (a) "Mental illness" means an organic disorder of the brain 
148.29 	or a clinically significant disorder of thought, mood, perception, orientation, memory, or 
148.30 	behavior that is detailed in a diagnostic codes list published by the commissioner, and that 
148.31 	seriously limits a person's capacity to function in primary aspects of daily living such as 
148.32 	personal relations, living arrangements, work, and recreation.
148.33 	(b) An "adult with acute mental illness" means an adult who has a mental illness that 
148.34 	is serious enough to require prompt intervention.
149.1 	(c) For purposes of case management and community support services, a "person 
149.2 	with serious and persistent mental illness" means an adult who has a mental illness and 
149.3 	meets at least one of the following criteria:
149.4 	(1) the adult has undergone two or more episodes of inpatient care for a mental 
149.5 	illness within the preceding 24 months;
149.6 	(2) the adult has experienced a continuous psychiatric hospitalization or residential 
149.7 	treatment exceeding six months' duration within the preceding 12 months;
149.8 	(3) the adult has been treated by a crisis team two or more times within the preceding 
149.9 	24 months;
149.10 	(4) the adult:
149.11 	(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, 
149.12 	schizoaffective disorder, or borderline personality disorder;
149.13 	(ii) indicates a significant impairment in functioning; and
149.14 	(iii) has a written opinion from a mental health professional, in the last three years, 
149.15 	stating that the adult is reasonably likely to have future episodes requiring inpatient or 
149.16 	residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 
149.17 	management or community support services are provided;
149.18 	(5) the adult has, in the last three years, been committed by a court as a person who is 
149.19 	mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
149.20 	(6) the adult (i) was eligible under clauses (1) to (5), but the specified time period 
149.21 	has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and 
149.22 	(ii) has a written opinion from a mental health professional, in the last three years, stating 
149.23 	that the adult is reasonably likely to have future episodes requiring inpatient or residential 
149.24 	treatment, of a frequency described in clause (1) or (2), unless ongoing case management 
149.25 	or community support services are provided; or
149.26 	(7) the adult was eligible as a child under section 245.4871, subdivision 6, and is 
149.27 	age 21 or younger.

149.28 	Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
149.29 		Subd. 5.Planning for pilot projects. (a) Each local plan for a pilot project, with 
149.30 	the exception of the placement of a Minnesota specialty treatment facility as defined in 
149.31 	paragraph (c), must be developed under the direction of the county board, or multiple 
149.32 	county boards acting jointly, as the local mental health authority. The planning process 
149.33 	for each pilot shall include, but not be limited to, mental health consumers, families, 
149.34 	advocates, local mental health advisory councils, local and state providers, representatives 
149.35 	of state and local public employee bargaining units, and the department of human services. 
150.1 	As part of the planning process, the county board or boards shall designate a managing 
150.2 	entity responsible for receipt of funds and management of the pilot project.
150.3 	(b) For Minnesota specialty treatment facilities, the commissioner shall issue a 
150.4 	request for proposal for regions in which a need has been identified for services.
150.5 	(c) For purposes of this section, Minnesota specialty treatment facility is defined as 
150.6 	an intensive rehabilitative mental health service under section 256B.0622, subdivision 2, 
150.7 	paragraph (b).

150.8 	Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
150.9 		Subd. 6.Duties of commissioner. (a) For purposes of the pilot projects, the 
150.10 	commissioner shall facilitate integration of funds or other resources as needed and 
150.11 	requested by each project. These resources may include:
150.12 	(1) residential services funds administered under Minnesota Rules, parts 9535.2000 
150.13 	to 9535.3000, in an amount to be determined by mutual agreement between the project's 
150.14 	managing entity and the commissioner of human services after an examination of the 
150.15 	county's historical utilization of facilities located both within and outside of the county 
150.16 	and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
150.17 	(2) community support services funds administered under Minnesota Rules, parts 
150.18 	9535.1700 to 9535.1760;
150.19 	(3) other mental health special project funds;
150.20 	(4) medical assistance, general assistance medical care, MinnesotaCare and group 
150.21 	residential housing if requested by the project's managing entity, and if the commissioner 
150.22 	determines this would be consistent with the state's overall health care reform efforts; and
150.23 	(5) regional treatment center resources consistent with section 246.0136, subdivision 
150.24 	1.; and
150.25 	(6) funds transferred from section 246.18, subdivision 8, for grants to providers to 
150.26 	participate in mental health specialty treatment services, awarded to providers through 
150.27 	a request for proposal process.
150.28 	(b) The commissioner shall consider the following criteria in awarding start-up and 
150.29 	implementation grants for the pilot projects:
150.30 	(1) the ability of the proposed projects to accomplish the objectives described in 
150.31 	subdivision 2;
150.32 	(2) the size of the target population to be served; and
150.33 	(3) geographical distribution.
151.1 	(c) The commissioner shall review overall status of the projects initiatives at least 
151.2 	every two years and recommend any legislative changes needed by January 15 of each 
151.3 	odd-numbered year.
151.4 	(d) The commissioner may waive administrative rule requirements which are 
151.5 	incompatible with the implementation of the pilot project.
151.6 	(e) The commissioner may exempt the participating counties from fiscal sanctions 
151.7 	for noncompliance with requirements in laws and rules which are incompatible with the 
151.8 	implementation of the pilot project.
151.9 	(f) The commissioner may award grants to an entity designated by a county board or 
151.10 	group of county boards to pay for start-up and implementation costs of the pilot project.

151.11 	Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
151.12 		Subd. 2.General provisions. (a) In the design and implementation of reforms to 
151.13 	the mental health system, the commissioner shall:
151.14 	(1) consult with consumers, families, counties, tribes, advocates, providers, and 
151.15 	other stakeholders;
151.16 	(2) bring to the legislature, and the State Advisory Council on Mental Health, by 
151.17 	January 15, 2008, recommendations for legislation to update the role of counties and to 
151.18 	clarify the case management roles, functions, and decision-making authority of health 
151.19 	plans and counties, and to clarify county retention of the responsibility for the delivery of 
151.20 	social services as required under subdivision 3, paragraph (a);
151.21 	(3) withhold implementation of any recommended changes in case management 
151.22 	roles, functions, and decision-making authority until after the release of the report due 
151.23 	January 15, 2008;
151.24 	(4) ensure continuity of care for persons affected by these reforms including 
151.25 	ensuring client choice of provider by requiring broad provider networks and developing 
151.26 	mechanisms to facilitate a smooth transition of service responsibilities;
151.27 	(5) provide accountability for the efficient and effective use of public and private 
151.28 	resources in achieving positive outcomes for consumers;
151.29 	(6) ensure client access to applicable protections and appeals; and
151.30 	(7) make budget transfers necessary to implement the reallocation of services and 
151.31 	client responsibilities between counties and health care programs that do not increase the 
151.32 	state and county costs and efficiently allocate state funds.
151.33 	(b) When making transfers under paragraph (a) necessary to implement movement 
151.34 	of responsibility for clients and services between counties and health care programs, 
151.35 	the commissioner, in consultation with counties, shall ensure that any transfer of state 
152.1 	grants to health care programs, including the value of case management transfer grants 
152.2 	under section 256B.0625, subdivision 20, does not exceed the value of the services being 
152.3 	transferred for the latest 12-month period for which data is available. The commissioner 
152.4 	may make quarterly adjustments based on the availability of additional data during the 
152.5 	first four quarters after the transfers first occur. If case management transfer grants under 
152.6 	section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior 
152.7 	to repeal, exceeds the value of the services being transferred, the difference becomes an 
152.8 	ongoing part of each county's adult and children's mental health grants under sections 
152.9 	245.4661, 245.4889, and 256E.12.
152.10 	(c) This appropriation is not authorized to be expended after December 31, 2010, 
152.11 	unless approved by the legislature.

152.12 	Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
152.13 		Subd. 8.Transition services. The county board may continue to provide mental 
152.14 	health services as defined in sections 245.487 to 245.4889 to persons over 18 years of 
152.15 	age, but under 21 years of age, if the person was receiving case management or family 
152.16 	community support services prior to age 18, and if one of the following conditions is met:
152.17 	(1) the person is receiving special education services through the local school 
152.18 	district; or
152.19 	(2) it is in the best interest of the person to continue services defined in sections 
152.20 	245.487 to 245.4889; or
152.21 	(3) the person is requesting services and the services are medically necessary.

152.22 	Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
152.23 		Subdivision 1.Availability of case management services. (a) The county board 
152.24 	shall provide case management services for each child with severe emotional disturbance 
152.25 	who is a resident of the county and the child's family who request or consent to the services. 
152.26 	Case management services may be continuedmust be offered to be provided for a child with 
152.27 	a serious emotional disturbance who is over the age of 18 consistent with section 245.4875, 
152.28 	subdivision 8, or the child's legal representative, provided the child's service needs can be 
152.29 	met within the children's service system. Before discontinuing case management services 
152.30 	under this subdivision for children between the ages of 17 and 21, a transition plan 
152.31 	must be developed. The transition plan must be developed with the child and, with the 
152.32 	consent of a child age 18 or over, the child's parent, guardian, or legal representative. The 
152.33 	transition plan should include plans for health insurance, housing, education, employment, 
153.1 	and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case 
153.2 	manager must meet the requirements in section 245.4871, subdivision 4.
153.3 	(b) Except as permitted by law and the commissioner under demonstration projects, 
153.4 	case management services provided to children with severe emotional disturbance eligible 
153.5 	for medical assistance must be billed to the medical assistance program under sections 
153.6 	256B.02, subdivision 8, and 256B.0625.
153.7 	(c) Case management services are eligible for reimbursement under the medical 
153.8 	assistance program. Costs of mentoring, supervision, and continuing education may be 
153.9 	included in the reimbursement rate methodology used for case management services under 
153.10 	the medical assistance program.

153.11 	Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
153.12 		Subd. 8.State-operated services account. (a) The state-operated services account is 
153.13 	established in the special revenue fund. Revenue generated by new state-operated services 
153.14 	listed under this section established after July 1, 2010, that are not enterprise activities must 
153.15 	be deposited into the state-operated services account, unless otherwise specified in law:
153.16 	(1) intensive residential treatment services;
153.17 	(2) foster care services; and
153.18 	(3) psychiatric extensive recovery treatment services.
153.19 	(b) Funds deposited in the state-operated services account are available to the 
153.20 	commissioner of human services for the purposes of:
153.21 	(1) providing services needed to transition individuals from institutional settings 
153.22 	within state-operated services to the community when those services have no other 
153.23 	adequate funding source; 
153.24 	(2) grants to providers participating in mental health specialty treatment services 
153.25 	under section 245.4661; and
153.26 	(3) to fund the operation of the Intensive Residential Treatment Service program in 
153.27 	Willmar.

153.28 	Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision 
153.29 	to read:
153.30 		Subd. 9.Transfers. The commissioner may transfer state mental health grant funds 
153.31 	to the account in subdivision 8 for noncovered allowable costs of a provider certified and 
153.32 	licensed under section 256B.0622 and operating under section 246.014.

153.33 	Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
154.1 		Subdivision 1.Administrative requirements. (a) When a person is committed, 
154.2 	the court shall issue a warrant or an order committing the patient to the custody of the 
154.3 	head of the treatment facility. The warrant or order shall state that the patient meets the 
154.4 	statutory criteria for civil commitment. 
154.5 	(b) The commissioner shall prioritize patients being admitted from jail or a 
154.6 	correctional institution who are:
154.7 	(1) ordered confined in a state hospital for an examination under Minnesota Rules of 
154.8 	Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
154.9 	(2) under civil commitment for competency treatment and continuing supervision 
154.10 	under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
154.11 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
154.12 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
154.13 	detained in a state hospital or other facility pending completion of the civil commitment 
154.14 	proceedings; or
154.15 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
154.16 	criminal charges.
154.17 	Patients described in this paragraph must be admitted to a service operated by the 
154.18 	commissioner within 48 hours. The commitment must be ordered by the court as provided 
154.19 	in section 253B.09, subdivision 1, paragraph (c).
154.20 	(c) Upon the arrival of a patient at the designated treatment facility, the head of the 
154.21 	facility shall retain the duplicate of the warrant and endorse receipt upon the original 
154.22 	warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment 
154.23 	must be filed in the court of commitment. After arrival, the patient shall be under the 
154.24 	control and custody of the head of the treatment facility.
154.25 	(d) Copies of the petition for commitment, the court's findings of fact and 
154.26 	conclusions of law, the court order committing the patient, the report of the examiners, 
154.27 	and the prepetition report shall be provided promptly to the treatment facility.

154.28 	Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:
154.29 	254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
154.30 		Subdivision 1.Authorization for navigator pilot projects. The commissioner may 
154.31 	approve and implement navigator pilot projects developed under the planning process 
154.32 	required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and 
154.33 	enhance coordination of the delivery of chemical health services required under section 
154.34 	254B.03.
155.1 		Subd. 2.Program design and implementation. (a) The commissioner and 
155.2 	counties participating in the navigator pilot projects shall continue to work in partnership 
155.3 	to refine and implement the navigator pilot projects initiated under Laws 2009, chapter 
155.4 	79, article 7, section 26.
155.5 	(b) The commissioner and counties participating in the navigator pilot projects shall 
155.6 	complete the planning phase by June 30, 2010, and, if approved by the commissioner for 
155.7 	implementation, enter into agreements governing the operation of the navigator pilot 
155.8 	projects with implementation scheduled no earlier than July 1, 2010.
155.9 		Subd. 2a.Eligibility for navigator pilot program. (a) To be considered for 
155.10 	participation in a navigator pilot program, an individual must:
155.11 	(1) be a resident of a county with an approved navigator program;
155.12 	(2) be eligible for consolidated chemical dependency treatment fund services;
155.13 	(3) be a voluntary participant in the navigator program;
155.14 	(4) satisfy one of the following items:
155.15 	(i) have at least one severity rating of three or above in dimension four, five, or six in 
155.16 	a comprehensive assessment under Minnesota Rules, part 9530.6422; or
155.17 	(ii) have at least one severity rating of two or above in dimension four, five, or six in 
155.18 	a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently 
155.19 	participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to 
155.20 	9530.6505, or be within 60 days following discharge after participation in a Rule 31 
155.21 	treatment program; and
155.22 	(5) have had at least two treatment episodes in the past two years, not limited 
155.23 	to episodes reimbursed by the consolidated chemical dependency treatment funds. An 
155.24 	admission to an emergency room, a detoxification program, or a hospital may be substituted 
155.25 	for one treatment episode if it resulted from the individual's substance use disorder.
155.26 	(b) New eligibility criteria may be added as mutually agreed upon by the 
155.27 	commissioner and participating navigator programs.
155.28 		Subd. 3.Program evaluation. The commissioner shall evaluate navigator pilot 
155.29 	projects under this section and report the results of the evaluation to the chairs and 
155.30 	ranking minority members of the legislative committees with jurisdiction over chemical 
155.31 	health issues by January 15, 2014. Evaluation of the navigator pilot projects must be 
155.32 	based on outcome evaluation criteria negotiated with the navigator pilot projects prior 
155.33 	to implementation.
155.34 		Subd. 4.Notice of navigator pilot project discontinuation. Each county's 
155.35 	participation in the navigator pilot project may be discontinued for any reason by the county 
155.36 	or the commissioner of human services after 30 days' written notice to the other party. 
156.1 	Any unspent funds held for the exiting county's pro rata share in the special revenue fund 
156.2 	under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated 
156.3 	chemical dependency treatment fund following discontinuation of the pilot project.
156.4 		Subd. 5.Duties of commissioner. (a) Notwithstanding any other provisions in 
156.5 	this chapter, the commissioner may authorize navigator pilot projects to use chemical 
156.6 	dependency treatment funds to pay for nontreatment navigator pilot services:
156.7 	(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph 
156.8 	(a); and
156.9 	(2) by vendors in addition to those authorized under section 254B.05 when not 
156.10 	providing chemical dependency treatment services.
156.11 	(b) For purposes of this section, "nontreatment navigator pilot services" include 
156.12 	navigator services, peer support, family engagement and support, housing support, rent 
156.13 	subsidies, supported employment, and independent living skills.
156.14 	(c) State expenditures for chemical dependency services and nontreatment navigator 
156.15 	pilot services provided by or through the navigator pilot projects must not be greater than 
156.16 	the chemical dependency treatment fund expected share of forecasted expenditures in the 
156.17 	absence of the navigator pilot projects. The commissioner may restructure the schedule of 
156.18 	payments between the state and participating counties under the local agency share and 
156.19 	division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to 
156.20 	facilitate the operation of the navigator pilot projects.
156.21 	(d) To the extent that state fiscal year expenditures within a pilot project are less 
156.22 	than the expected share of forecasted expenditures in the absence of the pilot projects, 
156.23 	the commissioner shall deposit the unexpended funds in a separate account within the 
156.24 	consolidated chemical dependency treatment fund, and make these funds available for 
156.25 	expenditure by the pilot projects the following year. To the extent that treatment and 
156.26 	nontreatment pilot services expenditures within the pilot project exceed the amount 
156.27 	expected in the absence of the pilot projects, the pilot project county or counties are 
156.28 	responsible for the portion of nontreatment pilot services expenditures in excess of the 
156.29 	otherwise expected share of forecasted expenditures.
156.30 	(e) (d) The commissioner may waive administrative rule requirements that are 
156.31 	incompatible with the implementation of the navigator pilot project, except that any 
156.32 	chemical dependency treatment funded under this section must continue to be provided 
156.33 	by a licensed treatment provider.
156.34 	(f) (e) The commissioner shall not approve or enter into any agreement related to 
156.35 	navigator pilot projects authorized under this section that puts current or future federal 
156.36 	funding at risk.
157.1 	(f) The commissioner shall provide participating navigator pilot projects with 
157.2 	transactional data, reports, provider data, and other data generated by county activity to 
157.3 	assess and measure outcomes. This information must be transmitted or made available in 
157.4 	an acceptable form to participating navigator pilot projects at least once every six months 
157.5 	or within a reasonable time following the commissioner's receipt of information from the 
157.6 	counties needed to comply with this paragraph.
157.7 		Subd. 6.Duties of county board. The county board, or other county entity that 
157.8 	is approved to administer a navigator pilot project, shall:
157.9 	(1) administer the navigator pilot project in a manner consistent with the objectives 
157.10 	described in subdivision 2 and the planning process in subdivision 5;
157.11 	(2) ensure that no one is denied chemical dependency treatment services for which 
157.12 	they would otherwise be eligible under section 254A.03, subdivision 3; and
157.13 	(3) provide the commissioner with timely and pertinent information as negotiated in 
157.14 	agreements governing operation of the navigator pilot projects.
157.15 		Subd. 7.Managed care. An individual who is eligible for the navigator pilot 
157.16 	program under subdivision 2a is excluded from mandatory enrollment in managed care 
157.17 	until these services are included in the health plan's benefit set.
157.18 		Subd. 8.Authorization for continuation of navigator pilots. The navigator pilot 
157.19 	projects implemented pursuant to subdivision 1 are authorized to continue operation after 
157.20 	July 1, 2013, under existing agreements governing operation of the pilot projects.

157.21 	EFFECTIVE DATE. The amendments to subdivisions 1 to 6 and 8 are effective 
157.22 	August 1, 2013. Subdivision 7 is effective July 1, 2013.

157.23 	Sec. 11. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL 
157.24 	HEALTH CARE.
157.25 		Subdivision 1.Authorization for continuum of care pilot projects. The 
157.26 	commissioner shall establish chemical dependency continuum of care pilot projects to 
157.27 	begin implementing the measures developed with stakeholder input and identified in the 
157.28 	report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot 
157.29 	projects are intended to improve the effectiveness and efficiency of the service continuum 
157.30 	for chemically dependent individuals in Minnesota while reducing duplication of efforts 
157.31 	and promoting scientifically supported practices.
157.32 		Subd. 2.Program implementation. (a) The commissioner, in coordination with 
157.33 	representatives of the Minnesota Association of County Social Service Administrators 
157.34 	and the Minnesota Inter-County Association, shall develop a process for identifying and 
157.35 	selecting interested counties and providers for participation in the continuum of care pilot 
158.1 	projects. There will be three pilot projects; one representing the northern region, one for 
158.2 	the metro region, and one for the southern region. The selection process of counties and 
158.3 	providers must include consideration of population size, geographic distribution, cultural 
158.4 	and racial demographics, and provider accessibility. The commissioner shall identify 
158.5 	counties and providers that are selected for participation in the continuum of care pilot 
158.6 	projects no later than September 30, 2013.
158.7 	(b) The commissioner and entities participating in the continuum of care pilot 
158.8 	projects shall enter into agreements governing the operation of the continuum of care pilot 
158.9 	projects. The agreements shall identify pilot project outcomes and include timelines for 
158.10 	implementation and beginning operation of the pilot projects.
158.11 	(c) Entities that are currently participating in the navigator pilot project are 
158.12 	eligible to participate in the continuum of care pilot project subsequent to or instead of 
158.13 	participating in the navigator pilot project.
158.14 	(d) The commissioner may waive administrative rule requirements that are 
158.15 	incompatible with implementation of the continuum of care pilot projects.
158.16 	(e) Notwithstanding section 254A.19, the commissioner may designate noncounty 
158.17 	entities to complete chemical use assessments and placement authorizations required 
158.18 	under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section 
158.19 	254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the 
158.20 	discretion of the commissioner.
158.21 		Subd. 3.Program design. (a) The operation of the pilot projects shall include:
158.22 	(1) new services that are responsive to the chronic nature of substance use disorder;
158.23 	(2) telehealth services, when appropriate to address barriers to services;
158.24 	(3) services that assure integration with the mental health delivery system when 
158.25 	appropriate;
158.26 	(4) services that address the needs of diverse populations; and
158.27 	(5) an assessment and access process that permits clients to present directly to a 
158.28 	service provider for a substance use disorder assessment and authorization of services.
158.29 	(b) Prior to implementation of the continuum of care pilot projects, a utilization 
158.30 	review process must be developed and agreed to by the commissioner, participating 
158.31 	counties, and providers. The utilization review process shall be described in the 
158.32 	agreements governing operation of the continuum of care pilot projects.
158.33 		Subd. 4.Notice of project discontinuation. Each entity's participation in the 
158.34 	continuum of care pilot project may be discontinued for any reason by the county or the 
158.35 	commissioner after 30 days' written notice to the entity.
159.1 		Subd. 5.Duties of commissioner. (a) Notwithstanding any other provisions in this 
159.2 	chapter, the commissioner may authorize chemical dependency treatment funds to pay for 
159.3 	nontreatment services arranged by continuum of care pilot projects. Individuals who are 
159.4 	currently accessing Rule 31 treatment services are eligible for concurrent participation in 
159.5 	the continuum of care pilot projects.
159.6 	(b) County expenditures for continuum of care pilot project services shall not 
159.7 	be greater than their expected share of forecasted expenditures in the absence of the 
159.8 	continuum of care pilot projects.

159.9 	EFFECTIVE DATE. This section is effective August 1, 2013.

159.10 	Sec. 12. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER 
159.11 	SPECIALIST.
159.12 		Subdivision 1.Scope. Medical assistance covers mental health certified family peer 
159.13 	specialists services, as established in subdivision 2, subject to federal approval, if provided 
159.14 	to recipients who have an emotional disturbance or severe emotional disturbance under 
159.15 	chapter 245, and are provided by a certified family peer specialist who has completed the 
159.16 	training under subdivision 5. A family peer specialist cannot provide services to the 
159.17 	peer specialist's family.
159.18 		Subd. 2.Establishment. The commissioner of human services shall establish a 
159.19 	certified family peer specialists program model which:
159.20 	(1) provides nonclinical family peer support counseling, building on the strengths 
159.21 	of families and helping them achieve desired outcomes;
159.22 	(2) collaborates with others providing care or support to the family;
159.23 	(3) provides nonadversarial advocacy;
159.24 	(4) promotes the individual family culture in the treatment milieu;
159.25 	(5) links parents to other parents in the community;
159.26 	(6) offers support and encouragement;
159.27 	(7) assists parents in developing coping mechanisms and problem-solving skills;
159.28 	(8) promotes resiliency, self-advocacy, development of natural supports, and 
159.29 	maintenance of skills learned in other support services;
159.30 	(9) establishes and provides peer led parent support groups; and
159.31 	(10) increases the child's ability to function better within the child's home, school, 
159.32 	and community by educating parents on community resources, assisting with problem 
159.33 	solving, and educating parents on mental illnesses.
160.1 		Subd. 3.Eligibility. Family peer support services may be located in inpatient 
160.2 	hospitalization, partial hospitalization, residential treatment, treatment foster care, day 
160.3 	treatment, children's therapeutic services and supports, or crisis services.
160.4 		Subd. 4.Peer support specialist program providers. The commissioner shall 
160.5 	develop a process to certify family peer support specialist programs, in accordance with 
160.6 	the federal guidelines, in order for the program to bill for reimbursable services. Family 
160.7 	peer support programs must operate within an existing mental health community provider 
160.8 	or center.
160.9 		Subd. 5.Certified family peer specialist training and certification. The 
160.10 	commissioner shall develop a training and certification process for certified family peer 
160.11 	specialists who must be at least 21 years of age and have a high school diploma or its 
160.12 	equivalent. The candidates must have raised or are currently raising a child with a mental 
160.13 	illness, have had experience navigating the children's mental health system, and must 
160.14 	demonstrate leadership and advocacy skills and a strong dedication to family-driven and 
160.15 	family-focused services. The training curriculum must teach participating family peer 
160.16 	specialists specific skills relevant to providing peer support to other parents. In addition 
160.17 	to initial training and certification, the commissioner shall develop ongoing continuing 
160.18 	educational workshops on pertinent issues related to family peer support counseling.

160.19 	Sec. 13. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
160.20 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
160.21 	meanings given them.
160.22 	(a) "Adult rehabilitative mental health services" means mental health services 
160.23 	which are rehabilitative and enable the recipient to develop and enhance psychiatric 
160.24 	stability, social competencies, personal and emotional adjustment, and independent living, 
160.25 	parenting skills, and community skills, when these abilities are impaired by the symptoms 
160.26 	of mental illness. Adult rehabilitative mental health services are also appropriate when 
160.27 	provided to enable a recipient to retain stability and functioning, if the recipient would 
160.28 	be at risk of significant functional decompensation or more restrictive service settings 
160.29 	without these services.
160.30 	(1) Adult rehabilitative mental health services instruct, assist, and support the 
160.31 	recipient in areas such as: interpersonal communication skills, community resource 
160.32 	utilization and integration skills, crisis assistance, relapse prevention skills, health care 
160.33 	directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking 
160.34 	and nutrition skills, transportation skills, medication education and monitoring, mental 
161.1 	illness symptom management skills, household management skills, employment-related 
161.2 	skills, parenting skills, and transition to community living services.
161.3 	(2) These services shall be provided to the recipient on a one-to-one basis in the 
161.4 	recipient's home or another community setting or in groups.
161.5 	(b) "Medication education services" means services provided individually or in 
161.6 	groups which focus on educating the recipient about mental illness and symptoms; the role 
161.7 	and effects of medications in treating symptoms of mental illness; and the side effects of 
161.8 	medications. Medication education is coordinated with medication management services 
161.9 	and does not duplicate it. Medication education services are provided by physicians, 
161.10 	pharmacists, physician's assistants, or registered nurses.
161.11 	(c) "Transition to community living services" means services which maintain 
161.12 	continuity of contact between the rehabilitation services provider and the recipient and 
161.13 	which facilitate discharge from a hospital, residential treatment program under Minnesota 
161.14 	Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community 
161.15 	living services are not intended to provide other areas of adult rehabilitative mental health 
161.16 	services.

161.17 	Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to 
161.18 	read:
161.19 		Subd. 48.Psychiatric consultation to primary care practitioners. Effective 
161.20 	January 1, 2006, Medical assistance covers consultation provided by a psychiatrist, 
161.21 	psychologist, or an advanced practice registered nurse certified in psychiatric mental 
161.22 	health via telephone, e-mail, facsimile, or other means of communication to primary care 
161.23 	practitioners, including pediatricians. The need for consultation and the receipt of the 
161.24 	consultation must be documented in the patient record maintained by the primary care 
161.25 	practitioner. If the patient consents, and subject to federal limitations and data privacy 
161.26 	provisions, the consultation may be provided without the patient present.

161.27 	Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to 
161.28 	read:
161.29 		Subd. 56.Medical service coordination. (a)(1)  Medical assistance covers in-reach 
161.30 	community-based service coordination that is performed through a hospital emergency 
161.31 	department as an eligible procedure under a state healthcare program for a frequent user. 
161.32 	A frequent user is defined as an individual who has frequented the hospital emergency 
161.33 	department for services three or more times in the previous four consecutive months. 
161.34 	In-reach community-based service coordination includes navigating services to address a 
162.1 	client's mental health, chemical health, social, economic, and housing needs, or any other 
162.2 	activity targeted at reducing the incidence of emergency room and other nonmedically 
162.3 	necessary health care utilization.
162.4 	(2) Medical assistance covers in-reach community-based service coordination that 
162.5 	is performed through a hospital emergency department or inpatient psychiatric unit 
162.6 	for a child or young adult up to age 21 with a serious emotional disturbance who has 
162.7 	frequented the hospital emergency room two or more times in the previous consecutive 
162.8 	three months or been admitted to an inpatient psychiatric unit two or more times in the 
162.9 	previous consecutive four months, or is being discharged to a shelter. 
162.10 	(b) Reimbursement must be made in 15-minute increments and allowed for up to 60 
162.11 	days posthospital discharge based upon the specific identified emergency department visit 
162.12 	or inpatient admitting event. In-reach community-based service coordination shall seek to 
162.13 	connect frequent users with existing covered services available to them, including, but not 
162.14 	limited to, targeted case management, waiver case management, or care coordination in a 
162.15 	health care home. For children and young adults with a serious emotional disturbance, 
162.16 	in-reach community-based service coordination includes navigating and arranging for 
162.17 	community-based services prior to discharge to address a client's mental health, chemical 
162.18 	health, social, educational, family support and housing needs, or any other activity targeted 
162.19 	at reducing multiple incidents of emergency room use, inpatient readmissions, and other 
162.20 	nonmedically necessary health care utilization. In-reach services shall seek to connect 
162.21 	them with existing covered services, including targeted case management, waiver case 
162.22 	management, care coordination in a health care home, children's therapeutic services and 
162.23 	supports, crisis services, and respite care. Eligible in-reach service coordinators must hold 
162.24 	a minimum of a bachelor's degree in social work, public health, corrections, or a related 
162.25 	field. The commissioner shall submit any necessary application for waivers to the Centers 
162.26 	for Medicare and Medicaid Services to implement this subdivision.
162.27 	(c)(1) For the purposes of this subdivision, "in-reach community-based service 
162.28 	coordination" means the practice of a community-based worker with training, knowledge, 
162.29 	skills, and ability to access a continuum of services, including housing, transportation, 
162.30 	chemical and mental health treatment, employment, education, and peer support services, 
162.31 	by working with an organization's staff to transition an individual back into the individual's 
162.32 	living environment. In-reach community-based service coordination includes working 
162.33 	with the individual during their discharge and for up to a defined amount of time in the 
162.34 	individual's living environment, reducing the individual's need for readmittance.
162.35 	(2) Hospitals utilizing in-reach service coordinators shall report annually to the 
162.36 	commissioner on the number of adults, children, and adolescents served; the postdischarge 
163.1 	services which they accessed; and emergency department/psychiatric hospitalization 
163.2 	readmissions. The commissioner shall ensure that services and payments provided under 
163.3 	in-reach care coordination do not duplicate services or payments provided under section 
163.4 	256B.0753, 256B.0755, or 256B.0625, subdivision 20.

163.5 	Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a 
163.6 	subdivision to read:
163.7 		Subd. 61.Family psychoeducation services. Effective July 1, 2013, or upon 
163.8 	federal approval, whichever is later, medical assistance covers family psychoeducation 
163.9 	services provided to a child up to age 21 with a diagnosed mental health condition when 
163.10 	identified in the child's individual treatment plan and provided by a licensed mental health 
163.11 	professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a 
163.12 	clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who 
163.13 	has determined it medically necessary to involve family members in the child's care. For 
163.14 	the purposes of this subdivision, "family psychoeducation services" means information 
163.15 	or demonstration provided to an individual or family as part of an individual, family, 
163.16 	multifamily group, or peer group session to explain, educate, and support the child and 
163.17 	family in understanding a child's symptoms of mental illness, the impact on the child's 
163.18 	development, and needed components of treatment and skill development so that the 
163.19 	individual, family, or group can help the child to prevent relapse, prevent the acquisition 
163.20 	of comorbid disorders, and to achieve optimal mental health and long-term resilience.

163.21 	Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a 
163.22 	subdivision to read:
163.23 		Subd. 62.Mental health clinical care consultation. Effective July 1, 2013, or upon 
163.24 	federal approval, whichever is later, medical assistance covers clinical care consultation 
163.25 	for a person up to age 21 who is diagnosed with a complex mental health condition or a 
163.26 	mental health condition that co-occurs with other complex and chronic conditions, when 
163.27 	described in the person's individual treatment plan and provided by a licensed mental 
163.28 	health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a 
163.29 	clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the 
163.30 	purposes of this subdivision, "clinical care consultation" means communication from a 
163.31 	treating mental health professional to other providers or educators not under the clinical 
163.32 	supervision of the treating mental health professional who are working with the same client 
163.33 	to inform, inquire, and instruct regarding the client's symptoms; strategies for effective 
164.1 	engagement, care, and intervention needs; treatment expectations across service settings; 
164.2 	and to direct and coordinate clinical service components provided to the client and family.

164.3 	Sec. 18. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
164.4 		Subdivision 1.Definitions. For purposes of this section, the following terms have 
164.5 	the meanings given them.
164.6 	(a) "Children's therapeutic services and supports" means the flexible package of 
164.7 	mental health services for children who require varying therapeutic and rehabilitative 
164.8 	levels of intervention. The services are time-limited interventions that are delivered using 
164.9 	various treatment modalities and combinations of services designed to reach treatment 
164.10 	outcomes identified in the individual treatment plan.
164.11 	(b) "Clinical supervision" means the overall responsibility of the mental health 
164.12 	professional for the control and direction of individualized treatment planning, service 
164.13 	delivery, and treatment review for each client. A mental health professional who is an 
164.14 	enrolled Minnesota health care program provider accepts full professional responsibility 
164.15 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
164.16 	and oversees or directs the supervisee's work.
164.17 	(c) "County board" means the county board of commissioners or board established 
164.18 	under sections 402.01 to 402.10 or 471.59.
164.19 	(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
164.20 	(e) "Culturally competent provider" means a provider who understands and can 
164.21 	utilize to a client's benefit the client's culture when providing services to the client. A 
164.22 	provider may be culturally competent because the provider is of the same cultural or 
164.23 	ethnic group as the client or the provider has developed the knowledge and skills through 
164.24 	training and experience to provide services to culturally diverse clients.
164.25 	(f) "Day treatment program" for children means a site-based structured program 
164.26 	consisting of group psychotherapy for more than three individuals and other intensive 
164.27 	therapeutic services provided by a multidisciplinary team, under the clinical supervision 
164.28 	of a mental health professional.
164.29 	(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 
164.30 	11.
164.31 	(h) "Direct service time" means the time that a mental health professional, mental 
164.32 	health practitioner, or mental health behavioral aide spends face-to-face with a client 
164.33 	and the client's family. Direct service time includes time in which the provider obtains 
164.34 	a client's history or provides service components of children's therapeutic services and 
164.35 	supports. Direct service time does not include time doing work before and after providing 
165.1 	direct services, including scheduling, maintaining clinical records, consulting with others 
165.2 	about the client's mental health status, preparing reports, receiving clinical supervision, 
165.3 	and revising the client's individual treatment plan.
165.4 	(i) "Direction of mental health behavioral aide" means the activities of a mental 
165.5 	health professional or mental health practitioner in guiding the mental health behavioral 
165.6 	aide in providing services to a client. The direction of a mental health behavioral aide 
165.7 	must be based on the client's individualized treatment plan and meet the requirements in 
165.8 	subdivision 6, paragraph (b), clause (5).
165.9 	(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 
165.10 	15. For persons at least age 18 but under age 21, mental illness has the meaning given in 
165.11 	section 245.462, subdivision 20, paragraph (a).
165.12 	(k) "Individual behavioral plan" means a plan of intervention, treatment, and 
165.13 	services for a child written by a mental health professional or mental health practitioner, 
165.14 	under the clinical supervision of a mental health professional, to guide the work of the 
165.15 	mental health behavioral aide.
165.16 	(l) "Individual treatment plan" has the meaning given in section 245.4871, 
165.17 	subdivision 21.
165.18 	(m) "Mental health behavioral aide services" means medically necessary one-on-one 
165.19 	activities performed by a trained paraprofessional to assist a child retain or generalize 
165.20 	psychosocial skills as taught by a mental health professional or mental health practitioner 
165.21 	and as described in the child's individual treatment plan and individual behavior plan. 
165.22 	Activities involve working directly with the child or child's family as provided in 
165.23 	subdivision 9, paragraph (b), clause (4).
165.24 	(n) "Mental health professional" means an individual as defined in section 245.4871, 
165.25 	subdivision 27, clauses (1) to (6), or tribal vendor as defined in section 256B.02, 
165.26 	subdivision 7, paragraph (b).
165.27 	(o) "Mental health service plan development" includes:
165.28 	(1) the development, review, and revision of a child's individual treatment plan, 
165.29 	as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of 
165.30 	the client or client's parents, primary caregiver, or other person authorized to consent to 
165.31 	mental health services for the client, and including arrangement of treatment and support 
165.32 	activities specified in the individual treatment plan; and
165.33 	(2) administering standardized outcome measurement instruments, determined 
165.34 	and updated by the commissioner, as periodically needed to evaluate the effectiveness 
165.35 	of treatment for children receiving clinical services and reporting outcome measures, 
165.36 	as required by the commissioner.
166.1 	(o) (p) "Preschool program" means a day program licensed under Minnesota Rules, 
166.2 	parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and 
166.3 	supports provider to provide a structured treatment program to a child who is at least 33 
166.4 	months old but who has not yet attended the first day of kindergarten.
166.5 	(p) (q) "Skills training" means individual, family, or group training, delivered 
166.6 	by or under the direction of a mental health professional, designed to facilitate the 
166.7 	acquisition of psychosocial skills that are medically necessary to rehabilitate the child 
166.8 	to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric 
166.9 	illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits 
166.10 	or maladaptive skills acquired over the course of a psychiatric illness. Skills training 
166.11 	is subject to the following requirements:
166.12 	(1) a mental health professional or a mental health practitioner must provide skills 
166.13 	training;
166.14 	(2) the child must always be present during skills training; however, a brief absence 
166.15 	of the child for no more than ten percent of the session unit may be allowed to redirect or 
166.16 	instruct family members;
166.17 	(3) skills training delivered to children or their families must be targeted to the 
166.18 	specific deficits or maladaptations of the child's mental health disorder and must be 
166.19 	prescribed in the child's individual treatment plan;
166.20 	(4) skills training delivered to the child's family must teach skills needed by parents 
166.21 	to enhance the child's skill development and to help the child use in daily life the skills 
166.22 	previously taught by a mental health professional or mental health practitioner and to 
166.23 	develop or maintain a home environment that supports the child's progressive use skills;
166.24 	(5) group skills training may be provided to multiple recipients who, because of the 
166.25 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
166.26 	interaction in a group setting, which must be staffed as follows:
166.27 	(i) one mental health professional or one mental health practitioner under supervision 
166.28 	of a licensed mental health professional must work with a group of four to eight clients; or
166.29 	(ii) two mental health professionals or two mental health practitioners under 
166.30 	supervision of a licensed mental health professional, or one professional plus one 
166.31 	practitioner must work with a group of nine to 12 clients.

166.32 	Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
166.33 		Subd. 2.Covered service components of children's therapeutic services and 
166.34 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
166.35 	children's therapeutic services and supports as defined in this section that an eligible 
167.1 	provider entity certified under subdivision 4 provides to a client eligible under subdivision 
167.2 	3.
167.3 	(b) The service components of children's therapeutic services and supports are:
167.4 	(1) individual, family, and group psychotherapy;
167.5 	(2) individual, family, or group skills training provided by a mental health 
167.6 	professional or mental health practitioner;
167.7 	(3) crisis assistance;
167.8 	(4) mental health behavioral aide services; and
167.9 	(5) direction of a mental health behavioral aide.;
167.10 	(6) mental health service plan development;
167.11 	(7) clinical care consultation provided by a mental health professional under section 
167.12 	256B.0625, subdivision 62; 
167.13 	(8) family psychoeducation under section 256B.0625, subdivision 61; and
167.14 	(9) services provided by a family peer specialist under section 256B.0616.
167.15 	(c) Service components in paragraph (b) may be combined to constitute therapeutic 
167.16 	programs, including day treatment programs and therapeutic preschool programs.

167.17 	Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
167.18 		Subd. 7.Qualifications of individual and team providers. (a) An individual 
167.19 	or team provider working within the scope of the provider's practice or qualifications 
167.20 	may provide service components of children's therapeutic services and supports that are 
167.21 	identified as medically necessary in a client's individual treatment plan.
167.22 	(b) An individual provider must be qualified as:
167.23 	(1) a mental health professional as defined in subdivision 1, paragraph (n); or
167.24 	(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The 
167.25 	mental health practitioner must work under the clinical supervision of a mental health 
167.26 	professional; or
167.27 	(3) a mental health behavioral aide working under the clinical supervision of a 
167.28 	mental health professional to implement the rehabilitative mental health services identified 
167.29 	in the client's individual treatment plan and individual behavior plan.
167.30 	(A) A level I mental health behavioral aide must:
167.31 	(i) be at least 18 years old;
167.32 	(ii) have a high school diploma or general equivalency diploma (GED) or two years 
167.33 	of experience as a primary caregiver to a child with severe emotional disturbance within 
167.34 	the previous ten years; and
167.35 	(iii) meet preservice and continuing education requirements under subdivision 8.
168.1 	(B) A level II mental health behavioral aide must:
168.2 	(i) be at least 18 years old;
168.3 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
168.4 	clinical services in the treatment of mental illness concerning children or adolescents or 
168.5 	complete a certificate program established under subdivision 8a; and
168.6 	(iii) meet preservice and continuing education requirements in subdivision 8.
168.7 	(c) A preschool program multidisciplinary team must include at least one mental 
168.8 	health professional and one or more of the following individuals under the clinical 
168.9 	supervision of a mental health professional:
168.10 	(i) a mental health practitioner; or
168.11 	(ii) a program person, including a teacher, assistant teacher, or aide, who meets the 
168.12 	qualifications and training standards of a level I mental health behavioral aide.
168.13 	(d) A day treatment multidisciplinary team must include at least one mental health 
168.14 	professional and one mental health practitioner.

168.15 	Sec. 21. Minnesota Statutes 2012, section 256B.0943, is amended by adding a 
168.16 	subdivision to read:
168.17 		Subd. 8a.Level II mental health behavioral aide. The commissioner of human 
168.18 	services, in collaboration with the Board of Trustees of the Minnesota State Colleges and 
168.19 	Universities, shall develop a certificate program of not fewer than 11 credits for level II 
168.20 	mental health behavioral aides. The program shall include classroom and field-based 
168.21 	learning. The program components must include, but not be limited to, mental illnesses 
168.22 	in children, parent and family perspectives, skill training, documentation and reporting, 
168.23 	communication skills, and cultural competence.

168.24 	Sec. 22. Minnesota Statutes 2012, section 256B.0946, is amended to read:
168.25 	256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
168.26 		Subdivision 1.Required covered service components. (a) Effective July 1, 2006,
168.27 	 upon enactment and subject to federal approval, medical assistance covers medically 
168.28 	necessary intensive treatment services described under paragraph (b) that are provided 
168.29 	by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2 
168.30 	who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000 
168.31 	to 2960.3340.
168.32 	(b) Intensive treatment services to children with severe emotional disturbance mental 
168.33 	illness residing in treatment foster care family settings must meet the relevant standards 
168.34 	for mental health services under sections 245.487 to 245.4889. In addition, that comprise
169.1 	 specific required service components provided in clauses (1) to (5), are reimbursed by 
169.2 	medical assistance must when they meet the following standards:
169.3 	(1) case management service component must meet the standards in Minnesota 
169.4 	Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
169.5 	(1) psychotherapy provided by a mental health professional as defined in Minnesota 
169.6 	Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota 
169.7 	Rules, part 9505.0371, subpart 5, item C;
169.8 	(2) psychotherapy, crisis assistance, and skills training components must meet the
169.9 	 provided according to standards for children's therapeutic services and supports in section 
169.10 	256B.0943; and
169.11 	(3) individual family, and group psychoeducation services under supervision of, 
169.12 	defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a 
169.13 	clinical trainee;
169.14 	(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental 
169.15 	health professional or a clinical trainee; and
169.16 	(5) service delivery payment requirements as provided under subdivision 4.
169.17 		Subd. 1a.Definitions. For the purposes of this section, the following terms have 
169.18 	the meanings given them.
169.19 	(a) "Clinical care consultation" means communication from a treating clinician to 
169.20 	other providers working with the same client to inform, inquire, and instruct regarding 
169.21 	the client's symptoms, strategies for effective engagement, care and intervention needs, 
169.22 	and treatment expectations across service settings, including but not limited to the client's 
169.23 	school, social services, day care, probation, home, primary care, medication prescribers, 
169.24 	disabilities services, and other mental health providers and to direct and coordinate clinical 
169.25 	service components provided to the client and family.
169.26 	(b) "Clinical supervision" means the documented time a clinical supervisor and 
169.27 	supervisee spend together to discuss the supervisee's work, to review individual client 
169.28 	cases, and for the supervisee's professional development. It includes the documented 
169.29 	oversight and supervision responsibility for planning, implementation, and evaluation of 
169.30 	services for a client's mental health treatment.
169.31 	(c) "Clinical supervisor" means the mental health professional who is responsible 
169.32 	for clinical supervision.
169.33 	(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, 
169.34 	subpart 5, item C;
170.1 	(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a, 
170.2 	including the development of a plan that addresses prevention and intervention strategies 
170.3 	to be used in a potential crisis, but does not include actual crisis intervention.
170.4 	(f) "Culturally appropriate" means providing mental health services in a manner that 
170.5 	incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370, 
170.6 	subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural 
170.7 	strengths and resources to promote overall wellness.
170.8 	(g) "Culture" means the distinct ways of living and understanding the world that 
170.9 	are used by a group of people and are transmitted from one generation to another or 
170.10 	adopted by an individual.
170.11 	(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part 
170.12 	9505.0370, subpart 11.
170.13 	(i) "Family" means a person who is identified by the client or the client's parent or 
170.14 	guardian as being important to the client's mental health treatment. Family may include, 
170.15 	but is not limited to, parents, foster parents, children, spouse, committed partners, former 
170.16 	spouses, persons related by blood or adoption, persons who are a part of the client's 
170.17 	permanency plan, or persons who are presently residing together as a family unit.
170.18 	(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
170.19 	(k) "Foster family setting" means the foster home in which the license holder resides.
170.20 	(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part 
170.21 	9505.0370, subpart 15.
170.22 	(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part 
170.23 	9505.0370, subpart 17.
170.24 	(n) "Mental health professional" has the meaning given in Minnesota Rules, part 
170.25 	9505.0370, subpart 18.
170.26 	(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, 
170.27 	subpart 20.
170.28 	(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
170.29 	(q) "Psychoeducation services" means information or demonstration provided to 
170.30 	an individual, family, or group to explain, educate, and support the individual, family, or 
170.31 	group in understanding a child's symptoms of mental illness, the impact on the child's 
170.32 	development, and needed components of treatment and skill development so that the 
170.33 	individual, family, or group can help the child to prevent relapse, prevent the acquisition 
170.34 	of comorbid disorders, and to achieve optimal mental health and long-term resilience.
170.35 	(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, 
170.36 	subpart 27.
171.1 	(s) "Team consultation and treatment planning" means the coordination of treatment 
171.2 	plans and consultation among providers in a group concerning the treatment needs of the 
171.3 	child, including disseminating the child's treatment service schedule to all members of the 
171.4 	service team. Team members must include all mental health professionals working with 
171.5 	the child, a parent, the child unless the team lead or parent deem it clinically inappropriate, 
171.6 	and at least two of the following: an individualized education program case manager; 
171.7 	probation agent; children's mental health case manager; child welfare worker, including 
171.8 	adoption or guardianship worker; primary care provider; foster parent; and any other 
171.9 	member of the child's service team.
171.10 		Subd. 2.Determination of client eligibility. A client's eligibility to receive 
171.11 	treatment foster care under this section shall be determined by An eligible recipient is an 
171.12 	individual, from birth through age 20, who is currently placed in a foster home licensed 
171.13 	under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic 
171.14 	assessment, and an evaluation of level of care needed, and development of an individual 
171.15 	treatment plan, as defined in paragraphs (a) to (c) and (b).
171.16 	(a) The diagnostic assessment must:
171.17 	(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be 
171.18 	conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social 
171.19 	worker that is mental health professional or a clinical trainee;
171.20 	(2) determine whether or not a child meets the criteria for mental illness, as defined 
171.21 	in Minnesota Rules, part 9505.0370, subpart 20;
171.22 	(3) document that intensive treatment services are medically necessary within a 
171.23 	foster family setting to ameliorate identified symptoms and functional impairments;
171.24 	(4) be  performed within 180 days prior to before the start of service; and
171.25 	(2) include current diagnoses on all five axes of the client's current mental health 
171.26 	status;
171.27 	(3) determine whether or not a child meets the criteria for severe emotional 
171.28 	disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness 
171.29 	in section 245.462, subdivision 20; and
171.30 	(4) be completed annually until age 18. For individuals between age 18 and 21, 
171.31 	unless a client's mental health condition has changed markedly since the client's most 
171.32 	recent diagnostic assessment, annual updating is necessary. For the purpose of this section, 
171.33 	"updating" means a written summary, including current diagnoses on all five axes, by a 
171.34 	mental health professional of the client's current mental status and service needs.
171.35 	(5) be completed as either a standard or extended diagnostic assessment annually to 
171.36 	determine continued eligibility for the service.
172.1 	(b) The evaluation of level of care must be conducted by the placing county with 
172.2 	an instrument, tribe, or case manager in conjunction with the diagnostic assessment as 
172.3 	described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
172.4 	 approved by the commissioner of human services and not subject to the rulemaking 
172.5 	process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which 
172.6 	evaluation demonstrates that the child requires intensive intervention without 24-hour 
172.7 	medical monitoring. The commissioner shall update the list of approved level of care 
172.8 	instruments tools annually and publish on the department's Web site.
172.9 	(c) The individual treatment plan must be:
172.10 	(1) based on the information in the client's diagnostic assessment;
172.11 	(2) developed through a child-centered, family driven planning process that identifies 
172.12 	service needs and individualized, planned, and culturally appropriate interventions that 
172.13 	contain specific measurable treatment goals and objectives for the client and treatment 
172.14 	strategies for the client's family and foster family;
172.15 	(3) reviewed at least once every 90 days and revised; and
172.16 	(4) signed by the client or, if appropriate, by the client's parent or other person 
172.17 	authorized by statute to consent to mental health services for the client.
172.18 		Subd. 3.Eligible mental health services providers. (a) Eligible providers for 
172.19 	intensive children's mental health services in a foster family setting must be certified 
172.20 	by the state and have a service provision contract with a county board or a reservation 
172.21 	tribal council and must be able to demonstrate the ability to provide all of the services 
172.22 	required in this section.
172.23 	(b) For purposes of this section, a provider agency must have an individual 
172.24 	placement agreement for each recipient and must be a licensed child placing agency, under 
172.25 	Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
172.26 	(1) a county county-operated entity certified by the state;
172.27 	(2) an Indian Health Services facility operated by a tribe or tribal organization under 
172.28 	funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the 
172.29 	Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
172.30 	(3) a noncounty entity under contract with a county board.
172.31 	(c) Certified providers that do not meet the service delivery standards required in 
172.32 	this section shall be subject to a decertification process.
172.33 	(d) For the purposes of this section, all services delivered to a client must be 
172.34 	provided by a mental health professional or a clinical trainee.
172.35 		Subd. 4.Eligible provider responsibilitiesService delivery payment 
172.36 	requirements. (a) To be an eligible provider for payment under this section, a provider 
173.1 	must develop and practice written policies and procedures for treatment foster care services
173.2 	 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1), 
173.3 	(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
173.4 	(b) In delivering services under this section, a treatment foster care provider must 
173.5 	ensure that staff caseload size reasonably enables the provider to play an active role in 
173.6 	service planning, monitoring, delivering, and reviewing for discharge planning to meet 
173.7 	the needs of the client, the client's foster family, and the birth family, as specified in each 
173.8 	client's individual treatment plan.
173.9 	(b) A qualified clinical supervisor, as defined in and performing in compliance with 
173.10 	Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and 
173.11 	provision of services described in this section.
173.12 	(c) Each client receiving treatment services must receive an extended diagnostic 
173.13 	assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 
173.14 	30 days of enrollment in this service unless the client has a previous extended diagnostic 
173.15 	assessment that the client, parent, and mental health professional agree still accurately 
173.16 	describes the client's current mental health functioning.
173.17 	(d) Each previous and current mental health, school, and physical health treatment 
173.18 	provider must be contacted to request documentation of treatment and assessments that the 
173.19 	eligible client has received and this information must be reviewed and incorporated into 
173.20 	the diagnostic assessment and team consultation and treatment planning review process.
173.21 	(e) Each client receiving treatment must be assessed for a trauma history and 
173.22 	the client's treatment plan must document how the results of the assessment will be 
173.23 	incorporated into treatment.
173.24 	(f) Each client receiving treatment services must have an individual treatment plan 
173.25 	that is reviewed, evaluated, and signed every 90 days using the team consultation and 
173.26 	treatment planning process, as defined in subdivision 1a, paragraph (s).
173.27 	(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided 
173.28 	in accordance with the client's individual treatment plan.
173.29 	(h) Each client must have a crisis assistance plan within ten days of initiating 
173.30 	services and must have access to clinical phone support 24 hours per day, seven days per 
173.31 	week, during the course of treatment, and the crisis plan must demonstrate coordination 
173.32 	with the local or regional mobile crisis intervention team.
173.33 	(i) Services must be delivered and documented at least three days per week, equaling 
173.34 	at least six hours of treatment per week, unless reduced units of service are specified on 
173.35 	the treatment plan as part of transition or on a discharge plan to another service or level of 
173.36 	care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
174.1 	(j) Location of service delivery must be in the client's home, day care setting, 
174.2 	school, or other community-based setting that is specified on the client's individualized 
174.3 	treatment plan.
174.4 	(k) Treatment must be developmentally and culturally appropriate for the client.
174.5 	(l) Services must be delivered in continual collaboration and consultation with the 
174.6 	client's medical providers and, in particular, with prescribers of psychotropic medications, 
174.7 	including those prescribed on an off-label basis, and members of the service team must be 
174.8 	aware of the medication regimen and potential side effects.
174.9 	(m) Parents, siblings, foster parents, and members of the child's permanency plan 
174.10 	must be involved in treatment and service delivery unless otherwise noted in the treatment 
174.11 	plan.
174.12 	(n) Transition planning for the child must be conducted starting with the first 
174.13 	treatment plan and must be addressed throughout treatment to support the child's 
174.14 	permanency plan and postdischarge mental health service needs.
174.15 		Subd. 5.Service authorization. The commissioner will administer authorizations 
174.16 	for services under this section in compliance with section 256B.0625, subdivision 25.
174.17 		Subd. 6.Excluded services. (a) Services in clauses (1) to (4) (7) are not covered 
174.18 	under this section and are not eligible for medical assistance payment as components of 
174.19 	intensive treatment in foster care services, but may be billed separately:
174.20 	(1) treatment foster care services provided in violation of medical assistance policy 
174.21 	in Minnesota Rules, part 9505.0220;
174.22 	(2) service components of children's therapeutic services and supports 
174.23 	simultaneously provided by more than one treatment foster care provider;
174.24 	(3) home and community-based waiver services; and
174.25 	(4) treatment foster care services provided to a child without a level of care 
174.26 	determination according to section 245.4885, subdivision 1.
174.27 	(1) inpatient psychiatric hospital treatment;
174.28 	(2) mental health targeted case management;
174.29 	(3) partial hospitalization;
174.30 	(4) medication management;
174.31 	(5) children's mental health day treatment services;
174.32 	(6) crisis response services under section 256B.0944; and
174.33 	(7) transportation.
174.34 	(b) Children receiving intensive treatment in foster care services are not eligible for 
174.35 	medical assistance reimbursement for the following services while receiving intensive 
174.36 	treatment in foster care:
175.1 	(1) mental health case management services under section 256B.0625, subdivision 
175.2 	20; and
175.3 	(2) (1) psychotherapy and skill skills training components of children's therapeutic 
175.4 	services and supports under section 256B.0625, subdivision 35b.;
175.5 	(2) mental health behavioral aide services as defined in section 256B.0943, 
175.6 	subdivision 1, paragraph (m);
175.7 	(3) home and community-based waiver services;
175.8 	(4) mental health residential treatment; and
175.9 	(5) room and board costs as defined in section 256I.03, subdivision 6.
175.10 		Subd. 7.Medical assistance payment and rate setting. The commissioner shall 
175.11 	establish a single daily per-client encounter rate for intensive treatment in foster care 
175.12 	services. The rate must be constructed to cover only eligible services delivered to an 
175.13 	eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

175.14 	Sec. 23. Minnesota Statutes 2012, section 256B.761, is amended to read:
175.15 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
175.16 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
175.17 	management provided to psychiatric patients, outpatient mental health services, day 
175.18 	treatment services, home-based mental health services, and family community support 
175.19 	services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 
175.20 	50th percentile of 1999 charges.
175.21 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
175.22 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
175.23 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 
175.24 	1993, with at least 33 percent of the clients receiving rehabilitation services in the most 
175.25 	recent calendar year who are medical assistance recipients, will be increased by 38 percent, 
175.26 	when those services are provided within the comprehensive outpatient rehabilitation 
175.27 	facility and provided to residents of nursing facilities owned by the entity.
175.28 	(c) The commissioner shall establish three levels of payment for mental health 
175.29 	diagnostic assessment, based on three levels of complexity. The aggregate payment under 
175.30 	the tiered rates must not exceed the projected aggregate payments for mental health 
175.31 	diagnostic assessment under the previous single rate. The new rate structure is effective 
175.32 	January 1, 2011, or upon federal approval, whichever is later.
175.33 	(d) In addition to rate increases otherwise provided, the commissioner may 
175.34 	restructure coverage policy and rates to improve access to adult rehabilitative mental 
175.35 	health services under section 256B.0623 and related mental health support services under 
176.1 	section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 
176.2 	2016, the projected state share of increased costs due to this paragraph is transferred 
176.3 	from adult mental health grants under sections 245.4661 and 256E.12. The transfer for 
176.4 	fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments 
176.5 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
176.6 	256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

176.7 	Sec. 24. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
176.8 		Subd. 1e.Supplementary rate for certain facilities. (a) Notwithstanding the 
176.9 	provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall 
176.10 	negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to 
176.11 	exceed $700 per month, including any legislatively authorized inflationary adjustments, 
176.12 	for a group residential housing provider that:
176.13 	(1) is located in Hennepin County and has had a group residential housing contract 
176.14 	with the county since June 1996;
176.15 	(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 
176.16 	26-bed facility; and
176.17 	(3) serves a chemically dependent clientele, providing 24 hours per day supervision 
176.18 	and limiting a resident's maximum length of stay to 13 months out of a consecutive 
176.19 	24-month period.
176.20 	(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a 
176.21 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 
176.22 	per month, including any legislatively authorized inflationary adjustments, of a group 
176.23 	residential provider that:
176.24 	(1) is located in St. Louis County and has had a group residential housing contract 
176.25 	with the county since 2006;
176.26 	(2) operates a 62-bed facility; and
176.27 	(3) serves a chemically dependent adult male clientele, providing 24 hours per 
176.28 	day supervision and limiting a resident's maximum length of stay to 13 months out of 
176.29 	a consecutive 24-month period.
176.30 	(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency 
176.31 	shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not 
176.32 	to exceed $700 per month, including any legislatively authorized inflationary adjustments, 
176.33 	for the group residential provider described under paragraphs (a) and (b), not to exceed 
176.34 	an additional 115 beds.

177.1 	Sec. 25. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
 177.2 	The commissioner of human services shall, in consultation with children's mental 
177.3 	health community providers, hospitals providing care to children, children's mental health 
177.4 	advocates, and other interested parties, develop recommendations and legislation, if 
177.5 	necessary, for the state-operated child and adolescent behavioral health services facility 
177.6 	to ensure that:
177.7 	(1) the facility and the services provided meet the needs of children with serious 
177.8 	emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD, 
177.9 	serious emotional disturbance co-occurring with a developmental disability, borderline 
177.10 	personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries, 
177.11 	violent tendencies, and complex medical issues;
177.12 	(2) qualified personnel and staff can be recruited who have specific expertise and 
177.13 	training to treat the children in the facility; and
177.14 	(3) the treatment provided at the facility is high-quality, effective treatment.

177.15 	Sec. 26. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND 
177.16 	CHILDREN'S MENTAL HEALTH SERVICES.
 177.17 	(a) To assess the efficiency and other operational issues in the management of the 
177.18 	health care delivery system, the commissioner of human services shall initiate a provider 
177.19 	survey. The pilot survey shall consist of an electronic survey of providers of pediatric 
177.20 	home health care services and children's mental health services to identify and measure 
177.21 	issues that arise in dealing with the management of medical assistance. To the maximum 
177.22 	degree possible, existing technology shall be used and interns sought to analyze the results.
177.23 	(b) The survey questions must focus on seven key business functions provided 
177.24 	by medical assistance contractors: provider inquiries; provider outreach and education; 
177.25 	claims processing; appeals; provider enrollment; medical review; and provider audit and 
177.26 	reimbursement. The commissioner must consider the results of the survey in evaluating 
177.27 	and renewing managed care and fee-for-service management contracts.
177.28 	(c) The commissioner shall report by January 15, 2014, the results of the survey to 
177.29 	the chairs of the health and human services policy and finance committees and shall 
177.30 	make recommendations on the value of implementing an annual survey with a rotating 
177.31 	list of provider groups as a component of the continuous quality improvement system for 
177.32 	medical assistance.

177.33 	Sec. 27. MENTALLY ILL AND DANGEROUS COMMITMENTS 
177.34 	STAKEHOLDERS GROUP.
 178.1 	(a) The commissioner of human services, in consultation with the state court 
178.2 	administrator, shall convene a stakeholder group to develop recommendations for the 
178.3 	legislature that address issues raised in the February 2013 Office of the Legislative 
178.4 	Auditor report on State-Operated Services for persons committed to the commissioner as 
178.5 	mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must 
178.6 	include representatives from the Department of Human Services, county human services, 
178.7 	county attorneys, commitment defense attorneys, the ombudsman for mental health and 
178.8 	developmental disabilities, the federal protection and advocacy system, and consumers 
178.9 	and advocates for persons with mental illnesses.
178.10 	(b) The stakeholder group shall provide recommendations in the following areas:
178.11 	(1) the role of the special review board, including the scope of authority of the 
178.12 	special review board and the authority of the commissioner to accept or reject special 
178.13 	review board recommendations;
178.14 	(2) review of special review board decisions by the district court;
178.15 	(3) annual district court review of commitment, scope of court authority, and 
178.16 	appropriate review criteria;
178.17 	(4) options, including annual court hearing and review, as alternatives to 
178.18 	indeterminate commitment under Minnesota Statutes, section 253B.18; and 
178.19 	(5) extension of the right to petition the court under Minnesota Statutes, 
178.20 	section 253B.17, to those committed under Minnesota Statutes, section 253B.18. 
178.21 	The commissioner of human services and the state court administrator shall provide 
178.22 	relevant data for the group's consideration in developing these recommendations, 
178.23 	including numbers of proceedings in each category and costs associated with court and 
178.24 	administrative proceedings under Minnesota Statutes, section 253B.18.
178.25 	(c) By January 15, 2014, the commissioner of human services shall submit the 
178.26 	recommendations of the stakeholder group to the chairs and ranking minority members 
178.27 	of the committees of the legislature with jurisdiction over civil commitment and human 
178.28 	services issues.

178.29 	ARTICLE 5
178.30 	DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY AND 
178.31 	OFFICE OF INSPECTOR GENERAL

178.32 	Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a 
178.33 	subdivision to read:
179.1 		Subd. 7b.Child care provider and recipient fraud investigations. Data related 
179.2 	to child care fraud and recipient fraud investigations are governed by section 245E.01, 
179.3 	subdivision 15.

179.4 	Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
179.5 		Subd. 7.Use of data. (a) Except as otherwise provided in subdivision 7a or sections 
179.6 	244.052 and 299C.093, the data provided under this section is private data on individuals 
179.7 	under section 13.02, subdivision 12.
179.8 	(b)  The data may be used only for by law enforcement and corrections agencies for
179.9 	 law enforcement and corrections purposes.
179.10 	(c) The commissioner of human services is authorized to have access to the data for:
179.11 	(1) state-operated services, as defined in section 246.014, are also authorized to 
179.12 	have access to the data for the purposes described in section 246.13, subdivision 2, 
179.13 	paragraph (b); and
179.14 	(2) purposes of completing background studies under chapter 245C.

179.15 	Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision 
179.16 	to read:
179.17 		Subd. 4a.Agency background studies. (a) The commissioner shall develop and 
179.18 	implement an electronic process for the regular transfer of new criminal case information 
179.19 	that is added to the Minnesota court information system. The commissioner's system 
179.20 	must include for review only information that relates to individuals who have been the 
179.21 	subject of a background study under this chapter that remain affiliated with the agency 
179.22 	that initiated the background study. For purposes of this paragraph, an individual remains 
179.23 	affiliated with an agency that initiated the background study until the agency informs the 
179.24 	commissioner that the individual is no longer affiliated. When any individual no longer 
179.25 	affiliated according to this paragraph returns to a position requiring a background study 
179.26 	under this chapter, the agency with whom the individual is again affiliated shall initiate 
179.27 	a new background study regardless of the length of time the individual was no longer 
179.28 	affiliated with the agency.
179.29 	(b) The commissioner shall develop and implement an online system for agencies that 
179.30 	initiate background studies under this chapter to access and maintain records of background 
179.31 	studies initiated by that agency. The system must show all active background study subjects 
179.32 	affiliated with that agency and the status of each individual's background study. Each 
179.33 	agency that initiates background studies must use this system to notify the commissioner 
179.34 	of discontinued affiliation for purposes of the processes required under paragraph (a).

180.1 	Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
180.2 		Subdivision 1.Background studies conducted by Department of Human 
180.3 	Services. (a) For a background study conducted by the Department of Human Services, 
180.4 	the commissioner shall review:
180.5 	(1) information related to names of substantiated perpetrators of maltreatment of 
180.6 	vulnerable adults that has been received by the commissioner as required under section 
180.7 	626.557, subdivision 9c, paragraph (j);
180.8 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
180.9 	programs, and from findings of maltreatment of minors as indicated through the social 
180.10 	service information system;
180.11 	(3) information from juvenile courts as required in subdivision 4 for individuals 
180.12 	listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
180.13 	(4) information from the Bureau of Criminal Apprehension, including information 
180.14 	regarding a background study subject's registration in Minnesota as a predatory offender 
180.15 	under section 243.166;
180.16 	(5) except as provided in clause (6), information from the national crime information 
180.17 	system when the commissioner has reasonable cause as defined under section 245C.05, 
180.18 	subdivision 5; and
180.19 	(6) for a background study related to a child foster care application for licensure or 
180.20 	adoptions, the commissioner shall also review:
180.21 	(i) information from the child abuse and neglect registry for any state in which the 
180.22 	background study subject has resided for the past five years; and
180.23 	(ii) information from national crime information databases, when the background 
180.24 	study subject is 18 years of age or older.
180.25 	(b) Notwithstanding expungement by a court, the commissioner may consider 
180.26 	information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 
180.27 	received notice of the petition for expungement and the court order for expungement is 
180.28 	directed specifically to the commissioner.
180.29 	(c) The commissioner shall also review criminal case information received according 
180.30 	to section 245C.04, subdivision 4a, from the Minnesota court information system that 
180.31 	relates to individuals who have already been studied under this chapter and who remain 
180.32 	affiliated with the agency that initiated the background study.

180.33 	Sec. 5. Minnesota Statutes 2012, section 245C.32, subdivision 2, is amended to read:
180.34 		Subd. 2.Use. (a) The commissioner may also use these systems and records to 
180.35 	obtain and provide criminal history data from the Bureau of Criminal Apprehension, 
181.1 	criminal history data held by the commissioner, and data about substantiated maltreatment 
181.2 	under section 626.556 or 626.557, for other purposes, provided that:
181.3 	(1) the background study is specifically authorized in statute; or
181.4 	(2) the request is made with the informed consent of the subject of the study as 
181.5 	provided in section 13.05, subdivision 4.
181.6 	(b) An individual making a request under paragraph (a), clause (2), must agree in 
181.7 	writing not to disclose the data to any other individual without the consent of the subject 
181.8 	of the data.
181.9 	(c) The commissioner may recover the cost of obtaining and providing background 
181.10 	study data by charging the individual or entity requesting the study a fee of no more 
181.11 	than $20 per study. The fees collected under this paragraph are appropriated to the 
181.12 	commissioner for the purpose of conducting background studies.
181.13 	(d) The commissioner shall recover the cost of obtaining background study data 
181.14 	required under section 524.5-118 through a fee of $100 per study for an individual who 
181.15 	has not lived outside Minnesota for the past ten years, and a fee of $115 for an individual 
181.16 	who has resided outside of Minnesota for any period during the ten years preceding the 
181.17 	background study. The commissioner shall recover, from the individual, any additional 
181.18 	fees charged by other states' licensing agencies that are associated with these data requests. 
181.19 	Fees under subdivision 3 also apply when criminal history data from the National Criminal 
181.20 	Records Repository is required.

181.21 	Sec. 6. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD 
181.22 	INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
181.23 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in this 
181.24 	subdivision have the meanings given them.
181.25 	(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
181.26 	(c) "Child care assistance program" means any of the assistance programs under 
181.27 	chapter 119B.
181.28 	(d) "Commissioner" means the commissioner of human services.
181.29 	(e) "Controlling individual" has the meaning given in section 245A.02, subdivision 
181.30 	5a.
181.31 	(f) "County" means a local county child care assistance program staff or 
181.32 	subcontracted staff, or a county investigator acting on behalf of the commissioner.
181.33 	(g) "Department" means the Department of Human Services.
181.34 	(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or 
181.35 	omissions that result in fraud and abuse or error against the Department of Human Services.
182.1 	(i) "Identify" means to furnish the full name, current or last known address, phone 
182.2 	number, and e-mail address of the individual or business entity.
182.3 	(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
182.4 	(k) "Mail" means the use of any mail service with proof of delivery and receipt.
182.5 	(l) "Provider" means either a provider as defined in section 119B.011, subdivision 
182.6 	19, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
182.7 	(m) "Recipient" means a family receiving assistance as defined under section 
182.8 	119B.011, subdivision 13.
182.9 	(n) "Terminate" means revocation of participation in the child care assistance 
182.10 	program.
182.11 		Subd. 2.Investigating provider or recipient financial misconduct. The 
182.12 	department shall investigate alleged or suspected financial misconduct by providers and 
182.13 	errors related to payments issued by the child care assistance program under this chapter. 
182.14 	Recipients, employees, and staff may be investigated when the evidence shows that their 
182.15 	conduct is related to the financial misconduct of a provider, license holder, or controlling 
182.16 	individual.
182.17 		Subd. 3.Scope of investigations. (a) The department may contact any person, 
182.18 	agency, organization, or other entity that is necessary to an investigation.
182.19 	(b) The department may examine or interview any individual, document, or piece of 
182.20 	evidence that may lead to information that is relevant to child care assistance program 
182.21 	benefits, payments, and child care provider authorizations. This includes, but is not 
182.22 	limited to:
182.23 	(1) child care assistance program payments;
182.24 	(2) services provided by the program or related to child care assistance program 
182.25 	recipients;
182.26 	(3) services provided to a provider;
182.27 	(4) provider financial records of any type;
182.28 	(5) daily attendance records of the children receiving services from the provider;
182.29 	(6) billings; and
182.30 	(7) verification of the credentials of a license holder, controlling individual, 
182.31 	employee, staff person, contractor, subcontractor, and entities under contract with the 
182.32 	provider to provide services or maintain service and the provider's financial records 
182.33 	related to those services.
182.34 		Subd. 4.Determination of investigation. After completing its investigation, the 
182.35 	department shall issue one of the following determinations:
182.36 	(1) no violation of child care assistance requirements occurred;
183.1 	(2) there is insufficient evidence to show that a violation of child care assistance 
183.2 	requirements occurred;
183.3 	(3) a preponderance of evidence shows a violation of child care assistance program 
183.4 	law, rule, or policy; or
183.5 	(4) there exists a credible allegation of fraud.
183.6 		Subd. 5.Actions or administrative sanctions. (a) In addition to section 256.98, 
183.7 	after completing the determination under subdivision 4, the department may take one or 
183.8 	more of the actions or sanctions specified in this subdivision.
183.9 	(b) The department may take the following actions:
183.10 	(1) refer the investigation to law enforcement or a county attorney for possible 
183.11 	criminal prosecution;
183.12 	(2) refer relevant information to the department's licensing division, the child care 
183.13 	assistance program, the Department of Education, the federal child and adult care food 
183.14 	program, or appropriate child or adult protection agency;
183.15 	(3) enter into a settlement agreement with a provider, license holder, controlling 
183.16 	individual, or recipient; or
183.17 	(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction 
183.18 	for possible civil action under the Minnesota False Claims Act, chapter 15C.
183.19 	(c) The department may impose sanctions by:
183.20 	(1) pursuing administrative disqualification through hearings or waivers;
183.21 	(2) establishing and seeking monetary recovery or recoupment; or 
183.22 	(3) issuing an order of corrective action that states the practices that are violations of 
183.23 	child care assistance program policies, laws, or regulations, and that they must be corrected.
183.24 		Subd. 6.Duty to provide access. (a) A provider, license holder, controlling 
183.25 	individual, employee, staff person, or recipient has an affirmative duty to provide access 
183.26 	upon request to information specified under subdivision 8 or the program facility.
183.27 	(b) Failure to provide access may result in denial or termination of authorizations for 
183.28 	or payments to a recipient, provider, license holder, or controlling individual in the child 
183.29 	care assistance program.
183.30 	(c) When a provider fails to provide access, a 15-day notice of denial or termination 
183.31 	must be issued to the provider, which prohibits the provider from participating in the child 
183.32 	care assistance program. Notice must be sent to recipients whose children are under the 
183.33 	provider's care pursuant to Minnesota Rules, part 3400.0185.
183.34 	(d) If the provider continues to fail to provide access at the expiration of the 15-day 
183.35 	notice period, child care assistance program payments to the provider must be denied 
183.36 	beginning the 16th day following notice of the initial failure or refusal to provide access. 
184.1 	The department may rescind the denial based upon good cause if the provider submits in 
184.2 	writing a good cause basis for having failed or refused to provide access. The writing must 
184.3 	be postmarked no later than the 15th day following the provider's notice of initial failure 
184.4 	to provide access. Additionally, the provider, license holder, or controlling individual 
184.5 	must immediately provide complete, ongoing access to the department. Repeated failures 
184.6 	to provide access must, after the initial failure or for any subsequent failure, result in 
184.7 	termination from participation in the child care assistance program.
184.8 	(e) The department, at its own expense, may photocopy or otherwise duplicate 
184.9 	records referenced in subdivision 8. Photocopying must be done on the provider's 
184.10 	premises on the day of the request or other mutually agreeable time, unless removal of 
184.11 	records is specifically permitted by the provider. If requested, a provider, license holder, 
184.12 	or controlling individual, or a designee, must assist the investigator in duplicating any 
184.13 	record, including a hard copy or electronically stored data, on the day of the request.
184.14 	(f) A provider, license holder, controlling individual, employee, or staff person must 
184.15 	grant the department access during the department's normal business hours, and any hours 
184.16 	that the program is operated, to examine the provider's program or the records listed in 
184.17 	subdivision 8. A provider shall make records available at the provider's place of business 
184.18 	on the day for which access is requested, unless the provider and the department both agree 
184.19 	otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday 
184.20 	through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
184.21 		Subd. 7.Honest and truthful statements. It shall be unlawful for a provider, 
184.22 	license holder, controlling individual, or recipient to:
184.23 	(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
184.24 	(2) make any materially false, fictitious, or fraudulent statement or representation; or
184.25 	(3) make or use any false writing or document knowing the same to contain any 
184.26 	materially false, fictitious, or fraudulent statement or entry related to any child care 
184.27 	assistance program services that the provider, license holder, or controlling individual 
184.28 	supplies or in relation to any child care assistance payments received by a provider, license 
184.29 	holder, or controlling individual or to any fraud investigator or law enforcement officer 
184.30 	conducting a financial misconduct investigation.
184.31 		Subd. 8.Record retention. (a) The following records must be maintained, 
184.32 	controlled, and made immediately accessible to license holders, providers, and controlling 
184.33 	individuals. The records must be organized and labeled to correspond to categories that 
184.34 	make them easy to identify so that they can be made available immediately upon request 
184.35 	to an investigator acting on behalf of the commissioner at the provider's place of business:
185.1 	(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting 
185.2 	records;
185.3 	(2) daily attendance records required by and that comply with section 119B.125, 
185.4 	subdivision 6;
185.5 	(3) billing transmittal forms requesting payments from the child care assistance 
185.6 	program and billing adjustments related to child care assistance program payments;
185.7 	(4) records identifying all persons, corporations, partnerships, and entities with an 
185.8 	ownership or controlling interest in the provider's child care business;
185.9 	(5) employee records identifying those persons currently employed by the provider's 
185.10 	child care business or who have been employed by the business at any time within the 
185.11 	previous five years. The records must include each employee's name, hourly and annual 
185.12 	salary, qualifications, position description, job title, and dates of employment. In addition, 
185.13 	employee records that must be made available include the employee's time sheets, current 
185.14 	home address of the employee or last known address of any former employee, and 
185.15 	documentation of background studies required under chapter 119B or 245C;
185.16 	(6) records related to transportation of children in care, including but not limited to:
185.17 	(i) the dates and times that transportation is provided to children for transportation to 
185.18 	and from the provider's business location for any purpose. For transportation related to 
185.19 	field trips or locations away from the provider's business location, the names and addresses 
185.20 	of those field trips and locations must also be provided;
185.21 	(ii) the name, business address, phone number, and Web site address, if any, of the 
185.22 	transportation service utilized; and
185.23 	(iii) all billing or transportation records related to the transportation.
185.24 	(b) A provider, license holder, or controlling individual must retain all records 
185.25 	in paragraph (a) for at least six years after the date the record is created. Microfilm or 
185.26 	electronically stored records satisfy the record keeping requirements of this subdivision.
185.27 	(c) A provider, license holder, or controlling individual who withdraws or is 
185.28 	terminated from the child care assistance program must retain the records required under 
185.29 	this subdivision and make them available to the department on demand.
185.30 	(d) If the ownership of a provider changes, the transferor, unless otherwise provided 
185.31 	by law or by written agreement with the transferee, is responsible for maintaining, 
185.32 	preserving, and upon request from the department, making available the records related to 
185.33 	the provider that were generated before the date of the transfer. Any written agreement 
185.34 	affecting this provision must be held in the possession of the transferor and transferee. 
185.35 	The written agreement must be provided to the department or county immediately upon 
186.1 	request, and the written agreement must be retained by the transferor and transferee for six 
186.2 	years after the agreement is fully executed.
186.3 	(e) In the event of an appealed case, the provider must retain all records required in 
186.4 	this subdivision for the duration of the appeal or six years, whichever is longer.
186.5 	(f) A provider's use of electronic record keeping or electronic signatures is governed 
186.6 	by chapter 325L.
186.7 		Subd. 9.Factors regarding imposition of administrative sanctions. (a) The 
186.8 	department shall consider the following factors in determining the administrative sanctions 
186.9 	to be imposed:
186.10 	(1) nature and extent of financial misconduct;
186.11 	(2) history of financial misconduct;
186.12 	(3) actions taken or recommended by other state agencies, other divisions of the 
186.13 	department, and court and administrative decisions;
186.14 	(4) prior imposition of sanctions;
186.15 	(5) size and type of provider;
186.16 	(6) information obtained through an investigation from any source;
186.17 	(7) convictions or pending criminal charges; and
186.18 	(8) any other information relevant to the acts or omissions related to the financial 
186.19 	misconduct.
186.20 	(b) Any single factor under paragraph (a) may be determinative of the department's 
186.21 	decision of whether and what sanctions are imposed.
186.22 		Subd. 10.Written notice of department sanction. (a) The department shall give 
186.23 	notice in writing to a person of an administrative sanction that is to be imposed. The notice 
186.24 	shall be sent by mail as defined in subdivision 1, paragraph (k).
186.25 	(b) The notice shall state:
186.26 	(1) the factual basis for the department's determination;
186.27 	(2) the sanction the department intends to take;
186.28 	(3) the dollar amount of the monetary recovery or recoupment, if any;
186.29 	(4) how the dollar amount was computed;
186.30 	(5) the right to dispute the department's determination and to provide evidence;
186.31 	(6) the right to appeal the department's proposed sanction; and
186.32 	(7) the option to meet informally with department staff, and to bring additional 
186.33 	documentation or information, to resolve the issues.
186.34 	(c) In cases of determinations resulting in denial or termination of payments, in 
186.35 	addition to the requirements of paragraph (b), the notice must state:
186.36 	(1) the length of the denial or termination;
187.1 	(2) the requirements and procedures for reinstatement; and
187.2 	(3) the provider's right to submit documents and written arguments against the 
187.3 	denial or termination of payments for review by the department before the effective date 
187.4 	of denial or termination.
187.5 	(d) The submission of documents and written argument for review by the department 
187.6 	under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the 
187.7 	deadline for filing an appeal.
187.8 	(e) Unless timely appealed, the effective date of the proposed sanction shall be 30 
187.9 	days after the license holder's, provider's, controlling individual's, or recipient's receipt of 
187.10 	the notice. If a timely appeal is made, the proposed sanction shall be delayed pending 
187.11 	the final outcome of the appeal. Implementation of a proposed sanction following the 
187.12 	resolution of a timely appeal may be postponed if, in the opinion of the department, the 
187.13 	delay of sanction is necessary to protect the health or safety of children in care. The 
187.14 	department may consider the economic hardship of a person in implementing the proposed 
187.15 	sanction, but economic hardship shall not be a determinative factor in implementing the 
187.16 	proposed sanction.
187.17 	(f) Requests for an informal meeting to attempt to resolve issues and requests 
187.18 	for appeals must be sent or delivered to the department's Office of Inspector General, 
187.19 	Financial Fraud and Abuse Division.
187.20 		Subd. 11.Appeal of department sanction under this section. (a) If the department 
187.21 	does not pursue a criminal action against a provider, license holder, controlling individual, 
187.22 	or recipient for financial misconduct, but the department imposes an administrative 
187.23 	sanction, any individual or entity against whom the sanction was imposed may appeal the 
187.24 	department's administrative sanction under this section pursuant to section 119B.16 or 
187.25 	256.045 with the additional requirements in clauses (1) to (4). An appeal must specify:
187.26 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar 
187.27 	amount involved for each disputed item, if appropriate;
187.28 	(2) the computation that is believed to be correct, if appropriate;
187.29 	(3) the authority in the statute or rule relied upon for each disputed item; and
187.30 	(4) the name, address, and phone number of the person at the provider's place of 
187.31 	business with whom contact may be made regarding the appeal.
187.32 	(b) An appeal is considered timely only if postmarked or received by the 
187.33 	department's Office of Inspector General, Financial Fraud and Abuse Division within 30 
187.34 	days after receiving a notice of department sanction.
188.1 	(c) Before the appeal hearing, the department may deny or terminate authorizations 
188.2 	or payment to the entity or individual if the department determines that the action is 
188.3 	necessary to protect the public welfare or the interests of the child care assistance program.
188.4 		Subd. 12.Consolidated hearings with licensing sanction. If a financial 
188.5 	misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing 
188.6 	sanction exists for which there is an appeal hearing right and the sanction is timely 
188.7 	appealed, and the overpayment recovery action and licensing sanction involve the same 
188.8 	set of facts, the overpayment recovery action and licensing sanction must be consolidated 
188.9 	in the contested case hearing related to the licensing sanction.
188.10 		Subd. 13.Grounds for and methods of monetary recovery. (a) The department 
188.11 	may obtain monetary recovery from a provider who has been improperly paid by the 
188.12 	child care assistance program, regardless of whether the error was intentional or county 
188.13 	error. The department does not need to establish a pattern as a precondition of monetary 
188.14 	recovery of erroneous or false billing claims, duplicate billing claims, or billing claims 
188.15 	based on false statements or financial misconduct.
188.16 	(b) The department shall obtain monetary recovery from providers by the following 
188.17 	means:
188.18 	(1) permitting voluntary repayment of money, either in lump-sum payment or 
188.19 	installment payments;
188.20 	(2) using any legal collection process;
188.21 	(3) deducting or withholding program payments; or
188.22 	(4) utilizing the means set forth in chapter 16D.
188.23 		Subd. 14.Reporting of suspected fraudulent activity. (a) A person who, in 
188.24 	good faith, makes a report of or testifies in any action or proceeding in which financial 
188.25 	misconduct is alleged, and who is not involved in, has not participated in, or has not aided 
188.26 	and abetted, conspired, or colluded in the financial misconduct, shall have immunity from 
188.27 	any liability, civil or criminal, that results by reason of the person's report or testimony. 
188.28 	For the purpose of any proceeding, the good faith of any person reporting or testifying 
188.29 	under this provision shall be presumed.
188.30 	(b) If a person that is or has been involved in, participated in, aided and abetted, 
188.31 	conspired, or colluded in the financial misconduct reports the financial misconduct, 
188.32 	the department may consider that person's report and assistance in investigating the 
188.33 	misconduct as a mitigating factor in the department's pursuit of civil, criminal, or 
188.34 	administrative remedies.
189.1 		Subd. 15.Data privacy. Data of any kind obtained or created in relation to a provider 
189.2 	or recipient investigation under this section is defined, classified, and protected the same as 
189.3 	all other data under section 13.46, and this data has the same classification as licensing data.
189.4 		Subd. 16.Monetary recovery; random sample extrapolation. The department is 
189.5 	authorized to calculate the amount of monetary recovery from a provider, license holder, or 
189.6 	controlling individual based upon extrapolation from a statistical random sample of claims 
189.7 	submitted by the provider, license holder, or controlling individual and paid by the child 
189.8 	care assistance program. The department's random sample extrapolation shall constitute a 
189.9 	rebuttable presumption of the accuracy of the calculation of monetary recovery. If the 
189.10 	presumption is not rebutted by the provider, license holder, or controlling individual in the 
189.11 	appeal process, the department shall use the extrapolation as the monetary recovery figure. 
189.12 	The department may use sampling and extrapolation to calculate the amount of monetary 
189.13 	recovery if the claims to be reviewed represent services to 50 or more children in care.
189.14 		Subd. 17.Effect of department's monetary penalty determination. Unless 
189.15 	a timely and proper appeal is received by the department's Office of Inspector General, 
189.16 	Financial Fraud and Abuse Division, the department's administrative determination or 
189.17 	sanction shall be considered a final department determination.
189.18 		Subd. 18.Office of Inspector General recoveries. Overpayment recoveries 
189.19 	resulting from child care provider fraud investigations initiated by the department's Office 
189.20 	of Inspector General's fraud investigations staff are excluded from the county recovery 
189.21 	provision in section 119B.11, subdivision 3.

189.22 	Sec. 7. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
189.23 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for 
189.24 	Medicare and Medicaid Services determines that a provider is designated "high-risk," the 
189.25 	commissioner may withhold payment from providers within that category upon initial 
189.26 	enrollment for a 90-day period. The withholding for each provider must begin on the date 
189.27 	of the first submission of a claim.
189.28 	(b) An enrolled provider that is also licensed by the commissioner under chapter 
189.29 	245A must designate an individual as the entity's compliance officer. The compliance 
189.30 	officer must:
189.31 	(1) develop policies and procedures to assure adherence to medical assistance laws 
189.32 	and regulations and to prevent inappropriate claims submissions;
189.33 	(2) train the employees of the provider entity, and any agents or subcontractors of 
189.34 	the provider entity including billers, on the policies and procedures under clause (1);
190.1 	(3) respond to allegations of improper conduct related to the provision or billing of 
190.2 	medical assistance services, and implement action to remediate any resulting problems;
190.3 	(4) use evaluation techniques to monitor compliance with medical assistance laws 
190.4 	and regulations;
190.5 	(5) promptly report to the commissioner any identified violations of medical 
190.6 	assistance laws or regulations; and
190.7 	(6) within 60 days of discovery by the provider of a medical assistance 
190.8 	reimbursement overpayment, report the overpayment to the commissioner and make 
190.9 	arrangements with the commissioner for the commissioner's recovery of the overpayment.
190.10 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
190.11 	provider within a particular industry sector or category establish a compliance program that 
190.12 	contains the core elements established by the Centers for Medicare and Medicaid Services.
190.13 	(c) The commissioner may revoke the enrollment of an ordering or rendering 
190.14 	provider for a period of not more than one year, if the provider fails to maintain and, upon 
190.15 	request from the commissioner, provide access to documentation relating to written orders 
190.16 	or requests for payment for durable medical equipment, certifications for home health 
190.17 	services, or referrals for other items or services written or ordered by such provider, when 
190.18 	the commissioner has identified a pattern of a lack of documentation. A pattern means a 
190.19 	failure to maintain documentation or provide access to documentation on more than one 
190.20 	occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a 
190.21 	provider under the provisions of section 256B.064.
190.22 	(d) The commissioner shall terminate or deny the enrollment of any individual or 
190.23 	entity if the individual or entity has been terminated from participation in Medicare or 
190.24 	under the Medicaid program or Children's Health Insurance Program of any other state.
190.25 	(e) As a condition of enrollment in medical assistance, the commissioner shall 
190.26 	require that a provider designated "moderate" or "high-risk" by the Centers for Medicare 
190.27 	and Medicaid Services or the Minnesota Department of Human Services commissioner
190.28 	 permit the Centers for Medicare and Medicaid Services, its agents, or its designated 
190.29 	contractors and the state agency, its agents, or its designated contractors to conduct 
190.30 	unannounced on-site inspections of any provider location. The commissioner shall publish 
190.31 	in the Minnesota Health Care Program Provider Manual a list of provider types designated 
190.32 	"limited," "moderate," or "high-risk," based on the criteria and standards used to designate 
190.33 	Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and 
190.34 	criteria are not subject to the requirements of chapter 14. The commissioner's designations 
190.35 	are not subject to administrative appeal.
191.1 	(f) As a condition of enrollment in medical assistance, the commissioner shall 
191.2 	require that a high-risk provider, or a person with a direct or indirect ownership interest in 
191.3 	the provider of five percent or higher, consent to criminal background checks, including 
191.4 	fingerprinting, when required to do so under state law or by a determination by the 
191.5 	commissioner or the Centers for Medicare and Medicaid Services that a provider is 
191.6 	designated high-risk for fraud, waste, or abuse.
191.7 	(g) As a condition of enrollment, all durable medical equipment, prosthetics, 
191.8 	orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name 
191.9 	the Department of Human Services, in addition to the Centers for Medicare and Medicaid 
191.10 	Services, as an obligee on all surety performance bonds required pursuant to section 
191.11 	4312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social 
191.12 	Security Act, section 1834(a). The performance bond must also allow for recovery of 
191.13 	costs and fees in pursuing a claim on the bond.
191.14 	(h) The Department of Human Services may require a provider to purchase a 
191.15 	performance surety bond as a condition of initial enrollment, reenrollment, reinstatement, 
191.16 	or continued enrollment if: (1) the provider fails to demonstrate financial viability; (2) the 
191.17 	department determines there is significant evidence of or potential for fraud and abuse 
191.18 	by the provider; or (3) the provider or category of providers is designated high-risk 
191.19 	pursuant to paragraph (a) and Code of Federal Regulations, title 42, section 455.450, or 
191.20 	the department otherwise finds it is in the best interest of the Medicaid program to do so. 
191.21 	The performance bond must be in an amount of $100,000 or ten percent of the provider's 
191.22 	payments from Medicaid during the immediately preceding 12 months, whichever is 
191.23 	greater. The performance bond must name the Department of Human Services as an 
191.24 	obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.

191.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

191.26 	Sec. 8. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision 
191.27 	to read:
191.28 		Subd. 22.Application fee. (a) The commissioner must collect and retain federally 
191.29 	required nonrefundable application fees to pay for provider screening activities in 
191.30 	accordance with Code of Federal Regulations, title 42, section 455, subpart E. The 
191.31 	enrollment application must be made under the procedures specified by the commissioner, 
191.32 	in the form specified by the commissioner, and accompanied by an application fee 
191.33 	described in paragraph (b), or a request for a hardship exception as described in the 
191.34 	specified procedures. Application fees must be deposited in the provider screening account 
191.35 	in the special revenue fund. Amounts in the provider screening account are appropriated 
192.1 	to the commissioner for costs associated with the provider screening activities required 
192.2 	in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner 
192.3 	shall conduct screening activities as required by Code of Federal Regulations, title 42, 
192.4 	section 455, subpart E, and as otherwise provided by law, to include database checks, 
192.5 	unannounced pre- and postenrollment site visits, fingerprinting, and criminal background 
192.6 	studies. The commissioner must revalidate all providers under this subdivision at least 
192.7 	once every five years.
192.8 	(b) The application fee under this subdivision is $532 for the calendar year 2013. 
192.9 	For calendar year 2014 and subsequent years, the fee:
192.10 	(1) is adjusted by the percentage change to the consumer price index for all urban 
192.11 	consumers, United States city average, for the 12-month period ending with June of the 
192.12 	previous year. The resulting fee must be announced in the Federal Register;
192.13 	(2) is effective from January 1 to December 31 of a calendar year;
192.14 	(3) is required on the submission of an initial application, an application to establish 
192.15 	a new practice location, an application for reenrollment when the provider is not enrolled 
192.16 	at the time of application of reenrollment, or at revalidation when required by federal 
192.17 	regulation; and
192.18 	(4) must be in the amount in effect for the calendar year during which the application 
192.19 	for enrollment, new practice location, or reenrollment is being submitted.
192.20 	(c) The application fee under this subdivision cannot be charged to:
192.21 	(1) providers who are enrolled in Medicare or who provide documentation of 
192.22 	payment of the fee to, and enrollment with, another state;
192.23 	(2) providers who are enrolled but are required to submit new applications for 
192.24 	purposes of reenrollment; or
192.25 	(3) a provider who enrolls as an individual.

192.26 	EFFECTIVE DATE. This section is effective the day following final enactment.

192.27 	Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
192.28 		Subd. 1a.Grounds for sanctions against vendors. The commissioner may 
192.29 	impose sanctions against a vendor of medical care for any of the following: (1) fraud, 
192.30 	theft, or abuse in connection with the provision of medical care to recipients of public 
192.31 	assistance; (2) a pattern of presentment of false or duplicate claims or claims for services 
192.32 	not medically necessary; (3) a pattern of making false statements of material facts for 
192.33 	the purpose of obtaining greater compensation than that to which the vendor is legally 
192.34 	entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state 
192.35 	agency access during regular business hours to examine all records necessary to disclose 
193.1 	the extent of services provided to program recipients and appropriateness of claims for 
193.2 	payment; (6) failure to repay an overpayment or a fine finally established under this 
193.3 	section; and (7) failure to correct errors in the maintenance of health service or financial 
193.4 	records for which a fine was imposed or after issuance of a warning by the commissioner; 
193.5 	and (8) any reason for which a vendor could be excluded from participation in the 
193.6 	Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act. 
193.7 	The determination of services not medically necessary may be made by the commissioner 
193.8 	in consultation with a peer advisory task force appointed by the commissioner on the 
193.9 	recommendation of appropriate professional organizations. The task force expires as 
193.10 	provided in section 15.059, subdivision 5.

193.11 	Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
193.12 		Subd. 1b.Sanctions available. The commissioner may impose the following 
193.13 	sanctions for the conduct described in subdivision 1a: suspension or withholding of 
193.14 	payments to a vendor and suspending or terminating participation in the program, or 
193.15 	imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under 
193.16 	this section, the commissioner shall consider the nature, chronicity, or severity of the 
193.17 	conduct and the effect of the conduct on the health and safety of persons served by the 
193.18 	vendor. Regardless of imposition of sanctions, the commissioner may make a referral 
193.19 	to the appropriate state licensing board.

193.20 	Sec. 11. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
193.21 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner 
193.22 	shall determine any monetary amounts to be recovered and sanctions to be imposed upon 
193.23 	a vendor of medical care under this section. Except as provided in paragraphs (b) and 
193.24 	(d), neither a monetary recovery nor a sanction will be imposed by the commissioner 
193.25 	without prior notice and an opportunity for a hearing, according to chapter 14, on the 
193.26 	commissioner's proposed action, provided that the commissioner may suspend or reduce 
193.27 	payment to a vendor of medical care, except a nursing home or convalescent care facility, 
193.28 	after notice and prior to the hearing if in the commissioner's opinion that action is 
193.29 	necessary to protect the public welfare and the interests of the program.
193.30 	(b) Except when the commissioner finds good cause not to suspend payments under 
193.31 	Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall 
193.32 	withhold or reduce payments to a vendor of medical care without providing advance 
193.33 	notice of such withholding or reduction if either of the following occurs:
194.1 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
194.2 	1a; or
194.3 	(2) the commissioner determines there is a credible allegation of fraud for which an 
194.4 	investigation is pending under the program. A credible allegation of fraud is an allegation 
194.5 	which has been verified by the state, from any source, including but not limited to:
194.6 	(i) fraud hotline complaints;
194.7 	(ii) claims data mining; and
194.8 	(iii) patterns identified through provider audits, civil false claims cases, and law 
194.9 	enforcement investigations.
194.10 	Allegations are considered to be credible when they have an indicia of reliability 
194.11 	and the state agency has reviewed all allegations, facts, and evidence carefully and acts 
194.12 	judiciously on a case-by-case basis.
194.13 	(c) The commissioner must send notice of the withholding or reduction of payments 
194.14 	under paragraph (b) within five days of taking such action unless requested in writing by a 
194.15 	law enforcement agency to temporarily withhold the notice. The notice must:
194.16 	(1) state that payments are being withheld according to paragraph (b);
194.17 	(2) set forth the general allegations as to the nature of the withholding action, but 
194.18 	need not disclose any specific information concerning an ongoing investigation;
194.19 	(3) except in the case of a conviction for conduct described in subdivision 1a, state 
194.20 	that the withholding is for a temporary period and cite the circumstances under which 
194.21 	withholding will be terminated;
194.22 	(4) identify the types of claims to which the withholding applies; and
194.23 	(5) inform the vendor of the right to submit written evidence for consideration by 
194.24 	the commissioner.
194.25 	The withholding or reduction of payments will not continue after the commissioner 
194.26 	determines there is insufficient evidence of fraud by the vendor, or after legal proceedings 
194.27 	relating to the alleged fraud are completed, unless the commissioner has sent notice of 
194.28 	intention to impose monetary recovery or sanctions under paragraph (a).
194.29 	(d) The commissioner shall suspend or terminate a vendor's participation in the 
194.30 	program without providing advance notice and an opportunity for a hearing when the 
194.31 	suspension or termination is required because of the vendor's exclusion from participation 
194.32 	in Medicare. Within five days of taking such action, the commissioner must send notice of 
194.33 	the suspension or termination. The notice must:
194.34 	(1) state that suspension or termination is the result of the vendor's exclusion from 
194.35 	Medicare;
194.36 	(2) identify the effective date of the suspension or termination; and
195.1 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying 
195.2 	for participation in the program.
195.3 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or 
195.4 	sanction is to be imposed, a vendor may request a contested case, as defined in section 
195.5 	14.02, subdivision 3, by filing with the commissioner a written request of appeal. The 
195.6 	appeal request must be received by the commissioner no later than 30 days after the date 
195.7 	the notification of monetary recovery or sanction was mailed to the vendor. The appeal 
195.8 	request must specify:
195.9 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar 
195.10 	amount involved for each disputed item;
195.11 	(2) the computation that the vendor believes is correct;
195.12 	(3) the authority in statute or rule upon which the vendor relies for each disputed item;
195.13 	(4) the name and address of the person or entity with whom contacts may be made 
195.14 	regarding the appeal; and
195.15 	(5) other information required by the commissioner.
195.16 	(f) The commissioner may order a vendor to forfeit a fine for failure to fully document 
195.17 	services according to standards in this chapter and Minnesota Rules, chapter 9505. The 
195.18 	commissioner may assess fines if specific required components of documentation are 
195.19 	missing. The fine for incomplete documentation shall equal 20 percent of the amount paid 
195.20 	on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
195.21 	(g) The vendor shall pay the fine assessed on or before the payment date specified. If 
195.22 	the vendor fails to pay the fine, the commissioner may withhold or reduce payments and 
195.23 	recover the amount of the fine. A timely appeal shall stay payment of the fine until the 
195.24 	commissioner issues a final order.

195.25 	Sec. 12. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to 
195.26 	read:
195.27 		Subd. 21.Requirements for initial enrollment of personal care assistance 
195.28 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
195.29 	time of enrollment as a personal care assistance provider agency in a format determined 
195.30 	by the commissioner, information and documentation that includes, but is not limited to, 
195.31 	the following:
195.32 	(1) the personal care assistance provider agency's current contact information 
195.33 	including address, telephone number, and e-mail address;
195.34 	(2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent 
195.35 	of the provider's payments from Medicaid in the previous year, whichever is less more. 
196.1 	The performance bond must be in a form approved by the commissioner, must be renewed 
196.2 	annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
196.3 	(3) proof of fidelity bond coverage in the amount of $20,000;
196.4 	(4) proof of workers' compensation insurance coverage;
196.5 	(5) proof of liability insurance;
196.6 	(6) a description of the personal care assistance provider agency's organization 
196.7 	identifying the names of all owners, managing employees, staff, board of directors, and 
196.8 	the affiliations of the directors, owners, or staff to other service providers;
196.9 	(7) a copy of the personal care assistance provider agency's written policies and 
196.10 	procedures including: hiring of employees; training requirements; service delivery; 
196.11 	and employee and consumer safety including process for notification and resolution 
196.12 	of consumer grievances, identification and prevention of communicable diseases, and 
196.13 	employee misconduct;
196.14 	(8) copies of all other forms the personal care assistance provider agency uses in 
196.15 	the course of daily business including, but not limited to:
196.16 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
196.17 	sheet varies from the standard time sheet for personal care assistance services approved 
196.18 	by the commissioner, and a letter requesting approval of the personal care assistance 
196.19 	provider agency's nonstandard time sheet;
196.20 	(ii) the personal care assistance provider agency's template for the personal care 
196.21 	assistance care plan; and
196.22 	(iii) the personal care assistance provider agency's template for the written 
196.23 	agreement in subdivision 20 for recipients using the personal care assistance choice 
196.24 	option, if applicable;
196.25 	(9) a list of all training and classes that the personal care assistance provider agency 
196.26 	requires of its staff providing personal care assistance services;
196.27 	(10) documentation that the personal care assistance provider agency and staff have 
196.28 	successfully completed all the training required by this section;
196.29 	(11) documentation of the agency's marketing practices;
196.30 	(12) disclosure of ownership, leasing, or management of all residential properties 
196.31 	that is used or could be used for providing home care services;
196.32 	(13) documentation that the agency will use the following percentages of revenue 
196.33 	generated from the medical assistance rate paid for personal care assistance services 
196.34 	for employee personal care assistant wages and benefits: 72.5 percent of revenue in the 
196.35 	personal care assistance choice option and 72.5 percent of revenue from other personal 
196.36 	care assistance providers. The revenue generated by the qualified professional and the 
197.1 	reasonable costs associated with the qualified professional shall not be used in making 
197.2 	this calculation; and
197.3 	(14) effective May 15, 2010, documentation that the agency does not burden 
197.4 	recipients' free exercise of their right to choose service providers by requiring personal 
197.5 	care assistants to sign an agreement not to work with any particular personal care 
197.6 	assistance recipient or for another personal care assistance provider agency after leaving 
197.7 	the agency and that the agency is not taking action on any such agreements or requirements 
197.8 	regardless of the date signed.
197.9 	(b) Personal care assistance provider agencies shall provide the information specified 
197.10 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
197.11 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
197.12 	shall collect the information specified in paragraph (a) from all personal care assistance 
197.13 	providers beginning July 1, 2009.
197.14 	(c) All personal care assistance provider agencies shall require all employees in 
197.15 	management and supervisory positions and owners of the agency who are active in the 
197.16 	day-to-day management and operations of the agency to complete mandatory training 
197.17 	as determined by the commissioner before enrollment of the agency as a provider. 
197.18 	Employees in management and supervisory positions and owners who are active in 
197.19 	the day-to-day operations of an agency who have completed the required training as 
197.20 	an employee with a personal care assistance provider agency do not need to repeat 
197.21 	the required training if they are hired by another agency, if they have completed the 
197.22 	training within the past three years. By September 1, 2010, the required training must 
197.23 	be available with meaningful access according to title VI of the Civil Rights Act and 
197.24 	federal regulations adopted under that law or any guidance from the United States Health 
197.25 	and Human Services Department. The required training must be available online or by 
197.26 	electronic remote connection. The required training must provide for competency testing. 
197.27 	Personal care assistance provider agency billing staff shall complete training about 
197.28 	personal care assistance program financial management. This training is effective July 1, 
197.29 	2009. Any personal care assistance provider agency enrolled before that date shall, if it 
197.30 	has not already, complete the provider training within 18 months of July 1, 2009. Any new 
197.31 	owners or employees in management and supervisory positions involved in the day-to-day 
197.32 	operations are required to complete mandatory training as a requisite of working for the 
197.33 	agency. Personal care assistance provider agencies certified for participation in Medicare 
197.34 	as home health agencies are exempt from the training required in this subdivision. When 
197.35 	available, Medicare-certified home health agency owners, supervisors, or managers must 
197.36 	successfully complete the competency test.

198.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

198.2 	Sec. 13. Minnesota Statutes 2012, section 299C.093, is amended to read:
198.3 	299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
198.4 	The superintendent of the Bureau of Criminal Apprehension shall maintain a 
198.5 	computerized data system relating to individuals required to register as predatory offenders 
198.6 	under section 243.166. To the degree feasible, the system must include the data required 
198.7 	to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period 
198.8 	that the person is required to register. The superintendent shall maintain this data in a 
198.9 	manner that ensures that it is readily available to law enforcement agencies. This data is 
198.10 	private data on individuals under section 13.02, subdivision 12, but may be used for law 
198.11 	enforcement and corrections purposes. The commissioner of human services has access 
198.12 	to the data for state-operated services, as defined in section 246.014, are also authorized 
198.13 	to have access to the data for the purposes described in section 246.13, subdivision 2, 
198.14 	paragraph (b), and for purposes of conducting background studies under chapter 245C.

198.15 	Sec. 14. Minnesota Statutes 2012, section 524.5-118, subdivision 1, is amended to read:
198.16 		Subdivision 1.When required; exception. (a) The court shall require a background 
198.17 	study under this section:
198.18 	(1) before the appointment of a guardian or conservator, unless a background study 
198.19 	has been done on the person under this section within the previous fivetwo years; and
198.20 	(2) once every fivetwo years after the appointment, if the person continues to serve 
198.21 	as a guardian or conservator.
198.22 	(b) The background study must include:
198.23 	(1) criminal history data from the Bureau of Criminal Apprehension, other criminal 
198.24 	history data held by the commissioner of human services, and data regarding whether the 
198.25 	person has been a perpetrator of substantiated maltreatment of a vulnerable adult and a
198.26 	or minor.;
198.27 	(c) The court shall request a search of the(2) criminal history data from the National 
198.28 	Criminal Records Repository if the proposed guardian or conservator has not resided in 
198.29 	Minnesota for the previous fiveten years or if the Bureau of Criminal Apprehension 
198.30 	information received from the commissioner of human services under subdivision 2, 
198.31 	paragraph (b), indicates that the subject is a multistate offender or that the individual's 
198.32 	multistate offender status is undetermined.; and
198.33 	(3) state licensing agency data if the proposed guardian or conservator has ever been 
198.34 	denied a professional license in the state of Minnesota or elsewhere that is directly related 
199.1 	to the responsibilities of a professional fiduciary, or has ever held a professional license 
199.2 	directly related to the responsibilities of a professional fiduciary that was conditioned, 
199.3 	suspended, revoked, or canceled.
199.4 	(d) (c) If the guardian or conservator is not an individual, the background study must 
199.5 	be done on all individuals currently employed by the proposed guardian or conservator 
199.6 	who will be responsible for exercising powers and duties under the guardianship or 
199.7 	conservatorship.
199.8 	(e) (d) If the court determines that it would be in the best interests of the ward or 
199.9 	protected person to appoint a guardian or conservator before the background study can 
199.10 	be completed, the court may make the appointment pending the results of the study, 
199.11 	however, the background study must then be completed as soon as reasonably possible 
199.12 	after appointment, no later than 30 days after appointment.
199.13 	(f) (e) The fee for conducting a background study for appointment of a professional 
199.14 	guardian or conservator must be paid by the guardian or conservator. In other cases, 
199.15 	the fee must be paid as follows:
199.16 	(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes 
199.17 	of section 524.5-502, paragraph (a);
199.18 	(2) if there is an estate of the ward or protected person, the fee must be paid from 
199.19 	the estate; or
199.20 	(3) in the case of a guardianship or conservatorship of the person that is not 
199.21 	proceeding in forma pauperis, the court may order that the fee be paid by the guardian or 
199.22 	conservator or by the court.
199.23 	(g) (f) The requirements of this subdivision do not apply if the guardian or 
199.24 	conservator is:
199.25 	(1) a state agency or county;
199.26 	(2) a parent or guardian of a proposed ward or protected person who has a 
199.27 	developmental disability, if the parent or guardian has raised the proposed ward or 
199.28 	protected person in the family home until the time the petition is filed, unless counsel 
199.29 	appointed for the proposed ward or protected person under section 524.5-205, paragraph 
199.30 	(d); 524.5-304, paragraph (b); 524.5-405, paragraph (a); or 524.5-406, paragraph (b), 
199.31 	recommends a background study; or
199.32 	(3) a bank with trust powers, bank and trust company, or trust company, organized 
199.33 	under the laws of any state or of the United States and which is regulated by the 
199.34 	commissioner of commerce or a federal regulator.

200.1 	Sec. 15. Minnesota Statutes 2012, section 524.5-118, is amended by adding a 
200.2 	subdivision to read:
200.3 		Subd. 2a.Procedure; state licensing agency data. The court shall request 
200.4 	the commissioner of human services to provide the court within 25 working days of 
200.5 	receipt of the request with licensing agency data from Minnesota licensing agencies 
200.6 	that the commissioner determines issue professional licenses directly related to the 
200.7 	responsibilities of a professional fiduciary. The commissioner shall enter into agreements 
200.8 	with these agencies to provide for electronic access to the relevant licensing data by the 
200.9 	commissioner. The data provided by the commissioner to the court shall include, as 
200.10 	applicable, license number and status; original date of issue; last renewal date; expiration 
200.11 	date; date of the denial, condition, suspension, revocation, or cancellation; the name of the 
200.12 	licensing agency that denied, conditioned, suspended, revoked, or canceled the license; 
200.13 	and the basis for denial, condition, suspension, revocation, or cancellation of the license. 
200.14 	If the proposed guardian or conservator has resided in a state other than Minnesota in the 
200.15 	previous ten years, licensing agency data shall also include the licensing agency data 
200.16 	from any other state where the proposed guardian or conservator resided. If the proposed 
200.17 	guardian or conservator has or has had a professional license in another state that is 
200.18 	directly related to the responsibilities of a professional fiduciary, state licensing agency 
200.19 	data shall also include data from the relevant licensing agency of that state.

200.20 	Sec. 16. Minnesota Statutes 2012, section 524.5-303, is amended to read:
200.21 	524.5-303 JUDICIAL APPOINTMENT OF GUARDIAN: PETITION.
200.22 	(a) An individual or a person interested in the individual's welfare may petition for 
200.23 	a determination of incapacity, in whole or in part, and for the appointment of a limited 
200.24 	or unlimited guardian for the individual.
200.25 	(b) The petition must set forth the petitioner's name, residence, current address if 
200.26 	different, relationship to the respondent, and interest in the appointment and, to the extent 
200.27 	known, state or contain the following with respect to the respondent and the relief requested:
200.28 	(1) the respondent's name, age, principal residence, current street address, and, if 
200.29 	different, the address of the dwelling in which it is proposed that the respondent will 
200.30 	reside if the appointment is made;
200.31 	(2) the name and address of the respondent's:
200.32 	(i) spouse, or if the respondent has none, an adult with whom the respondent has 
200.33 	resided for more than six months before the filing of the petition; and
201.1 	(ii) adult children or, if the respondent has none, the respondent's parents and adult 
201.2 	brothers and sisters, or if the respondent has none, at least one of the adults nearest in 
201.3 	kinship to the respondent who can be found;
201.4 	(3) the name of the administrative head and address of the institution where the 
201.5 	respondent is a patient, resident, or client of any hospital, nursing home, home care 
201.6 	agency, or other institution;
201.7 	(4) the name and address of any legal representative for the respondent;
201.8 	(5) the name, address, and telephone number of any person nominated as guardian 
201.9 	by the respondent in any manner permitted by law, including a health care agent nominated 
201.10 	in a health care directive;
201.11 	(6) the name, address, and telephone number of any proposed guardian and the 
201.12 	reason why the proposed guardian should be selected;
201.13 	(7) the name and address of any health care agent or proxy appointed pursuant to 
201.14 	a health care directive as defined in section 145C.01, a living will under chapter 145B, 
201.15 	or other similar document executed in another state and enforceable under the laws of 
201.16 	this state;
201.17 	(8) the reason why guardianship is necessary, including a brief description of the 
201.18 	nature and extent of the respondent's alleged incapacity;
201.19 	(9) if an unlimited guardianship is requested, the reason why limited guardianship 
201.20 	is inappropriate and, if a limited guardianship is requested, the powers to be granted to 
201.21 	the limited guardian; and
201.22 	(10) a general statement of the respondent's property with an estimate of its value, 
201.23 	including any insurance or pension, and the source and amount of any other anticipated 
201.24 	income or receipts.
201.25 	(c) The petition must also set forth the following information regarding the proposed 
201.26 	guardian or any employee of the guardian responsible for exercising powers and duties 
201.27 	under the guardianship:
201.28 	(1) whether the proposed guardian has ever been removed for cause from serving as 
201.29 	a guardian or conservator and, if so, the case number and court location; and
201.30 	(2) if the proposed guardian is a professional guardian or conservator, a summary of 
201.31 	the proposed guardian's educational background and relevant work and other experience.;
201.32 	(3) whether the proposed guardian has ever applied for or held, at any time, any 
201.33 	professional license, and if so, the name of the licensing agency, and as applicable, the 
201.34 	license number and status; whether the license is active or has been denied, conditioned, 
201.35 	suspended, revoked, or canceled; and the basis for the denial, condition, suspension, 
201.36 	revocation, or cancellation of the license;
202.1 	(4) whether the proposed guardian has ever been found civilly liable in an action 
202.2 	that involved fraud, misrepresentation, material omission, misappropriation, theft, or 
202.3 	conversion, and if so, the case number and court location;
202.4 	(5) whether the proposed guardian has ever filed for or received protection under the 
202.5 	bankruptcy laws, and if so, the case number and court location;
202.6 	(6) whether the proposed guardian has any outstanding civil monetary judgments 
202.7 	against the proposed guardian, and if so, the case number, court location, and outstanding 
202.8 	amount owed;
202.9 	(7) whether an order for protection or harassment restraining order has ever been 
202.10 	issued against the proposed guardian, and if so, the case number and court location; and
202.11 	(8) whether the proposed guardian has ever been convicted of a crime other than a 
202.12 	petty misdemeanor or traffic offense, and if so, the case number and the crime of which 
202.13 	the guardian was convicted.

202.14 	Sec. 17. Minnesota Statutes 2012, section 524.5-316, is amended to read:
202.15 	524.5-316 REPORTS; MONITORING OF GUARDIANSHIP; COURT 
202.16 	ORDERS.
202.17 	(a) A guardian shall report to the court in writing on the condition of the ward at least 
202.18 	annually and whenever ordered by the court. A copy of the report must be provided to the 
202.19 	ward and to interested persons of record with the court. A report must state or contain:
202.20 	(1) the current mental, physical, and social condition of the ward;
202.21 	(2) the living arrangements for all addresses of the ward during the reporting period;
202.22 	(3) any restrictions placed on the ward's right to communication and visitation with 
202.23 	persons of the ward's choice and the factual bases for those restrictions;
202.24 	(4) the medical, educational, vocational, and other services provided to the ward and 
202.25 	the guardian's opinion as to the adequacy of the ward's care;
202.26 	(5) a recommendation as to the need for continued guardianship and any 
202.27 	recommended changes in the scope of the guardianship;
202.28 	(6) an address and telephone number where the guardian can be contacted; and
202.29 	(7) whether the guardian has ever been removed for cause from serving as a guardian 
202.30 	or conservator and, if so, the case number and court location;
202.31 	(8) any changes occurring that would affect the accuracy of information contained 
202.32 	in the most recent criminal background study of the guardian conducted under section 
202.33 	524.5-118; and
203.1 	(9) (7) if applicable, the amount of reimbursement for services rendered to the ward 
203.2 	that the guardian received during the previous year that were not reimbursed by county 
203.3 	contract.
203.4 	(b) A guardian shall report to the court in writing within 30 days of the occurrence of 
203.5 	any of the events listed in this paragraph. The guardian must report any of the occurrences 
203.6 	in this paragraph and follow the same reporting requirements in this paragraph for 
203.7 	any employee of the guardian responsible for exercising powers and duties under the 
203.8 	guardianship. A copy of the report must be provided to the ward and to interested persons 
203.9 	of record with the court. A guardian shall report when:
203.10 	(1) the guardian is removed for cause from serving as a guardian or conservator, and 
203.11 	if so, the case number and court location;
203.12 	(2) the guardian has a professional license denied, conditioned, suspended, revoked, 
203.13 	or canceled, and if so, the licensing agency and license number, and the basis for denial, 
203.14 	condition, suspension, revocation, or cancellation of the license;
203.15 	(3) the guardian is found civilly liable in an action that involves fraud, 
203.16 	misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the 
203.17 	case number and court location;
203.18 	(4) the guardian files for or receives protection under the bankruptcy laws, and 
203.19 	if so, the case number and court location;
203.20 	(5) a civil monetary judgment is entered against the guardian, and if so, the case 
203.21 	number, court location, and outstanding amount owed;
203.22 	(6) the guardian is convicted of a crime other than a petty misdemeanor or traffic 
203.23 	offense, and if so, the case number and court location; or
203.24 	(7) an order for protection or harassment restraining order is issued against the 
203.25 	guardian, and if so, the case number and court location.
203.26 	(b) (c) A ward or interested person of record with the court may submit to the court a 
203.27 	written statement disputing statements or conclusions regarding the condition of the ward 
203.28 	or addressing any disciplinary or legal action that are is contained in the report guardian's 
203.29 	reports and may petition the court for an order that is in the best interests of the ward or 
203.30 	for other appropriate relief.
203.31 	(c) (d) An interested person may notify the court in writing that the interested person 
203.32 	does not wish to receive copies of reports required under this section.
203.33 	(d) (e) The court may appoint a visitor to review a report, interview the ward or 
203.34 	guardian, and make any other investigation the court directs.
204.1 	(e) (f) The court shall establish a system for monitoring guardianships, including the 
204.2 	filing and review of annual reports. If an annual report is not filed within 60 days of the 
204.3 	required date, the court shall issue an order to show cause.
204.4 	(g) If a guardian fails to comply with this section, the court may decline to appoint that 
204.5 	person as a guardian or conservator, or may remove a person as guardian or conservator.

204.6 	Sec. 18. Minnesota Statutes 2012, section 524.5-403, is amended to read:
204.7 	524.5-403 ORIGINAL PETITION FOR APPOINTMENT OR PROTECTIVE 
204.8 	ORDER.
204.9 	(a) The following may petition for the appointment of a conservator or for any 
204.10 	other appropriate protective order:
204.11 	(1) the person to be protected;
204.12 	(2) an individual interested in the estate, affairs, or welfare of the person to be 
204.13 	protected; or
204.14 	(3) a person who would be adversely affected by lack of effective management of 
204.15 	the property and business affairs of the person to be protected.
204.16 	(b) The petition must set forth the petitioner's name, residence, current address 
204.17 	if different, relationship to the respondent, and interest in the appointment or other 
204.18 	protective order, and, to the extent known, state or contain the following with respect to 
204.19 	the respondent and the relief requested:
204.20 	(1) the respondent's name, age, principal residence, current street address, and, if 
204.21 	different, the address of the dwelling where it is proposed that the respondent will reside if 
204.22 	the appointment is made;
204.23 	(2) if the petition alleges impairment in the respondent's ability to receive and 
204.24 	evaluate information, a brief description of the nature and extent of the respondent's 
204.25 	alleged impairment;
204.26 	(3) if the petition alleges that the respondent is missing, detained, or unable to 
204.27 	return to the United States, a statement of the relevant circumstances, including the time 
204.28 	and nature of the disappearance or detention and a description of any search or inquiry 
204.29 	concerning the respondent's whereabouts;
204.30 	(4) the name and address of the respondent's:
204.31 	(i) spouse, or if the respondent has none, an adult with whom the respondent has 
204.32 	resided for more than six months before the filing of the petition; and
204.33 	(ii) adult children or, if the respondent has none, the respondent's parents and adult 
204.34 	brothers and sisters or, if the respondent has none, at least one of the adults nearest in 
204.35 	kinship to the respondent who can be found;
205.1 	(5) the name of the administrative head and address of the institution where the 
205.2 	respondent is a patient, resident, or client of any hospital, nursing home, home care 
205.3 	agency, or other institution;
205.4 	(6) the name and address of any legal representative for the respondent;
205.5 	(7) the name and address of any health care agent or proxy appointed pursuant to 
205.6 	a health care directive as defined in section 145C.01, a living will under chapter 145B, 
205.7 	or other similar document executed in another state and enforceable under the laws of 
205.8 	this state;
205.9 	(8) a general statement of the respondent's property with an estimate of its value, 
205.10 	including any insurance or pension, and the source and amount of other anticipated 
205.11 	income or receipts; and
205.12 	(9) the reason why a conservatorship or other protective order is in the best interest 
205.13 	of the respondent.
205.14 	(c) If a conservatorship is requested, the petition must also set forth to the extent 
205.15 	known:
205.16 	(1) the name, address, and telephone number of any proposed conservator and the 
205.17 	reason why the proposed conservator should be selected;
205.18 	(2) the name, address, and telephone number of any person nominated as conservator 
205.19 	by the respondent if the respondent has attained 14 years of age; and
205.20 	(3) the type of conservatorship requested and, if an unlimited conservatorship, 
205.21 	the reason why limited conservatorship is inappropriate or, if a limited conservatorship, 
205.22 	the property to be placed under the conservator's control and any limitation on the 
205.23 	conservator's powers and duties.
205.24 	(d) The petition must also set forth the following information regarding the proposed 
205.25 	conservator or any employee of the conservator responsible for exercising powers and 
205.26 	duties under the conservatorship:
205.27 	(1) whether the proposed conservator has ever been removed for cause from serving 
205.28 	as a guardian or conservator and, if so, the case number and court location; and
205.29 	(2) if the proposed conservator is a professional guardian or conservator, a summary 
205.30 	of the proposed conservator's educational background and relevant work and other 
205.31 	experience.;
205.32 	(3) whether the proposed conservator has ever applied for or held, at any time, any 
205.33 	professional license, and if so, the name of the licensing agency, and as applicable, the 
205.34 	license number and status; whether the license is active or has been denied, conditioned, 
205.35 	suspended, revoked, or canceled; and the basis for the denial, condition, suspension, 
205.36 	revocation, or cancellation of the license;
206.1 	(4) whether the proposed conservator has ever been found civilly liable in an action 
206.2 	that involved fraud, misrepresentation, material omission, misappropriation, theft, or 
206.3 	conversion, and if so, the case number and court location;
206.4 	(5) whether the proposed conservator has ever filed for or received protection under 
206.5 	the bankruptcy laws, and if so, the case number and court location;
206.6 	(6) whether the proposed conservator has any outstanding civil monetary judgments 
206.7 	against the proposed conservator, and if so, the case number, court location, and 
206.8 	outstanding amount owed;
206.9 	(7) whether an order for protection or harassment restraining order has ever been 
206.10 	issued against the proposed conservator, and if so, the case number and court location; and
206.11 	(8) whether the proposed conservator has ever been convicted of a crime other than 
206.12 	a petty misdemeanor or traffic offense, and if so, the case number and the crime of which 
206.13 	the conservator was convicted.

206.14 	Sec. 19. Minnesota Statutes 2012, section 524.5-420, is amended to read:
206.15 	524.5-420 REPORTS; APPOINTMENT OF VISITOR; MONITORING; 
206.16 	COURT ORDERS.
206.17 	(a) A conservator shall report to the court for administration of the estate annually 
206.18 	unless the court otherwise directs, upon resignation or removal, upon termination of the 
206.19 	conservatorship, and at other times as the court directs. An order, after notice and hearing, 
206.20 	allowing an intermediate report of a conservator adjudicates liabilities concerning the 
206.21 	matters adequately disclosed in the accounting. An order, after notice and hearing, allowing 
206.22 	a final report adjudicates all previously unsettled liabilities relating to the conservatorship.
206.23 	(b) A report must state or contain a listing of the assets of the estate under the 
206.24 	conservator's control and a listing of the receipts, disbursements, and distributions during 
206.25 	the reporting period.
206.26 	(c) The report must also state:
206.27 	(1) an address and telephone number where the conservator can be contacted;.
206.28 	(2) whether the conservator has ever been removed for cause from serving as a 
206.29 	guardian or conservator and, if so, the case number and court locations; and
206.30 	(3) any changes occurring that would affect the accuracy of information contained in 
206.31 	the most recent criminal background study of the conservator conducted under section 
206.32 	524.5-118.
206.33 	(d) A conservator shall report to the court in writing within 30 days of the occurrence 
206.34 	of any of the events listed in this paragraph. The conservator must report any of the 
206.35 	occurrences in this paragraph and follow the same reporting requirements in this paragraph 
207.1 	for any employee of the conservator responsible for exercising powers and duties under 
207.2 	the conservatorship. A copy of the report must be provided to the protected person and to 
207.3 	interested persons of record with the court. A conservator shall report when:
207.4 	(1) the conservator is removed for cause from serving as a guardian or conservator, 
207.5 	and if so, the case number and court location;
207.6 	(2) the conservator has a professional license denied, conditioned, suspended, 
207.7 	revoked, or canceled, and if so, the licensing agency and license number, and the basis for 
207.8 	denial, condition, suspension, revocation, or cancellation of the license;
207.9 	(3) the conservator is found civilly liable in an action that involves fraud, 
207.10 	misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the 
207.11 	case number and court location;
207.12 	(4) the conservator files for or receives protection under the bankruptcy laws, and 
207.13 	if so, the case number and court location;
207.14 	(5) a civil monetary judgment is entered against the conservator, and if so, the case 
207.15 	number, court location, and outstanding amount owed;
207.16 	(6) the conservator is convicted of a crime other than a petty misdemeanor or traffic 
207.17 	offense, and if so, the case number and court location; or
207.18 	(7) an order for protection or harassment restraining order is issued against the 
207.19 	conservator, and if so, the case number and court location.
207.20 	(d) (e) A protected person or an interested person of record with the court may 
207.21 	submit to the court a written statement disputing account statements regarding the 
207.22 	administration of the estate or addressing any disciplinary or legal action that are is
207.23 	 contained in the report reports and may petition the court for any order that is in the best 
207.24 	interests of the protected person and the estate or for other appropriate relief.
207.25 	(e) (f) An interested person may notify the court in writing that the interested person 
207.26 	does not wish to receive copies of reports required under this section.
207.27 	(f) (g) The court may appoint a visitor to review a report or plan, interview the 
207.28 	protected person or conservator, and make any other investigation the court directs. In 
207.29 	connection with a report, the court may order a conservator to submit the assets of the 
207.30 	estate to an appropriate examination to be made in a manner the court directs.
207.31 	(g) (h) The court shall establish a system for monitoring of conservatorships, 
207.32 	including the filing and review of conservators' reports and plans. If an annual report is 
207.33 	not filed within 60 days of the required date, the court shall issue an order to show cause.
207.34 	(i) If a conservator fails to comply with this section, the court may decline to appoint 
207.35 	that person as a guardian or conservator, or may remove a person as guardian or conservator.

208.1 	Sec. 20. INSTRUCTIONS TO THE COMMISSIONER.
 208.2 	In collaboration with labor organizations, the commissioner of human services shall 
208.3 	develop clear and consistent standards for state-operated services programs to:
208.4 	(1) address direct service staffing shortages;
208.5 	(2) identify and help resolve workplace safety issues; and
208.6 	(3) elevate the use and visibility of performance measures and objectives related to 
208.7 	overtime use.

208.8 	ARTICLE 6
208.9 	HEALTH CARE

208.10 	Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:
208.11 		Subdivision 1.Establishment. There is created a Department of Human Services. 
208.12 	A commissioner of human services shall be appointed by the governor under the 
208.13 	provisions of section 15.06. The commissioner shall be selected on the basis of ability and 
208.14 	experience in welfare and without regard to political affiliations. The commissioner shall
208.15 	 may appoint a up to two deputy commissioner commissioners.

208.16 	Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:
208.17 		Subd. 3.Surcharge on HMOs and community integrated service networks. (a) 
208.18 	Effective October 1, 1992, each health maintenance organization with a certificate of 
208.19 	authority issued by the commissioner of health under chapter 62D and each community 
208.20 	integrated service network licensed by the commissioner under chapter 62N shall pay to 
208.21 	the commissioner of human services a surcharge equal to six-tenths of one percent of the 
208.22 	total premium revenues of the health maintenance organization or community integrated 
208.23 	service network as reported to the commissioner of health according to the schedule in 
208.24 	subdivision 4.
208.25 	(b) Effective July 1, 2013, to June 30, 2015, the surcharge under paragraph (a) is 
208.26 	increased to 1.48 percent.
208.27 	(c) For purposes of this subdivision, total premium revenue means:
208.28 	(1) premium revenue recognized on a prepaid basis from individuals and groups 
208.29 	for provision of a specified range of health services over a defined period of time which 
208.30 	is normally one month, excluding premiums paid to a health maintenance organization 
208.31 	or community integrated service network from the Federal Employees Health Benefit 
208.32 	Program;
208.33 	(2) premiums from Medicare wraparound subscribers for health benefits which 
208.34 	supplement Medicare coverage;
209.1 	(3) Medicare revenue, as a result of an arrangement between a health maintenance 
209.2 	organization or a community integrated service network and the Centers for Medicare 
209.3 	and Medicaid Services of the federal Department of Health and Human Services, for 
209.4 	services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited 
209.5 	from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social 
209.6 	Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 
209.7 	1395w-24, respectively, as they may be amended from time to time; and
209.8 	(4) medical assistance revenue, as a result of an arrangement between a health 
209.9 	maintenance organization or community integrated service network and a Medicaid state 
209.10 	agency, for services to a medical assistance beneficiary.
209.11 	If advance payments are made under clause (1) or (2) to the health maintenance 
209.12 	organization or community integrated service network for more than one reporting period, 
209.13 	the portion of the payment that has not yet been earned must be treated as a liability.
209.14 	(c) (d)  When a health maintenance organization or community integrated service 
209.15 	network merges or consolidates with or is acquired by another health maintenance 
209.16 	organization or community integrated service network, the surviving corporation or the 
209.17 	new corporation shall be responsible for the annual surcharge originally imposed on 
209.18 	each of the entities or corporations subject to the merger, consolidation, or acquisition, 
209.19 	regardless of whether one of the entities or corporations does not retain a certificate of 
209.20 	authority under chapter 62D or a license under chapter 62N.
209.21 	(d) (e)  Effective July 1 of each year, the surviving corporation's or the new 
209.22 	corporation's surcharge shall be based on the revenues earned in the second previous 
209.23 	calendar year by all of the entities or corporations subject to the merger, consolidation, 
209.24 	or acquisition regardless of whether one of the entities or corporations does not retain a 
209.25 	certificate of authority under chapter 62D or a license under chapter 62N until the total 
209.26 	premium revenues of the surviving corporation include the total premium revenues of all 
209.27 	the merged entities as reported to the commissioner of health.
209.28 	(e) (f)  When a health maintenance organization or community integrated service 
209.29 	network, which is subject to liability for the surcharge under this chapter, transfers, 
209.30 	assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability 
209.31 	for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer 
209.32 	of the health maintenance organization or community integrated service network.
209.33 	(f) (g)  In the event a health maintenance organization or community integrated 
209.34 	service network converts its licensure to a different type of entity subject to liability 
209.35 	for the surcharge under this chapter, but survives in the same or substantially similar 
209.36 	form, the surviving entity remains liable for the surcharge regardless of whether one of 
210.1 	the entities or corporations does not retain a certificate of authority under chapter 62D 
210.2 	or a license under chapter 62N.
210.3 	(g) (h)  The surcharge assessed to a health maintenance organization or community 
210.4 	integrated service network ends when the entity ceases providing services for premiums 
210.5 	and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

210.6 	Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
210.7 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
210.8 	assistance program must not be submitted until the recipient is discharged. However, 
210.9 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
210.10 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
210.11 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
210.12 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
210.13 	hospital payments established under this section and sections 256.9685, 256.9686, and 
210.14 	256.9695, in addition to third-party and recipient liability, for discharges occurring during 
210.15 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
210.16 	inpatient services paid for the same period of time to the hospital. This payment limitation 
210.17 	shall be calculated separately for medical assistance and general assistance medical 
210.18 	care services. The limitation on general assistance medical care shall be effective for 
210.19 	admissions occurring on or after July 1, 1991. Services that have rates established under 
210.20 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
210.21 	the affected hospitals, the commissioner may consider related hospitals one entity and 
210.22 	may merge the payment rates while maintaining separate provider numbers. The operating 
210.23 	and property base rates per admission or per day shall be derived from the best Medicare 
210.24 	and claims data available when rates are established. The commissioner shall determine 
210.25 	the best Medicare and claims data, taking into consideration variables of recency of the 
210.26 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
210.27 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
210.28 	preceding the rate year. The rate setting data must reflect the admissions data used to 
210.29 	establish relative values. Base year changes from 1981 to the base year established for the 
210.30 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
210.31 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
210.32 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
210.33 	to exclude the costs of services that have been discontinued by the October 1 of the year 
210.34 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
210.35 	that encompass portions of two or more rate years shall have payments established based 
211.1 	on payment rates in effect at the time of admission unless the date of admission preceded 
211.2 	the rate year in effect by six months or more. In this case, operating payment rates for 
211.3 	services rendered during the rate year in effect and established based on the date of 
211.4 	admission shall be adjusted to the rate year in effect by the hospital cost index.
211.5 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
211.6 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
211.7 	services is reduced by .5 percent from the current statutory rates.
211.8 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
211.9 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
211.10 	before third-party liability and spenddown, is reduced five percent from the current 
211.11 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
211.12 	facilities defined under subdivision 16 are excluded from this paragraph.
211.13 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
211.14 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
211.15 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
211.16 	from the current statutory rates. Mental health services within diagnosis related groups 
211.17 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
211.18 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
211.19 	assistance does not include general assistance medical care. Payments made to managed 
211.20 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
211.21 	this reduction.
211.22 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
211.23 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
211.24 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
211.25 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
211.26 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
211.27 	paragraph. Payments made to managed care plans shall be reduced for services provided 
211.28 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
211.29 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
211.30 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
211.31 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
211.32 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
211.33 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
211.34 	paragraph. Payments made to managed care plans shall be reduced for services provided 
211.35 	on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
212.1 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
212.2 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
212.3 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
212.4 	from the current statutory rates. Mental health services with diagnosis related groups 
212.5 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
212.6 	Payments made to managed care plans shall be reduced for services provided on or after 
212.7 	July 1, 2011, to reflect this reduction.
212.8 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
212.9 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
212.10 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
212.11 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
212.12 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
212.13 	services provided on or after October 1, 2009, to reflect this reduction.
212.14 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total 
212.15 	payment for fee-for-service admissions occurring on or after July 1, 2011, made to 
212.16 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
212.17 	1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are 
212.18 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
212.19 	services provided on or after January 1, 2011, to reflect this reduction.
212.20 	(j) For admissions occurring on or after January 1, 2015, the rate for inpatient 
212.21 	hospital services must be increased 1.4 percent from the rate in effect on December 31, 
212.22 	2014. Payments made to managed care plans and county-based purchasing plans shall 
212.23 	not be adjusted to reflect payments under this paragraph.

212.24 	Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
212.25 		Subd. 29.Reimbursement for the fee increase for the early hearing detection 
212.26 	and intervention program. (a) For admissions occurring on or after July 1, 2010, 
212.27 	payment rates shall be adjusted to include the increase to the fee that is effective on July 1, 
212.28 	2010, for the early hearing detection and intervention program recipients under section 
212.29 	144.125, subdivision 1, that is paid by the hospital for public program recipients. This 
212.30 	payment increase shall be in effect until the increase is fully recognized in the base year 
212.31 	cost under subdivision 2b. This payment shall be included in payments to contracted 
212.32 	managed care organizations.
212.33 	(b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted 
212.34 	to include the increase to the fee that is effective July 1, 2013, for the early hearing detection 
212.35 	and intervention program recipients under section 144.125, subdivision 1, that is paid by 
213.1 	the hospital for public program recipients. This payment increase shall be in effect until 
213.2 	the increase is fully recognized in the base-year cost under subdivision 2b. This payment 
213.3 	shall be included in payments to managed care plans and county-based purchasing plans.

213.4 	Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
213.5 		Subd. 14.Persons detained by law. (a) Medical assistance may be paid for an 
213.6 	inmate of a correctional facility who is conditionally released as authorized under section 
213.7 	241.26, 244.065, or 631.425, if the individual does not require the security of a public 
213.8 	detention facility and is housed in a halfway house or community correction center, or 
213.9 	under house arrest and monitored by electronic surveillance in a residence approved 
213.10 	by the commissioner of corrections, and if the individual meets the other eligibility 
213.11 	requirements of this chapter.
213.12 	(b) An individual who is enrolled in medical assistance, and who is charged with a 
213.13 	crime and incarcerated for less than 12 months shall be suspended from eligibility at the 
213.14 	time of incarceration until the individual is released. Upon release, medical assistance 
213.15 	eligibility is reinstated without reapplication using a reinstatement process and form, if the 
213.16 	individual is otherwise eligible.
213.17 	(c) An individual, regardless of age, who is considered an inmate of a public 
213.18 	institution as defined in Code of Federal Regulations, title 42, section 435.1010, and 
213.19 	who meets the eligibility requirements in section 256B.056, is not eligible for medical 
213.20 	assistance, except for covered services received while an inpatient in a medical institution 
213.21 	as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues, 
213.22 	including costs, related to the inpatient treatment of an inmate are the responsibility of the 
213.23 	entity with jurisdiction over the inmate.

213.24 	EFFECTIVE DATE. This section is effective January 1, 2014.

213.25 	Sec. 6. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
213.26 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
213.27 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
213.28 	other persons residing lawfully in the United States. Citizens or nationals of the United 
213.29 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
213.30 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
213.31 	Public Law 109-171.
213.32 	(b) "Qualified noncitizen" means a person who meets one of the following 
213.33 	immigration criteria:
213.34 	(1) admitted for lawful permanent residence according to United States Code, title 8;
214.1 	(2) admitted to the United States as a refugee according to United States Code, 
214.2 	title 8, section 1157;
214.3 	(3) granted asylum according to United States Code, title 8, section 1158;
214.4 	(4) granted withholding of deportation according to United States Code, title 8, 
214.5 	section 1253(h);
214.6 	(5) paroled for a period of at least one year according to United States Code, title 8, 
214.7 	section 1182(d)(5);
214.8 	(6) granted conditional entrant status according to United States Code, title 8, 
214.9 	section 1153(a)(7);
214.10 	(7) determined to be a battered noncitizen by the United States Attorney General 
214.11 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
214.12 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
214.13 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
214.14 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
214.15 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
214.16 	Public Law 104-200; or
214.17 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
214.18 	Law 96-422, the Refugee Education Assistance Act of 1980.
214.19 	(c) All qualified noncitizens who were residing in the United States before August 
214.20 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
214.21 	medical assistance with federal financial participation.
214.22 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United 
214.23 	States on or after August 22, 1996, and who otherwise meet the eligibility requirements 
214.24 	of this chapter are eligible for medical assistance with federal participation for five years 
214.25 	if they meet one of the following criteria:
214.26 	(1) refugees admitted to the United States according to United States Code, title 8, 
214.27 	section 1157;
214.28 	(2) persons granted asylum according to United States Code, title 8, section 1158;
214.29 	(3) persons granted withholding of deportation according to United States Code, 
214.30 	title 8, section 1253(h);
214.31 	(4) veterans of the United States armed forces with an honorable discharge for 
214.32 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
214.33 	children; or
214.34 	(5) persons on active duty in the United States armed forces, other than for training, 
214.35 	their spouses and unmarried minor dependent children.
215.1 	 Beginning July 1, 2010, children and pregnant women who are noncitizens 
215.2 	described in paragraph (b) or who are lawfully present in the United States as defined 
215.3 	in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet 
215.4 	eligibility requirements of this chapter, are eligible for medical assistance with federal 
215.5 	financial participation as provided by the federal Children's Health Insurance Program 
215.6 	Reauthorization Act of 2009, Public Law 111-3.
215.7 	(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
215.8 	are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this 
215.9 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
215.10 	Code, title 8, section 1101(a)(15).
215.11 	(f) Payment shall also be made for care and services that are furnished to noncitizens, 
215.12 	regardless of immigration status, who otherwise meet the eligibility requirements of 
215.13 	this chapter, if such care and services are necessary for the treatment of an emergency 
215.14 	medical condition.
215.15 	(g) For purposes of this subdivision, the term "emergency medical condition" means 
215.16 	a medical condition that meets the requirements of United States Code, title 42, section 
215.17 	1396b(v).
215.18 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment 
215.19 	of an emergency medical condition are limited to the following:
215.20 	(i) services delivered in an emergency room or by an ambulance service licensed 
215.21 	under chapter 144E that are directly related to the treatment of an emergency medical 
215.22 	condition;
215.23 	(ii) services delivered in an inpatient hospital setting following admission from an 
215.24 	emergency room or clinic for an acute emergency condition; and
215.25 	(iii) follow-up services that are directly related to the original service provided 
215.26 	to treat the emergency medical condition and are covered by the global payment made 
215.27 	to the provider.
215.28 	(2) Services for the treatment of emergency medical conditions do not include:
215.29 	(i) services delivered in an emergency room or inpatient setting to treat a 
215.30 	nonemergency condition;
215.31 	(ii) organ transplants, stem cell transplants, and related care;
215.32 	(iii) services for routine prenatal care;
215.33 	(iv) continuing care, including long-term care, nursing facility services, home health 
215.34 	care, adult day care, day training, or supportive living services;
215.35 	(v) elective surgery;
216.1 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
216.2 	part of an emergency room visit;
216.3 	(vii) preventative health care and family planning services;
216.4 	(viii) dialysis;
216.5 	(ix) chemotherapy or therapeutic radiation services;
216.6 	(x) (viii) rehabilitation services;
216.7 	(xi) (ix) physical, occupational, or speech therapy;
216.8 	(xii) (x) transportation services;
216.9 	(xiii) (xi) case management;
216.10 	(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
216.11 	(xv) (xiii) dental services;
216.12 	(xvi) (xiv) hospice care;
216.13 	(xvii) (xv) audiology services and hearing aids;
216.14 	(xviii) (xvi) podiatry services;
216.15 	(xix) (xvii) chiropractic services;
216.16 	(xx) (xviii) immunizations;
216.17 	(xxi) (xix) vision services and eyeglasses;
216.18 	(xxii) (xx) waiver services;
216.19 	(xxiii) (xxi) individualized education programs; or
216.20 	(xxiv) (xxii) chemical dependency treatment.
216.21 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
216.22 	nonimmigrants, or lawfully present in the United States as defined in Code of Federal 
216.23 	Regulations, title 8, section 103.12, are not covered by a group health plan or health 
216.24 	insurance coverage according to Code of Federal Regulations, title 42, section 457.310, 
216.25 	and who otherwise meet the eligibility requirements of this chapter, are eligible for 
216.26 	medical assistance through the period of pregnancy, including labor and delivery, and 60 
216.27 	days postpartum, to the extent federal funds are available under title XXI of the Social 
216.28 	Security Act, and the state children's health insurance program.
216.29 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
216.30 	services from a nonprofit center established to serve victims of torture and are otherwise 
216.31 	ineligible for medical assistance under this chapter are eligible for medical assistance 
216.32 	without federal financial participation. These individuals are eligible only for the period 
216.33 	during which they are receiving services from the center. Individuals eligible under this 
216.34 	paragraph shall not be required to participate in prepaid medical assistance.
217.1 	(k) Notwithstanding paragraph (h), clause (2), the following services are covered as 
217.2 	emergency medical conditions under paragraph (f) except where coverage is prohibited 
217.3 	under federal law:
217.4 	(1) dialysis services provided in a hospital or freestanding dialysis facility; and
217.5 	(2) surgery and the administration of chemotherapy, radiation, and related services 
217.6 	necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission 
217.7 	and requires surgery, chemotherapy, or radiation treatment.
217.8 	(l) The commissioner or its third party medical review agent may authorize payment 
217.9 	for follow-up care and alternative services, including, but not limited to, long-term care 
217.10 	services that would not otherwise be paid for under this subdivision if the commissioner 
217.11 	determines that the services, if provided, will directly prevent a medical emergency from 
217.12 	immediately occurring.

217.13 	Sec. 7. Minnesota Statutes 2012, section 256B.0625, is amended by adding a 
217.14 	subdivision to read:
217.15 		Subd. 28b.Doula services. Medical assistance covers doula services provided by a 
217.16 	certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For 
217.17 	purposes of this section, "doula services" means childbirth education and support services, 
217.18 	including emotional and physical support provided during pregnancy, labor, birth, and 
217.19 	postpartum.

217.20 	EFFECTIVE DATE. This section is effective July 1, 2014, or upon federal 
217.21 	approval, whichever is later, and applies to services provided on or after the effective date.

217.22 	Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:
217.23 		Subd. 31.Medical supplies and equipment. (a) Medical assistance covers medical 
217.24 	supplies and equipment. Separate payment outside of the facility's payment rate shall 
217.25 	be made for wheelchairs and wheelchair accessories for recipients who are residents 
217.26 	of intermediate care facilities for the developmentally disabled. Reimbursement for 
217.27 	wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 
217.28 	conditions and limitations as coverage for recipients who do not reside in institutions. A 
217.29 	wheelchair purchased outside of the facility's payment rate is the property of the recipient. 
217.30 	The commissioner may set reimbursement rates for specified categories of medical 
217.31 	supplies at levels below the Medicare payment rate.
217.32 	(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies 
217.33 	must enroll as a Medicare provider.
218.1 	(c) When necessary to ensure access to durable medical equipment, prosthetics, 
218.2 	orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare 
218.3 	enrollment requirement if:
218.4 	(1) the vendor supplies only one type of durable medical equipment, prosthetic, 
218.5 	orthotic, or medical supply;
218.6 	(2) the vendor serves ten or fewer medical assistance recipients per year;
218.7 	(3) the commissioner finds that other vendors are not available to provide same or 
218.8 	similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
218.9 	(4) the vendor complies with all screening requirements in this chapter and Code of 
218.10 	Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from 
218.11 	the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare 
218.12 	and Medicaid Services approved national accreditation organization as complying with 
218.13 	the Medicare program's supplier and quality standards and the vendor serves primarily 
218.14 	pediatric patients.
218.15 	(d) Durable medical equipment means a device or equipment that:
218.16 	(1) can withstand repeated use;
218.17 	(2) is generally not useful in the absence of an illness, injury, or disability; and
218.18 	(3) is provided to correct or accommodate a physiological disorder or physical 
218.19 	condition or is generally used primarily for a medical purpose.
218.20 	(e) Electronic tablets may be considered durable medical equipment if the electronic 
218.21 	tablet will be used as an augmentative and alternative communication system as defined 
218.22 	under subdivision 31a, paragraph (a). To be covered by medical assistance, the device 
218.23 	must be locked in order to prevent use not related to communication.

218.24 	Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a 
218.25 	subdivision to read:
218.26 		Subd. 31b.Preferred diabetic testing supply program. (a) The commissioner 
218.27 	shall implement a point-of-sale preferred diabetic testing supply program by January 1, 
218.28 	2014. Medical assistance coverage for diabetic testing supplies shall conform to the 
218.29 	limitations established under the program. The commissioner may enter into a contract 
218.30 	with a vendor for the purpose of participating in a preferred diabetic testing supply list and 
218.31 	supplemental rebate program. The commissioner shall ensure that any contract meets all 
218.32 	federal requirements and maximizes federal financial participation. The commissioner 
218.33 	shall maintain an accurate and up-to-date list on the department's Web site.
218.34 	(b) The commissioner may add to, delete from, and otherwise modify the preferred 
218.35 	diabetic testing supply program drug list after consulting with the Drug Formulary 
219.1 	Committee and appropriate medial specialists and providing public notice and the 
219.2 	opportunity for public comment.
219.3 	(c) The commissioner shall adopt and administer the preferred diabetic testing 
219.4 	supply program as part of the administration of the diabetic testing supply rebate program. 
219.5 	Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply 
219.6 	list may be subject to prior authorization.
219.7 	(d) All claims for diabetic testing supplies in categories on the preferred diabetic 
219.8 	testing supply list must be submitted by enrolled pharmacy providers using the most 
219.9 	current National Council of Prescription Drug Providers electronic claims standard.
219.10 	(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a 
219.11 	list of diabetic testing supplies selected by the commissioner, for which prior authorization 
219.12 	is not required.
219.13 	(f) The commissioner shall seek any federal waivers or approvals necessary to 
219.14 	implement this subdivision.

219.15 	Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to 
219.16 	read:
219.17 		Subd. 39.Childhood immunizations. Providers who administer pediatric vaccines 
219.18 	within the scope of their licensure, and who are enrolled as a medical assistance provider, 
219.19 	must enroll in the pediatric vaccine administration program established by section 13631 
219.20 	of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an 
219.21 	$8.50 fee per dose for administration of the vaccine to children eligible for medical 
219.22 	assistance. Medical assistance does not pay for vaccines that are available at no cost from 
219.23 	the pediatric vaccine administration program.

219.24 	Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to 
219.25 	read:
219.26 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 219.27 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
219.28 	(EPSDT). The payment amount for a complete EPSDT screening shall not include charges 
219.29 	for vaccines that are available at no cost to the provider and shall not exceed the rate 
219.30 	established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

219.31 	Sec. 12. Minnesota Statutes 2012, section 256B.0625, is amended by adding a 
219.32 	subdivision to read:
220.1 		Subd. 61.Payment for multiple services provided on the same day. The 
220.2 	commissioner shall not prohibit payment, including supplemental payments, for mental 
220.3 	health services or dental services provided to a patient by a clinic or health care 
220.4 	professional solely because the mental health or dental services were provided on the same 
220.5 	day as other covered health services furnished by the same provider.

220.6 	Sec. 13. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
220.7 		Subdivision 1.Cost-sharing. (a) Except as provided in subdivision 2, the medical 
220.8 	assistance benefit plan shall include the following cost-sharing for all recipients, effective 
220.9 	for services provided on or after September 1, 2011:
220.10 	(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 
220.11 	of this subdivision, a visit means an episode of service which is required because of 
220.12 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
220.13 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
220.14 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
220.15 	(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that 
220.16 	this co-payment shall be increased to $20 upon federal approval;
220.17 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
220.18 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
220.19 	shall apply to antipsychotic drugs when used for the treatment of mental illness;
220.20 	(4) effective January 1, 2012, a family deductible equal to the maximum amount 
220.21 	allowed under Code of Federal Regulations, title 42, part 447.54; and
220.22 	(5) for individuals identified by the commissioner with income at or below 100 
220.23 	percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five 
220.24 	percent of family income. For purposes of this paragraph, family income is the total 
220.25 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
220.26 	enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
220.27 	(b) Recipients of medical assistance are responsible for all co-payments and 
220.28 	deductibles in this subdivision.
220.29 	(c) Notwithstanding paragraph (b), the commissioner, through the contracting 
220.30 	process under sections 256B.69 and 256B.692, may allow managed care plans and 
220.31 	county-based purchasing plans to waive the family deductible under paragraph (a), 
220.32 	clause (4). The value of the family deductible shall not be included in the capitation 
220.33 	payment to managed care plans and county-based purchasing plans. Managed care plans 
220.34 	and county-based purchasing plans shall certify annually to the commissioner the dollar 
220.35 	value of the family deductible.
221.1 	(d) Notwithstanding paragraph (b), the commissioner may shall waive the collection 
221.2 	of the family deductible described under paragraph (a), clause (4), from individuals and 
221.3 	allow long-term care and waivered service providers to assume responsibility for payment.
221.4 	(e) Notwithstanding paragraph (b), the commissioner, through the contracting 
221.5 	process under section 256B.0756 shall allow the pilot program in Hennepin County to 
221.6 	waive co-payments. The value of the co-payments shall not be included as part of the 
221.7 	payment system for the integrated health care delivery networks under the pilot program.

221.8 	Sec. 14. Minnesota Statutes 2012, section 256B.0756, is amended to read:
221.9 	256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
221.10 	(a) The commissioner, upon federal approval of a new waiver request or amendment 
221.11 	of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey 
221.12 	County, or both, to test alternative and innovative integrated health care delivery networks.
221.13 	(b) Individuals eligible for the pilot program shall be individuals who are eligible for 
221.14 	medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin 
221.15 	County or Ramsey County. The commissioner may identify individuals to be enrolled 
221.16 	in the Hennepin County pilot program by zip code or by whether the individuals would 
221.17 	benefit from an integrated health care delivery network.
221.18 	(c) Individuals enrolled in the pilot program shall be enrolled in an integrated 
221.19 	health care delivery network in their county of residence. The integrated health care 
221.20 	delivery network in Hennepin County shall be a network, such as an accountable care 
221.21 	organization or a community-based collaborative care network, created by or including 
221.22 	Hennepin County Medical Center. The integrated health care delivery network in Ramsey 
221.23 	County shall be a network, such as an accountable care organization or community-based 
221.24 	collaborative care network, created by or including Regions Hospital.
221.25 	(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for 
221.26 	Hennepin County and 3,500 enrollees for Ramsey County.
221.27 	(e) (d) In developing a payment system for the pilot programs, the commissioner 
221.28 	shall establish a total cost of care for the recipients enrolled in the pilot programs that 
221.29 	equals the cost of care that would otherwise be spent for these enrollees in the prepaid 
221.30 	medical assistance program.
221.31 	(f) Counties may transfer funds necessary to support the nonfederal share of 
221.32 	payments for integrated health care delivery networks in their county. Such transfers per 
221.33 	county shall not exceed 15 percent of the expected expenses for county enrollees.
221.34 	(g) (e) The commissioner shall apply to the federal government for, or as appropriate, 
221.35 	cooperate with counties, providers, or other entities that are applying for any applicable 
222.1 	grant or demonstration under the Patient Protection and Affordable Health Care Act, Public 
222.2 	Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 
222.3 	111-152, that would further the purposes of or assist in the creation of an integrated health 
222.4 	care delivery network for the purposes of this subdivision, including, but not limited to, a 
222.5 	global payment demonstration or the community-based collaborative care network grants.

222.6 	Sec. 15. Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:
222.7 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and 
222.8 	subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital 
222.9 	services upper payment limit for nonstate government hospitals. The commissioner shall 
222.10 	then determine the amount of a supplemental payment to Hennepin County Medical 
222.11 	Center and Regions Hospital for these services that would increase medical assistance 
222.12 	spending in this category to the aggregate upper payment limit for all nonstate government 
222.13 	hospitals in Minnesota. In making this determination, the commissioner shall allot the 
222.14 	available increases between Hennepin County Medical Center and Regions Hospital 
222.15 	based on the ratio of medical assistance fee-for-service outpatient hospital payments to 
222.16 	the two facilities. The commissioner shall adjust this allotment as necessary based on 
222.17 	federal approvals, the amount of intergovernmental transfers received from Hennepin and 
222.18 	Ramsey Counties, and other factors, in order to maximize the additional total payments. 
222.19 	The commissioner shall inform Hennepin County and Ramsey County of the periodic 
222.20 	intergovernmental transfers necessary to match federal Medicaid payments available 
222.21 	under this subdivision in order to make supplementary medical assistance payments to 
222.22 	Hennepin County Medical Center and Regions Hospital equal to an amount that when 
222.23 	combined with existing medical assistance payments to nonstate governmental hospitals 
222.24 	would increase total payments to hospitals in this category for outpatient services to 
222.25 	the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon 
222.26 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
222.27 	to Hennepin County Medical Center and Regions Hospital.
222.28 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
222.29 	determine an upper payment limit for physicians and other billing professionals affiliated 
222.30 	with Hennepin County Medical Center and with Regions Hospital. The upper payment 
222.31 	limit shall be based on the average commercial rate or be determined using another method 
222.32 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
222.33 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
222.34 	necessary to match the federal Medicaid payments available under this subdivision in order 
222.35 	to make supplementary payments to physicians and other billing professionals affiliated 
223.1 	with Hennepin County Medical Center and to make supplementary payments to physicians 
223.2 	and other billing professionals affiliated with Regions Hospital through HealthPartners 
223.3 	Medical Group equal to the difference between the established medical assistance 
223.4 	payment for physician and other billing professional services and the upper payment limit. 
223.5 	Upon receipt of these periodic transfers, the commissioner shall make supplementary 
223.6 	payments to physicians and other billing professionals affiliated with Hennepin County 
223.7 	Medical Center and shall make supplementary payments to physicians and other billing 
223.8 	professionals affiliated with Regions Hospital through HealthPartners Medical Group.
223.9 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make 
223.10 	monthly voluntary intergovernmental transfers to the commissioner in amounts not to 
223.11 	exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from 
223.12 	Ramsey County. The commissioner shall increase the medical assistance capitation 
223.13 	payments to any licensed health plan under contract with the medical assistance program 
223.14 	that agrees to make enhanced payments to Hennepin County Medical Center or Regions 
223.15 	Hospital. The increase shall be in an amount equal to the annual value of the monthly 
223.16 	transfers plus federal financial participation, with each health plan receiving its pro rata 
223.17 	share of the increase based on the pro rata share of medical assistance admissions to 
223.18 	Hennepin County Medical Center and Regions Hospital by those plans. Upon the request 
223.19 	of the commissioner, health plans shall submit individual-level cost data for verification 
223.20 	purposes. The commissioner may ratably reduce these payments on a pro rata basis in 
223.21 	order to satisfy federal requirements for actuarial soundness. If payments are reduced, 
223.22 	transfers shall be reduced accordingly. Any licensed health plan that receives increased 
223.23 	medical assistance capitation payments under the intergovernmental transfer described in 
223.24 	this paragraph shall increase its medical assistance payments to Hennepin County Medical 
223.25 	Center and Regions Hospital by the same amount as the increased payments received in 
223.26 	the capitation payment described in this paragraph.
223.27 	(d) For the purposes of this subdivision and subdivision 3, the commissioner shall 
223.28 	determine an upper payment limit for ambulance services affiliated with Hennepin County 
223.29 	Medical Center. The upper payment limit shall be based on the average commercial 
223.30 	rate or be determined using another method acceptable to the Centers for Medicare and 
223.31 	Medicaid Services. The commissioner shall inform Hennepin County of the periodic 
223.32 	intergovernmental transfers necessary to match the federal Medicaid payments available 
223.33 	under this subdivision in order to make supplementary payments to Hennepin County 
223.34 	Medical Center equal to the difference between the established medical assistance 
223.35 	payment for ambulance services and the upper payment limit. Upon receipt of these 
224.1 	periodic transfers, the commissioner shall make supplementary payments to Hennepin 
224.2 	County Medical Center.
224.3 	(e) The commissioner shall inform the transferring governmental entities on an 
224.4 	ongoing basis of the need for any changes needed in the intergovernmental transfers in 
224.5 	order to continue the payments under paragraphs (a) to (c) (d), at their maximum level, 
224.6 	including increases in upper payment limits, changes in the federal Medicaid match, and 
224.7 	other factors.
224.8 	(e) (f)  The payments in paragraphs (a) to (c) (d)  shall be implemented independently 
224.9 	of each other, subject to federal approval and to the receipt of transfers under subdivision 3.

224.10 	Sec. 16. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
224.11 		Subd. 5c.Medical education and research fund. (a) The commissioner of human 
224.12 	services shall transfer each year to the medical education and research fund established 
224.13 	under section 62J.692, an amount specified in this subdivision. The commissioner shall 
224.14 	calculate the following:
224.15 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
224.16 	specified in this clause. Until January 1, 2002, the county medical assistance capitation 
224.17 	base rate prior to plan specific adjustments and after the regional rate adjustments under 
224.18 	subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 
224.19 	metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after 
224.20 	January 1, 2002, the county medical assistance capitation base rate prior to plan specific 
224.21 	adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining 
224.22 	metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing 
224.23 	facility and elderly waiver payments and demonstration project payments operating 
224.24 	under subdivision 23 are excluded from this reduction. The amount calculated under 
224.25 	this clause shall not be adjusted for periods already paid due to subsequent changes to 
224.26 	the capitation payments;
224.27 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 
224.28 	section;
224.29 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
224.30 	paid under this section; and
224.31 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
224.32 	under this section.
224.33 	(b) This subdivision shall be effective upon approval of a federal waiver which 
224.34 	allows federal financial participation in the medical education and research fund. The 
224.35 	amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount 
225.1 	transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under 
225.2 	paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally 
225.3 	reduce the amount specified under paragraph (a), clause (1).
225.4 	(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner 
225.5 	shall transfer $21,714,000 each fiscal year to the medical education and research fund.
225.6 	(d) Beginning September 1, 2011, of the amount in paragraph (a), following the 
225.7 	transfer under paragraph (c), the commissioner shall transfer to the medical education 
225.8 	research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $43,148,000 in 
225.9 	fiscal year 2014 and thereafter.

225.10 	Sec. 17. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
225.11 		Subd. 31.Payment reduction. (a) Beginning September 1, 2011, the commissioner 
225.12 	shall reduce payments and limit future rate increases paid to managed care plans and 
225.13 	county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved 
225.14 	on a statewide aggregate basis by program. The commissioner may use competitive 
225.15 	bidding, payment reductions, or other reductions to achieve the reductions and limits 
225.16 	in this subdivision.
225.17 	(b) Beginning September 1, 2011, the commissioner shall reduce payments to 
225.18 	managed care plans and county-based purchasing plans as follows:
225.19 	(1) 2.0 percent for medical assistance elderly basic care. This shall not apply 
225.20 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
225.21 	services;
225.22 	(2) 2.82 percent for medical assistance families and children;
225.23 	(3) 10.1 percent for medical assistance adults without children; and
225.24 	(4) 6.0 percent for MinnesotaCare families and children.
225.25 	(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed 
225.26 	care plans and county-based purchasing plans for calendar year 2012 to a percentage of 
225.27 	the rates in effect on August 31, 2011, as follows:
225.28 	(1) 98 percent for medical assistance elderly basic care. This shall not apply to 
225.29 	Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
225.30 	services;
225.31 	(2) 97.18 percent for medical assistance families and children;
225.32 	(3) 89.9 percent for medical assistance adults without children; and
225.33 	(4) 94 percent for MinnesotaCare families and children.
226.1 	(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit 
226.2 	the maximum annual trend increases to rates paid to managed care plans and county-based 
226.3 	purchasing plans as follows:
226.4 	(1) 7.5 percent for medical assistance elderly basic care. This shall not apply 
226.5 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
226.6 	services;
226.7 	(2) 5.0 percent for medical assistance special needs basic care;
226.8 	(3) 2.0 percent for medical assistance families and children;
226.9 	(4) 3.0 percent for medical assistance adults without children;
226.10 	(5) 3.0 percent for MinnesotaCare families and children; and
226.11 	(6) 3.0 percent for MinnesotaCare adults without children.
226.12 	(e) The commissioner may limit trend increases to less than the maximum. 
226.13 	Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend 
226.14 	increases to rates paid to managed care plans and county-based purchasing plans as 
226.15 	follows for calendar years 2014 and, 2015, 2016, and 2017:
226.16 	(1) 7.5 6.0  percent for medical assistance elderly basic care. This shall not apply 
226.17 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
226.18 	services;
226.19 	(2) 5.0 0.5  percent for medical assistance special needs basic care;
226.20 	(3) 2.0 0.5 percent for medical assistance families and children;
226.21 	(4) 3.0 0  percent for medical assistance adults without children;
226.22 	(5) 3.0 percent for MinnesotaCare families and children; and
226.23 	(6) 4.0 percent for MinnesotaCare adults without children.
226.24 	The commissioner may limit trend increases to less than the maximum.

226.25 	Sec. 18. Minnesota Statutes 2012, section 256B.69, is amended by adding a 
226.26 	subdivision to read:
226.27 		Subd. 34.Risk corridors. (a) Effective for services rendered on or after January 1, 
226.28 	2014, the commissioner shall establish risk corridors that are actuarially sound for each 
226.29 	managed care plan and each county-based purchasing plan providing services under this 
226.30 	section and section 256B.692. The risk corridors shall be calculated annually based on the 
226.31 	calendar year's net underwriting gain or loss. If the managed care plan or county-based 
226.32 	purchasing plan achieved a net underwriting gain of greater than three percent of 
226.33 	revenue, any excess must be repaid to the commissioner by July 31 of the year following 
226.34 	calculation of the risk corridor year. If the managed care plan or county-based purchasing 
226.35 	plan has incurred a net underwriting loss greater than three percent of total revenue, any 
227.1 	excess must be repaid to the managed care plan or county-based purchasing plan by 
227.2 	the commissioner by July 31 of the year following calculation of the risk corridor year. 
227.3 	Determination of total revenues and net underwriting gain or loss must be based on the 
227.4 	Minnesota supplement report #1 that is filed on April 1 of the year following calculation 
227.5 	of the risk corridor and adjusted for the actual withhold calculation under subdivision 5a 
227.6 	and section 256L.12, subdivision 9. The report must be filed with the commissioner of 
227.7 	health and must be made available on the Department of Health's Web site.
227.8 	(b) This subdivision shall not apply to the special demonstration projects under 
227.9 	subdivisions 23 and 28.

227.10 	Sec. 19. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:
227.11 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
227.12 	or after October 1, 1992, the commissioner shall make payments for physician services 
227.13 	as follows:
227.14 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
227.15 	procedural coding system codes titled "office and other outpatient services," "preventive 
227.16 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
227.17 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
227.18 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
227.19 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
227.20 	30, 1992. If the rate on any procedure code within these categories is different than the 
227.21 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
227.22 	then the larger rate shall be paid;
227.23 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
227.24 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
227.25 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
227.26 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
227.27 	except that payment rates for home health agency services shall be the rates in effect 
227.28 	on September 30, 1992.
227.29 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
227.30 	physician and professional services shall be increased by three percent over the rates 
227.31 	in effect on December 31, 1999, except for home health agency and family planning 
227.32 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
227.33 	for managed care.
227.34 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
227.35 	physician and professional services shall be reduced by five percent, except that for the 
228.1 	period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent 
228.2 	for the medical assistance and general assistance medical care programs, over the rates in 
228.3 	effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply 
228.4 	to office or other outpatient visits, preventive medicine visits and family planning visits 
228.5 	billed by physicians, advanced practice nurses, or physician assistants in a family planning 
228.6 	agency or in one of the following primary care practices: general practice, general internal 
228.7 	medicine, general pediatrics, general geriatrics, and family medicine. This reduction 
228.8 	and the reductions in paragraph (d) do not apply to federally qualified health centers, 
228.9 	rural health centers, and Indian health services. Effective October 1, 2009, payments 
228.10 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
228.11 	256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
228.12 	(d) Effective for services rendered on or after July 1, 2010, payment rates for 
228.13 	physician and professional services shall be reduced an additional seven percent over 
228.14 	the five percent reduction in rates described in paragraph (c). This additional reduction 
228.15 	does not apply to physical therapy services, occupational therapy services, and speech 
228.16 	pathology and related services provided on or after July 1, 2010. This additional reduction 
228.17 	does not apply to physician services billed by a psychiatrist or an advanced practice nurse 
228.18 	with a specialty in mental health. Effective October 1, 2010, payments made to managed 
228.19 	care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 
228.20 	256L.12 shall reflect the payment reduction described in this paragraph.
228.21 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 
228.22 	2013, payment rates for physician and professional services shall be reduced three percent 
228.23 	from the rates in effect on August 31, 2011. This reduction does not apply to physical 
228.24 	therapy services, occupational therapy services, and speech pathology and related services.
228.25 	(f) Effective for services rendered on or after January 1, 2015, payment rates for 
228.26 	physician and professional services, including physical therapy, occupational therapy, 
228.27 	speech pathology, and mental health services shall be increased by five percent from 
228.28 	the rates in effect on December 31, 2014. This increase does not apply to federally 
228.29 	qualified health centers, rural health centers, and Indian health services. Payments made to 
228.30 	managed care plans and county-based purchasing plans shall not be adjusted to reflect 
228.31 	payments under this paragraph.

228.32 	Sec. 20. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:
228.33 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after 
228.34 	October 1, 1992, the commissioner shall make payments for dental services as follows:
229.1 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
229.2 	percent above the rate in effect on June 30, 1992; and
229.3 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
229.4 	percentile of 1989, less the percent in aggregate necessary to equal the above increases.
229.5 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
229.6 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
229.7 	(c) Effective for services rendered on or after January 1, 2000, payment rates for 
229.8 	dental services shall be increased by three percent over the rates in effect on December 
229.9 	31, 1999.
229.10 	(d) Effective for services provided on or after January 1, 2002, payment for 
229.11 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
229.12 	lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
229.13 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 
229.14 	2000, for managed care.
229.15 	(f) Effective for dental services rendered on or after October 1, 2010, by a 
229.16 	state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 
229.17 	on the Medicare principles of reimbursement. This payment shall be effective for services 
229.18 	rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 
229.19 	county-based purchasing plans.
229.20 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 
229.21 	in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 
229.22 	year, a supplemental state payment equal to the difference between the total payments 
229.23 	in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 
229.24 	services for the operation of the dental clinics.
229.25 	(h) If the cost-based payment system for state-operated dental clinics described in 
229.26 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
229.27 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
229.28 	receive the critical access dental reimbursement rate as described under subdivision 4, 
229.29 	paragraph (a).
229.30 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 
229.31 	2013, payment rates for dental services shall be reduced by three percent. This reduction 
229.32 	does not apply to state-operated dental clinics in paragraph (f).
229.33 	(j) Effective for services rendered on or after January 1, 2015, payment rates for 
229.34 	dental services shall be increased by five percent from the rates in effect on December 
229.35 	31, 2014. This increase does not apply to state-operated dental clinics in paragraph 
229.36 	(f), federally qualified health centers, rural health centers, and Indian health services. 
230.1 	Effective January 1, 2015, payments made to managed care plans and county-based 
230.2 	purchasing plans under sections 256B.69, 256B.692, and chapter 256L shall reflect the 
230.3 	payment increase described in this paragraph.

230.4 	Sec. 21. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
230.5 		Subd. 4.Critical access dental providers.  (a) Effective for dental services rendered 
230.6 	on or after January 1, 2002, the commissioner shall increase reimbursements to dentists 
230.7 	and dental clinics deemed by the commissioner to be critical access dental providers. 
230.8 	For dental services rendered on or after July 1, 2007, the commissioner shall increase 
230.9 	reimbursement by 30 35 percent above the reimbursement rate that would otherwise be 
230.10 	paid to the critical access dental provider. The commissioner shall pay the managed 
230.11 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
230.12 	reimbursements to critical access dental providers as approved by the commissioner.
230.13 	(b) The commissioner shall designate the following dentists and dental clinics as 
230.14 	critical access dental providers:
230.15 	(1) nonprofit community clinics that:
230.16 	(i) have nonprofit status in accordance with chapter 317A;
230.17 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
230.18 	501(c)(3);
230.19 	(iii) are established to provide oral health services to patients who are low income, 
230.20 	uninsured, have special needs, and are underserved;
230.21 	(iv) have professional staff familiar with the cultural background of the clinic's 
230.22 	patients;
230.23 	(v) charge for services on a sliding fee scale designed to provide assistance to 
230.24 	low-income patients based on current poverty income guidelines and family size;
230.25 	(vi) do not restrict access or services because of a patient's financial limitations 
230.26 	or public assistance status; and
230.27 	(vii) have free care available as needed;
230.28 	(2) federally qualified health centers, rural health clinics, and public health clinics;
230.29 	(3) city or county owned and operated hospital-based dental clinics;
230.30 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
230.31 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
230.32 	patients who are uninsured or covered by medical assistance, general assistance medical 
230.33 	care, or MinnesotaCare; and
230.34 	(5) a dental clinic owned and operated by the University of Minnesota or the 
230.35 	Minnesota State Colleges and Universities system.; and
231.1 	(6) private practicing dentists if:
231.2 	(i) the dentist's office is located within a health professional shortage area as defined 
231.3 	under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, 
231.4 	section 254E;
231.5 	(ii) more than 50 percent of the dentist's patient encounters per year are with patients 
231.6 	who are uninsured or covered by medical assistance or MinnesotaCare;
231.7 	(iii) the dentist does not restrict access or services because of a patient's financial 
231.8 	limitations or public assistance status; and
231.9 	(iv) the level of service provided by the dentist is critical to maintaining adequate 
231.10 	levels of patient access within the service area in which the dentist operates.
231.11 	(c) The commissioner may designate a dentist or dental clinic as a critical access 
231.12 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
231.13 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
231.14 	significantly increases access to dental care in the service area.
231.15 	(d) (c) A designated critical access clinic shall receive the reimbursement rate 
231.16 	specified in paragraph (a) for dental services provided off site at a private dental office if 
231.17 	the following requirements are met:
231.18 	(1) the designated critical access dental clinic is located within a health professional 
231.19 	shortage area as defined under Code of Federal Regulations, title 42, part 5, and United 
231.20 	States Code, title 42, section 254E, and is located outside the seven-county metropolitan 
231.21 	area;
231.22 	(2) the designated critical access dental clinic is not able to provide the service 
231.23 	and refers the patient to the off-site dentist;
231.24 	(3) the service, if provided at the critical access dental clinic, would be reimbursed 
231.25 	at the critical access reimbursement rate;
231.26 	(4) the dentist and allied dental professionals providing the services off site are 
231.27 	licensed and in good standing under chapter 150A;
231.28 	(5) the dentist providing the services is enrolled as a medical assistance provider;
231.29 	(6) the critical access dental clinic submits the claim for services provided off site 
231.30 	and receives the payment for the services; and
231.31 	(7) the critical access dental clinic maintains dental records for each claim submitted 
231.32 	under this paragraph, including the name of the dentist, the off-site location, and the 
231.33 	license number of the dentist and allied dental professionals providing the services.

231.34 	Sec. 22. Minnesota Statutes 2012, section 256B.76, is amended by adding a 
231.35 	subdivision to read:
232.1 		Subd. 7.Payment for certain primary care services and immunization 
232.2 	administration. Payment for certain primary care services and immunization 
232.3 	administration services rendered on or after January 1, 2013, through December 31, 2014, 
232.4 	shall be made in accordance with section 1902(a)(13) of the Social Security Act.

232.5 	Sec. 23. Minnesota Statutes 2012, section 256B.764, is amended to read:
232.6 	256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
232.7 	(a) Effective for services rendered on or after July 1, 2007, payment rates for family 
232.8 	planning services shall be increased by 25 percent over the rates in effect June 30, 2007, 
232.9 	when these services are provided by a community clinic as defined in section 145.9268, 
232.10 	subdivision 1.
232.11 	(b) Effective for services rendered on or after July 1, 2014, payment rates for 
232.12 	family planning services shall be increased by 20 percent over the rates in effect June 
232.13 	30, 2014, when these services are provided by a community clinic as defined in section 
232.14 	145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care 
232.15 	and county-based purchasing plans to reflect this increase, and shall require plans to pass 
232.16 	on the full amount of the rate increase to eligible community clinics, in the form of higher 
232.17 	payment rates for family planning services.

232.18 	Sec. 24. Minnesota Statutes 2012, section 256B.766, is amended to read:
232.19 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
232.20 	(a) Effective for services provided on or after July 1, 2009, total payments for basic 
232.21 	care services, shall be reduced by three percent, except that for the period July 1, 2009, 
232.22 	through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical 
232.23 	assistance and general assistance medical care programs, prior to third-party liability and 
232.24 	spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical 
232.25 	therapy services, occupational therapy services, and speech-language pathology and 
232.26 	related services as basic care services. The reduction in this paragraph shall apply to 
232.27 	physical therapy services, occupational therapy services, and speech-language pathology 
232.28 	and related services provided on or after July 1, 2010.
232.29 	(b) Payments made to managed care plans and county-based purchasing plans shall 
232.30 	be reduced for services provided on or after October 1, 2009, to reflect the reduction 
232.31 	effective July 1, 2009, and payments made to the plans shall be reduced effective October 
232.32 	1, 2010, to reflect the reduction effective July 1, 2010.
233.1 	(c) Effective for services provided on or after September 1, 2011, through June 30, 
233.2 	2013, total payments for outpatient hospital facility fees shall be reduced by five percent 
233.3 	from the rates in effect on August 31, 2011.
233.4 	(d) Effective for services provided on or after September 1, 2011, through June 
233.5 	30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies 
233.6 	and durable medical equipment not subject to a volume purchase contract, prosthetics 
233.7 	and orthotics, renal dialysis services, laboratory services, public health nursing services, 
233.8 	physical therapy services, occupational therapy services, speech therapy services, 
233.9 	eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume 
233.10 	purchase contract, and  anesthesia services, and hospice services shall be reduced by three 
233.11 	percent from the rates in effect on August 31, 2011.
233.12 	(e) Effective for services provided on or after January 1, 2015, payments for 
233.13 	ambulatory surgery centers facility fees, medical supplies and durable medical equipment 
233.14 	not subject to a volume purchase contract, prosthetics and orthotics, hospice services, 
233.15 	renal dialysis services, laboratory services, public health nursing services, eyeglasses 
233.16 	not subject to a volume purchase contract, and hearing aids not subject to a volume 
233.17 	purchase contract shall be increased by three percent. Payments made to managed care 
233.18 	plans and county-based purchasing plans shall not be adjusted to reflect payments under 
233.19 	this paragraph.
233.20 	(e) (f) This section does not apply to physician and professional services, inpatient 
233.21 	hospital services, family planning services, mental health services, dental services, 
233.22 	prescription drugs, medical transportation, federally qualified health centers, rural health 
233.23 	centers, Indian health services, and Medicare cost-sharing.

233.24 	Sec. 25. Laws 2012, chapter 247, article 1, section 28, is amended to read:
233.25 	Sec. 28. EMERGENCY MEDICAL ASSISTANCE STUDY.
 233.26 	(a) The commissioner of human services shall convene a work group to develop a 
233.27 	plan to provide coordinated and cost-effective health care and coverage for individuals 
233.28 	who meet eligibility standards for emergency medical assistance and who are ineligible 
233.29 	for other state public programs. The commissioner shall consult with work group shall 
233.30 	consist of representatives of  relevant stakeholders in the development of the plan, 
233.31 	including but not limited to safety net hospitals, nonprofit health care coverage programs, 
233.32 	nonprofit community clinics, and counties. The commissioner work group shall consider 
233.33 	the following elements:
233.34 	(1) strategies to provide individuals with the most appropriate care in the appropriate 
233.35 	setting, utilizing higher quality and lower cost providers;
234.1 	(2) payment mechanisms to encourage providers to manage the care of these 
234.2 	populations, and to produce lower cost of care and better patient outcomes;
234.3 	(3) ensure coverage and payment options that address the unique needs of those 
234.4 	needing episodic care, chronic care, and long-term care services;
234.5 	(4) strategies for coordinating health care and nonhealth care services, and 
234.6 	integrating with existing coverage; and
234.7 	(5) other issues and strategies to ensure cost-effective and coordinated delivery 
234.8 	of coverage and services.
234.9 	(b) The commissioner shall submit the plan of the work group to the chairs and 
234.10 	ranking minority members of the legislative committees with jurisdiction over health and 
234.11 	human services policy and financing by January 15 July 15, 2013.

234.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

234.13 	Sec. 26. Laws 2013, chapter 1, section 6, is amended to read:
234.14 	Sec. 6. TRANSFER.
 234.15 	(a) The commissioner of management and budget shall transfer from the health care 
234.16 	access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000 
234.17 	in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal 
234.18 	year 2017.
234.19 	(b) The commissioner of human services shall determine the difference between the 
234.20 	actual cost to the medical assistance program of adding 19 and 20 year olds and caretaker 
234.21 	populations with income between 100 and 138 percent of the federal poverty guidelines 
234.22 	and the cost of adding those populations that was estimated during the 2013 legislative 
234.23 	session based on the data from the February 2013 forecast.
234.24 	(c) For each fiscal year from 2014 to 2017, the commissioner of human services shall 
234.25 	certify and report to the commissioner of management and budget the actual cost difference 
234.26 	of adding 19 and 20 year olds and caretaker populations with income between 100 and 
234.27 	138 percent of the federal poverty guidelines, as determined under paragraph (b), by June 
234.28 	30 of each fiscal year. In each fiscal year, the commissioner of management and budget 
234.29 	shall reduce the transfer under paragraph (a) by the amount of the costs certified under 
234.30 	paragraph (b). If, for any fiscal year, the amount of the cost difference determined under 
234.31 	paragraph (b) exceeds the amount of the transfer, the transfer for that year must be zero.

234.32 	Sec. 27. 340B PROVIDER PRESCRIPTION DRUGS REIMBURSEMENT 
234.33 	STUDY.
 235.1 	(a) The commissioner of human services shall study and make recommendations on 
235.2 	changes to standardize the medical assistance reimbursement rates for prescription drugs 
235.3 	obtained through the federal 340B Program and dispensed to medical assistance enrollees. 
235.4 	The study must examine the current medical assistance rate 340B providers are receiving 
235.5 	through claims submissions and make recommendations on an overall reimbursement 
235.6 	discount that will pay the same for drugs dispensed through the 340B Program as is paid 
235.7 	for drugs dispensed by non340B providers, taking into consideration any federal rebate.
235.8 	(b) The commissioner shall consult with 340B providers that would be most 
235.9 	affected by a change in the reimbursement formula, including but not limited to safety net 
235.10 	hospitals, children's hospitals, community health centers, and family planning clinics.
235.11 	(c) The commissioner shall submit recommendations to the chairs and ranking 
235.12 	minority members of the legislative committees and divisions with jurisdiction over health 
235.13 	and human services policy and finance by January 15, 2014.

235.14 	Sec. 28. DENTAL ACCESS AND REIMBURSEMENT REPORT.
 235.15 		Subdivision 1.Study. (a) The commissioner of human services shall study the 
235.16 	current oral health and dental services delivery system for Minnesota public health 
235.17 	care programs to improve access and ensure cost-effective delivery of services. The 
235.18 	commissioner shall make recommendations on modifying the delivery of services and 
235.19 	reimbursement methods, including modifications to the critical access dental provider 
235.20 	payments under Minnesota Statutes, section 256B.76, subdivision 4.
235.21 	(b) The commissioner shall consult with dental providers enrolled in Minnesota 
235.22 	health care programs, including providers who serve substantial numbers of low-income 
235.23 	and uninsured patients and are currently receiving enhanced critical access dental provider 
235.24 	payments.
235.25 		Subd. 2.Service delivery and reimbursement methods. The recommendations 
235.26 	must address:
235.27 	(1) targeting state funding and critical access dental payments to improve access 
235.28 	to oral health services for individuals enrolled in Minnesota health care programs who 
235.29 	are not receiving timely and appropriate dental services;
235.30 	(2) encouraging the use of cost-effective service delivery methods, workforce 
235.31 	innovations, and the delivery of preventive services, including, but not limited to, dental 
235.32 	sealants that will reduce dental disease and future costs of treatment;
235.33 	(3) improving access in all geographic areas of the state;
235.34 	(4) encouraging the use of tele-dentistry and mobile dental equipment to serve 
235.35 	underserved patients and communities;
236.1 	(5) evaluating the use of a single administrator delivery model;
236.2 	(6) compensating providers for the added costs to providers of serving low-income 
236.3 	and underserved patients and populations who experience the greatest oral health 
236.4 	disparities in terms of incidence of oral health disease and access to and utilization of 
236.5 	needed oral health services;
236.6 	(7) encouraging coordination of oral health care with other health care services;
236.7 	(8) preventing overtreatment, fraud, and abuse; and
236.8 	(9) reducing administrative costs for the state and for dental providers.
236.9 		Subd. 3.Report. The commissioner shall submit a report on the recommendations to 
236.10 	the chairs and ranking minority members of the of the legislative committees and divisions 
236.11 	with jurisdiction over health and human services policy and finance by December 15, 2013.

236.12 	ARTICLE 7
236.13 	CONTINUING CARE

236.14 	Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:
236.15 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete 
236.16 	or submit an assessment for a RUG-III or RUG-IV classification within seven days of the 
236.17 	time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident. 
236.18 	The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on 
236.19 	the day of admission for new admission assessments or on the day that the assessment 
236.20 	was due for all other assessments and continues in effect until the first day of the month 
236.21 	following the date of submission of the resident's assessment.
236.22 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
236.23 	are equal to or greater than 1.0 percent of the total operating costs on the facility's most 
236.24 	recent annual statistical and cost report, a facility may apply to the commissioner of 
236.25 	human services for a reduction in the total penalty amount. The commissioner of human 
236.26 	services, in consultation with the commissioner of health, may, at the sole discretion of 
236.27 	the commissioner of human services, limit the penalty for residents covered by medical 
236.28 	assistance to 15 days.

236.29 	Sec. 2. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
236.30 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
236.31 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
236.32 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
236.33 	9555.6265, under this chapter for a physical location that will not be the primary residence 
236.34 	of the license holder for the entire period of licensure. If a license is issued during this 
237.1 	moratorium, and the license holder changes the license holder's primary residence away 
237.2 	from the physical location of the foster care license, the commissioner shall revoke the 
237.3 	license according to section 245A.07. Exceptions to the moratorium include:
237.4 	(1) foster care settings that are required to be registered under chapter 144D;
237.5 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 
237.6 	and determined to be needed by the commissioner under paragraph (b);
237.7 	(3) new foster care licenses determined to be needed by the commissioner under 
237.8 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, 
237.9 	or; restructuring of state-operated services that limits the capacity of state-operated 
237.10 	facilities;or allowing movement to the community for people who no longer require the 
237.11 	level of care provided in state-operated facilities as provided under section 256B.092, 
237.12 	subdivision 13, or 256B.49, subdivision 24;
237.13 	(4) new foster care licenses determined to be needed by the commissioner under 
237.14 	paragraph (b) for persons requiring hospital level care; or
237.15 	(5) new foster care licenses determined to be needed by the commissioner for the 
237.16 	transition of people from personal care assistance to the home and community-based 
237.17 	services.
237.18 	(b) The commissioner shall determine the need for newly licensed foster care homes 
237.19 	as defined under this subdivision. As part of the determination, the commissioner shall 
237.20 	consider the availability of foster care capacity in the area in which the licensee seeks to 
237.21 	operate, and the recommendation of the local county board. The determination by the 
237.22 	commissioner must be final. A determination of need is not required for a change in 
237.23 	ownership at the same address.
237.24 	(c) The commissioner shall study the effects of the license moratorium under this 
237.25 	subdivision and shall report back to the legislature by January 15, 2011. This study shall 
237.26 	include, but is not limited to the following:
237.27 	(1) the overall capacity and utilization of foster care beds where the physical location 
237.28 	is not the primary residence of the license holder prior to and after implementation 
237.29 	of the moratorium;
237.30 	(2) the overall capacity and utilization of foster care beds where the physical 
237.31 	location is the primary residence of the license holder prior to and after implementation 
237.32 	of the moratorium; and
237.33 	(3) the number of licensed and occupied ICF/MR beds prior to and after 
237.34 	implementation of the moratorium.
237.35 	(d) (c) When a foster care recipient moves out of a foster home that is not the primary 
237.36 	residence of the license holder according to section 256B.49, subdivision 15, paragraph 
238.1 	(f), the county shall immediately inform the Department of Human Services Licensing 
238.2 	Division. The department shall decrease the statewide licensed capacity for foster care 
238.3 	settings where the physical location is not the primary residence of the license holder, if 
238.4 	the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings 
238.5 	required by reductions in licensed bed capacity under Laws 2011, First Special Session 
238.6 	chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term 
238.7 	care residential services capacity within budgetary limits. Implementation of the statewide 
238.8 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
238.9 	up to 128 beds by June 30, 2014, using the needs determination process. Under this 
238.10 	paragraph, the commissioner has the authority to reduce unused licensed capacity of a 
238.11 	current foster care program to accomplish the consolidation or closure of settings. Under 
238.12 	this paragraph, the commissioner has the authority to manage statewide capacity, including 
238.13 	adjusting the capacity available to each county and adjusting statewide available capacity, 
238.14 	to meet the statewide needs identified through the process in paragraph (e). A decreased 
238.15 	licensed capacity according to this paragraph is not subject to appeal under this chapter.
238.16 	(e) (d) Residential settings that would otherwise be subject to the decreased license 
238.17 	capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
238.18 	(1) until August 1, 2013, the license holder's beds occupied by residents whose 
238.19 	primary diagnosis is mental illness and the license holder is:
238.20 	(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 
238.21 	health services (ARMHS) as defined in section 256B.0623;
238.22 	(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 
238.23 	9520.0870;
238.24 	(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 
238.25 	9520.0870; or
238.26 	(iv) a provider of intensive residential treatment services (IRTS) licensed under 
238.27 	Minnesota Rules, parts 9520.0500 to 9520.0670; or
238.28 	(2) the license holder's beds occupied by residents whose primary diagnosis is 
238.29 	mental illness and the license holder is certified under the requirements in subdivision 6a.
238.30 	(f) (e) A resource need determination process, managed at the state level, using the 
238.31 	available reports required by section 144A.351, and other data and information shall 
238.32 	be used to determine where the reduced capacity required under paragraph (d) (c) will 
238.33 	be implemented. The commissioner shall consult with the stakeholders described in 
238.34 	section 144A.351, and employ a variety of methods to improve the state's capacity to 
238.35 	meet long-term care service needs within budgetary limits, including seeking proposals 
238.36 	from service providers or lead agencies to change service type, capacity, or location to 
239.1 	improve services, increase the independence of residents, and better meet needs identified 
239.2 	by the long-term care services reports and statewide data and information. By February 
239.3 	1 of each, 2013, and August 1, 2014, and each following year, the commissioner shall 
239.4 	provide information and data on the overall capacity of licensed long-term care services, 
239.5 	actions taken under this subdivision to manage statewide long-term care services and 
239.6 	supports resources, and any recommendations for change to the legislative committees 
239.7 	with jurisdiction over health and human services budget.
239.8 	(g) (f) At the time of application and reapplication for licensure, the applicant and the 
239.9 	license holder that are subject to the moratorium or an exclusion established in paragraph 
239.10 	(a) are required to inform the commissioner whether the physical location where the foster 
239.11 	care will be provided is or will be the primary residence of the license holder for the entire 
239.12 	period of licensure. If the primary residence of the applicant or license holder changes, the 
239.13 	applicant or license holder must notify the commissioner immediately. The commissioner 
239.14 	shall print on the foster care license certificate whether or not the physical location is the 
239.15 	primary residence of the license holder.
239.16 	(h) (g) License holders of foster care homes identified under paragraph (g) (f) that 
239.17 	are not the primary residence of the license holder and that also provide services in the 
239.18 	foster care home that are covered by a federally approved home and community-based 
239.19 	services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must 
239.20 	inform the human services licensing division that the license holder provides or intends to 
239.21 	provide these waiver-funded services. These license holders must be considered registered 
239.22 	under section 256B.092, subdivision 11, paragraph (c), and this registration status must 
239.23 	be identified on their license certificates.

239.24 	Sec. 3. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision 
239.25 	to read:
239.26 		Subd. 2b. Nicollet County facility project. The commissioner of health shall 
239.27 	certify one additional bed in an intermediate care facility for persons with developmental 
239.28 	disabilities in Nicollet County.

239.29 	Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to 
239.30 	read:
239.31 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
239.32 	shall be the lower of the actual acquisition costs of the drugs or the maximum allowable 
239.33 	cost by the commissioner plus the fixed dispensing fee; or the usual and customary price 
239.34 	charged to the public. The amount of payment basis must be reduced to reflect all discount 
240.1 	amounts applied to the charge by any provider/insurer agreement or contract for submitted 
240.2 	charges to medical assistance programs. The net submitted charge may not be greater 
240.3 	than the patient liability for the service. The pharmacy dispensing fee shall be $3.65, 
240.4 	except that the dispensing fee for intravenous solutions which must be compounded by the 
240.5 	pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 
240.6 	per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per 
240.7 	bag for total parenteral nutritional products dispensed in quantities greater than one liter. 
240.8 	Actual acquisition cost includes quantity and other special discounts except time and cash 
240.9 	discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at 
240.10 	wholesale acquisition cost plus four percent for independently owned pharmacies located 
240.11 	in a designated rural area within Minnesota, and at wholesale acquisition cost plus two 
240.12 	percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four 
240.13 	or fewer pharmacies under the same ownership nationally. A "designated rural area" means 
240.14 	an area defined as a small rural area or isolated rural area according to the four-category 
240.15 	classification of the Rural Urban Commuting Area system developed for the United States 
240.16 	Health Resources and Services Administration. Wholesale acquisition cost is defined as the 
240.17 	manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the 
240.18 	United States, not including prompt pay or other discounts, rebates, or reductions in price, 
240.19 	for the most recent month for which information is available, as reported in wholesale price 
240.20 	guides or other publications of drug or biological pricing data. The maximum allowable 
240.21 	cost of a multisource drug may be set by the commissioner and it shall be comparable to, 
240.22 	but no higher than, the maximum amount paid by other third-party payors in this state who 
240.23 	have maximum allowable cost programs. Establishment of the amount of payment for 
240.24 	drugs shall not be subject to the requirements of the Administrative Procedure Act.
240.25 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
240.26 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
240.27 	facilities when a unit dose blister card system, approved by the department, is used. Under 
240.28 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The 
240.29 	National Drug Code (NDC) from the drug container used to fill the blister card must be 
240.30 	identified on the claim to the department. The unit dose blister card containing the drug 
240.31 	must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that 
240.32 	govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will 
240.33 	be required to credit the department for the actual acquisition cost of all unused drugs that 
240.34 	are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in 
240.35 	a quantity that is less than a 30-day supply.
241.1 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
241.2 	payment shall be the lower of the usual and customary price charged to the public or the 
241.3 	maximum allowable cost established by the commissioner unless prior authorization 
241.4 	for the brand name product has been granted according to the criteria established by 
241.5 	the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the 
241.6 	prescriber has indicated "dispense as written" on the prescription in a manner consistent 
241.7 	with section 151.21, subdivision 2.
241.8 	(d) The basis for determining the amount of payment for drugs administered in an 
241.9 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
241.10 	provider or, 106 percent of the average sales price as determined by the United States 
241.11 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
241.12 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
241.13 	set by the commissioner. If average sales price is unavailable, the amount of payment 
241.14 	must be lower of the usual and customary cost submitted by the provider or, the wholesale 
241.15 	acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the 
241.16 	commissioner. The payment for drugs administered in an outpatient setting shall be made 
241.17 	to the administering facility or practitioner. A retail or specialty pharmacy dispensing a 
241.18 	drug for administration in an outpatient setting is not eligible for direct reimbursement.
241.19 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
241.20 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
241.21 	require individuals enrolled in the health care programs administered by the department 
241.22 	to obtain specialty pharmacy products from providers with whom the commissioner has 
241.23 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
241.24 	used by a small number of recipients or recipients with complex and chronic diseases 
241.25 	that require expensive and challenging drug regimens. Examples of these conditions 
241.26 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
241.27 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
241.28 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
241.29 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
241.30 	that require complex care. The commissioner shall consult with the formulary committee 
241.31 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
241.32 	with the formulary committee in developing this list, the commissioner shall take into 
241.33 	consideration the population served by specialty pharmacy products, the current delivery 
241.34 	system and standard of care in the state, and access to care issues. The commissioner shall 
241.35 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
242.1 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
242.2 	must be paid at rates according to subdivision 8d.

242.3 	EFFECTIVE DATE. This section is effective January 1, 2014.

242.4 	Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:
242.5 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
242.6 	waivered services to an individual elderly waiver client except for individuals described in 
242.7 	paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility 
242.8 	rate of the case mix resident class to which the elderly waiver client would be assigned 
242.9 	under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance 
242.10 	needs allowance as described in subdivision 1d, paragraph (a), until the first day of the 
242.11 	state fiscal year in which the resident assessment system as described in section 256B.438
242.12 	for nursing home rate determination is implemented. Effective on the first day of the state 
242.13 	fiscal year in which the resident assessment system as described in section 256B.438 for 
242.14 	nursing home rate determination is implemented and the first day of each subsequent state 
242.15 	fiscal year, the monthly limit for the cost of waivered services to an individual elderly 
242.16 	waiver client shall be the rate of the case mix resident class to which the waiver client 
242.17 	would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on 
242.18 	the last day of the previous state fiscal year, adjusted by any legislatively adopted home 
242.19 	and community-based services percentage rate adjustment.
242.20 	(b) The monthly limit for the cost of waivered services to an individual elderly 
242.21 	waiver client assigned to a case mix classification A under paragraph (a) with:
242.22 	(1) no dependencies in activities of daily living; or
242.23 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating 
242.24 	when the dependency score in eating is three or greater as determined by an assessment 
242.25 	performed under section 256B.0911
242.26 	shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in 
242.27 	the program on or after July 1, 2011. This monthly limit shall be applied to all other 
242.28 	participants who meet this criteria at reassessment. This monthly limit shall be increased 
242.29 	annually as described in paragraph (a).
242.30 	(c) If extended medical supplies and equipment or environmental modifications are 
242.31 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
242.32 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
242.33 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
242.34 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
243.1 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
243.2 	services as described in paragraph (a) or (b).
243.3 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including 
243.4 	any necessary home care services described in section 256B.0651, subdivision 2, for 
243.5 	individuals who meet the criteria as ventilator-dependent given in section 256B.0651, 
243.6 	subdivision 1, paragraph (g), shall be the average of the monthly medical assistance 
243.7 	amount established for home care services as described in section 256B.0652, subdivision 
243.8 	7, and the annual average contracted amount established by the commissioner for nursing 
243.9 	facility services for ventilator-dependent individuals. This monthly limit shall be increased 
243.10 	annually as described in paragraph (a).

243.11 	Sec. 6. Minnesota Statutes 2012, section 256B.0915, is amended by adding a 
243.12 	subdivision to read:
243.13 		Subd. 3j.Individual community living support. Upon federal approval, there 
243.14 	is established a new service called individual community living support (ICLS) that is 
243.15 	available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor 
243.16 	have any interest in the recipient's housing. ICLS must be delivered in a single-family 
243.17 	home or apartment where the service recipient or their family owns or rents, as 
243.18 	demonstrated by a lease agreement, and maintains control over the individual unit. Case 
243.19 	managers or care coordinators must develop individual ICLS plans in consultation with 
243.20 	the client using a tool developed by the commissioner. The commissioner shall establish 
243.21 	payment rates and mechanisms to align payments with the type and amount of service 
243.22 	provided, assure statewide uniformity for payment rates, and assure cost-effectiveness. 
243.23 	Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and 
243.24 	Human Services to avoid conflict with provider regulatory standards pursuant to section 
243.25 	144A.43 and chapter 245D. 

243.26 	Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a 
243.27 	subdivision to read:
243.28 		Subd. 11.Excess spending. County and tribal agencies are responsible for spending 
243.29 	in excess of the allocation made by the commissioner. In the event a county or tribal 
243.30 	agency spends in excess of the allocation made by the commissioner for a given allocation 
243.31 	period, they must submit a corrective action plan to the commissioner. The plan must state 
243.32 	the actions the agency will take to correct their overspending for the year following the 
243.33 	period when the overspending occurred. Failure to correct overspending shall result in 
243.34 	recoupment of spending in excess of the allocation. Nothing in this subdivision shall be 
244.1 	construed as reducing the county's responsibility to offer and make available feasible 
244.2 	home and community-based options to eligible waiver recipients within the resources 
244.3 	allocated to them for that purpose.

244.4 	Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
244.5 		Subd. 11.Residential support services. (a) Upon federal approval, there is 
244.6 	established a new service called residential support that is available on the community 
244.7 	alternative care, community alternatives for disabled individuals, developmental 
244.8 	disabilities, and brain injury waivers. Existing waiver service descriptions must be 
244.9 	modified to the extent necessary to ensure there is no duplication between other services. 
244.10 	Residential support services must be provided by vendors licensed as a community 
244.11 	residential setting as defined in section 245A.11, subdivision 8.
244.12 	(b) Residential support services must meet the following criteria:
244.13 	(1) providers of residential support services must own or control the residential site;
244.14 	(2) the residential site must not be the primary residence of the license holder;
244.15 	(3) the residential site must have a designated program supervisor responsible for 
244.16 	program oversight, development, and implementation of policies and procedures;
244.17 	(4) the provider of residential support services must provide supervision, training, 
244.18 	and assistance as described in the person's coordinated service and support plan; and
244.19 	(5) the provider of residential support services must meet the requirements of 
244.20 	licensure and additional requirements of the person's coordinated service and support plan.
244.21 	(c) Providers of residential support services that meet the definition in paragraph 
244.22 	(a) must be registered using a process determined by the commissioner beginning July 
244.23 	1, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts 
244.24 	2960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts 
244.25 	9555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision 
244.26 	7, paragraph (g) (f), are considered registered under this section.

244.27 	Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
244.28 		Subd. 12.Waivered services statewide priorities. (a) The commissioner shall 
244.29 	establish statewide priorities for individuals on the waiting list for developmental 
244.30 	disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must 
244.31 	include, but are not limited to, individuals who continue to have a need for waiver services 
244.32 	after they have maximized the use of state plan services and other funding resources, 
244.33 	including natural supports, prior to accessing waiver services, and who meet at least one 
244.34 	of the following criteria:
245.1 	(1) no longer require the intensity of services provided where they are currently 
245.2 	living; or
245.3 	(2) make a request to move from an institutional setting.
245.4 	(b) After the priorities in paragraph (a) are met, priority must also be given to 
245.5 	individuals who meet at least one of the following criteria:
245.6 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
245.7 	the primary caregivers;
245.8 	(2) are moving from an institution due to bed closures;
245.9 	(3) experience a sudden closure of their current living arrangement;
245.10 	(4) require protection from confirmed abuse, neglect, or exploitation;
245.11 	(5) experience a sudden change in need that can no longer be met through state plan 
245.12 	services or other funding resources alone; or
245.13 	(6) meet other priorities established by the department.
245.14 	(b) (c) When allocating resources to lead agencies, the commissioner must take into 
245.15 	consideration the number of individuals waiting who meet statewide priorities and the 
245.16 	lead agencies' current use of waiver funds and existing service options. The commissioner 
245.17 	has the authority to transfer funds between counties, groups of counties, and tribes to 
245.18 	accommodate statewide priorities and resource needs while accounting for a necessary 
245.19 	base level reserve amount for each county, group of counties, and tribe.
245.20 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
245.21 	provide recommendations to the legislature on whether to continue the use of statewide 
245.22 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
245.23 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

245.24 	Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a 
245.25 	subdivision to read:
245.26 		Subd. 14.Reduce avoidable behavioral crisis emergency room admissions, 
245.27 	psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons 
245.28 	receiving home and community-based services authorized under this section who have 
245.29 	had two or more admissions within a calendar year to an emergency room, psychiatric 
245.30 	unit, or institution must receive consultation from a mental health professional as defined 
245.31 	in section 245.462, subdivision 18, or a behavioral professional as defined in the home 
245.32 	and community-based services state plan within 30 days of discharge. The mental health 
245.33 	professional or behavioral professional must:
245.34 	(1) conduct a functional assessment of the crisis incident as defined in section 
245.35 	245D.02, subdivision 11, which led to the hospitalization with the goal of developing 
246.1 	proactive strategies as well as necessary reactive strategies to reduce the likelihood of 
246.2 	future avoidable hospitalizations due to a behavioral crisis;
246.3 	(2) use the results of the functional assessment to amend the coordinated service and 
246.4 	support plan set forth in section 245D.02, subdivision 4b, to address the potential need 
246.5 	for additional staff training, increased staffing, access to crisis mobility services, mental 
246.6 	health services, use of technology, and crisis stabilization services in section 256B.0624, 
246.7 	subdivision 7; and 
246.8 	(3) identify the need for additional consultation, testing, and mental health crisis 
246.9 	intervention team services as defined in section 245D.02, subdivision 20, psychotropic 
246.10 	medication use and monitoring under section 245D.051, and the frequency and duration 
246.11 	of ongoing consultation. 
246.12 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, 
246.13 	the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

246.14 	Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:
246.15 	256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
246.16 	(a) Effective July 1, 1998, a quality assurance system for persons with developmental 
246.17 	disabilities, which includes an alternative quality assurance licensing system for programs, 
246.18 	is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, 
246.19 	Steele, Wabasha, and Winona Counties for the purpose of improving the quality of 
246.20 	services provided to persons with developmental disabilities. A county, at its option, may 
246.21 	choose to have all programs for persons with developmental disabilities located within 
246.22 	the county licensed under chapter 245A using standards determined under the alternative 
246.23 	quality assurance licensing system or may continue regulation of these programs under the 
246.24 	licensing system operated by the commissioner. The project expires on June 30, 2014.
246.25 	(b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to 
246.26 	participate in the quality assurance system established under paragraph (a). The 
246.27 	commission established under section 256B.0951 may, at its option, allow additional 
246.28 	counties to participate in the system.
246.29 	(c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) 
246.30 	may establish a quality assurance system under this section. A new system established 
246.31 	under this section shall have the same rights and duties as the system established 
246.32 	under paragraph (a). A new system shall be governed by a commission under section 
246.33 	256B.0951. The commissioner shall appoint the initial commission members based 
246.34 	on recommendations from advocates, families, service providers, and counties in the 
246.35 	geographic area included in the new system. Counties that choose to participate in a 
247.1 	new system shall have the duties assigned under section 256B.0952. The new system 
247.2 	shall establish a quality assurance process under section 256B.0953. The provisions of 
247.3 	section 256B.0954 shall apply to a new system established under this paragraph. The 
247.4 	commissioner shall delegate authority to a new system established under this paragraph 
247.5 	according to section 256B.0955.
247.6 	(d) Effective July 1, 2007, the quality assurance system may be expanded to include 
247.7 	programs for persons with disabilities and older adults.
247.8 	(e) Effective July 1, 2013, a provider of service located in a county listed in 
247.9 	paragraph (a) that is a non-opted-in county may opt in to the quality assurance system 
247.10 	provided the county where services are provided indicates its agreement with a county 
247.11 	with a delegation agreement with the Department of Human Services.

247.12 	EFFECTIVE DATE. This section is effective July 1, 2013.

247.13 	Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
247.14 		Subdivision 1.Membership. The Quality Assurance Commission is established. 
247.15 	The commission consists of at least 14 but not more than 21 members as follows: at 
247.16 	least three but not more than five members representing advocacy organizations; at 
247.17 	least three but not more than five members representing consumers, families, and their 
247.18 	legal representatives; at least three but not more than five members representing service 
247.19 	providers; at least three but not more than five members representing counties; and the 
247.20 	commissioner of human services or the commissioner's designee. The first commission 
247.21 	shall establish membership guidelines for the transition and recruitment of membership for 
247.22 	the commission's ongoing existence. Members of the commission who do not receive a 
247.23 	salary or wages from an employer for time spent on commission duties may receive a per 
247.24 	diem payment when performing commission duties and functions. All members may be 
247.25 	reimbursed for expenses related to commission activities. Notwithstanding the provisions 
247.26 	of section 15.059, subdivision 5, the commission expires on June 30, 2014.

247.27 	Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
247.28 		Subd. 4.Commission's authority to recommend variances of licensing 
247.29 	standards. The commission may recommend to the commissioners of human services 
247.30 	and health variances from the standards governing licensure of programs for persons with 
247.31 	developmental disabilities in order to improve the quality of services by implementing 
247.32 	an alternative developmental disabilities licensing system if the commission determines 
247.33 	that the alternative licensing system does not adversely affect the health or safety of 
248.1 	persons being served by the licensed program nor compromise the qualifications of staff 
248.2 	to provide services.

248.3 	Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
248.4 		Subdivision 1.Notification. Counties or providers shall give notice to the 
248.5 	commission and commissioners of human services and health of intent to join the 
248.6 	alternative quality assurance licensing system. A county or provider choosing to participate 
248.7 	in the alternative quality assurance licensing system commits to participate for three years.

248.8 	Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
248.9 		Subd. 5.Quality assurance teams. Quality assurance teams shall be comprised 
248.10 	of county staff; providers; consumers, families, and their legal representatives; members 
248.11 	of advocacy organizations; and other involved community members. Team members 
248.12 	must satisfactorily complete the training program approved by the commission and must 
248.13 	demonstrate performance-based competency. Team members are not considered to be 
248.14 	county employees for purposes of workers' compensation, unemployment insurance, or 
248.15 	state retirement laws solely on the basis of participation on a quality assurance team. The 
248.16 	county may pay A per diem may be paid to team members for time spent on alternative 
248.17 	quality assurance process matters. All team members may be reimbursed for expenses 
248.18 	related to their participation in the alternative process.

248.19 	Sec. 16. Minnesota Statutes 2012, section 256B.0955, is amended to read:
248.20 	256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
248.21 	(a) Effective July 1, 1998, the commissioner of human services shall delegate 
248.22 	authority to perform licensing functions and activities, in accordance with section 
248.23 	245A.16, to counties participating in the alternative quality assurance licensing system. 
248.24 	The commissioner shall not license or reimburse a facility, program, or service for persons 
248.25 	with developmental disabilities in a county that participates in the alternative quality 
248.26 	assurance licensing system if the commissioner has received from the appropriate county 
248.27 	notification that the facility, program, or service has been reviewed by a quality assurance 
248.28 	team and has failed to qualify for licensure.
248.29 	(b) The commissioner may conduct random licensing inspections based on outcomes 
248.30 	adopted under section 256B.0951 at facilities, programs, and services governed by the 
248.31 	alternative quality assurance licensing system. The role of such random inspections shall 
248.32 	be to verify that the alternative quality assurance licensing system protects the safety 
249.1 	and well-being of consumers and maintains the availability of high-quality services for 
249.2 	persons with developmental disabilities.

249.3 	EFFECTIVE DATE. This section is effective July 1, 2013.

249.4 	Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
249.5 		Subdivision 1.Scope. (a) In order to improve the quality of services provided to 
249.6 	Minnesotans with disabilities and to meet the requirements of the federally approved home 
249.7 	and community-based waivers under section 1915c of the Social Security Act, a State 
249.8 	Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving 
249.9 	disability services is enacted. This system is a partnership between the Department of 
249.10 	Human Services and the State Quality Council established under subdivision 3.
249.11 	(b) This system is a result of the recommendations from the Department of Human 
249.12 	Services' licensing and alternative quality assurance study mandated under Laws 2005, 
249.13 	First Special Session chapter 4, article 7, section 57, and presented to the legislature 
249.14 	in February 2007.
249.15 	(c) The disability services eligible under this section include:
249.16 	(1) the home and community-based services waiver programs for persons with 
249.17 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
249.18 	including brain injuries and services for those who qualify for nursing facility level of care 
249.19 	or hospital facility level of care and any other services licensed under chapter 245D;
249.20 	(2) home care services under section 256B.0651;
249.21 	(3) family support grants under section 252.32;
249.22 	(4) consumer support grants under section 256.476;
249.23 	(5) semi-independent living services under section 252.275; and
249.24 	(6) services provided through an intermediate care facility for the developmentally 
249.25 	disabled.
249.26 	(d) For purposes of this section, the following definitions apply:
249.27 	(1) "commissioner" means the commissioner of human services;
249.28 	(2) "council" means the State Quality Council under subdivision 3;
249.29 	(3) "Quality Assurance Commission" means the commission under section 
249.30 	256B.0951; and
249.31 	(4) "system" means the State Quality Assurance, Quality Improvement and 
249.32 	Licensing System under this section.

249.33 	Sec. 18. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
250.1 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
250.2 	Council which must define regional quality councils, and carry out a community-based, 
250.3 	person-directed quality review component, and a comprehensive system for effective 
250.4 	incident reporting, investigation, analysis, and follow-up.
250.5 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
250.6 	members of the initial State Quality Council. Members shall include representatives 
250.7 	from the following groups:
250.8 	(1) disability service recipients and their family members;
250.9 	(2) during the first two four years of the State Quality Council, there must be at least 
250.10 	three members from the Region 10 stakeholders. As regional quality councils are formed 
250.11 	under subdivision 4, each regional quality council shall appoint one member;
250.12 	(3) disability service providers;
250.13 	(4) disability advocacy groups; and
250.14 	(5) county human services agencies and staff from the Department of Human 
250.15 	Services and Ombudsman for Mental Health and Developmental Disabilities.
250.16 	(c) Members of the council who do not receive a salary or wages from an employer 
250.17 	for time spent on council duties may receive a per diem payment when performing council 
250.18 	duties and functions.
250.19 	(d) The State Quality Council shall:
250.20 	(1) assist the Department of Human Services in fulfilling federally mandated 
250.21 	obligations by monitoring disability service quality and quality assurance and 
250.22 	improvement practices in Minnesota;
250.23 	(2) establish state quality improvement priorities with methods for achieving results 
250.24 	and provide an annual report to the legislative committees with jurisdiction over policy 
250.25 	and funding of disability services on the outcomes, improvement priorities, and activities 
250.26 	undertaken by the commission during the previous state fiscal year;
250.27 	(3) identify issues pertaining to financial and personal risk that impede Minnesotans 
250.28 	with disabilities from optimizing choice of community-based services; and
250.29 	(4) recommend to the chairs and ranking minority members of the legislative 
250.30 	committees with jurisdiction over human services and civil law by January 15, 2013
250.31 	 2014, statutory and rule changes related to the findings under clause (3) that promote 
250.32 	individualized service and housing choices balanced with appropriate individualized 
250.33 	protection.
250.34 	(e) The State Quality Council, in partnership with the commissioner, shall:
250.35 	(1) approve and direct implementation of the community-based, person-directed 
250.36 	system established in this section;
251.1 	(2) recommend an appropriate method of funding this system, and determine the 
251.2 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
251.3 	(3) approve measurable outcomes in the areas of health and safety, consumer 
251.4 	evaluation, education and training, providers, and systems;
251.5 	(4) establish variable licensure periods not to exceed three years based on outcomes 
251.6 	achieved; and
251.7 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
251.8 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
251.9 	(f) The State Quality Council shall notify the commissioner of human services that a 
251.10 	facility, program, or service has been reviewed by quality assurance team members under 
251.11 	subdivision 4, paragraph (b), clause (13), and qualifies for a license.
251.12 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
251.13 	an ongoing review process for the system. The review shall take into account the 
251.14 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
251.15 	licensed and unlicensed entities that provide services to persons with disabilities. The 
251.16 	review shall address efficiencies and effectiveness of the system.
251.17 	(h) The State Quality Council may recommend to the commissioner certain 
251.18 	variances from the standards governing licensure of programs for persons with disabilities 
251.19 	in order to improve the quality of services so long as the recommended variances do 
251.20 	not adversely affect the health or safety of persons being served or compromise the 
251.21 	qualifications of staff to provide services.
251.22 	(i) The safety standards, rights, or procedural protections referenced under 
251.23 	subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 
251.24 	recommendations to the commissioner or to the legislature in the report required under 
251.25 	paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 
251.26 	procedural protections referenced under subdivision 2, paragraph (c).
251.27 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
251.28 	subdivision.

251.29 	Sec. 19. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
251.30 		Subd. 44.Property rate increase increases for a facility in Bloomington effective 
251.31 	November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the 
251.32 	contrary, money available for moratorium projects under section 144A.073, subdivision 
251.33 	11, shall be used, effective November 1, 2010, to fund an approved moratorium exception 
251.34 	project for a nursing facility in Bloomington licensed for 137 beds as of November 1, 
251.35 	2010, up to a total property rate adjustment of $19.33.
252.1 	(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110 
252.2 	beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow 
252.3 	$1,129,463 of a completed construction project to increase the property payment rate. 
252.4 	Notwithstanding any other law to the contrary, money available under section 144A.073, 
252.5 	subdivision 11, after the completion of the moratorium exception approval process in 2013 
252.6 	under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the 
252.7 	medical assistance budget for the increase in the replacement-cost-new limit.
252.8 	(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for 
252.9 	61 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to 
252.10 	allow $1,407,624 of a completed construction project to increase their property payment 
252.11 	rate. Effective September 1, 2013, or later, their replacement-cost-new limit under 
252.12 	subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project 
252.13 	to increase the property payment rate. Notwithstanding any other law to the contrary, 
252.14 	money available under section 144A.073, subdivision 11, after the completion of the 
252.15 	moratorium exception approval process in 2013 under section 144A.073, subdivision 3, 
252.16 	shall be used to reduce the fiscal impact to the medical assistance budget for the increase 
252.17 	in the replacement-cost-new limit.

252.18 	EFFECTIVE DATE. Paragraph (b) is effective retroactively from June 1, 2012. 
252.19 	Paragraph (c) is effective retroactively from July 1, 2012.

252.20 	Sec. 20. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
252.21 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
252.22 	have their payment rates determined under this section rather than section 256B.431, the 
252.23 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
252.24 	into a written contract with the commissioner.
252.25 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
252.26 	contract under this section is the payment rate the facility would have received under 
252.27 	section 256B.431.
252.28 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
252.29 	of a facility's contract under this section are the previous rate year's contract payment 
252.30 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
252.31 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
252.32 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
252.33 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
252.34 	(United States City average) (CPI-U) forecasted by the commissioner of management and 
252.35 	budget's national economic consultant, as forecasted in the fourth quarter of the calendar 
253.1 	year preceding the rate year. The inflation adjustment must be based on the 12-month 
253.2 	period from the midpoint of the previous rate year to the midpoint of the rate year for 
253.3 	which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 
253.4 	2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, 
253.5 	July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall 
253.6 	apply only to the property-related payment rate. For the rate years beginning on October 
253.7 	1, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and 
253.8 	October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning 
253.9 	in 2005, adjustment to the property payment rate under this section and section 256B.431
253.10 	shall be effective on October 1. In determining the amount of the property-related payment 
253.11 	rate adjustment under this paragraph, the commissioner shall determine the proportion of 
253.12 	the facility's rates that are property-related based on the facility's most recent cost report.
253.13 	(d) The commissioner shall develop additional incentive-based payments of up to 
253.14 	five percent above a facility's operating payment rate for achieving outcomes specified 
253.15 	in a contract. The commissioner may solicit contract amendments and implement those 
253.16 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
253.17 	shall limit the amount of any incentive payment and the number of contract amendments 
253.18 	under this paragraph to operate the incentive payments within funds appropriated for this 
253.19 	purpose. The contract amendments may specify various levels of payment for various 
253.20 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
253.21 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
253.22 	the specified outcomes and related criteria, the commissioner shall consider the following 
253.23 	state policy objectives:
253.24 	(1) successful diversion or discharge of residents to the residents' prior home or other 
253.25 	community-based alternatives;
253.26 	(2) adoption of new technology to improve quality or efficiency;
253.27 	(3) improved quality as measured in the Nursing Home Report Card;
253.28 	(4) reduced acute care costs; and
253.29 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
253.30 	finds desirable.
253.31 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
253.32 	take action to come into compliance with existing or pending requirements of the life 
253.33 	safety code provisions or federal regulations governing sprinkler systems must receive 
253.34 	reimbursement for the costs associated with compliance if all of the following conditions 
253.35 	are met:
254.1 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
254.2 	and before December 31, 2008;
254.3 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
254.4 	144A.071 or 144A.073; and
254.5 	(3) the total allowable costs reported under this paragraph are less than the minimum 
254.6 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
254.7 	subdivision 16.
254.8 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
254.9 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
254.10 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
254.11 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
254.12 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
254.13 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
254.14 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
254.15 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
254.16 	costs of the project divided by the resident days reported for the report year ending 
254.17 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
254.18 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the 
254.19 	qualifying facilities by reducing the rate adjustment determined for each facility by an 
254.20 	equal percentage. Facilities that used estimated costs when requesting the rate adjustment 
254.21 	shall report to the commissioner by January 31, 2009, on the use of this money on a 
254.22 	form provided by the commissioner. If the nursing facility fails to provide the report, the 
254.23 	commissioner shall recoup the money paid to the facility for this purpose. If the facility 
254.24 	reports expenditures allowable under this subdivision that are less than the amount received 
254.25 	in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

254.26 	Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
254.27 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
254.28 	services shall calculate the amount of the planned closure rate adjustment available under 
254.29 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
254.30 	(1) the amount available is the net reduction of nursing facility beds multiplied 
254.31 	by $2,080;
254.32 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
254.33 	closure rate adjustment must be identified;
254.34 	(3) capacity days are determined by multiplying the number determined under 
254.35 	clause (2) by 365; and
255.1 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
255.2 	by capacity days determined under clause (3).
255.3 	(b) A planned closure rate adjustment under this section is effective on the first day 
255.4 	of the month following completion of closure of the facility designated for closure in 
255.5 	the application and becomes part of the nursing facility's total operating external fixed
255.6 	 payment rate.
255.7 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
255.8 	payment for a new nursing facility or an addition to an existing nursing facility or as 
255.9 	an operating payment external fixed rate adjustment. Applications approved under this 
255.10 	subdivision are exempt from other requirements for moratorium exceptions under section 
255.11 	144A.073, subdivisions 2 and 3.
255.12 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
255.13 	closure rate adjustment as provided under section 144A.161, subdivision 10.
255.14 	(e) A facility that has received a planned closure rate adjustment may reassign it 
255.15 	to another facility that is under the same ownership at any time within three years of its 
255.16 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
255.17 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
255.18 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
255.19 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
255.20 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
255.21 	from the date the per bed dollar amount is increased.
255.22 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
255.23 	services shall calculate the amount of the planned closure rate adjustment available under 
255.24 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
255.25 	(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no 
255.26 	longer not accept applications for planned closure rate adjustments under subdivision 3.

255.27 	Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
255.28 		Subd. 53.Calculation of payment rate for external fixed costs. The commissioner 
255.29 	shall calculate a payment rate for external fixed costs.
255.30 	(a) For a facility licensed as a nursing home, the portion related to section 256.9657 
255.31 	shall be equal to $8.86 $10.58. For a facility licensed as both a nursing home and a 
255.32 	boarding care home, the portion related to section 256.9657 shall be equal to $8.86
255.33 	 $10.58 multiplied by the result of its number of nursing home beds divided by its total 
255.34 	number of licensed beds.
256.1 	(b) The portion related to the licensure fee under section 144.122, paragraph (d), 
256.2 	shall be the amount of the fee divided by actual resident days.
256.3 	(c) The portion related to scholarships shall be determined under section 256B.431, 
256.4 	subdivision 36.
256.5 	(d) The portion related to long-term care consultation shall be determined according 
256.6 	to section 256B.0911, subdivision 6.
256.7 	(e) The portion related to development and education of resident and family advisory 
256.8 	councils under section 144A.33 shall be $5 divided by 365.
256.9 	(f) The portion related to planned closure rate adjustments shall be as determined 
256.10 	under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436. 
256.11 	Planned closure rate adjustments that take effect before October 1, 2014, shall no longer 
256.12 	be included in the payment rate for external fixed costs beginning October 1, 2016. 
256.13 	Planned closure rate adjustments that take effect on or after October 1, 2014, shall no 
256.14 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
256.15 	the first year not less than two years after their effective date.
256.16 	(g) The portions related to property insurance, real estate taxes, special assessments, 
256.17 	and payments made in lieu of real estate taxes directly identified or allocated to the nursing 
256.18 	facility shall be the actual amounts divided by actual resident days.
256.19 	(h) The portion related to the Public Employees Retirement Association shall be 
256.20 	actual costs divided by resident days.
256.21 	(i) The single bed room incentives shall be as determined under section 256B.431, 
256.22 	subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall 
256.23 	no longer be included in the payment rate for external fixed costs beginning October 1, 
256.24 	2016. Single bed room incentives that take effect on or after October 1, 2014, shall no 
256.25 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
256.26 	the first year not less than two years after their effective date.
256.27 	(j) The payment rate for external fixed costs shall be the sum of the amounts in 
256.28 	paragraphs (a) to (i).

256.29 	EFFECTIVE DATE. This section is effective June 1, 2013

256.30 	Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 55, is amended to read:
256.31 		Subd. 55.Phase-in of rebased operating payment rates.  (a) For the rate years 
256.32 	beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 
256.33 	under this section shall be phased in by blending the operating rate with the operating 
256.34 	payment rate determined under section 256B.434. For purposes of this subdivision, the 
256.35 	rate to be used that is determined under section 256B.434 shall not include the portion of 
257.1 	the operating payment rate related to performance-based incentive payments under section 
257.2 	256B.434, subdivision 4, paragraph (d).:
257.3 	(1)  for the rate year beginning October 1, 2008, the operating payment rate for each 
257.4 	facility shall be 13 percent of the operating payment rate from this section, and 87 percent 
257.5 	of the operating payment rate from section 256B.434.;
257.6 	(2) for the rate period from October 1, 2009, to September 30, 2013, no rate 
257.7 	adjustments shall be implemented under this section, but shall be determined under 
257.8 	section 256B.434.;
257.9 	(3) for the rate year beginning October 1, 2013, the operating payment rate for each 
257.10 	facility shall be 65 15.4 percent of the operating payment rate from this section, and 35
257.11 	 84.6 percent of the operating payment rate from section 256B.434.; and
257.12 	(4) for the rate year beginning October 1, 2014 2015, the operating payment rate for 
257.13 	each facility shall be 82 24.3 percent of the operating payment rate from this section, and 
257.14 	1875.7  percent of the operating payment rate from section 256B.434.
257.15 	 for the rate year beginning October 1, 2015, the operating payment rate for each 
257.16 	facility shall be the operating payment rate determined under this section. The blending 
257.17 	of operating payment rates under this section shall be performed separately for each 
257.18 	RUG's class.
257.19 	(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 
257.20 	to the operating payment rate increases under paragraph (a) by creating a minimum 
257.21 	percentage increase and a maximum percentage increase.:
257.22 	(1) each nursing facility that receives a blended October 1, 2008, operating payment 
257.23 	rate increase under paragraph (a) of less than one percent, when compared to its operating 
257.24 	payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 
257.25 	shall receive a rate adjustment of one percent.;
257.26 	(2) the commissioner shall determine a maximum percentage increase that will 
257.27 	result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 
257.28 	facilities with a blended October 1, 2008, operating payment rate increase under paragraph 
257.29 	(a) greater than the maximum percentage increase determined by the commissioner, when 
257.30 	compared to its operating payment rate on September 30, 2008, computed using rates with 
257.31 	a RUG's weight of 1.00, shall receive the maximum percentage increase.;
257.32 	(3) nursing facilities with a blended October 1, 2008, operating payment rate 
257.33 	increase under paragraph (a) greater than one percent and less than the maximum 
257.34 	percentage increase determined by the commissioner, when compared to its operating 
257.35 	payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 
258.1 	shall receive the blended October 1, 2008, operating payment rate increase determined 
258.2 	under paragraph (a).; and
258.3 	(4) the October 1, 2009, through October 1, 2015, operating payment rate for 
258.4 	facilities receiving the maximum percentage increase determined in clause (2) shall be 
258.5 	the amount determined under paragraph (a) less the difference between the amount 
258.6 	determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 
258.7 	(2). This rate restriction does not apply to rate increases provided in any other section.
258.8 	(c) A portion of the funds received under this subdivision that are in excess of 
258.9 	operating payment rates that a facility would have received under section 256B.434, as 
258.10 	determined in accordance with clauses (1) to (3), shall be subject to the requirements in 
258.11 	section 256B.434, subdivision 19, paragraphs (b) to (h).:
258.12 	(1) determine the amount of additional funding available to a facility, which shall be 
258.13 	equal to total medical assistance resident days from the most recent reporting year times 
258.14 	the difference between the blended rate determined in paragraph (a) for the rate year being 
258.15 	computed and the blended rate for the prior year.;
258.16 	(2) determine the portion of all operating costs, for the most recent reporting year, 
258.17 	that are compensation related. If this value exceeds 75 percent, use 75 percent.;
258.18 	(3) subtract the amount determined in clause (2) from 75 percent.; and
258.19 	(4) the portion of the fund received under this subdivision that shall be subject to the 
258.20 	requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal the 
258.21 	amount determined in clause (1) times the amount determined in clause (3).

258.22 	Sec. 24. Minnesota Statutes 2012, section 256B.441, subdivision 56, is amended to read:
258.23 		Subd. 56.Hold harmless. For the rate years beginning October 1, 2008, to October 
258.24 	1, 2016, no nursing facility shall receive an operating cost payment rate less than its 
258.25 	operating cost payment rate under section 256B.434. For rate years beginning between 
258.26 	October 1, 2009, and October 1, 2015, no nursing facility shall receive an operating 
258.27 	payment rate less than its operating payment rate in effect on September 30, 2009. The 
258.28 	comparison of operating payment rates under this section shall be made for a RUG's 
258.29 	rate with a weight of 1.00.

258.30 	Sec. 25. Minnesota Statutes 2012, section 256B.441, subdivision 62, is amended to read:
258.31 		Subd. 62.Repeal of rebased operating payment rates. Notwithstanding 
258.32 	subdivision 54 or 55, no further steps toward phase-in of rebased operating payment rates 
258.33 	shall be taken, except for subdivision 55, paragraph (a), clauses (3) and (4).

259.1 	Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
259.2 		Subd. 11a.Waivered services statewide priorities. (a) The commissioner shall 
259.3 	establish statewide priorities for individuals on the waiting list for community alternative 
259.4 	care, community alternatives for disabled individuals, and brain injury waiver services, 
259.5 	as of January 1, 2010. The statewide priorities must include, but are not limited to, 
259.6 	individuals who continue to have a need for waiver services after they have maximized the 
259.7 	use of state plan services and other funding resources, including natural supports, prior to 
259.8 	accessing waiver services, and who meet at least one of the following criteria:
259.9 	(1) no longer require the intensity of services provided where they are currently 
259.10 	living; or
259.11 	(2) make a request to move from an institutional setting.
259.12 	(b) After the priorities in paragraph (a) are met, priority must also be given to 
259.13 	individuals who meet at least one of the following criteria:
259.14 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
259.15 	the primary caregivers;
259.16 	(2) are moving from an institution due to bed closures;
259.17 	(3) experience a sudden closure of their current living arrangement;
259.18 	(4) require protection from confirmed abuse, neglect, or exploitation;
259.19 	(5) experience a sudden change in need that can no longer be met through state plan 
259.20 	services or other funding resources alone; or
259.21 	(6) meet other priorities established by the department.
259.22 	(b) (c) When allocating resources to lead agencies, the commissioner must take into 
259.23 	consideration the number of individuals waiting who meet statewide priorities and the 
259.24 	lead agencies' current use of waiver funds and existing service options. The commissioner 
259.25 	has the authority to transfer funds between counties, groups of counties, and tribes to 
259.26 	accommodate statewide priorities and resource needs while accounting for a necessary 
259.27 	base level reserve amount for each county, group of counties, and tribe.
259.28 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
259.29 	provide recommendations to the legislature on whether to continue the use of statewide 
259.30 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
259.31 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

259.32 	Sec. 27. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
259.33 		Subd. 15.Coordinated service and support plan; comprehensive transitional 
259.34 	service plan; maintenance service plan. (a) Each recipient of home and community-based 
260.1 	waivered services shall be provided a copy of the written coordinated service and support 
260.2 	plan which meets the requirements in section 256B.092, subdivision 1b.
260.3 	(b) In developing the comprehensive transitional service plan, the individual 
260.4 	receiving services, the case manager, and the guardian, if applicable, will identify the 
260.5 	transitional service plan fundamental service outcome and anticipated timeline to achieve 
260.6 	this outcome. Within the first 20 days following a recipient's request for an assessment or 
260.7 	reassessment, the transitional service planning team must be identified. A team leader must 
260.8 	be identified who will be responsible for assigning responsibility and communicating with 
260.9 	team members to ensure implementation of the transition plan and ongoing assessment and 
260.10 	communication process. The team leader should be an individual, such as the case manager 
260.11 	or guardian, who has the opportunity to follow the recipient to the next level of service.
260.12 	Within ten days following an assessment, a comprehensive transitional service plan 
260.13 	must be developed incorporating elements of a comprehensive functional assessment and 
260.14 	including short-term measurable outcomes and timelines for achievement of and reporting 
260.15 	on these outcomes. Functional milestones must also be identified and reported according 
260.16 	to the timelines agreed upon by the transitional service planning team. In addition, the 
260.17 	comprehensive transitional service plan must identify additional supports that may assist 
260.18 	in the achievement of the fundamental service outcome such as the development of greater 
260.19 	natural community support, increased collaboration among agencies, and technological 
260.20 	supports.
260.21 	The timelines for reporting on functional milestones will prompt a reassessment of 
260.22 	services provided, the units of services, rates, and appropriate service providers. It is 
260.23 	the responsibility of the transitional service planning team leader to review functional 
260.24 	milestone reporting to determine if the milestones are consistent with observable skills 
260.25 	and that milestone achievement prompts any needed changes to the comprehensive 
260.26 	transitional service plan.
260.27 	For those whose fundamental transitional service outcome involves the need to 
260.28 	procure housing, a plan for the recipient to seek the resources necessary to secure the least 
260.29 	restrictive housing possible should be incorporated into the plan, including employment 
260.30 	and public supports such as housing access and shelter needy funding.
260.31 	(c) Counties and other agencies responsible for funding community placement and 
260.32 	ongoing community supportive services are responsible for the implementation of the 
260.33 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
260.34 	effective transitional service delivery and efficient utilization of funding resources.
260.35 	(d) Following one year of transitional services, the transitional services planning team 
260.36 	will make a determination as to whether or not the individual receiving services requires 
261.1 	the current level of continuous and consistent support in order to maintain the recipient's 
261.2 	current level of functioning. Recipients who are determined to have not had a significant 
261.3 	change in functioning for 12 months must move from a transitional to a maintenance 
261.4 	service plan. Recipients on a maintenance service plan must be reassessed to determine if 
261.5 	the recipient would benefit from a transitional service plan at least every 12 months and at 
261.6 	other times when there has been a significant change in the recipient's functioning. This 
261.7 	assessment should consider any changes to technological or natural community supports.
261.8 	(e) When a county is evaluating denials, reductions, or terminations of home and 
261.9 	community-based services under section 256B.49 for an individual, the case manager 
261.10 	shall offer to meet with the individual or the individual's guardian in order to discuss 
261.11 	the prioritization of service needs within the coordinated service and support plan, 
261.12 	comprehensive transitional service plan, or maintenance service plan. The reduction in 
261.13 	the authorized services for an individual due to changes in funding for waivered services 
261.14 	may not exceed the amount needed to ensure medically necessary services to meet the 
261.15 	individual's health, safety, and welfare.
261.16 	(f) At the time of reassessment, local agency case managers shall assess each recipient 
261.17 	of community alternatives for disabled individuals or brain injury waivered services 
261.18 	currently residing in a licensed adult foster home that is not the primary residence of the 
261.19 	license holder, or in which the license holder is not the primary caregiver, to determine if 
261.20 	that recipient could appropriately be served in a community-living setting. If appropriate 
261.21 	for the recipient, the case manager shall offer the recipient, through a person-centered 
261.22 	planning process, the option to receive alternative housing and service options. In the 
261.23 	event that the recipient chooses to transfer from the adult foster home, the vacated bed 
261.24 	shall not be filled with another recipient of waiver services and group residential housing 
261.25 	and the licensed capacity shall be reduced accordingly, unless the savings required by the 
261.26 	licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7, 
261.27 	sections 1 and 40, paragraph (f), for foster care settings where the physical location is not 
261.28 	the primary residence of the license holder are met through voluntary changes described 
261.29 	in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a), 
261.30 	clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers, 
261.31 	the county agency, with the assistance of the department, shall facilitate a consolidation of 
261.32 	settings or closure. This reassessment process shall be completed by July 1, 2013.

261.33 	Sec. 28. Minnesota Statutes 2012, section 256B.49, is amended by adding a 
261.34 	subdivision to read:
262.1 		Subd. 25.Reduce avoidable behavioral crisis emergency room admissions, 
262.2 	psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons 
262.3 	receiving home and community-based services authorized under this section who have 
262.4 	two or more admissions within a calendar year to an emergency room, psychiatric unit, 
262.5 	or institution must receive consultation from a mental health professional as defined in 
262.6 	section 245.462, subdivision 18, or a behavioral professional as defined in the home and 
262.7 	community-based services state plan within 30 days of discharge. The mental health 
262.8 	professional or behavioral professional must:
262.9 	(1) conduct a functional assessment of the crisis incident as defined in section 
262.10 	245D.02, subdivision 11, which led to the hospitalization with the goal of developing 
262.11 	proactive strategies as well as necessary reactive strategies to reduce the likelihood of 
262.12 	future avoidable hospitalizations due to a behavioral crisis;
262.13 	(2) use the results of the functional assessment to amend the coordinated service and 
262.14 	support plan in section 245D.02, subdivision 4b, to address the potential need for additional 
262.15 	staff training, increased staffing, access to crisis mobility services, mental health services, 
262.16 	use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
262.17 	(3) identify the need for additional consultation, testing, mental health crisis 
262.18 	intervention team services as defined in section 245D.02, subdivision 20, psychotropic 
262.19 	medication use and monitoring under section 245D.051, and the frequency and duration 
262.20 	of ongoing consultation. 
262.21 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, 
262.22 	the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

262.23 	Sec. 29. Minnesota Statutes 2012, section 256B.49, is amended by adding a 
262.24 	subdivision to read:
262.25 		Subd. 26.Excess allocations. County and tribal agencies will be responsible for 
262.26 	authorizations in excess of the allocation made by the commissioner. In the event a county 
262.27 	or tribal agency authorizes in excess of the allocation made by the commissioner for a 
262.28 	given allocation period, the county or tribal agency must submit a corrective action plan to 
262.29 	the commissioner. The plan must state the actions the agency will take to correct their 
262.30 	overauthorization for the year following the period when the overspending occurred. 
262.31 	Failure to correct overauthorizations shall result in recoupment of authorizations in excess 
262.32 	of the allocation. Nothing in this subdivision shall be construed as reducing the county's 
262.33 	responsibility to offer and make available feasible home and community-based options to 
262.34 	eligible waiver recipients within the resources allocated to them for that purpose.

263.1 	Sec. 30. Minnesota Statutes 2012, section 256B.492, is amended to read:
263.2 	256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE 
263.3 	WITH DISABILITIES.
263.4 	(a) Individuals receiving services under a home and community-based waiver under 
263.5 	section 256B.092 or 256B.49 may receive services in the following settings:
263.6 	(1) an individual's own home or family home;
263.7 	(2) a licensed adult foster care setting of up to five people; and
263.8 	(3) community living settings as defined in section 256B.49, subdivision 23, where 
263.9 	individuals with disabilities may reside in all of the units in a building of four or fewer 
263.10 	units, and no more than the greater of four or 25 percent of the units in a multifamily 
263.11 	building of more than four units, unless required by the Housing Opportunities for Persons 
263.12 	with AIDS Program.
263.13 	(b) The settings in paragraph (a) must not:
263.14 	(1) be located in a building that is a publicly or privately operated facility that 
263.15 	provides institutional treatment or custodial care;
263.16 	(2) be located in a building on the grounds of or adjacent to a public or private 
263.17 	institution;
263.18 	(3) be a housing complex designed expressly around an individual's diagnosis or 
263.19 	disability, unless required by the Housing Opportunities for Persons with AIDS Program;
263.20 	(4) be segregated based on a disability, either physically or because of setting 
263.21 	characteristics, from the larger community; and
263.22 	(5) have the qualities of an institution which include, but are not limited to: 
263.23 	regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions 
263.24 	agreed to and documented in the person's individual service plan shall not result in a 
263.25 	residence having the qualities of an institution as long as the restrictions for the person are 
263.26 	not imposed upon others in the same residence and are the least restrictive alternative, 
263.27 	imposed for the shortest possible time to meet the person's needs.
263.28 	(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which 
263.29 	individuals receive services under a home and community-based waiver as of July 1, 
263.30 	2012, and the setting does not meet the criteria of this section.
263.31 	(d) Notwithstanding paragraph (c), a program in Hennepin County established as 
263.32 	part of a Hennepin County demonstration project is qualified for the exception allowed 
263.33 	under paragraph (c).
263.34 	(e) The commissioner shall submit an amendment to the waiver plan no later than 
263.35 	December 31, 2012.

264.1 	Sec. 31. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
264.2 		Subd. 2.Planned closure process needs determination. The commissioner shall 
264.3 	announce and implement a program for planned closure of adult foster care homes. Planned 
264.4 	closure shall be the preferred method for achieving necessary budgetary savings required by 
264.5 	the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
264.6 	 (c). If additional closures are required to achieve the necessary savings, the commissioner 
264.7 	shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

264.8 	Sec. 32. Minnesota Statutes 2012, section 256B.501, is amended by adding a 
264.9 	subdivision to read:
264.10 		Subd. 14.Rate adjustment for ICF/DD in Cottonwood County. The 
264.11 	commissioner of health shall decertify three beds in an intermediate care facility for 
264.12 	persons with developmental disabilities with 21 certified beds located in Cottonwood 
264.13 	County. The total payment rate shall be $282.62 per bed, per day.

264.14 	Sec. 33. Minnesota Statutes 2012, section 256B.5012, is amended by adding a 
264.15 	subdivision to read:
264.16 		Subd. 14.Rate increase effective June 1, 2013. For rate periods beginning on or 
264.17 	after June 1, 2013, the commissioner shall increase the total operating payment rate for 
264.18 	each facility reimbursed under this section by $7.81 per day. The increase shall not be 
264.19 	subject to any annual percentage increase.

264.20 	EFFECTIVE DATE. This section is effective June 1, 2013.

264.21 	Sec. 34. Minnesota Statutes 2012, section 256B.5012, is amended by adding a 
264.22 	subdivision to read:
264.23 		Subd. 15.ICF/DD rate increases effective January 1, 2015, and July 1, 2015. (a) 
264.24 	Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate 
264.25 	period beginning January 1, 2015, the commissioner shall increase operating payments 
264.26 	equal to one percent of the operating payment rates in effect on December 31, 2014. 
264.27 	For the rate period beginning July 1, 2015, the commissioner shall increase operating 
264.28 	payments equal to one percent of the operating payment rates in effect on June 30, 2015.
264.29 	(b) For each facility, the commissioner shall apply the rate increase based on 
264.30 	occupied beds, using the percentage specified in this subdivision multiplied by the total 
264.31 	payment rate, including the variable rate, but excluding the property-related payment 
264.32 	rate in effect on the preceding date. The total rate increase shall include the adjustment 
264.33 	provided in section 256B.501, subdivision 12.

265.1 	Sec. 35. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:
265.2 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
265.3 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
265.4 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
265.5 	center, or a group residential housing facility.
265.6 	(a) The county agency shall pay a monthly allowance for medically prescribed 
265.7 	diets if the cost of those additional dietary needs cannot be met through some other 
265.8 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
265.9 	a licensed physician. Costs for special diets shall be determined as percentages of the 
265.10 	allotment for a one-person household under the thrifty food plan as defined by the United 
265.11 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
265.12 	food plan that are covered are as follows:
265.13 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
265.14 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
265.15 	of thrifty food plan;
265.16 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
265.17 	percent of thrifty food plan;
265.18 	(4) low cholesterol diet, 25 percent of thrifty food plan;
265.19 	(5) high residue diet, 20 percent of thrifty food plan;
265.20 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
265.21 	(7) gluten-free diet, 25 percent of thrifty food plan;
265.22 	(8) lactose-free diet, 25 percent of thrifty food plan;
265.23 	(9) antidumping diet, 15 percent of thrifty food plan;
265.24 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
265.25 	(11) ketogenic diet, 25 percent of thrifty food plan.
265.26 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
265.27 	repairs or necessary repairs or replacement of household furniture and appliances using 
265.28 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
265.29 	as long as other funding sources are not available.
265.30 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
265.31 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
265.32 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
265.33 	guardian or conservator is a member of the county agency staff, no fee is allowed.
265.34 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
265.35 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
265.36 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
266.1 	until the person has not received Minnesota supplemental aid for one full calendar month 
266.2 	or until the person's living arrangement changes and the person no longer meets the criteria 
266.3 	for the restaurant meal allowance, whichever occurs first.
266.4 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
266.5 	is allowed for representative payee services provided by an agency that meets the 
266.6 	requirements under SSI regulations to charge a fee for representative payee services. This 
266.7 	special need is available to all recipients of Minnesota supplemental aid regardless of 
266.8 	their living arrangement.
266.9 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
266.10 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
266.11 	which is in effect on the first day of July of each year will be added to the standards of 
266.12 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
266.13 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
266.14 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
266.15 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
266.16 	community-based waiver recipients living in their own home or rented or leased apartment 
266.17 	which is not owned, operated, or controlled by a provider of service not related by blood 
266.18 	or marriage, unless allowed under paragraph (g).
266.19 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
266.20 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
266.21 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
266.22 	after the age of 65.
266.23 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
266.24 	exceed 40 percent of the assistance unit's gross income before the application of this 
266.25 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
266.26 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
266.27 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
266.28 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
266.29 	considered shelter needy for purposes of this paragraph.
266.30 	(g) Notwithstanding this subdivision, to access housing and services as provided 
266.31 	in paragraph (f), the recipient may choose housing that may be owned, operated, or 
266.32 	controlled by the recipient's service provider. In a multifamily building of more than four 
266.33 	units, the maximum number of units that may be used by recipients of this program shall 
266.34 	be the greater of four units or 25 percent of the units in the building, unless required by the 
266.35 	Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four 
266.36 	or fewer units, all of the units may be used by recipients of this program. When housing is 
267.1 	controlled by the service provider, the individual may choose the individual's own service 
267.2 	provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is 
267.3 	controlled by the service provider, the service provider shall implement a plan with the 
267.4 	recipient to transition the lease to the recipient's name. Within two years of signing the 
267.5 	initial lease, the service provider shall transfer the lease entered into under this subdivision 
267.6 	to the recipient. In the event the landlord denies this transfer, the commissioner may 
267.7 	approve an exception within sufficient time to ensure the continued occupancy by the 
267.8 	recipient. This paragraph expires June 30, 2016.

267.9 	Sec. 36. Laws 2011, First Special Session chapter 9, article 7, section 39, subdivision 
267.10 	14, is amended to read:
267.11 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
267.12 	strengths, informal support systems, and need for services shall be completed within 20 
267.13 	working days of the recipient's request as provided in section 256B.0911. Reassessment 
267.14 	of each recipient's strengths, support systems, and need for services shall be conducted 
267.15 	at least every 12 months and at other times when there has been a significant change in 
267.16 	the recipient's functioning.
267.17 	(b) There must be a determination that the client requires a hospital level of care or a 
267.18 	nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph 
267.19 	(d), at initial and subsequent assessments to initiate and maintain participation in the 
267.20 	waiver program.
267.21 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
267.22 	appropriate to determine nursing facility level of care for purposes of medical assistance 
267.23 	payment for nursing facility services, only face-to-face assessments conducted according 
267.24 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
267.25 	determination or a nursing facility level of care determination must be accepted for 
267.26 	purposes of initial and ongoing access to waiver services payment.
267.27 	(d) Persons with developmental disabilities who apply for services under the nursing 
267.28 	facility level waiver programs shall be screened for the appropriate level of care according 
267.29 	to section 256B.092.
267.30 	(e) Recipients who are found eligible for home and community-based services under 
267.31 	this section before their 65th birthday may remain eligible for these services after their 
267.32 	65th birthday if they continue to meet all other eligibility factors.
267.33 	(f) The commissioner shall develop criteria to identify recipients whose level of 
267.34 	functioning is reasonably expected to improve and reassess these recipients to establish 
267.35 	a baseline assessment. Recipients who meet these criteria must have a comprehensive 
268.1 	transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 
268.2 	reassessed every six months until there has been no significant change in the recipient's 
268.3 	functioning for at least 12 months. After there has been no significant change in the 
268.4 	recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 
268.5 	informal support systems, and need for services shall be conducted at least every 12 
268.6 	months and at other times when there has been a significant change in the recipient's 
268.7 	functioning. Counties, case managers, and service providers are responsible for 
268.8 	conducting these reassessments and shall complete the reassessments out of existing funds.

268.9 	Sec. 37. Laws 2012, chapter 247, article 6, section 4, is amended to read:

268.10
268.11	Sec. 4. BOARD OF NURSING HOME 
ADMINISTRATORS
 	$
	-0-
	$
	10,000
	
268.12 	Administrative Services Unit. This 
268.13 	appropriation is to provide a grant to the 
268.14 	Minnesota Ambulance Association to 
268.15 	coordinate and prepare an assessment of 
268.16 	the extent and costs of uncompensated care 
268.17 	as a direct result of emergency responses 
268.18 	on interstate highways in Minnesota. 
268.19 	The study will collect appropriate 
268.20 	information from medical response units 
268.21 	and ambulance services regulated under 
268.22 	Minnesota Statutes, chapter 144E, and to 
268.23 	the extent possible, firefighting agencies. 
268.24 	In preparing the assessment, the Minnesota 
268.25 	Ambulance Association shall consult with 
268.26 	its membership, the Minnesota Fire Chiefs 
268.27 	Association, the Office of the State Fire 
268.28 	Marshal, and the Emergency Medical 
268.29 	Services Regulatory Board. The findings 
268.30 	of the assessment will be reported to the 
268.31 	chairs and ranking minority members of the 
268.32 	legislative committees with jurisdiction over 
268.33 	health and public safety by January 1, 2013.
268.34 	 This is a onetime appropriation.

269.1 	Sec. 38. DIRECTION TO COMMISSIONER.
 269.2 	The commissioner of human services shall request authority, in whatever form is 
269.3 	necessary, from the federal Centers for Medicare and Medicaid Services to allow persons 
269.4 	under age 65 participating in the home and community-based services waivers to continue 
269.5 	to use the disregard of the nonassisted spouse's income and assets instead of the spousal 
269.6 	impoverishment provisions under the federal Patient Protection and Affordable Care Act, 
269.7 	Public Law 111-148, section 2404, as amended by the federal Health Care and Education 
269.8 	Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations 
269.9 	or guidance issued under, those acts.

269.10 	Sec. 39. RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR 
269.11 	SENIORS AND PERSONS WITH DISABILITIES.
 269.12 	The commissioner of human services shall consult with interested stakeholders to 
269.13 	develop recommendations and a request for a federal 1115 demonstration waiver in order 
269.14 	to increase the asset limit for individuals eligible for medical assistance due to disability 
269.15 	or age who are not residing in a nursing facility, intermediate care facility for persons 
269.16 	with developmental disabilities, or other institution whose costs for room and board are 
269.17 	covered by medical assistance or state funds. The recommendations must be provided to 
269.18 	the legislative committees and divisions with jurisdiction over health and human services 
269.19 	policy and finance by February 1, 2014.

269.20 	Sec. 40. NURSING HOME LEVEL OF CARE REPORT.
 269.21 	(a) The commissioner of human services shall report on the impact of the 
269.22 	modification to the nursing facility level of care to be implemented January 1, 2014, 
269.23 	including the following:
269.24 	(1) the number of individuals who lose eligibility for home and community-based 
269.25 	services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and 
269.26 	alternative care under Minnesota Statutes, section 256B.0913;
269.27 	(2) the number of individuals who lose eligibility for medical assistance; and 
269.28 	(3) for individuals reported under clauses (1) and (2), and to the extent possible:
269.29 	(i) their living situation before and after nursing facility level of care implementation; 
269.30 	and
269.31 	(ii) the programs or services they received before and after nursing facility level of 
269.32 	care implementation, including, but not limited to, personal care assistant services and 
269.33 	essential community supports.
270.1 	(b) The commissioner of human services shall report to the chairs and ranking 
270.2 	minority members of the legislative committees and divisions with jurisdiction over health 
270.3 	and human services policy and finance with the information required under paragraph 
270.4 	(a). A preliminary report shall be submitted on October 1, 2014, and a final report shall 
270.5 	be submitted February 15, 2015.

270.6 	Sec. 41. ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND 
270.7 	COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT.
 270.8 	(a) For the purposes of this section, "assistive technology equipment" includes 
270.9 	computer tablets, passive sensors, and other forms of technology allowing increased 
270.10 	safety and independence, and used by those receiving services through a home and 
270.11 	community-based services waiver under Minnesota Statutes, sections 256B.0915, 
270.12 	256B.092, and 256B.49.
270.13 	(b) The commissioner of human services shall develop recommendations for 
270.14 	assistive technology equipment funding to enable individuals receiving services identified 
270.15 	in paragraph (a) to live in the least restrictive setting possible. In developing the funding, 
270.16 	the commissioner shall examine funding for the following:
270.17 	(1) an assessment process to match the appropriate assistive technology equipment 
270.18 	with the waiver recipient, including when the recipient's condition changes or progresses;
270.19 	(2) the use of monitoring services, if applicable, to the assistive technology 
270.20 	equipment identified in clause (1);
270.21 	(3) the leasing of assistive technology equipment as a possible alternative to 
270.22 	purchasing the equipment; and
270.23 	(4) ongoing support services, such as technological support.
270.24 	(c) The commissioner shall provide the chairs and ranking minority members of the 
270.25 	legislative committees and divisions with jurisdiction over health and human services 
270.26 	policy and finance a recommendation for implementing an assistive technology equipment 
270.27 	program as developed in paragraph (b) by February 1, 2014.

270.28 	Sec. 42. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JANUARY 
270.29 	1, 2015, AND JULY 1, 2015.
 270.30 	(a) The commissioner of human services shall increase reimbursement rates, grants, 
270.31 	allocations, individual limits, and rate limits, as applicable, by one percent for the rate 
270.32 	period beginning January 1, 2015, and by one percent for the rate period beginning July 1, 
270.33 	2015, for services rendered on or after those dates. County or tribal contracts for services 
271.1 	specified in this section must be amended to pass through these rate increases within 60 
271.2 	days of the effective date.
271.3 	(b) The rate changes described in this section must be provided to:
271.4 	(1) home and community-based waivered services for persons with developmental 
271.5 	disabilities or related conditions, including consumer-directed community supports, under 
271.6 	Minnesota Statutes, section 256B.501;
271.7 	(2) waivered services under community alternatives for disabled individuals, 
271.8 	including consumer-directed community supports, under Minnesota Statutes, section 
271.9 	256B.49;
271.10 	(3) community alternative care waivered services, including consumer-directed 
271.11 	community supports, under Minnesota Statutes, section 256B.49;
271.12 	(4) brain injury waivered services, including consumer-directed community 
271.13 	supports, under Minnesota Statutes, section 256B.49;
271.14 	(5) home and community-based waivered services for the elderly under Minnesota 
271.15 	Statutes, section 256B.0915;
271.16 	(6) nursing services and home health services under Minnesota Statutes, section 
271.17 	256B.0625, subdivision 6a;
271.18 	(7) personal care services and qualified professional supervision of personal care 
271.19 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
271.20 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
271.21 	subdivision 7;
271.22 	(9) day training and habilitation services for adults with developmental disabilities 
271.23 	or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 
271.24 	additional cost of rate adjustments on day training and habilitation services, provided as a 
271.25 	social service, under Minnesota Statutes, section 256M.60;
271.26 	(10) alternative care services under Minnesota Statutes, section 256B.0913;
271.27 	(11) living skills training programs for persons with intractable epilepsy who need 
271.28 	assistance in the transition to independent living under Laws 1988, chapter 689;
271.29 	(12) semi-independent living services (SILS) under Minnesota Statutes, section 
271.30 	252.275, including SILS funding under county social services grants formerly funded 
271.31 	under Minnesota Statutes, chapter 256I;
271.32 	(13) consumer support grants under Minnesota Statutes, section 256.476;
271.33 	(14) family support grants under Minnesota Statutes, section 252.32;
271.34 	(15) housing access grants under Minnesota Statutes, section 256B.0658;
271.35 	(16) self-advocacy grants under Laws 2009, chapter 101; and
271.36 	(17) technology grants under Laws 2009, chapter 79.
272.1 	(c) A managed care plan receiving state payments for the services in this section 
272.2 	must include these increases in their payments to providers. To implement the rate increase 
272.3 	in this section, capitation rates paid by the commissioner to managed care organizations 
272.4 	under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the 
272.5 	specified services for the period beginning January 1, 2015.
272.6 	(d) Counties shall increase the budget for each recipient of consumer-directed 
272.7 	community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

272.8 	Sec. 43. SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES 
272.9 	WAIVERS.
 272.10 	The commissioner of human services shall submit a request by December 31, 2013, 
272.11 	to the federal government to amend the home and community-based services waivers for 
272.12 	individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to 
272.13 	modify the financial management of the home and community-based services waivers 
272.14 	to provide a state-administered safety net when costs for an individual increase above 
272.15 	an identified threshold. The implementation of the safety net may result in a decreased 
272.16 	allocation for individual counties, tribes, or collaboratives of counties or tribes, but must 
272.17 	not result in a net decreased statewide allocation.

272.18 	Sec. 44. SHARED LIVING MODEL.
 272.19 	The commissioner of human services shall develop and promote a shared living model 
272.20 	option for individuals receiving services through the home and community-based services 
272.21 	waivers for individuals with disabilities, authorized under Minnesota Statutes, section 
272.22 	256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The 
272.23 	option must be a companion model with a limit of one or two individuals receiving support 
272.24 	in the home, planned respite for the caregiver, and the availability of intensive training 
272.25 	and support on the needs of the individual or individuals. Any necessary amendments to 
272.26 	implement the model must be submitted to the federal government by December 31, 2013.

272.27 	Sec. 45. MONEY FOLLOWS THE PERSON GRANT.
 272.28 	The commissioner of human services shall submit to the federal government all 
272.29 	necessary waiver amendments to implement the Money Follows the Person federal grant 
272.30 	by December 31, 2013.

272.31 	Sec. 46.  REPEALER.
 273.1 	Minnesota Statutes 2012, sections 256B.096, subdivisions 1, 2, 3, and 4; and 
273.2 	256B.5012, subdivision 13; and Laws 2011, First Special Session chapter 9, article 7, 
273.3 	section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012, 
273.4 	chapter 298, section 3,  are repealed.

273.5 	ARTICLE 8
273.6 	WAIVER PROVIDER STANDARDS

273.7 	Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a 
273.8 	subdivision to read:
273.9 		Subd. 7c.Human services license holders. Section 245D.095, subdivision 3, 
273.10 	requires certain license holders to protect service recipient records in accordance with 
273.11 	specified provisions of this chapter.

273.12 	Sec. 2. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
273.13 		Subd. 7.Health care facility. "Health care facility" means a hospital or other entity 
273.14 	licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under 
273.15 	section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47, 
273.16 	an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts 
273.17 	9555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or 
273.18 	a hospice provider licensed under sections 144A.75 to 144A.755.

273.19 	Sec. 3. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
273.20 		Subd. 4b.Health care facility; notice of status. (a) For the purposes of this 
273.21 	subdivision, "health care facility" means a facility:
273.22 	(1) licensed by the commissioner of health as a hospital, boarding care home or 
273.23 	supervised living facility under sections 144.50 to 144.58, or a nursing home under 
273.24 	chapter 144A;
273.25 	(2) registered by the commissioner of health as a housing with services establishment 
273.26 	as defined in section 144D.01; or
273.27 	(3) licensed by the commissioner of human services as a residential facility under 
273.28 	chapter 245A to provide adult foster care, adult mental health treatment, chemical 
273.29 	dependency treatment to adults, or residential services to persons with developmental
273.30 	 disabilities.
273.31 	(b) Prior to admission to a health care facility, a person required to register under 
273.32 	this section shall disclose to:
274.1 	(1) the health care facility employee processing the admission the person's status 
274.2 	as a registered predatory offender under this section; and
274.3 	(2) the person's corrections agent, or if the person does not have an assigned 
274.4 	corrections agent, the law enforcement authority with whom the person is currently 
274.5 	required to register, that inpatient admission will occur.
274.6 	(c) A law enforcement authority or corrections agent who receives notice under 
274.7 	paragraph (b) or who knows that a person required to register under this section is 
274.8 	planning to be admitted and receive, or has been admitted and is receiving health care 
274.9 	at a health care facility shall notify the administrator of the facility and deliver a fact 
274.10 	sheet to the administrator containing the following information: (1) name and physical 
274.11 	description of the offender; (2) the offender's conviction history, including the dates of 
274.12 	conviction; (3) the risk level classification assigned to the offender under section 244.052, 
274.13 	if any; and (4) the profile of likely victims.
274.14 	(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care 
274.15 	facility receives a fact sheet under paragraph (c) that includes a risk level classification for 
274.16 	the offender, and if the facility admits the offender, the facility shall distribute the fact 
274.17 	sheet to all residents at the facility. If the facility determines that distribution to a resident 
274.18 	is not appropriate given the resident's medical, emotional, or mental status, the facility 
274.19 	shall distribute the fact sheet to the patient's next of kin or emergency contact.

274.20 	Sec. 4. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY 
274.21 	MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
274.22 		Subdivision 1.Rules. The commissioner of human services shall, within 24 months 
274.23 	of enactment of this section, adopt rules governing the use of positive support strategies, 
274.24 	safety interventions, and emergency use of manual restraint in facilities and services 
274.25 	licensed under chapter 245D.
274.26 		Subd. 2.Data collection. (a) The commissioner shall, with stakeholder input, 
274.27 	develop data collection elements specific to incidents on the use of controlled procedures 
274.28 	with persons receiving services from providers regulated under Minnesota Rules, parts 
274.29 	9525.2700 to 9525.2810, and incidents involving persons receiving services from 
274.30 	providers identified to be licensed under chapter 245D effective January 1, 2014. Providers 
274.31 	shall report the data in a format and at a frequency provided by the commissioner of 
274.32 	human services.
274.33 	(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts 
274.34 	9525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures 
274.35 	in a format and at a frequency provided by the commissioner.

275.1 	Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
275.2 		Subd. 10.Nonresidential program. "Nonresidential program" means care, 
275.3 	supervision, rehabilitation, training or habilitation of a person provided outside the 
275.4 	person's own home and provided for fewer than 24 hours a day, including adult day 
275.5 	care programs; and chemical dependency or chemical abuse programs that are located 
275.6 	in a nursing home or hospital and receive public funds for providing chemical abuse or 
275.7 	chemical dependency treatment services under chapter 254B. Nonresidential programs 
275.8 	include home and community-based services and semi-independent living services for 
275.9 	persons with developmental disabilities or persons age 65 and older that are provided in 
275.10 	or outside of a person's own home under chapter 245D.

275.11 	Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
275.12 		Subd. 14.Residential program. "Residential program" means a program 
275.13 	that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training, 
275.14 	education, habilitation, or treatment outside a person's own home, including a program 
275.15 	in an intermediate care facility for four or more persons with developmental disabilities; 
275.16 	and chemical dependency or chemical abuse programs that are located in a hospital 
275.17 	or nursing home and receive public funds for providing chemical abuse or chemical 
275.18 	dependency treatment services under chapter 254B. Residential programs include home 
275.19 	and community-based services for persons with developmental disabilities or persons age 
275.20 	65 and older that are provided in or outside of a person's own home under chapter 245D.

275.21 	Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
275.22 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial 
275.23 	license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, 
275.24 	or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under 
275.25 	this chapter for a physical location that will not be the primary residence of the license 
275.26 	holder for the entire period of licensure. If a license is issued during this moratorium, and 
275.27 	the license holder changes the license holder's primary residence away from the physical 
275.28 	location of the foster care license, the commissioner shall revoke the license according 
275.29 	to section 245A.07. The commissioner shall not issue an initial license for a community 
275.30 	residential setting licensed under chapter 245D. Exceptions to the moratorium include:
275.31 	(1) foster care settings that are required to be registered under chapter 144D;
275.32 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
275.33 	community residential setting licenses replacing adult foster care licenses in existence on 
275.34 	December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
276.1 	(3) new foster care licenses or community residential setting licenses determined to 
276.2 	be needed by the commissioner under paragraph (b) for the closure of a nursing facility, 
276.3 	ICF/MR, or regional treatment center, or restructuring of state-operated services that 
276.4 	limits the capacity of state-operated facilities;
276.5 	(4) new foster care licenses or community residential setting licenses determined 
276.6 	to be needed by the commissioner under paragraph (b) for persons requiring hospital 
276.7 	level care; or
276.8 	(5) new foster care licenses or community residential setting licenses determined to 
276.9 	be needed by the commissioner for the transition of people from personal care assistance 
276.10 	to the home and community-based services.
276.11 	(b) The commissioner shall determine the need for newly licensed foster care 
276.12 	homes or community residential settings as defined under this subdivision. As part of the 
276.13 	determination, the commissioner shall consider the availability of foster care capacity in 
276.14 	the area in which the licensee seeks to operate, and the recommendation of the local 
276.15 	county board. The determination by the commissioner must be final. A determination of 
276.16 	need is not required for a change in ownership at the same address.
276.17 	(c) The commissioner shall study the effects of the license moratorium under this 
276.18 	subdivision and shall report back to the legislature by January 15, 2011. This study shall 
276.19 	include, but is not limited to the following:
276.20 	(1) the overall capacity and utilization of foster care beds where the physical location 
276.21 	is not the primary residence of the license holder prior to and after implementation 
276.22 	of the moratorium;
276.23 	(2) the overall capacity and utilization of foster care beds where the physical 
276.24 	location is the primary residence of the license holder prior to and after implementation 
276.25 	of the moratorium; and
276.26 	(3) the number of licensed and occupied ICF/MR beds prior to and after 
276.27 	implementation of the moratorium.
276.28 	(d) When a foster care recipient resident served by the program moves out of a 
276.29 	foster home that is not the primary residence of the license holder according to section 
276.30 	256B.49, subdivision 15, paragraph (f), or the community residential setting, the county 
276.31 	shall immediately inform the Department of Human Services Licensing Division. 
276.32 	The department shall decrease the statewide licensed capacity for foster care settings 
276.33 	where the physical location is not the primary residence of the license holder, or for 
276.34 	community residential settings, if the voluntary changes described in paragraph (f) are 
276.35 	not sufficient to meet the savings required by reductions in licensed bed capacity under 
276.36 	Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), 
277.1 	and maintain statewide long-term care residential services capacity within budgetary 
277.2 	limits. Implementation of the statewide licensed capacity reduction shall begin on July 
277.3 	1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the 
277.4 	needs determination process. Under this paragraph, the commissioner has the authority 
277.5 	to reduce unused licensed capacity of a current foster care program, or the community 
277.6 	residential settings, to accomplish the consolidation or closure of settings. A decreased 
277.7 	licensed capacity according to this paragraph is not subject to appeal under this chapter.
277.8 	(e) Residential settings that would otherwise be subject to the decreased license 
277.9 	capacity established in paragraph (d) shall be exempt under the following circumstances:
277.10 	(1) until August 1, 2013, the license holder's beds occupied by residents whose 
277.11 	primary diagnosis is mental illness and the license holder is:
277.12 	(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 
277.13 	health services (ARMHS) as defined in section 256B.0623;
277.14 	(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 
277.15 	9520.0870;
277.16 	(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 
277.17 	9520.0870; or
277.18 	(iv) a provider of intensive residential treatment services (IRTS) licensed under 
277.19 	Minnesota Rules, parts 9520.0500 to 9520.0670; or
277.20 	(2) the license holder is certified under the requirements in subdivision 6a or section 
277.21 	245D.33.
277.22 	(f) A resource need determination process, managed at the state level, using the 
277.23 	available reports required by section 144A.351, and other data and information shall 
277.24 	be used to determine where the reduced capacity required under paragraph (d) will be 
277.25 	implemented. The commissioner shall consult with the stakeholders described in section 
277.26 	144A.351, and employ a variety of methods to improve the state's capacity to meet 
277.27 	long-term care service needs within budgetary limits, including seeking proposals from 
277.28 	service providers or lead agencies to change service type, capacity, or location to improve 
277.29 	services, increase the independence of residents, and better meet needs identified by the 
277.30 	long-term care services reports and statewide data and information. By February 1 of each 
277.31 	year, the commissioner shall provide information and data on the overall capacity of 
277.32 	licensed long-term care services, actions taken under this subdivision to manage statewide 
277.33 	long-term care services and supports resources, and any recommendations for change to 
277.34 	the legislative committees with jurisdiction over health and human services budget.
277.35 	(g) At the time of application and reapplication for licensure, the applicant and the 
277.36 	license holder that are subject to the moratorium or an exclusion established in paragraph 
278.1 	(a) are required to inform the commissioner whether the physical location where the foster 
278.2 	care will be provided is or will be the primary residence of the license holder for the entire 
278.3 	period of licensure. If the primary residence of the applicant or license holder changes, the 
278.4 	applicant or license holder must notify the commissioner immediately. The commissioner 
278.5 	shall print on the foster care license certificate whether or not the physical location is the 
278.6 	primary residence of the license holder.
278.7 	(h) License holders of foster care homes identified under paragraph (g) that are not 
278.8 	the primary residence of the license holder and that also provide services in the foster care 
278.9 	home that are covered by a federally approved home and community-based services 
278.10 	waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the 
278.11 	human services licensing division that the license holder provides or intends to provide 
278.12 	these waiver-funded services. These license holders must be considered registered under 
278.13 	section 256B.092, subdivision 11, paragraph (c), and this registration status must be 
278.14 	identified on their license certificates.

278.15 	Sec. 8. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
278.16 		Subd. 8.Excluded providers seeking licensure. Nothing in this section shall 
278.17 	prohibit a program that is excluded from licensure under subdivision 2, paragraph 
278.18 	(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any 
278.19 	application received from such an excluded provider is processed in the same manner as 
278.20 	all other applications for child care center licensure.

278.21 	Sec. 9. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
278.22 		Subd. 3.Implementation. (a) The commissioner shall implement the 
278.23 	responsibilities of this chapter according to the timelines in paragraphs (b) and (c) 
278.24 	only within the limits of available appropriations or other administrative cost recovery 
278.25 	methodology.
278.26 	(b) The licensure of home and community-based services according to this section 
278.27 	shall be implemented January 1, 2014. License applications shall be received and 
278.28 	processed on a phased-in schedule as determined by the commissioner beginning July 
278.29 	1, 2013. Licenses will be issued thereafter upon the commissioner's determination that 
278.30 	the application is complete according to section 245A.04.
278.31 	(c) Within the limits of available appropriations or other administrative cost recovery 
278.32 	methodology, implementation of compliance monitoring must be phased in after January 
278.33 	1, 2014.
279.1 	(1) Applicants who do not currently hold a license issued under this chapter 245B
279.2 	 must receive an initial compliance monitoring visit after 12 months of the effective date of 
279.3 	the initial license for the purpose of providing technical assistance on how to achieve and 
279.4 	maintain compliance with the applicable law or rules governing the provision of home and 
279.5 	community-based services under chapter 245D. If during the review the commissioner 
279.6 	finds that the license holder has failed to achieve compliance with an applicable law or 
279.7 	rule and this failure does not imminently endanger the health, safety, or rights of the 
279.8 	persons served by the program, the commissioner may issue a licensing review report with 
279.9 	recommendations for achieving and maintaining compliance.
279.10 	(2) Applicants who do currently hold a license issued under this chapter must receive 
279.11 	a compliance monitoring visit after 24 months of the effective date of the initial license.
279.12 	(d) Nothing in this subdivision shall be construed to limit the commissioner's 
279.13 	authority to suspend or revoke a license or issue a fine at any time under section 245A.07, 
279.14 	or make issue correction orders and make a license conditional for failure to comply with 
279.15 	applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity 
279.16 	of the violation of law or rule and the effect of the violation on the health, safety, or 
279.17 	rights of persons served by the program.

279.18 	Sec. 10. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
279.19 		Subd. 2a.Consolidated contested case hearings. (a) When a denial of a license 
279.20 	under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is 
279.21 	based on a disqualification for which reconsideration was requested and which was not 
279.22 	set aside under section 245C.22, the scope of the contested case hearing shall include the 
279.23 	disqualification and the licensing sanction or denial of a license, unless otherwise specified 
279.24 	in this subdivision. When the licensing sanction or denial of a license is based on a 
279.25 	determination of maltreatment under section 626.556 or 626.557, or a disqualification for 
279.26 	serious or recurring maltreatment which was not set aside, the scope of the contested case 
279.27 	hearing shall include the maltreatment determination, disqualification, and the licensing 
279.28 	sanction or denial of a license, unless otherwise specified in this subdivision. In such 
279.29 	cases, a fair hearing under section 256.045 shall not be conducted as provided for in 
279.30 	sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
279.31 	(b) Except for family child care and child foster care, reconsideration of a 
279.32 	maltreatment determination under sections 626.556, subdivision 10i, and 626.557, 
279.33 	subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall 
279.34 	not be conducted when:
280.1 	(1) a denial of a license under section 245A.05, or a licensing sanction under section 
280.2 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
280.3 	or the disqualification of a license holder is based on serious or recurring maltreatment;
280.4 	(2) the denial of a license or licensing sanction is issued at the same time as the 
280.5 	maltreatment determination or disqualification; and
280.6 	(3) the license holder appeals the maltreatment determination or disqualification, 
280.7 	and denial of a license or licensing sanction. In these cases, a fair hearing shall not be 
280.8 	conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 
280.9 	9d. The scope of the contested case hearing must include the maltreatment determination, 
280.10 	disqualification, and denial of a license or licensing sanction.
280.11 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
280.12 	determination or disqualification, but does not appeal the denial of a license or a licensing 
280.13 	sanction, reconsideration of the maltreatment determination shall be conducted under 
280.14 	sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
280.15 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing 
280.16 	shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
280.17 	626.557, subdivision 9d.
280.18 	(c) In consolidated contested case hearings regarding sanctions issued in family child 
280.19 	care, child foster care, family adult day services, and adult foster care, and community 
280.20 	residential settings, the county attorney shall defend the commissioner's orders in 
280.21 	accordance with section 245A.16, subdivision 4.
280.22 	(d) The commissioner's final order under subdivision 5 is the final agency action 
280.23 	on the issue of maltreatment and disqualification, including for purposes of subsequent 
280.24 	background studies under chapter 245C and is the only administrative appeal of the final 
280.25 	agency determination, specifically, including a challenge to the accuracy and completeness 
280.26 	of data under section 13.04.
280.27 	(e) When consolidated hearings under this subdivision involve a licensing sanction 
280.28 	based on a previous maltreatment determination for which the commissioner has issued 
280.29 	a final order in an appeal of that determination under section 256.045, or the individual 
280.30 	failed to exercise the right to appeal the previous maltreatment determination under 
280.31 	section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is 
280.32 	conclusive on the issue of maltreatment. In such cases, the scope of the administrative 
280.33 	law judge's review shall be limited to the disqualification and the licensing sanction or 
280.34 	denial of a license. In the case of a denial of a license or a licensing sanction issued to 
280.35 	a facility based on a maltreatment determination regarding an individual who is not the 
281.1 	license holder or a household member, the scope of the administrative law judge's review 
281.2 	includes the maltreatment determination.
281.3 	(f) The hearings of all parties may be consolidated into a single contested case 
281.4 	hearing upon consent of all parties and the administrative law judge, if:
281.5 	(1) a maltreatment determination or disqualification, which was not set aside under 
281.6 	section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing 
281.7 	sanction under section 245A.07;
281.8 	(2) the disqualified subject is an individual other than the license holder and upon 
281.9 	whom a background study must be conducted under section 245C.03; and
281.10 	(3) the individual has a hearing right under section 245C.27.
281.11 	(g) When a denial of a license under section 245A.05 or a licensing sanction under 
281.12 	section 245A.07 is based on a disqualification for which reconsideration was requested 
281.13 	and was not set aside under section 245C.22, and the individual otherwise has no hearing 
281.14 	right under section 245C.27, the scope of the administrative law judge's review shall 
281.15 	include the denial or sanction and a determination whether the disqualification should 
281.16 	be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In 
281.17 	determining whether the disqualification should be set aside, the administrative law judge 
281.18 	shall consider the factors under section 245C.22, subdivision 4, to determine whether the 
281.19 	individual poses a risk of harm to any person receiving services from the license holder.
281.20 	(h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction 
281.21 	under section 245A.07 is based on the termination of a variance under section 245C.30, 
281.22 	subdivision 4, the scope of the administrative law judge's review shall include the sanction 
281.23 	and a determination whether the disqualification should be set aside, unless section 
281.24 	245C.24 prohibits the set-aside of the disqualification. In determining whether the 
281.25 	disqualification should be set aside, the administrative law judge shall consider the factors 
281.26 	under section 245C.22, subdivision 4, to determine whether the individual poses a risk of 
281.27 	harm to any person receiving services from the license holder.

281.28 	Sec. 11. Minnesota Statutes 2012, section 245A.10, is amended to read:
281.29 	245A.10 FEES.
281.30 		Subdivision 1.Application or license fee required, programs exempt from fee.
 281.31 	(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation 
281.32 	of applications and inspection of programs which are licensed under this chapter.
281.33 	(b) Except as provided under subdivision 2, no application or license fee shall be 
281.34 	charged for child foster care, adult foster care, or family and group family child care, or 
281.35 	a community residential setting.
282.1 		Subd. 2.County fees for background studies and licensing inspections. (a) For 
282.2 	purposes of family and group family child care licensing under this chapter, a county 
282.3 	agency may charge a fee to an applicant or license holder to recover the actual cost of 
282.4 	background studies, but in any case not to exceed $100 annually. A county agency may 
282.5 	also charge a license fee to an applicant or license holder not to exceed $50 for a one-year 
282.6 	license or $100 for a two-year license.
282.7 	(b) A county agency may charge a fee to a legal nonlicensed child care provider or 
282.8 	applicant for authorization to recover the actual cost of background studies completed 
282.9 	under section 119B.125, but in any case not to exceed $100 annually.
282.10 	(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
282.11 	(1) in cases of financial hardship;
282.12 	(2) if the county has a shortage of providers in the county's area;
282.13 	(3) for new providers; or
282.14 	(4) for providers who have attained at least 16 hours of training before seeking 
282.15 	initial licensure.
282.16 	(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 
282.17 	an installment basis for up to one year. If the provider is receiving child care assistance 
282.18 	payments from the state, the provider may have the fees under paragraph (a) or (b) 
282.19 	deducted from the child care assistance payments for up to one year and the state shall 
282.20 	reimburse the county for the county fees collected in this manner.
282.21 	(e) For purposes of adult foster care and child foster care licensing, and licensing 
282.22 	the physical plant of a community residential setting, under this chapter, a county agency 
282.23 	may charge a fee to a corporate applicant or corporate license holder to recover the actual 
282.24 	cost of licensing inspections, not to exceed $500 annually.
282.25 	(f) Counties may elect to reduce or waive the fees in paragraph (e) under the 
282.26 	following circumstances:
282.27 	(1) in cases of financial hardship;
282.28 	(2) if the county has a shortage of providers in the county's area; or
282.29 	(3) for new providers.
282.30 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
282.31 	under subdivision 1, an applicant for an initial license or certification issued by the 
282.32 	commissioner shall submit a $500 application fee with each new application required 
282.33 	under this subdivision. An applicant for an initial day services facility license under 
282.34 	chapter 245D shall submit a $250 application fee with each new application. The 
282.35 	application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license 
283.1 	or certification fee that expires on December 31. The commissioner shall not process an 
283.2 	application until the application fee is paid.
283.3 	(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license 
283.4 	to provide services at a specific location.
283.5 	(1) For a license to provide residential-based habilitation services to persons with 
283.6 	developmental disabilities under chapter 245B, an applicant shall submit an application 
283.7 	for each county in which the services will be provided. Upon licensure, the license 
283.8 	holder may provide services to persons in that county plus no more than three persons 
283.9 	at any one time in each of up to ten additional counties. A license holder in one county 
283.10 	may not provide services under the home and community-based waiver for persons with 
283.11 	developmental disabilities to more than three people in a second county without holding 
283.12 	a separate license for that second county. Applicants or licensees providing services 
283.13 	under this clause to not more than three persons remain subject to the inspection fees 
283.14 	established in section 245A.10, subdivision 2, for each location. The license issued by 
283.15 	the commissioner must state the name of each additional county where services are being 
283.16 	provided to persons with developmental disabilities. A license holder must notify the 
283.17 	commissioner before making any changes that would alter the license information listed 
283.18 	under section 245A.04, subdivision 7, paragraph (a), including any additional counties 
283.19 	where persons with developmental disabilities are being served. For a license to provide 
283.20 	home and community-based services to persons with disabilities or age 65 and older under 
283.21 	chapter 245D, an applicant shall submit an application to provide services statewide.
283.22 	(2) For a license to provide supported employment, crisis respite, or 
283.23 	semi-independent living services to persons with developmental disabilities under chapter 
283.24 	245B, an applicant shall submit a single application to provide services statewide.
283.25 	(3) For a license to provide independent living assistance for youth under section 
283.26 	245A.22, an applicant shall submit a single application to provide services statewide.
283.27 	(4) (3) For a license for a private agency to provide foster care or adoption services 
283.28 	under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single 
283.29 	application to provide services statewide.
283.30 	(c) The initial application fee charged under this subdivision does not include the 
283.31 	temporary license surcharge under section 16E.22.
283.32 		Subd. 4.License or certification fee for certain programs. (a) Child care centers 
283.33 	shall pay an annual nonrefundable license fee based on the following schedule:

283.34
283.35		Licensed Capacity
	Child Care Center
License Fee
	
283.36		1 to 24 persons
	$200
	
283.37		25 to 49 persons
	$300
	
284.1		50 to 74 persons
	$400
	
284.2		75 to 99 persons
	$500
	
284.3		100 to 124 persons
	$600
	
284.4		125 to 149 persons
	$700
	
284.5		150 to 174 persons
	$800
	
284.6		175 to 199 persons
	$900
	
284.7		200 to 224 persons
	$1,000
	
284.8		225 or more persons
	$1,100
	
284.9 	(b) A day training and habilitation program serving persons with developmental 
284.10 	disabilities or related conditions shall pay an annual nonrefundable license fee based on 
284.11 	the following schedule:

284.12		Licensed Capacity
	License Fee
	
284.13		1 to 24 persons
	$800
	
284.14		25 to 49 persons
	$1,000
	
284.15		50 to 74 persons
	$1,200
	
284.16		75 to 99 persons
	$1,400
	
284.17		100 to 124 persons
	$1,600
	
284.18		125 to 149 persons
	$1,800
	
284.19		150 or more persons
	$2,000
	
284.20 	Except as provided in paragraph (c), when a day training and habilitation program 
284.21 	serves more than 50 percent of the same persons in two or more locations in a community, 
284.22 	the day training and habilitation program shall pay a license fee based on the licensed 
284.23 	capacity of the largest facility and the other facility or facilities shall be charged a license 
284.24 	fee based on a licensed capacity of a residential program serving one to 24 persons.
284.25 	(c) When a day training and habilitation program serving persons with developmental 
284.26 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
284.27 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
284.28 	capacity for each location.
284.29 	(d) A program licensed to provide supported employment services to persons 
284.30 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
284.31 	license fee of $650.
284.32 	(e) A program licensed to provide crisis respite services to persons with 
284.33 	developmental disabilities under chapter 245B shall pay an annual nonrefundable license 
284.34 	fee of $700.
284.35 	(f) A program licensed to provide semi-independent living services to persons 
284.36 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
284.37 	license fee of $700.
285.1 	(g) A program licensed to provide residential-based habilitation services under the 
285.2 	home and community-based waiver for persons with developmental disabilities shall pay 
285.3 	an annual license fee that includes a base rate of $690 plus $60 times the number of clients 
285.4 	served on the first day of July of the current license year.
285.5 	(h) A residential program certified by the Department of Health as an intermediate 
285.6 	care facility for persons with developmental disabilities (ICF/MR) and a noncertified 
285.7 	residential program licensed to provide health or rehabilitative services for persons 
285.8 	with developmental disabilities shall pay an annual nonrefundable license fee based on 
285.9 	the following schedule:

285.10		Licensed Capacity
	License Fee
	
285.11		1 to 24 persons
	$535
	
285.12		25 to 49 persons
	$735
	
285.13		50 or more persons
	$935
	
285.14 	(b) A program licensed to provide one or more of the home and community-based 
285.15 	services and supports identified under chapter 245D to persons with disabilities or age 
285.16 	65 and older, shall pay an annual nonrefundable license fee that includes a base rate of 
285.17 	$563, plus $46 times the number of persons served on the last day of June of the current 
285.18 	license year for programs serving ten or more persons. The fee is limited to a maximum of 
285.19 	200 persons, regardless of the actual number of persons served. Programs serving nine 
285.20 	or fewer persons pay only the base rate.
285.21 	(c) A facility licensed under chapter 245D to provide day services shall pay an 
285.22 	annual nonrefundable license fee of $100.
285.23 	(i) (d) A chemical dependency treatment program licensed under Minnesota Rules, 
285.24 	parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an 
285.25 	annual nonrefundable license fee based on the following schedule:

285.26		Licensed Capacity
	License Fee
	
285.27		1 to 24 persons
	$600
	
285.28		25 to 49 persons
	$800
	
285.29		50 to 74 persons
	$1,000
	
285.30		75 to 99 persons
	$1,200
	
285.31		100 or more persons
	$1,400
	
285.32 	(j) (e) A chemical dependency program licensed under Minnesota Rules, parts 
285.33 	9530.6510 to 9530.6590, to provide detoxification services shall pay an annual 
285.34 	nonrefundable license fee based on the following schedule:

285.35		Licensed Capacity
	License Fee
	
285.36		1 to 24 persons
	$760
	
286.1		25 to 49 persons
	$960
	
286.2		50 or more persons
	$1,160
	
286.3 	(k) (f) Except for child foster care, a residential facility licensed under Minnesota 
286.4 	Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee 
286.5 	based on the following schedule:

286.6		Licensed Capacity
	License Fee
	
286.7		1 to 24 persons
	$1,000
	
286.8		25 to 49 persons
	$1,100
	
286.9		50 to 74 persons
	$1,200
	
286.10		75 to 99 persons
	$1,300
	
286.11		100 or more persons
	$1,400
	
286.12 	(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 
286.13 	9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license 
286.14 	fee based on the following schedule:

286.15		Licensed Capacity
	License Fee
	
286.16		1 to 24 persons
	$2,525
	
286.17		25 or more persons
	$2,725
	
286.18 	(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 
286.19 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
286.20 	license fee based on the following schedule:

286.21		Licensed Capacity
	License Fee
	
286.22		1 to 24 persons
	$450
	
286.23		25 to 49 persons
	$650
	
286.24		50 to 74 persons
	$850
	
286.25		75 to 99 persons
	$1,050
	
286.26		100 or more persons
	$1,250
	
286.27 	(n) (i) A program licensed to provide independent living assistance for youth under 
286.28 	section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
286.29 	(o) (j) A private agency licensed to provide foster care and adoption services under 
286.30 	Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable 
286.31 	license fee of $875.
286.32 	(p) (k) A program licensed as an adult day care center licensed under Minnesota 
286.33 	Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based 
286.34 	on the following schedule:

286.35		Licensed Capacity
	License Fee
	
286.36		1 to 24 persons
	$500
	
286.37		25 to 49 persons
	$700
	
287.1		50 to 74 persons
	$900
	
287.2		75 to 99 persons
	$1,100
	
287.3		100 or more persons
	$1,300
	
287.4 	(q) (l) A program licensed to provide treatment services to persons with sexual 
287.5 	psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 
287.6 	9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
287.7 	(r) (m) A mental health center or mental health clinic requesting certification for 
287.8 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
287.9 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the 
287.10 	mental health center or mental health clinic provides services at a primary location with 
287.11 	satellite facilities, the satellite facilities shall be certified with the primary location without 
287.12 	an additional charge.
287.13 		Subd. 6.License not issued until license or certification fee is paid. The 
287.14 	commissioner shall not issue a license or certification until the license or certification fee 
287.15 	is paid. The commissioner shall send a bill for the license or certification fee to the billing 
287.16 	address identified by the license holder. If the license holder does not submit the license or 
287.17 	certification fee payment by the due date, the commissioner shall send the license holder 
287.18 	a past due notice. If the license holder fails to pay the license or certification fee by the 
287.19 	due date on the past due notice, the commissioner shall send a final notice to the license 
287.20 	holder informing the license holder that the program license will expire on December 31 
287.21 	unless the license fee is paid before December 31. If a license expires, the program is no 
287.22 	longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2, 
287.23 	must not operate after the expiration date. After a license expires, if the former license 
287.24 	holder wishes to provide licensed services, the former license holder must submit a new 
287.25 	license application and application fee under subdivision 3.
287.26 		Subd. 7.Human services licensing fees to recover expenditures. Notwithstanding 
287.27 	section 16A.1285, subdivision 2, related to activities for which the commissioner charges 
287.28 	a fee, the commissioner must plan to fully recover direct expenditures for licensing 
287.29 	activities under this chapter over a five-year period. The commissioner may have 
287.30 	anticipated expenditures in excess of anticipated revenues in a biennium by using surplus 
287.31 	revenues accumulated in previous bienniums.
287.32 		Subd. 8.Deposit of license fees. A human services licensing account is created in 
287.33 	the state government special revenue fund. Fees collected under subdivisions 3 and 4 must 
287.34 	be deposited in the human services licensing account and are annually appropriated to the 
287.35 	commissioner for licensing activities authorized under this chapter.

287.36 	EFFECTIVE DATE. This section is effective July 1, 2013.

288.1 	Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
288.2 		Subd. 2a.Adult foster care and community residential setting license capacity.
 288.3 	(a) The commissioner shall issue adult foster care and community residential setting
288.4 	 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and 
288.5 	boarders, except that the commissioner may issue a license with a capacity of five beds, 
288.6 	including roomers and boarders, according to paragraphs (b) to (f).
288.7 	(b) An adult foster care The license holder may have a maximum license capacity 
288.8 	of five if all persons in care are age 55 or over and do not have a serious and persistent 
288.9 	mental illness or a developmental disability.
288.10 	(c) The commissioner may grant variances to paragraph (b) to allow a foster care 
288.11 	provider facility with a licensed capacity of five persons to admit an individual under the 
288.12 	age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of 
288.13 	the variance is recommended by the county in which the licensed foster care provider
288.14 	 facility is located.
288.15 	(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth 
288.16 	bed for emergency crisis services for a person with serious and persistent mental illness 
288.17 	or a developmental disability, regardless of age, if the variance complies with section 
288.18 	245A.04, subdivision 9, and approval of the variance is recommended by the county in 
288.19 	which the licensed foster care provider facility is located.
288.20 	(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a 
288.21 	fifth bed for respite services, as defined in section 245A.02, for persons with disabilities, 
288.22 	regardless of age, if the variance complies with sections 245A.03, subdivision 7, and 
288.23 	245A.04, subdivision 9, and approval of the variance is recommended by the county in 
288.24 	which the licensed foster care provider facility is licensed located. Respite care may be 
288.25 	provided under the following conditions:
288.26 	(1) staffing ratios cannot be reduced below the approved level for the individuals 
288.27 	being served in the home on a permanent basis;
288.28 	(2) no more than two different individuals can be accepted for respite services in 
288.29 	any calendar month and the total respite days may not exceed 120 days per program in 
288.30 	any calendar year;
288.31 	(3) the person receiving respite services must have his or her own bedroom, which 
288.32 	could be used for alternative purposes when not used as a respite bedroom, and cannot be 
288.33 	the room of another person who lives in the foster care home facility; and
288.34 	(4) individuals living in the foster care home facility must be notified when the 
288.35 	variance is approved. The provider must give 60 days' notice in writing to the residents 
288.36 	and their legal representatives prior to accepting the first respite placement. Notice must 
289.1 	be given to residents at least two days prior to service initiation, or as soon as the license 
289.2 	holder is able if they receive notice of the need for respite less than two days prior to 
289.3 	initiation, each time a respite client will be served, unless the requirement for this notice is 
289.4 	waived by the resident or legal guardian.
289.5 	(f) The commissioner may issue an adult foster care or community residential setting
289.6 	 license with a capacity of five adults if the fifth bed does not increase the overall statewide 
289.7 	capacity of licensed adult foster care or community residential setting beds in homes that 
289.8 	are not the primary residence of the license holder, as identified in a plan submitted to the 
289.9 	commissioner by the county, when the capacity is recommended by the county licensing 
289.10 	agency of the county in which the facility is located and if the recommendation verifies that:
289.11 	(1) the facility meets the physical environment requirements in the adult foster 
289.12 	care licensing rule;
289.13 	(2) the five-bed living arrangement is specified for each resident in the resident's:
289.14 	(i) individualized plan of care;
289.15 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
289.16 	(iii) individual resident placement agreement under Minnesota Rules, part 
289.17 	9555.5105, subpart 19, if required;
289.18 	(3) the license holder obtains written and signed informed consent from each 
289.19 	resident or resident's legal representative documenting the resident's informed choice 
289.20 	to remain living in the home and that the resident's refusal to consent would not have 
289.21 	resulted in service termination; and
289.22 	(4) the facility was licensed for adult foster care before March 1, 2011.
289.23 	(g) The commissioner shall not issue a new adult foster care license under paragraph 
289.24 	(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care 
289.25 	license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five 
289.26 	adults if the license holder continues to comply with the requirements in paragraph (f).

289.27 	Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
289.28 		Subd. 7.Adult foster care; variance for alternate overnight supervision. (a) The 
289.29 	commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts 
289.30 	requiring a caregiver to be present in an adult foster care home during normal sleeping 
289.31 	hours to allow for alternative methods of overnight supervision. The commissioner may 
289.32 	grant the variance if the local county licensing agency recommends the variance and the 
289.33 	county recommendation includes documentation verifying that:
290.1 	(1) the county has approved the license holder's plan for alternative methods of 
290.2 	providing overnight supervision and determined the plan protects the residents' health, 
290.3 	safety, and rights;
290.4 	(2) the license holder has obtained written and signed informed consent from 
290.5 	each resident or each resident's legal representative documenting the resident's or legal 
290.6 	representative's agreement with the alternative method of overnight supervision; and
290.7 	(3) the alternative method of providing overnight supervision, which may include 
290.8 	the use of technology, is specified for each resident in the resident's: (i) individualized 
290.9 	plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if 
290.10 	required; or (iii) individual resident placement agreement under Minnesota Rules, part 
290.11 	9555.5105, subpart 19, if required.
290.12 	(b) To be eligible for a variance under paragraph (a), the adult foster care license 
290.13 	holder must not have had a conditional license issued under section 245A.06, or any 
290.14 	other licensing sanction issued under section 245A.07 during the prior 24 months based 
290.15 	on failure to provide adequate supervision, health care services, or resident safety in 
290.16 	the adult foster care home.
290.17 	(c) A license holder requesting a variance under this subdivision to utilize 
290.18 	technology as a component of a plan for alternative overnight supervision may request 
290.19 	the commissioner's review in the absence of a county recommendation. Upon receipt of 
290.20 	such a request from a license holder, the commissioner shall review the variance request 
290.21 	with the county.
290.22 	(d) A variance granted by the commissioner according to this subdivision before 
290.23 	January 1, 2014, to a license holder for an adult foster care home must transfer with the 
290.24 	license when the license converts to a community residential setting license under chapter 
290.25 	245D. The terms and conditions of the variance remain in effect as approved at the time 
290.26 	the variance was granted.

290.27 	Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
290.28 		Subd. 7a.Alternate overnight supervision technology; adult foster care license
290.29 	 and community residential setting licenses. (a) The commissioner may grant an 
290.30 	applicant or license holder an adult foster care or community residential setting license 
290.31 	for a residence that does not have a caregiver in the residence during normal sleeping 
290.32 	hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 
290.33 	245D.02, subdivision 33b, but uses monitoring technology to alert the license holder 
290.34 	when an incident occurs that may jeopardize the health, safety, or rights of a foster 
290.35 	care recipient. The applicant or license holder must comply with all other requirements 
291.1 	under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under 
291.2 	chapter 245D, and the requirements under this subdivision. The license printed by the 
291.3 	commissioner must state in bold and large font:
291.4 	(1) that the facility is under electronic monitoring; and
291.5 	(2) the telephone number of the county's common entry point for making reports of 
291.6 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
291.7 	(b) Applications for a license under this section must be submitted directly to 
291.8 	the Department of Human Services licensing division. The licensing division must 
291.9 	immediately notify the host county and lead county contract agency and the host county 
291.10 	licensing agency. The licensing division must collaborate with the county licensing 
291.11 	agency in the review of the application and the licensing of the program.
291.12 	(c) Before a license is issued by the commissioner, and for the duration of the 
291.13 	license, the applicant or license holder must establish, maintain, and document the 
291.14 	implementation of written policies and procedures addressing the requirements in 
291.15 	paragraphs (d) through (f).
291.16 	(d) The applicant or license holder must have policies and procedures that:
291.17 	(1) establish characteristics of target populations that will be admitted into the home, 
291.18 	and characteristics of populations that will not be accepted into the home;
291.19 	(2) explain the discharge process when a foster care recipient resident served by the 
291.20 	program requires overnight supervision or other services that cannot be provided by the 
291.21 	license holder due to the limited hours that the license holder is on site;
291.22 	(3) describe the types of events to which the program will respond with a physical 
291.23 	presence when those events occur in the home during time when staff are not on site, and 
291.24 	how the license holder's response plan meets the requirements in paragraph (e), clause 
291.25 	(1) or (2);
291.26 	(4) establish a process for documenting a review of the implementation and 
291.27 	effectiveness of the response protocol for the response required under paragraph (e), 
291.28 	clause (1) or (2). The documentation must include:
291.29 	(i) a description of the triggering incident;
291.30 	(ii) the date and time of the triggering incident;
291.31 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
291.32 	(iv) whether the response met the resident's needs;
291.33 	(v) whether the existing policies and response protocols were followed; and
291.34 	(vi) whether the existing policies and protocols are adequate or need modification.
291.35 	When no physical presence response is completed for a three-month period, the 
291.36 	license holder's written policies and procedures must require a physical presence response 
292.1 	drill to be conducted for which the effectiveness of the response protocol under paragraph 
292.2 	(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
292.3 	(5) establish that emergency and nonemergency phone numbers are posted in a 
292.4 	prominent location in a common area of the home where they can be easily observed by a 
292.5 	person responding to an incident who is not otherwise affiliated with the home.
292.6 	(e) The license holder must document and include in the license application which 
292.7 	response alternative under clause (1) or (2) is in place for responding to situations that 
292.8 	present a serious risk to the health, safety, or rights of people receiving foster care services 
292.9 	in the home residents served by the program:
292.10 	(1) response alternative (1) requires only the technology to provide an electronic 
292.11 	notification or alert to the license holder that an event is underway that requires a response. 
292.12 	Under this alternative, no more than ten minutes will pass before the license holder will be 
292.13 	physically present on site to respond to the situation; or
292.14 	(2) response alternative (2) requires the electronic notification and alert system under 
292.15 	alternative (1), but more than ten minutes may pass before the license holder is present on 
292.16 	site to respond to the situation. Under alternative (2), all of the following conditions are met:
292.17 	(i) the license holder has a written description of the interactive technological 
292.18 	applications that will assist the license holder in communicating with and assessing the 
292.19 	needs related to the care, health, and safety of the foster care recipients. This interactive 
292.20 	technology must permit the license holder to remotely assess the well being of the foster 
292.21 	care recipient resident served by the program without requiring the initiation of the 
292.22 	foster care recipient. Requiring the foster care recipient to initiate a telephone call does 
292.23 	not meet this requirement;
292.24 	(ii) the license holder documents how the remote license holder is qualified and 
292.25 	capable of meeting the needs of the foster care recipients and assessing foster care 
292.26 	recipients' needs under item (i) during the absence of the license holder on site;
292.27 	(iii) the license holder maintains written procedures to dispatch emergency response 
292.28 	personnel to the site in the event of an identified emergency; and
292.29 	(iv) each foster care recipient's resident's individualized plan of care, individual 
292.30 	service plan coordinated service and support plan under section sections 256B.0913, 
292.31 	subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49, 
292.32 	subdivision 15, if required, or individual resident placement agreement under Minnesota 
292.33 	Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time, 
292.34 	which may be greater than ten minutes, for the license holder to be on site for that foster 
292.35 	care recipient resident.
293.1 	(f) Each foster care recipient's resident's placement agreement, individual service 
293.2 	agreement, and plan must clearly state that the adult foster care or community residential 
293.3 	setting license category is a program without the presence of a caregiver in the residence 
293.4 	during normal sleeping hours; the protocols in place for responding to situations that 
293.5 	present a serious risk to the health, safety, or rights of foster care recipients residents 
293.6 	served by the program under paragraph (e), clause (1) or (2); and a signed informed 
293.7 	consent from each foster care recipient resident served by the program or the person's 
293.8 	legal representative documenting the person's or legal representative's agreement with 
293.9 	placement in the program. If electronic monitoring technology is used in the home, the 
293.10 	informed consent form must also explain the following:
293.11 	(1) how any electronic monitoring is incorporated into the alternative supervision 
293.12 	system;
293.13 	(2) the backup system for any electronic monitoring in times of electrical outages or 
293.14 	other equipment malfunctions;
293.15 	(3) how the caregivers or direct support staff are trained on the use of the technology;
293.16 	(4) the event types and license holder response times established under paragraph (e);
293.17 	(5) how the license holder protects the foster care recipient's each resident's privacy 
293.18 	related to electronic monitoring and related to any electronically recorded data generated 
293.19 	by the monitoring system. A foster care recipient resident served by the program may 
293.20 	not be removed from a program under this subdivision for failure to consent to electronic 
293.21 	monitoring. The consent form must explain where and how the electronically recorded 
293.22 	data is stored, with whom it will be shared, and how long it is retained; and
293.23 	(6) the risks and benefits of the alternative overnight supervision system.
293.24 	The written explanations under clauses (1) to (6) may be accomplished through 
293.25 	cross-references to other policies and procedures as long as they are explained to the 
293.26 	person giving consent, and the person giving consent is offered a copy.
293.27 	(g) Nothing in this section requires the applicant or license holder to develop or 
293.28 	maintain separate or duplicative policies, procedures, documentation, consent forms, or 
293.29 	individual plans that may be required for other licensing standards, if the requirements of 
293.30 	this section are incorporated into those documents.
293.31 	(h) The commissioner may grant variances to the requirements of this section 
293.32 	according to section 245A.04, subdivision 9.
293.33 	(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 
293.34 	under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 
293.35 	contractors affiliated with the license holder.
294.1 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 
294.2 	remotely determine what action the license holder needs to take to protect the well-being 
294.3 	of the foster care recipient.
294.4 	(k) The commissioner shall evaluate license applications using the requirements 
294.5 	in paragraphs (d) to (f). The commissioner shall provide detailed application forms, 
294.6 	including a checklist of criteria needed for approval.
294.7 	(l) To be eligible for a license under paragraph (a), the adult foster care or community 
294.8 	residential setting license holder must not have had a conditional license issued under 
294.9 	section 245A.06 or any licensing sanction under section 245A.07 during the prior 24 
294.10 	months based on failure to provide adequate supervision, health care services, or resident 
294.11 	safety in the adult foster care home or community residential setting.
294.12 	(m) The commissioner shall review an application for an alternative overnight 
294.13 	supervision license within 60 days of receipt of the application. When the commissioner 
294.14 	receives an application that is incomplete because the applicant failed to submit required 
294.15 	documents or that is substantially deficient because the documents submitted do not meet 
294.16 	licensing requirements, the commissioner shall provide the applicant written notice 
294.17 	that the application is incomplete or substantially deficient. In the written notice to the 
294.18 	applicant, the commissioner shall identify documents that are missing or deficient and 
294.19 	give the applicant 45 days to resubmit a second application that is substantially complete. 
294.20 	An applicant's failure to submit a substantially complete application after receiving 
294.21 	notice from the commissioner is a basis for license denial under section 245A.05. The 
294.22 	commissioner shall complete subsequent review within 30 days.
294.23 	(n) Once the application is considered complete under paragraph (m), the 
294.24 	commissioner will approve or deny an application for an alternative overnight supervision 
294.25 	license within 60 days.
294.26 	(o) For the purposes of this subdivision, "supervision" means:
294.27 	(1) oversight by a caregiver or direct support staff as specified in the individual 
294.28 	resident's place agreement or coordinated service and support plan and awareness of the 
294.29 	resident's needs and activities; and
294.30 	(2) the presence of a caregiver or direct support staff in a residence during normal 
294.31 	sleeping hours, unless a determination has been made and documented in the individual's
294.32 	 coordinated service and support plan that the individual does not require the presence of a 
294.33 	caregiver or direct support staff during normal sleeping hours.

294.34 	Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
295.1 		Subd. 7b.Adult foster care data privacy and security. (a) An adult foster care
295.2 	 or community residential setting license holder who creates, collects, records, maintains, 
295.3 	stores, or discloses any individually identifiable recipient data, whether in an electronic 
295.4 	or any other format, must comply with the privacy and security provisions of applicable 
295.5 	privacy laws and regulations, including:
295.6 	(1) the federal Health Insurance Portability and Accountability Act of 1996 
295.7 	(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, 
295.8 	title 45, part 160, and subparts A and E of part 164; and
295.9 	(2) the Minnesota Government Data Practices Act as codified in chapter 13.
295.10 	(b) For purposes of licensure, the license holder shall be monitored for compliance 
295.11 	with the following data privacy and security provisions:
295.12 	(1) the license holder must control access to data on foster care recipients residents 
295.13 	served by the program according to the definitions of public and private data on individuals 
295.14 	under section 13.02; classification of the data on individuals as private under section 
295.15 	13.46, subdivision 2; and control over the collection, storage, use, access, protection, 
295.16 	and contracting related to data according to section 13.05, in which the license holder is 
295.17 	assigned the duties of a government entity;
295.18 	(2) the license holder must provide each foster care recipient resident served by 
295.19 	the program with a notice that meets the requirements under section 13.04, in which 
295.20 	the license holder is assigned the duties of the government entity, and that meets the 
295.21 	requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall 
295.22 	describe the purpose for collection of the data, and to whom and why it may be disclosed 
295.23 	pursuant to law. The notice must inform the recipient individual that the license holder 
295.24 	uses electronic monitoring and, if applicable, that recording technology is used;
295.25 	(3) the license holder must not install monitoring cameras in bathrooms;
295.26 	(4) electronic monitoring cameras must not be concealed from the foster care 
295.27 	recipients residents served by the program; and
295.28 	(5) electronic video and audio recordings of foster care recipients residents served 
295.29 	by the program shall be stored by the license holder for five days unless: (i) a foster care 
295.30 	recipient resident served by the program or legal representative requests that the recording 
295.31 	be held longer based on a specific report of alleged maltreatment; or (ii) the recording 
295.32 	captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or 
295.33 	a crime under chapter 609. When requested by a recipient resident served by the program
295.34 	 or when a recording captures an incident or event of alleged maltreatment or a crime, the 
295.35 	license holder must maintain the recording in a secured area for no longer than 30 days 
295.36 	to give the investigating agency an opportunity to make a copy of the recording. The 
296.1 	investigating agency will maintain the electronic video or audio recordings as required in 
296.2 	section 626.557, subdivision 12b.
296.3 	(c) The commissioner shall develop, and make available to license holders and 
296.4 	county licensing workers, a checklist of the data privacy provisions to be monitored 
296.5 	for purposes of licensure.

296.6 	Sec. 16. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
296.7 		Subd. 8.Community residential setting license. (a) The commissioner shall 
296.8 	establish provider standards for residential support services that integrate service standards 
296.9 	and the residential setting under one license. The commissioner shall propose statutory 
296.10 	language and an implementation plan for licensing requirements for residential support 
296.11 	services to the legislature by January 15, 2012, as a component of the quality outcome 
296.12 	standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
296.13 	(b) Providers licensed under chapter 245B, and providing, contracting, or arranging 
296.14 	for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105 
296.15 	to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340; 
296.16 	and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section 
296.17 	245D.02, subdivision 4a, must be required to obtain a community residential setting license.

296.18 	Sec. 17. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
296.19 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and 
296.20 	private agencies that have been designated or licensed by the commissioner to perform 
296.21 	licensing functions and activities under section 245A.04 and background studies for family 
296.22 	child care under chapter 245C; to recommend denial of applicants under section 245A.05; 
296.23 	to issue correction orders, to issue variances, and recommend a conditional license under 
296.24 	section 245A.06, or to recommend suspending or revoking a license or issuing a fine under 
296.25 	section 245A.07, shall comply with rules and directives of the commissioner governing 
296.26 	those functions and with this section. The following variances are excluded from the 
296.27 	delegation of variance authority and may be issued only by the commissioner:
296.28 	(1) dual licensure of family child care and child foster care, dual licensure of child 
296.29 	and adult foster care, and adult foster care and family child care;
296.30 	(2) adult foster care maximum capacity;
296.31 	(3) adult foster care minimum age requirement;
296.32 	(4) child foster care maximum age requirement;
296.33 	(5) variances regarding disqualified individuals except that county agencies may 
296.34 	issue variances under section 245C.30 regarding disqualified individuals when the county 
297.1 	is responsible for conducting a consolidated reconsideration according to sections 245C.25 
297.2 	and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 
297.3 	and a disqualification based on serious or recurring maltreatment; and
297.4 	(6) the required presence of a caregiver in the adult foster care residence during 
297.5 	normal sleeping hours; and
297.6 	(7) variances for community residential setting licenses under chapter 245D.
297.7 	Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency 
297.8 	must not grant a license holder a variance to exceed the maximum allowable family child 
297.9 	care license capacity of 14 children.
297.10 	(b) County agencies must report information about disqualification reconsiderations 
297.11 	under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances 
297.12 	granted under paragraph (a), clause (5), to the commissioner at least monthly in a format 
297.13 	prescribed by the commissioner.
297.14 	(c) For family day care programs, the commissioner may authorize licensing reviews 
297.15 	every two years after a licensee has had at least one annual review.
297.16 	(d) For family adult day services programs, the commissioner may authorize 
297.17 	licensing reviews every two years after a licensee has had at least one annual review.
297.18 	(e) A license issued under this section may be issued for up to two years.

297.19 	Sec. 18. Minnesota Statutes 2012, section 245D.02, is amended to read:
297.20 	245D.02 DEFINITIONS.
297.21 		Subdivision 1.Scope. The terms used in this chapter have the meanings given 
297.22 	them in this section.
297.23 		Subd. 2.Annual and annually. "Annual" and "annually" have the meaning given 
297.24 	in section 245A.02, subdivision 2b.
297.25 		Subd. 2a.Authorized representative. "Authorized representative" means a parent, 
297.26 	family member, advocate, or other adult authorized by the person or the person's legal 
297.27 	representative, to serve as a representative in connection with the provision of services 
297.28 	licensed under this chapter. This authorization must be in writing or by another method 
297.29 	that clearly indicates the person's free choice. The authorized representative must have no 
297.30 	financial interest in the provision of any services included in the person's service delivery 
297.31 	plan and must be capable of providing the support necessary to assist the person in the use 
297.32 	of home and community-based services licensed under this chapter.
297.33 		Subd. 3.Case manager. "Case manager" means the individual designated 
297.34 	to provide waiver case management services, care coordination, or long-term care 
298.1 	consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, 
298.2 	or successor provisions.
298.3 		Subd. 3a.Certification. "Certification" means the commissioner's written 
298.4 	authorization for a license holder to provide specialized services based on certification 
298.5 	standards in section 245D.33. The term certification and its derivatives have the same 
298.6 	meaning and may be substituted for the term licensure and its derivatives in this chapter 
298.7 	and chapter 245A.
298.8 		Subd. 4.Commissioner. "Commissioner" means the commissioner of the 
298.9 	Department of Human Services or the commissioner's designated representative.
298.10 		Subd. 4a.Community residential setting. "Community residential setting" means 
298.11 	a residential program as identified in section 245A.11, subdivision 8, where residential 
298.12 	supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause 
298.13 	(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant 
298.14 	of the facility licensed according to this chapter, and the license holder does not reside 
298.15 	in the facility.
298.16 		Subd. 4b.Coordinated service and support plan. "Coordinated service and support 
298.17 	plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision 
298.18 	6; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
298.19 		Subd. 4c.Coordinated service and support plan addendum. "Coordinated 
298.20 	service and support plan addendum" means the documentation that this chapter requires 
298.21 	of the license holder for each person receiving services.
298.22 		Subd. 4d.Corporate foster care. "Corporate foster care" means a child foster 
298.23 	residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, 
298.24 	or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to 
298.25 	9555.6265, where the license holder does not live in the home.
298.26 		Subd. 4e.Cultural competence or culturally competent. "Cultural competence" 
298.27 	or "culturally competent" means the ability and the will to respond to the unique needs of 
298.28 	a person that arise from the person's culture and the ability to use the person's culture as a 
298.29 	resource or tool to assist with the intervention and help meet the person's needs.
298.30 		Subd. 4f.Day services facility. "Day services facility" means a facility licensed 
298.31 	according to this chapter at which persons receive day services licensed under this chapter 
298.32 	from the license holder's direct support staff for a cumulative total of more than 30 days 
298.33 	within any 12-month period and the license holder is the owner, lessor, or tenant of the 
298.34 	facility.
298.35 		Subd. 5.Department. "Department" means the Department of Human Services.
299.1 		Subd. 6.Direct contact. "Direct contact" has the meaning given in section 245C.02, 
299.2 	subdivision 11, and is used interchangeably with the term "direct support service."
299.3 		Subd. 6a.Direct support staff or staff. "Direct support staff" or "staff" means 
299.4 	employees of the license holder who have direct contact with persons served by the 
299.5 	program and includes temporary staff or subcontractors, regardless of employer, providing 
299.6 	program services for hire under the control of the license holder who have direct contact 
299.7 	with persons served by the program.
299.8 		Subd. 7.Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
299.9 		Subd. 8.Emergency. "Emergency" means any event that affects the ordinary 
299.10 	daily operation of the program including, but not limited to, fires, severe weather, natural 
299.11 	disasters, power failures, or other events that threaten the immediate health and safety of 
299.12 	a person receiving services and that require calling 911, emergency evacuation, moving 
299.13 	to an emergency shelter, or temporary closure or relocation of the program to another 
299.14 	facility or service site for more than 24 hours.
299.15 		Subd. 8a.Emergency use of manual restraint. "Emergency use of manual 
299.16 	restraint" means using a manual restraint when a person poses an imminent risk of 
299.17 	physical harm to self or others and is the least restrictive intervention that would achieve 
299.18 	safety. Property damage, verbal aggression, or a person's refusal to receive or participate 
299.19 	in treatment or programming on their own, do not constitute an emergency.
299.20 		Subd. 8b.Expanded support team. "Expanded support team" means the members 
299.21 	of the support team defined in subdivision 46, and a licensed health or mental health 
299.22 	professional or other licensed, certified, or qualified professionals or consultants working 
299.23 	with the person and included in the team at the request of the person or the person's legal 
299.24 	representative.
299.25 		Subd. 8c.Family foster care. "Family foster care" means a child foster family 
299.26 	setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult 
299.27 	foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265, 
299.28 	where the license holder lives in the home.
299.29 		Subd. 9.Health services. "Health services" means any service or treatment 
299.30 	consistent with the physical and mental health needs of the person, such as medication 
299.31 	administration and monitoring, medical, dental, nutritional, health monitoring, wellness 
299.32 	education, and exercise.
299.33 		Subd. 10.Home and community-based services. "Home and community-based 
299.34 	services" means the services subject to the provisions of this chapter identified in section 
299.35 	245D.03, subdivision 1, and as defined in:
300.1 	(1) the federal federally approved waiver plans governed by United States Code, 
300.2 	title 42, sections 1396 et seq., or the state's alternative care program according to section 
300.3 	256B.0913, including the waivers for persons with disabilities under section 256B.49, 
300.4 	subdivision 11, including the brain injury (BI) waiver, plan; the community alternative 
300.5 	care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI) 
300.6 	waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092, 
300.7 	subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1; 
300.8 	or successor plans respective to each waiver; or
300.9 	(2) the alternative care (AC) program under section 256B.0913.
300.10 		Subd. 11.Incident. "Incident" means an occurrence that affects the which involves 
300.11 	a person and requires the program to make a response that is not a part of the program's 
300.12 	 ordinary provision of services to a that person, and includes any of the following:
300.13 	(1) serious injury of a person as determined by section 245.91, subdivision 6;
300.14 	(2) a person's death;
300.15 	(3) any medical emergency, unexpected serious illness, or significant unexpected 
300.16 	change in an illness or medical condition, or the mental health status of a person that 
300.17 	requires calling the program to call 911 or a mental health crisis intervention team, 
300.18 	physician treatment, or hospitalization;
300.19 	(4) any mental health crisis that requires the program to call 911 or a mental health 
300.20 	crisis intervention team;
300.21 	(5) an act or situation involving a person that requires the program to call 911, 
300.22 	law enforcement, or the fire department;
300.23 	(4) (6) a person's unauthorized or unexplained absence from a program;
300.24 	(5) (7)physical aggression conduct by a person receiving services against another 
300.25 	person receiving services that causes physical pain, injury, or persistent emotional distress, 
300.26 	including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting, 
300.27 	pushing, and spitting;:
300.28 	(i) is so severe, pervasive, or objectively offensive that it substantially interferes with 
300.29 	a person's opportunities to participate in or receive service or support;
300.30 	(ii) places the person in actual and reasonable fear of harm;
300.31 	(iii) places the person in actual and reasonable fear of damage to property of the 
300.32 	person; or
300.33 	(iv) substantially disrupts the orderly operation of the program;
300.34 	(6) (8) any sexual activity between persons receiving services involving force or 
300.35 	coercion as defined under section 609.341, subdivisions 3 and 14; or
300.36 	(9) any emergency use of manual restraint as identified in section 245D.061; or
301.1 	(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment 
301.2 	under section 626.556 or 626.557.
301.3 		Subd. 11a.Intermediate care facility for persons with developmental disabilities 
301.4 	or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or 
301.5 	"ICF/DD" means a residential program licensed to serve four or more persons with 
301.6 	developmental disabilities under section 252.28 and chapter 245A and licensed as a 
301.7 	supervised living facility under chapter 144, which together are certified by the Department 
301.8 	of Health as an intermediate care facility for persons with developmental disabilities.
301.9 		Subd. 11b.Least restrictive alternative. "Least restrictive alternative" means 
301.10 	the alternative method for providing supports and services that is the least intrusive and 
301.11 	most normalized given the level of supervision and protection required for the person. 
301.12 	This level of supervision and protection allows risk taking to the extent that there is no 
301.13 	reasonable likelihood that serious harm will happen to the person or others.
301.14 		Subd. 12.Legal representative. "Legal representative" means the parent of a 
301.15 	person who is under 18 years of age, a court-appointed guardian, or other representative 
301.16 	with legal authority to make decisions about services for a person. Other representatives 
301.17 	with legal authority to make decisions include but are not limited to a health care agent or 
301.18 	an attorney-in-fact authorized through a health care directive or power of attorney.
301.19 		Subd. 13.License. "License" has the meaning given in section 245A.02, 
301.20 	subdivision 8.
301.21 		Subd. 14.Licensed health professional. "Licensed health professional" means a 
301.22 	person licensed in Minnesota to practice those professions described in section 214.01, 
301.23 	subdivision 2.
301.24 		Subd. 15.License holder. "License holder" has the meaning given in section 
301.25 	245A.02, subdivision 9.
301.26 		Subd. 16.Medication. "Medication" means a prescription drug or over-the-counter 
301.27 	drug. For purposes of this chapter, "medication" includes dietary supplements.
301.28 		Subd. 17.Medication administration. "Medication administration" means 
301.29 	performing the following set of tasks to ensure a person takes both prescription and 
301.30 	over-the-counter medications and treatments according to orders issued by appropriately 
301.31 	licensed professionals, and includes the following:
301.32 	(1) checking the person's medication record;
301.33 	(2) preparing the medication for administration;
301.34 	(3) administering the medication to the person;
301.35 	(4) documenting the administration of the medication or the reason for not 
301.36 	administering the medication; and
302.1 	(5) reporting to the prescriber or a nurse any concerns about the medication, 
302.2 	including side effects, adverse reactions, effectiveness, or the person's refusal to take the 
302.3 	medication or the person's self-administration of the medication.
302.4 		Subd. 18.Medication assistance. "Medication assistance" means providing verbal 
302.5 	or visual reminders to take regularly scheduled medication, which includes either of 
302.6 	the following:
302.7 	(1) bringing to the person and opening a container of previously set up medications 
302.8 	and emptying the container into the person's hand or opening and giving the medications 
302.9 	in the original container to the person, or bringing to the person liquids or food to 
302.10 	accompany the medication; or
302.11 	(2) providing verbal or visual reminders to perform regularly scheduled treatments 
302.12 	and exercises.
302.13 		Subd. 19.Medication management. "Medication management" means the 
302.14 	provision of any of the following:
302.15 	(1) medication-related services to a person;
302.16 	(2) medication setup;
302.17 	(3) medication administration;
302.18 	(4) medication storage and security;
302.19 	(5) medication documentation and charting;
302.20 	(6) verification and monitoring of effectiveness of systems to ensure safe medication 
302.21 	handling and administration;
302.22 	(7) coordination of medication refills;
302.23 	(8) handling changes to prescriptions and implementation of those changes;
302.24 	(9) communicating with the pharmacy; or
302.25 	(10) coordination and communication with prescriber.
302.26 	For the purposes of this chapter, medication management does not mean "medication 
302.27 	therapy management services" as identified in section 256B.0625, subdivision 13h.
302.28 		Subd. 20.Mental health crisis intervention team. "Mental health crisis 
302.29 	intervention team" means a mental health crisis response providers provider as identified 
302.30 	in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944, 
302.31 	subdivision 1, paragraph (d), for children.
302.32 		Subd. 20a.Most integrated setting. "Most integrated setting" means a setting that 
302.33 	enables individuals with disabilities to interact with nondisabled persons to the fullest 
302.34 	extent possible.
303.1 		Subd. 21.Over-the-counter drug. "Over-the-counter drug" means a drug that 
303.2 	is not required by federal law to bear the statement "Caution: Federal law prohibits 
303.3 	dispensing without prescription."
303.4 		Subd. 21a.Outcome. "Outcome" means the behavior, action, or status attained by 
303.5 	the person that can be observed, measured, and determined reliable and valid.
303.6 		Subd. 22.Person. "Person" has the meaning given in section 245A.02, subdivision 
303.7 	11.
303.8 		Subd. 23.Person with a disability. "Person with a disability" means a person 
303.9 	determined to have a disability by the commissioner's state medical review team as 
303.10 	identified in section 256B.055, subdivision 7, the Social Security Administration, or 
303.11 	the person is determined to have a developmental disability as defined in Minnesota 
303.12 	Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section 
303.13 	252.27, subdivision 1a.
303.14 		Subd. 23a.Physician. "Physician" means a person who is licensed under chapter 
303.15 	147.
303.16 		Subd. 24.Prescriber. "Prescriber" means a licensed practitioner as defined in 
303.17 	section 151.01, subdivision 23, person who is authorized under section 148.235; 151.01, 
303.18 	subdivision 23; or151.37 to prescribe drugs. For the purposes of this chapter, the term 
303.19 	"prescriber" is used interchangeably with "physician."
303.20 		Subd. 25.Prescription drug. "Prescription drug" has the meaning given in section 
303.21 	151.01, subdivision 17 16.
303.22 		Subd. 26.Program. "Program" means either the nonresidential or residential 
303.23 	program as defined in section 245A.02, subdivisions 10 and 14.
303.24 		Subd. 27.Psychotropic medication. "Psychotropic medication" means any 
303.25 	medication prescribed to treat the symptoms of mental illness that affect thought processes, 
303.26 	mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic 
303.27 	(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and 
303.28 	stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder. 
303.29 	Other miscellaneous medications are considered to be a psychotropic medication when 
303.30 	they are specifically prescribed to treat a mental illness or to control or alter behavior.
303.31 		Subd. 28.Restraint. "Restraint" means physical or mechanical limiting of the free 
303.32 	and normal movement of body or limbs.
303.33 		Subd. 29.Seclusion. "Seclusion" means separating a person from others in a way 
303.34 	that prevents social contact and prevents the person from leaving the situation if he or she 
303.35 	chooses the placement of a person alone in a room from which exit is prohibited by a staff 
304.1 	person or a mechanism such as a lock, a device, or an object positioned to hold the door 
304.2 	closed or otherwise prevent the person from leaving the room.
304.3 		Subd. 29a.Self-determination. "Self-determination" means the person makes 
304.4 	decisions independently, plans for the person's own future, determines how money is spent 
304.5 	for the person's supports, and takes responsibility for making these decisions. If a person 
304.6 	has a legal representative, the legal representative's decision-making authority is limited to 
304.7 	the scope of authority granted by the court or allowed in the document authorizing the 
304.8 	legal representative to act.
304.9 		Subd. 29b.Semi-independent living services. "Semi-independent living services" 
304.10 	has the meaning given in section 252.275.
304.11 		Subd. 30.Service. "Service" means care, training, supervision, counseling, 
304.12 	consultation, or medication assistance assigned to the license holder in the coordinated 
304.13 	service and support plan.
304.14 		Subd. 31.Service plan. "Service plan" means the individual service plan or 
304.15 	individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, 
304.16 	or successor provisions, and includes any support plans or service needs identified as 
304.17 	a result of long-term care consultation, or a support team meeting that includes the 
304.18 	participation of the person, the person's legal representative, and case manager, or assigned 
304.19 	to a license holder through an authorized service agreement.
304.20 		Subd. 32.Service site. "Service site" means the location where the service is 
304.21 	provided to the person, including, but not limited to, a facility licensed according to 
304.22 	chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's 
304.23 	own home; or a community-based location.
304.24 		Subd. 33.Staff. "Staff" means an employee who will have direct contact with a 
304.25 	person served by the facility, agency, or program.
304.26 		Subd. 33a.Supervised living facility. "Supervised living facility" has the meaning 
304.27 	given in Minnesota Rules, part 4665.0100, subpart 10.
304.28 		Subd. 33b.Supervision. (a) "Supervision" means:
304.29 	(1) oversight by direct support staff as specified in the person's coordinated service 
304.30 	and support plan or coordinated service and support plan addendum and awareness of 
304.31 	the person's needs and activities;
304.32 	(2) responding to situations that present a serious risk to the health, safety, or rights 
304.33 	of the person while services are being provided; and
304.34 	(3) the presence of direct support staff at a service site while services are being 
304.35 	provided, unless a determination has been made and documented in the person's coordinated 
305.1 	service and support plan or coordinated service and support plan addendum that the person 
305.2 	does not require the presence of direct support staff while services are being provided.
305.3 	(b) For the purposes of this definition, "while services are being provided," means 
305.4 	any period of time during which the license holder will seek reimbursement for services.
305.5 		Subd. 34.Support team. "Support team" means the service planning team 
305.6 	identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in 
305.7 	Minnesota Rules, part 9525.0004, subpart 14.
305.8 		Subd. 34a.Time out. "Time out" means removing a person involuntarily from an 
305.9 	ongoing activity to a room, either locked or unlocked, or otherwise separating a person 
305.10 	from others in a way that prevents social contact and prevents the person from leaving 
305.11 	the situation if the person chooses. For the purpose of chapter 245D, "time out" does 
305.12 	not mean voluntary removal or self-removal for the purpose of calming, prevention of 
305.13 	escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out" 
305.14 	does not include a person voluntarily moving from an ongoing activity to an unlocked 
305.15 	room or otherwise separating from a situation or social contact with others if the person 
305.16 	chooses. For the purposes of this definition, "voluntarily" means without being forced, 
305.17 	compelled, or coerced.
305.18 		Subd. 35.Unit of government. "Unit of government" means every city, county, 
305.19 	town, school district, other political subdivisions of the state, and any agency of the state 
305.20 	or the United States, and includes any instrumentality of a unit of government.
305.21 		Subd. 35a.Treatment. "Treatment" means the provision of care, other than 
305.22 	medications, ordered or prescribed by a licensed health or mental health professional, 
305.23 	provided to a person to cure, rehabilitate, or ease symptoms.
305.24 		Subd. 36.Volunteer. "Volunteer" means an individual who, under the direction of the 
305.25 	license holder, provides direct services without pay to a person served by the license holder.

305.26 	EFFECTIVE DATE. This section is effective January 1, 2014.

305.27 	Sec. 19. Minnesota Statutes 2012, section 245D.03, is amended to read:
305.28 	245D.03 APPLICABILITY AND EFFECT.
305.29 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of 
305.30 	home and community-based services to persons with disabilities and persons age 65 and 
305.31 	older pursuant to this chapter. The licensing standards in this chapter govern the provision 
305.32 	of the following basic support services: and intensive support services.
305.33 	(1) housing access coordination as defined under the current BI, CADI, and DD 
305.34 	waiver plans or successor plans;
306.1 	(2) respite services as defined under the current CADI, BI, CAC, DD, and EW 
306.2 	waiver plans or successor plans when the provider is an individual who is not an employee 
306.3 	of a residential or nonresidential program licensed by the Department of Human Services 
306.4 	or the Department of Health that is otherwise providing the respite service;
306.5 	(3) behavioral programming as defined under the current BI and CADI waiver 
306.6 	plans or successor plans;
306.7 	(4) specialist services as defined under the current DD waiver plan or successor plans;
306.8 	(5) companion services as defined under the current BI, CADI, and EW waiver 
306.9 	plans or successor plans, excluding companion services provided under the Corporation 
306.10 	for National and Community Services Senior Companion Program established under the 
306.11 	Domestic Volunteer Service Act of 1973, Public Law 98-288;
306.12 	(6) personal support as defined under the current DD waiver plan or successor plans;
306.13 	(7) 24-hour emergency assistance, on-call and personal emergency response as 
306.14 	defined under the current CADI and DD waiver plans or successor plans;
306.15 	(8) night supervision services as defined under the current BI waiver plan or 
306.16 	successor plans;
306.17 	(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW 
306.18 	waiver plans or successor plans, excluding providers licensed by the Department of Health 
306.19 	under chapter 144A and those providers providing cleaning services only;
306.20 	(10) independent living skills training as defined under the current BI and CADI 
306.21 	waiver plans or successor plans;
306.22 	(11) prevocational services as defined under the current BI and CADI waiver plans 
306.23 	or successor plans;
306.24 	(12) structured day services as defined under the current BI waiver plan or successor 
306.25 	plans; or
306.26 	(13) supported employment as defined under the current BI and CADI waiver plans 
306.27 	or successor plans.
306.28 	(b) Basic support services provide the level of assistance, supervision, and care that 
306.29 	is necessary to ensure the health and safety of the person and do not include services that 
306.30 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of 
306.31 	the person. Basic support services include:
306.32 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
306.33 	subdivision 15, and under the brain injury, community alternative care, community 
306.34 	alternatives for disabled individuals, developmental disability, and elderly waiver plans;
306.35 	(2) companion services as defined under the brain injury, community alternatives for 
306.36 	disabled individuals, and elderly waiver plans, excluding companion services provided 
307.1 	under the Corporation for National and Community Services Senior Companion Program 
307.2 	established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
307.3 	(3) personal support as defined under the developmental disability waiver plan;
307.4 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
307.5 	community alternatives for disabled individuals and developmental disability waiver plans;
307.6 	(5) night supervision services as defined under the brain injury waiver plan; and
307.7 	(6) homemaker services as defined under the community alternatives for disabled 
307.8 	individuals, brain injury, community alternative care, developmental disability, and elderly 
307.9 	waiver plans, excluding providers licensed by the Department of Health under chapter 
307.10 	144A and those providers providing cleaning services only.
307.11 	(c) Intensive support services provide assistance, supervision, and care that is 
307.12 	necessary to ensure the health and safety of the person and services specifically directed 
307.13 	toward the training, habilitation, or rehabilitation of the person. Intensive support services 
307.14 	include:
307.15 	(1) intervention services, including:
307.16 	(i) behavioral support services as defined under the brain injury and community 
307.17 	alternatives for disabled individuals waiver plans;
307.18 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
307.19 	disability waiver plan; and
307.20 	(iii) specialist services as defined under the current developmental disability waiver 
307.21 	plan;
307.22 	(2) in-home support services, including:
307.23 	(i) in-home family support and supported living services as defined under the 
307.24 	developmental disability waiver plan;
307.25 	(ii) independent living services training as defined under the brain injury and 
307.26 	community alternatives for disabled individuals waiver plans; and
307.27 	(iii) semi-independent living services;
307.28 	(3) residential supports and services, including:
307.29 	(i) supported living services as defined under the developmental disability waiver 
307.30 	plan provided in a family or corporate child foster care residence, a family adult foster 
307.31 	care residence, a community residential setting, or a supervised living facility;
307.32 	(ii) foster care services as defined in the brain injury, community alternative care, 
307.33 	and community alternatives for disabled individuals waiver plans provided in a family or 
307.34 	corporate child foster care residence, a family adult foster care residence, or a community 
307.35 	residential setting; and
308.1 	(iii) residential services provided in a supervised living facility that is certified by 
308.2 	the Department of Health as an ICF/DD;
308.3 	(4) day services, including:
308.4 	(i) structured day services as defined under the brain injury waiver plan;
308.5 	(ii) day training and habilitation services under sections 252.40 to 252.46, and as 
308.6 	defined under the developmental disability waiver plan; and
308.7 	(iii) prevocational services as defined under the brain injury and community 
308.8 	alternatives for disabled individuals waiver plans; and
308.9 	(5) supported employment as defined under the brain injury, developmental 
308.10 	disability, and community alternatives for disabled individuals waiver plans.
308.11 		Subd. 2.Relationship to other standards governing home and community-based 
308.12 	services. (a) A license holder governed by this chapter is also subject to the licensure 
308.13 	requirements under chapter 245A.
308.14 	(b) A license holder concurrently providing child foster care services licensed 
308.15 	according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed 
308.16 	under this chapter is exempt from section 245D.04 as it applies to the person. A corporate 
308.17 	or family child foster care site controlled by a license holder and providing services 
308.18 	governed by this chapter is exempt from compliance with section 245D.04. This exemption 
308.19 	applies to foster care homes where at least one resident is receiving residential supports 
308.20 	and services licensed according to this chapter. This chapter does not apply to corporate or 
308.21 	family child foster care homes that do not provide services licensed under this chapter.
308.22 	(c) A family adult foster care site controlled by a license holder and providing 
308.23 	services governed by this chapter is exempt from compliance with Minnesota Rules, parts 
308.24 	9555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart 
308.25 	2; and 9555.6265. These exemptions apply to family adult foster care homes where at 
308.26 	least one resident is receiving residential supports and services licensed according to this 
308.27 	chapter. This chapter does not apply to family adult foster care homes that do not provide 
308.28 	services licensed under this chapter.
308.29 	(d) A license holder providing services licensed according to this chapter in a 
308.30 	supervised living facility is exempt from compliance with sections 245D.04; 245D.05, 
308.31 	subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
308.32 	(e) A license holder providing residential services to persons in an ICF/DD is exempt 
308.33 	from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision 
308.34 	2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, 
308.35 	subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
309.1 	(c) (f) A license holder concurrently providing home care homemaker services 
309.2 	registered licensed according to sections 144A.43 to 144A.49 to the same person receiving 
309.3 	home management services licensed under this chapter and registered according to chapter 
309.4 	144A is exempt from compliance with section 245D.04as it applies to the person.
309.5 	(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt 
309.6 	from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557, 
309.7 	subdivision 14, paragraph (b).
309.8 	(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing 
309.9 	structured day, prevocational, or supported employment services under this chapter 
309.10 	and day training and habilitation or supported employment services licensed under 
309.11 	chapter 245B within the same program is exempt from compliance with this chapter 
309.12 	when the license holder notifies the commissioner in writing that the requirements under 
309.13 	chapter 245B will be met for all persons receiving these services from the program. For 
309.14 	the purposes of this paragraph, if the license holder has obtained approval from the 
309.15 	commissioner for an alternative inspection status according to section 245B.031, that 
309.16 	approval will apply to all persons receiving services in the program.
309.17 	(g) Nothing in this chapter prohibits a license holder from concurrently serving 
309.18 	persons without disabilities or people who are or are not age 65 and older, provided this 
309.19 	chapter's standards are met as well as other relevant standards.
309.20 	(h) The documentation required under sections 245D.07 and 245D.071 must meet 
309.21 	the individual program plan requirements identified in section 256B.092 or successor 
309.22 	provisions.
309.23 		Subd. 3.Variance. If the conditions in section 245A.04, subdivision 9, are met, 
309.24 	the commissioner may grant a variance to any of the requirements in this chapter, except 
309.25 	sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4, 
309.26 	paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and 
309.27 	information rights of persons.
309.28 		Subd. 4.License holders with multiple 245D licenses. (a) When a person changes 
309.29 	service from one license to a different license held by the same license holder, the license 
309.30 	holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
309.31 	(b) When a staff person begins providing direct service under one or more licenses 
309.32 	held by the same license holder, other than the license for which staff orientation was 
309.33 	initially provided according to section 245D.09, subdivision 4, the license holder is 
309.34 	exempt from those staff orientation requirements, except the staff person must review each 
309.35 	person's service plan and medication administration procedures in accordance with section 
309.36 	245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
310.1 		Subd. 5.Program certification. An applicant or a license holder may apply for 
310.2 	program certification as identified in section 245D.33.

310.3 	EFFECTIVE DATE. This section is effective January 1, 2014.

310.4 	Sec. 20. Minnesota Statutes 2012, section 245D.04, is amended to read:
310.5 	245D.04 SERVICE RECIPIENT RIGHTS.
310.6 		Subdivision 1.License holder responsibility for individual rights of persons 
310.7 	served by the program.  The license holder must:
310.8 	(1) provide each person or each person's legal representative with a written notice 
310.9 	that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of 
310.10 	those rights within five working days of service initiation and annually thereafter;
310.11 	(2) make reasonable accommodations to provide this information in other formats 
310.12 	or languages as needed to facilitate understanding of the rights by the person and the 
310.13 	person's legal representative, if any;
310.14 	(3) maintain documentation of the person's or the person's legal representative's 
310.15 	receipt of a copy and an explanation of the rights; and
310.16 	(4) ensure the exercise and protection of the person's rights in the services provided 
310.17 	by the license holder and as authorized in the coordinated service and support plan.
310.18 		Subd. 2.Service-related rights. A person's service-related rights include the right to:
310.19 	(1) participate in the development and evaluation of the services provided to the 
310.20 	person;
310.21 	(2) have services and supports identified in the coordinated service and support plan 
310.22 	and the coordinated service and support plan addendum provided in a manner that respects 
310.23 	and takes into consideration the person's preferences according to the requirements in 
310.24 	sections 245D.07 and 245D.071;
310.25 	(3) refuse or terminate services and be informed of the consequences of refusing 
310.26 	or terminating services;
310.27 	(4) know, in advance, limits to the services available from the license holder, 
310.28 	including the license holder's knowledge, skill, and ability to meet the person's service and 
310.29 	support needs based on the information required in section 245D.031, subdivision 2;
310.30 	(5) know conditions and terms governing the provision of services, including the 
310.31 	license holder's admission criteria and policies and procedures related to temporary 
310.32 	service suspension and service termination;
310.33 	(6) a coordinated transfer to ensure continuity of care when there will be a change 
310.34 	in the provider;
311.1 	(7) know what the charges are for services, regardless of who will be paying for the 
311.2 	services, and be notified of changes in those charges;
311.3 	(7) (8) know, in advance, whether services are covered by insurance, government 
311.4 	funding, or other sources, and be told of any charges the person or other private party 
311.5 	may have to pay; and
311.6 	(8) (9) receive services from an individual who is competent and trained, who has 
311.7 	professional certification or licensure, as required, and who meets additional qualifications 
311.8 	identified in the person's coordinated service and support plan. or coordinated service and 
311.9 	support plan addendum.
311.10 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include 
311.11 	the right to:
311.12 	(1) have personal, financial, service, health, and medical information kept private, 
311.13 	and be advised of disclosure of this information by the license holder;
311.14 	(2) access records and recorded information about the person in accordance with 
311.15 	applicable state and federal law, regulation, or rule;
311.16 	(3) be free from maltreatment;
311.17 	(4) be free from restraint, time out, or seclusion used for a purpose other than except 
311.18 	for emergency use of manual restraint to protect the person from imminent danger to self 
311.19 	or others according to the requirements in section 245D.06;
311.20 	(5) receive services in a clean and safe environment when the license holder is the 
311.21 	owner, lessor, or tenant of the service site;
311.22 	(6) be treated with courtesy and respect and receive respectful treatment of the 
311.23 	person's property;
311.24 	(7) reasonable observance of cultural and ethnic practice and religion;
311.25 	(8) be free from bias and harassment regarding race, gender, age, disability, 
311.26 	spirituality, and sexual orientation;
311.27 	(9) be informed of and use the license holder's grievance policy and procedures, 
311.28 	including knowing how to contact persons responsible for addressing problems and to 
311.29 	appeal under section 256.045;
311.30 	(10) know the name, telephone number, and the Web site, e-mail, and street 
311.31 	addresses of protection and advocacy services, including the appropriate state-appointed 
311.32 	ombudsman, and a brief description of how to file a complaint with these offices;
311.33 	(11) assert these rights personally, or have them asserted by the person's family, 
311.34 	authorized representative, or legal representative, without retaliation;
311.35 	(12) give or withhold written informed consent to participate in any research or 
311.36 	experimental treatment;
312.1 	(13) associate with other persons of the person's choice;
312.2 	(14) personal privacy; and
312.3 	(15) engage in chosen activities.
312.4 	(b) For a person residing in a residential site licensed according to chapter 245A, 
312.5 	or where the license holder is the owner, lessor, or tenant of the residential service site, 
312.6 	protection-related rights also include the right to:
312.7 	(1) have daily, private access to and use of a non-coin-operated telephone for local 
312.8 	calls and long-distance calls made collect or paid for by the person;
312.9 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
312.10 	correspondence or communication; and
312.11 	(3) have use of and free access to common areas in the residence; and 
312.12 	(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious 
312.13 	advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including 
312.14 	privacy in the person's bedroom.
312.15 	(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a), 
312.16 	clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure 
312.17 	the health, safety, and well-being of the person. Any restriction of those rights must be 
312.18 	documented in the person's coordinated service and support plan for the person and or 
312.19 	coordinated service and support plan addendum. The restriction must be implemented 
312.20 	in the least restrictive alternative manner necessary to protect the person and provide 
312.21 	support to reduce or eliminate the need for the restriction in the most integrated setting 
312.22 	and inclusive manner. The documentation must include the following information:
312.23 	(1) the justification for the restriction based on an assessment of the person's 
312.24 	vulnerability related to exercising the right without restriction;
312.25 	(2) the objective measures set as conditions for ending the restriction;
312.26 	(3) a schedule for reviewing the need for the restriction based on the conditions for 
312.27 	ending the restriction to occur, at a minimum, every three months for persons who do not 
312.28 	have a legal representative and annually for persons who do have a legal representative
312.29 	semiannually from the date of initial approval, at a minimum, or more frequently if 
312.30 	requested by the person, the person's legal representative, if any, and case manager; and
312.31 	(4) signed and dated approval for the restriction from the person, or the person's 
312.32 	legal representative, if any. A restriction may be implemented only when the required 
312.33 	approval has been obtained. Approval may be withdrawn at any time. If approval is 
312.34 	withdrawn, the right must be immediately and fully restored.

312.35 	EFFECTIVE DATE. This section is effective January 1, 2014.

313.1 	Sec. 21. Minnesota Statutes 2012, section 245D.05, is amended to read:
313.2 	245D.05 HEALTH SERVICES.
313.3 		Subdivision 1.Health needs. (a) The license holder is responsible for providing
313.4 	 meeting health services service needs assigned in the coordinated service and support plan 
313.5 	andor the coordinated service and support plan addendum, consistent with the person's 
313.6 	health needs. The license holder is responsible for promptly notifying the person or
313.7 	 the person's legal representative, if any, and the case manager of changes in a person's 
313.8 	physical and mental health needs affecting assigned health services service needs assigned 
313.9 	to the license holder in the coordinated service and support plan or the coordinated service 
313.10 	and support plan addendum, when discovered by the license holder, unless the license 
313.11 	holder has reason to know the change has already been reported. The license holder 
313.12 	must document when the notice is provided.
313.13 	(b) When assigned in the service plan, If responsibility for meeting the person's 
313.14 	health service needs has been assigned to the license holder in the coordinated service and 
313.15 	support plan or the coordinated service and support plan addendum, the license holder is 
313.16 	required to must maintain documentation on how the person's health needs will be met, 
313.17 	including a description of the procedures the license holder will follow in order to:
313.18 	(1) provide medication administration,assistance or medication assistance, or 
313.19 	medication management administration according to this chapter;
313.20 	(2) monitor health conditions according to written instructions from the person's 
313.21 	physician or a licensed health professional;
313.22 	(3) assist with or coordinate medical, dental, and other health service appointments; or
313.23 	(4) use medical equipment, devices, or adaptive aides or technology safely and 
313.24 	correctly according to written instructions from the person's physician or a licensed 
313.25 	health professional.
313.26 		Subd. 1a.Medication setup. For the purposes of this subdivision, "medication 
313.27 	setup" means the arranging of medications according to instructions from the pharmacy, 
313.28 	the prescriber, or a licensed nurse, for later administration when the license holder 
313.29 	is assigned responsibility for medication assistance or medication administration in 
313.30 	the coordinated service and support plan or the coordinated service and support plan 
313.31 	addendum. A prescription label or the prescriber's written or electronically recorded order 
313.32 	for the prescription is sufficient to constitute written instructions from the prescriber. The 
313.33 	license holder must document in the person's medication administration record: dates 
313.34 	of setup, name of medication, quantity of dose, times to be administered, and route of 
313.35 	administration at time of setup; and, when the person will be away from home, to whom 
313.36 	the medications were given.
314.1 		Subd. 1b.Medication assistance. If responsibility for medication assistance 
314.2 	is assigned to the license holder in the coordinated service and support plan or the 
314.3 	coordinated service and support plan addendum, the license holder must ensure that 
314.4 	the requirements of subdivision 2, paragraph (b), have been met when staff provides 
314.5 	medication assistance to enable a person to self-administer medication or treatment when 
314.6 	the person is capable of directing the person's own care, or when the person's legal 
314.7 	representative is present and able to direct care for the person. For the purposes of this 
314.8 	subdivision, "medication assistance" means any of the following:
314.9 	(1) bringing to the person and opening a container of previously set up medications, 
314.10 	emptying the container into the person's hand, or opening and giving the medications in 
314.11 	the original container to the person;
314.12 	(2) bringing to the person liquids or food to accompany the medication; or
314.13 	(3) providing reminders to take regularly scheduled medication or perform regularly 
314.14 	scheduled treatments and exercises.
314.15 		Subd. 2.Medication administration. (a) If responsibility for medication 
314.16 	administration is assigned to the license holder in the coordinated service and support plan 
314.17 	or the coordinated service and support plan addendum, the license holder must implement 
314.18 	the following medication administration procedures to ensure a person takes medications 
314.19 	and treatments as prescribed:
314.20 	(1) checking the person's medication record;
314.21 	(2) preparing the medication as necessary;
314.22 	(3) administering the medication or treatment to the person;
314.23 	(4) documenting the administration of the medication or treatment or the reason for 
314.24 	not administering the medication or treatment; and
314.25 	(5) reporting to the prescriber or a nurse any concerns about the medication or 
314.26 	treatment, including side effects, effectiveness, or a pattern of the person refusing to 
314.27 	take the medication or treatment as prescribed. Adverse reactions must be immediately 
314.28 	reported to the prescriber or a nurse.
314.29 	(b)(1) The license holder must ensure that the following criteria requirements in 
314.30 	clauses (2) to (4) have been met before staff that is not a licensed health professional 
314.31 	administersadministering medication or treatment:.
314.32 	(1) (2) The license holder must obtain written authorization has been obtained from 
314.33 	the person or the person's legal representative to administer medication or treatment 
314.34 	orders; and must obtain reauthorization annually as needed. If the person or the person's 
314.35 	legal representative refuses to authorize the license holder to administer medication, the 
315.1 	medication must not be administered. The refusal to authorize medication administration 
315.2 	must be reported to the prescriber as expediently as possible.
315.3 	(2) (3) The staff person has completed responsible for administering the medication 
315.4 	or treatment must complete medication administration training according to section 
315.5 	245D.09, subdivision 4, paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable 
315.6 	to the person, paragraph (d).
315.7 	(3) The medication or treatment will be administered under administration 
315.8 	procedures established for the person in consultation with a licensed health professional. 
315.9 	written instruction from the person's physician may constitute the medication 
315.10 	administration procedures. A prescription label or the prescriber's order for the 
315.11 	prescription is sufficient to constitute written instructions from the prescriber. A licensed 
315.12 	health professional may delegate medication administration procedures.
315.13 	(4) For a license holder providing intensive support services, the medication or 
315.14 	treatment must be administered according to the license holder's medication administration 
315.15 	policy and procedures as required under section 245D.11, subdivision 2, clause (3).
315.16 	(b) (c) The license holder must ensure the following information is documented in 
315.17 	the person's medication administration record:
315.18 	(1) the information on the current prescription label or the prescriber's current written 
315.19 	or electronically recorded order or prescription that includes directions for the person's 
315.20 	name, description of the medication or treatment to be provided, and the frequency and 
315.21 	other information needed to safely and correctly administering administer the medication 
315.22 	or treatment to ensure effectiveness;
315.23 	(2) information on any discomforts, risks, or other side effects that are reasonable to 
315.24 	expect, and any contraindications to its use. This information must be readily available 
315.25 	to all staff administering the medication;
315.26 	(3) the possible consequences if the medication or treatment is not taken or 
315.27 	administered as directed;
315.28 	(4) instruction from the prescriber on when and to whom to report the following:
315.29 	(i) if the a dose of medication or treatment is not administered or treatment is not 
315.30 	performed as prescribed, whether by error by the staff or the person or by refusal by 
315.31 	the person; and
315.32 	(ii) the occurrence of possible adverse reactions to the medication or treatment;
315.33 	(5) notation of any occurrence of a dose of medication not being administered or 
315.34 	treatment not performed as prescribed, whether by error by the staff or the person or by 
315.35 	refusal by the person, or of adverse reactions, and when and to whom the report was 
315.36 	made; and
316.1 	(6) notation of when a medication or treatment is started, administered, changed, or 
316.2 	discontinued.
316.3 	(c) The license holder must ensure that the information maintained in the medication 
316.4 	administration record is current and is regularly reviewed with the person or the person's 
316.5 	legal representative and the staff administering the medication to identify medication 
316.6 	administration issues or errors. At a minimum, the review must be conducted every three 
316.7 	months or more often if requested by the person or the person's legal representative. 
316.8 	Based on the review, the license holder must develop and implement a plan to correct 
316.9 	medication administration issues or errors. If issues or concerns are identified related to 
316.10 	the medication itself, the license holder must report those as required under subdivision 4.
316.11 		Subd. 3.Medication assistance. The license holder must ensure that the 
316.12 	requirements of subdivision 2, paragraph (a), have been met when staff provides assistance 
316.13 	to enable a person to self-administer medication when the person is capable of directing 
316.14 	the person's own care, or when the person's legal representative is present and able to 
316.15 	direct care for the person.
316.16 		Subd. 4.Reviewing and reporting medication and treatment issues. The 
316.17 	following medication administration issues must be reported to the person or the person's 
316.18 	legal representative and case manager as they occur or following timelines established 
316.19 	in the person's service plan or as requested in writing by the person or the person's legal 
316.20 	representative, or the case manager: (a) When assigned responsibility for medication 
316.21 	administration, the license holder must ensure that the information maintained in 
316.22 	the medication administration record is current and is regularly reviewed to identify 
316.23 	medication administration errors. At a minimum, the review must be conducted every 
316.24 	three months, or more frequently as directed in the coordinated service and support plan 
316.25 	or coordinated service and support plan addendum or as requested by the person or the 
316.26 	person's legal representative. Based on the review, the license holder must develop and 
316.27 	implement a plan to correct patterns of medication administration errors when identified.
316.28 	(b) If assigned responsibility for medication assistance or medication administration, 
316.29 	the license holder must report the following to the person's legal representative and case 
316.30 	manager as they occur or as otherwise directed in the coordinated service and support plan 
316.31 	or the coordinated service and support plan addendum:
316.32 	(1) any reports made to the person's physician or prescriber required under 
316.33 	subdivision 2, paragraph (b) (c), clause (4);
316.34 	(2) a person's refusal or failure to take or receive medication or treatment as 
316.35 	prescribed; or
316.36 	(3) concerns about a person's self-administration of medication or treatment.
317.1 		Subd. 5.Injectable medications. Injectable medications may be administered 
317.2 	according to a prescriber's order and written instructions when one of the following 
317.3 	conditions has been met:
317.4 	(1) a registered nurse or licensed practical nurse will administer the subcutaneous or 
317.5 	intramuscular injection;
317.6 	(2) a supervising registered nurse with a physician's order has delegated the 
317.7 	administration of subcutaneous injectable medication to an unlicensed staff member 
317.8 	and has provided the necessary training; or
317.9 	(3) there is an agreement signed by the license holder, the prescriber, and the 
317.10 	person or the person's legal representative specifying what subcutaneous injections may 
317.11 	be given, when, how, and that the prescriber must retain responsibility for the license 
317.12 	holder's giving the injections. A copy of the agreement must be placed in the person's 
317.13 	service recipient record.
317.14 	Only licensed health professionals are allowed to administer psychotropic 
317.15 	medications by injection.

317.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

317.17 	Sec. 22. [245D.051] PSYCHOTROPIC MEDICATION USE AND 
317.18 	MONITORING.
317.19 		Subdivision 1.Conditions for psychotropic medication administration. (a) 
317.20 	When a person is prescribed a psychotropic medication and the license holder is assigned 
317.21 	responsibility for administration of the medication in the person's coordinated service 
317.22 	and support plan or the coordinated service and support plan addendum, the license 
317.23 	holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05, 
317.24 	subdivision 2, are met.
317.25 	(b) Use of the medication must be included in the person's coordinated service and 
317.26 	support plan or in the coordinated service and support plan addendum and based on a 
317.27 	prescriber's current written or electronically recorded prescription.
317.28 	(c) The license holder must develop, implement, and maintain the following 
317.29 	documentation in the person's coordinated service and support plan addendum according 
317.30 	to the requirements in sections 245D.07 and 245D.071:
317.31 	(1) a description of the target symptoms that the psychotropic medication is to 
317.32 	alleviate; and
317.33 	(2) documentation methods the license holder will use to monitor and measure 
317.34 	changes in the target symptoms that are to be alleviated by the psychotropic medication if 
317.35 	required by the prescriber. The license holder must collect and report on medication and 
318.1 	symptom-related data as instructed by the prescriber. The license holder must provide 
318.2 	the monitoring data to the expanded support team for review every three months, or as 
318.3 	otherwise requested by the person or the person's legal representative.
318.4 	For the purposes of this section, "target symptom" refers to any perceptible 
318.5 	diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic 
318.6 	and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or 
318.7 	successive editions that has been identified for alleviation.
318.8 	(d) If a person is prescribed a psychotropic medication, monitoring the use of the 
318.9 	psychotropic medication must be assigned to the license holder in the coordinated service 
318.10 	and support plan or the coordinated service and support plan addendum. The assigned 
318.11 	license holder must monitor the psychotropic medication as required by this section.
318.12 		Subd. 2.Refusal to authorize psychotropic medication. If the person or the 
318.13 	person's legal representative refuses to authorize the administration of a psychotropic 
318.14 	medication as ordered by the prescriber, the license holder must follow the requirement 
318.15 	in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal 
318.16 	to the prescriber, the license holder must follow any directives or orders given by the 
318.17 	prescriber. A court order must be obtained to override the refusal. Refusal to authorize 
318.18 	administration of a specific psychotropic medication is not grounds for service termination 
318.19 	and does not constitute an emergency. A decision to terminate services must be reached in 
318.20 	compliance with section 245D.10, subdivision 3.

318.21 	EFFECTIVE DATE. This section is effective January 1, 2014.

318.22 	Sec. 23. Minnesota Statutes 2012, section 245D.06, is amended to read:
318.23 	245D.06 PROTECTION STANDARDS.
318.24 		Subdivision 1.Incident response and reporting.  (a) The license holder must 
318.25 	respond to all incidents under section 245D.02, subdivision 11, that occur while providing 
318.26 	services to protect the health and safety of and minimize risk of harm to the person.
318.27 	(b) The license holder must maintain information about and report incidents to the 
318.28 	person's legal representative or designated emergency contact and case manager within 24 
318.29 	hours of an incident occurring while services are being provided, or within 24 hours of 
318.30 	discovery or receipt of information that an incident occurred, unless the license holder 
318.31 	has reason to know that the incident has already been reported, or as otherwise directed 
318.32 	in a person's coordinated service and support plan or coordinated service and support 
318.33 	plan addendum. An incident of suspected or alleged maltreatment must be reported as 
319.1 	required under paragraph (d), and an incident of serious injury or death must be reported 
319.2 	as required under paragraph (e).
319.3 	(c) When the incident involves more than one person, the license holder must not 
319.4 	disclose personally identifiable information about any other person when making the report 
319.5 	to each person and case manager unless the license holder has the consent of the person.
319.6 	(d) Within 24 hours of reporting maltreatment as required under section 626.556
319.7 	or 626.557, the license holder must inform the case manager of the report unless there is 
319.8 	reason to believe that the case manager is involved in the suspected maltreatment. The 
319.9 	license holder must disclose the nature of the activity or occurrence reported and the 
319.10 	agency that received the report.
319.11 	(e) The license holder must report the death or serious injury of the person to the legal 
319.12 	representative, if any, and case manager, as required in paragraph (b) and to  the Department 
319.13 	of Human Services Licensing Division, and the Office of Ombudsman for Mental Health 
319.14 	and Developmental Disabilities as required under section 245.94, subdivision 2a, within 
319.15 	24 hours of the death, or receipt of information that the death occurred, unless the license 
319.16 	holder has reason to know that the death has already been reported.
319.17 	(f) When a death or serious injury occurs in a facility certified as an intermediate 
319.18 	care facility for persons with developmental disabilities, the death or serious injury must 
319.19 	be reported to the Department of Health, Office of Health Facility Complaints, and the 
319.20 	Office of Ombudsman for Mental Health and Developmental Disabilities, as required 
319.21 	under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to 
319.22 	know that the death has already been reported.
319.23 	(f) (g) The license holder must conduct a an internal review of incident reports of 
319.24 	deaths and serious injuries that occurred while services were being provided and that 
319.25 	were not reported by the program as alleged or suspected maltreatment, for identification 
319.26 	of incident patterns, and implementation of corrective action as necessary to reduce 
319.27 	occurrences. The review must include an evaluation of whether related policies and 
319.28 	procedures were followed, whether the policies and procedures were adequate, whether 
319.29 	there is a need for additional staff training, whether the reported event is similar to past 
319.30 	events with the persons or the services involved, and whether there is a need for corrective 
319.31 	action by the license holder to protect the health and safety of persons receiving services. 
319.32 	Based on the results of this review, the license holder must develop, document, and 
319.33 	implement a corrective action plan designed to correct current lapses and prevent future 
319.34 	lapses in performance by staff or the license holder, if any.
319.35 	(h) The license holder must verbally report the emergency use of manual restraint of 
319.36 	a person as required in paragraph (b), within 24 hours of the occurrence. The license holder 
320.1 	must ensure the written report and internal review of all incident reports of the emergency 
320.2 	use of manual restraints are completed according to the requirements in section 245D.061.
320.3 		Subd. 2.Environment and safety. The license holder must:
320.4 	(1) ensure the following when the license holder is the owner, lessor, or tenant 
320.5 	of the an unlicensed service site:
320.6 	(i) the service site is a safe and hazard-free environment;
320.7 	(ii) doors are locked or toxic substances or dangerous items normally accessible are 
320.8 	inaccessible to persons served by the program are stored in locked cabinets, drawers, or 
320.9 	containers only to protect the safety of a person receiving services and not as a substitute 
320.10 	for staff supervision or interactions with a person who is receiving services. If doors are 
320.11 	locked or toxic substances or dangerous items normally accessible to persons served by the 
320.12 	program are stored in locked cabinets, drawers, or containers are made inaccessible, the 
320.13 	license holder must justify and document how this determination was made in consultation 
320.14 	with the person or person's legal representative, and how access will otherwise be provided 
320.15 	to the person and all other affected persons receiving services; and document an assessment 
320.16 	of the physical plant, its environment, and its population identifying the risk factors which 
320.17 	require toxic substances or dangerous items to be inaccessible and a statement of specific 
320.18 	measures to be taken to minimize the safety risk to persons receiving services;
320.19 	(iii) doors are locked from the inside to prevent a person from exiting only when 
320.20 	necessary to protect the safety of a person receiving services and not as a substitute for 
320.21 	staff supervision or interactions with the person. If doors are locked from the inside, the 
320.22 	license holder must document an assessment of the physical plant, the environment and 
320.23 	the population served, identifying the risk factors which require the use of locked doors, 
320.24 	and a statement of specific measures to be taken to minimize the safety risk to persons 
320.25 	receiving services at the service site; and
320.26 	(iii) (iv) a staff person is available on site who is trained in basic first aid and, when 
320.27 	required in a person's coordinated service and support plan or coordinated service and 
320.28 	support plan addendum, cardiopulmonary resuscitation, "CPR," whenever persons are 
320.29 	present and staff are required to be at the site to provide direct service. The CPR training 
320.30 	must include in-person instruction, hands-on practice, and an observed skills assessment 
320.31 	under the direct supervision of a CPR instructor;
320.32 	(2) maintain equipment, vehicles, supplies, and materials owned or leased by the 
320.33 	license holder in good condition when used to provide services;
320.34 	(3) follow procedures to ensure safe transportation, handling, and transfers of the 
320.35 	person and any equipment used by the person, when the license holder is responsible for 
320.36 	transportation of a person or a person's equipment;
321.1 	(4) be prepared for emergencies and follow emergency response procedures to 
321.2 	ensure the person's safety in an emergency; and
321.3 	(5) follow universal precautions and sanitary practices, including hand washing, for 
321.4 	infection prevention and control, and to prevent communicable diseases.
321.5 		Subd. 3.Compliance with fire and safety codes. When services are provided at a
321.6 	 service site licensed according to chapter 245A or where the license holder is the owner, 
321.7 	lessor, or tenant of the service site, the license holder must document compliance with 
321.8 	applicable building codes, fire and safety codes, health rules, and zoning ordinances, or 
321.9 	document that an appropriate waiver has been granted.
321.10 		Subd. 4.Funds and property. (a) Whenever the license holder assists a person 
321.11 	with the safekeeping of funds or other property according to section 245A.04, subdivision 
321.12 	13, the license holder must have obtain written authorization to do so from the person or 
321.13 	the person's legal representative and the case manager. Authorization must be obtained 
321.14 	within five working days of service initiation and renewed annually thereafter. At the time 
321.15 	initial authorization is obtained, the license holder must survey, document, and implement 
321.16 	the preferences of the person or the person's legal representative and the case manager 
321.17 	for frequency of receiving a statement that itemizes receipts and disbursements of funds 
321.18 	or other property. The license holder must document changes to these preferences when 
321.19 	they are requested.
321.20 	(b) A license holder or staff person may not accept powers-of-attorney from a 
321.21 	person receiving services from the license holder for any purpose, and may not accept an 
321.22 	appointment as guardian or conservator of a person receiving services from the license 
321.23 	holder. This does not apply to license holders that are Minnesota counties or other 
321.24 	units of government or to staff persons employed by license holders who were acting 
321.25 	as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals 
321.26 	prior to April 23, 2012 implementation of this chapter. The license holder must maintain 
321.27 	documentation of the power-of-attorney, guardianship, or conservatorship in the service 
321.28 	recipient record.
321.29 	(c) Upon the transfer or death of a person, any funds or other property of the person 
321.30 	must be surrendered to the person or the person's legal representative, or given to the 
321.31 	executor or administrator of the estate in exchange for an itemized receipt.
321.32 		Subd. 5.Prohibitions. (a) The license holder is prohibited from using psychotropic 
321.33 	medication chemical restraints, mechanical restraint practices, manual restraints, time out, 
321.34 	or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program 
321.35 	to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason 
321.36 	other than as prescribed.
322.1 	(b) The license holder is prohibited from using restraints or seclusion under any 
322.2 	circumstance, unless the commissioner has approved a variance request from the license 
322.3 	holder that allows for the emergency use of restraints and seclusion according to terms 
322.4 	and conditions approved in the variance. Applicants and license holders who have 
322.5 	reason to believe they may be serving an individual who will need emergency use of 
322.6 	restraints or seclusion may request a variance on the application or reapplication, and 
322.7 	the commissioner shall automatically review the request for a variance as part of the 
322.8 	application or reapplication process. License holders may also request the variance any 
322.9 	time after issuance of a license. In the event a license holder uses restraint or seclusion for 
322.10 	any reason without first obtaining a variance as required, the license holder must report 
322.11 	the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the 
322.12 	occurrence and request the required variance.
322.13 	(b) For the purposes of this subdivision, "chemical restraint" means the 
322.14 	administration of a drug or medication to control the person's behavior or restrict the 
322.15 	person's freedom of movement and is not a standard treatment of dosage for the person's 
322.16 	medical or psychological condition.
322.17 	(c) For the purposes of this subdivision, "mechanical restraint practice" means the 
322.18 	use of any adaptive equipment or safety device to control the person's behavior or restrict 
322.19 	the person's freedom of movement and not as ordered by a licensed health professional. 
322.20 	Mechanical restraint practices include, but are not limited to, the use of bed rails or similar 
322.21 	devices on a bed to prevent the person from getting out of bed, chairs that prevent a person 
322.22 	from rising, or placing a person in a wheelchair so close to a wall that the wall prevents 
322.23 	the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to 
322.24 	warn staff that a person is leaving a room or area do not, in and of themselves, restrict 
322.25 	freedom of movement and should not be considered restraints.
322.26 	(d) A license holder must not use manual restraints, time out, or seclusion under any 
322.27 	circumstance, except for emergency use of manual restraints according to the requirements 
322.28 	in section 245D.061 or the use of controlled procedures with a person with a developmental 
322.29 	disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor 
322.30 	provisions. License holders implementing nonemergency use of manual restraint, or any 
322.31 	other programmatic use of mechanical restraint, time out, or seclusion with persons who 
322.32 	do not have a developmental disability that is not subject to the requirements of Minnesota 
322.33 	Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner 
322.34 	for continued use of the procedure within three months of implementation of this chapter.

322.35 	EFFECTIVE DATE. This section is effective January 1, 2014.

323.1 	Sec. 24. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
323.2 		Subdivision 1.Standards for emergency use of manual restraints. Except 
323.3 	for the emergency use of controlled procedures with a person with a developmental 
323.4 	disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions, 
323.5 	the license holder must ensure that emergency use of manual restraints complies with the 
323.6 	requirements of this chapter and the license holder's policy and procedures as required 
323.7 	under subdivision 10.
323.8 		Subd. 2.Definitions. (a) The terms used in this section have the meaning given 
323.9 	them in this subdivision.
323.10 	(b) "Manual restraint" means physical intervention intended to hold a person 
323.11 	immobile or limit a person's voluntary movement by using body contact as the only source 
323.12 	of physical restraint.
323.13 	(c) "Mechanical restraint" means the use of devices, materials, or equipment attached 
323.14 	or adjacent to the person's body, or the use of practices which restrict freedom of movement 
323.15 	or normal access to one's body or body parts, or limits a person's voluntary movement 
323.16 	or holds a person immobile as an intervention precipitated by a person's behavior. The 
323.17 	term does apply to mechanical restraint used to prevent injury with persons who engage in 
323.18 	self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue 
323.19 	damage that have caused or could cause medical problems resulting from the self-injury.
323.20 		Subd. 3.Conditions for emergency use of manual restraint. Emergency use of 
323.21 	manual restraint must meet the following conditions:
323.22 	(1) immediate intervention must be needed to protect the person or others from 
323.23 	imminent risk of physical harm; and
323.24 	(2) the type of manual restraint used must be the least restrictive intervention to 
323.25 	eliminate the immediate risk of harm and effectively achieve safety. The manual restraint 
323.26 	must end when the threat of harm ends.
323.27 		Subd. 4.Permitted instructional techniques and therapeutic conduct. (a) Use of 
323.28 	physical contact as therapeutic conduct or as an instructional technique as identified in 
323.29 	paragraphs (b) and (c), is permitted and is not subject to the requirements of this section 
323.30 	when such use is addressed in a person's coordinated service and support plan addendum 
323.31 	and the required conditions have been met. For the purposes of this subdivision, 
323.32 	"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.
323.33 	(b) Physical contact or instructional techniques must use the least restrictive 
323.34 	alternative possible to meet the needs of the person and may be used:
323.35 	(1) to calm or comfort a person by holding that person with no resistance from 
323.36 	that person; 
324.1 	(2) to protect a person known to be at risk of injury due to frequent falls as a result of 
324.2 	a medical condition; or
324.3 	(3) to position a person with physical disabilities in a manner specified in the 
324.4 	person's coordinated service and support plan addendum.
324.5 	(c) Restraint may be used as therapeutic conduct:
324.6 	(1) to allow a licensed health care professional to safely conduct a medical 
324.7 	examination or to provide medical treatment ordered by a licensed health care professional 
324.8 	to a person necessary to promote healing or recovery from an acute, meaning short-term, 
324.9 	medical condition;
324.10 	(2) to facilitate the person's completion of a task or response when the person does 
324.11 	not resist or the person's resistance is minimal in intensity and duration;
324.12 	(3) to briefly block or redirect a person's limbs or body without holding the person 
324.13 	or limiting the person's movement to interrupt the person's behavior that may result in 
324.14 	injury to self or others; or
324.15 	(4) to assist in the safe evacuation of a person in the event of an emergency or to 
324.16 	redirect a person who is at imminent risk of harm in a dangerous situation.
324.17 	(d) A plan for using restraint as therapeutic conduct must be developed according to 
324.18 	the requirements in sections 245D.07 and 245D.071, and must include methods to reduce 
324.19 	or eliminate the use of and need for restraint.
324.20 		Subd. 5.Restrictions when implementing emergency use of manual restraint.
 324.21 	(a) Emergency use of manual restraint procedures must not:
324.22 	(1) be implemented with a child in a manner that constitutes sexual abuse, neglect, 
324.23 	physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
324.24 	(2) be implemented with an adult in a manner that constitutes abuse or neglect as 
324.25 	defined in section 626.5572, subdivisions 2 and 17;
324.26 	(3) be implemented in a manner that violates a person's rights and protections 
324.27 	identified in section 245D.04;
324.28 	(4) restrict a person's normal access to a nutritious diet, drinking water, adequate 
324.29 	ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping 
324.30 	conditions, or necessary clothing, or to any protection required by state licensing standards 
324.31 	and federal regulations governing the program;
324.32 	(5) deny the person visitation or ordinary contact with legal counsel, a legal 
324.33 	representative, or next of kin;
324.34 	(6) be used as a substitute for adequate staffing, for the convenience of staff, as 
324.35 	punishment, or as a consequence if the person refuses to participate in the treatment 
324.36 	or services provided by the program; or
325.1 	(7) use prone restraint. For the purposes of this section, "prone restraint" means use 
325.2 	of manual restraint that places a person in a face-down position. This does not include 
325.3 	brief physical holding of a person who, during an emergency use of manual restraint, rolls 
325.4 	into a prone position, and the person is restored to a standing, sitting, or side-lying position 
325.5 	as quickly as possible. Applying back or chest pressure while a person is in the prone or 
325.6 	supine position or face-up is prohibited.
325.7 		Subd. 6.Monitoring emergency use of manual restraint. The license holder shall 
325.8 	monitor a person's health and safety during an emergency use of a manual restraint. Staff 
325.9 	monitoring the procedure must not be the staff implementing the procedure when possible. 
325.10 	The license holder shall complete a monitoring form, approved by the commissioner, for 
325.11 	each incident involving the emergency use of a manual restraint.
325.12 		Subd. 7.Reporting emergency use of manual restraint incident. (a) Within 
325.13 	three calendar days after an emergency use of a manual restraint, the staff person who 
325.14 	implemented the emergency use must report in writing to the designated coordinator the 
325.15 	following information about the emergency use: 
325.16 	(1) the staff and persons receiving services who were involved in the incident 
325.17 	leading up to the emergency use of manual restraint;
325.18 	(2) a description of the physical and social environment, including who was present 
325.19 	before and during the incident leading up to the emergency use of manual restraint;
325.20 	(3) a description of what less restrictive alternative measures were attempted to 
325.21 	de-escalate the incident and maintain safety before the manual restraint was implemented 
325.22 	that identifies when, how, and how long the alternative measures were attempted before 
325.23 	manual restraint was implemented;
325.24 	(4) a description of the mental, physical, and emotional condition of the person who 
325.25 	was restrained, and other persons involved in the incident leading up to, during, and 
325.26 	following the manual restraint;
325.27 	(5) whether there was any injury to the person who was restrained or other persons 
325.28 	involved in the incident, including staff, before or as a result of the use of manual 
325.29 	restraint; and
325.30 	(6) whether there was an attempt to debrief with the staff, and, if not contraindicated, 
325.31 	with the person who was restrained and other persons who were involved in or who 
325.32 	witnessed the restraint, following the incident and the outcome of the debriefing. If the 
325.33 	debriefing was not conducted at the time the incident report was made, the report should 
325.34 	identify whether a debriefing is planned.
326.1 	(b) Each single incident of emergency use of manual restraint must be reported 
326.2 	separately. For the purposes of this subdivision, an incident of emergency use of manual 
326.3 	restraint is a single incident when the following conditions have been met:
326.4 	(1) after implementing the manual restraint, staff attempt to release the person at the 
326.5 	moment staff believe the person's conduct no longer poses an imminent risk of physical 
326.6 	harm to self or others and less restrictive strategies can be implemented to maintain safety;
326.7 	(2) upon the attempt to release the restraint, the person's behavior immediately 
326.8 	re-escalates; and
326.9 	(3) staff must immediately reimplement the restraint in order to maintain safety.
326.10 		Subd. 8.Internal review of emergency use of manual restraint. (a) Within five 
326.11 	working days of the emergency use of manual restraint, the license holder must complete 
326.12 	an internal review of each report of emergency use of manual restraint. The review must 
326.13 	include an evaluation of whether:
326.14 	(1) the person's service and support strategies developed according to sections 
326.15 	245D.07 and 245D.071 need to be revised;
326.16 	(2) related policies and procedures were followed;
326.17 	(3) the policies and procedures were adequate;
326.18 	(4) there is a need for additional staff training;
326.19 	(5) the reported event is similar to past events with the persons, staff, or the services 
326.20 	involved; and
326.21 	(6) there is a need for corrective action by the license holder to protect the health 
326.22 	and safety of persons.
326.23 	(b) Based on the results of the internal review, the license holder must develop, 
326.24 	document, and implement a corrective action plan for the program designed to correct 
326.25 	current lapses and prevent future lapses in performance by individuals or the license 
326.26 	holder, if any. The corrective action plan, if any, must be implemented within 30 days of 
326.27 	the internal review being completed.
326.28 		Subd. 9.Expanded support team review. Within five working days after the 
326.29 	completion of the internal review required in subdivision 8, the license holder must consult 
326.30 	with the expanded support team following the emergency use of manual restraint to:
326.31 	(1) discuss the incident reported in subdivision 7, to define the antecedent or event 
326.32 	that gave rise to the behavior resulting in the manual restraint and identify the perceived 
326.33 	function the behavior served; and
326.34 	(2) determine whether the person's coordinated service and support plan addendum 
326.35 	needs to be revised according to sections 245D.07 and 245D.071 to positively and 
327.1 	effectively help the person maintain stability and to reduce or eliminate future occurrences 
327.2 	requiring emergency use of manual restraint.
327.3 		Subd. 10.Emergency use of manual restraints policy and procedures. The 
327.4 	license holder must develop, document, and implement a policy and procedures that 
327.5 	promote service recipient rights and protect health and safety during the emergency use of 
327.6 	manual restraints. The policy and procedures must comply with the requirements of this 
327.7 	section and must specify the following:
327.8 	(1) a description of the positive support strategies and techniques staff must use to 
327.9 	attempt to de-escalate a person's behavior before it poses an imminent risk of physical 
327.10 	harm to self or others;
327.11 	(2) a description of the types of manual restraints the license holder allows staff to 
327.12 	use on an emergency basis, if any. If the license holder will not allow the emergency use 
327.13 	of manual restraint, the policy and procedure must identify the alternative measures the 
327.14 	license holder will require staff to use when a person's conduct poses an imminent risk of 
327.15 	physical harm to self or others and less restrictive strategies would not achieve safety;
327.16 	(3) instructions for safe and correct implementation of the allowed manual restraint 
327.17 	procedures;
327.18 	(4) the training that staff must complete and the timelines for completion, before they 
327.19 	may implement an emergency use of manual restraint. In addition to the training on this 
327.20 	policy and procedure and the orientation and annual training required in section 245D.09, 
327.21 	subdivision 4, the training for emergency use of manual restraint must incorporate the 
327.22 	following subjects:
327.23 	(i) alternatives to manual restraint procedures, including techniques to identify 
327.24 	events and environmental factors that may escalate conduct that poses an imminent risk of 
327.25 	physical harm to self or others;
327.26 	(ii) de-escalation methods, positive support strategies, and how to avoid power 
327.27 	struggles;
327.28 	(iii) simulated experiences of administering and receiving manual restraint 
327.29 	procedures allowed by the license holder on an emergency basis;
327.30 	(iv) how to properly identify thresholds for implementing and ceasing restrictive 
327.31 	procedures;
327.32 	(v) how to recognize, monitor, and respond to the person's physical signs of distress, 
327.33 	including positional asphyxia; 
327.34 	(vi) the physiological and psychological impact on the person and the staff when 
327.35 	restrictive procedures are used;
327.36 	(vii) the communicative intent of behaviors; and
328.1 	(viii) relationship building;
328.2 	(5) the procedures and forms to be used to monitor the emergency use of manual 
328.3 	restraints, including what must be monitored and the frequency of monitoring per 
328.4 	each incident of emergency use of manual restraint, and the person or position who is 
328.5 	responsible for monitoring the use;
328.6 	(6) the instructions, forms, and timelines required for completing and submitting an 
328.7 	incident report by the person or persons who implemented the manual restraint; and
328.8 	(7) the procedures and timelines for conducting the internal review and the expanded 
328.9 	support team review, and the person or position responsible for completing the reviews and 
328.10 	who is responsible for ensuring that corrective action is taken or the person's coordinated 
328.11 	service and support plan addendum is revised, when determined necessary.

328.12 	EFFECTIVE DATE. This section is effective January 1, 2014.

328.13 	Sec. 25. Minnesota Statutes 2012, section 245D.07, is amended to read:
328.14 	245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
328.15 		Subdivision 1.Provision of services. The license holder must provide services as 
328.16 	specified assigned in the coordinated service and support plan and assigned to the license 
328.17 	holder. The provision of services must comply with the requirements of this chapter and 
328.18 	the federal waiver plans.
328.19 		Subd. 1a.Person-centered planning and service delivery. (a) The license holder 
328.20 	must provide services in response to the person's identified needs, interests, preferences, 
328.21 	and desired outcomes as specified in the coordinated service and support plan, the 
328.22 	coordinated service and support plan addendum, and in compliance with the requirements 
328.23 	of this chapter. License holders providing intensive support services must also provide 
328.24 	outcome-based services according to the requirements in section 245D.071.
328.25 	(b) Services must be provided in a manner that supports the person's preferences, 
328.26 	daily needs, and activities and accomplishment of the person's personal goals and service 
328.27 	outcomes, consistent with the principles of:
328.28 	(1) person-centered service planning and delivery that:
328.29 	(i) identifies and supports what is important to the person as well as what is 
328.30 	important for the person, including preferences for when, how, and by whom direct 
328.31 	support service is provided;
328.32 	(ii) uses that information to identify outcomes the person desires; and
328.33 	(iii) respects each person's history, dignity, and cultural background;
328.34 	(2) self-determination that supports and provides:
329.1 	(i) opportunities for the development and exercise of functional and age-appropriate 
329.2 	skills, decision making and choice, personal advocacy, and communication; and
329.3 	(ii) the affirmation and protection of each person's civil and legal rights;
329.4 	(3) providing the most integrated setting and inclusive service delivery that supports, 
329.5 	promotes, and allows:
329.6 	(i) inclusion and participation in the person's community as desired by the person 
329.7 	in a manner that enables the person to interact with nondisabled persons to the fullest 
329.8 	extent possible and supports the person in developing and maintaining a role as a valued 
329.9 	community member;
329.10 	(ii) opportunities for self-sufficiency as well as developing and maintaining social 
329.11 	relationships and natural supports; and
329.12 	(iii) a balance between risk and opportunity, meaning the least restrictive supports or 
329.13 	interventions necessary are provided in the most integrated settings in the most inclusive 
329.14 	manner possible to support the person to engage in activities of the person's own choosing 
329.15 	that may otherwise present a risk to the person's health, safety, or rights.
329.16 		Subd. 2.Service planning requirements for basic support services. (a) License 
329.17 	holders providing basic support services must meet the requirements of this subdivision.
329.18 	(b) Within 15 days of service initiation the license holder must complete a 
329.19 	preliminary coordinated service and support plan addendum based on the coordinated 
329.20 	service and support plan.
329.21 	(c) Within 60 days of service initiation the license holder must review and revise as 
329.22 	needed the preliminary coordinated service and support plan addendum to document the 
329.23 	services that will be provided including how, when, and by whom services will be provided, 
329.24 	and the person responsible for overseeing the delivery and coordination of services.
329.25 	(d) The license holder must participate in service planning and support team 
329.26 	meetings related to for the person following stated timelines established in the person's
329.27 	 coordinated service and support plan or as requested by the support team, the person, or 
329.28 	the person's legal representative, the support team or the expanded support team.
329.29 		Subd. 3.Reports. The license holder must provide written reports regarding the 
329.30 	person's progress or status as requested by the person, the person's legal representative, the 
329.31 	case manager, or the team.

329.32 	EFFECTIVE DATE. This section is effective January 1, 2014.

329.33 	Sec. 26. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE 
329.34 	SUPPORT SERVICES.
330.1 		Subdivision 1.Requirements for intensive support services. A license holder 
330.2 	providing intensive support services identified in section 245D.03, subdivision 1, 
330.3 	paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1 
330.4 	and 3, and this section.
330.5 		Subd. 2.Abuse prevention. Prior to or upon initiating services, the license holder 
330.6 	must develop, document, and implement an abuse prevention plan according to section 
330.7 	245A.65, subdivision 2.
330.8 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service 
330.9 	initiation the license holder must complete a preliminary coordinated service and support 
330.10 	plan addendum based on the coordinated service and support plan.
330.11 	(b) Within 45 days of service initiation the license holder must meet with the person, 
330.12 	the person's legal representative, the case manager, and other members of the support team 
330.13 	or expanded support team to assess and determine the following based on the person's 
330.14 	coordinated service and support plan and the requirements in subdivision 4 and section 
330.15 	245D.07, subdivision 1a:
330.16 	(1) the scope of the services to be provided to support the person's daily needs 
330.17 	and activities;
330.18 	(2) the person's desired outcomes and the supports necessary to accomplish the 
330.19 	person's desired outcomes;
330.20 	(3) the person's preferences for how services and supports are provided;
330.21 	(4) whether the current service setting is the most integrated setting available and 
330.22 	appropriate for the person; and
330.23 	(5) how services must be coordinated across other providers licensed under this 
330.24 	chapter serving the same person to ensure continuity of care for the person.
330.25 	(c) Within the scope of services, the license holder must, at a minimum, assess 
330.26 	the following areas:
330.27 	(1) the person's ability to self-manage health and medical needs to maintain or 
330.28 	improve physical, mental, and emotional well-being, including, when applicable, allergies, 
330.29 	seizures, choking, special dietary needs, chronic medical conditions, self-administration 
330.30 	of medication or treatment orders, preventative screening, and medical and dental 
330.31 	appointments;
330.32 	(2) the person's ability to self-manage personal safety to avoid injury or accident in 
330.33 	the service setting, including, when applicable, risk of falling, mobility, regulating water 
330.34 	temperature, community survival skills, water safety skills, and sensory disabilities; and
330.35 	(3) the person's ability to self-manage symptoms or behavior that may otherwise 
330.36 	result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to 
331.1 	(7), suspension or termination of services by the license holder, or other symptoms 
331.2 	or behaviors that may jeopardize the health and safety of the person or others. The 
331.3 	assessments must produce information about the person that is descriptive of the person's 
331.4 	overall strengths, functional skills and abilities, and behaviors or symptoms.
331.5 		Subd. 4.Service outcomes and supports. (a) Within ten working days of the 
331.6 	45-day meeting, the license holder must develop and document the service outcomes and 
331.7 	supports based on the assessments completed under subdivision 3 and the requirements 
331.8 	in section 245D.07, subdivision 1a. The outcomes and supports must be included in the 
331.9 	coordinated service and support plan addendum.
331.10 	(b) The license holder must document the supports and methods to be implemented 
331.11 	to support the accomplishment of outcomes related to acquiring, retaining, or improving 
331.12 	skills. The documentation must include:
331.13 	(1) the methods or actions that will be used to support the person and to accomplish 
331.14 	the service outcomes, including information about:
331.15 	(i) any changes or modifications to the physical and social environments necessary 
331.16 	when the service supports are provided;
331.17 	(ii) any equipment and materials required; and
331.18 	(iii) techniques that are consistent with the person's communication mode and 
331.19 	learning style;
331.20 	(2) the measurable and observable criteria for identifying when the desired outcome 
331.21 	has been achieved and how data will be collected;
331.22 	(3) the projected starting date for implementing the supports and methods and 
331.23 	the date by which progress towards accomplishing the outcomes will be reviewed and 
331.24 	evaluated; and
331.25 	(4) the names of the staff or position responsible for implementing the supports 
331.26 	and methods.
331.27 	(c) Within 20 working days of the 45-day meeting, the license holder must obtain 
331.28 	dated signatures from the person or the person's legal representative and case manager 
331.29 	to document completion and approval of the assessment and coordinated service and 
331.30 	support plan addendum.
331.31 		Subd. 5.Progress reviews. (a) The license holder must give the person or the 
331.32 	person's legal representative and case manager an opportunity to participate in the ongoing 
331.33 	review and development of the methods used to support the person and accomplish 
331.34 	outcomes identified in subdivisions 3 and 4. The license holder, in coordination with 
331.35 	the person's support team or expanded support team, must meet with the person, the 
331.36 	person's legal representative, and the case manager, and participate in progress review 
332.1 	meetings following stated timelines established in the person's coordinated service and 
332.2 	support plan or coordinated service and support plan addendum or within 30 days of a 
332.3 	written request by the person, the person's legal representative, or the case manager, 
332.4 	at a minimum of once per year.
332.5 	(b) The license holder must summarize the person's progress toward achieving the 
332.6 	identified outcomes and make recommendations and identify the rationale for changing, 
332.7 	continuing, or discontinuing implementation of supports and methods identified in 
332.8 	subdivision 4 in a written report sent to the person or the person's legal representative 
332.9 	and case manager five working days prior to the review meeting, unless the person, the 
332.10 	person's legal representative, or the case manager request to receive the report at the 
332.11 	time of the meeting.
332.12 	(c) Within ten working days of the progress review meeting, the license holder 
332.13 	must obtain dated signatures from the person or the person's legal representative and 
332.14 	the case manager to document approval of any changes to the coordinated service and 
332.15 	support plan addendum.

332.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

332.17 	Sec. 27. [245D.081] PROGRAM COORDINATION, EVALUATION, AND 
332.18 	OVERSIGHT.
332.19 		Subdivision 1.Program coordination and evaluation. (a) The license holder 
332.20 	is responsible for:
332.21 	(1) coordination of service delivery and evaluation for each person served by the 
332.22 	program as identified in subdivision 2; and
332.23 	(2) program management and oversight that includes evaluation of the program 
332.24 	quality and program improvement for services provided by the license holder as identified 
332.25 	in subdivision 3.
332.26 	(b) The same person may perform the functions in paragraph (a) if the work and 
332.27 	education qualifications are met in subdivisions 2 and 3.
332.28 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
332.29 	and evaluation of services provided by the license holder must be coordinated by a 
332.30 	designated staff person. The designated coordinator must provide supervision, support, 
332.31 	and evaluation of activities that include:
332.32 	(1) oversight of the license holder's responsibilities assigned in the person's 
332.33 	coordinated service and support plan and the coordinated service and support plan 
332.34 	addendum;
333.1 	(2) taking the action necessary to facilitate the accomplishment of the outcomes 
333.2 	according to the requirements in section 245D.07;
333.3 	(3) instruction and assistance to direct support staff implementing the coordinated 
333.4 	service and support plan and the service outcomes, including direct observation of service 
333.5 	delivery sufficient to assess staff competency; and
333.6 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
333.7 	the person's outcomes based on the measurable and observable criteria for identifying when 
333.8 	the desired outcome has been achieved according to the requirements in section 245D.07.
333.9 	(b) The license holder must ensure that the designated coordinator is competent to 
333.10 	perform the required duties identified in paragraph (a) through education and training in 
333.11 	human services and disability-related fields, and work experience in providing direct care 
333.12 	services and supports to persons with disabilities. The designated coordinator must have 
333.13 	the skills and ability necessary to develop effective plans and to design and use data 
333.14 	systems to measure effectiveness of services and supports. The license holder must verify 
333.15 	and document competence according to the requirements in section 245D.09, subdivision 
333.16 	3. The designated coordinator must minimally have:
333.17 	(1) a baccalaureate degree in a field related to human services, and one year of 
333.18 	full-time work experience providing direct care services to persons with disabilities or 
333.19 	persons age 65 and older;
333.20 	(2) an associate degree in a field related to human services, and two years of 
333.21 	full-time work experience providing direct care services to persons with disabilities or 
333.22 	persons age 65 and older;
333.23 	(3) a diploma in a field related to human services from an accredited postsecondary 
333.24 	institution and three years of full-time work experience providing direct care services to 
333.25 	persons with disabilities or persons age 65 and older; or
333.26 	(4) a minimum of 50 hours of education and training related to human services 
333.27 	and disabilities; and
333.28 	(5) four years of full-time work experience providing direct care services to persons 
333.29 	with disabilities or persons age 65 and older under the supervision of a staff person who 
333.30 	meets the qualifications identified in clauses (1) to (3).
333.31 		Subd. 3.Program management and oversight. (a) The license holder must 
333.32 	designate a managerial staff person or persons to provide program management and 
333.33 	oversight of the services provided by the license holder. The designated manager is 
333.34 	responsible for the following:
333.35 	(1) maintaining a current understanding of the licensing requirements sufficient to 
333.36 	ensure compliance throughout the program as identified in section 245A.04, subdivision 
334.1 	1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, 
334.2 	paragraph (b);
334.3 	(2) ensuring the duties of the designated coordinator are fulfilled according to the 
334.4 	requirements in subdivision 2;
334.5 	(3) ensuring the program implements corrective action identified as necessary 
334.6 	by the program following review of incident and emergency reports according to the 
334.7 	requirements in section 245D.11, subdivision 2, clause (7). An internal review of 
334.8 	incident reports of alleged or suspected maltreatment must be conducted according to the 
334.9 	requirements in section 245A.65, subdivision 1, paragraph (b);
334.10 	(4) evaluation of satisfaction of persons served by the program, the person's legal 
334.11 	representative, if any, and the case manager, with the service delivery and progress 
334.12 	towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and 
334.13 	ensuring and protecting each person's rights as identified in section 245D.04;
334.14 	(5) ensuring staff competency requirements are met according to the requirements in 
334.15 	section 245D.09, subdivision 3, and ensuring staff orientation and training is provided 
334.16 	according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
334.17 	(6) ensuring corrective action is taken when ordered by the commissioner and that 
334.18 	the terms and condition of the license and any variances are met; and
334.19 	(7) evaluating the information identified in clauses (1) to (6) to develop, document, 
334.20 	and implement ongoing program improvements.
334.21 	(b) The designated manager must be competent to perform the duties as required and 
334.22 	must minimally meet the education and training requirements identified in subdivision 
334.23 	2, paragraph (b), and have a minimum of three years of supervisory level experience in 
334.24 	a program providing direct support services to persons with disabilities or persons age 
334.25 	65 and older.

334.26 	EFFECTIVE DATE. This section is effective January 1, 2014.

334.27 	Sec. 28. Minnesota Statutes 2012, section 245D.09, is amended to read:
334.28 	245D.09 STAFFING STANDARDS.
334.29 		Subdivision 1.Staffing requirements.  The license holder must provide the level of
334.30 	 direct service support staff sufficient supervision, assistance, and training necessary:
334.31 	(1) to ensure the health, safety, and protection of rights of each person; and
334.32 	(2) to be able to implement the responsibilities assigned to the license holder in each 
334.33 	person's coordinated service and support plan or identified in the coordinated service and 
334.34 	support plan addendum, according to the requirements of this chapter.
335.1 		Subd. 2.Supervision of staff having direct contact. Except for a license holder 
335.2 	who is the sole direct service support staff, the license holder must provide adequate 
335.3 	supervision of staff providing direct service support to ensure the health, safety, and 
335.4 	protection of rights of each person and implementation of the responsibilities assigned to 
335.5 	the license holder in each person's service plan coordinated service and support plan or 
335.6 	coordinated service and support plan addendum.
335.7 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff is
335.8 	 providing direct support, or staff who have responsibilities related to supervising or 
335.9 	managing the provision of direct support service, are competent as demonstrated through
335.10 	 skills and knowledge training, experience, and education to meet the person's needs 
335.11 	and additional requirements as written in the coordinated service and support plan or 
335.12 	coordinated service and support plan addendum, or when otherwise required by the case 
335.13 	manager or the federal waiver plan. The license holder must verify and maintain evidence 
335.14 	of staff competency, including documentation of:
335.15 	(1) education and experience qualifications relevant to the job responsibilities 
335.16 	assigned to the staff and the needs of the general population of persons served by the 
335.17 	program, including a valid degree and transcript, or a current license, registration, or 
335.18 	certification, when a degree or licensure, registration, or certification is required by this 
335.19 	chapter or in the coordinated service and support plan or coordinated service and support 
335.20 	plan addendum;
335.21 	(2) completion of required demonstrated competency in the orientation and training
335.22 	 areas required under this chapter, including and when applicable, completion of continuing 
335.23 	education required to maintain professional licensure, registration, or certification 
335.24 	requirements. Competency in these areas is determined by the license holder through 
335.25 	knowledge testing and observed skill assessment conducted by the trainer or instructor; and
335.26 	(3) except for a license holder who is the sole direct service support staff, periodic
335.27 	 performance evaluations completed by the license holder of the direct service support staff 
335.28 	person's ability to perform the job functions based on direct observation.
335.29 	(b) Staff under 18 years of age may not perform overnight duties or administer 
335.30 	medication.
335.31 		Subd. 4.Orientation to program requirements. (a) Except for a license holder 
335.32 	who does not supervise any direct service support staff, within 90 days of hiring direct 
335.33 	service staff 60 days of hire, unless stated otherwise, the license holder must provide 
335.34 	and ensure completion of 30 hours of orientation for direct support staff that combines 
335.35 	supervised on-the-job training with review of and instruction on in the following areas:
335.36 	(1) the job description and how to complete specific job functions, including:
336.1 	(i) responding to and reporting incidents as required under section 245D.06, 
336.2 	subdivision 1; and
336.3 	(ii) following safety practices established by the license holder and as required in 
336.4 	section 245D.06, subdivision 2;
336.5 	(2) the license holder's current policies and procedures required under this chapter, 
336.6 	including their location and access, and staff responsibilities related to implementation 
336.7 	of those policies and procedures;
336.8 	(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the 
336.9 	federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff 
336.10 	responsibilities related to complying with data privacy practices;
336.11 	(4) the service recipient rights under section 245D.04, and staff responsibilities 
336.12 	related to ensuring the exercise and protection of those rights according to the requirements 
336.13 	in section 245D.04;
336.14 	(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment 
336.15 	reporting and service planning for children and vulnerable adults, and staff responsibilities 
336.16 	related to protecting persons from maltreatment and reporting maltreatment. This 
336.17 	orientation must be provided within 72 hours of first providing direct contact services and 
336.18 	annually thereafter according to section 245A.65, subdivision 3;
336.19 	(6) what constitutes use of restraints, seclusion, and psychotropic medications, 
336.20 	and staff responsibilities related to the prohibitions of their use the principles of 
336.21 	person-centered service planning and delivery as identified in section 245D.07, subdivision 
336.22 	1a, and how they apply to direct support service provided by the staff person; and
336.23 	(7) other topics as determined necessary in the person's coordinated service and 
336.24 	support plan by the case manager or other areas identified by the license holder.
336.25 	(b) License holders who provide direct service themselves must complete the 
336.26 	orientation required in paragraph (a), clauses (3) to (7).
336.27 		Subd. 4a.Orientation to individual service recipient needs. (c) (a) Before 
336.28 	providing having unsupervised direct service to contact with a person served by the 
336.29 	program, or for whom the staff person has not previously provided direct service support, 
336.30 	or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to 
336.31 	(f) are revised, the staff person must review and receive instruction on the following 
336.32 	as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job 
336.33 	functions for that person:.
336.34 	(b) Training and competency evaluations must include the following:
337.1 	(1) appropriate and safe techniques in personal hygiene and grooming, including 
337.2 	hair care, bathing, care of teeth, gums, oral prosthetic devices, and other activities of daily 
337.3 	living (ADLs) as defined under section 256B.0659, subdivision 1;
337.4 	(2) an understanding of what constitutes a healthy diet according to data from the 
337.5 	Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
337.6 	(3) skills necessary to provide appropriate support in instrumental activities of daily 
337.7 	living (IADLs) as defined under section 256B.0659, subdivision 1; and
337.8 	(4) demonstrated competence in providing first aid.
337.9 	(1) (c) The staff person must review and receive instruction on the person's
337.10 	 coordinated service and support plan or coordinated service and support plan addendum as 
337.11 	it relates to the responsibilities assigned to the license holder, and when applicable, the 
337.12 	person's individual abuse prevention plan according to section 245A.65, to achieve and 
337.13 	demonstrate an understanding of the person as a unique individual, and how to implement 
337.14 	those plans; and.
337.15 	(2) (d) The staff person must review and receive instruction on medication 
337.16 	administration procedures established for the person when medication administration is
337.17 	 assigned to the license holder according to section 245D.05, subdivision 1, paragraph 
337.18 	(b). Unlicensed staff may administer medications only after successful completion of a 
337.19 	medication administration training, from a training curriculum developed by a registered 
337.20 	nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse 
337.21 	practitioner, physician's assistant, or physician incorporating. The training curriculum 
337.22 	must incorporate an observed skill assessment conducted by the trainer to ensure staff 
337.23 	demonstrate the ability to safely and correctly follow medication procedures.
337.24 	Medication administration must be taught by a registered nurse, clinical nurse 
337.25 	specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of 
337.26 	service initiation or any time thereafter, the person has or develops a health care condition 
337.27 	that affects the service options available to the person because the condition requires:
337.28 	(i) (1) specialized or intensive medical or nursing supervision; and
337.29 	(ii) (2) nonmedical service providers to adapt their services to accommodate the 
337.30 	health and safety needs of the person; and.
337.31 	(iii) necessary training in order to meet the health service needs of the person as 
337.32 	determined by the person's physician.
337.33 	(e) The staff person must review and receive instruction on the safe and correct 
337.34 	operation of medical equipment used by the person to sustain life, including but not 
337.35 	limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided 
337.36 	by a licensed health care professional or a manufacturer's representative and incorporate 
338.1 	an observed skill assessment to ensure staff demonstrate the ability to safely and correctly 
338.2 	operate the equipment according to the treatment orders and the manufacturer's instructions.
338.3 	(f) The staff person must review and receive instruction on what constitutes use of 
338.4 	restraints, time out, and seclusion, including chemical restraint, and staff responsibilities 
338.5 	related to the prohibitions of their use according to the requirements in section 245D.06, 
338.6 	subdivision 5, why such procedures are not effective for reducing or eliminating symptoms 
338.7 	or undesired behavior and why they are not safe, and the safe and correct use of manual 
338.8 	restraint on an emergency basis according to the requirements in section 245D.061.
338.9 	(g) In the event of an emergency service initiation, the license holder must ensure 
338.10 	the training required in this subdivision occurs within 72 hours of the direct support staff 
338.11 	person first having unsupervised contact with the person receiving services. The license 
338.12 	holder must document the reason for the unplanned or emergency service initiation and 
338.13 	maintain the documentation in the person's service recipient record.
338.14 	(h) License holders who provide direct support services themselves must complete 
338.15 	the orientation required in subdivision 4, clauses (3) to (7).
338.16 		Subd. 5.Annual training. (a) A license holder must provide annual training 
338.17 	to direct service support staff on the topics identified in subdivision 4, paragraph (a),
338.18 	 clauses (3) to (6) (7), and subdivision 4a. A license holder must provide a minimum of 24 
338.19 	hours of annual training to direct service staff with fewer than five years of documented 
338.20 	experience and 12 hours of annual training to direct service staff with five or more years 
338.21 	of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) 
338.22 	to (h). Training on relevant topics received from sources other than the license holder 
338.23 	may count toward training requirements.
338.24 	(b) A license holder providing behavioral programming, specialist services, personal 
338.25 	support, 24-hour emergency assistance, night supervision, independent living skills, 
338.26 	structured day, prevocational, or supported employment services must provide a minimum 
338.27 	of eight hours of annual training to direct service staff that addresses:
338.28 	(1) topics related to the general health, safety, and service needs of the population 
338.29 	served by the license holder; and
338.30 	(2) other areas identified by the license holder or in the person's current service plan.
338.31 	Training on relevant topics received from sources other than the license holder 
338.32 	may count toward training requirements.
338.33 	(c) When the license holder is the owner, lessor, or tenant of the service site and 
338.34 	whenever a person receiving services is present at the site, the license holder must have 
338.35 	a staff person available on site who is trained in basic first aid and, when required in a 
338.36 	person's service plan, cardiopulmonary resuscitation.
339.1 		Subd. 5a.Alternative sources of training.  Orientation or training received by the 
339.2 	staff person from sources other than the license holder in the same subjects as identified 
339.3 	in subdivision 4 may count toward the orientation and annual training requirements if 
339.4 	received in the 12-month period before the staff person's date of hire. The license holder 
339.5 	must maintain documentation of the training received from other sources and of each staff 
339.6 	person's competency in the required area according to the requirements in subdivision 3.
339.7 		Subd. 6.Subcontractors and temporary staff. If the license holder uses a 
339.8 	subcontractor or temporary staff to perform services licensed under this chapter on the 
339.9 	license holder's behalf, the license holder must ensure that the subcontractor or temporary 
339.10 	staff meets and maintains compliance with all requirements under this chapter that apply 
339.11 	to the services to be provided, including training, orientation, and supervision necessary 
339.12 	to fulfill their responsibilities. The license holder must ensure that a background study 
339.13 	has been completed according to the requirements in sections 245C.03, subdivision 1, 
339.14 	and 245C.04. Subcontractors and temporary staff hired by the license holder must meet 
339.15 	the Minnesota licensing requirements applicable to the disciplines in which they are 
339.16 	providing services. The license holder must maintain documentation that the applicable 
339.17 	requirements have been met.
339.18 		Subd. 7.Volunteers. The license holder must ensure that volunteers who provide 
339.19 	direct support services to persons served by the program receive the training, orientation, 
339.20 	and supervision necessary to fulfill their responsibilities. The license holder must ensure 
339.21 	that a background study has been completed according to the requirements in sections 
339.22 	245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation 
339.23 	that the applicable requirements have been met.
339.24 		Subd. 8.Staff orientation and training plan. The license holder must develop 
339.25 	a staff orientation and training plan documenting when and how compliance with 
339.26 	subdivisions 4, 4a, and 5 will be met.

339.27 	EFFECTIVE DATE. This section is effective January 1, 2014.

339.28 	Sec. 29. [245D.091] INTERVENTION SERVICES.
339.29 		Subdivision 1.Licensure requirements. An individual meeting the staff 
339.30 	qualification requirements of this section who is an employee of a program licensed 
339.31 	according to this chapter and providing behavioral support services, specialist services, 
339.32 	or crisis respite services is not required to hold a separate license under this chapter. 
339.33 	An individual meeting the staff qualifications of this section who is not providing these 
339.34 	services as an employee of a program licensed according to this chapter must obtain a 
339.35 	license according to this chapter.
340.1 		Subd. 2.Behavior professional qualifications. A behavior professional, as defined 
340.2 	in the brain injury and community alternatives for disabled individuals waiver plans or 
340.3 	successor plans, must have competencies in areas related to:
340.4 	(1) ethical considerations;
340.5 	(2) functional assessment;
340.6 	(3) functional analysis;
340.7 	(4) measurement of behavior and interpretation of data;
340.8 	(5) selecting intervention outcomes and strategies;
340.9 	(6) behavior reduction and elimination strategies that promote least restrictive 
340.10 	approved alternatives;
340.11 	(7) data collection;
340.12 	(8) staff and caregiver training;
340.13 	(9) support plan monitoring;
340.14 	(10) co-occurring mental disorders or neuro-cognitive disorder;
340.15 	(11) demonstrated expertise with populations being served; and
340.16 	(12) must be a:
340.17 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the 
340.18 	Board of Psychology competencies in the above identified areas;
340.19 	(ii) clinical social worker licensed as an independent clinical social worker under 
340.20 	chapter 148D, or a person with a master's degree in social work from an accredited college 
340.21 	or university, with at least 4,000 hours of post-master's supervised experience in the 
340.22 	delivery of clinical services in the areas identified in clauses (1) to (11);
340.23 	(iii) physician licensed under chapter 147 and certified by the American Board 
340.24 	of Psychiatry and Neurology or eligible for board certification in psychiatry with 
340.25 	competencies in the areas identified in clauses (1) to (11);
340.26 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 
340.27 	148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery 
340.28 	of clinical services who has demonstrated competencies in the areas identified in clauses 
340.29 	(1) to (11);
340.30 	(v) person with a master's degree from an accredited college or university in one 
340.31 	of the behavioral sciences or related fields, with at least 4,000 hours of post-master's 
340.32 	supervised experience in the delivery of clinical services with demonstrated competencies 
340.33 	in the areas identified in clauses (1) to (11); or
340.34 	(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
340.35 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
340.36 	mental health nursing by a national nurse certification organization, or who has a master's 
341.1 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
341.2 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
341.3 	experience in the delivery of clinical services.
341.4 		Subd. 3.Behavior analyst qualifications. (a) A behavior analyst, as defined in 
341.5 	the brain injury and community alternatives for disabled individuals waiver plans or 
341.6 	successor plans, must:
341.7 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
341.8 	discipline; or
341.9 	(2) meet the qualifications of a mental health practitioner as defined in section 
341.10 	245.462, subdivision 17.
341.11 	(b) In addition, a behavior analyst must:
341.12 	(1) have four years of supervised experience working with individuals who exhibit 
341.13 	challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
341.14 	(2) have received ten hours of instruction in functional assessment and functional 
341.15 	analysis;
341.16 	(3) have received 20 hours of instruction in the understanding of the function of 
341.17 	behavior;
341.18 	(4) have received ten hours of instruction on design of positive practices behavior 
341.19 	support strategies;
341.20 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
341.21 	strategies used only in combination with behavior positive practices strategies;
341.22 	(6) be determined by a behavior professional to have the training and prerequisite 
341.23 	skills required to provide positive practice strategies as well as behavior reduction 
341.24 	approved and permitted intervention to the person who receives behavioral support; and
341.25 	(7) be under the direct supervision of a behavior professional.
341.26 		Subd. 4.Behavior specialist qualifications. (a) A behavior specialist, as defined 
341.27 	in the brain injury and community alternatives for disabled individuals waiver plans or 
341.28 	successor plans, must meet the following qualifications:
341.29 	(1) have an associate's degree in a social services discipline; or
341.30 	(2) have two years of supervised experience working with individuals who exhibit 
341.31 	challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
341.32 	(b) In addition, a behavior specialist must:
341.33 	(1) have received a minimum of four hours of training in functional assessment;
341.34 	(2) have received 20 hours of instruction in the understanding of the function of 
341.35 	behavior;
342.1 	(3) have received ten hours of instruction on design of positive practices behavioral 
342.2 	support strategies;
342.3 	(4) be determined by a behavior professional to have the training and prerequisite 
342.4 	skills required to provide positive practices strategies as well as behavior reduction 
342.5 	approved intervention to the person who receives behavioral support; and
342.6 	(5) be under the direct supervision of a behavior professional.
342.7 		Subd. 5.Specialist services qualifications. An individual providing specialist 
342.8 	services, as defined in the developmental disabilities waiver plan or successor plan, must 
342.9 	have:
342.10 	(1) the specific experience and skills required of the specialist to meet the needs of 
342.11 	the person identified by the person's service planning team; and
342.12 	(2) the qualifications of the specialist identified in the person's coordinated service 
342.13 	and support plan.

342.14 	EFFECTIVE DATE. This section is effective January 1, 2014.

342.15 	Sec. 30. [245D.095] RECORD REQUIREMENTS.
342.16 		Subdivision 1.Record-keeping systems. The license holder must ensure that the 
342.17 	content and format of service recipient, personnel, and program records are uniform and 
342.18 	legible according to the requirements of this chapter.
342.19 		Subd. 2.Admission and discharge register. The license holder must keep a written 
342.20 	or electronic register, listing in chronological order the dates and names of all persons 
342.21 	served by the program who have been admitted, discharged, or transferred, including 
342.22 	service terminations initiated by the license holder and deaths.
342.23 		Subd. 3.Service recipient record. (a) The license holder must maintain a record of 
342.24 	current services provided to each person on the premises where the services are provided 
342.25 	or coordinated. When the services are provided in a licensed facility, the records must 
342.26 	be maintained at the facility, otherwise the records must be maintained at the license 
342.27 	holder's program office. The license holder must protect service recipient records against 
342.28 	loss, tampering, or unauthorized disclosure according to the requirements in sections 
342.29 	13.01 to 13.10 and 13.46.
342.30 	(b) The license holder must maintain the following information for each person:
342.31 	(1) an admission form signed by the person or the person's legal representative 
342.32 	that includes:
342.33 	(i) identifying information, including the person's name, date of birth, address, 
342.34 	and telephone number; and
343.1 	(ii) the name, address, and telephone number of the person's legal representative, if 
343.2 	any, and a primary emergency contact, the case manager, and family members or others as 
343.3 	identified by the person or case manager;
343.4 	(2) service information, including service initiation information, verification of the 
343.5 	person's eligibility for services, documentation verifying that services have been provided 
343.6 	as identified in the coordinated service and support plan or coordinated service and support 
343.7 	plan addendum according to paragraph (a), and date of admission or readmission;
343.8 	(3) health information, including medical history, special dietary needs, and 
343.9 	allergies, and when the license holder is assigned responsibility for meeting the person's 
343.10 	health service needs according to section 245D.05:
343.11 	(i) current orders for medication, treatments, or medical equipment and a signed 
343.12 	authorization from the person or the person's legal representative to administer or assist in 
343.13 	administering the medication or treatments, if applicable;
343.14 	(ii) a signed statement authorizing the license holder to act in a medical emergency 
343.15 	when the person's legal representative, if any, cannot be reached or is delayed in arriving;
343.16 	(iii) medication administration procedures;
343.17 	(iv) a medication administration record documenting the implementation of the 
343.18 	medication administration procedures, and the medication administration record reviews, 
343.19 	including any agreements for administration of injectable medications by the license 
343.20 	holder according to the requirements in section 245D.05; and
343.21 	(v) a medical appointment schedule when the license holder is assigned 
343.22 	responsibility for assisting with medical appointments;
343.23 	(4) the person's current coordinated service and support plan or that portion of the 
343.24 	plan assigned to the license holder;
343.25 	(5) copies of the individual abuse prevention plan and assessments as required under 
343.26 	section 245D.071, subdivisions 2 and 3;
343.27 	(6) a record of other service providers serving the person when the person's 
343.28 	coordinated service and support plan or coordinated service and support plan addendum 
343.29 	identifies the need for coordination between the service providers, that includes a contact 
343.30 	person and telephone numbers, services being provided, and names of staff responsible for 
343.31 	coordination;
343.32 	(7) documentation of orientation to service recipient rights according to section 
343.33 	245D.04, subdivision 1, and maltreatment reporting policies and procedures according to 
343.34 	section 245A.65, subdivision 1, paragraph (c);
343.35 	(8) copies of authorizations to handle a person's funds, according to section 245D.06, 
343.36 	subdivision 4, paragraph (a);
344.1 	(9) documentation of complaints received and grievance resolution;
344.2 	(10) incident reports involving the person, required under section 245D.06, 
344.3 	subdivision 1;
344.4 	(11) copies of written reports regarding the person's status when requested according 
344.5 	to section 245D.07, subdivision 3, progress review reports as required under section 
344.6 	245D.071, subdivision 5, progress or daily log notes that are recorded by the program, 
344.7 	and reports received from other agencies involved in providing services or care to the 
344.8 	person; and
344.9 	(12) discharge summary, including service termination notice and related 
344.10 	documentation, when applicable.
344.11 		Subd. 4.Access to service recipient records. The license holder must ensure that 
344.12 	the following people have access to the information in subdivision 1 in accordance with 
344.13 	applicable state and federal laws, regulations, or rules:
344.14 	(1) the person, the person's legal representative, and anyone properly authorized 
344.15 	by the person;
344.16 	(2) the person's case manager;
344.17 	(3) staff providing services to the person unless the information is not relevant to 
344.18 	carrying out the coordinated service and support plan or coordinated service and support 
344.19 	plan addendum; and
344.20 	(4) the county child or adult foster care licensor, when services are also licensed as 
344.21 	child or adult foster care.
344.22 		Subd. 5.Personnel records. (a) The license holder must maintain a personnel 
344.23 	record of each employee to document and verify staff qualifications, orientation, and 
344.24 	training. The personnel record must include:
344.25 	(1) the employee's date of hire, completed application, an acknowledgement signed 
344.26 	by the employee that job duties were reviewed with the employee and the employee 
344.27 	understands those duties, and documentation that the employee meets the position 
344.28 	requirements as determined by the license holder;
344.29 	 (2) documentation of staff qualifications, orientation, training, and performance 
344.30 	evaluations as required under section 245D.09, subdivisions 3 to 5, including the date 
344.31 	the training was completed, the number of hours per subject area, and the name of the 
344.32 	trainer or instructor; and
344.33 	(3) a completed background study as required under chapter 245C.
344.34 	(b) For employees hired after January 1, 2014, the license holder must maintain 
344.35 	documentation in the personnel record or elsewhere, sufficient to determine the date of the 
345.1 	employee's first supervised direct contact with a person served by the program, and the 
345.2 	date of first unsupervised direct contact with a person served by the program.

345.3 	EFFECTIVE DATE. This section is effective January 1, 2014.

345.4 	Sec. 31. Minnesota Statutes 2012, section 245D.10, is amended to read:
345.5 	245D.10 POLICIES AND PROCEDURES.
345.6 		Subdivision 1.Policy and procedure requirements.  The A license holder
345.7 	 providing either basic or intensive supports and services must establish, enforce, and 
345.8 	maintain policies and procedures as required in this chapter, chapter 245A, and other 
345.9 	applicable state and federal laws and regulations governing the provision of home and 
345.10 	community-based services licensed according to this chapter.
345.11 		Subd. 2.Grievances. The license holder must establish policies and procedures 
345.12 	that provide promote service recipient rights by providing a simple complaint process for 
345.13 	persons served by the program and their authorized representatives to bring a grievance that:
345.14 	(1) provides staff assistance with the complaint process when requested, and the 
345.15 	addresses and telephone numbers of outside agencies to assist the person;
345.16 	(2) allows the person to bring the complaint to the highest level of authority in the 
345.17 	program if the grievance cannot be resolved by other staff members, and that provides 
345.18 	the name, address, and telephone number of that person;
345.19 	(3) requires the license holder to promptly respond to all complaints affecting a 
345.20 	person's health and safety. For all other complaints, the license holder must provide an 
345.21 	initial response within 14 calendar days of receipt of the complaint. All complaints must 
345.22 	be resolved within 30 calendar days of receipt or the license holder must document the 
345.23 	reason for the delay and a plan for resolution;
345.24 	(4) requires a complaint review that includes an evaluation of whether:
345.25 	(i) related policies and procedures were followed and adequate;
345.26 	(ii) there is a need for additional staff training;
345.27 	(iii) the complaint is similar to past complaints with the persons, staff, or services 
345.28 	involved; and
345.29 	(iv) there is a need for corrective action by the license holder to protect the health 
345.30 	and safety of persons receiving services;
345.31 	(5) based on the review in clause (4), requires the license holder to develop, 
345.32 	document, and implement a corrective action plan designed to correct current lapses and 
345.33 	prevent future lapses in performance by staff or the license holder, if any;
346.1 	(6) provides a written summary of the complaint and a notice of the complaint 
346.2 	resolution to the person and case manager that:
346.3 	(i) identifies the nature of the complaint and the date it was received;
346.4 	(ii) includes the results of the complaint review;
346.5 	(iii) identifies the complaint resolution, including any corrective action; and
346.6 	(7) requires that the complaint summary and resolution notice be maintained in the 
346.7 	service recipient record.
346.8 		Subd. 3.Service suspension and service termination. (a) The license holder must 
346.9 	establish policies and procedures for temporary service suspension and service termination 
346.10 	that promote continuity of care and service coordination with the person and the case 
346.11 	manager and with other licensed caregivers, if any, who also provide support to the person.
346.12 	(b) The policy must include the following requirements:
346.13 	(1) the license holder must notify the person or the person's legal representative and 
346.14 	case manager in writing of the intended termination or temporary service suspension, and 
346.15 	the person's right to seek a temporary order staying the termination of service according to 
346.16 	the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
346.17 	(2) notice of the proposed termination of services, including those situations 
346.18 	that began with a temporary service suspension, must be given at least 60 days before 
346.19 	the proposed termination is to become effective when a license holder is providing 
346.20 	independent living skills training, structured day, prevocational or supported employment 
346.21 	services to the person intensive supports and services identified in section 245D.03, 
346.22 	subdivision 1, paragraph (c), and 30 days prior to termination for all other services 
346.23 	licensed under this chapter;
346.24 	(3) the license holder must provide information requested by the person or case 
346.25 	manager when services are temporarily suspended or upon notice of termination;
346.26 	(4) prior to giving notice of service termination or temporary service suspension, 
346.27 	the license holder must document actions taken to minimize or eliminate the need for 
346.28 	service suspension or termination;
346.29 	(5) during the temporary service suspension or service termination notice period, 
346.30 	the license holder will work with the appropriate county agency to develop reasonable 
346.31 	alternatives to protect the person and others;
346.32 	(6) the license holder must maintain information about the service suspension or 
346.33 	termination, including the written termination notice, in the service recipient record; and
346.34 	(7) the license holder must restrict temporary service suspension to situations in 
346.35 	which the person's behavior causes immediate and serious danger to the health and safety 
347.1 	of the person or others conduct poses an imminent risk of physical harm to self or others 
347.2 	and less restrictive or positive support strategies would not achieve safety.
347.3 		Subd. 4.Availability of current written policies and procedures. (a) The license 
347.4 	holder must review and update, as needed, the written policies and procedures required 
347.5 	under this chapter.
347.6 	(b)(1) The license holder must inform the person and case manager of the policies 
347.7 	and procedures affecting a person's rights under section 245D.04, and provide copies of 
347.8 	those policies and procedures, within five working days of service initiation.
347.9 	(2) If a license holder only provides basic services and supports, this includes the:
347.10 	(i) grievance policy and procedure required under subdivision 2; and
347.11 	(ii) service suspension and termination policy and procedure required under 
347.12 	subdivision 3.
347.13 	(3) For all other license holders this includes the:
347.14 	(i) policies and procedures in clause (2);
347.15 	(ii) emergency use of manual restraints policy and procedure required under 
347.16 	subdivision 3a; and
347.17 	(iii) data privacy requirements under section 245D.11, subdivision 3.
347.18 	(c) The license holder must provide a written notice to all persons or their legal 
347.19 	representatives and case managers at least 30 days before implementing any revised 
347.20 	policies and procedures procedural revisions to policies affecting a person's service-related 
347.21 	or protection-related rights under section 245D.04 and maltreatment reporting policies and 
347.22 	procedures. The notice must explain the revision that was made and include a copy of the 
347.23 	revised policy and procedure. The license holder must document the reason reasonable 
347.24 	cause for not providing the notice at least 30 days before implementing the revisions.
347.25 	(d) Before implementing revisions to required policies and procedures, the license 
347.26 	holder must inform all employees of the revisions and provide training on implementation 
347.27 	of the revised policies and procedures.
347.28 	(e) The license holder must annually notify all persons, or their legal representatives, 
347.29 	and case managers of any procedural revisions to policies required under this chapter, 
347.30 	other than those in paragraph (c). Upon request, the license holder must provide the 
347.31 	person, or the person's legal representative, and case manager with copies of the revised 
347.32 	policies and procedures.

347.33 	EFFECTIVE DATE. This section is effective January 1, 2014.

347.34 	Sec. 32. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT 
347.35 	SERVICES.
348.1 		Subdivision 1.Policy and procedure requirements. A license holder providing 
348.2 	intensive support services as identified in section 245D.03, subdivision 1, paragraph (c), 
348.3 	must establish, enforce, and maintain policies and procedures as required in this section.
348.4 		Subd. 2.Health and safety. The license holder must establish policies and 
348.5 	procedures that promote health and safety by ensuring:
348.6 	(1) use of universal precautions and sanitary practices in compliance with section 
348.7 	245D.06, subdivision 2, clause (5);
348.8 	(2) if the license holder operates a residential program, health service coordination 
348.9 	and care according to the requirements in section 245D.05, subdivision 1;
348.10 	(3) safe medication assistance and administration according to the requirements 
348.11 	in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in 
348.12 	consultation with a registered nurse, nurse practitioner, physician's assistant, or medical 
348.13 	doctor and require completion of medication administration training according to the 
348.14 	requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance 
348.15 	and administration includes, but is not limited to:
348.16 	(i) providing medication-related services for a person;
348.17 	(ii) medication setup;
348.18 	(iii) medication administration;
348.19 	(iv) medication storage and security;
348.20 	(v) medication documentation and charting;
348.21 	(vi) verification and monitoring of effectiveness of systems to ensure safe medication 
348.22 	handling and administration;
348.23 	(vii) coordination of medication refills;
348.24 	(viii) handling changes to prescriptions and implementation of those changes;
348.25 	(ix) communicating with the pharmacy; and
348.26 	(x) coordination and communication with prescriber;
348.27 	(4) safe transportation, when the license holder is responsible for transportation of 
348.28 	persons, with provisions for handling emergency situations according to the requirements 
348.29 	in section 245D.06, subdivision 2, clauses (2) to (4);
348.30 	(5) a plan for ensuring the safety of persons served by the program in emergencies as 
348.31 	defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies 
348.32 	to the license holder. A license holder with a community residential setting or a day service 
348.33 	facility license must ensure the policy and procedures comply with the requirements in 
348.34 	section 245D.22, subdivision 4;
349.1 	(6) a plan for responding to all incidents as defined in section 245D.02, subdivision 
349.2 	11; and reporting all incidents required to be reported according to section 245D.06, 
349.3 	subdivision 1. The plan must:
349.4 	(i) provide the contact information of a source of emergency medical care and 
349.5 	transportation; and
349.6 	(ii) require staff to first call 911 when the staff believes a medical emergency may be 
349.7 	life threatening, or to call the mental health crisis intervention team when the person is 
349.8 	experiencing a mental health crisis; and
349.9 	(7) a procedure for the review of incidents and emergencies to identify trends or 
349.10 	patterns, and corrective action if needed. The license holder must establish and maintain 
349.11 	a record-keeping system for the incident and emergency reports. Each incident and 
349.12 	emergency report file must contain a written summary of the incident. The license holder 
349.13 	must conduct a review of incident reports for identification of incident patterns, and 
349.14 	implementation of corrective action as necessary to reduce occurrences. Each incident 
349.15 	report must include:
349.16 	(i) the name of the person or persons involved in the incident. It is not necessary 
349.17 	to identify all persons affected by or involved in an emergency unless the emergency 
349.18 	resulted in an incident;
349.19 	(ii) the date, time, and location of the incident or emergency;
349.20 	(iii) a description of the incident or emergency;
349.21 	(iv) a description of the response to the incident or emergency and whether a person's 
349.22 	coordinated service and support plan addendum or program policies and procedures were 
349.23 	implemented as applicable;
349.24 	(v) the name of the staff person or persons who responded to the incident or 
349.25 	emergency; and
349.26 	(vi) the determination of whether corrective action is necessary based on the results 
349.27 	of the review.
349.28 		Subd. 3.Data privacy. The license holder must establish policies and procedures that 
349.29 	promote service recipient rights by ensuring data privacy according to the requirements in:
349.30 	(1) the Minnesota Government Data Practices Act, section 13.46, and all other 
349.31 	applicable Minnesota laws and rules in handling all data related to the services provided; 
349.32 	and
349.33 	(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the 
349.34 	extent that the license holder performs a function or activity involving the use of protected 
349.35 	health information as defined under Code of Federal Regulations, title 45, section 164.501, 
349.36 	including, but not limited to, providing health care services; health care claims processing 
350.1 	or administration; data analysis, processing, or administration; utilization review; quality 
350.2 	assurance; billing; benefit management; practice management; repricing; or as otherwise 
350.3 	provided by Code of Federal Regulations, title 45, section 160.103. The license holder 
350.4 	must comply with the Health Insurance Portability and Accountability Act of 1996 and 
350.5 	its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164, 
350.6 	and all applicable requirements.
350.7 		Subd. 4.Admission criteria. The license holder must establish policies and 
350.8 	procedures that promote continuity of care by ensuring that admission or service initiation 
350.9 	criteria:
350.10 	(1) is consistent with the license holder's registration information identified in the 
350.11 	requirements in section 245D.031, subdivision 2, and with the service-related rights 
350.12 	identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
350.13 	(2) identifies the criteria to be applied in determining whether the license holder 
350.14 	can develop services to meet the needs specified in the person's coordinated service and 
350.15 	support plan;
350.16 	(3) requires a license holder providing services in a health care facility to comply 
350.17 	with the requirements in section 243.166, subdivision 4b, to provide notification to 
350.18 	residents when a registered predatory offender is admitted into the program or to a 
350.19 	potential admission when the facility was already serving a registered predatory offender. 
350.20 	For purposes of this clause, "health care facility" means a facility licensed by the 
350.21 	commissioner as a residential facility under chapter 245A to provide adult foster care or 
350.22 	residential services to persons with disabilities; and
350.23 	(4) requires that when a person or the person's legal representative requests services 
350.24 	from the license holder, a refusal to admit the person must be based on an evaluation of 
350.25 	the person's assessed needs and the license holder's lack of capacity to meet the needs of 
350.26 	the person. The license holder must not refuse to admit a person based solely on the 
350.27 	type of residential services the person is receiving, or solely on the person's severity of 
350.28 	disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of 
350.29 	communication skills, physical disabilities, toilet habits, behavioral disorders, or past 
350.30 	failure to make progress. Documentation of the basis for refusal must be provided to the 
350.31 	person or the person's legal representative and case manager upon request.

350.32 	EFFECTIVE DATE. This section is effective January 1, 2014.

350.33 	Sec. 33. [245D.21] FACILITY LICENSURE REQUIREMENTS AND 
350.34 	APPLICATION PROCESS.
351.1 		Subdivision 1.Community residential settings and day service facilities. For 
351.2 	purposes of this section, "facility" means both a community residential setting and day 
351.3 	service facility and the physical plant.
351.4 		Subd. 2.Inspections and code compliance. (a) Physical plants must comply with 
351.5 	applicable state and local fire, health, building, and zoning codes.
351.6 	(b)(1) The facility must be inspected by a fire marshal or their delegate within 
351.7 	12 months before initial licensure to verify that it meets the applicable occupancy 
351.8 	requirements as defined in the State Fire Code and that the facility complies with the fire 
351.9 	safety standards for that occupancy code contained in the State Fire Code.
351.10 	(2) The fire marshal inspection of a community residential setting must verify the 
351.11 	residence is a dwelling unit within a residential occupancy as defined in section 9.117 of 
351.12 	the State Fire Code. A home safety checklist, approved by the commissioner, must be 
351.13 	completed for a community residential setting by the license holder and the commissioner 
351.14 	before the satellite license is reissued.
351.15 	(3) The facility shall be inspected according to the facility capacity specified on the 
351.16 	initial application form.
351.17 	(4) If the commissioner has reasonable cause to believe that a potentially hazardous 
351.18 	condition may be present or the licensed capacity is increased, the commissioner shall 
351.19 	request a subsequent inspection and written report by a fire marshal to verify the absence 
351.20 	of hazard.
351.21 	(5) Any condition cited by a fire marshal, building official, or health authority as 
351.22 	hazardous or creating an immediate danger of fire or threat to health and safety must be 
351.23 	corrected before a license is issued by the department, and for community residential 
351.24 	settings, before a license is reissued.
351.25 	(c) The facility must maintain in a permanent file the reports of health, fire, and 
351.26 	other safety inspections.
351.27 	(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other 
351.28 	fixtures and equipment, including elevators or food service, if provided, must conform to 
351.29 	applicable health, sanitation, and safety codes and regulations.

351.30 	EFFECTIVE DATE. This section is effective January 1, 2014.

351.31 	Sec. 34. [245D.22] FACILITY SANITATION AND HEALTH.
351.32 		Subdivision 1.General maintenance. The license holder must maintain the interior 
351.33 	and exterior of buildings, structures, or enclosures used by the facility, including walls, 
351.34 	floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a 
351.35 	sanitary and safe condition. The facility must be clean and free from accumulations of 
352.1 	dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must 
352.2 	correct building and equipment deterioration, safety hazards, and unsanitary conditions.
352.3 		Subd. 2.Hazards and toxic substances. The license holder must ensure that 
352.4 	service sites owned or leased by the license holder are free from hazards that would 
352.5 	threaten the health or safety of a person receiving services by ensuring the requirements 
352.6 	in paragraphs (a) to (g) are met.
352.7 	(a) Chemicals, detergents, and other hazardous or toxic substances must not be 
352.8 	stored with food products or in any way that poses a hazard to persons receiving services.
352.9 	(b) The license holder must install handrails and nonslip surfaces on interior and 
352.10 	exterior runways, stairways, and ramps according to the applicable building code.
352.11 	(c) If there are elevators in the facility, the license holder must have elevators 
352.12 	inspected each year. The date of the inspection, any repairs needed, and the date the 
352.13 	necessary repairs were made must be documented.
352.14 	(d) The license holder must keep stairways, ramps, and corridors free of obstructions.
352.15 	(e) Outside property must be free from debris and safety hazards. Exterior stairs and 
352.16 	walkways must be kept free of ice and snow.
352.17 	(f) Heating, ventilation, air conditioning units, and other hot surfaces and moving 
352.18 	parts of machinery must be shielded or enclosed.
352.19 	(g) Use of dangerous items or equipment by persons served by the program must be 
352.20 	allowed in accordance with the person's coordinated service and support plan addendum 
352.21 	or the program abuse prevention plan, if not addressed in the coordinated service and 
352.22 	support plan addendum.
352.23 		Subd. 3.Storage and disposal of medication. Schedule II controlled substances in 
352.24 	the facility that are named in section 152.02, subdivision 3, must be stored in a locked 
352.25 	storage area permitting access only by persons and staff authorized to administer the 
352.26 	medication. This must be incorporated into the license holder's medication administration 
352.27 	policy and procedures required under section 245D.11, subdivision 2, clause (3). 
352.28 	Medications must be disposed of according to the Environmental Protection Agency 
352.29 	recommendations.
352.30 		Subd. 4.First aid must be available on site. (a) A staff person trained in first 
352.31 	aid must be available on site and, when required in a person's coordinated service and 
352.32 	support plan or coordinated service and support plan addendum, be able to provide 
352.33 	cardiopulmonary resuscitation, whenever persons are present and staff are required to be 
352.34 	at the site to provide direct service. The CPR training must include in-person instruction, 
352.35 	hands-on practice, and an observed skills assessment under the direct supervision of a 
352.36 	CPR instructor.
353.1 	(b) A facility must have first aid kits readily available for use by, and that meet 
353.2 	the needs of, persons receiving services and staff. At a minimum, the first aid kit must 
353.3 	be equipped with accessible first aid supplies including bandages, sterile compresses, 
353.4 	scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, 
353.5 	adhesive tape, and first aid manual.
353.6 		Subd. 5.Emergencies. (a) The license holder must have a written plan for 
353.7 	responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the 
353.8 	safety of persons served in the facility. The plan must include:
353.9 	(1) procedures for emergency evacuation and emergency sheltering, including:
353.10 	(i) how to report a fire or other emergency;
353.11 	(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive 
353.12 	procedures or equipment to assist with the safe evacuation of persons with physical or 
353.13 	sensory disabilities; and
353.14 	(iii) instructions on closing off the fire area, using fire extinguishers, and activating 
353.15 	and responding to alarm systems;
353.16 	(2) a floor plan that identifies:
353.17 	(i) the location of fire extinguishers;
353.18 	(ii) the location of audible or visual alarm systems, including but not limited to 
353.19 	manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and 
353.20 	sprinkler systems;
353.21 	(iii) the location of exits, primary and secondary evacuation routes, and accessible 
353.22 	egress routes, if any; and
353.23 	(iv) the location of emergency shelter within the facility;
353.24 	(3) a site plan that identifies:
353.25 	(i) designated assembly points outside the facility;
353.26 	(ii) the locations of fire hydrants; and
353.27 	(iii) the routes of fire department access;
353.28 	(4) the responsibilities each staff person must assume in case of emergency;
353.29 	(5) procedures for conducting quarterly drills each year and recording the date of 
353.30 	each drill in the file of emergency plans;
353.31 	(6) procedures for relocation or service suspension when services are interrupted 
353.32 	for more than 24 hours;
353.33 	(7) for a community residential setting with three or more dwelling units, a floor 
353.34 	plan that identifies the location of enclosed exit stairs; and
353.35 	(8) an emergency escape plan for each resident.
353.36 	(b) The license holder must:
354.1 	(1) maintain a log of quarterly fire drills on file in the facility;
354.2 	(2) provide an emergency response plan that is readily available to staff and persons 
354.3 	receiving services;
354.4 	(3) inform each person of a designated area within the facility where the person 
354.5 	should go for emergency shelter during severe weather and the designated assembly points 
354.6 	outside the facility; and
354.7 	(4) maintain emergency contact information for persons served at the facility that 
354.8 	can be readily accessed in an emergency.
354.9 		Subd. 6.Emergency equipment. The facility must have a flashlight and a portable 
354.10 	radio or television set that do not require electricity and can be used if a power failure 
354.11 	occurs.
354.12 		Subd. 7.Telephone and posted numbers. A facility must have a non-coin operated 
354.13 	telephone that is readily accessible. A list of emergency numbers must be posted in a 
354.14 	prominent location. When an area has a 911 number or a mental health crisis intervention 
354.15 	team number, both numbers must be posted and the emergency number listed must be 
354.16 	911. In areas of the state without a 911 number, the numbers listed must be those of the 
354.17 	local fire department, police department, emergency transportation, and poison control 
354.18 	center. The names and telephone numbers of each person's representative, physician, and 
354.19 	dentist must be readily available.

354.20 	EFFECTIVE DATE. This section is effective January 1, 2014.

354.21 	Sec. 35. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE 
354.22 	LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
354.23 		Subdivision 1.Separate satellite license required for separate sites. (a) A license 
354.24 	holder providing residential support services must obtain a separate satellite license for 
354.25 	each community residential setting located at separate addresses when the community 
354.26 	residential settings are to be operated by the same license holder. For purposes of this 
354.27 	chapter, a community residential setting is a satellite of the home and community-based 
354.28 	services license.
354.29 	(b) Community residential settings are permitted single-family use homes. After a 
354.30 	license has been issued, the commissioner shall notify the local municipality where the 
354.31 	residence is located of the approved license.
354.32 		Subd. 2.Notification to local agency. The license holder must notify the local 
354.33 	agency within 24 hours of the onset of changes in a residence resulting from construction, 
354.34 	remodeling, or damages requiring repairs that require a building permit or may affect a 
354.35 	licensing requirement in this chapter.
355.1 		Subd. 3.Alternate overnight supervision. A license holder granted an alternate 
355.2 	overnight supervision technology adult foster care license according to section 245A.11, 
355.3 	subdivision 7a, that converts to a community residential setting satellite license according 
355.4 	to this chapter, must retain that designation.

355.5 	EFFECTIVE DATE. This section is effective January 1, 2014.

355.6 	Sec. 36. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL 
355.7 	PLANT AND ENVIRONMENT.
355.8 		Subdivision 1.Occupancy. The residence must meet the definition of a dwelling 
355.9 	unit in a residential occupancy.
355.10 		Subd. 2.Common area requirements. The living area must be provided with an 
355.11 	adequate number of furnishings for the usual functions of daily living and social activities. 
355.12 	The dining area must be furnished to accommodate meals shared by all persons living in 
355.13 	the residence. These furnishings must be in good repair and functional to meet the daily 
355.14 	needs of the persons living in the residence.
355.15 		Subd. 3.Bedrooms. (a) People receiving services must mutually consent, in 
355.16 	writing, to sharing a bedroom with one another. No more than two people receiving 
355.17 	services may share one bedroom.
355.18 	(b) A single occupancy bedroom must have at least 80 square feet of floor space with 
355.19 	a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor 
355.20 	space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and 
355.21 	other habitable rooms by floor to ceiling walls containing no openings except doorways 
355.22 	and must not serve as a corridor to another room used in daily living.
355.23 	(c) A person's personal possessions and items for the person's own use are the only 
355.24 	items permitted to be stored in a person's bedroom.
355.25 	(d) Unless otherwise documented through assessment as a safety concern for the 
355.26 	person, each person must be provided with the following furnishings:
355.27 	(1) a separate bed of proper size and height for the convenience and comfort of the 
355.28 	person, with a clean mattress in good repair;
355.29 	(2) clean bedding appropriate for the season for each person;
355.30 	(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal 
355.31 	possessions and clothing; and
355.32 	(4) a mirror for grooming.
355.33 	(e) When possible, a person must be allowed to have items of furniture that the 
355.34 	person personally owns in the bedroom, unless doing so would interfere with safety 
355.35 	precautions, violate a building or fire code, or interfere with another person's use of the 
356.1 	bedroom. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the 
356.2 	bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may 
356.3 	choose to use a mattress other than an innerspring mattress and may choose not to have 
356.4 	the mattress on a mattress frame or support. If a person chooses not to have a piece of 
356.5 	required furniture, the license holder must document this choice and is not required to 
356.6 	provide the item. If a person chooses to use a mattress other than an innerspring mattress 
356.7 	or chooses not to have a mattress frame or support, the license holder must document this 
356.8 	choice and allow the alternative desired by the person.
356.9 	(f) A person must be allowed to bring personal possessions into the bedroom 
356.10 	and other designated storage space, if such space is available, in the residence. The 
356.11 	person must be allowed to accumulate possessions to the extent the residence is able to 
356.12 	accommodate them, unless doing so is contraindicated for the person's physical or mental 
356.13 	health, would interfere with safety precautions or another person's use of the bedroom, or 
356.14 	would violate a building or fire code. The license holder must allow for locked storage 
356.15 	of personal items. Any restriction on the possession or locked storage of personal items, 
356.16 	including requiring a person to use a lock provided by the license holder, must comply 
356.17 	with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if 
356.18 	and when the license holder opens the lock.

356.19 	EFFECTIVE DATE. This section is effective January 1, 2014.

356.20 	Sec. 37. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND 
356.21 	WATER.
356.22 		Subdivision 1.Water. Potable water from privately owned wells must be tested 
356.23 	annually by a Department of Health-certified laboratory for coliform bacteria and nitrate 
356.24 	nitrogens to verify safety. The health authority may require retesting and corrective 
356.25 	measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in 
356.26 	the event of flooding or an incident which may put the well at risk of contamination. To 
356.27 	prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
356.28 		Subd. 2.Food. Food served must meet any special dietary needs of a person as 
356.29 	prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day 
356.30 	must be served or made available to persons, and nutritious snacks must be available 
356.31 	between meals.
356.32 		Subd. 3.Food safety. Food must be obtained, handled, and properly stored to 
356.33 	prevent contamination, spoilage, or a threat to the health of a person.

356.34 	EFFECTIVE DATE. This section is effective January 1, 2014.

357.1 	Sec. 38. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION 
357.2 	AND HEALTH.
357.3 		Subdivision 1.Goods provided by the license holder. Individual clean bed linens 
357.4 	appropriate for the season and the person's comfort, including towels and wash cloths, 
357.5 	must be available for each person. Usual or customary goods for the operation of a 
357.6 	residence which are communally used by all persons receiving services living in the 
357.7 	residence must be provided by the license holder, including household items for meal 
357.8 	preparation, cleaning supplies to maintain the cleanliness of the residence, window 
357.9 	coverings on windows for privacy, toilet paper, and hand soap.
357.10 		Subd. 2.Personal items. Personal health and hygiene items must be stored in a 
357.11 	safe and sanitary manner.
357.12 		Subd. 3.Pets and service animals. Pets and service animals housed within 
357.13 	the residence must be immunized and maintained in good health as required by local 
357.14 	ordinances and state law. The license holder must ensure that the person and the person's 
357.15 	representative are notified before admission of the presence of pets in the residence.
357.16 		Subd. 4.Smoking in the residence. License holders must comply with the 
357.17 	requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when 
357.18 	smoking is permitted in the residence.
357.19 		Subd. 5.Weapons. Weapons and ammunition must be stored separately in locked 
357.20 	areas that are inaccessible to a person receiving services. For purposes of this subdivision, 
357.21 	"weapons" means firearms and other instruments or devices designed for and capable of 
357.22 	producing bodily harm.

357.23 	EFFECTIVE DATE. This section is effective January 1, 2014.

357.24 	Sec. 39. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE 
357.25 	REQUIREMENTS AND APPLICATION PROCESS.
357.26 	Except for day service facilities on the same or adjoining lot, the license holder 
357.27 	providing day services must apply for a separate license for each facility-based service 
357.28 	site when the license holder is the owner, lessor, or tenant of the service site at which 
357.29 	persons receive day services and the license holder's employees who provide day services 
357.30 	are present for a cumulative total of more than 30 days within any 12-month period. For 
357.31 	purposes of this chapter, a day services facility license is a satellite license of the day 
357.32 	services program. A day services program may operate multiple licensed day service 
357.33 	facilities in one or more counties in the state. For the purposes of this section, "adjoining 
357.34 	lot" means day services facilities that are next door to or across the street from one another.

358.1 	EFFECTIVE DATE. This section is effective January 1, 2014.

358.2 	Sec. 40. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND 
358.3 	SPACE REQUIREMENTS.
358.4 		Subdivision 1.Facility capacity and useable space requirements. (a) The facility 
358.5 	capacity of each day service facility must be determined by the amount of primary space 
358.6 	available, the scheduling of activities at other service sites, and the space requirements of 
358.7 	all persons receiving services at the facility, not just the licensed services. The facility 
358.8 	capacity must specify the maximum number of persons that may receive services on 
358.9 	site at any one time.
358.10 	(b) When a facility is located in a multifunctional organization, the facility may 
358.11 	share common space with the multifunctional organization if the required available 
358.12 	primary space for use by persons receiving day services is maintained while the facility is 
358.13 	operating. The license holder must comply at all times with all applicable fire and safety 
358.14 	codes under section 245A.04, subdivision 2a, and adequate supervision requirements 
358.15 	under section 245D.31 for all persons receiving day services.
358.16 	(c) A day services facility must have a minimum of 40 square feet of primary space 
358.17 	available for each person receiving services who is present at the site at any one time. 
358.18 	Primary space does not include:
358.19 	(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms, 
358.20 	and kitchens;
358.21 	(2) floor areas beneath stationary equipment; or
358.22 	(3) any space occupied by persons associated with the multifunctional organization 
358.23 	while persons receiving day services are using common space.
358.24 		Subd. 2.Individual personal articles. Each person must be provided space in a 
358.25 	closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own 
358.26 	use while receiving services at the facility, unless doing so would interfere with safety 
358.27 	precautions, another person's work space, or violate a building or fire code.

358.28 	EFFECTIVE DATE. This section is effective January 1, 2014.

358.29 	Sec. 41. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY 
358.30 	REQUIREMENTS.
358.31 		Subdivision 1.Refrigeration. If the license holder provides refrigeration at service 
358.32 	sites owned or leased by the license holder for storing perishable foods and perishable 
358.33 	portions of bag lunches, whether the foods are supplied by the license holder or the 
359.1 	persons receiving services, the refrigeration must have a temperature of 40 degrees 
359.2 	Fahrenheit or less.
359.3 		Subd. 2.Drinking water. Drinking water must be available to all persons 
359.4 	receiving services. If a person is unable to request or obtain drinking water, it must be 
359.5 	provided according to that person's individual needs. Drinking water must be provided in 
359.6 	single-service containers or from drinking fountains accessible to all persons.
359.7 		Subd. 3.Individuals who become ill during the day. There must be an area in 
359.8 	which a person receiving services can rest if:
359.9 	(1) the person becomes ill during the day; 
359.10 	(2) the person does not live in a licensed residential site;
359.11 	(3) the person requires supervision; and
359.12 	(4) there is not a caretaker immediately available. Supervision must be provided 
359.13 	until the caretaker arrives to bring the person home.
359.14 		Subd. 4.Safety procedures. The license holder must establish general written 
359.15 	safety procedures that include criteria for selecting, training, and supervising persons who 
359.16 	work with hazardous machinery, tools, or substances. Safety procedures specific to each 
359.17 	person's activities must be explained and be available in writing to all staff members 
359.18 	and persons receiving services.

359.19 	EFFECTIVE DATE. This section is effective January 1, 2014.

359.20 	Sec. 42. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND 
359.21 	FACILITY COVERAGE.
359.22 		Subdivision 1.Scope. This section applies only to facility-based day services.
359.23 		Subd. 2.Factors. (a) The number of direct support service staff members that a 
359.24 	license holder must have on duty at the facility at a given time to meet the minimum 
359.25 	staffing requirements established in this section varies according to:
359.26 	(1) the number of persons who are enrolled and receiving direct support services 
359.27 	at that given time;
359.28 	(2) the staff ratio requirement established under subdivision 3 for each person who 
359.29 	is present; and
359.30 	(3) whether the conditions described in subdivision 8 exist and warrant additional 
359.31 	staffing beyond the number determined to be needed under subdivision 7.
359.32 	(b) The commissioner must consider the factors in paragraph (a) in determining a 
359.33 	license holder's compliance with the staffing requirements and must further consider 
359.34 	whether the staff ratio requirement established under subdivision 3 for each person 
359.35 	receiving services accurately reflects the person's need for staff time.
360.1 		Subd. 3.Staff ratio requirement for each person receiving services. The case 
360.2 	manager, in consultation with the interdisciplinary team, must determine at least once each 
360.3 	year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving 
360.4 	services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio 
360.5 	assigned each person and the documentation of how the ratio was arrived at must be kept 
360.6 	in each person's individual service plan. Documentation must include an assessment of the 
360.7 	person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard 
360.8 	assessment form required by the commissioner.
360.9 		Subd. 4.Person requiring staff ratio of one to four. A person must be assigned a 
360.10 	staff ratio requirement of one to four if:
360.11 	(1) on a daily basis the person requires total care and monitoring or constant 
360.12 	hand-over-hand physical guidance to successfully complete at least three of the following 
360.13 	activities: toileting, communicating basic needs, eating, ambulating; or is not capable of 
360.14 	taking appropriate action for self-preservation under emergency conditions; or
360.15 	(2) the person engages in conduct that poses an imminent risk of physical harm to 
360.16 	self or others at a documented level of frequency, intensity, or duration requiring frequent 
360.17 	daily ongoing intervention and monitoring as established in the person's coordinated 
360.18 	service and support plan or coordinated service and support plan addendum.
360.19 		Subd. 5.Person requiring staff ratio of one to eight. A person must be assigned a 
360.20 	staff ratio requirement of one to eight if:
360.21 	(1) the person does not meet the requirements in subdivision 4; and
360.22 	(2) on a daily basis the person requires verbal prompts or spot checks and minimal 
360.23 	or no physical assistance to successfully complete at least four of the following activities: 
360.24 	toileting, communicating basic needs, eating, ambulating, or taking appropriate action for 
360.25 	self-preservation under emergency conditions.
360.26 		Subd. 6.Person requiring staff ratio of one to six. A person who does not have 
360.27 	any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio 
360.28 	requirement of one to six.
360.29 		Subd. 7.Determining number of direct support service staff required. The 
360.30 	minimum number of direct support service staff members required at any one time to 
360.31 	meet the combined staff ratio requirements of the persons present at that time can be 
360.32 	determined by the following steps:
360.33 	(1) assign to each person in attendance the three-digit decimal below that corresponds 
360.34 	to the staff ratio requirement assigned to that person. A staff ratio requirement of one to 
360.35 	four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio 
360.36 	requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
361.1 	(2) add all of the three-digit decimals (one three-digit decimal for every person in 
361.2 	attendance) assigned in clause (1);
361.3 	(3) when the sum in clause (2) falls between two whole numbers, round off the sum 
361.4 	to the larger of the two whole numbers; and
361.5 	(4) the larger of the two whole numbers in clause (3) equals the number of direct 
361.6 	support service staff members needed to meet the staff ratio requirements of the persons 
361.7 	in attendance.
361.8 		Subd. 8.Staff to be included in calculating minimum staffing requirement.
 361.9 	Only staff providing direct support must be counted as staff members in calculating 
361.10 	the staff-to-participant ratio. A volunteer may be counted as a direct support staff in 
361.11 	calculating the staff to participant ratio if the volunteer meets the same standards and 
361.12 	requirements as paid staff. No person receiving services must be counted as or be 
361.13 	substituted for a staff member in calculating the staff-to-participant ratio.
361.14 		Subd. 9.Conditions requiring additional direct support staff. The license holder 
361.15 	must increase the number of direct support staff members present at any one time beyond 
361.16 	the number arrived at in subdivision 4 if necessary when any one or combination of the 
361.17 	following circumstances can be documented by the commissioner as existing:
361.18 	(1) the health and safety needs of the persons receiving services cannot be met by 
361.19 	the number of staff members available under the staffing pattern in effect even though the 
361.20 	number has been accurately calculated under subdivision 7; or
361.21 	(2) the person's conduct frequently presents an imminent risk of physical harm to 
361.22 	self or others.
361.23 		Subd. 10.Supervision requirements. (a) At no time must one direct support 
361.24 	staff member be assigned responsibility for supervision and training of more than ten 
361.25 	persons receiving supervision and training, except as otherwise stated in each person's risk 
361.26 	management plan.
361.27 	(b) In the temporary absence of the director or a supervisor, a direct support staff 
361.28 	member must be designated to supervise the center.
361.29 		Subd. 11.Multifunctional programs. A multifunctional program may count other 
361.30 	employees of the organization besides direct support staff of the day service facility in 
361.31 	calculating the staff-to-participant ratio if the employee is assigned to the day services 
361.32 	facility for a specified amount of time, during which the employee is not assigned to 
361.33 	another organization or program.

361.34 	EFFECTIVE DATE. This section is effective January 1, 2014.

361.35 	Sec. 43. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
362.1 		Subdivision 1.Eligibility for an alternative licensing inspection. (a) A license 
362.2 	holder providing services licensed under this chapter, with a qualifying accreditation and 
362.3 	meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an 
362.4 	alternative licensing inspection when all services provided under the license holder's 
362.5 	license are accredited. A license holder with a qualifying accreditation and meeting 
362.6 	the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative 
362.7 	licensing inspection for individual community residential settings or day services facilities 
362.8 	licensed under this chapter.
362.9 	(b) In order to be eligible for an alternative licensing inspection, the program must 
362.10 	have had at least one inspection by the commissioner following issuance of the initial 
362.11 	license. For programs operating a day services facility, each facility must have had at least 
362.12 	one on-site inspection by the commissioner following issuance of the initial license.
362.13 	(c) In order to be eligible for an alternative licensing inspection, the program must 
362.14 	have been in substantial and consistent compliance at the time of the last licensing 
362.15 	inspection and during the current licensing period. For purposes of this section, 
362.16 	"substantial and consistent compliance" means:
362.17 	(1) the license holder's license was not made conditional, suspended, or revoked;
362.18 	(2) there have been no substantiated allegations of maltreatment against the license 
362.19 	holder;
362.20 	(3) there were no program deficiencies identified that would jeopardize the health, 
362.21 	safety, or rights of persons being served; and
362.22 	(4) the license holder maintained substantial compliance with the other requirements 
362.23 	of chapters 245A and 245C and other applicable laws and rules.
362.24 	(d) For the purposes of this section, the license holder's license includes services 
362.25 	licensed under this chapter that were previously licensed under chapter 245B until 
362.26 	December 31, 2013.
362.27 		Subd. 2.Qualifying accreditation. The commissioner must accept a three-year 
362.28 	accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) 
362.29 	as a qualifying accreditation.
362.30 		Subd. 3.Request for approval of an alternative inspection status. (a) A request 
362.31 	for an alternative inspection must be made on the forms and in the manner prescribed 
362.32 	by the commissioner. When submitting the request, the license holder must submit all 
362.33 	documentation issued by the accrediting body verifying that the license holder has obtained 
362.34 	and maintained the qualifying accreditation and has complied with recommendations 
362.35 	or requirements from the accrediting body during the period of accreditation. Based 
363.1 	on the request and the additional required materials, the commissioner may approve 
363.2 	an alternative inspection status.
363.3 	(b) The commissioner must notify the license holder in writing that the request for 
363.4 	an alternative inspection status has been approved. Approval must be granted until the 
363.5 	end of the qualifying accreditation period.
363.6 	(c) The license holder must submit a written request for approval to be renewed 
363.7 	one month before the end of the current approval period according to the requirements 
363.8 	in paragraph (a). If the license holder does not submit a request to renew approval as 
363.9 	required, the commissioner must conduct a licensing inspection.
363.10 		Subd. 4.Programs approved for alternative licensing inspection; deemed 
363.11 	compliance licensing requirements. (a) A license holder approved for alternative 
363.12 	licensing inspection under this section is required to maintain compliance with all 
363.13 	licensing standards according to this chapter.
363.14 	(b) A license holder approved for alternative licensing inspection under this section 
363.15 	must be deemed to be in compliance with all the requirements of this chapter, and the 
363.16 	commissioner must not perform routine licensing inspections.
363.17 	(c) Upon receipt of a complaint regarding the services of a license holder approved 
363.18 	for alternative licensing inspection under this section, the commissioner must investigate 
363.19 	the complaint and may take any action as provided under section 245A.06 or 245A.07.
363.20 		Subd. 5.Investigations of alleged or suspected maltreatment. Nothing in this 
363.21 	section changes the commissioner's responsibilities to investigate alleged or suspected 
363.22 	maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
363.23 		Subd. 6.Termination or denial of subsequent approval. Following approval of 
363.24 	an alternative licensing inspection, the commissioner may terminate or deny subsequent 
363.25 	approval of an alternative licensing inspection if the commissioner determines that:
363.26 	(1) the license holder has not maintained the qualifying accreditation;
363.27 	(2) the commissioner has substantiated maltreatment for which the license holder or 
363.28 	facility is determined to be responsible during the qualifying accreditation period; or
363.29 	(3) during the qualifying accreditation period, the license holder has been issued 
363.30 	an order for conditional license, fine, suspension, or license revocation that has not been 
363.31 	reversed upon appeal.
363.32 		Subd. 7.Appeals. The commissioner's decision that the conditions for approval for 
363.33 	an alternative licensing inspection have not been met is final and not subject to appeal 
363.34 	under the provisions of chapter 14.
364.1 		Subd. 8.Commissioner's programs. Home and community-based services licensed 
364.2 	under this chapter for which the commissioner is the license holder with a qualifying 
364.3 	accreditation are excluded from being approved for an alternative licensing inspection.

364.4 	EFFECTIVE DATE. This section is effective January 1, 2014.

364.5 	Sec. 44. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
364.6 	(a) The commissioner of human services shall issue a mental health certification 
364.7 	for services licensed under this chapter when a license holder is determined to have met 
364.8 	the requirements under paragraph (b). This certification is voluntary for license holders. 
364.9 	The certification shall be printed on the license and identified on the commissioner's 
364.10 	public Web site.
364.11 	(b) The requirements for certification are:
364.12 	(1) all staff have received at least seven hours of annual training covering all of 
364.13 	the following topics:
364.14 	(i) mental health diagnoses;
364.15 	(ii) mental health crisis response and de-escalation techniques;
364.16 	(iii) recovery from mental illness;
364.17 	(iv) treatment options, including evidence-based practices;
364.18 	(v) medications and their side effects;
364.19 	(vi) co-occurring substance abuse and health conditions; and
364.20 	(vii) community resources;
364.21 	(2) a mental health professional, as defined in section 245.462, subdivision 18, or a 
364.22 	mental health practitioner as defined in section 245.462, subdivision 17, is available 
364.23 	for consultation and assistance;
364.24 	(3) there is a plan and protocol in place to address a mental health crisis; and
364.25 	(4) each person's individual service and support plan identifies who is providing 
364.26 	clinical services and their contact information, and includes an individual crisis prevention 
364.27 	and management plan developed with the person.
364.28 	(c) License holders seeking certification under this section must request this 
364.29 	certification on forms and in the manner prescribed by the commissioner.
364.30 	(d) If the commissioner finds that the license holder has failed to comply with the 
364.31 	certification requirements under paragraph (b), the commissioner may issue a correction 
364.32 	order and an order of conditional license in accordance with section 245A.06 or may 
364.33 	issue a sanction in accordance with section 245A.07, including and up to removal of 
364.34 	the certification.
365.1 	(e) A denial of the certification or the removal of the certification based on a 
365.2 	determination that the requirements under paragraph (b) have not been met is not subject to 
365.3 	appeal. A license holder that has been denied a certification or that has had a certification 
365.4 	removed may again request certification when the license holder is in compliance with the 
365.5 	requirements of paragraph (b).

365.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

365.7 	Sec. 45. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
365.8 		Subd. 11.Residential support services. (a) Upon federal approval, there is 
365.9 	established a new service called residential support that is available on the community 
365.10 	alternative care, community alternatives for disabled individuals, developmental 
365.11 	disabilities, and brain injury waivers. Existing waiver service descriptions must be 
365.12 	modified to the extent necessary to ensure there is no duplication between other services. 
365.13 	Residential support services must be provided by vendors licensed as a community 
365.14 	residential setting as defined in section 245A.11, subdivision 8, a foster care setting 
365.15 	licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care 
365.16 	setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
365.17 	(b) Residential support services must meet the following criteria:
365.18 	(1) providers of residential support services must own or control the residential site;
365.19 	(2) the residential site must not be the primary residence of the license holder;
365.20 	(3) (1) the residential site must have a designated program supervisor person
365.21 	 responsible for program management, oversight, development, and implementation of 
365.22 	policies and procedures;
365.23 	(4) (2) the provider of residential support services must provide supervision, training, 
365.24 	and assistance as described in the person's coordinated service and support plan; and
365.25 	(5) (3) the provider of residential support services must meet the requirements of 
365.26 	licensure and additional requirements of the person's coordinated service and support plan.
365.27 	(c) Providers of residential support services that meet the definition in paragraph (a) 
365.28 	must be registered using a process determined by the commissioner beginning July 1, 2009
365.29 	 must be licensed according to chapter 245D. Providers licensed to provide child foster care 
365.30 	under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under 
365.31 	Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section 
365.32 	245A.03, subdivision 7, paragraph (g), are considered registered under this section.

365.33 	Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
366.1 		Subdivision 1.Provider qualifications. (a) For the home and community-based 
366.2 	waivers providing services to seniors and individuals with disabilities under sections 
366.3 	256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
366.4 	(1) agreements with enrolled waiver service providers to ensure providers meet 
366.5 	Minnesota health care program requirements;
366.6 	(2) regular reviews of provider qualifications, and including requests of proof of 
366.7 	documentation; and
366.8 	(3) processes to gather the necessary information to determine provider qualifications.
366.9 	(b) Beginning July 1, 2012, staff that provide direct contact, as defined in section 
366.10 	245C.02, subdivision 11, for services specified in the federally approved waiver plans 
366.11 	must meet the requirements of chapter 245C prior to providing waiver services and as 
366.12 	part of ongoing enrollment. Upon federal approval, this requirement must also apply to 
366.13 	consumer-directed community supports.
366.14 	(c) Beginning January 1, 2014, service owners and managerial officials overseeing 
366.15 	the management or policies of services that provide direct contact as specified in the 
366.16 	federally approved waiver plans must meet the requirements of chapter 245C prior to 
366.17 	reenrollment or, for new providers, prior to initial enrollment if they have not already done 
366.18 	so as a part of service licensure requirements.

366.19 	Sec. 47. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
366.20 		Subd. 7.Applicant and license holder training. An applicant or license holder 
366.21 	for the home and community-based waivers providing services to seniors and individuals 
366.22 	with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is 
366.23 	not enrolled as a Minnesota health care program home and community-based services 
366.24 	waiver provider at the time of application must ensure that at least one controlling 
366.25 	individual completes a onetime training on the requirements for providing home and 
366.26 	community-based services from a qualified source as determined by the commissioner, 
366.27 	before a provider is enrolled or license is issued. Within six months of enrollment, a newly 
366.28 	enrolled home and community-based waiver service provider must ensure that at least one 
366.29 	controlling individual has completed training on waiver and related program billing.

366.30 	Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a 
366.31 	subdivision to read:
366.32 		Subd. 8.Data on use of emergency use of manual restraint. Beginning July 1, 
366.33 	2013, facilities and services to be licensed under chapter 245D shall submit data regarding 
367.1 	the use of emergency use of manual restraint as identified in section 245D.061 in a format 
367.2 	and at a frequency identified by the commissioner.

367.3 	Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a 
367.4 	subdivision to read:
367.5 		Subd. 9.Definitions. (a) For the purposes of this section, the following terms 
367.6 	have the meanings given them. 
367.7 	(b) "Controlling individual" means a public body, governmental agency, business 
367.8 	entity, officer, owner, or managerial official whose responsibilities include the direction of 
367.9 	the management or policies of a program.
367.10 	(c) "Managerial official" means an individual who has decision-making authority 
367.11 	related to the operation of the program and responsibility for the ongoing management of 
367.12 	or direction of the policies, services, or employees of the program.
367.13 	(d) "Owner" means an individual who has direct or indirect ownership interest in 
367.14 	a corporation or partnership, or business association enrolling with the Department of 
367.15 	Human Services as a provider of waiver services.

367.16 	Sec. 50. Minnesota Statutes 2012, section 256B.4912, is amended by adding a 
367.17 	subdivision to read:
367.18 		Subd. 10.Enrollment requirements. All home and community-based waiver 
367.19 	providers must provide, at the time of enrollment and within 30 days of a request, in a 
367.20 	format determined by the commissioner, information and documentation that includes, but 
367.21 	is not limited to, the following:
367.22 	(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
367.23 	provider's payments from Medicaid in the previous calendar year, whichever is greater;
367.24 	(2) proof of fidelity bond coverage in the amount of $20,000; and
367.25 	(3) proof of liability insurance.

367.26 	Sec. 51. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
367.27 		Subd. 9a.Evaluation and referral of reports made to common entry point unit.
 367.28 	The common entry point must screen the reports of alleged or suspected maltreatment for 
367.29 	immediate risk and make all necessary referrals as follows:
367.30 	(1) if the common entry point determines that there is an immediate need for 
367.31 	adult protective services, the common entry point agency shall immediately notify the 
367.32 	appropriate county agency;
368.1 	(2) if the report contains suspected criminal activity against a vulnerable adult, the 
368.2 	common entry point shall immediately notify the appropriate law enforcement agency;
368.3 	(3) the common entry point shall refer all reports of alleged or suspected 
368.4 	maltreatment to the appropriate lead investigative agency as soon as possible, but in any 
368.5 	event no longer than two working days; and
368.6 	(4) if the report involves services licensed by the Department of Human Services 
368.7 	and subject to chapter 245D, the common entry point shall refer the report to the county as 
368.8 	the lead agency according to clause (3), but shall also notify the Department of Human 
368.9 	Services of the report; and
368.10 	(5) (4) if the report contains information about a suspicious death, the common 
368.11 	entry point shall immediately notify the appropriate law enforcement agencies, the local 
368.12 	medical examiner, and the ombudsman for mental health and developmental disabilities 
368.13 	established under section 245.92. Law enforcement agencies shall coordinate with the 
368.14 	local medical examiner and the ombudsman as provided by law.

368.15 	Sec. 52. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
368.16 		Subd. 13.Lead investigative agency. "Lead investigative agency" is the primary 
368.17 	administrative agency responsible for investigating reports made under section 626.557.
368.18 	(a) The Department of Health is the lead investigative agency for facilities or 
368.19 	services licensed or required to be licensed as hospitals, home care providers, nursing 
368.20 	homes, boarding care homes, hospice providers, residential facilities that are also federally 
368.21 	certified as intermediate care facilities that serve people with developmental disabilities, 
368.22 	or any other facility or service not listed in this subdivision that is licensed or required to 
368.23 	be licensed by the Department of Health for the care of vulnerable adults. "Home care 
368.24 	provider" has the meaning provided in section 144A.43, subdivision 4, and applies when 
368.25 	care or services are delivered in the vulnerable adult's home, whether a private home or a 
368.26 	housing with services establishment registered under chapter 144D, including those that 
368.27 	offer assisted living services under chapter 144G.
368.28 	(b) Except as provided under paragraph (c), for services licensed according to 
368.29 	chapter 245D, The Department of Human Services is the lead investigative agency for 
368.30 	facilities or services licensed or required to be licensed as adult day care, adult foster care, 
368.31 	programs for people with developmental disabilities, family adult day services, mental 
368.32 	health programs, mental health clinics, chemical dependency programs, the Minnesota 
368.33 	sex offender program, or any other facility or service not listed in this subdivision that is 
368.34 	licensed or required to be licensed by the Department of Human Services.
369.1 	(c) The county social service agency or its designee is the lead investigative agency 
369.2 	for all other reports, including, but not limited to, reports involving vulnerable adults 
369.3 	receiving services from a personal care provider organization under section 256B.0659, 
369.4 	or receiving home and community-based services licensed by the Department of Human 
369.5 	Services and subject to chapter 245D.

369.6 	Sec. 53. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME 
369.7 	AND COMMUNITY-BASED SERVICES.
 369.8 	(a) The Department of Health Compliance Monitoring Division and the Department 
369.9 	of Human Services Licensing Division shall jointly develop an integrated licensing system 
369.10 	for providers of both home care services subject to licensure under Minnesota Statutes, 
369.11 	chapter 144A, and for home and community-based services subject to licensure under 
369.12 	Minnesota Statutes, chapter 245D. The integrated licensing system shall:
369.13 	(1) require only one license of any provider of services under Minnesota Statutes, 
369.14 	sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
369.15 	(2) promote quality services that recognize a person's individual needs and protect 
369.16 	the person's health, safety, rights, and well-being;
369.17 	(3) promote provider accountability through application requirements, compliance 
369.18 	inspections, investigations, and enforcement actions;
369.19 	(4) reference other applicable requirements in existing state and federal laws, 
369.20 	including the federal Affordable Care Act;
369.21 	(5) establish internal procedures to facilitate ongoing communications between the 
369.22 	agencies and with providers and services recipients about the regulatory activities;
369.23 	(6) create a link between the agency Web sites so that providers and the public can 
369.24 	access the same information regardless of which Web site is accessed initially; and
369.25 	(7) collect data on identified outcome measures as necessary for the agencies to 
369.26 	report to the Centers for Medicare and Medicaid Services.
369.27 	(b) The joint recommendations for legislative changes to implement the integrated 
369.28 	licensing system are due to the legislature by February 15, 2014.
369.29 	(c) Before implementation of the integrated licensing system, providers licensed as 
369.30 	home care providers under Minnesota Statutes, chapter 144A, may also provide home 
369.31 	and community-based services subject to licensure under Minnesota Statutes, chapter 
369.32 	245D, without obtaining a home and community-based services license under Minnesota 
369.33 	Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall 
369.34 	apply to these providers:
370.1 	(1) the provider must comply with all requirements under Minnesota Statutes, chapter 
370.2 	245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
370.3 	(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be 
370.4 	enforced by the Department of Health under the enforcement authority set forth in 
370.5 	Minnesota Statutes, section 144A.475; and
370.6 	(3) the Department of Health will provide information to the Department of Human 
370.7 	Services about each provider licensed under this section, including the provider's license 
370.8 	application, licensing documents, inspections, information about complaints received, and 
370.9 	investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

370.10 	Sec. 54.  REPEALER.
 370.11 	(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031; 
370.12 	245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and 
370.13 	245B.08, are repealed effective January 1, 2014. 
370.14 	(b) Minnesota Statutes 2012, section 245D.08, is repealed.

370.15 	ARTICLE 9
370.16 	WAIVER PROVIDER STANDARDS TECHNICAL CHANGES

370.17 	Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
370.18 		Subd. 5.Specific purchases. The solicitation process described in this chapter is 
370.19 	not required for acquisition of the following:
370.20 	(1) merchandise for resale purchased under policies determined by the commissioner;
370.21 	(2) farm and garden products which, as determined by the commissioner, may be 
370.22 	purchased at the prevailing market price on the date of sale;
370.23 	(3) goods and services from the Minnesota correctional facilities;
370.24 	(4) goods and services from rehabilitation facilities and extended employment 
370.25 	providers that are certified by the commissioner of employment and economic 
370.26 	development, and day training and habilitation services licensed under sections 245B.01 
370.27 	to 245B.08 chapter 245D;
370.28 	(5) goods and services for use by a community-based facility operated by the 
370.29 	commissioner of human services;
370.30 	(6) goods purchased at auction or when submitting a sealed bid at auction provided 
370.31 	that before authorizing such an action, the commissioner consult with the requesting 
370.32 	agency to determine a fair and reasonable value for the goods considering factors 
370.33 	including, but not limited to, costs associated with submitting a bid, travel, transportation, 
370.34 	and storage. This fair and reasonable value must represent the limit of the state's bid;
371.1 	(7) utility services where no competition exists or where rates are fixed by law or 
371.2 	ordinance; and
371.3 	(8) goods and services from Minnesota sex offender program facilities.

371.4 	EFFECTIVE DATE. This section is effective January 1, 2014.

371.5 	Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
371.6 		Subdivision 1.Service contracts. The commissioner of administration shall 
371.7 	ensure that a portion of all contracts for janitorial services; document imaging; 
371.8 	document shredding; and mailing, collating, and sorting services be awarded by the 
371.9 	state to rehabilitation programs and extended employment providers that are certified 
371.10 	by the commissioner of employment and economic development, and day training and 
371.11 	habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The 
371.12 	amount of each contract awarded under this section may exceed the estimated fair market 
371.13 	price as determined by the commissioner for the same goods and services by up to six 
371.14 	percent. The aggregate value of the contracts awarded to eligible providers under this 
371.15 	section in any given year must exceed 19 percent of the total value of all contracts for 
371.16 	janitorial services; document imaging; document shredding; and mailing, collating, and 
371.17 	sorting services entered into in the same year. For the 19 percent requirement to be 
371.18 	applicable in any given year, the contract amounts proposed by eligible providers must be 
371.19 	within six percent of the estimated fair market price for at least 19 percent of the contracts 
371.20 	awarded for the corresponding service area.

371.21 	EFFECTIVE DATE. This section is effective January 1, 2014.

371.22 	Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
371.23 		Subd. 4.Housing with services establishment or establishment. (a) "Housing 
371.24 	with services establishment" or "establishment" means:
371.25 	(1) an establishment providing sleeping accommodations to one or more adult 
371.26 	residents, at least 80 percent of which are 55 years of age or older, and offering or 
371.27 	providing, for a fee, one or more regularly scheduled health-related services or two or 
371.28 	more regularly scheduled supportive services, whether offered or provided directly by the 
371.29 	establishment or by another entity arranged for by the establishment; or
371.30 	(2) an establishment that registers under section 144D.025.
371.31 	(b) Housing with services establishment does not include:
371.32 	(1) a nursing home licensed under chapter 144A;
372.1 	(2) a hospital, certified boarding care home, or supervised living facility licensed 
372.2 	under sections 144.50 to 144.56;
372.3 	(3) a board and lodging establishment licensed under chapter 157 and Minnesota 
372.4 	Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, 
372.5 	or 9530.4100 to 9530.4450, or under chapter 245B 245D;
372.6 	(4) a board and lodging establishment which serves as a shelter for battered women 
372.7 	or other similar purpose;
372.8 	(5) a family adult foster care home licensed by the Department of Human Services;
372.9 	(6) private homes in which the residents are related by kinship, law, or affinity with 
372.10 	the providers of services;
372.11 	(7) residential settings for persons with developmental disabilities in which the 
372.12 	services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable 
372.13 	successor rules or laws;
372.14 	(8) a home-sharing arrangement such as when an elderly or disabled person or 
372.15 	single-parent family makes lodging in a private residence available to another person 
372.16 	in exchange for services or rent, or both;
372.17 	(9) a duly organized condominium, cooperative, common interest community, or 
372.18 	owners' association of the foregoing where at least 80 percent of the units that comprise the 
372.19 	condominium, cooperative, or common interest community are occupied by individuals 
372.20 	who are the owners, members, or shareholders of the units; or
372.21 	(10) services for persons with developmental disabilities that are provided under 
372.22 	a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until 
372.23 	January 1, 1998, or under chapter 245B 245D.

372.24 	EFFECTIVE DATE. This section is effective January 1, 2014.

372.25 	Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
372.26 		Subdivision 1.Applicability. (a) The operating standards for special transportation 
372.27 	service adopted under this section do not apply to special transportation provided by:
372.28 	(1) a common carrier operating on fixed routes and schedules;
372.29 	(2) a volunteer driver using a private automobile;
372.30 	(3) a school bus as defined in section 169.011, subdivision 71; or
372.31 	(4) an emergency ambulance regulated under chapter 144.
372.32 	(b) The operating standards adopted under this section only apply to providers 
372.33 	of special transportation service who receive grants or other financial assistance from 
372.34 	either the state or the federal government, or both, to provide or assist in providing that 
372.35 	service; except that the operating standards adopted under this section do not apply 
373.1 	to any nursing home licensed under section 144A.02, to any board and care facility 
373.2 	licensed under section 144.50, or to any day training and habilitation services, day care, 
373.3 	or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or 
373.4 	program provides transportation to nonresidents on a regular basis and the facility receives 
373.5 	reimbursement, other than per diem payments, for that service under rules promulgated 
373.6 	by the commissioner of human services.
373.7 	(c) Notwithstanding paragraph (b), the operating standards adopted under this 
373.8 	section do not apply to any vendor of services licensed under chapter 245B 245D that 
373.9 	provides transportation services to consumers or residents of other vendors licensed under 
373.10 	chapter 245B 245D and transports 15 or fewer persons, including consumers or residents 
373.11 	and the driver.

373.12 	EFFECTIVE DATE. This section is effective January 1, 2014.

373.13 	Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
373.14 		Subdivision 1.Scope. The terms used in this chapter and chapter 245B have the 
373.15 	meanings given them in this section.

373.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

373.17 	Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
373.18 		Subd. 9.License holder. "License holder" means an individual, corporation, 
373.19 	partnership, voluntary association, or other organization that is legally responsible for the 
373.20 	operation of the program, has been granted a license by the commissioner under this chapter 
373.21 	or chapter 245B245D and the rules of the commissioner, and is a controlling individual.

373.22 	EFFECTIVE DATE. This section is effective January 1, 2014.

373.23 	Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
373.24 		Subd. 9.Permitted services by an individual who is related. Notwithstanding 
373.25 	subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a 
373.26 	person receiving supported living services may provide licensed services to that person if:
373.27 	(1) the person who receives supported living services received these services in a 
373.28 	residential site on July 1, 2005;
373.29 	(2) the services under clause (1) were provided in a corporate foster care setting for 
373.30 	adults and were funded by the developmental disabilities home and community-based 
373.31 	services waiver defined in section 256B.092;
374.1 	(3) the individual who is related obtains and maintains both a license under chapter 
374.2 	245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105 
374.3 	to 9555.6265; and
374.4 	(4) the individual who is related is not the guardian of the person receiving supported 
374.5 	living services.

374.6 	EFFECTIVE DATE. This section is effective January 1, 2014.

374.7 	Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
374.8 		Subd. 13.Funds and property; other requirements. (a) A license holder must 
374.9 	ensure that persons served by the program retain the use and availability of personal funds 
374.10 	or property unless restrictions are justified in the person's individual plan. This subdivision 
374.11 	does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
374.12 	(b) The license holder must ensure separation of funds of persons served by the 
374.13 	program from funds of the license holder, the program, or program staff.
374.14 	(c) Whenever the license holder assists a person served by the program with the 
374.15 	safekeeping of funds or other property, the license holder must:
374.16 	(1) immediately document receipt and disbursement of the person's funds or other 
374.17 	property at the time of receipt or disbursement, including the person's signature, or the 
374.18 	signature of the conservator or payee; and
374.19 	(2) return to the person upon the person's request, funds and property in the license 
374.20 	holder's possession subject to restrictions in the person's treatment plan, as soon as 
374.21 	possible, but no later than three working days after the date of request.
374.22 	(d) License holders and program staff must not:
374.23 	(1) borrow money from a person served by the program;
374.24 	(2) purchase personal items from a person served by the program;
374.25 	(3) sell merchandise or personal services to a person served by the program;
374.26 	(4) require a person served by the program to purchase items for which the license 
374.27 	holder is eligible for reimbursement; or
374.28 	(5) use funds of persons served by the program to purchase items for which the 
374.29 	facility is already receiving public or private payments.

374.30 	EFFECTIVE DATE. This section is effective January 1, 2014.

374.31 	Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
374.32 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may 
374.33 	suspend or revoke a license, or impose a fine if:
375.1 	(1) a license holder fails to comply fully with applicable laws or rules;
375.2 	(2) a license holder, a controlling individual, or an individual living in the household 
375.3 	where the licensed services are provided or is otherwise subject to a background study has 
375.4 	a disqualification which has not been set aside under section 245C.22;
375.5 	(3) a license holder knowingly withholds relevant information from or gives false 
375.6 	or misleading information to the commissioner in connection with an application for 
375.7 	a license, in connection with the background study status of an individual, during an 
375.8 	investigation, or regarding compliance with applicable laws or rules; or
375.9 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails 
375.10 	to submit the information required of an applicant under section 245A.04, subdivision 1, 
375.11 	paragraph (f) or (g).
375.12 	A license holder who has had a license suspended, revoked, or has been ordered 
375.13 	to pay a fine must be given notice of the action by certified mail or personal service. If 
375.14 	mailed, the notice must be mailed to the address shown on the application or the last 
375.15 	known address of the license holder. The notice must state the reasons the license was 
375.16 	suspended, revoked, or a fine was ordered.
375.17 	(b) If the license was suspended or revoked, the notice must inform the license 
375.18 	holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
375.19 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
375.20 	a license. The appeal of an order suspending or revoking a license must be made in writing 
375.21 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
375.22 	the commissioner within ten calendar days after the license holder receives notice that the 
375.23 	license has been suspended or revoked. If a request is made by personal service, it must be 
375.24 	received by the commissioner within ten calendar days after the license holder received 
375.25 	the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits 
375.26 	a timely appeal of an order suspending or revoking a license, the license holder may 
375.27 	continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs 
375.28 	(g) and (h), until the commissioner issues a final order on the suspension or revocation.
375.29 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the 
375.30 	license holder of the responsibility for payment of fines and the right to a contested case 
375.31 	hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal 
375.32 	of an order to pay a fine must be made in writing by certified mail or personal service. If 
375.33 	mailed, the appeal must be postmarked and sent to the commissioner within ten calendar 
375.34 	days after the license holder receives notice that the fine has been ordered. If a request is 
375.35 	made by personal service, it must be received by the commissioner within ten calendar 
375.36 	days after the license holder received the order.
376.1 	(2) The license holder shall pay the fines assessed on or before the payment date 
376.2 	specified. If the license holder fails to fully comply with the order, the commissioner 
376.3 	may issue a second fine or suspend the license until the license holder complies. If the 
376.4 	license holder receives state funds, the state, county, or municipal agencies or departments 
376.5 	responsible for administering the funds shall withhold payments and recover any payments 
376.6 	made while the license is suspended for failure to pay a fine. A timely appeal shall stay 
376.7 	payment of the fine until the commissioner issues a final order.
376.8 	(3) A license holder shall promptly notify the commissioner of human services, 
376.9 	in writing, when a violation specified in the order to forfeit a fine is corrected. If upon 
376.10 	reinspection the commissioner determines that a violation has not been corrected as 
376.11 	indicated by the order to forfeit a fine, the commissioner may issue a second fine. The 
376.12 	commissioner shall notify the license holder by certified mail or personal service that a 
376.13 	second fine has been assessed. The license holder may appeal the second fine as provided 
376.14 	under this subdivision.
376.15 	(4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for 
376.16 	each determination of maltreatment of a child under section 626.556 or the maltreatment 
376.17 	of a vulnerable adult under section 626.557 for which the license holder is determined 
376.18 	responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i), 
376.19 	or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each 
376.20 	occurrence of a violation of law or rule governing matters of health, safety, or supervision, 
376.21 	including but not limited to the provision of adequate staff-to-child or adult ratios, and 
376.22 	failure to comply with background study requirements under chapter 245C; and the license 
376.23 	holder shall forfeit $100 for each occurrence of a violation of law or rule other than 
376.24 	those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence" 
376.25 	means each violation identified in the commissioner's fine order. Fines assessed against a 
376.26 	license holder that holds a license to provide the residential-based habilitationhome and 
376.27 	community-based services, as defined under identified in section 245B.02, subdivision 
376.28 	20 245D.03, subdivision 1, and a community residential setting or day services facility 
376.29 	license to provide foster care under chapter 245D where the services are provided, may be 
376.30 	assessed against both licenses for the same occurrence, but the combined amount of the 
376.31 	fines shall not exceed the amount specified in this clause for that occurrence.
376.32 	(5) When a fine has been assessed, the license holder may not avoid payment by 
376.33 	closing, selling, or otherwise transferring the licensed program to a third party. In such an 
376.34 	event, the license holder will be personally liable for payment. In the case of a corporation, 
376.35 	each controlling individual is personally and jointly liable for payment.
377.1 	(d) Except for background study violations involving the failure to comply with an 
377.2 	order to immediately remove an individual or an order to provide continuous, direct 
377.3 	supervision, the commissioner shall not issue a fine under paragraph (c) relating to a 
377.4 	background study violation to a license holder who self-corrects a background study 
377.5 	violation before the commissioner discovers the violation. A license holder who has 
377.6 	previously exercised the provisions of this paragraph to avoid a fine for a background 
377.7 	study violation may not avoid a fine for a subsequent background study violation unless at 
377.8 	least 365 days have passed since the license holder self-corrected the earlier background 
377.9 	study violation.

377.10 	EFFECTIVE DATE. This section is effective January 1, 2014.

377.11 	Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to 
377.12 	read:
377.13 		Subd. 19c.Personal care. Medical assistance covers personal care assistance 
377.14 	services provided by an individual who is qualified to provide the services according to 
377.15 	subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a 
377.16 	plan, and supervised by a qualified professional.
377.17 	"Qualified professional" means a mental health professional as defined in section 
377.18 	245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6); 
377.19 	or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker 
377.20 	as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities 
377.21 	specialist under section 245B.07, subdivision 4 designated coordinator under section 
377.22 	245D.081, subdivision 2. The qualified professional shall perform the duties required in 
377.23 	section 256B.0659.

377.24 	EFFECTIVE DATE. This section is effective January 1, 2014.

377.25 	Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
377.26 		Subd. 2.Contract provisions. (a) The service contract with each intermediate 
377.27 	care facility must include provisions for:
377.28 	(1) modifying payments when significant changes occur in the needs of the 
377.29 	consumers;
377.30 	(2) appropriate and necessary statistical information required by the commissioner;
377.31 	(3) annual aggregate facility financial information; and
377.32 	(4) additional requirements for intermediate care facilities not meeting the standards 
377.33 	set forth in the service contract.
378.1 	(b) The commissioner of human services and the commissioner of health, in 
378.2 	consultation with representatives from counties, advocacy organizations, and the provider 
378.3 	community, shall review the consolidated standards under chapter 245B andthe home and 
378.4 	community-based services standards under chapter 245D and the supervised living facility 
378.5 	rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota 
378.6 	Rules, chapter 4665, may be waived by the commissioner of health for intermediate care 
378.7 	facilities in order to enable facilities to implement the performance measures in their 
378.8 	contract and provide quality services to residents without a duplication of or increase in 
378.9 	regulatory requirements.

378.10 	EFFECTIVE DATE. This section is effective January 1, 2014.

378.11 	Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
378.12 		Subdivision 1.Agreement. Two or more governmental units, by agreement entered 
378.13 	into through action of their governing bodies, may jointly or cooperatively exercise 
378.14 	any power common to the contracting parties or any similar powers, including those 
378.15 	which are the same except for the territorial limits within which they may be exercised. 
378.16 	The agreement may provide for the exercise of such powers by one or more of the 
378.17 	participating governmental units on behalf of the other participating units. The term 
378.18 	"governmental unit" as used in this section includes every city, county, town, school 
378.19 	district, independent nonprofit firefighting corporation, other political subdivision of 
378.20 	this or another state, another state, federally recognized Indian tribe, the University 
378.21 	of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under 
378.22 	sections 144.50 to 144.56, rehabilitation facilities and extended employment providers 
378.23 	that are certified by the commissioner of employment and economic development, day 
378.24 	training and habilitation services licensed under sections 245B.01 to 245B.08,day and 
378.25 	supported employment services licensed under chapter 245D, and any agency of the state 
378.26 	of Minnesota or the United States, and includes any instrumentality of a governmental 
378.27 	unit. For the purpose of this section, an instrumentality of a governmental unit means an 
378.28 	instrumentality having independent policy-making and appropriating authority.

378.29 	EFFECTIVE DATE. This section is effective January 1, 2014.

378.30 	Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
378.31 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
378.32 	given them unless the specific content indicates otherwise:
379.1 	(a) "Family assessment" means a comprehensive assessment of child safety, risk 
379.2 	of subsequent child maltreatment, and family strengths and needs that is applied to a 
379.3 	child maltreatment report that does not allege substantial child endangerment. Family 
379.4 	assessment does not include a determination as to whether child maltreatment occurred 
379.5 	but does determine the need for services to address the safety of family members and the 
379.6 	risk of subsequent maltreatment.
379.7 	(b) "Investigation" means fact gathering related to the current safety of a child 
379.8 	and the risk of subsequent maltreatment that determines whether child maltreatment 
379.9 	occurred and whether child protective services are needed. An investigation must be used 
379.10 	when reports involve substantial child endangerment, and for reports of maltreatment in 
379.11 	facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 
379.12 	144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 
379.13 	13, and 124D.10; or in a nonlicensed personal care provider association as defined in 
379.14 	sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
379.15 	(c) "Substantial child endangerment" means a person responsible for a child's care, 
379.16 	and in the case of sexual abuse includes a person who has a significant relationship to the 
379.17 	child as defined in section 609.341, or a person in a position of authority as defined in 
379.18 	section 609.341, who by act or omission commits or attempts to commit an act against a 
379.19 	child under their care that constitutes any of the following:
379.20 	(1) egregious harm as defined in section 260C.007, subdivision 14;
379.21 	(2) sexual abuse as defined in paragraph (d);
379.22 	(3) abandonment under section 260C.301, subdivision 2;
379.23 	(4) neglect as defined in paragraph (f), clause (2), that substantially endangers the 
379.24 	child's physical or mental health, including a growth delay, which may be referred to as 
379.25 	failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
379.26 	(5) murder in the first, second, or third degree under section 609.185, 609.19, or 
379.27 	609.195;
379.28 	(6) manslaughter in the first or second degree under section 609.20 or 609.205;
379.29 	(7) assault in the first, second, or third degree under section 609.221, 609.222, or 
379.30 	609.223;
379.31 	(8) solicitation, inducement, and promotion of prostitution under section 609.322;
379.32 	(9) criminal sexual conduct under sections 609.342 to 609.3451;
379.33 	(10) solicitation of children to engage in sexual conduct under section 609.352;
379.34 	(11) malicious punishment or neglect or endangerment of a child under section 
379.35 	609.377 or 609.378;
379.36 	(12) use of a minor in sexual performance under section 617.246; or
380.1 	(13) parental behavior, status, or condition which mandates that the county attorney 
380.2 	file a termination of parental rights petition under section 260C.301, subdivision 3, 
380.3 	paragraph (a).
380.4 	(d) "Sexual abuse" means the subjection of a child by a person responsible for the 
380.5 	child's care, by a person who has a significant relationship to the child, as defined in 
380.6 	section 609.341, or by a person in a position of authority, as defined in section 609.341, 
380.7 	subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 
380.8 	conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 
380.9 	609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 
380.10 	in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 
380.11 	abuse also includes any act which involves a minor which constitutes a violation of 
380.12 	prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 
380.13 	threatened sexual abuse which includes the status of a parent or household member 
380.14 	who has committed a violation which requires registration as an offender under section 
380.15 	243.166, subdivision 1b, paragraph (a) or (b), or required registration under section 
380.16 	243.166, subdivision 1b, paragraph (a) or (b).
380.17 	(e) "Person responsible for the child's care" means (1) an individual functioning 
380.18 	within the family unit and having responsibilities for the care of the child such as a 
380.19 	parent, guardian, or other person having similar care responsibilities, or (2) an individual 
380.20 	functioning outside the family unit and having responsibilities for the care of the child 
380.21 	such as a teacher, school administrator, other school employees or agents, or other lawful 
380.22 	custodian of a child having either full-time or short-term care responsibilities including, 
380.23 	but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 
380.24 	and coaching.
380.25 	(f) "Neglect" means the commission or omission of any of the acts specified under 
380.26 	clauses (1) to (9), other than by accidental means:
380.27 	(1) failure by a person responsible for a child's care to supply a child with necessary 
380.28 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
380.29 	mental health when reasonably able to do so;
380.30 	(2) failure to protect a child from conditions or actions that seriously endanger the 
380.31 	child's physical or mental health when reasonably able to do so, including a growth delay, 
380.32 	which may be referred to as a failure to thrive, that has been diagnosed by a physician and 
380.33 	is due to parental neglect;
380.34 	(3) failure to provide for necessary supervision or child care arrangements 
380.35 	appropriate for a child after considering factors as the child's age, mental ability, physical 
381.1 	condition, length of absence, or environment, when the child is unable to care for the 
381.2 	child's own basic needs or safety, or the basic needs or safety of another child in their care;
381.3 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
381.4 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
381.5 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
381.6 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
381.7 	because the child's parent, guardian, or other person responsible for the child's care in 
381.8 	good faith selects and depends upon spiritual means or prayer for treatment or care of 
381.9 	disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 
381.10 	or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 
381.11 	if a lack of medical care may cause serious danger to the child's health. This section does 
381.12 	not impose upon persons, not otherwise legally responsible for providing a child with 
381.13 	necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
381.14 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, 
381.15 	subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 
381.16 	symptoms in the child at birth, results of a toxicology test performed on the mother at 
381.17 	delivery or the child at birth, medical effects or developmental delays during the child's 
381.18 	first year of life that medically indicate prenatal exposure to a controlled substance, or the 
381.19 	presence of a fetal alcohol spectrum disorder;
381.20 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
381.21 	(8) chronic and severe use of alcohol or a controlled substance by a parent or 
381.22 	person responsible for the care of the child that adversely affects the child's basic needs 
381.23 	and safety; or
381.24 	(9) emotional harm from a pattern of behavior which contributes to impaired 
381.25 	emotional functioning of the child which may be demonstrated by a substantial and 
381.26 	observable effect in the child's behavior, emotional response, or cognition that is not 
381.27 	within the normal range for the child's age and stage of development, with due regard to 
381.28 	the child's culture.
381.29 	(g) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
381.30 	inflicted by a person responsible for the child's care on a child other than by accidental 
381.31 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
381.32 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
381.33 	that have not been authorized under section 121A.67 or 245.825.
381.34 	Abuse does not include reasonable and moderate physical discipline of a child 
381.35 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
381.36 	not include the use of reasonable force by a teacher, principal, or school employee as 
382.1 	allowed by section 121A.582. Actions which are not reasonable and moderate include, 
382.2 	but are not limited to, any of the following that are done in anger or without regard to the 
382.3 	safety of the child:
382.4 	(1) throwing, kicking, burning, biting, or cutting a child;
382.5 	(2) striking a child with a closed fist;
382.6 	(3) shaking a child under age three;
382.7 	(4) striking or other actions which result in any nonaccidental injury to a child 
382.8 	under 18 months of age;
382.9 	(5) unreasonable interference with a child's breathing;
382.10 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
382.11 	(7) striking a child under age one on the face or head;
382.12 	(8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
382.13 	substances which were not prescribed for the child by a practitioner, in order to control or 
382.14 	punish the child; or other substances that substantially affect the child's behavior, motor 
382.15 	coordination, or judgment or that results in sickness or internal injury, or subjects the 
382.16 	child to medical procedures that would be unnecessary if the child were not exposed 
382.17 	to the substances;
382.18 	(9) unreasonable physical confinement or restraint not permitted under section 
382.19 	609.379, including but not limited to tying, caging, or chaining; or
382.20 	(10) in a school facility or school zone, an act by a person responsible for the child's 
382.21 	care that is a violation under section 121A.58.
382.22 	(h) "Report" means any report received by the local welfare agency, police 
382.23 	department, county sheriff, or agency responsible for assessing or investigating 
382.24 	maltreatment pursuant to this section.
382.25 	(i) "Facility" means:
382.26 	(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 
382.27 	sanitarium, or other facility or institution required to be licensed under sections 144.50 to 
382.28 	144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
382.29 	(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 
382.30 	124D.10; or
382.31 	(3) a nonlicensed personal care provider organization as defined in sections 256B.04, 
382.32 	subdivision 16, and 256B.0625, subdivision 19a.
382.33 	(j) "Operator" means an operator or agency as defined in section 245A.02.
382.34 	(k) "Commissioner" means the commissioner of human services.
383.1 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is 
383.2 	not limited to employee assistance counseling and the provision of guardian ad litem and 
383.3 	parenting time expeditor services.
383.4 	(m) "Mental injury" means an injury to the psychological capacity or emotional 
383.5 	stability of a child as evidenced by an observable or substantial impairment in the child's 
383.6 	ability to function within a normal range of performance and behavior with due regard to 
383.7 	the child's culture.
383.8 	(n) "Threatened injury" means a statement, overt act, condition, or status that 
383.9 	represents a substantial risk of physical or sexual abuse or mental injury. Threatened 
383.10 	injury includes, but is not limited to, exposing a child to a person responsible for the 
383.11 	child's care, as defined in paragraph (e), clause (1), who has:
383.12 	(1) subjected a child to, or failed to protect a child from, an overt act or condition 
383.13 	that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 
383.14 	similar law of another jurisdiction;
383.15 	(2) been found to be palpably unfit under section 260C.301, paragraph (b), clause 
383.16 	(4), or a similar law of another jurisdiction;
383.17 	(3) committed an act that has resulted in an involuntary termination of parental rights 
383.18 	under section 260C.301, or a similar law of another jurisdiction; or
383.19 	(4) committed an act that has resulted in the involuntary transfer of permanent 
383.20 	legal and physical custody of a child to a relative under Minnesota Statutes 2010, section 
383.21 	260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a 
383.22 	similar law of another jurisdiction.
383.23 	A child is the subject of a report of threatened injury when the responsible social 
383.24 	services agency receives birth match data under paragraph (o) from the Department of 
383.25 	Human Services.
383.26 	(o) Upon receiving data under section 144.225, subdivision 2b, contained in a 
383.27 	birth record or recognition of parentage identifying a child who is subject to threatened 
383.28 	injury under paragraph (n), the Department of Human Services shall send the data to the 
383.29 	responsible social services agency. The data is known as "birth match" data. Unless the 
383.30 	responsible social services agency has already begun an investigation or assessment of the 
383.31 	report due to the birth of the child or execution of the recognition of parentage and the 
383.32 	parent's previous history with child protection, the agency shall accept the birth match 
383.33 	data as a report under this section. The agency may use either a family assessment or 
383.34 	investigation to determine whether the child is safe. All of the provisions of this section 
383.35 	apply. If the child is determined to be safe, the agency shall consult with the county 
383.36 	attorney to determine the appropriateness of filing a petition alleging the child is in need 
384.1 	of protection or services under section 260C.007, subdivision 6, clause (16), in order to 
384.2 	deliver needed services. If the child is determined not to be safe, the agency and the county 
384.3 	attorney shall take appropriate action as required under section 260C.301, subdivision 3.
384.4 	(p) Persons who conduct assessments or investigations under this section shall take 
384.5 	into account accepted child-rearing practices of the culture in which a child participates 
384.6 	and accepted teacher discipline practices, which are not injurious to the child's health, 
384.7 	welfare, and safety.
384.8 	(q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected 
384.9 	occurrence or event which:
384.10 	(1) is not likely to occur and could not have been prevented by exercise of due 
384.11 	care; and
384.12 	(2) if occurring while a child is receiving services from a facility, happens when the 
384.13 	facility and the employee or person providing services in the facility are in compliance 
384.14 	with the laws and rules relevant to the occurrence or event.
384.15 	(r) "Nonmaltreatment mistake" means:
384.16 	(1) at the time of the incident, the individual was performing duties identified in the 
384.17 	center's child care program plan required under Minnesota Rules, part 9503.0045;
384.18 	(2) the individual has not been determined responsible for a similar incident that 
384.19 	resulted in a finding of maltreatment for at least seven years;
384.20 	(3) the individual has not been determined to have committed a similar 
384.21 	nonmaltreatment mistake under this paragraph for at least four years;
384.22 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
384.23 	remedies that are available over the counter, whether ordered by a medical professional or 
384.24 	not; and
384.25 	(5) except for the period when the incident occurred, the facility and the individual 
384.26 	providing services were both in compliance with all licensing requirements relevant to the 
384.27 	incident.
384.28 	This definition only applies to child care centers licensed under Minnesota 
384.29 	Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of 
384.30 	substantiated maltreatment by the individual, the commissioner of human services shall 
384.31 	determine that a nonmaltreatment mistake was made by the individual.

384.32 	EFFECTIVE DATE. This section is effective January 1, 2014.

384.33 	Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
384.34 		Subd. 3.Persons mandated to report. (a) A person who knows or has reason 
384.35 	to believe a child is being neglected or physically or sexually abused, as defined in 
385.1 	subdivision 2, or has been neglected or physically or sexually abused within the preceding 
385.2 	three years, shall immediately report the information to the local welfare agency, agency 
385.3 	responsible for assessing or investigating the report, police department, or the county 
385.4 	sheriff if the person is:
385.5 	(1) a professional or professional's delegate who is engaged in the practice of 
385.6 	the healing arts, social services, hospital administration, psychological or psychiatric 
385.7 	treatment, child care, education, correctional supervision, probation and correctional 
385.8 	services, or law enforcement; or
385.9 	(2) employed as a member of the clergy and received the information while 
385.10 	engaged in ministerial duties, provided that a member of the clergy is not required by 
385.11 	this subdivision to report information that is otherwise privileged under section 595.02, 
385.12 	subdivision 1, paragraph (c).
385.13 	The police department or the county sheriff, upon receiving a report, shall 
385.14 	immediately notify the local welfare agency or agency responsible for assessing or 
385.15 	investigating the report, orally and in writing. The local welfare agency, or agency 
385.16 	responsible for assessing or investigating the report, upon receiving a report, shall 
385.17 	immediately notify the local police department or the county sheriff orally and in writing. 
385.18 	The county sheriff and the head of every local welfare agency, agency responsible 
385.19 	for assessing or investigating reports, and police department shall each designate a 
385.20 	person within their agency, department, or office who is responsible for ensuring that 
385.21 	the notification duties of this paragraph and paragraph (b) are carried out. Nothing in 
385.22 	this subdivision shall be construed to require more than one report from any institution, 
385.23 	facility, school, or agency.
385.24 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
385.25 	for assessing or investigating the report, police department, or the county sheriff if the 
385.26 	person knows, has reason to believe, or suspects a child is being or has been neglected or 
385.27 	subjected to physical or sexual abuse. The police department or the county sheriff, upon 
385.28 	receiving a report, shall immediately notify the local welfare agency or agency responsible 
385.29 	for assessing or investigating the report, orally and in writing. The local welfare agency or 
385.30 	agency responsible for assessing or investigating the report, upon receiving a report, shall 
385.31 	immediately notify the local police department or the county sheriff orally and in writing.
385.32 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
385.33 	within a licensed facility shall report the information to the agency responsible for 
385.34 	licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 
385.35 	chapter 245B 245D; or a nonlicensed personal care provider organization as defined in 
385.36 	sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections 
386.1 	agency receiving a report may request the local welfare agency to provide assistance 
386.2 	pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees 
386.3 	perform work within a school facility, upon receiving a complaint of alleged maltreatment, 
386.4 	shall provide information about the circumstances of the alleged maltreatment to the 
386.5 	commissioner of education. Section 13.03, subdivision 4, applies to data received by the 
386.6 	commissioner of education from a licensing entity.
386.7 	(d) Any person mandated to report shall receive a summary of the disposition of 
386.8 	any report made by that reporter, including whether the case has been opened for child 
386.9 	protection or other services, or if a referral has been made to a community organization, 
386.10 	unless release would be detrimental to the best interests of the child. Any person who is 
386.11 	not mandated to report shall, upon request to the local welfare agency, receive a concise 
386.12 	summary of the disposition of any report made by that reporter, unless release would be 
386.13 	detrimental to the best interests of the child.
386.14 	(e) For purposes of this section, "immediately" means as soon as possible but in 
386.15 	no event longer than 24 hours.

386.16 	EFFECTIVE DATE. This section is effective January 1, 2014.

386.17 	Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
386.18 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is 
386.19 	received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while 
386.20 	in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
386.21 	sanitarium, or other facility or institution required to be licensed according to sections 
386.22 	144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as 
386.23 	defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed 
386.24 	personal care provider organization as defined in section 256B.04, subdivision 16, and 
386.25 	256B.0625, subdivision 19a, the commissioner of the agency responsible for assessing 
386.26 	or investigating the report or local welfare agency investigating the report shall provide 
386.27 	the following information to the parent, guardian, or legal custodian of a child alleged to 
386.28 	have been neglected, physically abused, sexually abused, or the victim of maltreatment 
386.29 	of a child in the facility: the name of the facility; the fact that a report alleging neglect, 
386.30 	physical abuse, sexual abuse, or maltreatment of a child in the facility has been received; 
386.31 	the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child 
386.32 	in the facility; that the agency is conducting an assessment or investigation; any protective 
386.33 	or corrective measures being taken pending the outcome of the investigation; and that a 
386.34 	written memorandum will be provided when the investigation is completed.
387.1 	(b) The commissioner of the agency responsible for assessing or investigating the 
387.2 	report or local welfare agency may also provide the information in paragraph (a) to the 
387.3 	parent, guardian, or legal custodian of any other child in the facility if the investigative 
387.4 	agency knows or has reason to believe the alleged neglect, physical abuse, sexual 
387.5 	abuse, or maltreatment of a child in the facility has occurred. In determining whether 
387.6 	to exercise this authority, the commissioner of the agency responsible for assessing 
387.7 	or investigating the report or local welfare agency shall consider the seriousness of the 
387.8 	alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the 
387.9 	number of children allegedly neglected, physically abused, sexually abused, or victims of 
387.10 	maltreatment of a child in the facility; the number of alleged perpetrators; and the length 
387.11 	of the investigation. The facility shall be notified whenever this discretion is exercised.
387.12 	(c) When the commissioner of the agency responsible for assessing or investigating 
387.13 	the report or local welfare agency has completed its investigation, every parent, guardian, 
387.14 	or legal custodian previously notified of the investigation by the commissioner or 
387.15 	local welfare agency shall be provided with the following information in a written 
387.16 	memorandum: the name of the facility investigated; the nature of the alleged neglect, 
387.17 	physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's 
387.18 	name; a summary of the investigation findings; a statement whether maltreatment was 
387.19 	found; and the protective or corrective measures that are being or will be taken. The 
387.20 	memorandum shall be written in a manner that protects the identity of the reporter and 
387.21 	the child and shall not contain the name, or to the extent possible, reveal the identity of 
387.22 	the alleged perpetrator or of those interviewed during the investigation. If maltreatment 
387.23 	is determined to exist, the commissioner or local welfare agency shall also provide the 
387.24 	written memorandum to the parent, guardian, or legal custodian of each child in the facility 
387.25 	who had contact with the individual responsible for the maltreatment. When the facility is 
387.26 	the responsible party for maltreatment, the commissioner or local welfare agency shall also 
387.27 	provide the written memorandum to the parent, guardian, or legal custodian of each child 
387.28 	who received services in the population of the facility where the maltreatment occurred. 
387.29 	This notification must be provided to the parent, guardian, or legal custodian of each child 
387.30 	receiving services from the time the maltreatment occurred until either the individual 
387.31 	responsible for maltreatment is no longer in contact with a child or children in the facility 
387.32 	or the conclusion of the investigation. In the case of maltreatment within a school facility, 
387.33 	as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner 
387.34 	of education need not provide notification to parents, guardians, or legal custodians of 
387.35 	each child in the facility, but shall, within ten days after the investigation is completed, 
387.36 	provide written notification to the parent, guardian, or legal custodian of any student 
388.1 	alleged to have been maltreated. The commissioner of education may notify the parent, 
388.2 	guardian, or legal custodian of any student involved as a witness to alleged maltreatment.

388.3 	EFFECTIVE DATE. This section is effective January 1, 2014.

388.4 	Sec. 16.  REPEALER.
 388.5 	Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective 
388.6 	January 1, 2014.

388.7 	ARTICLE 10
388.8 	HEALTH-RELATED LICENSING BOARDS

388.9 	Section 1. Minnesota Statutes 2012, section 13.411, subdivision 7, is amended to read:
388.10 		Subd. 7.Examining and licensing boards. (a) Health licensing boards. Data 
388.11 	held by health licensing boards are classified under sections 214.10, subdivision 8, and 
388.12 	214.25, subdivision 1.
388.13 	(b) Combined boards data. Data held by licensing boards participating in a health 
388.14 	professional services program are classified under sections 214.34 and 214.35.
388.15 	(c) Criminal background checks. Criminal history record information obtained by 
388.16 	a health-related licensing board is classified under section 214.075, subdivision 7.

388.17 	Sec. 2. Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:
388.18 		Subd. 2.Licensure and application fees. Nonrefundable licensure and application 
388.19 	fees charged established by the board are as follows shall not exceed the following amounts:
388.20 	(1) application fee for national examination is $220 $110;
388.21 	(2) application fee for Licensed Marriage and Family Therapist (LMFT) state 
388.22 	examination is $110;
388.23 	(3) initial LMFT license fee is prorated, but cannot exceed $125;
388.24 	(4) annual renewal fee for LMFT license is $125;
388.25 	(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
388.26 	LMFT license renewal is $50;
388.27 	(6) application fee for LMFT licensure by reciprocity is $340 $220;
388.28 	(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) 
388.29 	license is $75;
388.30 	(8) annual renewal fee for LAMFT license is $75;
388.31 	(9) late fee for LAMFT renewal is $50 $25;
388.32 	(10) fee for reinstatement of license is $150; and
389.1 	(11) fee for emeritus status is $125.

389.2 	Sec. 3. Minnesota Statutes 2012, section 151.01, subdivision 27, is amended to read:
389.3 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
389.4 	(1) interpretation and evaluation of prescription drug orders;
389.5 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by 
389.6 	a manufacturer or packager of nonprescription drugs or commercially packaged legend 
389.7 	drugs and devices);
389.8 	(3) participation in clinical interpretations and monitoring of drug therapy for 
389.9 	assurance of safe and effective use of drugs;
389.10 	(4) participation in drug and therapeutic device selection; drug administration for first 
389.11 	dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
389.12 	(5) participation in administration of influenza vaccines to all eligible individuals ten 
389.13 	years of age and older and all other vaccines to patients 18 years of age and older under 
389.14 	standing orders from a physician licensed under chapter 147 or by written protocol with a 
389.15 	physician licensed under chapter 147 provided that:
389.16 	(i) the standing orders or protocol include, at a minimum, the name, dosage, and 
389.17 	route of each vaccine that may be given, the patient population to whom the vaccine may 
389.18 	be given, contraindications and precautions to the vaccine, the procedure for handling an 
389.19 	adverse reaction, the name and signature of the physician, the address of the physician, a 
389.20 	phone number at which the physician can be contacted, and the date and time period for 
389.21 	which the standing orders or protocol are valid;
389.22 	(i) (ii) the pharmacist is trained in has successfully completed a program approved 
389.23 	by the American Accreditation Council of Pharmaceutical for Pharmacy Education, 
389.24 	specifically for the administration of immunizations, or graduated from a college of 
389.25 	pharmacy in 2001 or thereafter; and a program approved according to rules adopted by 
389.26 	the board;
389.27 	(iii) the pharmacist completes continuing education concerning the administration of 
389.28 	immunizations, as required by Minnesota Rules;
389.29 	(iv) the pharmacist has a current cardiopulmonary resuscitation certificate;
389.30 	(ii) (v) the pharmacist reports the administration of the immunization to the patient's 
389.31 	primary physician or clinic or to the Minnesota Immunization Information Connection;
389.32 	(vi) the pharmacist complies with guidelines for vaccines and immunizations 
389.33 	established by the federal Advisory Committee on Immunization Practices (ACIP), except 
389.34 	that a pharmacist does not need to comply with those guidelines if administering a vaccine 
389.35 	pursuant to a valid, patient-specific order issued by a physician licensed under chapter 147 
390.1 	when the order is consistent with United States Food and Drug Administration-approved 
390.2 	labeling of the vaccine; and
390.3 	(vii) the pharmacist complies with Centers for Disease Control and Prevention 
390.4 	guidelines relating to immunization schedules, vaccine storage and handling, and vaccine 
390.5 	administration and documentation;
390.6 	(6) participation in the practice of managing drug therapy and modifying drug 
390.7 	therapy, according to section 151.21, subdivision 1, according to a written protocol 
390.8 	between the specific pharmacist and the individual dentist, optometrist, physician, 
390.9 	podiatrist, or veterinarian who is responsible for the patient's care and authorized to 
390.10 	independently prescribe drugs. Any significant changes in drug therapy must be reported 
390.11 	by the pharmacist to the patient's medical record;
390.12 	(7) participation in the storage of drugs and the maintenance of records;
390.13 	(8) responsibility for participation in patient counseling on therapeutic values, 
390.14 	content, hazards, and uses of drugs and devices; and
390.15 	(9) offering or performing those acts, services, operations, or transactions necessary 
390.16 	in the conduct, operation, management, and control of a pharmacy.

390.17 	Sec. 4. Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:
390.18 		Subdivision 1.Pharmacy registration licensure requirements. The board shall 
390.19 	require and provide for the annual registration of every pharmacy now or hereafter doing 
390.20 	business within this state. Upon the payment of any applicable fee specified in section 
390.21 	151.065, the board shall issue a registration certificate in such form as it may prescribe to 
390.22 	such persons as may be qualified by law to conduct a pharmacy. Such certificate shall 
390.23 	be displayed in a conspicuous place in the pharmacy for which it is issued and expire on 
390.24 	the 30th day of June following the date of issue. It shall be unlawful for any person to 
390.25 	conduct a pharmacy unless such certificate has been issued to the person by the board. (a) 
390.26 	No person shall operate a pharmacy without first obtaining a license from the board and 
390.27 	paying any applicable fee specified in section 151.065. The license shall be displayed in a 
390.28 	conspicuous place in the pharmacy for which it is issued and expires on June 30 following 
390.29 	the date of issue. It is unlawful for any person to operate a pharmacy unless the license 
390.30 	has been issued to the person by the board.
390.31 	(b) Application for a pharmacy license under this section shall be made in a manner 
390.32 	specified by the board.
390.33 	(c) No license shall be issued or renewed for a pharmacy located within the state 
390.34 	unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and 
390.35 	state law and according to rules adopted by the board. No license shall be issued for a 
391.1 	pharmacy located outside of the state unless the applicant agrees to operate the pharmacy 
391.2 	in a manner prescribed by federal law and, when dispensing medications for residents of 
391.3 	this state, the laws of this state, and Minnesota Rules.
391.4 	(d) No license shall be issued or renewed for a pharmacy that is required to be 
391.5 	licensed or registered by the state in which it is physically located unless the applicant 
391.6 	supplies the board with proof of such licensure or registration.
391.7 	(e) The board shall require a separate license for each pharmacy located within 
391.8 	the state and for each pharmacy located outside of the state at which any portion of the 
391.9 	dispensing process occurs for drugs dispensed to residents of this state.
391.10 	(f) The board shall not issue an initial or renewed license for a pharmacy unless the 
391.11 	pharmacy passes an inspection conducted by an authorized representative of the board. In 
391.12 	the case of a pharmacy located outside of the state, the board may require the applicant to 
391.13 	pay the cost of the inspection, in addition to the license fee in section 151.065, unless the 
391.14 	applicant furnishes the board with a report, issued by the appropriate regulatory agency of 
391.15 	the state in which the facility is located, of an inspection that has occurred within the 24 
391.16 	months immediately preceding receipt of the license application by the board. The board 
391.17 	may deny licensure unless the applicant submits documentation satisfactory to the board 
391.18 	that any deficiencies noted in an inspection report have been corrected.
391.19 	(g) The board shall not issue an initial or renewed license for a pharmacy located 
391.20 	outside of the state unless the applicant discloses and certifies:
391.21 	(1) the location, names, and titles of all principal corporate officers and all 
391.22 	pharmacists who are involved in dispensing drugs to residents of this state;
391.23 	(2) that it maintains its records of drugs dispensed to residents of this state so that the 
391.24 	records are readily retrievable from the records of other drugs dispensed;
391.25 	(3) that it agrees to cooperate with, and provide information to, the board concerning 
391.26 	matters related to dispensing drugs to residents of this state;
391.27 	(4) that, during its regular hours of operation, but no less than six days per week, for 
391.28 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
391.29 	communication between patients in this state and a pharmacist at the pharmacy who has 
391.30 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
391.31 	to each container of drugs dispensed to residents of this state; and
391.32 	(5) that, upon request of a resident of a long-term care facility located in this 
391.33 	state, the resident's authorized representative, or a contract pharmacy or licensed health 
391.34 	care facility acting on behalf of the resident, the pharmacy will dispense medications 
391.35 	prescribed for the resident in unit-dose packaging or, alternatively, comply with section 
391.36 	151.415, subdivision 5.

392.1 	Sec. 5. Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:
392.2 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
392.3 	provide for the annual registration of every person or establishment not licensed as a 
392.4 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
392.5 	medical gases. Upon the payment of any applicable fee specified in section 151.065, the 
392.6 	board shall issue a registration certificate in such form as it may prescribe to those persons 
392.7 	or places that may be qualified to sell or distribute federally restricted medical gases. The 
392.8 	certificate shall be displayed in a conspicuous place in the business for which it is issued 
392.9 	and expire on the date set by the board. It is unlawful for a person to sell or distribute 
392.10 	federally restricted medical gases unless a certificate has been issued to that person by the 
392.11 	board. (a) A person or establishment not licensed as a pharmacy or a practitioner shall not 
392.12 	engage in the retail sale or distribution of federally restricted medical gases without first 
392.13 	obtaining a registration from the board and paying the applicable fee specified in section 
392.14 	151.065. The registration shall be displayed in a conspicuous place in the business for 
392.15 	which it is issued and expires on the date set by the board. It is unlawful for a person to 
392.16 	sell or distribute federally restricted medical gases unless a certificate has been issued to 
392.17 	that person by the board.
392.18 	(b) Application for a medical gas distributor registration under this section shall be 
392.19 	made in a manner specified by the board.
392.20 	(c) No registration shall be issued or renewed for a medical gas distributor located 
392.21 	within the state unless the applicant agrees to operate in a manner prescribed by federal 
392.22 	and state law and according to the rules adopted by the board. No license shall be issued 
392.23 	for a medical gas distributor located outside of the state unless the applicant agrees to 
392.24 	operate in a manner prescribed by federal law and, when distributing medical gases for 
392.25 	residents of this state, the laws of this state and Minnesota Rules.
392.26 	(d) No registration shall be issued or renewed for a medical gas distributor that is 
392.27 	required to be licensed or registered by the state in which it is physically located unless the 
392.28 	applicant supplies the board with proof of the licensure or registration. The board may, by 
392.29 	rule, establish standards for the registration of a medical gas distributor that is not required 
392.30 	to be licensed or registered by the state in which it is physically located.
392.31 	(e) The board shall require a separate registration for each medical gas distributor 
392.32 	located within the state and for each facility located outside of the state from which 
392.33 	medical gases are distributed to residents of this state.
392.34 	(f) The board shall not issue an initial or renewed registration for a medical gas 
392.35 	distributor unless the medical gas distributor passes an inspection conducted by an 
392.36 	authorized representative of the board. In the case of a medical gas distributor located 
393.1 	outside of the state, the board may require the applicant to pay the cost of the inspection, 
393.2 	in addition to the license fee in section 151.065, unless the applicant furnishes the board 
393.3 	with a report, issued by the appropriate regulatory agency of the state in which the facility 
393.4 	is located, of an inspection that has occurred within the 24 months immediately preceding 
393.5 	receipt of the license application by the board. The board may deny licensure unless the 
393.6 	applicant submits documentation satisfactory to the board that any deficiencies noted in 
393.7 	an inspection report have been corrected.

393.8 	Sec. 6. [151.252] LICENSING OF DRUG MANUFACTURERS; FEES; 
393.9 	PROHIBITIONS.
393.10 		Subdivision 1.Requirements. (a) No person shall act as a manufacturer without 
393.11 	first obtaining a license from the board and paying any applicable fee specified in section 
393.12 	151.065.
393.13 	(b) Application for a manufacturer license under this section shall be made in a 
393.14 	manner specified by the board.
393.15 	(c) No license shall be issued or renewed for a manufacturer unless the applicant 
393.16 	agrees to operate in a manner prescribed by federal and state law and according to 
393.17 	Minnesota Rules.
393.18 	(d) No license shall be issued or renewed for a manufacturer that is required to 
393.19 	be registered pursuant to United State Code, title 21, section 360, unless the applicant 
393.20 	supplies the board with proof of registration. The board may establish by rule the 
393.21 	standards for licensure of manufacturers that are not required to be registered under United 
393.22 	States Code, title 21, section 360.
393.23 	(e) No license shall be issued or renewed for a manufacturer that is required to be 
393.24 	licensed or registered by the state in which it is physically located unless the applicant 
393.25 	supplies the board with proof of licensure or registration. The board may establish, by 
393.26 	rule, standards for the licensure of a manufacturer that is not required to be licensed or 
393.27 	registered by the state in which it is physically located.
393.28 	(f) The board shall require a separate license for each facility located within the state 
393.29 	at which manufacturing occurs and for each facility located outside of the state at which 
393.30 	drugs that are shipped into the state are manufactured.
393.31 	(g) The board shall not issue an initial or renewed license for a manufacturing 
393.32 	facility unless the facility passes an inspection conducted by an authorized representative 
393.33 	of the board. In the case of a manufacturing facility located outside of the state, the board 
393.34 	may require the applicant to pay the cost of the inspection, in addition to the license fee 
393.35 	in section 151.065, unless the applicant furnishes the board with a report, issued by the 
394.1 	appropriate regulatory agency of the state in which the facility is located or by the United 
394.2 	States Food and Drug Administration, of an inspection that has occurred within the 24 
394.3 	months immediately preceding receipt of the license application by the board. The board 
394.4 	may deny licensure unless the applicant submits documentation satisfactory to the board 
394.5 	that any deficiencies noted in an inspection report have been corrected.
394.6 		Subd. 2.Prohibition. It is unlawful for any person engaged in manufacturing to sell 
394.7 	legend drugs to anyone located in this state except as provided in this chapter.

394.8 	Sec. 7. Minnesota Statutes 2012, section 151.26, subdivision 1, is amended to read:
394.9 		Subdivision 1.Generally. Nothing in this chapter shall subject a person duly 
394.10 	licensed in this state to practice medicine, dentistry, or veterinary medicine, to inspection 
394.11 	by the State Board of Pharmacy, nor prevent the person from administering drugs, 
394.12 	medicines, chemicals, or poisons in the person's practice, nor prevent a duly licensed 
394.13 	practitioner from furnishing to a patient properly packaged and labeled drugs, medicines, 
394.14 	chemicals, or poisons as may be considered appropriate in the treatment of such patient; 
394.15 	unless the person is engaged in the dispensing, sale, or distribution of drugs and the board 
394.16 	provides reasonable notice of an inspection.
394.17 	Except for the provisions of section 151.37, nothing in this chapter applies to or 
394.18 	interferes with the dispensing, in its original package and at no charge to the patient, of 
394.19 	a legend drug, other than a controlled substance, that was packaged by a manufacturer 
394.20 	and provided to the dispenser for distributiondispensing as a professional sample, so 
394.21 	long as the sample is prepared and distributed pursuant to Code of Federal Regulations, 
394.22 	title 21, section 203, subpart D.
394.23 	Nothing in this chapter shall prevent the sale of drugs, medicines, chemicals, or 
394.24 	poisons at wholesale to licensed physicians, dentists and veterinarians for use in their 
394.25 	practice, nor to hospitals for use therein.
394.26 	Nothing in this chapter shall prevent the sale of drugs, chemicals, or poisons either 
394.27 	at wholesale or retail for use for commercial purposes, or in the arts, nor interfere with the 
394.28 	sale of insecticides, as defined in Minnesota Statutes 1974, section 24.069, and nothing in 
394.29 	this chapter shall prevent the sale of common household preparations and other drugs, 
394.30 	chemicals, and poisons sold exclusively for use for nonmedicinal purposes.
394.31 	Nothing in this chapter shall apply to or interfere with the vending or retailing 
394.32 	of any nonprescription medicine or drug not otherwise prohibited by statute which is 
394.33 	prepackaged, fully prepared by the manufacturer or producer for use by the consumer, and 
394.34 	labeled in accordance with the requirements of the state or federal Food and Drug Act; nor 
394.35 	to the manufacture, wholesaling, vending, or retailing of flavoring extracts, toilet articles, 
395.1 	cosmetics, perfumes, spices, and other commonly used household articles of a chemical 
395.2 	nature, for use for nonmedicinal purposes. Nothing in this chapter shall prevent the sale of 
395.3 	drugs or medicines by licensed pharmacists at a discount to persons over 65 years of age.

395.4 	Sec. 8. Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:
395.5 		Subd. 4.Research. (a) Any qualified person may use legend drugs in the course 
395.6 	of a bona fide research project, but cannot administer or dispense such drugs to human 
395.7 	beings unless such drugs are prescribed, dispensed, and administered by a person lawfully 
395.8 	authorized to do so.
395.9 	(b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for 
395.10 	use by, or administration to, patients enrolled in a bona fide research study that is being 
395.11 	conducted pursuant to either an investigational new drug application approved by the 
395.12 	United States Food and Drug Administration or that has been approved by an institutional 
395.13 	review board. For the purposes of this subdivision only:
395.14 	(1) a prescription drug order is not required for a pharmacy to dispense a research 
395.15 	drug, unless the study protocol requires the pharmacy to receive such an order;
395.16 	(2) notwithstanding the prescription labeling requirements found in this chapter or 
395.17 	the rules promulgated by the board, a research drug may be labeled as required by the 
395.18 	study protocol; and
395.19 	(3) dispensing and distribution of research drugs by pharmacies shall not be 
395.20 	considered compounding, manufacturing, or wholesaling under this chapter.
395.21 	(c) An entity that is under contract to a federal agency for the purpose of distributing 
395.22 	drugs for bona fide research studies is exempt from the drug wholesaler licensing 
395.23 	requirements of this chapter. Any other entity is exempt from the drug wholesaler 
395.24 	licensing requirements of this chapter if the board finds that the entity is licensed or 
395.25 	registered according to the laws of the state in which it is physically located and it is 
395.26 	distributing drugs for use by, or administration to, patients enrolled in a bona fide research 
395.27 	study that is being conducted pursuant to either an investigational new drug application 
395.28 	approved by the United States Food and Drug Administration or that has been approved 
395.29 	by an institutional review board.

395.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

395.31 	Sec. 9. Minnesota Statutes 2012, section 151.47, subdivision 1, is amended to read:
395.32 		Subdivision 1.Requirements. (a) All wholesale drug distributors are subject to the 
395.33 	requirements in paragraphs (a) to (f) of this subdivision.
396.1 	(a) (b) No person or distribution outlet shall act as a wholesale drug distributor 
396.2 	without first obtaining a license from the board and paying any applicable fee specified 
396.3 	in section 151.065.
396.4 	(c) Application for a wholesale drug distributor license under this section shall be 
396.5 	made in a manner specified by the board.
396.6 	(b) (d) No license shall be issued or renewed for a wholesale drug distributor to 
396.7 	operate unless the applicant agrees to operate in a manner prescribed by federal and state 
396.8 	law and according to the rules adopted by the board.
396.9 	(c) The board may require a separate license for each facility directly or indirectly 
396.10 	owned or operated by the same business entity within the state, or for a parent entity 
396.11 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
396.12 	are conducted at more than one location and joint ownership and control exists among 
396.13 	all the entities.
396.14 	(e) No license may be issued or renewed for a drug wholesale distributor that is 
396.15 	required to be licensed or registered by the state in which it is physically located unless 
396.16 	the applicant supplies the board with proof of licensure or registration. The board may 
396.17 	establish, by rule, standards for the licensure of a drug wholesale distributor that is not 
396.18 	required to be licensed or registered by the state in which it is physically located.
396.19 	(f) The board shall require a separate license for each drug wholesale distributor 
396.20 	facility located within the state and for each drug wholesale distributor facility located 
396.21 	outside of the state from which drugs are shipped into the state or to which drugs are 
396.22 	reverse distributed.
396.23 	(g) The board shall not issue an initial or renewed license for a drug wholesale 
396.24 	distributor facility unless the facility passes an inspection conducted by an authorized 
396.25 	representative of the board. In the case of a drug wholesale distributor facility located 
396.26 	outside of the state, the board may require the applicant to pay the cost of the inspection, 
396.27 	in addition to the license fee in section 151.065, unless the applicant furnishes the board 
396.28 	with a report, issued by the appropriate regulatory agency of the state in which the facility 
396.29 	is located, of an inspection that has occurred within the 24 months immediately preceding 
396.30 	receipt of the license application by the board.  The board may deny licensure unless the 
396.31 	applicant submits documentation satisfactory to the board that any deficiencies noted in 
396.32 	an inspection report have been corrected.
396.33 	(d) (h) As a condition for receiving and retaining a wholesale drug distributor license 
396.34 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
396.35 	and will continuously maintain:
396.36 	(1) adequate storage conditions and facilities;
397.1 	(2) minimum liability and other insurance as may be required under any applicable 
397.2 	federal or state law;
397.3 	(3) a viable security system that includes an after hours central alarm, or comparable 
397.4 	entry detection capability; restricted access to the premises; comprehensive employment 
397.5 	applicant screening; and safeguards against all forms of employee theft;
397.6 	(4) a system of records describing all wholesale drug distributor activities set forth 
397.7 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
397.8 	accessible as defined by board regulations in any inspection authorized by the board;
397.9 	(5) principals and persons, including officers, directors, primary shareholders, 
397.10 	and key management executives, who must at all times demonstrate and maintain their 
397.11 	capability of conducting business in conformity with sound financial practices as well 
397.12 	as state and federal law;
397.13 	(6) complete, updated information, to be provided to the board as a condition for 
397.14 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
397.15 	including all pertinent corporate licensee information, if applicable, or other ownership, 
397.16 	principal, key personnel, and facilities information found to be necessary by the board;
397.17 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
397.18 	preparation for, protection against, and handling of any facility security or operation 
397.19 	problems, including, but not limited to, those caused by natural disaster or government 
397.20 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
397.21 	or other unauthorized product control, appropriate disposition of returned goods, and 
397.22 	product recalls;
397.23 	(8) sufficient inspection procedures for all incoming and outgoing product 
397.24 	shipments; and
397.25 	(9) operations in compliance with all federal requirements applicable to wholesale 
397.26 	drug distribution.
397.27 	(e) (i)  An agent or employee of any licensed wholesale drug distributor need not 
397.28 	seek licensure under this section.
397.29 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
397.30 	form and on the date prescribed by the board, identifying all payments, honoraria, 
397.31 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
397.32 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
397.33 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
397.34 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
397.35 	provision are public data.

398.1 	Sec. 10. Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision 
398.2 	to read:
398.3 		Subd. 3.Prohibition. It is unlawful for any person engaged in wholesale drug 
398.4 	distribution to sell drugs to anyone located within the state or to receive drugs in reverse 
398.5 	distribution from anyone located within the state except as provided in this chapter.

398.6 	Sec. 11. Minnesota Statutes 2012, section 151.49, is amended to read:
398.7 	151.49 LICENSE RENEWAL APPLICATION PROCEDURES.
398.8 	Application blanks or notices for renewal of a license required by sections 151.42
398.9 	to 151.51 shall be mailed or otherwise provided to each licensee on or before the first 
398.10 	day of the month prior to the month in which the license expires and, if application for 
398.11 	renewal of the license with the required fee and supporting documents is not made before 
398.12 	the expiration date, the existing license or renewal shall lapse and become null and void 
398.13 	upon the date of expiration.

398.14 	Sec. 12. Minnesota Statutes 2012, section 152.126, is amended to read:
398.15 	152.126 CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC 
398.16 	REPORTING SYSTEM PRESCRIPTION MONITORING PROGRAM.
398.17 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
398.18 	this subdivision have the meanings given.
398.19 	(a) (b) "Board" means the Minnesota State Board of Pharmacy established under 
398.20 	chapter 151.
398.21 	(b) (c) "Controlled substances" means those substances listed in section 152.02, 
398.22 	subdivisions 3 to 5 6, and those substances defined by the board pursuant to section 
398.23 	152.02, subdivisions 7, 8, and 12. For the purpose of this section only, "controlled 
398.24 	substances" includes tramadol and butalbital.
398.25 	(c) (d) "Dispense" or "dispensing" has the meaning given in section 151.01, 
398.26 	subdivision 30. Dispensing does not include the direct administering of a controlled 
398.27 	substance to a patient by a licensed health care professional.
398.28 	(d) (e) "Dispenser" means a person authorized by law to dispense a controlled 
398.29 	substance, pursuant to a valid prescription. For the purposes of this section, a dispenser does 
398.30 	not include a licensed hospital pharmacy that distributes controlled substances for inpatient 
398.31 	hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
398.32 	(e) (f) "Prescriber" means a licensed health care professional who is authorized to 
398.33 	prescribe a controlled substance under section 152.12, subdivision 1.
398.34 	(f) (g) "Prescription" has the meaning given in section 151.01, subdivision 16.
399.1 		Subd. 1a.Treatment of intractable pain. This section is not intended to limit or 
399.2 	interfere with the legitimate prescribing of controlled substances for pain. No prescriber 
399.3 	shall be subject to disciplinary action by a health-related licensing board for prescribing a 
399.4 	controlled substance according to the provisions of section 152.125.
399.5 		Subd. 2.Prescription electronic reporting system. (a) The board shall establish 
399.6 	by January 1, 2010, an electronic system for reporting the information required under 
399.7 	subdivision 4 for all controlled substances dispensed within the state.
399.8 	(b) The board may contract with a vendor for the purpose of obtaining technical 
399.9 	assistance in the design, implementation, operation, and maintenance of the electronic 
399.10 	reporting system.
399.11 		Subd. 3.Prescription Electronic Reporting Monitoring Program Advisory 
399.12 	Committee. (a) The board shall convene an advisory committee. The committee must 
399.13 	include at least one representative of:
399.14 	(1) the Department of Health;
399.15 	(2) the Department of Human Services;
399.16 	(3) each health-related licensing board that licenses prescribers;
399.17 	(4) a professional medical association, which may include an association of pain 
399.18 	management and chemical dependency specialists;
399.19 	(5) a professional pharmacy association;
399.20 	(6) a professional nursing association;
399.21 	(7) a professional dental association;
399.22 	(8) a consumer privacy or security advocate; and
399.23 	(9) a consumer or patient rights organization; and
399.24 	(10) an association of medical examiners and coroners.
399.25 	(b) The advisory committee shall advise the board on the development and operation 
399.26 	of the electronic reporting system prescription monitoring program, including, but not 
399.27 	limited to:
399.28 	(1) technical standards for electronic prescription drug reporting;
399.29 	(2) proper analysis and interpretation of prescription monitoring data; and
399.30 	(3) an evaluation process for the program.
399.31 		Subd. 4.Reporting requirements; notice. (a) Each dispenser must submit the 
399.32 	following data to the board or its designated vendor, subject to the notice required under 
399.33 	paragraph (d):
399.34 	(1) name of the prescriber;
399.35 	(2) national provider identifier of the prescriber;
399.36 	(3) name of the dispenser;
400.1 	(4) national provider identifier of the dispenser;
400.2 	(5) prescription number;
400.3 	(6) name of the patient for whom the prescription was written;
400.4 	(7) address of the patient for whom the prescription was written;
400.5 	(8) date of birth of the patient for whom the prescription was written;
400.6 	(9) date the prescription was written;
400.7 	(10) date the prescription was filled;
400.8 	(11) name and strength of the controlled substance;
400.9 	(12) quantity of controlled substance prescribed;
400.10 	(13) quantity of controlled substance dispensed; and
400.11 	(14) number of days supply.
400.12 	(b) The dispenser must submit the required information by a procedure and in a 
400.13 	format established by the board. The board may allow dispensers to omit data listed in this 
400.14 	subdivision or may require the submission of data not listed in this subdivision provided 
400.15 	the omission or submission is necessary for the purpose of complying with the electronic 
400.16 	reporting or data transmission standards of the American Society for Automation in 
400.17 	Pharmacy, the National Council on Prescription Drug Programs, or other relevant national 
400.18 	standard-setting body.
400.19 	(c) A dispenser is not required to submit this data for those controlled substance 
400.20 	prescriptions dispensed for:
400.21 	(1) individuals residing in licensed skilled nursing or intermediate care facilities;
400.22 	(2) individuals receiving assisted living services under chapter 144G or through a 
400.23 	medical assistance home and community-based waiver;
400.24 	(3) individuals receiving medication intravenously;
400.25 	(4) individuals receiving hospice and other palliative or end-of-life care; and
400.26 	(5) individuals receiving services from a home care provider regulated under 
400.27 	chapter 144A. individuals residing in a health care facility as defined in section 151.58, 
400.28 	subdivision 2, paragraph (b), when a drug is distributed through the use of an automated 
400.29 	drug distribution system according to section 151.58; and
400.30 	(2) individuals receiving a drug sample that was packaged by a manufacturer and 
400.31 	provided to the dispenser for dispensing as a professional sample pursuant to Code of 
400.32 	Federal Regulations, title 21, section 203, subpart D.
400.33 	(d) A dispenser must not submit data under this subdivision unless provide a 
400.34 	conspicuous notice of the reporting requirements of this section is given to the patient for 
400.35 	whom the prescription was written.
401.1 		Subd. 5.Use of data by board. (a) The board shall develop and maintain a database 
401.2 	of the data reported under subdivision 4. The board shall maintain data that could identify 
401.3 	an individual prescriber or dispenser in encrypted form. The database may be used by 
401.4 	permissible users identified under subdivision 6 for the identification of:
401.5 	(1) individuals receiving prescriptions for controlled substances from prescribers 
401.6 	who subsequently obtain controlled substances from dispensers in quantities or with a 
401.7 	frequency inconsistent with generally recognized standards of use for those controlled 
401.8 	substances, including standards accepted by national and international pain management 
401.9 	associations; and
401.10 	(2) individuals presenting forged or otherwise false or altered prescriptions for 
401.11 	controlled substances to dispensers.
401.12 	(b) No permissible user identified under subdivision 6 may access the database 
401.13 	for the sole purpose of identifying prescribers of controlled substances for unusual or 
401.14 	excessive prescribing patterns without a valid search warrant or court order.
401.15 	(c) No personnel of a state or federal occupational licensing board or agency may 
401.16 	access the database for the purpose of obtaining information to be used to initiate or 
401.17 	substantiate a disciplinary action against a prescriber.
401.18 	(d) Data reported under subdivision 4 shall be retained by the board in the an active
401.19 	 database for a 12-month period, and shall be removed from the active database no later 
401.20 	than 12 months from the last day of the month during which the data was received. The 
401.21 	board may transfer the data into a database that may only be used by the authorized staff 
401.22 	of the board for the purposes of administering, operating, and maintaining the prescription 
401.23 	monitoring program and conducting trend analyses and other studies as necessary to 
401.24 	evaluate the effectiveness of the program. No data that can be used to identify an 
401.25 	individual may be transferred into this database.
401.26 		Subd. 6.Access to reporting system data. (a) Except as indicated in this 
401.27 	subdivision, the data submitted to the board under subdivision 4 is private data on 
401.28 	individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
401.29 	(b) Except as specified in subdivision 5, the following persons shall be considered 
401.30 	permissible users and may access the data submitted under subdivision 4 in the same or 
401.31 	similar manner, and for the same or similar purposes, as those persons who are authorized 
401.32 	to access similar private data on individuals under federal and state law:
401.33 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
401.34 	delegated the task of accessing the data, to the extent the information relates specifically to 
401.35 	a current patient, to whom the prescriber is prescribing or considering prescribing any 
401.36 	controlled substance or to whom the prescriber is providing other medical treatment for 
402.1 	which access to the data may be necessary and with the provision that the prescriber remains 
402.2 	responsible for the use or misuse of data accessed by a delegated agent or employee;
402.3 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
402.4 	delegated the task of accessing the data, to the extent the information relates specifically 
402.5 	to a current patient to whom that dispenser is dispensing or considering dispensing any 
402.6 	controlled substance or to whom the dispenser is providing other pharmaceutical care for 
402.7 	which access to the data may be necessary and with the provision that the dispenser remains 
402.8 	responsible for the use or misuse of data accessed by a delegated agent or employee;
402.9 	(3) a licensed pharmacist who is providing pharmaceutical care for which access to 
402.10 	the data may be necessary or when consulted by a prescriber who is requesting data in 
402.11 	accordance with clause (1);
402.12 	(3) (4) an individual who is the recipient of a controlled substance prescription for 
402.13 	which data was submitted under subdivision 4, or a guardian of the individual, parent or 
402.14 	guardian of a minor, or health care agent of the individual acting under a health care 
402.15 	directive under chapter 145C;
402.16 	(4) (5) personnel of the board specifically assigned to conduct a bona fide 
402.17 	investigation of a specific licensee;
402.18 	(5) (6) personnel of the board engaged in the collection of controlled substance 
402.19 	prescription information as part of the assigned duties and responsibilities under this 
402.20 	section;
402.21 	(6) (7) authorized personnel of a vendor under contract with the board who are 
402.22 	engaged in the design, implementation, operation, and maintenance of the electronic 
402.23 	reporting system prescription monitoring program as part of the assigned duties and 
402.24 	responsibilities of their employment, provided that access to data is limited to the 
402.25 	minimum amount necessary to carry out such duties and responsibilities;
402.26 	(7) (8) federal, state, and local law enforcement authorities acting pursuant to a 
402.27 	valid search warrant; and
402.28 	(8) (9) personnel of the medical assistance program Minnesota health care programs
402.29 	 assigned to use the data collected under this section to identify and manage recipients 
402.30 	whose usage of controlled substances may warrant restriction to a single primary care 
402.31 	physician provider, a single outpatient pharmacy, or and a single hospital; and
402.32 	(10) a coroner or medical examiner, or an agent or employee of the coroner or 
402.33 	medical examiner to whom the coroner or medical examiner has delegated the task of 
402.34 	accessing the data, conducting an investigation pursuant to section 390.11, and with the 
402.35 	provision that the coroner or medical examiner remains responsible for the use or misuse 
402.36 	of data accessed by a delegated agent or employee.
403.1 	For purposes of clause (3) (4), access by an individual includes persons in the 
403.2 	definition of an individual under section 13.02.
403.3 	(c) Any permissible user identified in paragraph (b), who directly accesses 
403.4 	the data electronically, shall implement and maintain a comprehensive information 
403.5 	security program that contains administrative, technical, and physical safeguards that 
403.6 	are appropriate to the user's size and complexity, and the sensitivity of the personal 
403.7 	information obtained. The permissible user shall identify reasonably foreseeable internal 
403.8 	and external risks to the security, confidentiality, and integrity of personal information 
403.9 	that could result in the unauthorized disclosure, misuse, or other compromise of the 
403.10 	information and assess the sufficiency of any safeguards in place to control the risks.
403.11 	(d) The board shall not release data submitted under this section unless it is provided 
403.12 	with evidence, satisfactory to the board, that the person requesting the information is 
403.13 	entitled to receive the data.
403.14 	(e) The board shall not release the name of a prescriber without the written consent 
403.15 	of the prescriber or a valid search warrant or court order. The board shall provide a 
403.16 	mechanism for a prescriber to submit to the board a signed consent authorizing the release 
403.17 	of the prescriber's name when data containing the prescriber's name is requested.
403.18 	(f) The board shall maintain a log of all persons who access the data for a period of 
403.19 	at least five years and shall ensure that any permissible user complies with paragraph (c) 
403.20 	prior to attaining direct access to the data.
403.21 	(g) (f) Section 13.05, subdivision 6, shall apply to any contract the board enters into 
403.22 	pursuant to subdivision 2. A vendor shall not use data collected under this section for 
403.23 	any purpose not specified in this section.
403.24 	(g) The board may participate in an interstate prescription monitoring program data 
403.25 	exchange system provided that permissible users in other states may have access to the data 
403.26 	only as allowed under this section and that section 13.05, subdivision 6, shall apply to any 
403.27 	contract or memorandum of understanding that the board enters into under this paragraph.
403.28 		Subd. 7.Disciplinary action. (a) A dispenser who knowingly fails to submit data to 
403.29 	the board as required under this section is subject to disciplinary action by the appropriate 
403.30 	health-related licensing board.
403.31 	(b) A prescriber or dispenser authorized to access the data who knowingly discloses 
403.32 	the data in violation of state or federal laws relating to the privacy of health care data 
403.33 	shall be subject to disciplinary action by the appropriate health-related licensing board, 
403.34 	and appropriate civil penalties.
403.35 		Subd. 8.Evaluation and reporting. (a) The board shall evaluate the prescription 
403.36 	electronic reporting system to determine if the system is negatively impacting appropriate 
404.1 	prescribing practices of controlled substances. The board may contract with a vendor to 
404.2 	design and conduct the evaluation.
404.3 	(b) The board shall submit the evaluation of the system to the legislature by July 
404.4 	15, 2011.
404.5 		Subd. 9.Immunity from liability; no requirement to obtain information. (a) A 
404.6 	pharmacist, prescriber, or other dispenser making a report to the program in good faith 
404.7 	under this section is immune from any civil, criminal, or administrative liability, which 
404.8 	might otherwise be incurred or imposed as a result of the report, or on the basis that the 
404.9 	pharmacist or prescriber did or did not seek or obtain or use information from the program.
404.10 	(b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 
404.11 	to obtain information about a patient from the program, and the pharmacist, prescriber, 
404.12 	or other dispenser, if acting in good faith, is immune from any civil, criminal, or 
404.13 	administrative liability that might otherwise be incurred or imposed for requesting, 
404.14 	receiving, or using information from the program.
404.15 		Subd. 10.Funding. (a) The board may seek grants and private funds from nonprofit 
404.16 	charitable foundations, the federal government, and other sources to fund the enhancement 
404.17 	and ongoing operations of the prescription electronic reporting system monitoring 
404.18 	program established under this section. Any funds received shall be appropriated to the 
404.19 	board for this purpose. The board may not expend funds to enhance the program in a way 
404.20 	that conflicts with this section without seeking approval from the legislature.
404.21 	(b) Notwithstanding any other section, the administrative services unit for the 
404.22 	health-related licensing boards shall apportion between the Board of Medical Practice, the 
404.23 	Board of Nursing, the Board of Dentistry, the Board of Podiatric Medicine, the Board of 
404.24 	Optometry, the Board of Veterinary Medicine, and the Board of Pharmacy an amount to 
404.25 	be paid through fees by each respective board. The amount apportioned to each board 
404.26 	shall equal each board's share of the annual appropriation to the Board of Pharmacy 
404.27 	from the state government special revenue fund for operating the prescription electronic 
404.28 	reporting system monitoring program under this section. Each board's apportioned share 
404.29 	shall be based on the number of prescribers or dispensers that each board identified in 
404.30 	this paragraph licenses as a percentage of the total number of prescribers and dispensers 
404.31 	licensed collectively by these boards. Each respective board may adjust the fees that the 
404.32 	boards are required to collect to compensate for the amount apportioned to each board by 
404.33 	the administrative services unit.

404.34 	Sec. 13. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL 
404.35 	BACKGROUND CHECKS.
405.1 		Subdivision 1.Applications. (a) By January 1, 2018, each health-related licensing 
405.2 	board, as defined in section 214.01, subdivision 2, shall require applicants for initial 
405.3 	licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse 
405.4 	in licensure, as defined by the individual health-related licensing boards, to submit to 
405.5 	a criminal history records check of state data completed by the Bureau of Criminal 
405.6 	Apprehension (BCA) and a national criminal history records check, including a search of 
405.7 	the records of the Federal Bureau of Investigation (FBI).
405.8 	(b) An applicant must complete a criminal background check if more than one year 
405.9 	has elapsed since the applicant last submitted a background check to the board.
405.10 		Subd. 2.Investigations. If a health-related licensing board has reasonable cause 
405.11 	to believe a licensee has been charged with or convicted of a crime in this or any other 
405.12 	jurisdiction, the health-related licensing board may require the licensee to submit to a 
405.13 	criminal history records check of state data completed by the BCA and a national criminal 
405.14 	history records check, including a search of the records of the FBI.
405.15 		Subd. 3.Consent form; fees; fingerprints. (a) In order to effectuate the federal 
405.16 	and state level, fingerprint-based criminal background check, the applicant or licensee 
405.17 	must submit a completed criminal history records check consent form and a full set of 
405.18 	fingerprints to the respective health-related licensing board or a designee in the manner 
405.19 	and form specified by the board. 
405.20 	(b) The applicant or licensee is responsible for all fees associated with preparation of 
405.21 	the fingerprints, the criminal records check consent form, and the criminal background 
405.22 	check. The fees for the criminal records background check shall be set by the BCA and 
405.23 	the FBI and are not refundable. The fees shall be submitted to the respective health-related 
405.24 	licensing board by the applicant or licensee as prescribed by the respective board. 
405.25 	(c) All fees received by the health-related licensing boards under this subdivision 
405.26 	shall be deposited in a dedicated account in the special revenue fund and are appropriated 
405.27 	to the Board of Nursing Home Administrators for the administrative services unit to pay 
405.28 	for the criminal background checks conducted by the Bureau of Criminal Apprehension 
405.29 	and Federal Bureau of Investigation.
405.30 		Subd. 4.Refusal to consent. (a) The health-related licensing boards shall not issue 
405.31 	a license to any applicant who refuses to consent to a criminal background check or fails 
405.32 	to submit fingerprints within 90 days after submission of an application for licensure. Any 
405.33 	fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent 
405.34 	to the criminal background check or fails to submit the required fingerprints.
405.35 	(b) The failure of a licensee to submit to a criminal background check as provided in 
405.36 	subdivision 3 is grounds for disciplinary action by the respective health licensing board.
406.1 		Subd. 5.Submission of fingerprints to the Bureau of Criminal Apprehension.
 406.2 	The health-related licensing board or designee shall submit applicant or licensee 
406.3 	fingerprints to the BCA. The BCA shall perform a check for state criminal justice 
406.4 	information and shall forward the applicant's or licensee's fingerprints to the FBI to 
406.5 	perform a check for national criminal justice information regarding the applicant or 
406.6 	licensee. The BCA shall report to the board the results of the state and national criminal 
406.7 	justice information checks.
406.8 		Subd. 6.Alternatives to fingerprint-based criminal background checks. The 
406.9 	health-related licensing board may require an alternative method of criminal history 
406.10 	checks for an applicant or licensee who has submitted at least three sets of fingerprints in 
406.11 	accordance with this section that have been unreadable by the BCA or the FBI.
406.12 		Subd. 7.Data practices. Criminal history record information obtained by the 
406.13 	health-related licensing board under this section is private data on individuals under 
406.14 	section 13.02, subdivision 12.
406.15 		Subd. 8.Opportunity to challenge accuracy of report. Prior to taking disciplinary 
406.16 	action against an applicant or a licensee based on a criminal conviction, the health-related 
406.17 	licensing board shall provide the applicant or the licensee an opportunity to complete or 
406.18 	challenge the accuracy of the criminal history information reported to the board. The 
406.19 	applicant or licensee shall have 30 calendar days following notice from the board of 
406.20 	the intent to deny licensure or to take disciplinary action to request an opportunity to 
406.21 	correct or complete the record prior to the board taking disciplinary action based on the 
406.22 	information reported to the board. The board shall provide the applicant up to 180 days to 
406.23 	challenge the accuracy or completeness of the report with the agency responsible for the 
406.24 	record. This subdivision does not affect the right of the subject of the data to contest the 
406.25 	accuracy or completeness under section 13.04, subdivision 4.
406.26 		Subd. 9.Instructions to the board; plans. The health-related licensing boards, in 
406.27 	collaboration with the commissioner of human services and the BCA, shall establish a 
406.28 	plan for completing criminal background checks of all licensees who were licensed before 
406.29 	the effective date requirement under subdivision 1. The plan must seek to minimize 
406.30 	duplication of requirements for background checks of licensed health professionals. The 
406.31 	plan for background checks of current licensees shall be developed no later than January 
406.32 	1, 2017, and may be contingent upon the implementation of a system by the BCA or FBI 
406.33 	in which any new crimes that an applicant or licensee commits after an initial background 
406.34 	check are flagged in the BCA's or FBI's database and reported back to the board. The plan 
406.35 	shall include recommendations for any necessary statutory changes.

407.1 	Sec. 14. Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision 
407.2 	to read:
407.3 		Subd. 4.Parental depression. The health-related licensing boards that regulate 
407.4 	professions that serve caregivers at risk of depression, or their children, including 
407.5 	behavioral health and therapy, chiropractic, marriage and family therapy, medical practice, 
407.6 	nursing, psychology, and social work, shall provide educational materials to licensees on 
407.7 	the subject of parental depression and its potential effects on children if unaddressed, 
407.8 	including how to:
407.9 	(1) screen mothers for depression;
407.10 	(2) identify children who are affected by their mother's depression; and
407.11 	(3) provide treatment or referral information on needed services.

407.12 	Sec. 15. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:
407.13 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this 
407.14 	section.
407.15 	(b) "Administrative services unit" means the administrative services unit for the 
407.16 	health-related licensing boards.
407.17 	(c) "Charitable organization" means a charitable organization within the meaning of 
407.18 	section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or 
407.19 	support of programs designed to improve the quality, awareness, and availability of health 
407.20 	care services and that serves as a funding mechanism for providing those services.
407.21 	(d) "Health care facility or organization" means a health care facility licensed under 
407.22 	chapter 144 or 144A, or a charitable organization.
407.23 	(e) "Health care provider" means a physician licensed under chapter 147, physician 
407.24 	assistant registered licensed and practicing under chapter 147A, nurse licensed and 
407.25 	registered to practice under chapter 148, or dentist or, dental hygienist, or dental therapist
407.26 	 licensed under chapter 150A, or an advanced dental therapist licensed and certified under 
407.27 	chapter 150A.
407.28 	(f) "Health care services" means health promotion, health monitoring, health 
407.29 	education, diagnosis, treatment, minor surgical procedures, the administration of local 
407.30 	anesthesia for the stitching of wounds, and primary dental services, including preventive, 
407.31 	diagnostic, restorative, and emergency treatment. Health care services do not include the 
407.32 	administration of general anesthesia or surgical procedures other than minor surgical 
407.33 	procedures.
407.34 	(g) "Medical professional liability insurance" means medical malpractice insurance 
407.35 	as defined in section 62F.03.

408.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

408.2 	Sec. 16. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO 
408.3 	CRIMINAL BACKGROUND CHECKS.
 408.4 	(a) If the Department of Health is not reviewed by the Sunset Advisory Commission 
408.5 	according to the schedule in Minnesota Statutes, section 3D.21, the commissioner 
408.6 	of health, as the regulator for occupational therapy practitioners, speech-language 
408.7 	pathologists, audiologists, and hearing instrument dispensers, shall require applicants 
408.8 	for licensure or renewal to submit to a criminal history records check as required under 
408.9 	Minnesota Statutes, section 214.075, for other health-related licensed occupations 
408.10 	regulated by the health-related licensing boards.
408.11 	(b) Any statutory changes necessary to include the commissioner of health to 
408.12 	Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota 
408.13 	Statutes, section 214.075, subdivision 9.

408.14 	Sec. 17.  REPEALER.
 408.15 	Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47, 
408.16 	subdivision 2; and 151.48, are repealed.

408.17 	ARTICLE 11
408.18 	HOME CARE PROVIDERS

408.19 	Section 1. Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:
408.20 		Subd. 2.Health occupations data. (a) Health-related licensees and registrants.
408.21 	The collection, analysis, reporting, and use of data on individuals licensed or registered by 
408.22 	the commissioner of health or health-related licensing boards are governed by sections 
408.23 	144.051, subdivision 2 subdivisions 2 to 6, and 144.052.
408.24 	(b) Health services personnel. Data collected by the commissioner of health for the 
408.25 	database on health services personnel are classified under section 144.1485.

408.26 	Sec. 2. Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:
408.27 		Subd. 10.Home care and hospice provider. Data regarding a home care provider 
408.28 	under sections 144A.43 to 144A.47 are governed by section 144A.45. Data regarding 
408.29 	home care provider background studies are governed by section 144A.476, subdivision 1. 
408.30 	Data regarding a hospice provider under sections 144A.75 to 144A.755 are governed by 
408.31 	sections 144A.752 and 144A.754.

409.1 	Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision 
409.2 	to read:
409.3 		Subd. 3.Data classification; private data. For providers regulated pursuant to 
409.4 	sections 144A.43 to 144A.482, the following data collected, created, or maintained by 
409.5 	the commissioner are classified as private data on individuals as defined in section 13.02, 
409.6 	subdivision 12:
409.7 	(1) data submitted by or on behalf of applicants for licenses prior to issuance of 
409.8 	the license;
409.9 	(2) the identity of complainants who have made reports concerning licensees or 
409.10 	applicants unless the complainant consents to the disclosure;
409.11 	(3) the identity of individuals who provide information as part of surveys and 
409.12 	investigations;
409.13 	(4) Social Security numbers; and
409.14 	(5) health record data.

409.15 	Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision 
409.16 	to read:
409.17 		Subd. 4.Data classification; public data. For providers regulated pursuant to 
409.18 	sections 144A.43 to 144A.482, the following data collected, created, or maintained by the 
409.19 	commissioner are public:
409.20 	(1) all application data on licensees, license numbers, license status;
409.21 	(2) licensing information about licenses previously held under this chapter;
409.22 	(3) correction orders, including information about compliance with the order and 
409.23 	whether the fine was paid;
409.24 	(4) final enforcement actions pursuant to chapter 14;
409.25 	(5) orders for hearing, findings of fact and conclusions of law; and
409.26 	(6) when the licensee and department agree to resolve the matter without a hearing, 
409.27 	the agreement and specific reasons for the agreement are public data.

409.28 	Sec. 5. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision 
409.29 	to read:
409.30 		Subd. 5.Data classification; confidential data. For providers regulated pursuant to 
409.31 	sections 144A.43 to 144A.482, the following data collected, created, or maintained by 
409.32 	the Department of Health are classified as confidential data on individuals as defined in 
409.33 	section 13.02, subdivision 3: active investigative data relating to the investigation of 
410.1 	potential violations of law by a licensee including data from the survey process before the 
410.2 	correction order is issued by the department.

410.3 	Sec. 6. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision 
410.4 	to read:
410.5 		Subd. 6.Release of private or confidential data. For providers regulated pursuant 
410.6 	to sections 144A.43 to 144A.482, the department may release private or confidential data, 
410.7 	except Social Security numbers, to the appropriate state, federal, or local agency and law 
410.8 	enforcement office to facilitate investigative or enforcement efforts or further the public 
410.9 	health protective process. Types of offices include Adult Protective Services, Office of the 
410.10 	Ombudsmen for Long-Term Care and Office of the Ombudsmen for Mental Health and 
410.11 	Developmental Disabilities, health licensing boards, the Department of Human Services, 
410.12 	county or city attorney's offices, police, and local or county public health offices.

410.13 	Sec. 7. Minnesota Statutes 2012, section 144A.43, is amended to read:
410.14 	144A.43 DEFINITIONS.
410.15 		Subdivision 1.Applicability. The definitions in this section apply to sections 
410.16 	144.699, subdivision 2, and 144A.43 to 144A.47 144A.482. 
410.17 		Subd. 1a.Agent. "Agent" means the person upon whom all notices and orders shall 
410.18 	be served and who is authorized to accept service of notices and orders on behalf of 
410.19 	the home care provider.
410.20 		Subd. 1b.Applicant. "Applicant" means an individual, organization, association, 
410.21 	corporation, unit of government, or other entity that applies for a temporary license, 
410.22 	license, or renewal of their home care provider license under section 144A.472.
410.23 		Subd. 1c.Client. "Client" means a person to whom home care services are provided.
410.24 		Subd. 1d.Client record. "Client record" means all records that document 
410.25 	information about the home care services provided to the client by the home care provider.
410.26 		Subd. 1e.Client representative. "Client representative" means a person who, 
410.27 	because of the client's needs, makes decisions about the client's care on behalf of the 
410.28 	client. A client representative may be a guardian, health care agent, family member, or 
410.29 	other agent of the client. Nothing in this section expands or diminishes the rights of 
410.30 	persons to act on behalf of clients under other law.
410.31 		Subd. 2.Commissioner. "Commissioner" means the commissioner of health.
410.32 		Subd. 2a.Controlled substance. "Controlled substance" has the meaning given 
410.33 	in section 152.01, subdivision 4.
410.34 		Subd. 2b.Department. "Department" means the Minnesota Department of Health.
411.1 		Subd. 2c.Dietary supplement. "Dietary supplement" means a product taken by 
411.2 	mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary 
411.3 	ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and 
411.4 	substances such as enzymes, organ tissue, glandulars, or metabolites.
411.5 		Subd. 2d.Dietitian. "Dietitian" is a person licensed under sections 148.621 to 
411.6 	148.633.
411.7 		Subd. 2e.Dietetics or nutrition practice. "Dietetics or nutrition practice" is 
411.8 	performed by a licensed dietitian or licensed nutritionist and includes the activities of 
411.9 	assessment, setting priorities and objectives, providing nutrition counseling, developing 
411.10 	and implementing nutrition care services, and evaluating and maintaining appropriate 
411.11 	standards of quality of nutrition care under sections 148.621 to 148.633.
411.12 		Subd. 3.Home care service. "Home care service" means any of the following 
411.13 	services when delivered in a place of residence tothe home of a person whose illness, 
411.14 	disability, or physical condition creates a need for the service:
411.15 	(1) nursing services, including the services of a home health aide;
411.16 	(2) personal care services not included under sections 148.171 to 148.285; 
411.17 	(3) physical therapy;
411.18 	(4) speech therapy;
411.19 	(5) respiratory therapy;
411.20 	(6) occupational therapy;
411.21 	(7) nutritional services;
411.22 	(8) home management services when provided to a person who is unable to perform 
411.23 	these activities due to illness, disability, or physical condition. Home management 
411.24 	services include at least two of the following services: housekeeping, meal preparation, 
411.25 	and shopping;
411.26 	(9) medical social services;
411.27 	(10) the provision of medical supplies and equipment when accompanied by the 
411.28 	provision of a home care service; and
411.29 	(11) other similar medical services and health-related support services identified by 
411.30 	the commissioner in rule.
411.31 	"Home care service" does not include the following activities conducted by the 
411.32 	commissioner of health or a board of health as defined in section 145A.02, subdivision 2: 
411.33 	communicable disease investigations or testing; administering or monitoring a prescribed 
411.34 	therapy necessary to control or prevent a communicable disease; or the monitoring 
411.35 	of an individual's compliance with a health directive as defined in section 144.4172, 
411.36 	subdivision 6. 
412.1 	(1) assistive tasks as defined in section 144A.471, subdivision 6, provided by 
412.2 	unlicensed personnel;
412.3 	(2) services provided by a registered nurse or licensed practical nurse, physical 
412.4 	therapist, respiratory therapist, occupational therapist, speech-language pathologist, 
412.5 	dietitian or nutritionist, or social worker;
412.6 	(3) medication and treatment management services; or
412.7 	(4) the provision of durable medical equipment services when provided with any of 
412.8 	the home care services listed in clauses (1) to (3).
412.9 		Subd. 3a.Hands-on-assistance. "Hands-on-assistance" means physical help by 
412.10 	another person without which the client is not able to perform the activity.
412.11 		Subd. 3b.Home. "Home" means the client's temporary or permanent place of 
412.12 	residence.
412.13 		Subd. 4.Home care provider. "Home care provider" means an individual, 
412.14 	organization, association, corporation, unit of government, or other entity that is regularly 
412.15 	engaged in the delivery of at least one home care service, directly or by contractual 
412.16 	arrangement, of home care services in a client's home for a fee and who has a valid current 
412.17 	temporary license or license issued under sections 144A.43 to 144A.482. At least one 
412.18 	home care service must be provided directly, although additional home care services may 
412.19 	be provided by contractual arrangements. "Home care provider" does not include:
412.20 	(1) any home care or nursing services conducted by and for the adherents of any 
412.21 	recognized church or religious denomination for the purpose of providing care and 
412.22 	services for those who depend upon spiritual means, through prayer alone, for healing;
412.23 	(2) an individual who only provides services to a relative;
412.24 	(3) an individual not connected with a home care provider who provides assistance 
412.25 	with home management services or personal care needs if the assistance is provided 
412.26 	primarily as a contribution and not as a business;
412.27 	(4) an individual not connected with a home care provider who shares housing with 
412.28 	and provides primarily housekeeping or homemaking services to an elderly or disabled 
412.29 	person in return for free or reduced-cost housing;
412.30 	(5) an individual or agency providing home-delivered meal services;
412.31 	(6) an agency providing senior companion services and other older American 
412.32 	volunteer programs established under the Domestic Volunteer Service Act of 1973, 
412.33 	Public Law 98-288;
412.34 	(7) an employee of a nursing home licensed under this chapter or an employee of a 
412.35 	boarding care home licensed under sections 144.50 to 144.56 who responds to occasional 
413.1 	emergency calls from individuals residing in a residential setting that is attached to or 
413.2 	located on property contiguous to the nursing home or boarding care home; 
413.3 	(8) a member of a professional corporation organized under chapter 319B that does 
413.4 	not regularly offer or provide home care services as defined in subdivision 3;
413.5 	(9) the following organizations established to provide medical or surgical services 
413.6 	that do not regularly offer or provide home care services as defined in subdivision 3: 
413.7 	a business trust organized under sections 318.01 to 318.04, a nonprofit corporation 
413.8 	organized under chapter 317A, a partnership organized under chapter 323, or any other 
413.9 	entity determined by the commissioner; 
413.10 	(10) an individual or agency that provides medical supplies or durable medical 
413.11 	equipment, except when the provision of supplies or equipment is accompanied by a 
413.12 	home care service;
413.13 	(11) an individual licensed under chapter 147; or
413.14 	(12) an individual who provides home care services to a person with a developmental 
413.15 	disability who lives in a place of residence with a family, foster family, or primary caregiver.
413.16 		Subd. 5.Medication reminder. "Medication reminder" means providing a verbal 
413.17 	or visual reminder to a client to take medication. This includes bringing the medication 
413.18 	to the client and providing liquids or nutrition to accompany medication that a client is 
413.19 	self-administering.
413.20 		Subd. 6.License. "License" means a basic or comprehensive home care license 
413.21 	issued by the commissioner to a home care provider.
413.22 		Subd. 7.Licensed health professional. "Licensed health professional" means a 
413.23 	person, other than a registered nurse or licensed practical nurse, who provides home care 
413.24 	services within the scope of practice of the person's health occupation license, registration, 
413.25 	or certification as regulated and who is licensed by the appropriate Minnesota state board 
413.26 	or agency.
413.27 		Subd. 8.Licensee. "Licensee" means a home care provider that is licensed under 
413.28 	this chapter.
413.29 		Subd. 9.Managerial official. "Managerial official" means an administrator, 
413.30 	director, officer, trustee, or employee of a home care provider, however designated, who 
413.31 	has the authority to establish or control business policy.
413.32 		Subd. 10.Medication. "Medication" means a prescription or over-the-counter drug. 
413.33 	For purposes of this chapter only, medication includes dietary supplements.
413.34 		Subd. 11.Medication administration. "Medication administration" means 
413.35 	performing a set of tasks to ensure a client takes medications, and includes the following:
413.36 	(1) checking the client's medication record;
414.1 	(2) preparing the medication as necessary;
414.2 	(3) administering the medication to the client;
414.3 	(4) documenting the administration or reason for not administering the medication; 
414.4 	and
414.5 	(5) reporting to a nurse any concerns about the medication, the client, or the client's 
414.6 	refusal to take the medication.
414.7 		Subd. 12.Medication management. "Medication management" means the 
414.8 	provision of any of the following medication-related services to a client:
414.9 	(1) performing medication setup;
414.10 	(2) administering medication;
414.11 	(3) storing and securing medications;
414.12 	(4) documenting medication activities;
414.13 	(5) verifying and monitoring effectiveness of systems to ensure safe handling and 
414.14 	administration;
414.15 	(6) coordinating refills;
414.16 	(7) handling and implementing changes to prescriptions;
414.17 	(8) communicating with the pharmacy about the client's medications; and
414.18 	(9) coordinating and communicating with the prescriber.
414.19 		Subd. 13.Medication setup. "Medication setup" means arranging medications by a 
414.20 	nurse, pharmacy, or authorized prescriber for later administration by the client or by 
414.21 	comprehensive home care staff.
414.22 		Subd. 14.Nurse. "Nurse" means a person who is licensed under sections 148.171 to 
414.23 	148.285.
414.24 		Subd. 15.Occupational therapist. "Occupational therapist" means a person who is 
414.25 	licensed under sections 148.6401 to 148.6450.
414.26 		Subd. 16.Over-the-counter drug. "Over-the-counter drug" means a drug that is 
414.27 	not required by federal law to bear the symbol "Rx only."
414.28 		Subd. 17.Owner. "Owner" means a proprietor, general partner, limited partner who 
414.29 	has five percent or more of equity interest in a limited partnership, a person who owns or 
414.30 	controls voting stock in a corporation in an amount equal to or greater than five percent of 
414.31 	the shares issued and outstanding, or a corporation that owns equity interest in a licensee 
414.32 	or applicant for a license.
414.33 		Subd. 18.Pharmacist. "Pharmacist" has the meaning given in section 151.01, 
414.34 	subdivision 3.
414.35 		Subd. 19.Physical therapist. "Physical therapist" means a person who is licensed 
414.36 	under sections 148.65 to 148.78.
415.1 		Subd. 20.Physician. "Physician" means a person who is licensed under chapter 147.
415.2 		Subd. 21.Prescriber. "Prescriber" means a person who is authorized by sections 
415.3 	148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
415.4 		Subd. 22.Prescription. "Prescription" has the meaning given in section 151.01, 
415.5 	subdivision 16.
415.6 		Subd. 23.Regularly scheduled. "Regularly scheduled" means ordered or planned 
415.7 	to be completed at predetermined times or according to a predetermined routine.
415.8 		Subd. 24.Reminder. "Reminder" means providing a verbal or visual reminder 
415.9 	to a client.
415.10 		Subd. 25.Respiratory therapist. "Respiratory therapist" means a person who 
415.11 	is licensed under chapter 147C.
415.12 		Subd. 26.Revenues. "Revenues" means all money received by a licensee derived 
415.13 	from the provisions of home care services, including fees for services and appropriations 
415.14 	of public money for home care services.
415.15 		Subd. 27.Service plan. "Service plan" means the written plan between the client or 
415.16 	client's representative and the temporary licensee or licensee about the services that will 
415.17 	be provided to the client.
415.18 		Subd. 28.Social worker. "Social worker" means a person who is licensed under 
415.19 	chapter 148D or 148E.
415.20 		Subd. 29.Speech language pathologist. "Speech language pathologist" has the 
415.21 	meaning given in section 148.512.
415.22 		Subd. 30.Standby assistance. "Standby assistance" means the presence of another 
415.23 	person within arm's reach to minimize the risk of injury while performing daily activities 
415.24 	through physical intervention or cuing.
415.25 		Subd. 31.Substantial compliance. "Substantial compliance" means complying 
415.26 	with the requirements in this chapter sufficiently to prevent unacceptable health or safety 
415.27 	risks to the home care client.
415.28 		Subd. 32.Survey. "Survey" means an inspection of a licensee or applicant for 
415.29 	licensure for compliance with this chapter.
415.30 		Subd. 33.Surveyor. "Surveyor" means a staff person of the department authorized 
415.31 	to conduct surveys of home care providers and applicants.
415.32 		Subd. 34.Temporary license. "Temporary license" means the initial basic or 
415.33 	comprehensive home care license the department issues after approval of a complete 
415.34 	written application and before the department completes the temporary license survey and 
415.35 	determines that the temporary licensee is in substantial compliance.
416.1 		Subd. 35.Treatment or therapy. "Treatment" or "therapy" means the provision 
416.2 	of care, other than medications, ordered or prescribed by a licensed health professional 
416.3 	provided to a client to cure, rehabilitate, or ease symptoms.
416.4 		Subd. 36.Unit of government. "Unit of government" means every city, county, 
416.5 	town, school district, other political subdivisions of the state, and any agency of the state 
416.6 	or federal government, which includes any instrumentality of a unit of government.
416.7 		Subd. 37.Unlicensed personnel. "Unlicensed personnel" are individuals not 
416.8 	otherwise licensed or certified by a governmental health board or agency who provide 
416.9 	home care services in the client's home.
416.10 		Subd. 38.Verbal. "Verbal" means oral and not in writing.

416.11 	Sec. 8. Minnesota Statutes 2012, section 144A.44, is amended to read:
416.12 	144A.44 HOME CARE BILL OF RIGHTS.
416.13 		Subdivision 1.Statement of rights. A person who receives home care services 
416.14 	has these rights:
416.15 	(1) the right to receive written information about rights in advance ofbefore 
416.16 	receiving care or during the initial evaluation visit before the initiation of treatment
416.17 	 services, including what to do if rights are violated;
416.18 	(2) the right to receive care and services according to a suitable and up-to-date plan, 
416.19 	and subject to accepted health care, medical or nursing standards, to take an active part 
416.20 	in creating and changing the plan developing, modifying, and evaluating care the plan
416.21 	 and services;
416.22 	(3) the right to be told in advance of before receiving care about the services that will 
416.23 	be provided, the disciplines that will furnish care the type and disciplines of staff who will 
416.24 	be providing the services, the frequency of visits proposed to be furnished, other choices 
416.25 	that are available for addressing home care needs, and the consequences of these choices 
416.26 	including the potential consequences of refusing these services;
416.27 	(4) the right to be told in advance of any change recommended changes by the 
416.28 	provider in the service plan of care and to take an active part in any change decisions 
416.29 	about changes to the service plan;
416.30 	(5) the right to refuse services or treatment;
416.31 	(6) the right to know, in advance before receiving services or during the initial 
416.32 	visit, any limits to the services available from a home care provider, and the provider's 
416.33 	grounds for a termination of services;
417.1 	(7) the right to know in advance of receiving care whether the services are covered 
417.2 	by health insurance, medical assistance, or other health programs, the charges for services 
417.3 	that will not be covered by Medicare, and the charges that the individual may have to pay;
417.4 	(8) (7) the right to know be told before services are initiated what the provider 
417.5 	charges are for the services, no matter who will be paying the bill and if known, to what 
417.6 	extent payment may be expected from health insurance, public programs or other sources, 
417.7 	and what charges the client may be responsible for paying;
417.8 	(9)(8) the right to know that there may be other services available in the community, 
417.9 	including other home care services and providers, and to know where to go for find
417.10 	 information about these services;
417.11 	(10) (9) the right to choose freely among available providers and to change providers 
417.12 	after services have begun, within the limits of health insurance, long-term care insurance, 
417.13 	medical assistance, or other health programs;
417.14 	(11) (10) the right to have personal, financial, and medical information kept private, 
417.15 	and to be advised of the provider's policies and procedures regarding disclosure of such 
417.16 	information;
417.17 	(12) (11) the right to be allowed access tothe client's own records and written 
417.18 	information from those records in accordance with sections 144.291 to 144.298;
417.19 	(13) (12) the right to be served by people who are properly trained and competent 
417.20 	to perform their duties;
417.21 	(14) (13) the right to be treated with courtesy and respect, and to have the patient's
417.22 	 client's property treated with respect;
417.23 	(15) (14) the right to be free from physical and verbal abuse, neglect, financial 
417.24 	exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and 
417.25 	the Maltreatment of Minors Act;
417.26 	(16) (15) the right to reasonable, advance notice of changes in services or charges, 
417.27 	including;
417.28 	(16) the right to know the provider's reason for termination of services;
417.29 	(17) the right to at least ten days' advance notice of the termination of a service by a 
417.30 	provider, except in cases where:
417.31 	(i) the recipient of services client engages in conduct that significantly alters the 
417.32 	conditions of employment as specified in the employment contract between terms of 
417.33 	the service plan with the home care provider and the individual providing home care 
417.34 	services, or creates;
417.35 	(ii) the client, person who lives with the client, or others create an abusive or unsafe 
417.36 	work environment for the individual person providing home care services; or
418.1 	(ii) (iii) an emergency for the informal caregiver or a significant change in the 
418.2 	recipient's client's condition has resulted in service needs that exceed the current service 
418.3 	provider agreement plan and that cannot be safely met by the home care provider;
418.4 	(17) (18) the right to a coordinated transfer when there will be a change in the 
418.5 	provider of services;
418.6 	(18) (19) the right to voice grievances regarding treatment or care that is complain 
418.7 	about services that are provided, or fails to be, furnished, or regarding fail to be provided, 
418.8 	and  the lack of courtesy or respect to the patientclient or the patient'sclient's property;
418.9 	(19) (20) the right to know how to contact an individual associated with the home 
418.10 	care provider who is responsible for handling problems and to have the home care provider 
418.11 	investigate and attempt to resolve the grievance or complaint;
418.12 	(20) (21) the right to know the name and address of the state or county agency to 
418.13 	contact for additional information or assistance; and
418.14 	(21) (22) the right to assert these rights personally, or have them asserted by 
418.15 	the patient's family or guardian when the patient has been judged incompetent, client's 
418.16 	representative or by anyone on behalf of the client, without retaliation.
418.17 		Subd. 2.Interpretation and enforcement of rights. These rights are established 
418.18 	for the benefit of persons clients who receive home care services. "Home care services" 
418.19 	means home care services as defined in section 144A.43, subdivision 3, and unlicensed 
418.20 	personal care assistance services, including services covered by medical assistance under 
418.21 	section 256B.0625, subdivision 19a.All home care providers, including those exempted 
418.22 	under section 144A.471, must comply with this section. The commissioner shall enforce 
418.23 	this section and the home care bill of rights requirement against home care providers 
418.24 	exempt from licensure in the same manner as for licensees. A home care provider may 
418.25 	not request or require a person client to surrender any of these rights as a condition of 
418.26 	receiving services. A guardian or conservator or, when there is no guardian or conservator, 
418.27 	a designated person, may seek to enforce these rights. This statement of rights does not 
418.28 	replace or diminish other rights and liberties that may exist relative to persons clients
418.29 	 receiving home care services, persons providing home care services, or providers licensed 
418.30 	under Laws 1987, chapter 378. A copy of these rights must be provided to an individual 
418.31 	at the time home care services, including personal care assistance services, are initiated. 
418.32 	The copy shall also contain the address and phone number of the Office of Health Facility 
418.33 	Complaints and the Office of Ombudsman for Long-Term Care and a brief statement 
418.34 	describing how to file a complaint with these offices. Information about how to contact 
418.35 	the Office of Ombudsman for Long-Term Care shall be included in notices of change in 
419.1 	client fees and in notices where home care providers initiate transfer or discontinuation of 
419.2 	services sections 144A.43 to 144A.482.

419.3 	Sec. 9. Minnesota Statutes 2012, section 144A.45, is amended to read:
419.4 	144A.45 REGULATION OF HOME CARE SERVICES.
419.5 		Subdivision 1.Rules Regulations. The commissioner shall adopt rules for the 
419.6 	regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
419.7 	 144A.482. The rules regulations shall include the following:
419.8 	(1) provisions to assure, to the extent possible, the health, safety and well-being, 
419.9 	and appropriate treatment of persons who receive home care services while respecting 
419.10 	clients' autonomy and choice;
419.11 	(2) requirements that home care providers furnish the commissioner with specified 
419.12 	information necessary to implement sections 144A.43 to 144A.47 144A.482;
419.13 	(3) standards of training of home care provider personnel, which may vary according 
419.14 	to the nature of the services provided or the health status of the consumer;
419.15 	(4) standards for provision of home care services;
419.16 	(4) (5) standards for medication management which may vary according to the 
419.17 	nature of the services provided, the setting in which the services are provided, or the 
419.18 	status of the consumer. Medication management includes the central storage, handling, 
419.19 	distribution, and administration of medications;
419.20 	(5) (6) standards for supervision of home care services requiring supervision by a 
419.21 	registered nurse or other appropriate health care professional which must occur on site 
419.22 	at least every 62 days, or more frequently if indicated by a clinical assessment, and in 
419.23 	accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a 
419.24 	person performing home care aide tasks for a class B licensee providing paraprofessional 
419.25 	services does not require nursing supervision;
419.26 	(6) (7) standards for client evaluation or assessment which may vary according to 
419.27 	the nature of the services provided or the status of the consumer;
419.28 	(7) (8) requirements for the involvement of a consumer's physician client's health 
419.29 	care provider, the documentation of physicians' health care providers' orders, if required, 
419.30 	and the consumer's treatment client's service plan, and;
419.31 	(9) the maintenance of accurate, current clinical client records;
419.32 	(8) (10) the establishment of different classes basic and comprehensive levels of 
419.33 	licenses for different types of providers and different standards and requirements for 
419.34 	different kinds of home carebased on services provided; and
420.1 	(9) operating procedures required to implement (11) provisions to enforce these 
420.2 	regulations and the home care bill of rights.
420.3 		Subd. 1a.Home care aide tasks. Notwithstanding the provisions of Minnesota 
420.4 	Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting 
420.5 	toileting, transfers, and ambulation if the client is ambulatory and if the client has no 
420.6 	serious acute illness or infectious disease.
420.7 		Subd. 1b.Home health aide qualifications. Notwithstanding the provisions of 
420.8 	Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks 
420.9 	if the person maintains current registration as a nursing assistant on the Minnesota nursing 
420.10 	assistant registry. Maintaining current registration on the Minnesota nursing assistant 
420.11 	registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110, 
420.12 	subpart 3.
420.13 		Subd. 2.Regulatory functions. (a) The commissioner shall:
420.14 	(1) evaluate, monitor, and license, survey, and monitor without advance notice,  home 
420.15 	care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
420.16 	(2) inspect the office and records of a provider during regular business hours without 
420.17 	advance notice to the home care provider;
420.18 	(2) survey every temporary licensee within one year of the temporary license issuance 
420.19 	date subject to the temporary licensee providing home care services to a client or clients;
420.20 	(3) survey all licensed home care providers on an interval that will promote the 
420.21 	health and safety of clients;
420.22 	(3) (4) with the consent of the consumer client, visit the home where services are 
420.23 	being provided;
420.24 	(4) (5) issue correction orders and assess civil penalties in accordance with section 
420.25 	144.653, subdivisions 5 to 8, for violations of sections 144A.43 to 144A.47 or the rules 
420.26 	adopted under those sections 144A.482;
420.27 	(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
420.28 	(6) (7) take other action reasonably required to accomplish the purposes of sections 
420.29 	144A.43 to 144A.47 144A.482.
420.30 	(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the 
420.31 	commissioner shall comply with the applicable requirements of section 144.122, the 
420.32 	Government Data Practices Act, and the Administrative Procedure Act.
420.33 		Subd. 4.Medicaid reimbursement. Notwithstanding the provisions of section 
420.34 	256B.37 or state plan requirements to the contrary, certification by the federal Medicare 
420.35 	program must not be a requirement of Medicaid payment for services delivered under 
420.36 	section 144A.4605.
421.1 		Subd. 5.Home care providers; services for Alzheimer's disease or related 
421.2 	disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets 
421.3 	or otherwise promotes services for persons with Alzheimer's disease or related disorders, 
421.4 	the facility's direct care staff and their supervisors must be trained in dementia care.
421.5 	(b) Areas of required training include:
421.6 	(1) an explanation of Alzheimer's disease and related disorders;
421.7 	(2) assistance with activities of daily living;
421.8 	(3) problem solving with challenging behaviors; and
421.9 	(4) communication skills.
421.10 	(c) The licensee shall provide to consumers in written or electronic form a 
421.11 	description of the training program, the categories of employees trained, the frequency 
421.12 	of training, and the basic topics covered.

421.13 	Sec. 10. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
421.14 		Subdivision 1.License required. A home care provider may not open, operate, 
421.15 	manage, conduct, maintain, or advertise itself as a home care provider or provide home 
421.16 	care services in Minnesota without a temporary or current home care provider license 
421.17 	issued by the commissioner of health.
421.18 		Subd. 2.Determination of direct home care service. "Direct home care service" 
421.19 	means a home care service provided to a client by the home care provider or its employees, 
421.20 	and not by contract. Factors that must be considered in determining whether an individual 
421.21 	or a business entity provides at least one home care service directly include, but are not 
421.22 	limited to, whether the individual or business entity:
421.23 	(1) has the right to control, and does control, the types of services provided;
421.24 	(2) has the right to control, and does control, when and how the services are provided;
421.25 	(3) establishes the charges;
421.26 	(4) collects fees from the clients or receives payment from third-party payers on 
421.27 	the clients' behalf;
421.28 	(5) pays individuals providing services compensation on an hourly, weekly, or 
421.29 	similar basis;
421.30 	(6) treats the individuals providing services as employees for the purposes of payroll 
421.31 	taxes and workers' compensation insurance; and
421.32 	(7) holds itself out as a provider of home care services or acts in a manner that 
421.33 	leads clients or potential clients to believe that it is a home care provider providing home 
421.34 	care services.
421.35 	None of the factors listed in this subdivision is solely determinative.
422.1 		Subd. 3.Determination of regularly engaged. "Regularly engaged" means 
422.2 	providing, or offering to provide, home care services as a regular part of a business. The 
422.3 	following factors must be considered by the commissioner in determining whether an 
422.4 	individual or a business entity is regularly engaged in providing home care services:
422.5 	(1) whether the individual or business entity states or otherwise promotes that the 
422.6 	individual or business entity provides home care services;
422.7 	(2) whether persons receiving home care services constitute a substantial part of the 
422.8 	individual's or the business entity's clientele; and
422.9 	(3) whether the home care services provided are other than occasional or incidental 
422.10 	to the provision of services other than home care services.
422.11 	None of the factors listed in this subdivision is solely determinative.
422.12 		Subd. 4.Penalties for operating without license. A person involved in the 
422.13 	management, operation, or control of a home care provider that operates without an 
422.14 	appropriate license is guilty of a misdemeanor. This section does not apply to a person 
422.15 	who has no legal authority to affect or change decisions related to the management, 
422.16 	operation, or control of a home care provider.
422.17 		Subd. 5.Basic and comprehensive levels of licensure. An applicant seeking 
422.18 	to become a home care provider must apply for either a basic or comprehensive home 
422.19 	care license.
422.20 		Subd. 6.Basic home care license provider. Home care services that can be 
422.21 	provided with a basic home care license are assistive tasks provided by licensed or 
422.22 	unlicensed personnel that include:
422.23 	(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, 
422.24 	and bathing;
422.25 	(2) providing standby assistance;
422.26 	(3) providing verbal or visual reminders to the client to take regularly scheduled 
422.27 	medication which includes bringing the client previously set-up medication, medication in 
422.28 	original containers, or liquid or food to accompany the medication;
422.29 	(4) providing verbal or visual reminders to the client to perform regularly scheduled 
422.30 	treatments and exercises;
422.31 	(5) preparing modified diets ordered by a licensed health professional; and
422.32 	(6) assisting with laundry, housekeeping, meal preparation, shopping, or other 
422.33 	household chores and services if the provider is also providing at least one of the activities 
422.34 	in clauses (1) to (5)
423.1 		Subd. 7.Comprehensive home care license provider. Home care services that 
423.2 	may be provided with a comprehensive home care license include any of the basic home 
423.3 	care services listed in subdivision 6, and one or more of the following:
423.4 	(1) services of an advanced practice nurse, registered nurse, licensed practical 
423.5 	nurse, physical therapist, respiratory therapist, occupational therapist, speech-language 
423.6 	pathologist, dietitian or nutritionist, or social worker;
423.7 	(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a 
423.8 	licensed health professional within the person's scope of practice;
423.9 	(3) medication management services;
423.10 	(4) hands-on assistance with transfers and mobility;
423.11 	(5) assisting clients with eating when the clients have complicating eating problems 
423.12 	as identified in the client record or through an assessment such as difficulty swallowing, 
423.13 	recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous 
423.14 	instruments to be fed; or
423.15 	(6) providing other complex or specialty health care services.
423.16 		Subd. 8.Exemptions from home care services licensure. (a) Except as otherwise 
423.17 	provided in this chapter, home care services that are provided by the state, counties, or 
423.18 	other units of government must be licensed under this chapter.
423.19 	(b) An exemption under this subdivision does not excuse the exempted individual or 
423.20 	organization from complying with applicable provisions of the home care bill of rights 
423.21 	in section 144A.44. The following individuals or organizations are exempt from the 
423.22 	requirement to obtain a home care provider license:
423.23 	(1) an individual or organization that offers, provides, or arranges for personal care 
423.24 	assistance services under the medical assistance program as authorized under sections 
423.25 	256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
423.26 	(2) a provider that is licensed by the commissioner of human services to provide 
423.27 	semi-independent living services for persons with developmental disabilities under section 
423.28 	252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
423.29 	(3) a provider that is licensed by the commissioner of human services to provide 
423.30 	home and community-based services for persons with developmental disabilities under 
423.31 	section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
423.32 	(4) an individual or organization that provides only home management services, if 
423.33 	the individual or organization is registered under section 144A.482; or 
423.34 	(5) an individual who is licensed in this state as a nurse, dietitian, social worker, 
423.35 	occupational therapist, physical therapist, or speech-language pathologist who provides 
424.1 	health care services in the home independently and not through any contractual or 
424.2 	employment relationship with a home care provider or other organization.
424.3 		Subd. 9.Exclusions from home care licensure. The following are excluded from 
424.4 	home care licensure and are not required to provide the home care bill of rights:
424.5 	(1) an individual or business entity providing only coordination of home care that 
424.6 	includes one or more of the following:
424.7 	(i) determination of whether a client needs home care services, or assisting a client 
424.8 	in determining what services are needed;
424.9 	(ii) referral of clients to a home care provider;
424.10 	(iii) administration of payments for home care services; or
424.11 	(iv) administration of a health care home established under section 256B.0751;
424.12 	(2) an individual who is not an employee of a licensed home care provider if the 
424.13 	individual:
424.14 	(i) only provides services as an independent contractor to one or more licensed 
424.15 	home care providers;
424.16 	(ii) provides no services under direct agreements or contracts with clients; and
424.17 	(iii) is contractually bound to perform services in compliance with the contracting 
424.18 	home care provider's policies and service plans;
424.19 	(3) a business that provides staff to home care providers, such as a temporary 
424.20 	employment agency, if the business:
424.21 	(i) only provides staff under contract to licensed or exempt providers;
424.22 	(ii) provides no services under direct agreements with clients; and
424.23 	(iii) is contractually bound to perform services under the contracting home care 
424.24 	provider's direction and supervision;
424.25 	(4) any home care services conducted by and for the adherents of any recognized 
424.26 	church or religious denomination for its members through spiritual means, or by prayer 
424.27 	for healing;
424.28 	(5) an individual who only provides home care services to a relative;
424.29 	(6) an individual not connected with a home care provider that provides assistance 
424.30 	with basic home care needs if the assistance is provided primarily as a contribution and 
424.31 	not as a business;
424.32 	(7) an individual not connected with a home care provider that shares housing with 
424.33 	and provides primarily housekeeping or homemaking services to an elderly or disabled 
424.34 	person in return for free or reduced-cost housing;
424.35 	(8) an individual or provider providing home-delivered meal services;
425.1 	(9) an individual providing senior companion services and other Older American 
425.2 	Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of 
425.3 	1973, United States Code, title 42, chapter 66;
425.4 	(10) an employee of a nursing home licensed under this chapter or an employee of a 
425.5 	boarding care home licensed under sections 144.50 to 144.56 who responds to occasional 
425.6 	emergency calls from individuals residing in a residential setting that is attached to or 
425.7 	located on property contiguous to the nursing home or boarding care home;
425.8 	(11) a member of a professional corporation organized under chapter 319B that 
425.9 	does not regularly offer or provide home care services as defined in section 144A.43, 
425.10 	subdivision 3;
425.11 	(12) the following organizations established to provide medical or surgical services 
425.12 	that do not regularly offer or provide home care services as defined in section 144A.43, 
425.13 	subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit 
425.14 	corporation organized under chapter 317A, a partnership organized under chapter 323, or 
425.15 	any other entity determined by the commissioner;
425.16 	(13) an individual or agency that provides medical supplies or durable medical 
425.17 	equipment, except when the provision of supplies or equipment is accompanied by a 
425.18 	home care service;
425.19 	(14) a physician licensed under chapter 147;
425.20 	(15) an individual who provides home care services to a person with a developmental 
425.21 	disability who lives in a place of residence with a family, foster family, or primary caregiver;
425.22 	(16) a business that only provides services that are primarily instructional and not 
425.23 	medical services or health-related support services;
425.24 	(17) an individual who performs basic home care services for no more than 14 hours 
425.25 	each calendar week to no more than one client;
425.26 	(18) an individual or business licensed as hospice as defined in sections 144A.75 to 
425.27 	144A.755 who is not providing home care services independent of hospice service;
425.28 	(19) activities conducted by the commissioner of health or a board of health as 
425.29 	defined in section 145A.02, subdivision 2, including communicable disease investigations 
425.30 	or testing; or
425.31 	(20) administering or monitoring a prescribed therapy necessary to control or 
425.32 	prevent a communicable disease, or the monitoring of an individual's compliance with a 
425.33 	health directive as defined in section 144.4172, subdivision 6.

425.34 	Sec. 11. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION 
425.35 	AND RENEWAL.
426.1 		Subdivision 1.License applications. Each application for a home care provider 
426.2 	license must include information sufficient to show that the applicant meets the 
426.3 	requirements of licensure, including:
426.4 	(1) the applicant's name, e-mail address, physical address, and mailing address, 
426.5 	including the name of the county in which the applicant resides and has a principal 
426.6 	place of business;
426.7 	(2) the initial license fee in the amount specified in subdivision 7;
426.8 	(3) e-mail address, physical address, mailing address, and telephone number of the 
426.9 	principal administrative office;
426.10 	(4) e-mail address, physical address, mailing address, and telephone number of 
426.11 	each branch office, if any;
426.12 	(5) names, e-mail and mailing addresses, and telephone numbers of all owners 
426.13 	and managerial officials;
426.14 	(6) documentation of compliance with the background study requirements of section 
426.15 	144A.476 for all persons involved in the management, operation, or control of the home 
426.16 	care provider;
426.17 	(7) documentation of a background study as required by section 144.057 for any 
426.18 	individual seeking employment, paid or volunteer, with the home care provider;
426.19 	(8) evidence of workers' compensation coverage as required by sections 176.181 
426.20 	and 176.182;
426.21 	(9) documentation of liability coverage, if the provider has it;
426.22 	(10) identification of the license level the provider is seeking;
426.23 	(11) documentation that identifies the managerial official who is in charge of 
426.24 	day-to-day operations and attestation that the person has reviewed and understands the 
426.25 	home care provider regulations;
426.26 	(12) documentation that the applicant has designated one or more owners, 
426.27 	managerial officials, or employees as an agent or agents, which shall not affect the legal 
426.28 	responsibility of any other owner or managerial official under this chapter;
426.29 	(13) the signature of the officer or managing agent on behalf of an entity, corporation, 
426.30 	association, or unit of government;
426.31 	(14) verification that the applicant has the following policies and procedures in place 
426.32 	so that if a license is issued, the applicant will implement the policies and procedures 
426.33 	and keep them current:
426.34 	(i) requirements in sections 626.556, reporting of maltreatment of minors, and 
426.35 	626.557, reporting of maltreatment of vulnerable adults;
426.36 	(ii) conducting and handling background studies on employees;
427.1 	(iii) orientation, training, and competency evaluations of home care staff, and a 
427.2 	process for evaluating staff performance;
427.3 	(iv) handling complaints from clients, family members, or client representatives 
427.4 	regarding staff or services provided by staff;
427.5 	(v) conducting initial evaluation of clients' needs and the providers' ability to provide 
427.6 	those services;
427.7 	(vi) conducting initial and ongoing client evaluations and assessments and how 
427.8 	changes in a client's condition are identified, managed, and communicated to staff and 
427.9 	other health care providers as appropriate;
427.10 	(vii) orientation to and implementation of the home care client bill of rights;
427.11 	(viii) infection control practices;
427.12 	(ix) reminders for medications, treatments, or exercises, if provided; and
427.13 	(x) conducting appropriate screenings, or documentation of prior screenings, to 
427.14 	show that staff are free of tuberculosis, consistent with current United States Centers for 
427.15 	Disease Control standards; and
427.16 	(15) other information required by the department.
427.17 		Subd. 2.Comprehensive home care license applications. In addition to the 
427.18 	information and fee required in subdivision 1, applicants applying for a comprehensive 
427.19 	home care license must also provide verification that the applicant has the following 
427.20 	policies and procedures in place so that if a license is issued, the applicant will implement 
427.21 	the policies and procedures in this subdivision and keep them current:
427.22 	(1) conducting initial and ongoing assessments of the client's needs by a registered 
427.23 	nurse or appropriate licensed health professional, including how changes in the client's 
427.24 	conditions are identified, managed, and communicated to staff and other health care 
427.25 	providers, as appropriate;
427.26 	(2) ensuring that nurses and licensed health professionals have current and valid 
427.27 	licenses to practice;
427.28 	(3) medication and treatment management;
427.29 	(4) delegation of home care tasks by registered nurses or licensed health professionals;
427.30 	(5) supervision of registered nurses and licensed health professionals; and
427.31 	(6) supervision of unlicensed personnel performing delegated home care tasks.
427.32 		Subd. 3.License renewal. (a) Except as provided in section 144A.475, a license 
427.33 	may be renewed for a period of one year if the licensee satisfies the following:
427.34 	(1) submits an application for renewal in the format provided by the commissioner 
427.35 	at least 30 days before expiration of the license;
427.36 	(2) submits the renewal fee in the amount specified in subdivision 7;
428.1 	(3) has provided home care services within the past 12 months;
428.2 	(4) complies with sections 144A.43 to 144A.4799;
428.3 	(5) provides information sufficient to show that the applicant meets the requirements 
428.4 	of licensure, including items required under subdivision 1;
428.5 	(6) provides verification that all policies under subdivision 1 are current; and 
428.6 	(7) provides any other information deemed necessary by the commissioner.
428.7 	(b) A renewal applicant who holds a comprehensive home care license must also 
428.8 	provide verification that policies listed under subdivision 2 are current.
428.9 		Subd. 4.Multiple units. Multiple units or branches of a licensee must be separately 
428.10 	licensed if the commissioner determines that the units cannot adequately share supervision 
428.11 	and administration of services from the main office.
428.12 		Subd. 5.Transfers prohibited; changes in ownership. Any home care license 
428.13 	issued by the commissioner may not be transferred to another party. Before acquiring 
428.14 	ownership of a home care provider business, a prospective applicant must apply for a 
428.15 	new temporary license. A change of ownership is a transfer of operational control to 
428.16 	a different business entity, and includes:
428.17 	(1) transfer of the business to a different or new corporation;
428.18 	(2) in the case of a partnership, the dissolution or termination of the partnership under 
428.19 	chapter 323A, with the business continuing by a successor partnership or other entity; 
428.20 	(3) relinquishment of control of the provider to another party, including to a contract 
428.21 	management firm that is not under the control of the owner of the business' assets;
428.22 	(4) transfer of the business by a sole proprietor to another party or entity; or
428.23 	(5) in the case of a privately held corporation, the change in ownership or control of 
428.24 	50 percent or more of the outstanding voting stock.
428.25 		Subd. 6.Notification of changes of information. The temporary licensee or 
428.26 	licensee shall notify the commissioner in writing within ten working days after any 
428.27 	change in the information required in subdivision 1, except the information required in 
428.28 	subdivision 1, clause (5), is required at the time of license renewal.
428.29 		Subd. 7.Fees; application, change of ownership, and renewal. (a) An applicant 
428.30 	seeking a temporary home care licensure must submit the following application fee to the 
428.31 	commissioner along with a completed application:
428.32 	(1) basic home care provider, $2,100; or
428.33 	(2) comprehensive home care provider, $4,200.
428.34 	(b) A home care provider who is filing a change of ownership as required under 
428.35 	subdivision 5 must submit the following application fee to the commissioner, along with 
428.36 	the documentation required for the change of ownership:
429.1 	(1) basic home care provider, $2,100; or
429.2 	(2) comprehensive home care provider, $4,200.
429.3 	(c) A home care provider who is seeking to renew the provider's license shall pay a 
429.4 	fee to the commissioner based on revenues derived from the provision of home care 
429.5 	services during the calendar year prior to the year in which the application is submitted, 
429.6 	according to the following schedule:
429.7 	License Renewal Fee

429.8	Provider Annual Revenue
		Fee
		
429.9	greater than $1,500,000
		$6,625
		
429.10
429.11	greater than $1,275,000 and no more 
than $1,500,000
		$5,797
		
429.12
429.13	greater than $1,100,000 and no more 
than $1,275,000
		$4,969
		
429.14
429.15	greater than $950,000 and no more 
than $1,100,000
		$4,141
		
429.16
429.17	greater than $850,000 and no more 
than $950,000
		$3,727
		
429.18
429.19	greater than $750,000 and no more 
than $850,000
		$3,313
		
429.20
429.21	greater than $650,000 and no more 
than $750,000
		$2,898
		
429.22
429.23	greater than $550,000 and no more 
than $650,000
		$2,485
		
429.24
429.25	greater than $450,000 and no more 
than $550,000
		$2,070
		
429.26
429.27	greater than $350,000 and no more 
than $450,000
		$1,656
		
429.28
429.29	greater than $250,000 and no more 
than $350,000
		$1,242
		
429.30
429.31	greater than $100,000 and no more 
than $250,000
		$828
		
429.32
429.33	greater than $50,000 and no more than 
$100,000
		$500
		
429.34
429.35	greater than $25,000 and no more than 
$50,000
		$400
		
429.36	no more than $25,000
		$200
		
429.37 	(d) If requested, the home care provider shall provide the commissioner information 
429.38 	to verify the provider's annual revenues or other information as needed, including copies 
429.39 	of documents submitted to the Department of Revenue.
429.40 	(e) At each annual renewal, a home care provider may elect to pay the highest 
429.41 	renewal fee for its license category, and not provide annual revenue information to the 
429.42 	commissioner.
430.1 	(f) A temporary license or license applicant, or temporary licensee or licensee that 
430.2 	knowingly provides the commissioner incorrect revenue amounts for the purpose of 
430.3 	paying a lower license fee, shall be subject to a civil penalty in the amount of double the 
430.4 	fee the provider should have paid.
430.5 	(g) Fees and penalties collected under this section shall be deposited in the state 
430.6 	treasury and credited to the special state government revenue fund.

430.7 	Sec. 12. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE 
430.8 	RENEWAL.
430.9 		Subdivision 1.Temporary license and renewal of license. (a) The department 
430.10 	shall review each application to determine the applicant's knowledge of and compliance 
430.11 	with Minnesota home care regulations. Before granting a temporary license or renewing a 
430.12 	license, the commissioner may further evaluate the applicant or licensee by requesting 
430.13 	additional information or documentation or by conducting an on-site survey of the 
430.14 	applicant to determine compliance with sections 144A.43 to 144A.482.
430.15 	(b) Within 14 calendar days after receiving an application for a license, 
430.16 	the commissioner shall acknowledge receipt of the application in writing. The 
430.17 	acknowledgment must indicate whether the application appears to be complete or whether 
430.18 	additional information is required before the application will be considered complete.
430.19 	(c) Within 90 days after receiving a complete application, the commissioner shall 
430.20 	issue a temporary license, renew the license, or deny the license.
430.21 	(d) The commissioner shall issue a license that contains the home care provider's 
430.22 	name, address, license level, expiration date of the license, and unique license number. All 
430.23 	licenses are valid for one year from the date of issuance.
430.24 		Subd. 2.Temporary license. (a) For new license applicants, the commissioner 
430.25 	shall issue a temporary license for either the basic or comprehensive home care level. A 
430.26 	temporary license is effective for one year from the date of issuance. Temporary licensees 
430.27 	must comply with sections 144A.43 to 144A.482.
430.28 	(b) During the temporary license year, the commissioner shall survey the temporary 
430.29 	licensee after the commissioner is notified or has evidence that the temporary licensee 
430.30 	is providing home care services.
430.31 	(c) Within five days of beginning the provision of services, the temporary 
430.32 	licensee must notify the commissioner that it is serving clients. The notification to the 
430.33 	commissioner may be mailed or e-mailed to the commissioner at the address provided by 
430.34 	the commissioner. If the temporary licensee does not provide home care services during 
431.1 	the temporary license year, then the temporary license expires at the end of the year and 
431.2 	the applicant must reapply for a temporary home care license.
431.3 	(d) A temporary licensee may request a change in the level of licensure prior to 
431.4 	being surveyed and granted a license by notifying the commissioner in writing and 
431.5 	providing additional documentation or materials required to update or complete the 
431.6 	changed temporary license application. The applicant must pay the difference between the 
431.7 	application fees when changing from the basic to the comprehensive level of licensure. 
431.8 	No refund will be made if the provider chooses to change the license application to the 
431.9 	basic level.
431.10 	(e) If the temporary licensee notifies the commissioner that the licensee has clients 
431.11 	within 45 days prior to the temporary license expiration, the commissioner may extend the 
431.12 	temporary license for up to 60 days in order to allow the commissioner to complete the 
431.13 	on-site survey required under this section and follow-up survey visits.
431.14 		Subd. 3.Temporary licensee survey. (a) If the temporary licensee is in substantial 
431.15 	compliance with the survey, the commissioner shall issue either a basic or comprehensive 
431.16 	home care license. If the temporary licensee is not in substantial compliance with the 
431.17 	survey, the commissioner shall not issue a basic or comprehensive license and there will 
431.18 	be no contested hearing right under chapter 14.
431.19 	(b) If the temporary licensee whose basic or comprehensive license has been denied 
431.20 	disagrees with the conclusions of the commissioner, then the licensee may request a 
431.21 	reconsideration by the commissioner or commissioner's designee. The reconsideration 
431.22 	request process will be conducted internally by the commissioner or commissioner's 
431.23 	designee, and chapter 14 does not apply.
431.24 	(c) The temporary licensee requesting reconsideration must make the request in 
431.25 	writing and must list and describe the reasons why the licensee disagrees with the decision 
431.26 	to deny the basic or comprehensive home care license.
431.27 	(d) A temporary licensee whose license is denied must comply with the requirements 
431.28 	for notification and transfer of clients in section 144A.475, subdivision 5.

431.29 	Sec. 13. [144A.474] SURVEYS AND INVESTIGATIONS.
431.30 		Subdivision 1.Surveys. The commissioner shall conduct surveys of each home 
431.31 	care provider. By June 30, 2016, the commissioner shall conduct a survey of home care 
431.32 	providers on a frequency of at least once every three years. Survey frequency may be 
431.33 	based on the license level, the provider's compliance history, number of clients served, 
431.34 	or other factors as determined by the department deemed necessary to ensure the health, 
431.35 	safety, and welfare of clients and compliance with the law.
432.1 		Subd. 2.Types of home care surveys. (a) "Initial full survey" is the survey 
432.2 	conducted of a new temporary licensee after the department is notified or has evidence that 
432.3 	the licensee is providing home care services to determine if the provider is in compliance 
432.4 	with home care requirements. Initial surveys must be completed within 14 months after 
432.5 	the department's issuance of a temporary basic or comprehensive license.
432.6 	(b) "Core survey" means periodic inspection of home care providers to determine 
432.7 	ongoing compliance with the home care requirements focusing on the essential health and 
432.8 	safety requirements.  Core surveys are available to licensed home care providers who have 
432.9 	been licensed for three years, and been surveyed at least once in the past three years, 
432.10 	with the latest survey having no widespread violation or violations beyond Level 1 as 
432.11 	provided in subdivision 11.   Providers must also have not had any substantiated licensing 
432.12 	complaints, substantiated complaints against the agency under the Vulnerable Adults 
432.13 	Act or Maltreatment of Minors Act, or an enforcement action as authorized in section  
432.14 	144A.475 in the past three years. The core survey for basic license level providers will 
432.15 	review compliance in the following areas:
432.16 	(1) reporting of maltreatment;
432.17 	(2) orientation to and implementation of home care client bill of rights;
432.18 	(3) statement of home care services;
432.19 	(4) initial evaluation of clients and initiation of services;
432.20 	(5) basic license level client review and monitoring;
432.21 	(6) service plan implementation and changes to the service plan;
432.22 	(7) client complaint and investigative process;
432.23 	(8) competency of unlicensed personnel; and
432.24 	(9) infection control.
432.25 	For comprehensive license level providers, the core survey will include everything 
432.26 	in the basic license level core survey plus these areas: 
432.27 	(1) assessment, monitoring, and reassessments of clients; and
432.28 	(2) medication, treatment, and therapy management. 
432.29 	(c) "Full survey" means the periodic inspection of home care providers to determine 
432.30 	ongoing compliance with the home care requirements that cover the core survey areas and 
432.31 	all the legal requirements for home care providers. A full survey will be conducted for 
432.32 	all temporary licensees, providers who do not meet the requirements needed for a core 
432.33 	survey, and when a surveyor identifies unacceptable client health or safety risks during a 
432.34 	core survey.  A full survey will include all the tasks identified as part of the core survey 
432.35 	and any additional review deemed necessary by the department, including additional 
432.36 	observation, interviewing, or records review of additional clients and staff.  
433.1 	(d) "Follow-up surveys" are conducted to determine if a home care provider has 
433.2 	corrected deficient issues and systems identified during a core survey, full survey, or 
433.3 	complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax, 
433.4 	mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be 
433.5 	concluded with an exit conference and written information provided on the process for 
433.6 	requesting a reconsideration of the survey results.
433.7 	(e) Upon receiving information alleging that a home care provider has violated or 
433.8 	is currently violating a requirement of sections  144A.43 to 144A.482, the commissioner 
433.9 	shall investigate the complaint according to sections 144A.51 to 144A.54.
433.10 		Subd. 3.Survey process.  The survey process for core surveys shall include the 
433.11 	following as applicable to the particular licensee and setting surveyed:
433.12 	(1) presurvey review of  pertinent documents and notification to the ombudsman 
433.13 	for long-term care;  
433.14 	(2) an entrance conference with available staff; 
433.15 	(3) communication with managerial officials or the RN in charge, if available, and 
433.16 	ongoing communication with key staff throughout the survey regarding information 
433.17 	needed by the surveyor, clarifications regarding home care requirements, and applicable 
433.18 	standards of practice;
433.19 	(4) presentation of written contact information to the provider about the survey staff 
433.20 	conducting the survey, the supervisor, and the process for requesting a reconsideration of 
433.21 	the survey results;
433.22 	(5) a brief tour of a sampling of  the housing with services establishments in which 
433.23 	the provider is providing home care services; 
433.24 	(6) a sample selection of home care clients;
433.25 	(7) information gathering through client and staff observations, client and staff 
433.26 	interviews, and reviews of records, policies, procedures, practices, and other agency 
433.27 	information; 
433.28 	(8) interviews of client's family members, if available, with client's consent when the 
433.29 	client can legally give consent;
433.30 	(9) except for complaint surveys conducted by the Office of Health Facilities 
433.31 	Complaints, an on-site exit conference with preliminary findings shared and discussed 
433.32 	with the provider, documentation that an exit conference occurred, and written information 
433.33 	on the process for requesting a reconsideration of the survey results; and
433.34 	(10) postsurvey analysis of findings and formulation of survey results, including 
433.35 	correction orders when applicable.
434.1 		Subd. 4.Scheduling surveys. Surveys and investigations shall be conducted 
434.2 	without advance notice to home care providers. Surveyors may contact the home care 
434.3 	provider on the day of a survey to arrange for someone to be available at the survey site. 
434.4 	The contact does not constitute advance notice.
434.5 		Subd. 5.Information provided by home care provider. The home care provider 
434.6 	shall provide accurate and truthful information to the department during a survey, 
434.7 	investigation, or other licensing activities.
434.8 		Subd. 6.Providing client records. Upon request of a surveyor, home care providers 
434.9 	shall provide a list of current and past clients or client representatives that includes 
434.10 	addresses and telephone numbers and any other information requested about the services 
434.11 	to clients within a reasonable period of time.
434.12 		Subd. 7.Contacting and visiting clients. Surveyors may contact or visit a home 
434.13 	care provider's clients to gather information without notice to the home care provider. 
434.14 	Before visiting a client, a surveyor shall obtain the client's or client's representative's 
434.15 	permission by telephone, mail, or in person. Surveyors shall inform all clients or client's 
434.16 	representatives of their right to decline permission for a visit.
434.17 		Subd. 8.Correction orders. (a) A correction order may be issued whenever the 
434.18 	commissioner finds upon survey or during a complaint investigation that a home care 
434.19 	provider, managerial official, or an employee of the provider is not in compliance with 
434.20 	sections 144A.43 to 144A.482. The correction order shall cite the specific statute and 
434.21 	document areas of noncompliance and the time allowed for correction.
434.22 	(b) The commissioner shall mail copies of any correction order to the last known 
434.23 	address of the home care provider. A copy of each correction order and copies of any 
434.24 	documentation supplied to the commissioner shall be kept on file by the home care 
434.25 	provider, and public documents shall be made available for viewing by any person upon 
434.26 	request. Copies may be kept electronically.
434.27 	(c) By the correction order date, the home care provider must document in the 
434.28 	provider's records any action taken to comply with the correction order. The commissioner 
434.29 	may request a copy of this documentation and the home care provider's action to respond 
434.30 	to the correction order in future surveys, upon a complaint investigation, and as otherwise 
434.31 	needed.
434.32 		Subd. 9.Follow-up surveys. For providers that have Level III or Level IV 
434.33 	violations or any violations determined to be widespread, the department shall conduct a 
434.34 	follow-up survey within 90 calendar days of the survey. When conducting a follow-up 
434.35 	survey, the surveyor will focus on whether the previous violations have been corrected and 
434.36 	may also address any new violations that are observed while evaluating the corrections 
435.1 	that have been made. If a new violation is identified on a follow-up survey, no fine will be 
435.2 	imposed unless it is not corrected on the next follow-up survey.
435.3 		Subd. 10.Performance incentive. A licensee is eligible for a performance 
435.4 	incentive if there are no violations identified in a core or full survey.  The performance 
435.5 	incentive is a ten percent discount on the licensee's next home care renewal license fee.
435.6 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be 
435.7 	assessed based on the level and scope of the violations described in paragraph (c) as follows:
435.8 	(1) Level I, no fines or enforcement;
435.9 	(2) Level II, fines ranging from $0 to $500, in addition to any of the enforcement 
435.10 	mechanisms authorized in section 144A.475 for widespread violations;
435.11 	(3) Level III, fines ranging from $500 to $1,000, in addition to any of the 
435.12 	enforcement mechanisms authorized in section 144A.475; and
435.13 	(4) Level IV, fines ranging from $1,000 to $5,000, in addition to any of the 
435.14 	enforcement mechanisms authorized in section 144A.475.
435.15 	(b) Correction orders for violations will be categorized by both level and scope as 
435.16 	follows, and fines will be assessed accordingly: 
435.17 	(1) level of violation:
435.18 	(i) Level I, a violation that has no potential to cause more than a minimal impact on 
435.19 	the client and does not affect health or safety;
435.20 	(ii) Level II, a violation that did not harm the client's health or safety, but had the 
435.21 	potential to have harmed a client's health or safety, but not likely to cause serious injury, 
435.22 	impairment, or death;
435.23 	(iii) Level III, a violation that harmed a client's health or safety, not including serious 
435.24 	injury, impairment, or death, or a violation that has the potential to lead to serious injury, 
435.25 	impairment, or death; and
435.26 	(iv) Level IV, a violation that results in serious injury, impairment or death.
435.27 	(2) scope of violation: 
435.28 	(i) isolated, when one or a limited number of clients are affected, or one or a limited 
435.29 	number of staff are involved,  or the situation has occurred only occasionally;
435.30 	(ii) pattern,  when more than a limited number of clients are affected, more than a 
435.31 	limited number of staff are involved, or the situation has had repeated occurrences but 
435.32 	is not found to be pervasive; or
435.33 	(iii) widespread; when problems are pervasive or represent a systemic failure that 
435.34 	has affected or has the potential to affect a large portion or all of the clients.
435.35 	(c) If the commissioner finds that the applicant or a home care provider required 
435.36 	to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the 
436.1 	date specified in the correction order or conditional license resulting from a survey or 
436.2 	complaint investigation, the commissioner may impose a fine. A notice of noncompliance 
436.3 	with a correction order must be mailed to the applicant's or provider's last known address. 
436.4 	The noncompliance notice must list the violations not corrected.
436.5 	(d) The license holder must pay the fines assessed on or before the payment date 
436.6 	specified. If the license holder fails to fully comply with the order, the commissioner 
436.7 	may issue a second fine or suspend the license until the license holder complies by 
436.8 	paying the fine. A timely appeal shall stay payment of the fine until the commissioner 
436.9 	issues a final order.
436.10 	(e) A license holder shall promptly notify the commissioner in writing when a 
436.11 	violation specified in the order is corrected. If upon reinspection, the commissioner 
436.12 	determines that a violation has not been corrected as indicated by the order, the 
436.13 	commissioner may issue a second fine. The commissioner shall notify the license holder by 
436.14 	mail to the last known address in the licensing record that a second fine has been assessed. 
436.15 	The license holder may appeal the second fine as provided under this subdivision.
436.16 	(f) A home care provider that has been assessed a fine under this subdivision has a 
436.17 	right to a reconsideration or a hearing under this section and chapter 14.
436.18 	(g) When a fine has been assessed, the license holder may not avoid payment by 
436.19 	closing, selling, or otherwise transferring the licensed program to a third party. In such an 
436.20 	event, the license holder shall be liable for payment of the fine. 
436.21 	(h) In addition to any fine imposed under this section, the commissioner may assess 
436.22 	costs related to an investigation that results in a final order assessing a fine or other 
436.23 	enforcement action authorized by this chapter.
436.24 	(i) Fines collected under this subdivision shall be deposited in the state government 
436.25 	special revenue fund and credited to an account separate from the revenue collected under 
436.26 	section 144A.472. Subject to an appropriation by the legislature, the revenue from the 
436.27 	fines collected may be used by the commissioner for special projects to improve home care 
436.28 	in Minnesota as recommended by the advisory council established in section 144A.4799.
436.29 		Subd. 12.Reconsideration. (a) The commissioner shall make available to home 
436.30 	care providers a correction order reconsideration process.  This process may be used 
436.31 	to challenge the correction order issued, including the level and scope described in 
436.32 	subdivision 11, and any fine assessed. During the correction order reconsideration 
436.33 	request, the issuance of the correction orders under reconsideration are not stayed, but 
436.34 	the department will post information on the Web site with the correction order that the 
436.35 	licensee has requested a reconsideration review and that the review is pending.
437.1 	(b) A licensed home care provider may request from the commissioner, in writing, 
437.2 	a correction order reconsideration regarding any correction order issued to the provider. 
437.3 	The correction order reconsideration shall not be reviewed by any surveyor, investigator, 
437.4 	or supervisor that participated in the writing or reviewing of the correction order being 
437.5 	disputed. The correction order reconsiderations may be conducted in person by telephone, 
437.6 	by another electronic form, or in writing, as determined by the commissioner. The 
437.7 	commissioner shall respond in writing to the request from a home care provider for 
437.8 	a correction order reconsideration within 60 days of the date the provider requests a 
437.9 	reconsideration. The commissioner's response shall identify the commissioner's decision 
437.10 	regarding each citation challenged by the home care provider.
437.11 	(c) The findings of a correction order reconsideration process shall be one or more of 
437.12 	the following:
437.13 	(1) supported in full: the correction order is supported in full, with no deletion of 
437.14 	findings to the citation;
437.15 	(2) supported in substance: the correction order is supported, but one or more 
437.16 	findings are deleted or modified without any change in the citation;
437.17 	 (3) correction order cited an incorrect home care licensing requirement: the correction 
437.18 	order is amended by changing the correction order to the appropriate statutory reference;
437.19 	(4) correction order was issued under an incorrect citation: the correction order is 
437.20 	amended to be issued under the more appropriate correction order citation;
437.21 	(5) the correction order is rescinded;
437.22 	(6) fine is amended: it is determined the fine assigned to the correction order was 
437.23 	applied incorrectly; or
437.24 	(7) the level or scope of the citation is modified based on the reconsideration. 
437.25 	(d) If the correction order findings are changed by the commissioner, the 
437.26 	commissioner shall update the correction order on the Web site accordingly.
437.27 		Subd. 13.Home care surveyor training. Before conducting a home care survey, 
437.28 	each home care surveyor must receive training on the following topics: 
437.29 	(1) Minnesota home care licensure requirements;
437.30 	(2) Minnesota home care client bill of rights;
437.31 	(3) Minnesota Vulnerable Adults Act and Reporting of Maltreatment of Minors;
437.32 	(4) principles of documentation;
437.33 	(5) survey protocol and processes;
437.34 	(6) Offices of the Ombudsman roles;
437.35 	(7) Office of Health Facility Complaints;
437.36 	(8) Minnesota landlord and tenant, and housing with services laws;
438.1 	(9) types of payors for home care services; and 
438.2 	(10) Minnesota Nurse Practice Act for nurse surveyors.
438.3 	Materials used for this training will be posted on the Department of Health Web 
438.4 	site.  Requisite understanding of these topics will be reviewed as part of the quality 
438.5 	improvement plan in section 30.

438.6 	Sec. 14. [144A.475] ENFORCEMENT.
438.7 		Subdivision 1.Conditions. (a) The commissioner may refuse to grant a temporary 
438.8 	license or refuse to renew a license, may suspend or revoke a license, or may impose a 
438.9 	conditional license if the home care provider or owner or managerial official of the home 
438.10 	care provider:
438.11 	(1) is in violation of, or during the term of the license has violated, any of the 
438.12 	requirements in sections 144A.471 to 144A.482;
438.13 	(2) permits, aids, or abets the commission of any illegal act in the provision of 
438.14 	home care;
438.15 	(3) performs any act detrimental to the health, safety, and welfare of a client;
438.16 	(4) obtains the license by fraud or misrepresentation;
438.17 	(5) knowingly made or makes a false statement of a material fact in the application 
438.18 	for a license or in any other record or report required by this chapter;
438.19 	(6) denies representatives of the department access to any part of the home care 
438.20 	provider's books, records, files, or employees;
438.21 	(7) interferes with or impedes a representative of the department in contacting the 
438.22 	home care provider's clients;
438.23 	(8) interferes with or impedes a representative of the department in the enforcement 
438.24 	of this chapter or has failed to fully cooperate with an inspection, survey, or investigation 
438.25 	by the department;
438.26 	(9) destroys or makes unavailable any records or other evidence relating to the home 
438.27 	care provider's compliance with this chapter;
438.28 	(10) refuses to initiate a background study under section 144.057 or 245A.04;
438.29 	(11) fails to timely pay any fines assessed by the department;
438.30 	(12) violates any local, city, or township ordinance relating to home care services;
438.31 	(13) has repeated incidents of personnel performing services beyond their 
438.32 	competency level; or
438.33 	(14) has operated beyond the scope of the home care provider's license level.
438.34 	(b) A violation by a contractor providing the home care services of the home care 
438.35 	provider is a violation by the home care provider.
439.1 		Subd. 2.Terms to suspension or conditional license. A suspension or conditional 
439.2 	license designation may include terms that must be completed or met before a suspension 
439.3 	or conditional license designation is lifted. A conditional license designation may include 
439.4 	restrictions or conditions that are imposed on the provider. Terms for a suspension or 
439.5 	conditional license may include one or more of the following and the scope of each will be 
439.6 	determined by the commissioner:
439.7 	(1) requiring a consultant to review, evaluate, and make recommended changes to 
439.8 	the home care provider's practices and submit reports to the commissioner at the cost of 
439.9 	the home care provider;
439.10 	(2) requiring supervision of the home care provider or staff practices at the cost 
439.11 	of the home care provider by an unrelated person who has sufficient knowledge and 
439.12 	qualifications to oversee the practices and who will submit reports to the commissioner;
439.13 	(3) requiring the home care provider or employees to obtain training at the cost of 
439.14 	the home care provider;
439.15 	(4) requiring the home care provider to submit reports to the commissioner;
439.16 	(5) prohibiting the home care provider from taking any new clients for a period 
439.17 	of time; or
439.18 	(6) any other action reasonably required to accomplish the purpose of this 
439.19 	subdivision and section 144A.45, subdivision 2.
439.20 		Subd. 3.Notice. Prior to any suspension, revocation, or refusal to renew a license, 
439.21 	the home care provider shall be entitled to notice and a hearing as provided by sections 
439.22 	14.57 to 14.69. In addition to any other remedy provided by law, the commissioner may, 
439.23 	without a prior contested case hearing, temporarily suspend a license or prohibit delivery 
439.24 	of services by a provider for not more than 90 days if the commissioner determines that 
439.25 	the health or safety of a consumer is in imminent danger, provided:
439.26 	(1) advance notice is given to the home care provider;
439.27 	(2) after notice, the home care provider fails to correct the problem;
439.28 	(3) the commissioner has reason to believe that other administrative remedies are not 
439.29 	likely to be effective; and
439.30 	(4) there is an opportunity for a contested case hearing within the 90 days.
439.31 		Subd. 4.Time limits for appeals. To appeal the assessment of civil penalties 
439.32 	under section 144A.45, subdivision 2, clause (5), and an action against a license under 
439.33 	this section, a provider must request a hearing no later than 15 days after the provider 
439.34 	receives notice of the action.
439.35 		Subd. 5.Plan required. (a) The process of suspending or revoking a license 
439.36 	must include a plan for transferring affected clients to other providers by the home care 
440.1 	provider, which will be monitored by the commissioner. Within three business days of 
440.2 	being notified of the final revocation or suspension action, the home care provider shall 
440.3 	provide the commissioner, the lead agencies as defined in section 256B.0911, and the 
440.4 	ombudsman for long-term care with the following information:
440.5 	(1) a list of all clients, including full names and all contact information on file;
440.6 	(2) a list of each client's representative or emergency contact person, including full 
440.7 	names and all contact information on file;
440.8 	(3) the location or current residence of each client;
440.9 	(4) the payor sources for each client, including payor source identification numbers; 
440.10 	and
440.11 	(5) for each client, a copy of the client's service plan, and a list of the types of 
440.12 	services being provided.
440.13 	(b) The revocation or suspension notification requirement is satisfied by mailing the 
440.14 	notice to the address in the license record. The home care provider shall cooperate with 
440.15 	the commissioner and the lead agencies during the process of transferring care of clients to 
440.16 	qualified providers. Within three business days of being notified of the final revocation or 
440.17 	suspension action, the home care provider must notify and disclose to each of the home 
440.18 	care provider's clients, or the client's representative or emergency contact persons, that 
440.19 	the commissioner is taking action against the home care provider's license by providing a 
440.20 	copy of the revocation or suspension notice issued by the commissioner.
440.21 		Subd. 6.Owners and managerial officials; refusal to grant license. (a) The owner 
440.22 	and managerial officials of a home care provider whose Minnesota license has not been 
440.23 	renewed or that has been revoked because of noncompliance with applicable laws or rules 
440.24 	shall not be eligible to apply for and shall not be granted a home care license, including 
440.25 	other licenses under this chapter, or be given status as an enrolled personal care assistance 
440.26 	provider agency or personal care assistant by the Department of Human Services under 
440.27 	section 256B.0659 for five years following the effective date of the nonrenewal or 
440.28 	revocation. If the owner and managerial officials already have enrollment status, their 
440.29 	enrollment will be terminated by the Department of Human Services.
440.30 	(b) The commissioner shall not issue a license to a home care provider for five 
440.31 	years following the effective date of license nonrenewal or revocation if the owner or 
440.32 	managerial official, including any individual who was an owner or managerial official 
440.33 	of another home care provider, had a Minnesota license that was not renewed or was 
440.34 	revoked as described in paragraph (a).
440.35 	(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall 
440.36 	suspend or revoke, the license of any home care provider that includes any individual 
441.1 	as an owner or managerial official who was an owner or managerial official of a home 
441.2 	care provider whose Minnesota license was not renewed or was revoked as described in 
441.3 	paragraph (a) for five years following the effective date of the nonrenewal or revocation.
441.4 	(d) The commissioner shall notify the home care provider 30 days in advance of 
441.5 	the date of nonrenewal, suspension, or revocation of the license. Within ten days after 
441.6 	the receipt of the notification, the home care provider may request, in writing, that the 
441.7 	commissioner stay the nonrenewal, revocation, or suspension of the license. The home 
441.8 	care provider shall specify the reasons for requesting the stay; the steps that will be taken 
441.9 	to attain or maintain compliance with the licensure laws and regulations; any limits on the 
441.10 	authority or responsibility of the owners or managerial officials whose actions resulted in 
441.11 	the notice of nonrenewal, revocation, or suspension; and any other information to establish 
441.12 	that the continuing affiliation with these individuals will not jeopardize client health, safety, 
441.13 	or well-being. The commissioner shall determine whether the stay will be granted within 
441.14 	30 days of receiving the provider's request. The commissioner may propose additional 
441.15 	restrictions or limitations on the provider's license and require that the granting of the stay 
441.16 	be contingent upon compliance with those provisions. The commissioner shall take into 
441.17 	consideration the following factors when determining whether the stay should be granted:
441.18 	(1) the threat that continued involvement of the owners and managerial officials with 
441.19 	the home care provider poses to client health, safety, and well-being;
441.20 	(2) the compliance history of the home care provider; and
441.21 	(3) the appropriateness of any limits suggested by the home care provider.
441.22 	If the commissioner grants the stay, the order shall include any restrictions or 
441.23 	limitation on the provider's license. The failure of the provider to comply with any 
441.24 	restrictions or limitations shall result in the immediate removal of the stay and the 
441.25 	commissioner shall take immediate action to suspend, revoke, or not renew the license.
441.26 		Subd. 7.Request for hearing. A request for a hearing must be in writing and must:
441.27 	(1) be mailed or delivered to the department or the commissioner's designee;
441.28 	(2) contain a brief and plain statement describing every matter or issue contested; and
441.29 	(3) contain a brief and plain statement of any new matter that the applicant or home 
441.30 	care provider believes constitutes a defense or mitigating factor.
441.31 		Subd. 8.Informal conference. At any time, the applicant or home care provider 
441.32 	and the commissioner may hold an informal conference to exchange information, clarify 
441.33 	issues, or resolve issues.
441.34 		Subd. 9.Injunctive relief. In addition to any other remedy provided by law, the 
441.35 	commissioner may bring an action in district court to enjoin a person who is involved in 
441.36 	the management, operation, or control of a home care provider or an employee of the 
442.1 	home care provider from illegally engaging in activities regulated by sections 144A.43 to 
442.2 	144A.482. The commissioner may bring an action under this subdivision in the district 
442.3 	court in Ramsey County or in the district in which a home care provider is providing 
442.4 	services. The court may grant a temporary restraining order in the proceeding if continued 
442.5 	activity by the person who is involved in the management, operation, or control of a home 
442.6 	care provider, or by an employee of the home care provider, would create an imminent 
442.7 	risk of harm to a recipient of home care services.
442.8 		Subd. 10.Subpoena. In matters pending before the commissioner under sections 
442.9 	144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance 
442.10 	of witnesses and the production of all necessary papers, books, records, documents, and 
442.11 	other evidentiary material. If a person fails or refuses to comply with a subpoena or 
442.12 	order of the commissioner to appear or testify regarding any matter about which the 
442.13 	person may be lawfully questioned or to produce any papers, books, records, documents, 
442.14 	or evidentiary materials in the matter to be heard, the commissioner may apply to the 
442.15 	district court in any district, and the court shall order the person to comply with the 
442.16 	commissioner's order or subpoena. The commissioner of health may administer oaths to 
442.17 	witnesses or take their affirmation. Depositions may be taken in or outside the state in the 
442.18 	manner provided by law for the taking of depositions in civil actions. A subpoena or other 
442.19 	process or paper may be served on a named person anywhere in the state by an officer 
442.20 	authorized to serve subpoenas in civil actions, with the same fees and mileage and in the 
442.21 	same manner as prescribed by law for a process issued out of a district court. A person 
442.22 	subpoenaed under this subdivision shall receive the same fees, mileage, and other costs 
442.23 	that are paid in proceedings in district court.

442.24 	Sec. 15. [144A.476] BACKGROUND STUDIES.
442.25 		Subdivision 1.Prior criminal convictions; owner and managerial officials. (a) 
442.26 	Before the commissioner issues a temporary license or renews a license, an owner or 
442.27 	managerial official is required to complete a background study under section 144.057. No 
442.28 	person may be involved in the management, operation, or control of a home care provider 
442.29 	if the person has been disqualified under chapter 245C. If an individual is disqualified 
442.30 	under section 144.057 or chapter 245C, the individual may request reconsideration of 
442.31 	the disqualification. If the individual requests reconsideration and the commissioner 
442.32 	sets aside or rescinds the disqualification, the individual is eligible to be involved in the 
442.33 	management, operation, or control of the provider. If an individual has a disqualification 
442.34 	under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's 
443.1 	disqualification is barred from a set aside, and the individual must not be involved in the 
443.2 	management, operation, or control of the provider.
443.3 	(b) For purposes of this section, owners of a home care provider subject to the 
443.4 	background check requirement are those individuals whose ownership interest provides 
443.5 	sufficient authority or control to affect or change decisions related to the operation of the 
443.6 	home care provider. An owner includes a sole proprietor, a general partner, or any other 
443.7 	individual whose individual ownership interest can affect the management and direction 
443.8 	of the policies of the home care provider.
443.9 	(c) For the purposes of this section, managerial officials subject to the background 
443.10 	check requirement are individuals who provide direct contact as defined in section 
443.11 	245C.02, subdivision 11, or individuals who have the responsibility for the ongoing 
443.12 	management or direction of the policies, services, or employees of the home care provider. 
443.13 	Data collected under this subdivision shall be classified as private data on individuals as 
443.14 	defined in section 13.02, subdivision 12.
443.15 	(d) The department shall not issue any license if the applicant, owner, or managerial 
443.16 	official has been unsuccessful in having a background study disqualification set aside 
443.17 	under section 144.057 and chapter 245C; if the owner or managerial official, as an owner 
443.18 	or managerial official of another home care provider, was substantially responsible for 
443.19 	the other home care provider's failure to substantially comply with sections 144A.43 to 
443.20 	144A.482; or if an owner that has ceased doing business, either individually or as an 
443.21 	owner of a home care provider, was issued a correction order for failing to assist clients in 
443.22 	violation of this chapter.
443.23 		Subd. 2.Employees, contractors, and volunteers. (a) Employees, contractors, 
443.24 	and volunteers of a home care provider are subject to the background study required by 
443.25 	section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall 
443.26 	be construed to prohibit a home care provider from requiring self-disclosure of criminal 
443.27 	conviction information.
443.28 	(b) Termination of an employee in good faith reliance on information or records 
443.29 	obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not 
443.30 	subject the home care provider to civil liability or liability for unemployment benefits.

443.31 	Sec. 16. [144A.477] COMPLIANCE.
443.32 		Subdivision 1.Medicare-certified providers; coordination of surveys. If feasible, 
443.33 	the commissioner shall survey licensees to determine compliance with this chapter at the 
443.34 	same time as surveys for certification for Medicare if Medicare certification is based on 
443.35 	compliance with the federal conditions of participation and on survey and enforcement 
444.1 	by the Department of Health as agent for the United States Department of Health and 
444.2 	Human Services.
444.3 		Subd. 2.Medicare-certified providers; equivalent requirements. For home care 
444.4 	providers licensed to provide comprehensive home care services that are also certified for 
444.5 	participation in Medicare as a home health agency under Code of Federal Regulations, 
444.6 	title 42, part 484, the following state licensure regulations are considered equivalent to 
444.7 	the federal requirements:
444.8 	(1) quality management, section 144A.479, subdivision 3;
444.9 	(2) personnel records, section 144A.479, subdivision 7;
444.10 	(3) acceptance of clients, section 144A.4791, subdivision 4;
444.11 	(4) referrals, section 144A.4791, subdivision 5;
444.12 	(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792, 
444.13 	subdivisions 2 and 3;
444.14 	(6) individualized monitoring and reassessment, sections 144A.4791, subdivision 
444.15 	8, and 144A.4792, subdivisions 2 and 3;
444.16 	(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792, 
444.17 	subdivision 5, and 144A.4793, subdivision 3;
444.18 	(8) client complaint and investigation process, section 144A.4791, subdivision 11;
444.19 	(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
444.20 	(10) client records, section 144A.4794, subdivisions 1 to 3;
444.21 	(11) qualifications for unlicensed personnel performing delegated tasks, section 
444.22 	144A.4795;
444.23 	(12) training and competency staff, section 144A.4795;
444.24 	(13) training and competency for unlicensed personnel, section 144A.4795, 
444.25 	subdivision 7;
444.26 	(14) delegation of home care services, section 144A.4795, subdivision 4;
444.27 	(15) availability of contact person, section 144A.4797, subdivision 1; and
444.28 	(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
444.29 	Violations of the requirements in clauses (1) to (16) may lead to enforcement actions 
444.30 	under section 144A.474.

444.31 	Sec. 17. [144A.478] INNOVATION VARIANCE.
444.32 		Subdivision 1.Definition. For purposes of this section, "innovation variance" 
444.33 	means a specified alternative to a requirement of this chapter. An innovation variance may 
444.34 	be granted to allow a home care provider to offer home care services of a type or in a 
444.35 	manner that is innovative, will not impair the services provided, will not adversely affect 
445.1 	the health, safety, or welfare of the clients, and is likely to improve the services provided. 
445.2 	The innovative variance cannot change any of the client's rights under section 144A.44.
445.3 		Subd. 2.Conditions. The commissioner may impose conditions on the granting of 
445.4 	an innovation variance that the commissioner considers necessary.
445.5 		Subd. 3.Duration and renewal. The commissioner may limit the duration of any 
445.6 	innovation variance and may renew a limited innovation variance.
445.7 		Subd. 4.Applications; innovation variance. An application for innovation 
445.8 	variance from the requirements of this chapter may be made at any time, must be made in 
445.9 	writing to the commissioner, and must specify the following:
445.10 	(1) the statute or law from which the innovation variance is requested;
445.11 	(2) the time period for which the innovation variance is requested;
445.12 	(3) the specific alternative action that the licensee proposes;
445.13 	(4) the reasons for the request; and
445.14 	(5) justification that an innovation variance will not impair the services provided; 
445.15 	will not adversely affect the health, safety, or welfare of clients; and is likely to improve 
445.16 	the services provided.
445.17 	The commissioner may require additional information from the home care provider before 
445.18 	acting on the request.
445.19 		Subd. 5.Grants and denials. The commissioner shall grant or deny each request 
445.20 	for an innovation variance in writing within 45 days of receipt of a complete request. 
445.21 	Notice of a denial shall contain the reasons for the denial. The terms of a requested 
445.22 	innovation variance may be modified upon agreement between the commissioner and 
445.23 	the home care provider.
445.24 		Subd. 6.Violation of innovation variances. A failure to comply with the terms of 
445.25 	an innovation variance shall be deemed to be a violation of this chapter.
445.26 		Subd. 7.Revocation or denial of renewal. The commissioner shall revoke or 
445.27 	deny renewal of an innovation variance if:
445.28 	(1) it is determined that the innovation variance is adversely affecting the health, 
445.29 	safety, or welfare of the licensee's clients;
445.30 	(2) the home care provider has failed to comply with the terms of the innovation 
445.31 	variance;
445.32 	(3) the home care provider notifies the commissioner in writing that it wishes to 
445.33 	relinquish the innovation variance and be subject to the statute previously varied; or
445.34 	(4) the revocation or denial is required by a change in law.

446.1 	Sec. 18. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES; 
446.2 	BUSINESS OPERATION.
446.3 		Subdivision 1.Display of license. The original current license must be displayed 
446.4 	in the home care provider's principal business office and copies must be displayed in 
446.5 	any branch office. The home care provider must provide a copy of the license to any 
446.6 	person who requests it.
446.7 		Subd. 2.Advertising. Home care providers shall not use false, fraudulent, 
446.8 	or misleading advertising in the marketing of services. For purposes of this section, 
446.9 	advertising includes any verbal, written, or electronic means of communicating to 
446.10 	potential clients about the availability, nature, or terms of home care services.
446.11 		Subd. 3.Quality management. The home care provider shall engage in quality 
446.12 	management appropriate to the size of the home care provider and relevant to the type 
446.13 	of services the home care provider provides. The quality management activity means 
446.14 	evaluating the quality of care by periodically reviewing client services, complaints made, 
446.15 	and other issues that have occurred and determining whether changes in services, staffing, 
446.16 	or other procedures need to be made in order to ensure safe and competent services to 
446.17 	clients. Documentation about quality management activity must be available for two 
446.18 	years. Information about quality management must be available to the commissioner at 
446.19 	the time of the survey, investigation, or renewal.
446.20 		Subd. 4.Provider restrictions. (a) This subdivision does not apply to licensees 
446.21 	that are Minnesota counties or other units of government.
446.22 	(b) A home care provider or staff cannot accept powers-of-attorney from clients for 
446.23 	any purpose, and may not accept appointments as guardians or conservators of clients.
446.24 	(c) A home care provider cannot serve as a client's representative. 
446.25 		Subd. 5.Handling of client's finances and property. (a) A home care provider 
446.26 	may assist clients with household budgeting, including paying bills and purchasing 
446.27 	household goods, but may not otherwise manage a client's property. A home care provider 
446.28 	must provide a client with receipts for all transactions and purchases paid with the client's 
446.29 	funds. When receipts are not available, the transaction or purchase must be documented. 
446.30 	A home care provider must maintain records of all such transactions.
446.31 	(b) A home care provider or staff may not borrow a client's funds or personal or 
446.32 	real property, nor in any way convert a client's property to the home care provider's or 
446.33 	staff's possession.
446.34 	(c) Nothing in this section precludes a home care provider or staff from accepting 
446.35 	gifts of minimal value, or precludes the acceptance of donations or bequests made to a 
447.1 	home care provider that are exempt from income tax under section 501(c) of the Internal 
447.2 	Revenue Code of 1986.
447.3 		Subd. 6.Reporting maltreatment of vulnerable adults and minors. (a) All 
447.4 	home care providers must comply with requirements for the reporting of maltreatment 
447.5 	of minors in section 626.556 and the requirements for the reporting of maltreatment 
447.6 	of vulnerable adults in section 626.557. Home care providers must report suspected 
447.7 	maltreatment of minors and vulnerable adults to the common entry point. Each home 
447.8 	care provider must establish and implement a written procedure to ensure that all cases 
447.9 	of suspected maltreatment are reported.
447.10 	(b) Each home care provider must develop and implement an individual abuse 
447.11 	prevention plan for each vulnerable minor or adult for whom home care services are 
447.12 	provided by a home care provider. The plan shall contain an individualized review or 
447.13 	assessment of the person's susceptibility to abuse by another individual, including other 
447.14 	vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors; 
447.15 	and statements of the specific measures to be taken to minimize the risk of abuse to that 
447.16 	person and other vulnerable adults or minors. For purposes of the abuse prevention plan, 
447.17 	the term abuse includes self-abuse.
447.18 		Subd. 7.Employee records. The home care provider must maintain current records 
447.19 	of each paid employee, regularly scheduled volunteers providing home care services, 
447.20 	and each individual contractor providing home care services. The records must include 
447.21 	the following information:
447.22 	(1) evidence of current professional licensure, registration, or certification, if 
447.23 	licensure, registration, or certification is required by this statute, or other rules;
447.24 	(2) records of orientation, required annual training and infection control training, 
447.25 	and competency evaluations;
447.26 	(3) current job description, including qualifications, responsibilities, and 
447.27 	identification of staff providing supervision;
447.28 	(4) documentation of annual performance reviews which identify areas of 
447.29 	improvement needed and training needs;
447.30 	(5) for individuals providing home care services, verification that required health 
447.31 	screenings under section 144A.4798 have taken place and the dates of those screenings; and
447.32 	(6) documentation of the background study as required under section 144.057.
447.33 	Each employee record must be retained for at least three years after a paid employee, 
447.34 	home care volunteer, or contractor ceases to be employed by or under contract with the 
447.35 	home care provider. If a home care provider ceases operation, employee records must be 
447.36 	maintained for three years.

448.1 	Sec. 19. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH 
448.2 	RESPECT TO CLIENTS.
448.3 		Subdivision 1.Home care bill of rights; notification to client. (a) The home care 
448.4 	provider shall make all reasonable efforts to provide the client or the client's representative 
448.5 	a written notice of the rights under section 144A.44 before the initiation of services. The 
448.6 	home care provider shall make all reasonable efforts to provide the notice in a language 
448.7 	the client or client's representative understands. If a written version is not effective or 
448.8 	available, the notice may be provided verbally.
448.9 	(b) In addition to the text of the home care bill of rights in section 144A.44, 
448.10 	subdivision 1, the notice shall also contain the following statement describing how to file 
448.11 	a complaint with these offices.
448.12 	"If you have a complaint about the provider or the person providing your 
448.13 	home care services, you may call, write, or visit the Office of Health Facility 
448.14 	Complaints, Minnesota Department of Health. You may also contact the Office of 
448.15 	Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health 
448.16 	and Developmental Disabilities."
448.17 	The statement should include the telephone number, Web site address, e-mail 
448.18 	address, mailing address, and street address of the Office of Health Facility Complaints at 
448.19 	the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, 
448.20 	and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The 
448.21 	statement should also include the home care provider's name, address, e-mail, telephone 
448.22 	number, and name or title of the person at the provider to whom problems or complaints 
448.23 	may be directed. It must also include a statement that the home care provider will not 
448.24 	retaliate because of a complaint.
448.25 	(c) The home care provider shall obtain written acknowledgment of the client's 
448.26 	receipt of the home care bill of rights or shall document why an acknowledgment cannot 
448.27 	be obtained. The acknowledgment may be obtained from the client or the client's 
448.28 	representative. Acknowledgment of receipt shall be retained in the client's record.
448.29 		Subd. 2.Notice of services for dementia, Alzheimer's disease, or related 
448.30 	disorders. The home care provider that provides services to clients with dementia shall 
448.31 	provide in written or electronic form, to clients and families or other persons who request 
448.32 	it, a description of the training program and related training it provides, including the 
448.33 	categories of employees trained, the frequency of training, and the basic topics covered. 
448.34 	This information satisfies the disclosure requirements in section 325F.72, subdivision 
448.35 	2, clause (4).
449.1 		Subd. 3.Statement of home care services. Prior to the initiation of services, 
449.2 	a home care provider must provide to the client or the client's representative a written 
449.3 	statement which identifies if they have a basic or comprehensive home care license, the 
449.4 	services they are authorized to provide, and which services they cannot provide under the 
449.5 	scope of their license. The home care provider shall obtain written acknowledgment 
449.6 	from the clients that they have provided the statement or must document why they could 
449.7 	not obtain the acknowledgment.
449.8 		Subd. 4.Acceptance of clients. No home care provider may accept a person as a 
449.9 	client unless the home care provider has staff, sufficient in qualifications, competency, 
449.10 	and numbers, to adequately provide the services agreed to in the service plan and that 
449.11 	are within the provider's scope of practice.
449.12 		Subd. 5.Referrals. If a home care provider reasonably believes that a client is in 
449.13 	need of another medical or health service, including a licensed health professional, or 
449.14 	social service provider, the home care provider shall:
449.15 	(1) determine the client's preferences with respect to obtaining the service; and
449.16 	(2) inform the client of resources available, if known, to assist the client in obtaining 
449.17 	services.
449.18 		Subd. 6.Initiation of services. When a provider initiates services and the 
449.19 	individualized review or assessment required in subdivisions 7 and 8 has not been 
449.20 	completed, the provider must complete a temporary plan and agreement with the client for 
449.21 	services.
449.22 		Subd. 7.Basic individualized client review and monitoring. (a) When services 
449.23 	being provided are basic home care services, an individualized initial review of the client's 
449.24 	needs and preferences must be conducted at the client's residence with the client or client's 
449.25 	representative. This initial review must be completed within 30 days after the initiation of 
449.26 	the home care services.
449.27 	(b) Client monitoring and review must be conducted as needed based on changes 
449.28 	in the needs of the client and cannot exceed 90 days from the date of the last review. 
449.29 	The monitoring and review may be conducted at the client's residence or through the 
449.30 	utilization of telecommunication methods based on practice standards that meet the 
449.31 	individual client's needs.
449.32 		Subd. 8.Comprehensive assessment, monitoring, and reassessment. (a) When 
449.33 	the services being provided are comprehensive home care services, an individualized 
449.34 	initial assessment must be conducted in-person by a registered nurse. When the services 
449.35 	are provided by other licensed health professionals, the assessment must be conducted by 
450.1 	the appropriate health professional. This initial assessment must be completed within five 
450.2 	days after initiation of home care services.
450.3 	(b) Client monitoring and reassessment must be conducted in the client's home no 
450.4 	more than 14 days after initiation of services.
450.5 	(c) Ongoing client monitoring and reassessment must be conducted as needed based 
450.6 	on changes in the needs of the client and cannot exceed 90 days from the last date of the 
450.7 	assessment. The monitoring and reassessment may be conducted at the client's residence 
450.8 	or through the utilization of telecommunication methods based on practice standards that 
450.9 	meet the individual client's needs.
450.10 		Subd. 9.Service plan, implementation, and revisions to service plan. (a) No later 
450.11 	than 14 days after the initiation of services, a home care provider shall finalize a current 
450.12 	written service plan.
450.13 	(b) The service plan and any revisions must include a signature or other 
450.14 	authentication by the home care provider and by the client or the client's representative 
450.15 	documenting agreement on the services to be provided. The service plan must be revised, 
450.16 	if needed, based on client review or reassessment under subdivisions 7 and 8. The provider 
450.17 	must provide information to the client about changes to the provider's fee for services and 
450.18 	how to contact the Office of the Ombudsman for Long-Term Care.
450.19 	(c) The home care provider must implement and provide all services required by 
450.20 	the current service plan.
450.21 	(d) The service plan and revised service plan must be entered into the client's record, 
450.22 	including notice of a change in a client's fees when applicable.
450.23 	(e) Staff providing home care services must be informed of the current written 
450.24 	service plan.
450.25 	(f) The service plan must include:
450.26 	(1) a description of the home care services to be provided, the fees for services, and 
450.27 	the frequency of each service, according to the client's current review or assessment and 
450.28 	client preferences;
450.29 	(2) the identification of the staff or categories of staff who will provide the services;
450.30 	(3) the schedule and methods of monitoring reviews or assessments of the client;
450.31 	(4) the frequency of sessions of supervision of staff and type of personnel who 
450.32 	will supervise staff; and
450.33 	(5) a contingency plan that includes:
450.34 	(i) the action to be taken by the home care provider and by the client or client's 
450.35 	representative if the scheduled service cannot be provided;
451.1 	(ii) information and method for a client or client's representative to contact the 
451.2 	home care provider;
451.3 	(iii) names and contact information of persons the client wishes to have notified 
451.4 	in an emergency or if there is a significant adverse change in the client's condition, 
451.5 	including identification of and information as to who has authority to sign for the client in 
451.6 	an emergency; and
451.7 	(iv) the circumstances in which emergency medical services are not to be summoned 
451.8 	consistent with chapters 145B and 145C, and declarations made by the client under those 
451.9 	chapters.
451.10 		Subd. 10.Termination of service plan. (a) If a home care provider terminates a 
451.11 	service plan with a client, and the client continues to need home care services, the home 
451.12 	care provider shall provide the client and the client's representative, if any, with a written 
451.13 	notice of termination which includes the following information:
451.14 	(1) the effective date of termination;
451.15 	(2) the reason for termination;
451.16 	(3) a list of known licensed home care providers in the client's immediate geographic 
451.17 	area;
451.18 	(4) a statement that the home care provider will participate in a coordinated transfer 
451.19 	of care of the client to another home care provider, health care provider, or caregiver, as 
451.20 	required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
451.21 	(5) the name and contact information of a person employed by the home care 
451.22 	provider with whom the client may discuss the notice of termination; and
451.23 	(6) if applicable, a statement that the notice of termination of home care services 
451.24 	does not constitute notice of termination of the housing with services contract with a 
451.25 	housing with services establishment.
451.26 	(b) When the home care provider voluntarily discontinues services to all clients, the 
451.27 	home care provider must notify the commissioner, lead agencies, and the ombudsman for 
451.28 	long-term care about its clients and comply with the requirements in this subdivision.
451.29 		Subd. 11.Client complaint and investigative process. (a) The home care 
451.30 	provider must have a written policy and system for receiving, investigating, reporting, 
451.31 	and attempting to resolve complaints from its clients or clients' representatives. The 
451.32 	policy should clearly identify the process by which clients may file a complaint or concern 
451.33 	about home care services and an explicit statement that the home care provider will not 
451.34 	discriminate or retaliate against a client for expressing concerns or complaints. A home 
451.35 	care provider must have a process in place to conduct investigations of complaints made 
451.36 	by the client or the client's representative about the services in the client's plan that are or 
452.1 	are not being provided or other items covered in the client's home care bill of rights. This 
452.2 	complaint system must provide reasonable accommodations for any special needs of the 
452.3 	client or client's representative if requested.
452.4 	(b) The home care provider must document the complaint, name of the client, 
452.5 	investigation, and resolution of each complaint filed. The home care provider must 
452.6 	maintain a record of all activities regarding complaints received, including the date the 
452.7 	complaint was received, and the home care provider's investigation and resolution of the 
452.8 	complaint. This complaint record must be kept for each event for at least two years after 
452.9 	the date of entry and must be available to the commissioner for review.
452.10 	(c) The required complaint system must provide for written notice to each client or 
452.11 	client's representative that includes:
452.12 	(1) the client's right to complain to the home care provider about the services received;
452.13 	(2) the name or title of the person or persons with the home care provider to contact 
452.14 	with complaints;
452.15 	(3) the method of submitting a complaint to the home care provider; and
452.16 	(4) a statement that the provider is prohibited against retaliation according to 
452.17 	paragraph (d).
452.18 	(d) A home care provider must not take any action that negatively affects a client 
452.19 	in retaliation for a complaint made or a concern expressed by the client or the client's 
452.20 	representative.
452.21 		Subd. 12.Disaster planning and emergency preparedness plan. The home care 
452.22 	provider must have a written plan of action to facilitate the management of the client's care 
452.23 	and services in response to a natural disaster, such as flood and storms, or other emergencies 
452.24 	that may disrupt the home care provider's ability to provide care or services. The licensee 
452.25 	must provide adequate orientation and training of staff on emergency preparedness.
452.26 		Subd. 13.Request for discontinuation of life-sustaining treatment. (a) If a 
452.27 	client, family member, or other caregiver of the client requests that an employee or other 
452.28 	agent of the home care provider discontinue a life-sustaining treatment, the employee or 
452.29 	agent receiving the request:
452.30 	(1) shall take no action to discontinue the treatment; and
452.31 	(2) shall promptly inform their supervisor or other agent of the home care provider 
452.32 	of the client's request.
452.33 	(b) Upon being informed of a request for termination of treatment, the home care 
452.34 	provider shall promptly:
452.35 	(1) inform the client that the request will be made known to the physician who 
452.36 	ordered the client's treatment;
453.1 	(2) inform the physician of the client's request; and
453.2 	(3) work with the client and the client's physician to comply with the provisions of 
453.3 	the Health Care Directive Act in chapter 145C.
453.4 	(c) This section does not require the home care provider to discontinue treatment, 
453.5 	except as may be required by law or court order.
453.6 	(d) This section does not diminish the rights of clients to control their treatments, 
453.7 	refuse services, or terminate their relationships with the home care provider.
453.8 	(e) This section shall be construed in a manner consistent with chapter 145B or 
453.9 	145C, whichever applies, and declarations made by clients under those chapters.

453.10 	Sec. 20. [144A.4792] MEDICATION MANAGEMENT.
453.11 		Subdivision 1.Medication management services; comprehensive home care 
453.12 	license. (a) This subdivision applies only to home care providers with a comprehensive 
453.13 	home care license that provides medication management services to clients. Medication 
453.14 	management services may not be provided by a home care provider that has a basic 
453.15 	home care license.
453.16 	(b) A comprehensive home care provider who provides medication management 
453.17 	services must develop, implement, and maintain current written medication management 
453.18 	policies and procedures. The policies and procedures must be developed under the 
453.19 	supervision and direction of a registered nurse, licensed health professional, or pharmacist 
453.20 	consistent with current practice standards and guidelines.
453.21 	(c) The written policies and procedures must address requesting and receiving 
453.22 	prescriptions for medications; preparing and giving medications; verifying that 
453.23 	prescription drugs are administered as prescribed; documenting medication management 
453.24 	activities; controlling and storing medications; monitoring and evaluating medication use; 
453.25 	resolving medication errors; communicating with the prescriber, pharmacist, client, and 
453.26 	client representative, if any; disposing of unused medications; and educating clients and 
453.27 	client representatives about medications. When controlled substances are being managed, 
453.28 	the policies and procedures must also identify how the provider will ensure security and 
453.29 	accountability for the overall management, control, and disposition of those substances in 
453.30 	compliance with state and federal regulations and with subdivision 22.
453.31 		Subd. 2.Provision of medication management services. (a) For each client who 
453.32 	requests medication management services, the comprehensive home care provider shall, 
453.33 	prior to providing medication management services, have a registered nurse, licensed 
453.34 	health professional, or authorized prescriber under section 151.37 conduct an assessment 
453.35 	to determine what medication management services will be provided and how the services 
454.1 	will be provided. This assessment must be conducted face-to-face with the client. The 
454.2 	assessment must include an identification and review of all medications the client is known 
454.3 	to be taking. The review and identification must include indications for medications, side 
454.4 	effects, contraindications, allergic or adverse reactions, and actions to address these issues.
454.5 	(b) The assessment must identify interventions needed in management of 
454.6 	medications to prevent diversion of medication by the client or others who may have 
454.7 	access to the medications. Diversion of medications means the misuse, theft, or illegal 
454.8 	or improper disposition of medications.
454.9 		Subd. 3.Individualized medication monitoring and reassessment. The 
454.10 	comprehensive home care provider must monitor and reassess the client's medication 
454.11 	management services as needed under subdivision 14 when the client presents with 
454.12 	symptoms or other issues that may be medication-related and, at a minimum, annually.
454.13 		Subd. 4.Client refusal. The home care provider must document in the client's 
454.14 	record any refusal for an assessment for medication management by the client. The 
454.15 	provider must discuss with the client the possible consequences of the client's refusal and 
454.16 	document the discussion in the client's record.
454.17 		Subd. 5.Individualized medication management plan. (a) For each client 
454.18 	receiving medication management services, the comprehensive home care provider must 
454.19 	prepare and include in the service plan a written statement of the medication management 
454.20 	services that will be provided to the client. The provider must develop and maintain a 
454.21 	current individualized medication management record for each client based on the client's 
454.22 	assessment that contains the following:
454.23 	(1) a statement describing the medication management services that will be provided;
454.24 	(2) a description of storage of medications based on the client's needs and 
454.25 	preferences, risk of diversion, and consistent with the manufacturer's directions;
454.26 	(3) documentation of specific client instructions relating to the administration 
454.27 	of medications;
454.28 	(4) identification of persons responsible for monitoring medication supplies and 
454.29 	ensuring that medication refills are ordered on a timely basis;
454.30 	(5) identification of medication management tasks that may be delegated to 
454.31 	unlicensed personnel;
454.32 	(6) procedures for staff notifying a registered nurse or appropriate licensed health 
454.33 	professional when a problem arises with medication management services; and
454.34 	(7) any client-specific requirements relating to documenting medication 
454.35 	administration, verification that all medications are administered as prescribed, and 
454.36 	monitoring of medication use to prevent possible complications or adverse reactions.
455.1 	(b) The medication management record must be current and updated when there are 
455.2 	any changes.
455.3 		Subd. 6.Administration of medication. Medications may be administered by a 
455.4 	nurse, physician, or other licensed health practitioner authorized to administer medications 
455.5 	or by unlicensed personnel who have been delegated medication administration tasks by 
455.6 	a registered nurse.
455.7 		Subd. 7.Delegation of medication administration. When administration of 
455.8 	medications is delegated to unlicensed personnel, the comprehensive home care provider 
455.9 	must ensure that the registered nurse has:
455.10 	(1) instructed the unlicensed personnel in the proper methods to administer the 
455.11 	medications, and the unlicensed personnel has demonstrated ability to competently follow 
455.12 	the procedures;
455.13 	(2) specified, in writing, specific instructions for each client and documented those 
455.14 	instructions in the client's records; and
455.15 	(3) communicated with the unlicensed personnel about the individual needs of 
455.16 	the client.
455.17 		Subd. 8.Documentation of administration of medications. Each medication 
455.18 	administered by comprehensive home care provider staff must be documented in the 
455.19 	client's record. The documentation must include the signature and title of the person 
455.20 	who administered the medication. The documentation must include the medication 
455.21 	name, dosage, date and time administered, and method and route of administration. The 
455.22 	staff must document the reason why medication administration was not completed as 
455.23 	prescribed and document any follow-up procedures that were provided to meet the client's 
455.24 	needs when medication was not administered as prescribed and in compliance with the 
455.25 	client's medication management plan.
455.26 		Subd. 9.Documentation of medication set up. Documentation of dates of 
455.27 	medication set up, name of medication, quantity of dose, times to be administered, route 
455.28 	of administration, and name of person completing medication set up must be done at 
455.29 	time of set up.
455.30 		Subd. 10.Medications management for clients who will be away from home.
 455.31 	(a) A home care provider that is providing medication management services to the client 
455.32 	and controls the client's access to the medications must develop and implement policies 
455.33 	and procedures for giving accurate and current medications to clients for planned or 
455.34 	unplanned times away from home according to the client's individualized medication 
455.35 	management plan.
455.36 	The policy and procedures must state that: 
456.1 	(1) for planned time away, the medications must be obtained from the pharmacy or 
456.2 	set up by the registered nurse according to appropriate state and federal laws and nursing 
456.3 	standards of  practice;
456.4 	(2) for unplanned time away, when the pharmacy is not able to provide the 
456.5 	medications, a licensed nurse or unlicensed personnel shall give the client or the client's 
456.6 	representative medications in  amounts and dosages needed for the length of the anticipated 
456.7 	absence, not to exceed 120 hours;
456.8 	(3) the client, or the client's representative, must be provided written information 
456.9 	on medications, including any special instructions for administering or handling the 
456.10 	medications, including controlled substances;
456.11 	(4) the medications must be placed in a medication container or containers 
456.12 	appropriate to the provider's medication system and must be labeled with the client's name 
456.13 	and the dates and times that the medications are scheduled; and
456.14 	(5) the client or client's representative must be provided in writing the home  care 
456.15 	provider's name and information on how to contact them.
456.16 	(b) For unplanned time away when the licensed nurse is not available, the registered 
456.17 	nurse may delegate this task to unlicensed personnel if: 
456.18 	(1) the registered nurse has trained and determined the unlicensed staff to be 
456.19 	competent to follow the procedures for giving medications to clients;
456.20 	(2) the registered nurse has developed written procedures for the unlicensed 
456.21 	personnel, including any special instructions or procedures regarding controlled substances 
456.22 	that are prescribed for the client.  The procedures must address: 
456.23 	(i) the type of container or containers to be used for the medications appropriate to 
456.24 	the provider's medication system;
456.25 	(ii) how the container or containers must be labeled;
456.26 	(iii) the written information about the medications to be given to the client or the 
456.27 	client' s representative;
456.28 	(iv) how the unlicensed staff will document in the client's record that medications 
456.29 	have been given to the client or the client's responsible person, including documenting the 
456.30 	date the medications were given to the client or the client's responsible person and who 
456.31 	received the medications, the person who gave the medications to the client, the number of 
456.32 	medications that were given to the client, and other required information;
456.33 	(v) how the registered nurse will be notified that medications have been given to 
456.34 	the client or the client's responsible person and whether the registered nurse needs to 
456.35 	be contacted before the medications are given to the client or the client's responsible 
456.36 	person; and
457.1 	(vi) a review by the registered nurse of the completion of this task to verify that this 
457.2 	task was completed accurately by the unlicensed personnel.
457.3 		Subd. 11.Prescribed and nonprescribed medication. The comprehensive home 
457.4 	care provider must determine whether it will require a prescription for all medications it 
457.5 	manages. The comprehensive home care provider must inform the client or the client's 
457.6 	representative whether the comprehensive home care provider requires a prescription 
457.7 	for all over-the-counter and dietary supplements before the comprehensive home care 
457.8 	provider will agree to manage those medications.
457.9 		Subd. 12.Medications; over-the-counter; dietary supplements not prescribed.
 457.10 	A comprehensive home care provider providing medication management services for 
457.11 	over-the-counter drugs or dietary supplements must retain those items in the original labeled 
457.12 	container with directions for use prior to setting up for immediate or later administration. 
457.13 	The provider must verify that the medications are up-to-date and stored as appropriate.
457.14 		Subd. 13.Prescriptions. There must be a current written or electronically recorded 
457.15 	prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed 
457.16 	medications that the comprehensive home care provider is managing for the client.
457.17 		Subd. 14.Renewal of prescriptions. Prescriptions must be renewed at least 
457.18 	every 12 months or more frequently as indicated by the assessment in subdivision 2. 
457.19 	Prescriptions for controlled substances must comply with chapter 152.
457.20 		Subd. 15.Verbal prescription orders. Verbal prescription orders from an 
457.21 	authorized prescriber must be received by a nurse or pharmacist. The order must be 
457.22 	handled according to Minnesota Rules, part 6800.6200. 
457.23 		Subd. 16.Written or electronic prescription. When a written or electronic 
457.24 	prescription is received, it must be communicated to the registered nurse in charge and 
457.25 	recorded or placed in the client's record.
457.26 		Subd. 17.Records confidential. A prescription or order received verbally, in 
457.27 	writing, or electronically must be kept according to sections 144.291 to 144.298 and 
457.28 	144A.44.
457.29 		Subd. 18.Medications provided by client or family members. When the 
457.30 	comprehensive home care provider is aware of any medications or dietary supplements 
457.31 	that are being used by the client and are not included in the assessment for medication 
457.32 	management services, the staff must advise the registered nurse and document that in 
457.33 	the client's record.
457.34 		Subd. 19.Storage of drugs. A comprehensive home care provider providing 
457.35 	storage of medications outside of the client's private living space must store all prescription 
458.1 	drugs in securely locked and substantially constructed compartments according to the 
458.2 	manufacturer's directions and permit only authorized personnel to have access.
458.3 		Subd. 20.Prescription drugs. A prescription drug, prior to being set up for 
458.4 	immediate or later administration, must be kept in the original container in which it was 
458.5 	dispensed by the pharmacy bearing the original prescription label with legible information 
458.6 	including the expiration or beyond-use date of a time-dated drug.
458.7 		Subd. 21.Prohibitions. No prescription drug supply for one client may be used or 
458.8 	saved for use by anyone other than the client.
458.9 		Subd. 22.Disposition of drugs. (a) Any current medications being managed by the 
458.10 	comprehensive home care provider must be given to the client or the client's representative 
458.11 	when the client's service plan ends or medication management services are no longer part 
458.12 	of the service plan. Medications that have been stored in the client's private living space 
458.13 	for a client that is deceased or that have been discontinued or that have expired may be 
458.14 	given to the client or the client's representative for disposal.
458.15 	(b) The comprehensive home care provider will dispose of any medications 
458.16 	remaining with the comprehensive home care provider that are discontinued or expired or 
458.17 	upon the termination of the service contract or the client's death according to state and 
458.18 	federal regulations for disposition of drugs and controlled substances.
458.19 	(c) Upon disposition, the comprehensive home care provider must document in the 
458.20 	client's record the disposition of the medications including the medication's name, strength, 
458.21 	prescription number as applicable, quantity, to whom the medications were given, date of 
458.22 	disposition, and names of staff and other individuals involved in the disposition.
458.23 		Subd. 23.Loss or spillage. (a) Comprehensive home care providers providing 
458.24 	medication management must develop and implement procedures for loss or spillage of all 
458.25 	controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must 
458.26 	require that when a spillage of a controlled substance occurs, a notation must be made 
458.27 	in the client's record explaining the spillage and the actions taken. The notation must 
458.28 	be signed by the person responsible for the spillage and include verification that any 
458.29 	contaminated substance was disposed of according to state or federal regulations.
458.30 	(b) The procedures must require the comprehensive home care provider of 
458.31 	medication management to investigate any known loss or unaccounted for prescription 
458.32 	drugs and take appropriate action required under state or federal regulations and document 
458.33 	the investigation in required records.

458.34 	Sec. 21. [144A.4793] TREATMENT AND THERAPY MANAGEMENT 
458.35 	SERVICES.
459.1 		Subdivision 1.Providers with a comprehensive home care license. This section 
459.2 	applies only to home care providers with a comprehensive home care license that provide 
459.3 	treatment or therapy management services to clients. Treatment or therapy management 
459.4 	services cannot be provided by a home care provider that has a basic home care license.
459.5 		Subd. 2.Policies and procedures. (a) A comprehensive home care provider who 
459.6 	provides treatment and therapy management services must develop, implement, and 
459.7 	maintain up-to-date written treatment or therapy management policies and procedures. 
459.8 	The policies and procedures must be developed under the supervision and direction of 
459.9 	a registered nurse or appropriate licensed health professional consistent with current 
459.10 	practice standards and guidelines.
459.11 	(b) The written policies and procedures must address requesting and receiving 
459.12 	orders or prescriptions for treatments or therapies, providing the treatment or therapy, 
459.13 	documenting of treatment or therapy activities, educating and communicating with clients 
459.14 	about treatments or therapy they are receiving, monitoring and evaluating the treatment 
459.15 	and therapy, and communicating with the prescriber.
459.16 		Subd. 3.Individualized treatment or therapy management plan. For each 
459.17 	client receiving management of ordered or prescribed treatments or therapy services, the 
459.18 	comprehensive home care provider must prepare and include in the service plan a written 
459.19 	statement of the treatment or therapy services that will be provided to the client. The 
459.20 	provider must also develop and maintain a current individualized treatment and therapy 
459.21 	management record for each client that contains at least the following:
459.22 	(1) a statement of the type of services that will be provided;
459.23 	(2) documentation of specific client instructions relating to the treatments or therapy 
459.24 	administration;
459.25 	(3) identification of treatment or therapy tasks that will be delegated to unlicensed 
459.26 	personnel; 
459.27 	(4) procedures for notifying a registered nurse or appropriate licensed health 
459.28 	professional when a problem arises with treatments or therapy services; and
459.29 	(5) any client-specific requirements relating to documentation of treatment and 
459.30 	therapy received, verification that all treatments and therapy was administered as 
459.31 	prescribed, and monitoring of treatment or therapy to prevent possible complications or 
459.32 	adverse reactions. The treatment or therapy management record must be current and 
459.33 	updated when there are any changes.
459.34 		Subd. 4.Administration of treatments and therapy. Ordered or prescribed 
459.35 	treatments or therapies must be administered by a nurse, physician, or other licensed health 
459.36 	professional authorized to perform the treatment or therapy, or may be delegated or assigned 
460.1 	to unlicensed personnel by the licensed health professional according to the appropriate 
460.2 	practice standards for delegation or assignment. When administration of a treatment or 
460.3 	therapy is delegated or assigned to unlicensed personnel, the home care provider must 
460.4 	ensure that the registered nurse or authorized licensed health professional has:
460.5 	(1) instructed the unlicensed personnel in the proper methods with respect to each 
460.6 	client and has demonstrated their ability to competently follow the procedures;
460.7 	(2) specified, in writing, specific instructions for each client and documented those 
460.8 	instructions in the client's record; and
460.9 	(3) communicated with the unlicensed personnel about the individual needs of 
460.10 	the client.
460.11 		Subd. 5.Documentation of administration of treatments and therapies. Each 
460.12 	treatment or therapy administered by a comprehensive home care provider must be 
460.13 	documented in the client's record. The documentation must include the signature and title 
460.14 	of the person who administered the treatment or therapy and must include the date and 
460.15 	time of administration. When treatment or therapies are not administered as ordered or 
460.16 	prescribed, the provider must document the reason why it was not administered and any 
460.17 	follow-up procedures that were provided to meet the client's needs.
460.18 		Subd. 6.Orders or prescriptions. There must be an up-to-date written or 
460.19 	electronically recorded order or prescription for all treatments and therapies. The order 
460.20 	must contain the name of the client, description of the treatment or therapy to be provided, 
460.21 	and the frequency and other information needed to administer the treatment or therapy.

460.22 	Sec. 22. [144A.4794] CLIENT RECORD REQUIREMENTS.
460.23 		Subdivision 1.Client record. (a) The home care provider must maintain records 
460.24 	for each client to whom it is providing services. Entries in the client records must be 
460.25 	current, legible, permanently recorded, dated, and authenticated with the name and title 
460.26 	of the person making the entry.
460.27 	(b) Client records, whether written or electronic, must be protected against loss, 
460.28 	tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable 
460.29 	relevant federal and state laws. The home care provider shall establish and implement 
460.30 	written procedures to control use, storage, and security of client's records and establish 
460.31 	criteria for release of client information.
460.32 	(c) The home care provider may not disclose to any other person any personal, 
460.33 	financial, medical, or other information about the client, except:
460.34 	(1) as may be required by law;
461.1 	(2) to employees or contractors of the home care provider, another home care 
461.2 	provider, other health care practitioner or provider, or inpatient facility needing 
461.3 	information in order to provide services to the client, but only such information that 
461.4 	is necessary for the provision of services;
461.5 	(3) to persons authorized in writing by the client or the client's representative to 
461.6 	receive the information, including third-party payers; and
461.7 	(4) to representatives of the commissioner authorized to survey or investigate home 
461.8 	care providers under this chapter or federal laws.
461.9 		Subd. 2.Access to records. The home care provider must ensure that the 
461.10 	appropriate records are readily available to employees or contractors authorized to access 
461.11 	the records. Client records must be maintained in a manner that allows for timely access, 
461.12 	printing, or transmission of the records.
461.13 		Subd. 3.Contents of client record. Contents of a client record include the 
461.14 	following for each client:
461.15 	(1) identifying information, including the client's name, date of birth, address, and 
461.16 	telephone number;
461.17 	(2) the name, address, and telephone number of an emergency contact, family 
461.18 	members, client's representative, if any, or others as identified;
461.19 	(3) names, addresses, and telephone numbers of the client's health and medical 
461.20 	service providers and other home care providers, if known;
461.21 	(4) health information, including medical history, allergies, and when the provider 
461.22 	is managing medications, treatments or therapies that require documentation, and other 
461.23 	relevant health records;
461.24 	(5) client's advance directives, if any;
461.25 	(6) the home care provider's current and previous assessments and service plans;
461.26 	(7) all records of communications pertinent to the client's home care services;
461.27 	(8) documentation of significant changes in the client's status and actions taken in 
461.28 	response to the needs of the client including reporting to the appropriate supervisor or 
461.29 	health care professional;
461.30 	(9) documentation of incidents involving the client and actions taken in response 
461.31 	to the needs of the client including reporting to the appropriate supervisor or health 
461.32 	care professional;
461.33 	(10) documentation that services have been provided as identified in the service plan;
461.34 	(11) documentation that the client has received and reviewed the home care bill 
461.35 	of rights;
462.1 	(12) documentation that the client has been provided the statement of disclosure on 
462.2 	limitations of services under section 144A.4791, subdivision 3;
462.3 	(13) documentation of complaints received and resolution;
462.4 	(14) discharge summary, including service termination notice and related 
462.5 	documentation, when applicable; and
462.6 	(15) other documentation required under this chapter and relevant to the client's 
462.7 	services or status.
462.8 		Subd. 4.Transfer of client records. If a client transfers to another home care 
462.9 	provider or other health care practitioner or provider, or is admitted to an inpatient facility, 
462.10 	the home care provider, upon request of the client or the client's representative, shall take 
462.11 	steps to ensure a coordinated transfer including sending a copy or summary of the client's 
462.12 	record to the new home care provider, facility, or the client, as appropriate.
462.13 		Subd. 5.Record retention. Following the client's discharge or termination of 
462.14 	services, a home care provider must retain a client's record for at least five years, or as 
462.15 	otherwise required by state or federal regulations. Arrangements must be made for secure 
462.16 	storage and retrieval of client records if the home care provider ceases business.

462.17 	Sec. 23. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
462.18 		Subdivision 1.Qualifications, training, and competency. All staff providing 
462.19 	home care services must be trained and competent in the provision of home care services 
462.20 	consistent with current practice standards appropriate to the client's needs.
462.21 		Subd. 2.Licensed health professionals and nurses. (a) Licensed health 
462.22 	professionals and nurses providing home care services as an employee of a licensed home 
462.23 	care provider must possess current Minnesota license or registration to practice.
462.24 	(b) Licensed health professionals and registered nurses must be competent in 
462.25 	assessing client needs, planning appropriate home care services to meet client needs, 
462.26 	implementing services, and supervising staff if assigned.
462.27 	(c) Nothing in this section limits or expands the rights of nurses or licensed health 
462.28 	professionals to provide services within the scope of their licenses or registrations, as 
462.29 	provided by law.
462.30 		Subd. 3.Unlicensed personnel. (a) Unlicensed personnel providing basic home 
462.31 	care services must have:
462.32 	(1) successfully completed a training and competency evaluation appropriate to 
462.33 	the services provided by the home care provider and the topics listed in subdivision 7, 
462.34 	paragraph (b); or
463.1 	(2) demonstrated competency by satisfactorily completing a written or oral test on 
463.2 	the tasks the unlicensed personnel will perform and in the topics listed in subdivision 
463.3 	7, paragraph (b); and successfully demonstrate competency of topics in subdivision 7, 
463.4 	paragraph (b), clauses (5), (7), and (8), by a practical skills test.
463.5 	Unlicensed personnel providing home care services for a basic home care provider may 
463.6 	not perform delegated nursing or therapy tasks.
463.7 	(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive 
463.8 	home care provider must have:
463.9 	(1) successfully completed training and demonstrated competency by successfully 
463.10 	completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and 
463.11 	a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7), 
463.12 	and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; or
463.13 	(2) satisfy the current requirements of Medicare for training or competency of home 
463.14 	health aides or nursing assistants, as provided by Code of Federal Regulations, title 42, 
463.15 	section 483 or section 484.36; or
463.16 	(3) before April 19, 1993, completed a training course for nursing assistants that was 
463.17 	approved by the commissioner.
463.18 	(c) Unlicensed personnel performing therapy or treatment tasks delegated or 
463.19 	assigned by a licensed health professional must meet the requirements for delegated 
463.20 	tasks in subdivision 4 and any other training or competency requirements within the 
463.21 	licensed health professional scope of practice relating to delegation or assignment of tasks 
463.22 	to unlicensed personnel.
463.23 		Subd. 4.Delegation of home care tasks. A registered nurse or licensed health 
463.24 	professional may delegate tasks only to staff that are competent and possess the knowledge 
463.25 	and skills consistent with the complexity of the tasks and according to the appropriate 
463.26 	Minnesota Practice Act. The comprehensive home care provider must establish and 
463.27 	implement a system to communicate up-to-date information to the registered nurse or 
463.28 	licensed health professional regarding the current available staff and their competency so 
463.29 	the registered nurse or licensed health professional has sufficient information to determine 
463.30 	the appropriateness of delegating tasks to meet individual client needs and preferences.
463.31 		Subd. 5.Individual contractors. When a home care provider contracts with an 
463.32 	individual contractor excluded from licensure under section 144A.471 to provide home 
463.33 	care services, the contractor must meet the same requirements required by this section for 
463.34 	personnel employed by the home care provider.
463.35 		Subd. 6.Temporary staff. When a home care provider contracts with a temporary 
463.36 	staffing agency excluded from licensure under section 144A.471, those individuals must 
464.1 	meet the same requirements required by this section for personnel employed by the home 
464.2 	care provider and shall be treated as if they are staff of the home care provider.
464.3 		Subd. 7.Requirements for instructors, training content, and competency 
464.4 	evaluations for unlicensed personnel. (a) Instructors and competency evaluators must 
464.5 	meet the following requirements:
464.6 	(1) training and competency evaluations of unlicensed personnel providing basic 
464.7 	home care services must be conducted by individuals with work experience and training in 
464.8 	providing home care services listed in section 144A.471, subdivisions 6 and 7; and
464.9 	(2) training and competency evaluations of unlicensed personnel providing 
464.10 	comprehensive home care services must be conducted by a registered nurse, or another 
464.11 	instructor may provide training in conjunction with the registered nurse. If the home care 
464.12 	provider is providing services by licensed health professionals only, then that specific 
464.13 	training and competency evaluation may be conducted by the licensed health professionals 
464.14 	as appropriate.
464.15 	(b) Training and competency evaluations for all unlicensed personnel must include 
464.16 	the following:
464.17 	(1) documentation requirements for all services provided;
464.18 	(2) reports of changes in the client's condition to the supervisor designated by the 
464.19 	home care provider;
464.20 	(3) basic infection control, including blood-borne pathogens;
464.21 	(4) maintenance of a clean and safe environment;
464.22 	(5) appropriate and safe techniques in personal hygiene and grooming, including:
464.23 	(i) hair care and bathing;
464.24 	(ii) care of teeth, gums, and oral prosthetic devices;
464.25 	(iii) care and use of hearing aids; and
464.26 	(iv) dressing and assisting with toileting;
464.27 	(6) training on the prevention of falls for providers working with the elderly or 
464.28 	individuals at risk of falls;
464.29 	(7) standby assistance techniques and how to perform them;
464.30 	(8) medication, exercise, and treatment reminders;
464.31 	(9) basic nutrition, meal preparation, food safety, and assistance with eating;
464.32 	(10) preparation of modified diets as ordered by a licensed health professional;
464.33 	(11) communication skills that include preserving the dignity of the client and 
464.34 	showing respect for the client and the client's preferences, cultural background, and family;
464.35 	(12) awareness of confidentiality and privacy;
465.1 	(13) understanding appropriate boundaries between staff and clients and the client's 
465.2 	family;
465.3 	(14) procedures to utilize in handling various emergency situations; and
465.4 	(15) awareness of commonly used health technology equipment and assistive devices.
465.5 	(c) In addition to paragraph (b), training and competency evaluation for unlicensed 
465.6 	personnel providing comprehensive home care services must include:
465.7 	(1) observation, reporting, and documenting of client status;
465.8 	(2) basic knowledge of body functioning and changes in body functioning, injuries, 
465.9 	or other observed changes that must be reported to appropriate personnel;
465.10 	(3) reading and recording temperature, pulse, and respirations of the client;
465.11 	(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
465.12 	(5) safe transfer techniques and ambulation;
465.13 	(6) range of motioning and positioning; and
465.14 	(7) administering medications or treatments as required.
465.15 	(d) When the registered nurse or licensed health professional delegates tasks, they 
465.16 	must ensure that prior to the delegation the unlicensed personnel is trained in the proper 
465.17 	methods to perform the tasks or procedures for each client and are able to demonstrate 
465.18 	the ability to competently follow the procedures and perform the tasks. If an unlicensed 
465.19 	personnel has not regularly performed the delegated home care task for a period of 24 
465.20 	consecutive months, the unlicensed personnel must demonstrate competency in the task 
465.21 	to the registered nurse or appropriate licensed health professional. The registered nurse 
465.22 	or licensed health professional must document instructions for the delegated tasks in 
465.23 	the client's record.

465.24 	Sec. 24. [144A.4796] ORIENTATION AND ANNUAL TRAINING 
465.25 	REQUIREMENTS.
465.26 		Subdivision 1.Orientation of staff and supervisors to home care. All staff 
465.27 	providing and supervising direct home care services must complete an orientation to home 
465.28 	care licensing requirements and regulations before providing home care services to clients. 
465.29 	The orientation may be incorporated into the training required under subdivision 6. The 
465.30 	orientation need only be completed once for each staff person and is not transferable 
465.31 	to another home care provider.
465.32 		Subd. 2.Content. The orientation must contain the following topics:
465.33 	(1) an overview of sections 144A.43 to 144A.4798;
465.34 	(2) introduction and review of all the provider's policies and procedures related to 
465.35 	the provision of home care services;
466.1 	(3) handling of emergencies and use of emergency services;
466.2 	(4) compliance with and reporting the maltreatment of minors or vulnerable adults 
466.3 	under sections 626.556 and 626.557;
466.4 	(5) home care bill of rights, under section 144A.44;
466.5 	(6) handling of clients' complaints, reporting of complaints, and where to report 
466.6 	complaints including information on the Office of Health Facility Complaints and the 
466.7 	Common Entry Point;
466.8 	(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care, 
466.9 	Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care 
466.10 	Ombudsman at the Department of Human Services, county managed care advocates, 
466.11 	or other relevant advocacy services; and
466.12 	(8) review of the types of home care services the employee will be providing and 
466.13 	the provider's scope of licensure.
466.14 		Subd. 3.Verification and documentation of orientation. Each home care provider 
466.15 	shall retain evidence in the employee record of each staff person having completed the 
466.16 	orientation required by this section.
466.17 		Subd. 4.Orientation to client. Staff providing home care services must be oriented 
466.18 	specifically to each individual client and the services to be provided. This orientation may 
466.19 	be provided in person, orally, in writing, or electronically.
466.20 		Subd. 5.Training required relating to Alzheimer's disease and related disorders.
 466.21 	For home care providers that provide services for persons with Alzheimer's or related 
466.22 	disorders, all direct care staff and supervisors working with these clients must receive 
466.23 	training that includes a current explanation of Alzheimer's disease and related disorders, 
466.24 	effective approaches to use to problem solve when working with a client's challenging 
466.25 	behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
466.26 		Subd. 6.Required annual training. All staff that perform direct home care 
466.27 	services must complete at least eight hours of annual training for each 12 months of 
466.28 	employment. The training may be obtained from the home care provider or another source 
466.29 	and must include topics relevant to the provision of home care services. The annual 
466.30 	training must include:
466.31 	(1) training on reporting of maltreatment of minors under section 626.556 and 
466.32 	maltreatment of vulnerable adults under section 626.557, whichever is applicable to the 
466.33 	services provided;
466.34 	(2) review of the home care bill of rights in section 144A.44;
466.35 	(3) review of infection control techniques used in the home and implementation of 
466.36 	infection control standards including a review of hand washing techniques; the need for 
467.1 	and use of protective gloves, gowns, and masks; appropriate disposal of contaminated 
467.2 	materials and equipment, such as dressings, needles, syringes, and razor blades; 
467.3 	disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of 
467.4 	communicable diseases; and
467.5 	(4) review of the provider's policies and procedures relating to the provision of home 
467.6 	care services and how to implement those policies and procedures.
467.7 		Subd. 7.Documentation. A home care provider must retain documentation in the 
467.8 	employee records of the staff that have satisfied the orientation and training requirements 
467.9 	of this section.

467.10 	Sec. 25. [144A.4797] PROVISION OF SERVICES.
467.11 		Subdivision 1.Availability of contact person to staff. (a) A home care provider 
467.12 	with a basic home care license must have a person available to staff for consultation on 
467.13 	items relating to the provision of services or about the client.
467.14 	(b) A home care provider with a comprehensive home care license must have a 
467.15 	registered nurse available for consultation to staff performing delegated nursing tasks 
467.16 	and must have an appropriate licensed health professional available if performing other 
467.17 	delegated services such as therapies.
467.18 	(c) The appropriate contact person must be readily available either in person, by 
467.19 	telephone, or by other means to the staff at times when the staff is providing services.
467.20 		Subd. 2.Supervision of staff; basic home care services. (a) Staff who perform 
467.21 	basic home care services must be supervised periodically where the services are being 
467.22 	provided to verify that the work is being performed competently and to identify problems 
467.23 	and solutions to address issues relating to the staff's ability to provide the services. The 
467.24 	supervision of the unlicensed personnel must be done by staff of the home care provider 
467.25 	having the authority, skills, and ability to provide the supervision of unlicensed personnel 
467.26 	and who can implement changes as needed, and train staff.
467.27 	(b) Supervision includes direct observation of unlicensed personnel while they 
467.28 	are providing the services and may also include indirect methods of gaining input such 
467.29 	as gathering feedback from the client. Supervisory review of staff must be provided at a 
467.30 	frequency based on the staff person's competency and performance.
467.31 	(c) For an individual who is licensed as a home care provider, this section does 
467.32 	not apply.
467.33 		Subd. 3.Supervision of staff performing delegated nursing or therapy home 
467.34 	care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must 
467.35 	be supervised by an appropriately licensed health professional or a registered nurse 
468.1 	periodically where the services are being provided to verify that the work is being 
468.2 	performed competently and to identify problems and solutions related to the staff person's 
468.3 	ability to perform the tasks. Supervision of staff performing medication or treatment 
468.4 	administration shall be provided by a registered nurse or appropriately licensed health 
468.5 	professional and must include observation of the staff administering the medication or 
468.6 	treatment and the interaction with the client.
468.7 	(b) The direct supervision of staff performing delegated tasks must be provided 
468.8 	within 30 days after the individual begins working for the home care provider and 
468.9 	thereafter as needed based on performance. This requirement also applies to staff who 
468.10 	have not performed delegated tasks for one year or longer.
468.11 		Subd. 4.Documentation. A home care provider must retain documentation of 
468.12 	supervision activities in the personnel records.
468.13 		Subd. 5.Exemption. This section does not apply to an individual licensed under 
468.14 	sections 144A.43 to 144A.4799.

468.15 	Sec. 26. [144A.4798] EMPLOYEE HEALTH STATUS.
468.16 		Subdivision 1.Tuberculosis (TB) prevention and control. A home care provider 
468.17 	must establish and maintain a TB prevention and control program based on the most 
468.18 	current guidelines issued by the Centers for Disease Control and Prevention (CDC). 
468.19 	Components of a TB prevention and control program include screening all staff providing 
468.20 	home care services, both paid and unpaid, at the time of hire for active TB disease and 
468.21 	latent TB infection, and developing and implementing a written TB infection control plan. 
468.22 	The commissioner shall make the most recent CDC standards available to home care 
468.23 	providers on the department's Web site.
468.24 		Subd. 2.Communicable diseases. A home care provider must follow 
468.25 	current federal or state guidelines for prevention, control, and reporting of human 
468.26 	immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other 
468.27 	communicable diseases as defined in Minnesota Rules, part 4605.7040.

468.28 	Sec. 27. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE 
468.29 	PROVIDER ADVISORY COUNCIL.
468.30 		Subdivision 1.Membership. The commissioner of health shall appoint eight 
468.31 	persons to a home care provider advisory council consisting of the following:
468.32 	(1) three public members as defined in section 214.02 who shall be either persons 
468.33 	who are currently receiving home care services or have family members receiving home 
469.1 	care services, or persons who have family members who have received home care services 
469.2 	within five years of the application date;
469.3 	(2) three Minnesota home care licensees representing basic and comprehensive 
469.4 	levels of licensure who may be a managerial official, an administrator, a supervising 
469.5 	registered nurse, or an unlicensed personnel performing home care tasks;
469.6 	(3) one member representing the Minnesota Board of Nursing; and
469.7 	(4) one member representing the ombudsman for long-term care.
469.8 		Subd. 2.Organizations and meetings. The advisory council shall be organized 
469.9 	and administered under section 15.059 with per diems and costs paid within the limits of 
469.10 	available appropriations. Meetings will be held quarterly and hosted by the department. 
469.11 	Subcommittees may be developed as necessary by the commissioner. Advisory council 
469.12 	meetings are subject to the Open Meeting Law under chapter 13D.
469.13 		Subd. 3.Duties. At the commissioner's request, the advisory council shall provide 
469.14 	advice regarding regulations of Department of Health licensed home care providers in 
469.15 	this chapter such as:
469.16 	(1) advice to the commissioner regarding community standards for home care 
469.17 	practices;
469.18 	(2) advice to the commissioner on enforcement of licensing standards and whether 
469.19 	certain disciplinary actions are appropriate;
469.20 	(3) advice to the commissioner about ways of distributing information to licensees 
469.21 	and consumers of home care;
469.22 	(4) advice to the commissioner about training standards;
469.23 	(5) identify emerging issues and opportunities in the home care field, including the 
469.24 	use of technology in home and telehealth capabilities; and
469.25 	(6) perform other duties as directed by the commissioner.

469.26 	Sec. 28. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR 
469.27 	NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
469.28 		Subdivision 1.Temporary home care licenses and changes of ownership. (a) 
469.29 	Beginning January 1, 2014, all temporary license applicants must apply for either a 
469.30 	temporary basic or comprehensive home care license.
469.31 	(b) Temporary home care licenses issued beginning January 1, 2014, will be 
469.32 	issued according to the provisions in sections 144A.43 to 144A.4799 and fees in section 
469.33 	144A.472 and will be required to comply with this chapter.
469.34 	(c) No temporary licenses will be accepted or issued between December 1, 2013, 
469.35 	and December 31, 2013.
470.1 	(d) Beginning October 1, 2013, changes in ownership applications will require 
470.2 	payment of the new fees listed in section 144A.472. Providers who are providing 
470.3 	nursing, delegated nursing, or professional health care services, must submit the fee for 
470.4 	comprehensive home care providers, and all other providers must submit the fee for basic 
470.5 	home care providers as provided in section 144A.472. Change of ownership applicants will 
470.6 	be issued a new home care license based on the licensure law in effect on June 30, 2013.
470.7 		Subd. 2.Current home care licensees with licenses prior to July 1, 2013. (a) 
470.8 	Beginning July 1, 2014, department licensed home care providers must apply for either 
470.9 	the basic or comprehensive home care license on their regularly scheduled renewal date.
470.10 	(b) By June 30, 2015, all home care providers must either have a basic or 
470.11 	comprehensive home care license or temporary license.
470.12 		Subd. 3.Renewal and change of ownership application of home care licensure 
470.13 	during transition period. Renewal and change of ownership applications of home care 
470.14 	licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 
470.15 	to 144A.4799, and upon license renewal or issuance of a new license for a change of 
470.16 	ownership, providers must comply with sections 144A.43 to 144A.4799. Prior to renewal, 
470.17 	providers must comply with the home care licensure law in effect on June 30, 2013.
470.18 	The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, 
470.19 	shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 
470.20 	increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
470.21 	For fiscal year 2014 only the fees for providers with revenues greater than $25,000 
470.22 	and no more than $100,000 will be $313 and for providers with revenues no more than 
470.23 	$25,000 the fee will be $125.
470.24 	The license renewal fee schedule in section 144A.472 will be effective July 1, 2016.

470.25 	Sec. 29. [144A.482] REGISTRATION OF HOME MANAGEMENT 
470.26 	PROVIDERS.
470.27 	(a) For purposes of this section, a home management provider is an individual or 
470.28 	organization that provides at least two of the following services: housekeeping, meal 
470.29 	preparation, and shopping, to a person who is unable to perform these activities due to 
470.30 	illness, disability, or physical condition.
470.31 	(b) A person or organization that provides only home management services may not 
470.32 	operate in the state without a current certificate of registration issued by the commissioner 
470.33 	of health. To obtain a certificate of registration, the person or organization must annually 
470.34 	submit to the commissioner the name, mailing and physical address, e-mail address, and 
470.35 	telephone number of the individual or organization and a signed statement declaring that 
471.1 	the individual or organization is aware that the home care bill of rights applies to their 
471.2 	clients and that the person or organization will comply with the home care bill of rights 
471.3 	provisions contained in section 144A.44. An individual or organization applying for a 
471.4 	certificate must also provide the name, business address, and telephone number of each of 
471.5 	the individuals responsible for the management or direction of the organization. 
471.6 	(c) The commissioner shall charge an annual registration fee of $20 for individuals 
471.7 	and $50 for organizations. The registration fee shall be deposited in the state treasury and 
471.8 	credited to the state government special revenue fund.
471.9 	(d) A home care provider that provides home management services and other home 
471.10 	care services must be licensed, but licensure requirements other than the home care bill of 
471.11 	rights do not apply to those employees or volunteers who provide only home management 
471.12 	services to clients who do not receive any other home care services from the provider. 
471.13 	A licensed home care provider need not be registered as a home management service 
471.14 	provider, but must provide an orientation on the home care bill of rights to its employees 
471.15 	or volunteers who provide home management services.
471.16 	(e) An individual who provides home management services under this section must, 
471.17 	within 120 days after beginning to provide services, attend an orientation session approved 
471.18 	by the commissioner that provides training on the home care bill of rights and an orientation 
471.19 	on the aging process and the needs and concerns of elderly and disabled persons.
471.20 	(f) The commissioner may suspend or revoke a provider's certificate of registration 
471.21 	or assess fines for violation of the home care bill of rights. Any fine assessed for a 
471.22 	violation of the home care bill of rights by a provider registered under this section shall be 
471.23 	in the amount established in the licensure rules for home care providers. As a condition 
471.24 	of registration, a provider must cooperate fully with any investigation conducted by the 
471.25 	commissioner, including providing specific information requested by the commissioner on 
471.26 	clients served and the employees and volunteers who provide services. Fines collected 
471.27 	under this paragraph shall be deposited in the state treasury and credited to the fund 
471.28 	specified in the statute or rule in which the penalty was established.
471.29 	(g) The commissioner may use any of the powers granted in sections 144A.43 to 
471.30 	144A.4799 to administer the registration system and enforce the home care bill of rights 
471.31 	under this section.

471.32 	Sec. 30. AGENCY QUALITY IMPROVEMENT PROGRAM.
 471.33 		Subdivision 1.Annual legislative report on home care licensing. The 
471.34 	commissioner shall establish a quality improvement program for the home care survey 
471.35 	and home care complaint investigation processes.  The commissioner shall submit to the 
472.1 	legislature an annual report, beginning October 1, 2015, and each October 1 thereafter. 
472.2 	Each report will review the previous state fiscal year of home care licensing and regulatory 
472.3 	activities.  The report must include, but is not limited to, an analysis of:
472.4 	(1) the number of FTE's in the Compliance Monitoring Division, including the 
472.5 	Office of Health Facilities Complaint units assigned to home care licensing, survey, 
472.6 	investigation, and enforcement process;
472.7 	(2) numbers of and descriptive information about licenses issued, complaints 
472.8 	received and investigated, including allegations made and correction orders issued, 
472.9 	surveys completed and timelines, correction order reconsiderations, and results;
472.10 	(3) descriptions of emerging trends in home care provision and areas of concern 
472.11 	identified by the department in its regulation of home care providers;
472.12 	(4) information and data regarding performance improvement projects underway 
472.13 	and planned by the commissioner in the area of home care surveys; and 
472.14 	(5) work of the Department of Health Home Care Advisory Council.
472.15 		Subd. 2.Study of correction order appeal process. Starting July 1, 2015, the 
472.16 	commissioner shall study whether to add a correction order appeal process conducted by 
472.17 	an independent reviewer, such as an administrative law judge or other office, and submit a 
472.18 	report to the legislature by February 1, 2016.  The commissioner shall review home care 
472.19 	regulatory systems in other states as part of that study.  The commissioner shall consult 
472.20 	with the home care providers and representatives.  

472.21 	Sec. 31. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME 
472.22 	AND COMMUNITY-BASED SERVICES.
 472.23 	(a) The Department of Health Compliance Monitoring Division and the Department 
472.24 	of Human Services Licensing Division shall jointly develop an integrated licensing system 
472.25 	for providers of both home care services subject to licensure under Minnesota Statutes, 
472.26 	chapter 144A, and for home and community-based services subject to licensure under 
472.27 	Minnesota Statutes, chapter 245D. The integrated licensing system shall:
472.28 	(1) require only one license of any provider of services under Minnesota Statutes, 
472.29 	sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
472.30 	(2) promote quality services that recognize a person's individual needs and protect 
472.31 	the person's health, safety, rights, and well-being;
472.32 	(3) promote provider accountability through application requirements, compliance 
472.33 	inspections, investigations, and enforcement actions;
472.34 	(4) reference other applicable requirements in existing state and federal laws, 
472.35 	including the federal Affordable Care Act;
473.1 	(5) establish internal procedures to facilitate ongoing communications between the 
473.2 	agencies, and with providers and services recipients about the regulatory activities;
473.3 	(6) create a link between the agency Web sites so that providers and the public can 
473.4 	access the same information regardless of which Web site is accessed initially; and
473.5 	(7) collect data on identified outcome measures as necessary for the agencies to 
473.6 	report to the Centers for Medicare and Medicaid Services.
473.7 	(b) The joint recommendations for legislative changes to implement the integrated 
473.8 	licensing system are due to the legislature by February 15, 2014.
473.9 	(c) Before implementation of the integrated licensing system, providers licensed as 
473.10 	home care providers under Minnesota Statutes, chapter 144A, may also provide home 
473.11 	and community-based services subject to licensure under Minnesota Statutes, chapter 
473.12 	245D, without obtaining a home and community-based services license under Minnesota 
473.13 	Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall 
473.14 	apply to these providers:
473.15 	(1) the provider must comply with all requirements under Minnesota Statutes, chapter 
473.16 	245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
473.17 	(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be 
473.18 	enforced by the Department of Health under the enforcement authority set forth in 
473.19 	Minnesota Statutes, section 144A.475; and
473.20 	(3) the Department of Health will provide information to the Department of Human 
473.21 	Services about each provider licensed under this section, including the provider's license 
473.22 	application, licensing documents, inspections, information about complaints received, and 
473.23 	investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

473.24 	Sec. 32. STUDY OF CORRECTION ORDER APPEAL PROCESS.
 473.25 	Beginning July 1, 2015, the commissioner of health shall study whether to use 
473.26 	a correction order appeal process conducted by an independent reviewer, such as 
473.27 	an administrative law judge or other office. The commissioner shall review home 
473.28 	care regulatory systems in other states and consult with the home care providers and 
473.29 	representatives. By February 1, 2016, the commissioner shall submit a report to the chairs 
473.30 	and ranking minority members of the committees of the legislature with jurisdiction over 
473.31 	health and human services and judiciary issues with any recommendations regarding 
473.32 	an independent appeal process.

473.33 	Sec. 33.  REPEALER.
 473.34 	(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
474.1 	(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 
474.2 	4668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 
474.3 	4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100; 
474.4 	4668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170; 
474.5 	4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240; 
474.6 	4668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 
474.7 	4668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870; 
474.8 	4669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

474.9 	Sec. 34. EFFECTIVE DATE.
 474.10 	Sections 1 to 30 are effective the day following final enactment.

474.11 	ARTICLE 12
474.12 	HEALTH DEPARTMENT

474.13 	Section 1. Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:
474.14 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
474.15 	apply:
474.16 	(a) "Accredited clinical training" means the clinical training provided by a medical 
474.17 	education program that is accredited through an organization recognized by the Department 
474.18 	of Education, the Centers for Medicare and Medicaid Services, or another national body 
474.19 	who reviews the accrediting organizations for multiple disciplines and whose standards 
474.20 	for recognizing accrediting organizations are reviewed and approved by the commissioner 
474.21 	of health in consultation with the Medical Education and Research Advisory Committee.
474.22 	(b) "Commissioner" means the commissioner of health.
474.23 	(c) "Clinical medical education program" means the accredited clinical training of 
474.24 	physicians (medical students and residents), doctor of pharmacy practitioners, doctors 
474.25 	of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 
474.26 	registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
474.27 	 physician assistants, dental therapists and advanced dental therapists, psychologists, 
474.28 	clinical social workers, community paramedics, and community health workers.
474.29 	(d) "Sponsoring institution" means a hospital, school, or consortium located in 
474.30 	Minnesota that sponsors and maintains primary organizational and financial responsibility 
474.31 	for a clinical medical education program in Minnesota and which is accountable to the 
474.32 	accrediting body.
474.33 	(e) "Teaching institution" means a hospital, medical center, clinic, or other 
474.34 	organization that conducts a clinical medical education program in Minnesota.
475.1 	(f) "Trainee" means a student or resident involved in a clinical medical education 
475.2 	program.
475.3 	(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time 
475.4 	equivalent counts, that are at training sites located in Minnesota with currently active 
475.5 	medical assistance enrollment status and a National Provider Identification (NPI) number 
475.6 	where training occurs in either an inpatient or ambulatory patient care setting and where 
475.7 	the training is funded, in part, by patient care revenues. Training that occurs in nursing 
475.8 	facility settings is not eligible for funding under this section.

475.9 	Sec. 2. Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:
475.10 		Subd. 3.Application process. (a) A clinical medical education program conducted 
475.11 	in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, 
475.12 	dentists, chiropractors, or physician assistants is, dental therapists and advanced dental 
475.13 	therapists, psychologists, clinical social workers, community paramedics, or community 
475.14 	health workers are eligible for funds under subdivision 4 if the program:
475.15 	(1) is funded, in part, by patient care revenues;
475.16 	(2) occurs in patient care settings that face increased financial pressure as a result 
475.17 	of competition with nonteaching patient care entities; and
475.18 	(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
475.19 	(b) A clinical medical education program for advanced practice nursing is eligible for 
475.20 	funds under subdivision 4 if the program meets the eligibility requirements in paragraph 
475.21 	(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health 
475.22 	Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges 
475.23 	and Universities system or members of the Minnesota Private College Council.
475.24 	(c) Applications must be submitted to the commissioner by a sponsoring institution 
475.25 	on behalf of an eligible clinical medical education program and must be received by 
475.26 	October 31 of each year for distribution in the following year. An application for funds 
475.27 	must contain the following information:
475.28 	(1) the official name and address of the sponsoring institution and the official 
475.29 	name and site address of the clinical medical education programs on whose behalf the 
475.30 	sponsoring institution is applying;
475.31 	(2) the name, title, and business address of those persons responsible for 
475.32 	administering the funds;
475.33 	(3) for each clinical medical education program for which funds are being sought; 
475.34 	the type and specialty orientation of trainees in the program; the name, site address, and 
475.35 	medical assistance provider number and national provider identification number of each 
476.1 	training site used in the program; the federal tax identification number of each training site 
476.2 	used in the program, where available; the total number of trainees at each training site; and 
476.3 	the total number of eligible trainee FTEs at each site; and
476.4 	(4) other supporting information the commissioner deems necessary to determine 
476.5 	program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the 
476.6 	equitable distribution of funds.
476.7 	(d) An application must include the information specified in clauses (1) to (3) for 
476.8 	each clinical medical education program on an annual basis for three consecutive years. 
476.9 	After that time, an application must include the information specified in clauses (1) to (3) 
476.10 	when requested, at the discretion of the commissioner:
476.11 	(1) audited clinical training costs per trainee for each clinical medical education 
476.12 	program when available or estimates of clinical training costs based on audited financial 
476.13 	data;
476.14 	(2) a description of current sources of funding for clinical medical education costs, 
476.15 	including a description and dollar amount of all state and federal financial support, 
476.16 	including Medicare direct and indirect payments; and
476.17 	(3) other revenue received for the purposes of clinical training.
476.18 	(e) An applicant that does not provide information requested by the commissioner 
476.19 	shall not be eligible for funds for the current funding cycle.

476.20 	Sec. 3. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
476.21 		Subd. 4.Distribution of funds. (a) The commissioner shall annually distribute the 
476.22 	available medical education funds to all qualifying applicants based on a distribution 
476.23 	formula that reflects a summation of two factors:
476.24 	(1) a public program volume factor, which is determined by the total volume of 
476.25 	public program revenue received by each training site as a percentage of all public 
476.26 	program revenue received by all training sites in the fund pool; and
476.27 	(2) a supplemental public program volume factor, which is determined by providing 
476.28 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
476.29 	public program revenue accounted for at least 0.98 percent of the total public program 
476.30 	revenue received by all eligible training sites. Grants to training sites whose public 
476.31 	program revenue accounted for less than 0.98 percent of the total public program revenue 
476.32 	received by all eligible training sites shall be reduced by an amount equal to the total 
476.33 	value of the supplemental payment.
476.34 	Public program revenue for the distribution formula includes revenue from medical 
476.35 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
477.1 	general assistance medical care. Training sites that receive no public program revenue 
477.2 	are ineligible for funds available under this subdivision. For purposes of determining 
477.3 	training-site level grants to be distributed under paragraph (a), total statewide average 
477.4 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
477.5 	in primary care clinical medical education programs for medical residents. Total statewide 
477.6 	average costs per trainee for dental residents is based on audited clinical training costs 
477.7 	per trainee in clinical medical education programs for dental students. Total statewide 
477.8 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
477.9 	per trainee in clinical medical education programs for pharmacy students. Training sites 
477.10 	whose training site level grant is less than $1,000 $5,000, based on the formula described 
477.11 	in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for 
477.12 	funds available under this subdivision. No training sites shall receive a grant per FTE 
477.13 	trainee that is in excess of the 95th percentile grant per FTE across all eligible training 
477.14 	sites; grants in excess of this amount will be redistributed to other eligible sites based on 
477.15 	the formula described in this paragraph.
477.16 	(b) Funds distributed shall not be used to displace current funding appropriations 
477.17 	from federal or state sources.
477.18 	(c) Funds shall be distributed to the sponsoring institutions indicating the amount 
477.19 	to be distributed to each of the sponsor's clinical medical education programs based on 
477.20 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
477.21 	Each clinical medical education program must distribute funds allocated under paragraph 
477.22 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
477.23 	institutions, which are accredited through an organization recognized by the Department 
477.24 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
477.25 	with training sites to provide clinical training. To ensure the quality of clinical training, 
477.26 	those accredited sponsoring institutions must:
477.27 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
477.28 	training conducted at sites; and
477.29 	(2) take necessary action if the contract requirements are not met. Action may include 
477.30 	the withholding of payments under this section or the removal of students from the site.
477.31 	(d) Use of funds is limited to expenses related to clinical training program costs for 
477.32 	eligible programs.
477.33 	(e) Any funds not distributed in accordance with the commissioner's approval letter 
477.34 	must be returned to the medical education and research fund within 30 days of receiving 
477.35 	notice from the commissioner. The commissioner shall distribute returned funds to the 
477.36 	appropriate training sites in accordance with the commissioner's approval letter.
478.1 	(e) (f) A maximum of $150,000 of the funds dedicated to the commissioner 
478.2 	under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
478.3 	administrative expenses associated with implementing this section.

478.4 	Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:
478.5 		Subd. 5.Report. (a) Sponsoring institutions receiving funds under this section 
478.6 	must sign and submit a medical education grant verification report (GVR) to verify that 
478.7 	the correct grant amount was forwarded to each eligible training site. If the sponsoring 
478.8 	institution fails to submit the GVR by the stated deadline, or to request and meet 
478.9 	the deadline for an extension, the sponsoring institution is required to return the full 
478.10 	amount of funds received to the commissioner within 30 days of receiving notice from 
478.11 	the commissioner. The commissioner shall distribute returned funds to the appropriate 
478.12 	training sites in accordance with the commissioner's approval letter.
478.13 	(b) The reports must provide verification of the distribution of the funds and must 
478.14 	include:
478.15 	(1) the total number of eligible trainee FTEs in each clinical medical education 
478.16 	program;
478.17 	(2) the name of each funded program and, for each program, the dollar amount 
478.18 	distributed to each training site and a training site expenditure report;
478.19 	(3) documentation of any discrepancies between the initial grant distribution notice 
478.20 	included in the commissioner's approval letter and the actual distribution;
478.21 	(4) a statement by the sponsoring institution stating that the completed grant 
478.22 	verification report is valid and accurate; and
478.23 	(5) other information the commissioner, with advice from the advisory committee,
478.24 	 deems appropriate to evaluate the effectiveness of the use of funds for medical education.
478.25 	(c) By February 15 of Each year, the commissioner, with advice from the 
478.26 	advisory committee, shall provide an annual summary report to the legislature on the 
478.27 	implementation of this section.

478.28 	Sec. 5. Minnesota Statutes 2012, section 62J.692, subdivision 7a, is amended to read:
478.29 		Subd. 7a.Clinical medical education innovations grants. (a) The commissioner 
478.30 	shall award grants to teaching institutions and clinical training sites for projects that 
478.31 	increase dental access for underserved populations and promote innovative clinical 
478.32 	training of dental professionals.
478.33 	(b) $1,000,000 of the funds dedicated to the commissioner under section 297F.10, 
478.34 	subdivision 1, clause (2), plus any federal financial participation on these funds, shall 
479.1 	be distributed by the commissioner for primary care development grants pursuant to 
479.2 	paragraph (c).
479.3 	(c) The commissioner shall award grants to teaching institutions and clinical training 
479.4 	sites for projects that increase the supply and availability of primary care providers for 
479.5 	public program enrollees, improve access for underserved and rural populations, and 
479.6 	promote interdisciplinary and team training of primary care providers and related personnel.
479.7 	(d) In awarding the grants, the commissioner, in consultation with the commissioner 
479.8 	of human services, shall consider the following:
479.9 	(1) potential to successfully increase access to an underserved population;
479.10 	(2) the long-term viability of the project to improve access beyond the period 
479.11 	of initial funding;
479.12 	(3) evidence of collaboration between the applicant and local communities;
479.13 	(4) the efficiency in the use of the funding; and
479.14 	(5) the priority level of the project in relation to state clinical education, access, 
479.15 	and workforce goals.
479.16 	(b) (e) The commissioner shall periodically evaluate the priorities in awarding the 
479.17 	innovations grants in order to ensure that the priorities meet the changing workforce 
479.18 	needs of the state.

479.19 	Sec. 6. Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:
479.20 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
479.21 	Education and Research Costs Advisory Committee may review provider groups included 
479.22 	in the definition of a clinical medical education program to assure that the distribution 
479.23 	of the funds continue to be consistent with the purpose of this section. The results of 
479.24 	any such reviews must be reported to the chairs and ranking minority members of the 
479.25 	legislative committees with jurisdiction over health care policy and finance.

479.26 	Sec. 7. Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision 
479.27 	to read:
479.28 		Subd. 11.Distribution of funds. If federal approval is not received for the formula 
479.29 	described in subdivision 4, paragraph (a), 100 percent of available medical education 
479.30 	and research funds shall be distributed based on a distribution formula that reflects as 
479.31 	summation of two factors:
479.32 	(1) a public program volume factor, that is determined by the total volume of public 
479.33 	program revenue received by each training site as a percentage of all public program 
479.34 	revenue received by all training sites in the fund pool; and
480.1 	(2) a supplemental public program volume factor, that is determined by providing a 
480.2 	supplemental payment of 20 percent of each training site's grant to training sites whose 
480.3 	public program revenue accounted for a least 0.98 percent of the total public program 
480.4 	revenue received by all eligible training sites. Grants to training sites whose public 
480.5 	program revenue accounted for less than 0.98 percent of the total public program revenue 
480.6 	received by all eligible training sites shall be reduced by an amount equal to the total 
480.7 	value of the supplemental payment.

480.8 	Sec. 8. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
480.9 		Subdivision 1.Designation. (a) The commissioner shall designate essential 
480.10 	community providers. The criteria for essential community provider designation shall be 
480.11 	the following:
480.12 	(1) a demonstrated ability to integrate applicable supportive and stabilizing services 
480.13 	with medical care for uninsured persons and high-risk and special needs populations, 
480.14 	underserved, and other special needs populations; and
480.15 	(2) a commitment to serve low-income and underserved populations by meeting the 
480.16 	following requirements:
480.17 	(i) has nonprofit status in accordance with chapter 317A;
480.18 	(ii) has tax-exempt status in accordance with the Internal Revenue Service Code, 
480.19 	section 501(c)(3);
480.20 	(iii) charges for services on a sliding fee schedule based on current poverty income 
480.21 	guidelines; and
480.22 	(iv) does not restrict access or services because of a client's financial limitation;
480.23 	(3) status as a local government unit as defined in section 62D.02, subdivision 11, a 
480.24 	hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal 
480.25 	government, an Indian health service unit, or a community health board as defined in 
480.26 	chapter 145A;
480.27 	(4) a former state hospital that specializes in the treatment of cerebral palsy, spina 
480.28 	bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling 
480.29 	conditions;
480.30 	(5) a sole community hospital. For these rural hospitals, the essential community 
480.31 	provider designation applies to all health services provided, including both inpatient and 
480.32 	outpatient services. For purposes of this section, "sole community hospital" means a 
480.33 	rural hospital that:
480.34 	(i) is eligible to be classified as a sole community hospital according to Code 
480.35 	of Federal Regulations, title 42, section 412.92, or is located in a community with a 
481.1 	population of less than 5,000 and located more than 25 miles from a like hospital currently 
481.2 	providing acute short-term services;
481.3 	(ii) has experienced net operating income losses in two of the previous three 
481.4 	most recent consecutive hospital fiscal years for which audited financial information is 
481.5 	available; and
481.6 	(iii) consists of 40 or fewer licensed beds; or
481.7 	(6) a birth center licensed under section 144.615; or
481.8 	(7) a hospital or affiliated specialty clinic that:
481.9 	(i) serves patients who are predominately under the age of 21;
481.10 	(ii) provides intensive specialty pediatric services that are only routinely provided 
481.11 	in less than five hospitals in the state; and
481.12 	(iii) serves children from at least half the counties in the state.
481.13 	(b) Prior to designation, the commissioner shall publish the names of all applicants 
481.14 	in the State Register. The public shall have 30 days from the date of publication to submit 
481.15 	written comments to the commissioner on the application. No designation shall be made 
481.16 	by the commissioner until the 30-day period has expired.
481.17 	(c) The commissioner may designate an eligible provider as an essential community 
481.18 	provider for all the services offered by that provider or for specific services designated by 
481.19 	the commissioner.
481.20 	(d) For the purpose of this subdivision, supportive and stabilizing services include at 
481.21 	a minimum, transportation, child care, cultural, and linguistic services where appropriate.

481.22 	Sec. 9. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision 
481.23 	to read:
481.24 		Subd. 1a.Bored geothermal heat exchanger. "Bored geothermal heat exchanger" 
481.25 	means an earth-coupled heating or cooling device consisting of a sealed closed-loop 
481.26 	piping system installed in a boring in the ground to transfer heat to or from the surrounding 
481.27 	earth with no discharge.

481.28 	Sec. 10. Minnesota Statutes 2012, section 103I.521, is amended to read:
481.29 	103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT 
481.30 	AND BUDGET.
481.31 	Unless otherwise specified, fees collected for licenses or registration by the 
481.32 	commissioner under this chapter shall be deposited in the state treasury and credited to 
481.33 	the state government special revenue fund.

482.1 	Sec. 11. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
482.2 		Subdivision 1.Who must pay. Except for the limitation contained in this section, 
482.3 	the commissioner of health shall charge a handling fee may enter into a contractual 
482.4 	agreement to recover costs incurred for analysis for diagnostic purposes for each specimen 
482.5 	submitted to the Department of Health for analysis for diagnostic purposes by any hospital, 
482.6 	private laboratory, private clinic, or physician. No fee shall be charged to any entity which 
482.7 	receives direct or indirect financial assistance from state or federal funds administered by 
482.8 	the Department of Health, including any public health department, nonprofit community 
482.9 	clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The 
482.10 	commissioner shall not charge for any biological materials submitted to the Department 
482.11 	of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological 
482.12 	materials requested by the department to gather information for disease prevention or 
482.13 	control purposes. The commissioner of health may establish other exceptions to the 
482.14 	handling fee as may be necessary to protect the public's health. All fees collected pursuant 
482.15 	to this section shall be deposited in the state treasury and credited to the state government 
482.16 	special revenue fund. Funds generated in a contractual agreement made pursuant to this 
482.17 	section shall be deposited in a special account and are appropriated to the commissioner 
482.18 	for purposes of providing the services specified in the contracts. All such contractual 
482.19 	agreements shall be processed in accordance with the provisions of chapter 16C.

482.20 	EFFECTIVE DATE. This section is effective July 1, 2014.

482.21 	Sec. 12. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
482.22 		Subdivision 1.Duty to perform testing. (a) It is the duty of (1) the administrative 
482.23 	officer or other person in charge of each institution caring for infants 28 days or less 
482.24 	of age, (2) the person required in pursuance of the provisions of section 144.215, to 
482.25 	register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 
482.26 	birth, to arrange to have administered to every infant or child in its care tests for heritable 
482.27 	and congenital disorders according to subdivision 2 and rules prescribed by the state 
482.28 	commissioner of health.
482.29 	(b) Testing and the, recording and of test results, reporting of test results, and 
482.30 	follow-up of infants with heritable congenital disorders, including hearing loss detected 
482.31 	through the early hearing detection and intervention program in section 144.966, shall be 
482.32 	performed at the times and in the manner prescribed by the commissioner of health. The 
482.33 	commissioner shall charge a fee so that the total of fees collected will approximate the 
482.34 	costs of conducting the tests and implementing and maintaining a system to follow-up 
483.1 	infants with heritable or congenital disorders, including hearing loss detected through the 
483.2 	early hearing detection and intervention program under section 144.966.
483.3 	(c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased 
483.4 	to $106 to support the newborn screening program, including tests administered under 
483.5 	this section and section 144.966, shall be $135 per specimen. The increased fee amount 
483.6 	shall be deposited in the general fund. Costs associated with capital expenditures and 
483.7 	the development of new procedures may be prorated over a three-year period when 
483.8 	calculating the amount of the fees. This fee amount shall be deposited in the state treasury 
483.9 	and credited to the state government special revenue fund.
483.10 	(d) The fee to offset the cost of the support services provided under section 144.966, 
483.11 	subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury 
483.12 	and credited to the general fund.

483.13 	Sec. 13. [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL 
483.14 	HEART DISEASE (CCHD).
483.15 		Subdivision 1.Required testing and reporting. (a) Each licensed hospital or 
483.16 	state-licensed birthing center or facility that provides maternity and newborn care services 
483.17 	shall provide screening for congenital heart disease to all newborns prior to discharge 
483.18 	using pulse oximetry screening. The screening must occur after the infant is 24 hours old, 
483.19 	before discharge from the nursery. If discharge occurs before the infant is 24 hours old, 
483.20 	the screening must occur as close as possible to the time of discharge.
483.21 	(b) For premature infants (less than 36 weeks of gestation) and infants admitted to a 
483.22 	higher-level nursery (special care or intensive care), pulse oximetry must be performed 
483.23 	when medically appropriate prior to discharge.
483.24 	(c) Results of the screening must be reported to the Department of Health.
483.25 		Subd. 2.Implementation. The Department of Health shall:
483.26 	(1) communicate the screening protocol requirements;
483.27 	(2) make information and forms available to the hospitals, birthing centers, and other 
483.28 	facilities that are required to provide the screening, health care providers who provide 
483.29 	prenatal care and care to newborns, and expectant parents and parents of newborns. The 
483.30 	information and forms must include screening protocol and reporting requirements and 
483.31 	parental options;
483.32 	(3) provide training to ensure compliance with and appropriate implementation of 
483.33 	the screening;
484.1 	(4) establish the mechanism for the required data collection and reporting of 
484.2 	screening and follow-up diagnostic results to the Department of Health according to the 
484.3 	Department of Health's recommendations;
484.4 	(5) coordinate the implementation of universal standardized screening;
484.5 	(6) act as a resource for providers as the screening program is implemented, and in 
484.6 	consultation with the Advisory Committee on Heritable and Congenital Disorders, develop 
484.7 	and implement policies for early medical and developmental intervention services and 
484.8 	long-term follow-up services for children and their families identified with a CCHD; and
484.9 	(7) comply with sections 144.125 to 144.128.

484.10 	Sec. 14. Minnesota Statutes 2012, section 144.212, is amended to read:
484.11 	144.212 DEFINITIONS.
484.12 		Subdivision 1.Scope. As used in sections 144.211 to 144.227, the following terms 
484.13 	have the meanings given.
484.14 		Subd. 1a.Amendment. "Amendment" means completion or correction of made 
484.15 	to certification items on  a vital record. after a certification has been issued or more 
484.16 	than one year after the event, whichever occurs first, that does not result in a sealed or 
484.17 	replaced record.
484.18 		Subd. 1b.Authorized representative. "Authorized representative" means an agent 
484.19 	designated in a written and witnessed statement signed by the subject of the record or 
484.20 	other qualified applicant.
484.21 		Subd. 1c.Certification item. "Certification item" means all individual items 
484.22 	appearing on a certificate of birth and the demographic and legal items on a certificate 
484.23 	of death.
484.24 		Subd. 2.Commissioner. "Commissioner" means the commissioner of health.
484.25 		Subd. 2a.Correction. "Correction" means a change made to a noncertification 
484.26 	item, including information collected for medical and statistical purposes. A correction 
484.27 	also means a change to a certification item within one year of the event provided that no 
484.28 	certification, whether paper or electronic, has been issued.
484.29 		Subd. 2b.Court of competent jurisdiction. "Court of competent jurisdiction" 
484.30 	means a court within the United States with jurisdiction over the individual and such other 
484.31 	individuals that the court deems necessary.
484.32 		Subd. 2a 2c.Delayed registration. "Delayed registration" means registration of a 
484.33 	record of birth or death filed one or more years after the date of birth or death.
485.1 		Subd. 2d.Disclosure. "Disclosure" means to make available or make known 
485.2 	personally identifiable information contained in a vital record, by any means of 
485.3 	communication.
485.4 		Subd. 3.File. "File" means to present a vital record or report for registration to the 
485.5 	Office of the State Registrar Vital Records and to have the vital record or report accepted 
485.6 	for registration by the Office of the State Registrar Vital Records.
485.7 		Subd. 4.Final disposition. "Final disposition" means the burial, interment, 
485.8 	cremation, removal from the state, or other authorized disposition of a dead body or 
485.9 	dead fetus.
485.10 		Subd. 4a.Institution. "Institution" means a public or private establishment that:
485.11 	(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment; 
485.12 	or
485.13 	(2) provides nursing, custodial, or domiciliary care, or to which persons are 
485.14 	committed by law.
485.15 		Subd. 4b.Legal representative. "Legal representative" means a licensed attorney 
485.16 	representing an individual.
485.17 		Subd. 4c.Local issuance office. "Local issuance office" means a county 
485.18 	governmental office authorized by the state registrar to issue certified birth and death 
485.19 	records.
485.20 		Subd. 4d.Record. "Record" means a report of a vital event that has been registered 
485.21 	by the state registrar.
485.22 		Subd. 5.Registration. "Registration" means the process by which vital records 
485.23 	are completed, filed, and incorporated into the official records of the Office of the State 
485.24 	Registrar.
485.25 		Subd. 6.State registrar. "State registrar" means the commissioner of health or a 
485.26 	designee.
485.27 		Subd. 7.System of vital statistics. "System of vital statistics" includes the 
485.28 	registration, collection, preservation, amendment, verification, maintenance of the security 
485.29 	and integrity of, and certification of vital records, the collection of other reports required 
485.30 	by sections 144.211 to 144.227, and related activities including the tabulation, analysis, 
485.31 	publication, and dissemination of vital statistics.
485.32 		Subd. 7a.Verification. "Verification" means a confirmation of the information on a 
485.33 	vital record based on the facts contained in a certification.
485.34 		Subd. 8.Vital record. "Vital record" means a record or report of birth, stillbirth, 
485.35 	death, marriage, dissolution and annulment, and data related thereto. The birth record is 
485.36 	not a medical record of the mother or the child.
486.1 		Subd. 9.Vital statistics. "Vital statistics" means the data derived from records and 
486.2 	reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment, 
486.3 	and related reports.
486.4 		Subd. 10.Local registrar. "Local registrar" means an individual designated under 
486.5 	section 144.214, subdivision 1, to perform the duties of a local registrar.
486.6 		Subd. 11.Consent to disclosure. "Consent to disclosure" means an affidavit filed 
486.7 	with the state registrar which sets forth the following information:
486.8 	(1) the current name and address of the affiant;
486.9 	(2) any previous name by which the affiant was known;
486.10 	(3) the original and adopted names, if known, of the adopted child whose original 
486.11 	birth record is to be disclosed;
486.12 	(4) the place and date of birth of the adopted child;
486.13 	(5) the biological relationship of the affiant to the adopted child; and
486.14 	(6) the affiant's consent to disclosure of information from the original birth record of 
486.15 	the adopted child.

486.16 	Sec. 15. Minnesota Statutes 2012, section 144.213, is amended to read:
486.17 	144.213 OFFICE OF THE STATE REGISTRAR VITAL RECORDS.
486.18 		Subdivision 1.Creation; state registrar; Office of Vital Records. The 
486.19 	commissioner shall establish an Office of the State RegistrarVital Records under the 
486.20 	supervision of the state registrar. The commissioner shall furnish to local registrars the 
486.21 	forms necessary for correct reporting of vital statistics, and shall instruct the local registrars 
486.22 	in the collection and compilation of the data. The commissioner shall promulgate rules for 
486.23 	the collection, filing, and registering of vital statistics information by the state and local 
486.24 	registrars registrar, physicians, morticians, and others. Except as otherwise provided in 
486.25 	sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to 
486.26 	the collection, filing and registering of vital statistics shall remain in effect until repealed, 
486.27 	modified or superseded by a rule promulgated by the commissioner.
486.28 		Subd. 2.General duties. (a) The state registrar shall coordinate the work of 
486.29 	local registrars to maintain a statewide system of vital statistics. The state registrar is 
486.30 	responsible for the administration and enforcement of sections 144.211 to 144.227, and 
486.31 	shall supervise local registrars in the enforcement of sections 144.211 to 144.227 and the 
486.32 	rules promulgated thereunder. Local issuance offices that fail to comply with the statutes 
486.33 	or rules or to properly train employees may have their issuance privileges and access to 
486.34 	the vital records system revoked.
487.1 	(b) To preserve vital records the state registrar is authorized to prepare typewritten, 
487.2 	photographic, electronic or other reproductions of original records and files in the Office 
487.3 	of Vital Records. The reproductions when certified by the state registrar shall be accepted 
487.4 	as the original records.
487.5 	(c) The state registrar shall also:
487.6 	(1) establish, designate, and eliminate offices in the state to aid in the efficient 
487.7 	issuance of vital records;
487.8 	(2) direct the activities of all persons engaged in activities pertaining to the operation 
487.9 	of the system of vital statistics;
487.10 	(3) develop and conduct training programs to promote uniformity of policy and 
487.11 	procedures throughout the state in matters pertaining to the system of vital statistics; and
487.12 	(4) prescribe, furnish, and distribute all forms required by sections 144.211 to 
487.13 	144.227 and any rules adopted under these sections, and prescribe other means for the 
487.14 	transmission of data, including electronic submission, that will accomplish the purpose of 
487.15 	complete, accurate, and timely reporting and registration.
487.16 		Subd. 3.Record keeping. To preserve vital records the state registrar is authorized 
487.17 	to prepare typewritten, photographic, electronic or other reproductions of original records 
487.18 	and files in the Office of the State Registrar. The reproductions when certified by the state 
487.19 	or local registrar shall be accepted as the original records.

487.20 	Sec. 16. [144.2131] SECURITY OF VITAL RECORDS SYSTEM.
487.21 	The state registrar shall:
487.22 	(1) authenticate all users of the system of vital statistics and document that all users 
487.23 	require access based on their official duties;
487.24 	(2) authorize authenticated users of the system of vital statistics to access specific 
487.25 	components of the vital statistics systems necessary for their official roles and duties;
487.26 	(3) establish separation of duties between staff roles that may be susceptible to fraud 
487.27 	or misuse and routinely perform audits of staff work for the purposes of identifying fraud 
487.28 	or misuse within the vital statistics system;
487.29 	(4) require that authenticated and authorized users of the system of vital 
487.30 	statistics maintain a specified level of training related to security and provide written 
487.31 	acknowledgment of security procedures and penalties;
487.32 	(5) validate data submitted for registration through site visits or with independent 
487.33 	sources outside the registration system at a frequency specified by the state registrar to 
487.34 	maximize the integrity of the data collected;
488.1 	(6) protect personally identifiable information and maintain systems pursuant to 
488.2 	applicable state and federal laws;
488.3 	(7) accept a report of death if the decedent was born in Minnesota or if the decedent 
488.4 	was a resident of Minnesota from the United States Department of Defense or the United 
488.5 	States Department of State when the death of a United States citizen occurs outside the 
488.6 	United States;
488.7 	(8) match death records registered in Minnesota and death records provided from 
488.8 	other jurisdictions to live birth records in Minnesota;
488.9 	(9) match death records received from the United States Department of Defense 
488.10 	or the United States Department of State for deaths of United States citizens occurring 
488.11 	outside the United States to live birth records in Minnesota;
488.12 	(10) work with law enforcement to initiate and provide evidence for active fraud 
488.13 	investigations;
488.14 	(11) provide secure workplace, storage, and technology environments that have 
488.15 	limited role-based access;
488.16 	(12) maintain overt, covert, and forensic security measures for certifications, 
488.17 	verifications, and automated systems that are part of the vital statistics system; and
488.18 	(13) comply with applicable state and federal laws and rules associated with 
488.19 	information technology systems and related information security requirements.

488.20 	Sec. 17. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:
488.21 		Subd. 3.Father's name; child's name. In any case in which paternity of a child is 
488.22 	determined by a court of competent jurisdiction, a declaration of parentage is executed 
488.23 	under section 257.34, or a recognition of parentage is executed under section 257.75, the 
488.24 	name of the father shall be entered on the birth record. If the order of the court declares 
488.25 	the name of the child, it shall also be entered on the birth record. If the order of the court 
488.26 	does not declare the name of the child, or there is no court order, then upon the request of 
488.27 	both parents in writing, the surname of the child shall be defined by both parents.

488.28 	Sec. 18. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:
488.29 		Subd. 4.Social Security number registration. (a) Parents of a child born within 
488.30 	this state shall give the parents' Social Security numbers to the Office of the State Registrar
488.31 	 Vital Records at the time of filing the birth record, but the numbers shall not appear on 
488.32 	the certified record.
488.33 	(b) The Social Security numbers are classified as private data, as defined in section 
488.34 	13.02, subdivision 12, on individuals, but the Office of the State Registrar Vital Records
489.1 	 shall provide a Social Security number to the public authority responsible for child support 
489.2 	services upon request by the public authority for use in the establishment of parentage and 
489.3 	the enforcement of child support obligations.

489.4 	Sec. 19. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:
489.5 		Subdivision 1.Reporting a foundling. Whoever finds a live born infant of unknown 
489.6 	parentage shall report within five days to the Office of the State Registrar Vital Records
489.7 	 such information as the commissioner may by rule require to identify the foundling.

489.8 	Sec. 20. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:
489.9 		Subd. 2.Court petition. If a delayed record of birth is rejected under subdivision 
489.10 	1, a person may petition the appropriate court in the county in which the birth allegedly 
489.11 	occurred for an order establishing a record of the date and place of the birth and the 
489.12 	parentage of the person whose birth is to be registered. The petition shall state:
489.13 	(1) that the person for whom a delayed record of birth is sought was born in this state;
489.14 	(2) that no record of birth can be found in the Office of the State Registrar Vital 
489.15 	Records;
489.16 	(3) that diligent efforts by the petitioner have failed to obtain the evidence required 
489.17 	in subdivision 1;
489.18 	(4) that the state registrar has refused to register a delayed record of birth; and
489.19 	(5) other information as may be required by the court.

489.20 	Sec. 21. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:
489.21 		Subd. 5.Replacement of vital records. Upon the order of a court of this state, upon 
489.22 	the request of a court of another state, upon the filing of a declaration of parentage under 
489.23 	section 257.34, or upon the filing of a recognition of parentage with a the state registrar, a 
489.24 	replacement birth record must be registered consistent with the findings of the court, the 
489.25 	declaration of parentage, or the recognition of parentage.

489.26 	Sec. 22. [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.
489.27 	(a) A vital record registered under sections 144.212 to 144.227 may be amended 
489.28 	or corrected only according to sections 144.212 to 144.227 and rules adopted by the 
489.29 	commissioner of health to protect the integrity and accuracy of vital records.
489.30 	(b)(1) A vital record that is amended under this section shall indicate that it has been 
489.31 	amended, except as otherwise provided in this section or by rule.
490.1 	(2) Electronic documentation shall be maintained by the state registrar that 
490.2 	identifies the evidence upon which the amendment or correction was based, the date 
490.3 	of the amendment or correction, and the identity of the authorized person making the 
490.4 	amendment or correction.
490.5 	(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction 
490.6 	changing the name of a person whose birth is registered in Minnesota and upon request of 
490.7 	such person if 18 years of age or older or having the status of emancipated minor, the state 
490.8 	registrar shall amend the birth record to show the new name. If the person is a minor or 
490.9 	an incapacitated person then a parent, guardian, or legal representative of the minor or 
490.10 	incapacitated person may make the request.
490.11 	(d) When an applicant does not submit the minimum documentation required for 
490.12 	amending a vital record or when the state registrar has cause to question the validity 
490.13 	or completeness of the applicant's statements or the documentary evidence, and the 
490.14 	deficiencies are not corrected, the state registrar shall not amend the vital record. The 
490.15 	state registrar shall advise the applicant of the reason for this action and shall further 
490.16 	advise the applicant of the right of appeal to a court with competent jurisdiction over 
490.17 	the Department of Health.

490.18 	Sec. 23. Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:
490.19 		Subdivision 1.Public information; access to vital records. Except as otherwise 
490.20 	provided for in this section and section 144.2252, information contained in vital records 
490.21 	shall be public information. Physical access to vital records shall be subject to the 
490.22 	supervision and regulation of the state and local registrarsregistrar and their employees 
490.23 	pursuant to rules promulgated by the commissioner in order to protect vital records from 
490.24 	loss, mutilation or destruction and to prevent improper disclosure of vital records which 
490.25 	are confidential or private data on individuals, as defined in section 13.02, subdivisions 
490.26 	3 and 12.

490.27 	Sec. 24. Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:
490.28 		Subd. 4.Access to records for research purposes. The state registrar may permit 
490.29 	persons performing medical research access to the information restricted in subdivision 
490.30 	2 or 2a if those persons agree in writing not to disclose private or confidential data on 
490.31 	individuals.

490.32 	Sec. 25. Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:
491.1 		Subd. 7.Certified birth or death record. (a) The state or local registrar or local 
491.2 	issuance office shall issue a certified birth or death record or a statement of no vital record 
491.3 	found to an individual upon the individual's proper completion of an attestation provided 
491.4 	by the commissioner and payment of the required fee:
491.5 	(1) to a person who has a tangible interest in the requested vital record. A person 
491.6 	who has a tangible interest is:
491.7 	(i) the subject of the vital record;
491.8 	(ii) a child of the subject;
491.9 	(iii) the spouse of the subject;
491.10 	(iv) a parent of the subject;
491.11 	(v) the grandparent or grandchild of the subject;
491.12 	(vi) if the requested record is a death record, a sibling of the subject;
491.13 	(vii) the party responsible for filing the vital record;
491.14 	(viii) the legal custodian, guardian or conservator, or health care agent of the subject;
491.15 	(ix) a personal representative, by sworn affidavit of the fact that the certified copy is 
491.16 	required for administration of the estate;
491.17 	(x) a successor of the subject, as defined in section 524.1-201, if the subject is 
491.18 	deceased, by sworn affidavit of the fact that the certified copy is required for administration 
491.19 	of the estate;
491.20 	(xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of 
491.21 	the fact that the certified copy is needed for the proper administration of the trust;
491.22 	(xii) a person or entity who demonstrates that a certified vital record is necessary for 
491.23 	the determination or protection of a personal or property right, pursuant to rules adopted 
491.24 	by the commissioner; or
491.25 	(xiii) adoption agencies in order to complete confidential postadoption searches as 
491.26 	required by section 259.83;
491.27 	(2) to any local, state, or federal governmental agency upon request if the certified 
491.28 	vital record is necessary for the governmental agency to perform its authorized duties. 
491.29 	An authorized governmental agency includes the Department of Human Services, the 
491.30 	Department of Revenue, and the United States Citizenship and Immigration Services;
491.31 	(3) to an attorney upon evidence of the attorney's license;
491.32 	(4) pursuant to a court order issued by a court of competent jurisdiction. For 
491.33 	purposes of this section, a subpoena does not constitute a court order; or
491.34 	(5) to a representative authorized by a person under clauses (1) to (4).
491.35 	(b) The state or local registrar or local issuance office shall also issue a certified 
491.36 	death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if, 
492.1 	on behalf of the individual, a licensed mortician furnishes the registrar with a properly 
492.2 	completed attestation in the form provided by the commissioner within 180 days of the 
492.3 	time of death of the subject of the death record. This paragraph is not subject to the 
492.4 	requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.

492.5 	Sec. 26. Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:
492.6 		Subd. 8.Standardized format for certified birth and death records. No later than 
492.7 	July 1, 2000, The commissioner shall develop maintain a standardized format for certified 
492.8 	birth records and death records issued by the state and local registrars registrar and local 
492.9 	issuance offices. The format shall incorporate security features in accordance with this 
492.10 	section. The standardized format must be implemented on a statewide basis by July 1, 2001.

492.11 	Sec. 27. Minnesota Statutes 2012, section 144.226, is amended to read:
492.12 	144.226 FEES.
492.13 		Subdivision 1.Which services are for fee. The fees for the following services shall 
492.14 	be the following or an amount prescribed by rule of the commissioner:
492.15 	(a) The fee for the issuance of a certified vital record, a search for a vital record that 
492.16 	cannot be issued, or a certification that the vital record cannot be found is $9. No fee shall be 
492.17 	charged for a certified birth, stillbirth, or death record that is reissued within one year of the 
492.18 	original issue, if an amendment is made to the vital record and if the previously issued vital 
492.19 	record is surrendered. The fee is payable at the time of application and is nonrefundable.
492.20 	(b) The fee for processing a request for the replacement of a birth record for 
492.21 	all events, except when filing a recognition of parentage pursuant to section 257.73, 
492.22 	subdivision 1, is $40. The fee is payable at the time of application and is nonrefundable.
492.23 	(c) The fee for reviewing and processing a request for the filing of a delayed 
492.24 	registration of birth, stillbirth, or death is $40. The fee is payable at the time of application 
492.25 	and is nonrefundable. This fee includes one subsequent review of the request if the request 
492.26 	is not acceptable upon the initial receipt.
492.27 	(d) The fee for reviewing and processing a request for the amendment of any vital 
492.28 	record when requested more than 45 days after the filing of the vital record is $40. No fee 
492.29 	shall be charged for an amendment requested within 45 days after the filing of the vital 
492.30 	record. The fee is payable at the time of application and is nonrefundable. This fee includes 
492.31 	one subsequent review of the request if the request is not acceptable upon the initial receipt.
492.32 	(e) The fee for reviewing and processing a request for the verification of information 
492.33 	from vital records is $9 when the applicant furnishes the specific information to locate 
492.34 	the vital record. When the applicant does not furnish specific information, the fee is 
493.1 	$20 per hour for staff time expended. Specific information includes the correct date of 
493.2 	the event and the correct name of the registrant subject of the record. Fees charged shall 
493.3 	approximate the costs incurred in searching and copying the vital records. The fee is 
493.4 	payable at the time of application and is nonrefundable.
493.5 	(f) The fee for reviewing and processing a request for the issuance of a copy of any 
493.6 	document on file pertaining to a vital record or statement that a related document cannot 
493.7 	be found is $9. The fee is payable at the time of application and is nonrefundable.
493.8 		Subd. 2.Fees to state government special revenue fund. Fees collected under 
493.9 	this section by the state registrar shall be deposited in the state treasury and credited to 
493.10 	the state government special revenue fund.
493.11 		Subd. 3.Birth record surcharge. (a) In addition to any fee prescribed under 
493.12 	subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or 
493.13 	stillbirth record and for a certification that the vital record cannot be found. The local or
493.14 	 state registrar or local issuance office shall forward this amount to the commissioner of 
493.15 	management and budget for deposit into the account for the children's trust fund for the 
493.16 	prevention of child abuse established under section 256E.22. This surcharge shall not be 
493.17 	charged under those circumstances in which no fee for a certified birth or stillbirth record 
493.18 	is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of 
493.19 	management and budget that the assets in that fund exceed $20,000,000, this surcharge 
493.20 	shall be discontinued.
493.21 	(b) In addition to any fee prescribed under subdivision 1, there shall be a 
493.22 	nonrefundable surcharge of $10 for each certified birth record. The local or state registrar 
493.23 	or local issuance office shall forward this amount to the commissioner of management and 
493.24 	budget for deposit in the general fund. This surcharge shall not be charged under those 
493.25 	circumstances in which no fee for a certified birth record is permitted under subdivision 1, 
493.26 	paragraph (a).
493.27 		Subd. 4.Vital records surcharge. (a) In addition to any fee prescribed under 
493.28 	subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and 
493.29 	noncertified birth, stillbirth, or death record, and for a certification that the record cannot 
493.30 	be found. The local issuance office or state registrar shall forward this amount to the 
493.31 	commissioner of management and budget to be deposited into the state government special 
493.32 	revenue fund. This surcharge shall not be charged under those circumstances in which no 
493.33 	fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
493.34 	(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.
493.35 		Subd. 5.Electronic verification. A fee for the electronic verification or electronic 
493.36 	certification of a vital event, when the information being verified or certified is obtained 
494.1 	from a certified birth or death record, shall be established through contractual or 
494.2 	interagency agreements with interested local, state, or federal government agencies.
494.3 		Subd. 6.Alternative payment methods. Notwithstanding subdivision 1, alternative 
494.4 	payment methods may be approved and implemented by the state registrar or a local 
494.5 	registrar issuance office.

494.6 	Sec. 28. [144.492] DEFINITIONS.
494.7 		Subdivision 1.Applicability. For the purposes of sections 144.492 to 144.494, the 
494.8 	terms defined in this section have the meanings given them.
494.9 		Subd. 2.Commissioner. "Commissioner" means the commissioner of health.
494.10 		Subd. 3.Joint commission. "Joint commission" means the independent, 
494.11 	not-for-profit organization that accredits and certifies health care organizations and 
494.12 	programs in the United States.
494.13 		Subd. 4.Stroke. "Stroke" means the sudden death of brain cells in a localized 
494.14 	area due to inadequate blood flow.

494.15 	Sec. 29. [144.493] CRITERIA.
494.16 		Subdivision 1.Comprehensive stroke center. A hospital meets the criteria for a 
494.17 	comprehensive stroke center if the hospital has been certified as a comprehensive stroke 
494.18 	center by the joint commission or another nationally recognized accreditation entity.
494.19 		Subd. 2.Primary stroke center. A hospital meets the criteria for a primary stroke 
494.20 	center if the hospital has been certified as a primary stroke center by the joint commission 
494.21 	or another nationally recognized accreditation entity.
494.22 		Subd. 3.Acute stroke ready hospital. A hospital meets the criteria for an acute 
494.23 	stroke ready hospital if the hospital has the following elements of an acute stroke ready 
494.24 	hospital:
494.25 	(1) an acute stroke team available or on-call 24 hours a days, seven days a week;
494.26 	(2) written stroke protocols, including triage, stabilization of vital functions, initial 
494.27 	diagnostic tests, and use of medications;
494.28 	(3) a written plan and letter of cooperation with emergency medical services regarding 
494.29 	triage and communication that are consistent with regional patient care procedures;
494.30 	(4) emergency department personnel who are trained in diagnosing and treating 
494.31 	acute stroke;
494.32 	(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest 
494.33 	x-rays 24 hours a day, seven days a week;
495.1 	(6) the capacity to perform and interpret brain injury imaging studies 24 hours a 
495.2 	days, seven days a week;
495.3 	(7) written protocols that detail available emergent therapies and reflect current 
495.4 	treatment guidelines, which include performance measures and are revised at least annually;
495.5 	(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
495.6 	(9) transfer protocols and agreements for stroke patients; and
495.7 	(10) a designated medical director with experience and expertise in acute stroke care.

495.8 	Sec. 30. [144.494] DESIGNATING STROKE HOSPITALS.
495.9 		Subdivision 1.Naming privileges. Unless it has been designated a stroke hospital 
495.10 	by the commissioner, the joint commission, or another nationally recognized accreditation 
495.11 	entity, no hospital shall use the term "stroke center" or "stroke hospital" in its name or its 
495.12 	advertising or shall otherwise indicate it has stroke treatment capabilities.
495.13 		Subd. 2.Designation. A hospital that voluntarily meets the criteria for a 
495.14 	comprehensive stroke center, primary stroke center, or acute stroke ready hospital may 
495.15 	apply to the commissioner for designation, and upon the commissioner's review and 
495.16 	approval of the application, shall be designated as a comprehensive stroke center, a 
495.17 	primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital 
495.18 	loses its certification as a comprehensive stroke center or primary stroke center from 
495.19 	the joint commission or other nationally recognized accreditation entity, its Minnesota 
495.20 	designation will be immediately withdrawn. Prior to the expiration of the three-year 
495.21 	designation, a hospital seeking to remain part of the voluntary acute stroke system may 
495.22 	reapply to the commissioner for designation.

495.23 	Sec. 31. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN 
495.24 	SUBMITTAL AND FEES.
495.25 	For hospitals, nursing homes, boarding care homes, residential hospices, supervised 
495.26 	living facilities, freestanding outpatient surgical centers, and end-stage renal disease 
495.27 	facilities, the commissioner shall collect a fee for the review and approval of architectural, 
495.28 	mechanical, and electrical plans and specifications submitted before construction begins 
495.29 	for each project relative to construction of new buildings, additions to existing buildings, 
495.30 	or for remodeling or alterations of existing buildings. All fees collected in this section 
495.31 	shall be deposited in the state treasury and credited to the state government special revenue 
495.32 	fund. Fees must be paid at the time of submission of final plans for review and are not 
495.33 	refundable. The fee is calculated as follows:

496.1	Construction project total estimated cost
	Fee
	
496.2	$0 - $10,000
	$30
	
496.3	$10,001 - $50,000
	$150
	
496.4	$50,001 - $100,000
	$300
	
496.5	$100,001 - $150,000
	$450
	
496.6	$150,001 - $200,000
	$600
	
496.7	$200,001 - $250,000
	$750
	
496.8	$250,001 - $300,000
	$900
	
496.9	$300,001 - $350,000
	$1,050
	
496.10	$350,001 - $400,000
	$1,200
	
496.11	$400,001 - $450,000
	$1,350
	
496.12	$450,001 - $500,000
	$1,500
	
496.13	$500,001 - $550,000
	$1,650
	
496.14	$550,001 - $600,000
	$1,800
	
496.15	$600,001 - $650,000
	$1,950
	
496.16	$650,001 - $700,000
	$2,100
	
496.17	$700,001 - $750,000
	$2,250
	
496.18	$750,001 - $800,000
	$2,400
	
496.19	$800,001 - $850,000
	$2,550
	
496.20	$850,001 - $900,000
	$2,700
	
496.21	$900,001 - $950,000
	$2,850
	
496.22	$950,001 - $1,000,000
	$3,000
	
496.23	$1,000,001 - $1,050,000
	$3,150
	
496.24	$1,050,001 - $1,100,000
	$3,300
	
496.25	$1,100,001 - $1,150,000
	$3,450
	
496.26	$1,150,001 - $1,200,000
	$3,600
	
496.27	$1,200,001 - $1,250,000
	$3,750
	
496.28	$1,250,001 - $1,300,000
	$3,900
	
496.29	$1,300,001 - $1,350,000
	$4,050
	
496.30	$1,350,001 - $1,400,000
	$4,200
	
496.31	$1,400,001 - $1,450,000
	$4,350
	
496.32	$1,450,001 - $1,500,000
	$4,500
	
496.33	$1,500,001 and over
	$4,800

496.34 	Sec. 32. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
496.35 		Subd. 2.Newborn Hearing Screening Advisory Committee. (a) The 
496.36 	commissioner of health shall establish a Newborn Hearing Screening Advisory Committee 
496.37 	to advise and assist the Department of Health and the Department of Education in:
496.38 	(1) developing protocols and timelines for screening, rescreening, and diagnostic 
496.39 	audiological assessment and early medical, audiological, and educational intervention 
496.40 	services for children who are deaf or hard-of-hearing;
497.1 	(2) designing protocols for tracking children from birth through age three that may 
497.2 	have passed newborn screening but are at risk for delayed or late onset of permanent 
497.3 	hearing loss;
497.4 	(3) designing a technical assistance program to support facilities implementing the 
497.5 	screening program and facilities conducting rescreening and diagnostic audiological 
497.6 	assessment;
497.7 	(4) designing implementation and evaluation of a system of follow-up and tracking; 
497.8 	and
497.9 	(5) evaluating program outcomes to increase effectiveness and efficiency and ensure 
497.10 	culturally appropriate services for children with a confirmed hearing loss and their families.
497.11 	(b) The commissioner of health shall appoint at least one member from each of the 
497.12 	following groups with no less than two of the members being deaf or hard-of-hearing:
497.13 	(1) a representative from a consumer organization representing culturally deaf 
497.14 	persons;
497.15 	(2) a parent with a child with hearing loss representing a parent organization;
497.16 	(3) a consumer from an organization representing oral communication options;
497.17 	(4) a consumer from an organization representing cued speech communication 
497.18 	options;
497.19 	(5) an audiologist who has experience in evaluation and intervention of infants 
497.20 	and young children;
497.21 	(6) a speech-language pathologist who has experience in evaluation and intervention 
497.22 	of infants and young children;
497.23 	(7) two primary care providers who have experience in the care of infants and young 
497.24 	children, one of which shall be a pediatrician;
497.25 	(8) a representative from the early hearing detection intervention teams;
497.26 	(9) a representative from the Department of Education resource center for the deaf 
497.27 	and hard-of-hearing or the representative's designee;
497.28 	(10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing 
497.29 	Minnesotans;
497.30 	(11) a representative from the Department of Human Services Deaf and 
497.31 	Hard-of-Hearing Services Division;
497.32 	(12) one or more of the Part C coordinators from the Department of Education, the 
497.33 	Department of Health, or the Department of Human Services or the department's designees;
497.34 	(13) the Department of Health early hearing detection and intervention coordinators;
497.35 	(14) two birth hospital representatives from one rural and one urban hospital;
497.36 	(15) a pediatric geneticist;
498.1 	(16) an otolaryngologist;
498.2 	(17) a representative from the Newborn Screening Advisory Committee under 
498.3 	this subdivision; and
498.4 	(18) a representative of the Department of Education regional low-incidence 
498.5 	facilitators.
498.6 	The commissioner must complete the appointments required under this subdivision by 
498.7 	September 1, 2007.
498.8 	(c) The Department of Health member shall chair the first meeting of the committee. 
498.9 	At the first meeting, the committee shall elect a chair from its membership. The committee 
498.10 	shall meet at the call of the chair, at least four times a year. The committee shall adopt 
498.11 	written bylaws to govern its activities. The Department of Health shall provide technical 
498.12 	and administrative support services as required by the committee. These services shall 
498.13 	include technical support from individuals qualified to administer infant hearing screening, 
498.14 	rescreening, and diagnostic audiological assessments.
498.15 	Members of the committee shall receive no compensation for their service, but 
498.16 	shall be reimbursed as provided in section 15.059 for expenses incurred as a result of 
498.17 	their duties as members of the committee.
498.18 	(d) This subdivision expires June 30, 2013 2019.

498.19 	Sec. 33. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:
498.20 		Subd. 3a.Support services to families. (a) The commissioner shall contract with a 
498.21 	nonprofit organization to provide support and assistance to families with children who are 
498.22 	deaf or have a hearing loss. The family support provided must include:
498.23 	(1) direct hearing loss specific parent-to-parent assistance and unbiased information 
498.24 	on communication, educational, and medical options; and
498.25 	(2) individualized deaf or hard-of-hearing mentors who provide education, including 
498.26 	instruction in American Sign Language as an available option. 
498.27 	The commissioner shall give preference to a nonprofit organization that has the ability to 
498.28 	provide these services throughout the state.
498.29 	(b) Family participation in the support and assistance services is voluntary.

498.30 	Sec. 34. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
498.31 		Subd. 3.Annual fees. (a) An application for accreditation under subdivision 6 must 
498.32 	be accompanied by the annual fees specified in this subdivision. The annual fees include:
498.33 	(1) base accreditation fee, $1,500 $600;
498.34 	(2) sample preparation techniques fee, $200 per technique;
499.1 	(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
499.2 	(4) test category fees.
499.3 	(b) For the programs in subdivision 3a, the commissioner may accredit laboratories 
499.4 	for fields of testing under the categories listed in clauses (1) to (10) upon completion of 
499.5 	the application requirements provided by subdivision 6 and receipt of the fees for each 
499.6 	category under each program that accreditation is requested. The categories offered and 
499.7 	related fees include:
499.8 	(1) microbiology, $450 $200;
499.9 	(2) inorganics, $450 $200;
499.10 	(3) metals, $1,000 $500;
499.11 	(4) volatile organics, $1,300 $1,000;
499.12 	(5) other organics, $1,300 $1,000;
499.13 	(6) radiochemistry, $1,500 $750;
499.14 	(7) emerging contaminants, $1,500 $1,000;
499.15 	(8) agricultural contaminants, $1,250 $1,000;
499.16 	(9) toxicity (bioassay), $1,000 $500; and
499.17 	(10) physical characterization, $250.
499.18 	(c) The total annual fee includes the base fee, the sample preparation techniques 
499.19 	fees, the test category fees per program, and, when applicable, an administrative fee for 
499.20 	out-of-state laboratories.

499.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

499.22 	Sec. 35. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
499.23 		Subd. 5.State government special revenue fund. Fees collected by the 
499.24 	commissioner under this section must be deposited in the state treasury and credited to 
499.25 	the state government special revenue fund.

499.26 	EFFECTIVE DATE. This section is effective the day following final enactment.

499.27 	Sec. 36. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision 
499.28 	to read:
499.29 		Subd. 10.Establishing a selection committee. (a) The commissioner shall 
499.30 	establish a selection committee for the purpose of recommending approval of qualified 
499.31 	laboratory assessors and assessment bodies. Committee members shall demonstrate 
499.32 	competence in assessment practices. The committee shall initially consist of seven 
499.33 	members appointed by the commissioner as follows:
500.1 	(1) one member from a municipal laboratory accredited by the commissioner;
500.2 	(2) one member from an industrial treatment laboratory accredited by the 
500.3 	commissioner;
500.4 	(3) one member from a commercial laboratory located in this state and accredited by 
500.5 	the commissioner;
500.6 	(4) one member from a commercial laboratory located outside the state and 
500.7 	accredited by the commissioner;
500.8 	(5) one member from a nongovernmental client of environmental laboratories;
500.9 	(6) one member from a professional organization with a demonstrated interest in 
500.10 	environmental laboratory data and accreditation; and
500.11 	(7) one employee of the laboratory accreditation program administered by the 
500.12 	department.
500.13 	(b) Committee appointments begin on January 1 and end on December 31 of the 
500.14 	same year.
500.15 	(c) The commissioner shall appoint persons to fill vacant committee positions, 
500.16 	expand the total number of appointed positions, or change the designated positions upon 
500.17 	the advice of the committee.
500.18 	(d) The commissioner shall rescind the appointment of a selection committee 
500.19 	member for sufficient cause as the commissioner determines, such as:
500.20 	(1) neglect of duty;
500.21 	(2) failure to notify the commissioner of a real or perceived conflict of interest;
500.22 	(3) nonconformance with committee procedures;
500.23 	(4) failure to demonstrate competence in assessment practices; or
500.24 	(5) official misconduct.
500.25 	(e) Members of the selection committee shall be compensated according to the 
500.26 	provisions in section 15.059, subdivision 3.

500.27 	Sec. 37. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision 
500.28 	to read:
500.29 		Subd. 11.Activities of the selection committee. (a) The selection committee 
500.30 	shall determine assessor and assessment body application requirements, the frequency 
500.31 	of application submittal, and the application review schedule. The commissioner shall 
500.32 	publish the application requirements and procedures on the accreditation program Web site.
500.33 	(b) In its selection process, the committee shall ensure its application requirements 
500.34 	and review process:
500.35 	(1) meet the standards implemented in subdivision 2a;
501.1 	(2) ensure assessors have demonstrated competence in technical disciplines offered 
501.2 	for accreditation by the commissioner; and
501.3 	(3) consider any history of repeated nonconformance or complaints regarding 
501.4 	assessors or assessment bodies.
501.5 	(c) The selection committee shall consider an application received from qualified 
501.6 	applicants and shall supply a list of recommended assessors and assessment bodies to 
501.7 	the commissioner of health no later than 90 days after the commissioner notifies the 
501.8 	committee of the need for review of applications.

501.9 	Sec. 38. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision 
501.10 	to read:
501.11 		Subd. 12.Commissioner approval of assessors and scheduling of assessments.
 501.12 	(a) The commissioner shall approve assessors who:
501.13 	(1) are employed by the commissioner for the purpose of accrediting laboratories 
501.14 	and demonstrate competence in assessment practices for environmental laboratories; or
501.15 	(2) are employed by a state or federal agency with established agreements for 
501.16 	mutual assistance or recognition with the commissioner and demonstrate competence in 
501.17 	assessment practices for environmental laboratories.
501.18 	(b) The commissioner may approve other assessors or assessment bodies who are 
501.19 	recommended by the selection committee according to subdivision 11, paragraph (c). The 
501.20 	commissioner shall publish the list of assessors and assessment bodies approved from the 
501.21 	recommendations.
501.22 	(c) The commissioner shall rescind approval for an assessor or assessment body for 
501.23 	sufficient cause as the commissioner determines, such as:
501.24 	(1) failure to meet the minimum qualifications for performing assessments;
501.25 	(2) lack of availability;
501.26 	(3) nonconformance with the applicable laws, rules, standards, policies, and 
501.27 	procedures;
501.28 	(4) misrepresentation of application information regarding qualifications and 
501.29 	training; or
501.30 	(5) excessive cost to perform the assessment activities.

501.31 	Sec. 39. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision 
501.32 	to read:
501.33 		Subd. 13.Laboratory requirements for assessor selection and scheduling 
501.34 	assessments. (a) A laboratory accredited or seeking accreditation that requires an 
502.1 	assessment by the commissioner must select an assessor, group of assessors, or an 
502.2 	assessment body from the published list specified in subdivision 12, paragraph (b). An 
502.3 	accredited laboratory must complete an assessment and make all corrective actions at least 
502.4 	once every 24 months. Unless the commissioner grants interim accreditation, a laboratory 
502.5 	seeking accreditation must complete an assessment and make all corrective actions 
502.6 	prior to, but no earlier than, 18 months prior to the date the application is submitted to 
502.7 	the commissioner.
502.8 	(b) A laboratory shall not select the same assessor more than twice in succession 
502.9 	for assessments of the same facility unless the laboratory receives written approval 
502.10 	from the commissioner for the selection. The laboratory must supply a written request 
502.11 	to the commissioner for approval and must justify the reason for the request and provide 
502.12 	the alternate options considered.
502.13 	(c) A laboratory must select assessors appropriate to the size and scope of the 
502.14 	laboratory's application or existing accreditation.
502.15 	(d) A laboratory must enter into its own contract for direct payment of the assessors 
502.16 	or assessment body. The contract must authorize the assessor, assessment body, or 
502.17 	subcontractors to release all records to the commissioner regarding the assessment activity, 
502.18 	when the assessment is performed in compliance with this statute.
502.19 	(e) A laboratory must agree to permit other assessors as selected by the commissioner 
502.20 	to participate in the assessment activities.
502.21 	(f) If the laboratory determines no approved assessor is available to perform 
502.22 	the assessment, the laboratory must notify the commissioner in writing and provide a 
502.23 	justification for the determination. If the commissioner confirms no approved assessor 
502.24 	is available, the commissioner may designate an alternate assessor from those approved 
502.25 	in subdivision 12, paragraph (a), or the commissioner may delay the assessment until 
502.26 	an assessor is available. If an approved alternate assessor performs the assessment, the 
502.27 	commissioner may collect fees equivalent to the cost of performing the assessment 
502.28 	activities.
502.29 	(g) Fees collected under this section are deposited in a special account and are 
502.30 	annually appropriated to the commissioner for the purpose of performing assessment 
502.31 	activities.

502.32 	EFFECTIVE DATE. This section is effective the day following final enactment.

502.33 	Sec. 40. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
502.34 		Subd. 4.Administrative penalty orders. (a) The commissioner may issue an 
502.35 	order requiring violations to be corrected and administratively assessing monetary 
503.1 	penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The 
503.2 	procedures in section 144.991 must be followed when issuing administrative penalty 
503.3 	orders. Except in the case of repeated or serious violations, the penalty assessed in the 
503.4 	order must be forgiven if the person who is subject to the order demonstrates in writing 
503.5 	to the commissioner before the 31st day after receiving the order that the person has 
503.6 	corrected the violation or has developed a corrective plan acceptable to the commissioner. 
503.7 	The maximum amount of an administrative penalty order is $10,000 for each violator for 
503.8 	all violations by that violator identified in an inspection or review of compliance.
503.9 	(b) Notwithstanding paragraph (a), the commissioner may issue to a large public 
503.10 	water supply, serving a population of more than 10,000 persons, an administrative penalty 
503.11 	order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000 
503.12 	for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
503.13 	(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead 
503.14 	firm or person performing regulated lead work, an administrative penalty order imposing a 
503.15 	penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of 
503.16 	sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from 
503.17 	monetary penalties in this section shall be deposited in the state treasury and credited to 
503.18 	the state government special revenue fund.

503.19 	Sec. 41. Minnesota Statutes 2012, section 145.906, is amended to read:
503.20 	145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
503.21 	(a) The commissioner of health shall work with health care facilities, licensed health 
503.22 	and mental health care professionals, the women, infants, and children (WIC) program, 
503.23 	mental health advocates, consumers, and families in the state to develop materials and 
503.24 	information about postpartum depression, including treatment resources, and develop 
503.25 	policies and procedures to comply with this section.
503.26 	(b) Physicians, traditional midwives, and other licensed health care professionals 
503.27 	providing prenatal care to women must have available to women and their families 
503.28 	information about postpartum depression.
503.29 	(c) Hospitals and other health care facilities in the state must provide departing new 
503.30 	mothers and fathers and other family members, as appropriate, with written information 
503.31 	about postpartum depression, including its symptoms, methods of coping with the illness, 
503.32 	and treatment resources.
503.33 	(d) Information about postpartum depression, including its symptoms, potential 
503.34 	impact on families, and treatment resources, must be available at WIC sites.
504.1 	(e) The commissioner of health, in collaboration with the commissioner of human 
504.2 	services and to the extent authorized by the federal Centers for Disease Control and 
504.3 	Prevention, shall review the materials and information related to postpartum depression to 
504.4 	determine their effectiveness in transmitting the information in a way that reduces racial 
504.5 	health disparities as reported in surveys of maternal attitudes and experiences before, 
504.6 	during, and after pregnancy, including those conducted by the commissioner of health. The 
504.7 	commissioner shall implement changes to reduce racial health disparities in the information 
504.8 	reviewed, as needed, and ensure that women of color are receiving the information.

504.9 	Sec. 42. [145.907] MATERNAL DEPRESSION; DEFINITION.
504.10 	"Maternal depression" means depression or other perinatal mood or anxiety disorder 
504.11 	experienced by a woman during pregnancy or during the first year following the birth of 
504.12 	her child.

504.13 	Sec. 43. Minnesota Statutes 2012, section 145.986, is amended to read:
504.14 	145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
504.15 		Subdivision 1.Grants to local communities Purpose. The purpose of the statewide 
504.16 	health improvement program is to:
504.17 	(1) address the top three leading preventable causes of illness and death: tobacco use 
504.18 	and exposure, poor diet, and lack of regular physical activity;
504.19 	(2) promote the development, availability, and use of evidence-based, community 
504.20 	level, comprehensive strategies to create healthy communities; and
504.21 	(3) measure the impact of the evidence-based, community health improvement 
504.22 	practices which over time work to contain health care costs and reduce chronic diseases.
504.23 		Subd. 1a.Grants to local communities. (a) Beginning July 1, 2009, the 
504.24 	commissioner of health shall award competitive grants to community health boards 
504.25 	established pursuant to section 145A.09 and tribal governments to convene, coordinate, 
504.26 	and implement evidence-based strategies targeted at reducing the percentage of 
504.27 	Minnesotans who are obese or overweight and to reduce the use of tobacco.
504.28 	(b) Grantee activities shall:
504.29 	(1) be based on scientific evidence;
504.30 	(2) be based on community input;
504.31 	(3) address behavior change at the individual, community, and systems levels;
504.32 	(4) occur in community, school, worksite, and health care settings; and
504.33 	(5) be focused on policy, systems, and environmental changes that support healthy 
504.34 	behaviors.; and
505.1 	(6) address the health disparities and inequities that exist in the grantee's community.
505.2 	(c) To receive a grant under this section, community health boards and tribal 
505.3 	governments must submit proposals to the commissioner. A local match of ten percent 
505.4 	of the total funding allocation is required. This local match may include funds donated 
505.5 	by community partners.
505.6 	(d) In order to receive a grant, community health boards and tribal governments 
505.7 	must submit a health improvement plan to the commissioner of health for approval. The 
505.8 	commissioner may require the plan to identify a community leadership team, community 
505.9 	partners, and a community action plan that includes an assessment of area strengths and 
505.10 	needs, proposed action strategies, technical assistance needs, and a staffing plan.
505.11 	(e) The grant recipient must implement the health improvement plan, evaluate the 
505.12 	effectiveness of the interventions strategies, and modify or discontinue interventions
505.13 	strategies found to be ineffective.
505.14 	(f) By January 15, 2011, the commissioner of health shall recommend whether any 
505.15 	funding should be distributed to community health boards and tribal governments based 
505.16 	on health disparities demonstrated in the populations served.
505.17 	(g) (f) Grant recipients shall report their activities and their progress toward the 
505.18 	outcomes established under subdivision 2 to the commissioner in a format and at a time 
505.19 	specified by the commissioner.
505.20 	(h) (g) All grant recipients shall be held accountable for making progress toward 
505.21 	the measurable outcomes established in subdivision 2. The commissioner shall require a 
505.22 	corrective action plan and may reduce the funding level of grant recipients that do not 
505.23 	make adequate progress toward the measurable outcomes.
505.24 	(h) Notwithstanding paragraph (a), the commissioner may award funding to 
505.25 	convene, coordinate, and implement evidence-based strategies targeted at reducing other 
505.26 	risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical 
505.27 	activity, that are associated with chronic disease and may impact public health. The 
505.28 	commissioner shall develop a criteria and procedures to allocate funding under this section.
505.29 		Subd. 2.Outcomes. (a) The commissioner shall set measurable outcomes to meet 
505.30 	the goals specified in subdivision 1, and annually review the progress of grant recipients 
505.31 	in meeting the outcomes.
505.32 	(b) The commissioner shall measure current public health status, using existing 
505.33 	measures and data collection systems when available, to determine baseline data against 
505.34 	which progress shall be monitored.
505.35 		Subd. 3.Technical assistance and oversight. (a) The commissioner shall provide 
505.36 	content expertise, technical expertise, and training to grant recipients and advice on 
506.1 	evidence-based strategies, including those based on populations and types of communities 
506.2 	served. The commissioner shall ensure that the statewide health improvement program 
506.3 	meets the outcomes established under subdivision 2 by conducting a comprehensive 
506.4 	statewide evaluation and assisting grant recipients to modify or discontinue interventions 
506.5 	found to be ineffective.
506.6 	(b) For the purposes of carrying out the grant program under this section, including 
506.7 	for administrative purposes, the commissioner shall award contracts to appropriate entities 
506.8 	to assist in training and provide technical assistance to grantees.
506.9 	(c) Contracts awarded under paragraph (b) may be used to provide technical 
506.10 	assistance and training in the areas of:
506.11 	(1) community engagement and capacity building;
506.12 	(2) tribal support;
506.13 	(3) community asset building and risk behavior reduction;
506.14 	(4) legal;
506.15 	(5) communications;
506.16 	(6) community, school, health care, work site, and other site-specific strategies; and
506.17 	(7) health equity.
506.18 		Subd. 4.Evaluation. (a) Using the outcome measures established in subdivision 3, 
506.19 	the commissioner shall conduct a biennial evaluation of the statewide health improvement 
506.20 	program funded under this section. Grant recipients shall cooperate with the commissioner 
506.21 	in the evaluation and provide the commissioner with the information necessary to conduct 
506.22 	the evaluation.
506.23 	(b) Grant recipients will collect, monitor, and submit to the Department of Health 
506.24 	baseline and annual data and provide information to improve the quality and impact of 
506.25 	community health improvement strategies.
506.26 	(c) For the purposes of carrying out the grant program under this section, including 
506.27 	for administrative purposes, the commissioner shall award contracts to appropriate entities 
506.28 	to assist in designing and implementing evaluation systems.
506.29 	(d) Contracts awarded under paragraph (c) may be used to:
506.30 	(1) develop grantee monitoring and reporting systems to track grantee progress, 
506.31 	including aggregated and disaggregated data;
506.32 	(2) manage, analyze, and report program evaluation data results; and
506.33 	(3) utilize innovative support tools to analyze and predict the impact of prevention 
506.34 	strategies on health outcomes and state health care costs over time.
506.35 		Subd. 5.Report. The commissioner shall submit a biennial report to the legislature 
506.36 	on the statewide health improvement program funded under this section. These reports 
507.1 	The report must include information on each grant recipients recipient, including the 
507.2 	activities that were conducted by the grantee using grant funds, evaluation data, and 
507.3 	outcome measures, if available.the grantee's progress toward achieving the measurable 
507.4 	outcomes established under subdivision 2, and the data provided to the commissioner by 
507.5 	the grantee to measure these outcomes for grant activities. The commissioner shall provide 
507.6 	information on grants in which a corrective action plan was required under subdivision 
507.7 	1a, the types of plan action, and the progress that has been made toward meeting the 
507.8 	measurable outcomes. In addition, the commissioner shall provide recommendations 
507.9 	on future areas of focus for health improvement. These reports are due by January 15 
507.10 	of every other year, beginning in 2010. In the report due on January 15, 2010, the 
507.11 	commissioner shall include recommendations on a sustainable funding source for the 
507.12 	statewide health improvement program other than the health care access fundIn the report 
507.13 	due on January 15, 2014, the commissioner shall include a description of the contracts 
507.14 	awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems 
507.15 	that were designed and implemented under these contracts. 
507.16 		Subd. 6.Supplantation of existing funds. Community health boards and tribal 
507.17 	governments must use funds received under this section to develop new programs, expand 
507.18 	current programs that work to reduce the percentage of Minnesotans who are obese or 
507.19 	overweight or who use tobacco, or replace discontinued state or federal funds previously 
507.20 	used to reduce the percentage of Minnesotans who are obese or overweight or who use 
507.21 	tobacco. Funds must not be used to supplant current state or local funding to community 
507.22 	health boards or tribal governments used to reduce the percentage of Minnesotans who are 
507.23 	obese or overweight or to reduce tobacco use.

507.24 	Sec. 44. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:
507.25 		Subdivision 1.Establishment; goals. The commissioner shall establish a program 
507.26 	to fund family home visiting programs designed to foster healthy beginnings, improve 
507.27 	pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 
507.28 	juvenile delinquency, promote positive parenting and resiliency in children, and promote 
507.29 	family health and economic self-sufficiency for children and families. The commissioner 
507.30 	shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 
507.31 	professionals and paraprofessionals from the fields of public health nursing, social work, 
507.32 	and early childhood education. A program funded under this section must serve families 
507.33 	at or below 200 percent of the federal poverty guidelines, and other families determined 
507.34 	to be at risk, including but not limited to being at risk for child abuse, child neglect, or 
508.1 	juvenile delinquency. Programs must begin prenatally whenever possible and must be 
508.2 	targeted to families with:
508.3 	(1) adolescent parents;
508.4 	(2) a history of alcohol or other drug abuse;
508.5 	(3) a history of child abuse, domestic abuse, or other types of violence;
508.6 	(4) a history of domestic abuse, rape, or other forms of victimization;
508.7 	(5) reduced cognitive functioning;
508.8 	(6) a lack of knowledge of child growth and development stages;
508.9 	(7) low resiliency to adversities and environmental stresses;
508.10 	(8) insufficient financial resources to meet family needs;
508.11 	(9) a history of homelessness;
508.12 	(10) a risk of long-term welfare dependence or family instability due to employment 
508.13 	barriers; or
508.14 	(11) a serious mental health disorder, including maternal depression as defined in 
508.15 	section 145.907; or
508.16 	(11) (12) other risk factors as determined by the commissioner.

508.17 	Sec. 45. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
508.18 		Subd. 1a.Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead 
508.19 	human body to essential elements through exposure to a combination of heat and alkaline 
508.20 	hydrolysis and the repositioning or movement of the body during the process to facilitate 
508.21 	reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and 
508.22 	pressure to accelerate natural decomposition; the processing of the hydrolyzed remains 
508.23 	after removal from the alkaline hydrolysis chamber, vessel; placement of the processed 
508.24 	remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an 
508.25 	appropriate party. Alkaline hydrolysis is a form of final disposition.

508.26 	Sec. 46. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
508.27 	subdivision to read:
508.28 		Subd. 1b.Alkaline hydrolysis container. "Alkaline hydrolysis container" means a 
508.29 	hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily 
508.30 	fluids that encases the body and into which a dead human body is placed prior to insertion 
508.31 	into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or 
508.32 	biodegradable alternative containers or caskets.

509.1 	Sec. 47. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
509.2 	subdivision to read:
509.3 		Subd. 1c.Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a 
509.4 	building or structure containing one or more alkaline hydrolysis vessels for the alkaline 
509.5 	hydrolysis of dead human bodies.

509.6 	Sec. 48. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
509.7 	subdivision to read:
509.8 		Subd. 1d.Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the 
509.9 	container in which the alkaline hydrolysis of a dead human body is performed.

509.10 	Sec. 49. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
509.11 		Subd. 2.Alternative container. "Alternative container" means a nonmetal 
509.12 	receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed 
509.13 	for the encasement of dead human bodies and is made of hydrolyzable or biodegradable 
509.14 	materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

509.15 	Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
509.16 		Subd. 3.Arrangements for disposition. "Arrangements for disposition" means 
509.17 	any action normally taken by a funeral provider in anticipation of or preparation for the 
509.18 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

509.19 	Sec. 51. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
509.20 		Subd. 4.Cash advance item. "Cash advance item" means any item of service 
509.21 	or merchandise described to a purchaser as a "cash advance," "accommodation," "cash 
509.22 	disbursement," or similar term. A cash advance item is also any item obtained from a 
509.23 	third party and paid for by the funeral provider on the purchaser's behalf. Cash advance 
509.24 	items include, but are not limited to, cemetery, alkaline hydrolysis,  or crematory services, 
509.25 	pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary 
509.26 	notices, gratuities, and death records.

509.27 	Sec. 52. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
509.28 		Subd. 5.Casket. "Casket" means a rigid container which is designed for the 
509.29 	encasement of a dead human body and is usually constructed of hydrolyzable or 
509.30 	biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented 
509.31 	and lined with fabric.

510.1 	Sec. 53. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
510.2 	subdivision to read:
510.3 		Subd. 12a.Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or 
510.4 	intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

510.5 	Sec. 54. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
510.6 	subdivision to read:
510.7 		Subd. 12b.Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a 
510.8 	final disposition of a dead human body by alkaline hydrolysis, without formal viewing, 
510.9 	visitation, or ceremony with the body present.

510.10 	Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
510.11 		Subd. 16.Final disposition. "Final disposition" means the acts leading to and the 
510.12 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

510.13 	Sec. 56. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
510.14 		Subd. 23.Funeral services. "Funeral services" means any services which may 
510.15 	be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis, 
510.16 	cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral 
510.17 	ceremony or the final disposition of dead human bodies.

510.18 	Sec. 57. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
510.19 	subdivision to read:
510.20 		Subd. 24a.Holding facility. "Holding facility" means a secure enclosed room or 
510.21 	confined area within a funeral establishment, crematory, or alkaline hydrolysis facility 
510.22 	used for temporary storage of human remains awaiting final disposition.

510.23 	Sec. 58. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
510.24 	subdivision to read:
510.25 		Subd. 24b.Hydrolyzed remains. "Hydrolyzed remains" means the remains of a 
510.26 	dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not 
510.27 	include pacemakers, prostheses, or similar foreign materials.

510.28 	Sec. 59. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
510.29 	subdivision to read:
511.1 		Subd. 24c.Hydrolyzed remains container. "Hydrolyzed remains container" means 
511.2 	a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a 
511.3 	hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage 
511.4 	jewelry.

511.5 	Sec. 60. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
511.6 	subdivision to read:
511.7 		Subd. 26a.Inurnment. "Inurnment" means placing hydrolyzed or cremated remains 
511.8 	in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

511.9 	Sec. 61. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
511.10 		Subd. 27.Licensee. "Licensee" means any person or entity that has been issued 
511.11 	a license to practice mortuary science, to operate a funeral establishment, to operate an 
511.12 	alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner 
511.13 	of health.

511.14 	Sec. 62. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
511.15 	subdivision to read:
511.16 		Subd. 30a.Niche. "Niche" means a space in a columbarium used, or intended to be 
511.17 	used, for the placement of hydrolyzed or cremated remains.

511.18 	Sec. 63. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
511.19 	subdivision to read:
511.20 		Subd. 32a.Placement. "Placement" means the placing of a container holding 
511.21 	hydrolyzed or cremated remains in a crypt, vault, or niche.

511.22 	Sec. 64. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
511.23 		Subd. 34.Preparation of the body. "Preparation of the body" means placement of 
511.24 	the body into an appropriate cremation or alkaline hydrolysis container, embalming of 
511.25 	the body or such items of care as washing, disinfecting, shaving, positioning of features, 
511.26 	restorative procedures, application of cosmetics, dressing, and casketing.

511.27 	Sec. 65. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
511.28 		Subd. 35.Processing. "Processing" means the removal of foreign objects, drying or 
511.29 	cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means 
512.1 	including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance 
512.2 	appropriate for final disposition.

512.3 	Sec. 66. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
512.4 		Subd. 37.Public transportation. "Public transportation" means all manner of 
512.5 	transportation via common carrier available to the general public including airlines, buses, 
512.6 	railroads, and ships. For purposes of this chapter, a livery service providing transportation 
512.7 	to private funeral establishments, alkaline hydrolysis facilities,  or crematories is not public 
512.8 	transportation.

512.9 	Sec. 67. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
512.10 	subdivision to read:
512.11 		Subd. 37c.Scattering. "Scattering" means the authorized dispersal of hydrolyzed 
512.12 	or cremated remains in a defined area of a dedicated cemetery or in areas where no local 
512.13 	prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable 
512.14 	to the public, are not in a container, and that the person who has control over disposition 
512.15 	of the hydrolyzed or cremated remains has obtained written permission of the property 
512.16 	owner or governing agency to scatter on the property.

512.17 	Sec. 68. Minnesota Statutes 2012, section 149A.02, is amended by adding a 
512.18 	subdivision to read:
512.19 		Subd. 41.Vault. "Vault" means a space in a mausoleum of sufficient size, used or 
512.20 	intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains. 
512.21 	Vault may also mean a sealed and lined casket enclosure.

512.22 	Sec. 69. Minnesota Statutes 2012, section 149A.03, is amended to read:
512.23 	149A.03 DUTIES OF COMMISSIONER.
512.24 	The commissioner shall:
512.25 	(1) enforce all laws and adopt and enforce rules relating to the:
512.26 	(i) removal, preparation, transportation, arrangements for disposition, and final 
512.27 	disposition of dead human bodies;
512.28 	(ii) licensure and professional conduct of funeral directors, morticians, interns, 
512.29 	practicum students, and clinical students;
512.30 	(iii) licensing and operation of a funeral establishment; and
512.31 	(iv) licensing and operation of an alkaline hydrolysis facility; and
512.32 	(iv)(v) licensing and operation of a crematory;
513.1 	(2) provide copies of the requirements for licensure and permits to all applicants;
513.2 	(3) administer examinations and issue licenses and permits to qualified persons 
513.3 	and other legal entities;
513.4 	(4) maintain a record of the name and location of all current licensees and interns;
513.5 	(5) perform periodic compliance reviews and premise inspections of licensees;
513.6 	(6) accept and investigate complaints relating to conduct governed by this chapter;
513.7 	(7) maintain a record of all current preneed arrangement trust accounts;
513.8 	(8) maintain a schedule of application, examination, permit, and licensure fees, 
513.9 	initial and renewal, sufficient to cover all necessary operating expenses;
513.10 	(9) educate the public about the existence and content of the laws and rules for 
513.11 	mortuary science licensing and the removal, preparation, transportation, arrangements 
513.12 	for disposition, and final disposition of dead human bodies to enable consumers to file 
513.13 	complaints against licensees and others who may have violated those laws or rules;
513.14 	(10) evaluate the laws, rules, and procedures regulating the practice of mortuary 
513.15 	science in order to refine the standards for licensing and to improve the regulatory and 
513.16 	enforcement methods used; and
513.17 	(11) initiate proceedings to address and remedy deficiencies and inconsistencies in 
513.18 	the laws, rules, or procedures governing the practice of mortuary science and the removal, 
513.19 	preparation, transportation, arrangements for disposition, and final disposition of dead 
513.20 	human bodies.

513.21 	Sec. 70. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS 
513.22 	FACILITY.
513.23 		Subdivision 1.License requirement. Except as provided in section 149A.01, 
513.24 	subdivision 3, a place or premise shall not be maintained, managed, or operated which 
513.25 	is devoted to or used in the holding and alkaline hydrolysis of a dead human body 
513.26 	without possessing a valid license to operate an alkaline hydrolysis facility issued by the 
513.27 	commissioner of health.
513.28 		Subd. 2.Requirements for an alkaline hydrolysis facility. (a) An alkaline 
513.29 	hydrolysis facility licensed under this section must consist of:
513.30 	(1) a building or structure that complies with applicable local and state building 
513.31 	codes, zoning laws and ordinances, wastewater management and environmental standards, 
513.32 	containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead 
513.33 	human bodies;
513.34 	(2) a method approved by the commissioner of health to dry the hydrolyzed remains 
513.35 	and which is located within the licensed facility;
514.1 	(3) a means approved by the commissioner of health for refrigeration of dead human 
514.2 	bodies awaiting alkaline hydrolysis;
514.3 	(4) an appropriate means of processing hydrolyzed remains to a granulated 
514.4 	appearance appropriate for final disposition; and
514.5 	(5) an appropriate holding facility for dead human bodies awaiting alkaline 
514.6 	hydrolysis.
514.7 	(b) An alkaline hydrolysis facility licensed under this section may also contain a 
514.8 	display room for funeral goods.
514.9 		Subd. 3.Application procedure; documentation; initial inspection. An 
514.10 	application to license and operate an alkaline hydrolysis facility shall be submitted to the 
514.11 	commissioner of health. A completed application includes:
514.12 	(1) a completed application form, as provided by the commissioner;
514.13 	(2) proof of business form and ownership;
514.14 	(3) proof of liability insurance coverage or other financial documentation, as 
514.15 	determined by the commissioner, that demonstrates the applicant's ability to respond in 
514.16 	damages for liability arising from the ownership, maintenance management, or operation 
514.17 	of an alkaline hydrolysis facility; and
514.18 	(4) copies of wastewater and other environmental regulatory permits and 
514.19 	environmental regulatory licenses necessary to conduct operations.
514.20 	Upon receipt of the application and appropriate fee, the commissioner shall review and 
514.21 	verify all information. Upon completion of the verification process and resolution of any 
514.22 	deficiencies in the application information, the commissioner shall conduct an initial 
514.23 	inspection of the premises to be licensed. After the inspection and resolution of any 
514.24 	deficiencies found and any reinspections as may be necessary, the commissioner shall 
514.25 	make a determination, based on all the information available, to grant or deny licensure. If 
514.26 	the commissioner's determination is to grant the license, the applicant shall be notified and 
514.27 	the license shall issue and remain valid for a period prescribed on the license, but not to 
514.28 	exceed one calendar year from the date of issuance of the license. If the commissioner's 
514.29 	determination is to deny the license, the commissioner must notify the applicant in writing 
514.30 	of the denial and provide the specific reason for denial.
514.31 		Subd. 4.Nontransferability of license. A license to operate an alkaline hydrolysis 
514.32 	facility is not assignable or transferable and shall not be valid for any entity other than the 
514.33 	one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the 
514.34 	location identified on the license. A 50 percent or more change in ownership or location of 
514.35 	the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall 
514.36 	be required of two or more persons or other legal entities operating from the same location.
515.1 		Subd. 5.Display of license. Each license to operate an alkaline hydrolysis 
515.2 	facility must be conspicuously displayed in the alkaline hydrolysis facility at all times. 
515.3 	Conspicuous display means in a location where a member of the general public within the 
515.4 	alkaline hydrolysis facility will be able to observe and read the license.
515.5 		Subd. 6.Period of licensure. All licenses to operate an alkaline hydrolysis facility 
515.6 	issued by the commissioner are valid for a period of one calendar year beginning on July 1 
515.7 	and ending on June 30, regardless of the date of issuance.
515.8 		Subd. 7.Reporting changes in license information. Any change of license 
515.9 	information must be reported to the commissioner, on forms provided by the 
515.10 	commissioner, no later than 30 calendar days after the change occurs. Failure to report 
515.11 	changes is grounds for disciplinary action.
515.12 		Subd. 8.Notification to the commissioner. If the licensee is operating under a 
515.13 	wastewater or an environmental permit or license that is subsequently revoked, denied, 
515.14 	or terminated, the licensee shall notify the commissioner.
515.15 		Subd. 9.Application information. All information submitted to the commissioner 
515.16 	for a license to operate an alkaline hydrolysis facility is classified as licensing data under 
515.17 	section 13.41, subdivision 5.

515.18 	Sec. 71. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE 
515.19 	HYDROLYSIS FACILITY.
515.20 		Subdivision 1.Renewal required. All licenses to operate an alkaline hydrolysis 
515.21 	facility issued by the commissioner expire on June 30 following the date of issuance of the 
515.22 	license and must be renewed to remain valid.
515.23 		Subd. 2.Renewal procedure and documentation. Licensees who wish to renew 
515.24 	their licenses must submit to the commissioner a completed renewal application no later 
515.25 	than June 30 following the date the license was issued. A completed renewal application 
515.26 	includes:
515.27 	(1) a completed renewal application form, as provided by the commissioner; and
515.28 	(2) proof of liability insurance coverage or other financial documentation, as 
515.29 	determined by the commissioner, that demonstrates the applicant's ability to respond in 
515.30 	damages for liability arising from the ownership, maintenance, management, or operation 
515.31 	of an alkaline hydrolysis facility.
515.32 	Upon receipt of the completed renewal application, the commissioner shall review and 
515.33 	verify the information. Upon completion of the verification process and resolution of 
515.34 	any deficiencies in the renewal application information, the commissioner shall make a 
515.35 	determination, based on all the information available, to reissue or refuse to reissue the 
516.1 	license. If the commissioner's determination is to reissue the license, the applicant shall 
516.2 	be notified and the license shall issue and remain valid for a period prescribed on the 
516.3 	license, but not to exceed one calendar year from the date of issuance of the license. If 
516.4 	the commissioner's determination is to refuse to reissue the license, section 149A.09, 
516.5 	subdivision 2, applies.
516.6 		Subd. 3.Penalty for late filing. Renewal applications received after the expiration 
516.7 	date of a license will result in the assessment of a late filing penalty. The late filing penalty 
516.8 	must be paid before the reissuance of the license and received by the commissioner no 
516.9 	later than 31 calendar days after the expiration date of the license.
516.10 		Subd. 4.Lapse of license. Licenses to operate alkaline hydrolysis facilities 
516.11 	shall automatically lapse when a completed renewal application is not received by the 
516.12 	commissioner within 31 calendar days after the expiration date of a license, or a late 
516.13 	filing penalty assessed under subdivision 3 is not received by the commissioner within 31 
516.14 	calendar days after the expiration of a license.
516.15 		Subd. 5.Effect of lapse of license. Upon the lapse of a license, the person to whom 
516.16 	the license was issued is no longer licensed to operate an alkaline hydrolysis facility in 
516.17 	Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed 
516.18 	license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue 
516.19 	any additional lawful remedies as justified by the case.
516.20 		Subd. 6.Restoration of lapsed license. The commissioner may restore a lapsed 
516.21 	license upon receipt and review of a completed renewal application, receipt of the late 
516.22 	filing penalty, and reinspection of the premises, provided that the receipt is made within 
516.23 	one calendar year from the expiration date of the lapsed license and the cease and desist 
516.24 	order issued by the commissioner has not been violated. If a lapsed license is not restored 
516.25 	within one calendar year from the expiration date of the lapsed license, the holder of the 
516.26 	lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
516.27 		Subd. 7.Reporting changes in license information. Any change of license 
516.28 	information must be reported to the commissioner, on forms provided by the 
516.29 	commissioner, no later than 30 calendar days after the change occurs. Failure to report 
516.30 	changes is grounds for disciplinary action.
516.31 		Subd. 8.Application information. All information submitted to the commissioner 
516.32 	by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is 
516.33 	classified as licensing data under section 13.41, subdivision 5.

516.34 	Sec. 72. Minnesota Statutes 2012, section 149A.65, is amended by adding a 
516.35 	subdivision to read:
517.1 		Subd. 6.Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline 
517.2 	hydrolysis facility is $300. The late fee charge for a license renewal is $25.

517.3 	Sec. 73. Minnesota Statutes 2012, section 149A.65, is amended by adding a 
517.4 	subdivision to read:
517.5 		Subd. 7.State government special revenue fund. Fees collected by the 
517.6 	commissioner under this section must be deposited in the state treasury and credited to 
517.7 	the state government special revenue fund.

517.8 	Sec. 74. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
517.9 		Subdivision 1.Use of titles. Only a person holding a valid license to practice 
517.10 	mortuary science issued by the commissioner may use the title of mortician, funeral 
517.11 	director, or any other title implying that the licensee is engaged in the business or practice 
517.12 	of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis 
517.13 	facility issued by the commissioner may use the title of alkaline hydrolysis facility, water 
517.14 	cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or 
517.15 	any other title, word, or term implying that the licensee operates an alkaline hydrolysis 
517.16 	facility. Only the holder of a valid license to operate a funeral establishment issued by the 
517.17 	commissioner may use the title of funeral home, funeral chapel, funeral service, or any 
517.18 	other title, word, or term implying that the licensee is engaged in the business or practice 
517.19 	of mortuary science. Only the holder of a valid license to operate a crematory issued by 
517.20 	the commissioner may use the title of crematory, crematorium, green-cremation, or any 
517.21 	other title, word, or term implying that the licensee operates a crematory or crematorium.

517.22 	Sec. 75. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
517.23 		Subd. 2.Business location. A funeral establishment, alkaline hydrolysis facility,  or 
517.24 	crematory shall not do business in a location that is not licensed as a funeral establishment, 
517.25 	alkaline hydrolysis facility,  or crematory and shall not advertise a service that is available 
517.26 	from an unlicensed location.

517.27 	Sec. 76. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
517.28 		Subd. 3.Advertising. No licensee, clinical student, practicum student, or intern 
517.29 	shall publish or disseminate false, misleading, or deceptive advertising. False, misleading, 
517.30 	or deceptive advertising includes, but is not limited to:
518.1 	(1) identifying, by using the names or pictures of, persons who are not licensed to 
518.2 	practice mortuary science in a way that leads the public to believe that those persons will 
518.3 	provide mortuary science services;
518.4 	(2) using any name other than the names under which the funeral establishment, 
518.5 	alkaline hydrolysis facility,  or crematory is known to or licensed by the commissioner;
518.6 	(3) using a surname not directly, actively, or presently associated with a licensed 
518.7 	funeral establishment, alkaline hydrolysis facility,  or crematory, unless the surname had 
518.8 	been previously and continuously used by the licensed funeral establishment, alkaline 
518.9 	hydrolysis facility,  or crematory; and
518.10 	(4) using a founding or establishing date or total years of service not directly or 
518.11 	continuously related to a name under which the funeral establishment, alkaline hydrolysis 
518.12 	facility,  or crematory is currently or was previously licensed.
518.13 	Any advertising or other printed material that contains the names or pictures of 
518.14 	persons affiliated with a funeral establishment, alkaline hydrolysis facility,  or crematory 
518.15 	shall state the position held by the persons and shall identify each person who is licensed 
518.16 	or unlicensed under this chapter.

518.17 	Sec. 77. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
518.18 		Subd. 5.Reimbursement prohibited. No licensee, clinical student, practicum 
518.19 	student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other 
518.20 	reimbursement in consideration for recommending or causing a dead human body to 
518.21 	be disposed of by a specific body donation program, funeral establishment, alkaline 
518.22 	hydrolysis facility, crematory, mausoleum, or cemetery.

518.23 	Sec. 78. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
518.24 		Subd. 2.Preventive requirements. (a) To prevent unfair or deceptive acts or 
518.25 	practices, the requirements of this subdivision must be met.
518.26 	(b) Funeral providers must tell persons who ask by telephone about the funeral 
518.27 	provider's offerings or prices any accurate information from the price lists described in 
518.28 	paragraphs (c) to (e) and any other readily available information that reasonably answers 
518.29 	the questions asked.
518.30 	(c) Funeral providers must make available for viewing to people who inquire in 
518.31 	person about the offerings or prices of funeral goods or burial site goods, separate printed 
518.32 	or typewritten price lists using a ten-point font or larger. Each funeral provider must have a 
518.33 	separate price list for each of the following types of goods that are sold or offered for sale:
518.34 	(1) caskets;
519.1 	(2) alternative containers;
519.2 	(3) outer burial containers;
519.3 	(4) alkaline hydrolysis containers;
519.4 	(4) (5) cremation containers;
519.5 	(6) hydrolyzed remains containers;
519.6 	(5)(7) cremated remains containers;
519.7 	(6)(8) markers; and
519.8 	(7)(9) headstones.
519.9 	(d) Each separate price list must contain the name of the funeral provider's place 
519.10 	of business, address, and telephone number and a caption describing the list as a price 
519.11 	list for one of the types of funeral goods or burial site goods described in paragraph (c), 
519.12 	clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion 
519.13 	of, but in any event before showing, the specific funeral goods or burial site goods and 
519.14 	must provide a photocopy of the price list, for retention, if so asked by the consumer. The 
519.15 	list must contain, at least, the retail prices of all the specific funeral goods and burial site 
519.16 	goods offered which do not require special ordering, enough information to identify each, 
519.17 	and the effective date for the price list. However, funeral providers are not required to 
519.18 	make a specific price list available if the funeral providers place the information required 
519.19 	by this paragraph on the general price list described in paragraph (e).
519.20 	(e) Funeral providers must give a printed price list, for retention, to persons who 
519.21 	inquire in person about the funeral goods, funeral services, burial site goods, or burial site 
519.22 	services or prices offered by the funeral provider. The funeral provider must give the list 
519.23 	upon beginning discussion of either the prices of or the overall type of funeral service or 
519.24 	disposition or specific funeral goods, funeral services, burial site goods, or burial site 
519.25 	services offered by the provider. This requirement applies whether the discussion takes 
519.26 	place in the funeral establishment or elsewhere. However, when the deceased is removed 
519.27 	for transportation to the funeral establishment, an in-person request for authorization to 
519.28 	embalm does not, by itself, trigger the requirement to offer the general price list. If the 
519.29 	provider, in making an in-person request for authorization to embalm, discloses that 
519.30 	embalming is not required by law except in certain special cases, the provider is not 
519.31 	required to offer the general price list. Any other discussion during that time about prices 
519.32 	or the selection of funeral goods, funeral services, burial site goods, or burial site services 
519.33 	triggers the requirement to give the consumer a general price list. The general price list 
519.34 	must contain the following information:
519.35 	(1) the name, address, and telephone number of the funeral provider's place of 
519.36 	business;
520.1 	(2) a caption describing the list as a "general price list";
520.2 	(3) the effective date for the price list;
520.3 	(4) the retail prices, in any order, expressed either as a flat fee or as the prices per 
520.4 	hour, mile, or other unit of computation, and other information described as follows:
520.5 	(i) forwarding of remains to another funeral establishment, together with a list of 
520.6 	the services provided for any quoted price;
520.7 	(ii) receiving remains from another funeral establishment, together with a list of 
520.8 	the services provided for any quoted price;
520.9 	(iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral 
520.10 	provider, with the price including an alternative container or alkaline hydrolysis or 
520.11 	cremation container, any alkaline hydrolysis or crematory charges, and a description of the 
520.12 	services and container included in the price, where applicable, and the price of alkaline 
520.13 	hydrolysis or cremation where the purchaser provides the container;
520.14 	(iv) separate prices for each immediate burial offered by the funeral provider, 
520.15 	including a casket or alternative container, and a description of the services and container 
520.16 	included in that price, and the price of immediate burial where the purchaser provides the 
520.17 	casket or alternative container;
520.18 	(v) transfer of remains to the funeral establishment or other location;
520.19 	(vi) embalming;
520.20 	(vii) other preparation of the body;
520.21 	(viii) use of facilities, equipment, or staff for viewing;
520.22 	(ix) use of facilities, equipment, or staff for funeral ceremony;
520.23 	(x) use of facilities, equipment, or staff for memorial service;
520.24 	(xi) use of equipment or staff for graveside service;
520.25 	(xii) hearse or funeral coach;
520.26 	(xiii) limousine; and
520.27 	(xiv) separate prices for all cemetery-specific goods and services, including all goods 
520.28 	and services associated with interment and burial site goods and services and excluding 
520.29 	markers and headstones;
520.30 	(5) the price range for the caskets offered by the funeral provider, together with the 
520.31 	statement "A complete price list will be provided at the funeral establishment or casket 
520.32 	sale location." or the prices of individual caskets, as disclosed in the manner described 
520.33 	in paragraphs (c) and (d);
520.34 	(6) the price range for the alternative containers offered by the funeral provider, 
520.35 	together with the statement "A complete price list will be provided at the funeral 
521.1 	establishment or alternative container sale location." or the prices of individual alternative 
521.2 	containers, as disclosed in the manner described in paragraphs (c) and (d);
521.3 	(7) the price range for the outer burial containers offered by the funeral provider, 
521.4 	together with the statement "A complete price list will be provided at the funeral 
521.5 	establishment or outer burial container sale location." or the prices of individual outer 
521.6 	burial containers, as disclosed in the manner described in paragraphs (c) and (d);
521.7 	(8) the price range for the alkaline hydrolysis container offered by the funeral 
521.8 	provider, together with the statement: "A complete price list will be provided at the funeral 
521.9 	establishment or alkaline hydrolysis container sale location.", or the prices of individual 
521.10 	alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) 
521.11 	and (d);
521.12 	(9) the price range for the hydrolyzed remains container offered by the funeral 
521.13 	provider, together with the statement: "A complete price list will be provided at the 
521.14 	funeral establishment or hydrolyzed remains container sale location.", or the prices 
521.15 	of individual hydrolyzed remains container, as disclosed in the manner described in 
521.16 	paragraphs (c) and (d);
521.17 	(8)(10) the price range for the cremation containers offered by the funeral provider, 
521.18 	together with the statement "A complete price list will be provided at the funeral 
521.19 	establishment or cremation container sale location." or the prices of individual cremation 
521.20 	containers and cremated remains containers, as disclosed in the manner described in 
521.21 	paragraphs (c) and (d);
521.22 	(9)(11) the price range for the cremated remains containers offered by the funeral 
521.23 	provider, together with the statement, "A complete price list will be provided at the funeral 
521.24 	establishment or cremation cremated remains container sale location," or the prices of 
521.25 	individual cremation containers as disclosed in the manner described in paragraphs (c) 
521.26 	and (d);
521.27 	(10)(12) the price for the basic services of funeral provider and staff, together with a 
521.28 	list of the principal basic services provided for any quoted price and, if the charge cannot 
521.29 	be declined by the purchaser, the statement "This fee for our basic services will be added 
521.30 	to the total cost of the funeral arrangements you select. (This fee is already included in 
521.31 	our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding 
521.32 	or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted 
521.33 	price shall include all charges for the recovery of unallocated funeral provider overhead, 
521.34 	and funeral providers may include in the required disclosure the phrase "and overhead" 
521.35 	after the word "services." This services fee is the only funeral provider fee for services, 
522.1 	facilities, or unallocated overhead permitted by this subdivision to be nondeclinable, 
522.2 	unless otherwise required by law;
522.3 	(11)(13) the price range for the markers and headstones offered by the funeral 
522.4 	provider, together with the statement "A complete price list will be provided at the funeral 
522.5 	establishment or marker or headstone sale location." or the prices of individual markers 
522.6 	and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
522.7 	(12)(14) any package priced funerals offered must be listed in addition to and 
522.8 	following the information required in this paragraph (e) and must clearly state the funeral 
522.9 	goods and services being offered, the price being charged for those goods and services, 
522.10 	and the discounted savings.
522.11 	(f) Funeral providers must give an itemized written statement, for retention, to each 
522.12 	consumer who arranges an at-need funeral or other disposition of human remains at the 
522.13 	conclusion of the discussion of the arrangements. The itemized written statement must be 
522.14 	signed by the consumer selecting the goods and services as required in section 149A.80. 
522.15 	If the statement is provided by a funeral establishment, the statement must be signed by 
522.16 	the licensed funeral director or mortician planning the arrangements. If the statement is 
522.17 	provided by any other funeral provider, the statement must be signed by an authorized 
522.18 	agent of the funeral provider. The statement must list the funeral goods, funeral services, 
522.19 	burial site goods, or burial site services selected by that consumer and the prices to be paid 
522.20 	for each item, specifically itemized cash advance items (these prices must be given to the 
522.21 	extent then known or reasonably ascertainable if the prices are not known or reasonably 
522.22 	ascertainable, a good faith estimate shall be given and a written statement of the actual 
522.23 	charges shall be provided before the final bill is paid), and the total cost of goods and 
522.24 	services selected. At the conclusion of an at-need arrangement, the funeral provider is 
522.25 	required to give the consumer a copy of the signed itemized written contract that must 
522.26 	contain the information required in this paragraph.
522.27 	(g) Upon receiving actual notice of the death of an individual with whom a funeral 
522.28 	provider has entered a preneed funeral agreement, the funeral provider must provide 
522.29 	a copy of all preneed funeral agreement documents to the person who controls final 
522.30 	disposition of the human remains or to the designee of the person controlling disposition. 
522.31 	The person controlling final disposition shall be provided with these documents at the time 
522.32 	of the person's first in-person contact with the funeral provider, if the first contact occurs 
522.33 	in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place 
522.34 	of business of the funeral provider. If the contact occurs by other means or at another 
522.35 	location, the documents must be provided within 24 hours of the first contact.

523.1 	Sec. 79. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
523.2 		Subd. 4.Casket, alternate container, alkaline hydrolysis containers, and 
523.3 	cremation container sales; records; required disclosures. Any funeral provider who 
523.4 	sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed 
523.5 	remains container, or cremation container, or cremated remains container to the public 
523.6 	must maintain a record of each sale that includes the name of the purchaser, the purchaser's 
523.7 	mailing address, the name of the decedent, the date of the decedent's death, and the place 
523.8 	of death. These records shall be open to inspection by the regulatory agency. Any funeral 
523.9 	provider selling a casket, alternate container, or cremation container to the public, and not 
523.10 	having charge of the final disposition of the dead human body, shall provide a copy of the 
523.11 	statutes and rules controlling the removal, preparation, transportation, arrangements for 
523.12 	disposition, and final disposition of a dead human body. This subdivision does not apply to 
523.13 	morticians, funeral directors, funeral establishments, crematories, or wholesale distributors 
523.14 	of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.

523.15 	Sec. 80. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
523.16 		Subd. 3.Casket for alkaline hydrolysis or cremation provisions; deceptive acts 
523.17 	or practices. In selling or offering to sell funeral goods or funeral services to the public, it 
523.18 	is a deceptive act or practice for a funeral provider to represent that a casket is required for 
523.19 	alkaline hydrolysis or cremations by state or local law or otherwise.

523.20 	Sec. 81. Minnesota Statutes 2012, section 149A.72, is amended by adding a 
523.21 	subdivision to read:
523.22 		Subd. 3a.Casket for alkaline hydrolysis provision; preventive measures. To 
523.23 	prevent deceptive acts or practices, funeral providers must place the following disclosure 
523.24 	in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota 
523.25 	law does not require you to purchase a casket for alkaline hydrolysis. If you want to 
523.26 	arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline 
523.27 	hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant 
523.28 	to leakage of bodily fluids that encases the body and into which a dead human body is 
523.29 	placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide 
523.30 	are (specify containers provided)." This disclosure is required only if the funeral provider 
523.31 	arranges alkaline hydrolysis.

523.32 	Sec. 82. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
524.1 		Subd. 9.Deceptive acts or practices. In selling or offering to sell funeral goods, 
524.2 	funeral services, burial site goods, or burial site services to the public, it is a deceptive act 
524.3 	or practice for a funeral provider to represent that federal, state, or local laws, or particular 
524.4 	cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral 
524.5 	goods, funeral services, burial site goods, or burial site services when that is not the case.

524.6 	Sec. 83. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
524.7 		Subdivision 1.Casket for alkaline hydrolysis or cremation provisions; deceptive 
524.8 	acts or practices. In selling or offering to sell funeral goods, funeral services, burial site 
524.9 	goods, or burial site services to the public, it is a deceptive act or practice for a funeral 
524.10 	provider to require that a casket be purchased for alkaline hydrolysis or cremation.

524.11 	Sec. 84. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
524.12 		Subd. 2.Casket for alkaline hydrolysis or cremation; preventive requirements.
 524.13 	To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline 
524.14 	hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation 
524.15 	container available for alkaline hydrolysis or cremations.

524.16 	Sec. 85. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
524.17 		Subd. 4.Required purchases of funeral goods or services; preventive 
524.18 	requirements. To prevent unfair or deceptive acts or practices, funeral providers must 
524.19 	place the following disclosure in the general price list, immediately above the prices 
524.20 	required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods 
524.21 	and services shown below are those we can provide to our customers. You may choose 
524.22 	only the items you desire. If legal or other requirements mean that you must buy any items 
524.23 	you did not specifically ask for, we will explain the reason in writing on the statement we 
524.24 	provide describing the funeral goods, funeral services, burial site goods, and burial site 
524.25 	services you selected." However, if the charge for "services of funeral director and staff" 
524.26 	cannot be declined by the purchaser, the statement shall include the sentence "However, 
524.27 	any funeral arrangements you select will include a charge for our basic services." between 
524.28 	the second and third sentences of the sentences specified in this subdivision. The statement 
524.29 	may include the phrase "and overhead" after the word "services" if the fee includes a 
524.30 	charge for the recovery of unallocated funeral overhead. If the funeral provider does 
524.31 	not include this disclosure statement, then the following disclosure statement must be 
524.32 	placed in the statement of funeral goods, funeral services, burial site goods, and burial site 
524.33 	services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges 
525.1 	are only for those items that you selected or that are required. If we are required by law or 
525.2 	by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain 
525.3 	the reasons in writing below." A funeral provider is not in violation of this subdivision by 
525.4 	failing to comply with a request for a combination of goods or services which would be 
525.5 	impossible, impractical, or excessively burdensome to provide.

525.6 	Sec. 86. Minnesota Statutes 2012, section 149A.74, is amended to read:
525.7 	149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
525.8 		Subdivision 1.Services provided without prior approval; deceptive acts or 
525.9 	practices. In selling or offering to sell funeral goods or funeral services to the public, it 
525.10 	is a deceptive act or practice for any funeral provider to embalm a dead human body 
525.11 	unless state or local law or regulation requires embalming in the particular circumstances 
525.12 	regardless of any funeral choice which might be made, or prior approval for embalming 
525.13 	has been obtained from an individual legally authorized to make such a decision. In 
525.14 	seeking approval to embalm, the funeral provider must disclose that embalming is not 
525.15 	required by law except in certain circumstances; that a fee will be charged if a funeral 
525.16 	is selected which requires embalming, such as a funeral with viewing; and that no 
525.17 	embalming fee will be charged if the family selects a service which does not require 
525.18 	embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
525.19 		Subd. 2.Services provided without prior approval; preventive requirement.
 525.20 	To prevent unfair or deceptive acts or practices, funeral providers must include on 
525.21 	the itemized statement of funeral goods or services, as described in section 149A.71, 
525.22 	subdivision 2, paragraph (f), the statement "If you selected a funeral that may require 
525.23 	embalming, such as a funeral with viewing, you may have to pay for embalming. You do 
525.24 	not have to pay for embalming you did not approve if you selected arrangements such 
525.25 	as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for 
525.26 	embalming, we will explain why below."

525.27 	Sec. 87. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
525.28 		Subd. 9.Embalmed Bodies awaiting final disposition. All embalmed bodies 
525.29 	awaiting final disposition shall be kept in an appropriate holding facility or preparation 
525.30 	and embalming room. The holding facility must be secure from access by anyone except 
525.31 	the authorized personnel of the funeral establishment, preserve the dignity and integrity of 
525.32 	the body, and protect the health and safety of the personnel of the funeral establishment.

525.33 	Sec. 88. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
526.1 		Subd. 3.Disposition permit. A disposition permit is required before a body can 
526.2 	be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be 
526.3 	issued until a fact of death record has been completed and filed with the local or state 
526.4 	registrar of vital statistics.

526.5 	Sec. 89. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
526.6 		Subd. 6.Conveyances permitted for transportation. A dead human body may be 
526.7 	transported by means of private vehicle or private aircraft, provided that the body must be 
526.8 	encased in an appropriate container, that meets the following standards:
526.9 	(1) promotes respect for and preserves the dignity of the dead human body;
526.10 	(2) shields the body from being viewed from outside of the conveyance;
526.11 	(3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket, 
526.12 	alternative container, alkaline hydrolysis container, or cremation container in a horizontal 
526.13 	position;
526.14 	(4) is designed to permit loading and unloading of the body without excessive tilting 
526.15 	of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
526.16 	 or cremation container; and
526.17 	(5) if used for the transportation of more than one dead human body at one time, 
526.18 	the vehicle must be designed so that a body or container does not rest directly on top of 
526.19 	another body or container and that each body or container is secured to prevent the body 
526.20 	or container from excessive movement within the conveyance.
526.21 	A vehicle that is a dignified conveyance and was specified for use by the deceased 
526.22 	or by the family of the deceased may be used to transport the body to the place of final 
526.23 	disposition.

526.24 	Sec. 90. Minnesota Statutes 2012, section 149A.94, is amended to read:
526.25 	149A.94 FINAL DISPOSITION.
526.26 		Subdivision 1.Generally. Every dead human body lying within the state, except 
526.27 	unclaimed bodies delivered for dissection by the medical examiner, those delivered for 
526.28 	anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through 
526.29 	the state for the purpose of disposition elsewhere; and the remains of any dead human 
526.30 	body after dissection or anatomical study, shall be decently buried, or entombed in a 
526.31 	public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time 
526.32 	after death. Where final disposition of a body will not be accomplished within 72 hours 
526.33 	following death or release of the body by a competent authority with jurisdiction over the 
526.34 	body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body 
527.1 	may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry 
527.2 	ice for a period that exceeds four calendar days, from the time of death or release of the 
527.3 	body from the coroner or medical examiner.
527.4 		Subd. 3.Permit required. No dead human body shall be buried, entombed, or 
527.5 	cremated without a disposition permit. The disposition permit must be filed with the person 
527.6 	in charge of the place of final disposition. Where a dead human body will be transported out 
527.7 	of this state for final disposition, the body must be accompanied by a certificate of removal.
527.8 		Subd. 4.Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or 
527.9 	cremated remains and release to an appropriate party is considered final disposition and no 
527.10 	further permits or authorizations are required for transportation, interment, entombment, or 
527.11 	placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

527.12 	Sec. 91. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE 
527.13 	HYDROLYSIS.
527.14 		Subdivision 1.License required. A dead human body may only be hydrolyzed in 
527.15 	this state at an alkaline hydrolysis facility licensed by the commissioner of health.
527.16 		Subd. 2.General requirements. Any building to be used as an alkaline hydrolysis 
527.17 	facility must comply with all applicable local and state building codes, zoning laws and 
527.18 	ordinances, wastewater management regulations, and environmental statutes, rules, and 
527.19 	standards. An alkaline hydrolysis facility must have, on site, a purpose built human 
527.20 	alkaline hydrolysis system approved by the commissioner of health, a system approved by 
527.21 	the commissioner of health for drying the hydrolyzed remains, a motorized mechanical 
527.22 	device approved by the commissioner of health for processing hydrolyzed remains and 
527.23 	must have in the building a holding facility approved by the commissioner of health for 
527.24 	the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility 
527.25 	must be secure from access by anyone except the authorized personnel of the alkaline 
527.26 	hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of 
527.27 	the alkaline hydrolysis facility personnel.
527.28 		Subd. 3.Lighting and ventilation. The room where the alkaline hydrolysis vessel 
527.29 	is located and the room where the chemical storage takes place shall be properly lit and 
527.30 	ventilated with an exhaust fan that provides at least 12 air changes per hour.
527.31 		Subd. 4.Plumbing connections. All plumbing fixtures, water supply lines, 
527.32 	plumbing vents, and waste drains shall be properly vented and connected pursuant to the 
527.33 	Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a 
527.34 	functional sink with hot and cold running water.
528.1 		Subd. 5.Flooring, walls, ceiling, doors, and windows. The room where the 
528.2 	alkaline hydrolysis vessel is located and the room where the chemical storage takes place 
528.3 	shall have nonporous flooring, so that a sanitary condition is provided. The walls and 
528.4 	ceiling of the room where the alkaline hydrolysis vessel is located and the room where 
528.5 	the chemical storage takes place shall run from floor to ceiling and be covered with tile, 
528.6 	or by plaster or sheetrock painted with washable paint or other appropriate material so 
528.7 	that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be 
528.8 	constructed to prevent odors from entering any other part of the building. All windows 
528.9 	or other openings to the outside must be screened and all windows must be treated in a 
528.10 	manner that prevents viewing into the room where the alkaline hydrolysis vessel is located 
528.11 	and the room where the chemical storage takes place. A viewing window for authorized 
528.12 	family members or their designees is not a violation of this subdivision.
528.13 		Subd. 6.Equipment and supplies. The alkaline hydrolysis facility must have a 
528.14 	functional emergency eye wash and quick drench shower.
528.15 		Subd. 7.Access and privacy. (a) The room where the alkaline hydrolysis vessel is 
528.16 	located and the room where the chemical storage takes place must be private and have no 
528.17 	general passageway through it. The room shall, at all times, be secure from the entrance of 
528.18 	unauthorized persons. Authorized persons are:
528.19 	(1) licensed morticians;
528.20 	(2) registered interns or students as described in section 149A.91, subdivision 6;
528.21 	(3) public officials or representatives in the discharge of their official duties; 
528.22 	(4) trained alkaline hydrolysis facility operators; and
528.23 	(5) the persons with the right to control the dead human body as defined in section 
528.24 	149A.80, subdivision 2, and their designees.
528.25 	(b) Each door allowing ingress or egress shall carry a sign that indicates that the 
528.26 	room is private and access is limited. All authorized persons who are present in or enter 
528.27 	the room where the alkaline hydrolysis vessel is located while a body is being prepared for 
528.28 	final disposition must be attired according to all applicable state and federal regulations 
528.29 	regarding the control of infectious disease and occupational and workplace health and 
528.30 	safety.
528.31 		Subd. 8.Sanitary conditions and permitted use. The room where the alkaline 
528.32 	hydrolysis vessel is located and the room where the chemical storage takes place and all 
528.33 	fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies 
528.34 	stored or used in the room must be maintained in a clean and sanitary condition at all times.
529.1 		Subd. 9.Boiler use. When a boiler is required by the manufacturer of the alkaline 
529.2 	hydrolysis vessel for its operation, all state and local regulations for that boiler must be 
529.3 	followed.
529.4 		Subd. 10.Occupational and workplace safety. All applicable provisions of state 
529.5 	and federal regulations regarding exposure to workplace hazards and accidents shall be 
529.6 	followed in order to protect the health and safety of all authorized persons at the alkaline 
529.7 	hydrolysis facility.
529.8 		Subd. 11.Licensed personnel. A licensed alkaline hydrolysis facility must employ 
529.9 	a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body. 
529.10 	It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for 
529.11 	all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for 
529.12 	compliance with this chapter and other applicable state and federal regulations regarding 
529.13 	occupational and workplace health and safety.
529.14 		Subd. 12.Authorization to hydrolyze required. No alkaline hydrolysis facility 
529.15 	shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part 
529.16 	without receiving written authorization to do so from the person or persons who have the 
529.17 	legal right to control disposition as described in section 149A.80 or the person's legal 
529.18 	designee. The written authorization must include:
529.19 	(1) the name of the deceased and the date of death of the deceased;
529.20 	(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
529.21 	(3) the name, address, telephone number, relationship to the deceased, and signature 
529.22 	of the person or persons with legal right to control final disposition or a legal designee;
529.23 	(4) directions for the disposition of any nonhydrolyzed materials or items recovered 
529.24 	from the alkaline hydrolysis vessel;
529.25 	(5) acknowledgment that the hydrolyzed remains will be dried and mechanically 
529.26 	reduced to a granulated appearance and placed in an appropriate container and 
529.27 	authorization to place any hydrolyzed remains that a selected urn or container will not 
529.28 	accommodate into a temporary container;
529.29 	(6) acknowledgment that, even with the exercise of reasonable care, it is not possible 
529.30 	to recover all particles of the hydrolyzed remains and that some particles may inadvertently 
529.31 	become commingled with particles of other hydrolyzed remains that remain in the alkaline 
529.32 	hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
529.33 	(7) directions for the ultimate disposition of the hydrolyzed remains; and
529.34 	(8) a statement that includes, but is not limited to, the following information: 
529.35 	"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an 
529.36 	alkaline solution is used to chemically break down the human tissue and the hydrolyzable 
530.1 	alkaline hydrolysis container. After the process is complete, the liquid effluent solution 
530.2 	contains the chemical by-products of the alkaline hydrolysis process except for the 
530.3 	deceased's bone fragments. The solution is cooled and released according to local 
530.4 	environmental regulations. A water rinse is applied to the hydrolyzed remains which are 
530.5 	then dried and processed to facilitate inurnment or scattering."
530.6 		Subd. 13.Limitation of liability. A licensed alkaline hydrolysis facility acting in 
530.7 	good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an 
530.8 	authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from 
530.9 	civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis 
530.10 	facility.
530.11 		Subd. 14.Acceptance of delivery of body. (a) No dead human body shall be 
530.12 	accepted for final disposition by alkaline hydrolysis unless:
530.13 	(1) encased in an appropriate alkaline hydrolysis container;
530.14 	(2) accompanied by a disposition permit issued pursuant to section 149A.93, 
530.15 	subdivision 3, including a photocopy of the completed death record or a signed release 
530.16 	authorizing alkaline hydrolysis of the body received from the coroner or medical 
530.17 	examiner; and
530.18 	(3) accompanied by an alkaline hydrolysis authorization that complies with 
530.19 	subdivision 12.
530.20 	(b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline 
530.21 	hydrolysis container where there is:
530.22 	(1) evidence of leakage of fluids from the alkaline hydrolysis container;
530.23 	(2) a known dispute concerning hydrolysis of the body delivered;
530.24 	(3) a reasonable basis for questioning any of the representations made on the written 
530.25 	authorization to hydrolyze; or
530.26 	(4) any other lawful reason.
530.27 		Subd. 15.Bodies awaiting hydrolysis. A dead human body must be hydrolyzed 
530.28 	within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of 
530.29 	the body.
530.30 		Subd. 16.Handling of alkaline hydrolysis containers for dead human bodies.
 530.31 	All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for 
530.32 	dead human bodies shall use universal precautions and otherwise exercise all reasonable 
530.33 	precautions to minimize the risk of transmitting any communicable disease from the body. 
530.34 	No dead human body shall be removed from the container in which it is delivered.
530.35 		Subd. 17.Identification of body. All licensed alkaline hydrolysis facilities shall 
530.36 	develop, implement, and maintain an identification procedure whereby dead human 
531.1 	bodes can be identified from the time the alkaline hydrolysis facility accepts delivery 
531.2 	of the remains until the hydrolyzed remains are released to an authorized party. After 
531.3 	hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the 
531.4 	hydrolyzed remains container before the hydrolyzed remains are released from the alkaline 
531.5 	hydrolysis facility. Each identification disk, tab, or label shall have a number that shall 
531.6 	be recorded on all paperwork regarding the decedent. This procedure shall be designed 
531.7 	to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains 
531.8 	are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the 
531.9 	inability to individually identify the hydrolyzed remains is a violation of this subdivision.
531.10 		Subd. 18.Alkaline hydrolysis vessel for human remains. A licensed alkaline 
531.11 	hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains 
531.12 	in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for 
531.13 	infectious disease control.
531.14 		Subd. 19.Alkaline hydrolysis procedures; privacy. The final disposition of 
531.15 	dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is 
531.16 	written authorization from the person with the legal right to control the disposition, 
531.17 	only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline 
531.18 	hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting 
531.19 	alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline 
531.20 	hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
531.21 		Subd. 20.Alkaline hydrolysis procedures; commingling of hydrolyzed remains 
531.22 	prohibited. Except with the express written permission of the person with the legal right 
531.23 	to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one 
531.24 	dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce 
531.25 	a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have 
531.26 	been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze 
531.27 	a dead human body and other human remains at the same time and in the same alkaline 
531.28 	hydrolysis vessel. This section does not apply where commingling of human remains 
531.29 	during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental 
531.30 	and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is 
531.31 	not a violation of this subdivision.
531.32 		Subd. 21.Alkaline hydrolysis procedures; removal from alkaline hydrolysis 
531.33 	vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be 
531.34 	made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed 
531.35 	remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be 
531.36 	made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed 
532.1 	human remains and dispose of these materials in a lawful manner, by the alkaline 
532.2 	hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate 
532.3 	container to be transported to the processing area.
532.4 		Subd. 22.Drying device or mechanical processor procedures; commingling of 
532.5 	hydrolyzed remains prohibited. Except with the express written permission of the 
532.6 	person with the legal right to control the final disposition or otherwise provided by 
532.7 	law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed 
532.8 	human remains of more than one body at a time in the same drying device or mechanical 
532.9 	processor, or introduce the hydrolyzed human remains of a second body into a drying 
532.10 	device or mechanical processor until processing of any preceding hydrolyzed human 
532.11 	remains has been terminated and reasonable efforts have been employed to remove all 
532.12 	fragments of the preceding hydrolyzed remains. The fact that there is incidental and 
532.13 	unavoidable residue in the drying device, the mechanical processor, or any container used 
532.14 	in a prior alkaline hydrolysis process, is not a violation of this provision.
532.15 		Subd. 23.Alkaline hydrolysis procedures; processing hydrolyzed remains. The 
532.16 	hydrolyzed human remains shall be dried and then reduced by a motorized mechanical 
532.17 	device to a granulated appearance appropriate for final disposition and placed in an 
532.18 	alkaline hydrolysis remains container along with the appropriate identifying disk, tab, 
532.19 	or permanent label. Processing must take place within the licensed alkaline hydrolysis 
532.20 	facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they 
532.21 	can be identified, may be removed prior to processing the hydrolyzed remains, only by 
532.22 	staff licensed or registered by the commissioner of health; however, any dental gold and 
532.23 	silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains 
532.24 	container unless otherwise directed by the person or persons having the right to control the 
532.25 	final disposition. Every person who removes or possesses dental gold or silver, jewelry, 
532.26 	or mementos from any hydrolyzed remains without specific written permission of the 
532.27 	person or persons having the right to control those remains is guilty of a misdemeanor. 
532.28 	The fact that residue and any unavoidable dental gold or dental silver, or other precious 
532.29 	metals remain in the alkaline hydrolysis vessel or other equipment or any container used 
532.30 	in a prior hydrolysis is not a violation of this section.
532.31 		Subd. 24.Alkaline hydrolysis procedures; container of insufficient capacity.
 532.32 	If a hydrolyzed remains container is of insufficient capacity to accommodate all 
532.33 	hydrolyzed remains of a given dead human body, subject to directives provided in the 
532.34 	written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess 
532.35 	hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the 
532.36 	second container, in a manner so as not to be easily detached through incidental contact, to 
533.1 	the primary alkaline hydrolysis remains container. The secondary container shall contain a 
533.2 	duplicate of the identification disk, tab, or permanent label that was placed in the primary 
533.3 	container and all paperwork regarding the given body shall include a notation that the 
533.4 	hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature 
533.5 	hydrolyzed remains containers are not subject to the requirements of this subdivision.
533.6 		Subd. 25.Disposition procedures; commingling of hydrolyzed remains 
533.7 	prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in 
533.8 	a location where the hydrolyzed remains are commingled with those of another person 
533.9 	without the express written permission of the person with the legal right to control 
533.10 	disposition or as otherwise provided by law. This subdivision does not apply to the 
533.11 	scattering or burial of hydrolyzed remains at sea or in a body of water from individual 
533.12 	containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to 
533.13 	the disposal in a dedicated cemetery of accumulated residue removed from an alkaline 
533.14 	hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members 
533.15 	of the same family in a common container designed for the hydrolyzed remains of more 
533.16 	than one body, or to the inurnment in a container or interment in a space that has been 
533.17 	previously designated, at the time of sale or purchase, as being intended for the inurnment 
533.18 	or interment of the hydrolyzed remains of more than one person.
533.19 		Subd. 26.Alkaline hydrolysis procedures; disposition of accumulated residue.
 533.20 	Every alkaline hydrolysis facility shall provide for the removal and disposition in a 
533.21 	dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel, 
533.22 	drying device, mechanical processor, container, or other equipment used in alkaline 
533.23 	hydrolysis. Disposition of accumulated residue shall be according to the regulations of the 
533.24 	dedicated cemetery and any applicable local ordinances.
533.25 		Subd. 27.Alkaline hydrolysis procedures; release of hydrolyzed remains.
 533.26 	Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be 
533.27 	released according to the instructions given on the written authorization to hydrolyze. If 
533.28 	the hydrolyzed remains are to be shipped, they must be securely packaged and transported 
533.29 	by a method which has an internal tracing system available and which provides for a 
533.30 	receipt signed by the person accepting delivery. Where there is a dispute over release 
533.31 	or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit 
533.32 	the hydrolyzed remains with a court of competent jurisdiction pending resolution of the 
533.33 	dispute or retain the hydrolyzed remains until the person with the legal right to control 
533.34 	disposition presents satisfactory indication that the dispute is resolved.
533.35 		Subd. 28.Unclaimed hydrolyzed remains. If, after 30 calendar days following 
533.36 	the inurnment, the hydrolyzed remains are not claimed or disposed of according to the 
534.1 	written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment 
534.2 	may give written notice, by certified mail, to the person with the legal right to control 
534.3 	the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and 
534.4 	requesting further release directions. Should the hydrolyzed remains be unclaimed 120 
534.5 	calendar days following the mailing of the written notification, the alkaline hydrolysis 
534.6 	facility or funeral establishment may dispose of the hydrolyzed remains in any lawful 
534.7 	manner deemed appropriate.
534.8 		Subd. 29.Required records. Every alkaline hydrolysis facility shall create and 
534.9 	maintain on its premises or other business location in Minnesota an accurate record of 
534.10 	every hydrolyzation provided. The record shall include all of the following information 
534.11 	for each hydrolyzation:
534.12 	(1) the name of the person or funeral establishment delivering the body for alkaline 
534.13 	hydrolysis;
534.14 	(2) the name of the deceased and the identification number assigned to the body;
534.15 	(3) the date of acceptance of delivery;
534.16 	(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical 
534.17 	processor operator;
534.18 	(5) the time and date that the body was placed in and removed from the alkaline 
534.19 	hydrolysis vessel;
534.20 	(6) the time and date that processing and inurnment of the hydrolyzed remains 
534.21 	was completed;
534.22 	(7) the time, date, and manner of release of the hydrolyzed remains;
534.23 	(8) the name and address of the person who signed the authorization to hydrolyze;
534.24 	(9) all supporting documentation, including any transit or disposition permits, a 
534.25 	photocopy of the death record, and the authorization to hydrolyze; and
534.26 	(10) the type of alkaline hydrolysis container.
534.27 		Subd. 30.Retention of records. Records required under subdivision 29 shall be 
534.28 	maintained for a period of three calendar years after the release of the hydrolyzed remains. 
534.29 	Following this period and subject to any other laws requiring retention of records, the 
534.30 	alkaline hydrolysis facility may then place the records in storage or reduce them to 
534.31 	microfilm, microfiche, laser disc, or any other method that can produce an accurate 
534.32 	reproduction of the original record, for retention for a period of ten calendar years from 
534.33 	the date of release of the hydrolyzed remains. At the end of this period and subject to any 
534.34 	other laws requiring retention of records, the alkaline hydrolysis facility may destroy 
534.35 	the records by shredding, incineration, or any other manner that protects the privacy of 
534.36 	the individuals identified.

535.1 	Sec. 92. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
535.2 		Subd. 9.Hydrolyzed and cremated remains. Subject to section 149A.95, 
535.3 	subdivision 16, inurnment of the hydrolyzed or cremated remains and release to an 
535.4 	appropriate party is considered final disposition and no further permits or authorizations 
535.5 	are required for disinterment, transportation, or placement of the hydrolyzed or cremated 
535.6 	remains.

535.7 	Sec. 93. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:
535.8 		Subd. 7.Hospital and Department of Health; recognition form. Hospitals that 
535.9 	provide obstetric services and the state registrar of vital statistics shall distribute the 
535.10 	educational materials and recognition of parentage forms prepared by the commissioner of 
535.11 	human services to new parents, shall assist parents in understanding the recognition of 
535.12 	parentage form, including following the provisions for notice under subdivision 5, shall 
535.13 	provide notary services for parents who complete the recognition of parentage form, and 
535.14 	shall timely file the completed recognition of parentage form with the Office of the State 
535.15 	Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State 
535.16 	Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not 
535.17 	distribute the declaration of parentage forms.

535.18 	Sec. 94. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:
535.19 		Subdivision 1.Legal effect. (a) Upon adoption, the adopted child becomes the legal 
535.20 	child of the adopting parent and the adopting parent becomes the legal parent of the child 
535.21 	with all the rights and duties between them of a birth parent and child.
535.22 	(b) The child shall inherit from the adoptive parent and the adoptive parent's 
535.23 	relatives the same as though the child were the birth child of the parent, and in case of the 
535.24 	child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit 
535.25 	the child's estate as if the child had been the adoptive parent's birth child.
535.26 	(c) After a decree of adoption is entered, the birth parents or previous legal parents 
535.27 	of the child shall be relieved of all parental responsibilities for the child except child 
535.28 	support that has accrued to the date of the order for guardianship to the commissioner 
535.29 	which continues to be due and owing. The child's birth or previous legal parent shall not 
535.30 	exercise or have any rights over the adopted child or the adopted child's property, person, 
535.31 	privacy, or reputation.
535.32 	(d) The adopted child shall not owe the birth parents or the birth parent's relatives 
535.33 	any legal duty nor shall the adopted child inherit from the birth parents or kindred unless 
535.34 	otherwise provided for in a will of the birth parent or kindred.
536.1 	(e) Upon adoption, the court shall complete a certificate of adoption form and mail 
536.2 	the form to the Office of the State Registrar Vital Records at the Minnesota Department 
536.3 	of Health. Upon receiving the certificate of adoption, the state registrar shall register a 
536.4 	replacement vital record in the new name of the adopted child as required under section 
536.5 	144.218.

536.6 	Sec. 95. Minnesota Statutes 2012, section 517.001, is amended to read:
536.7 	517.001 DEFINITION.
536.8 	As used in this chapter, "local registrar" has the meaning given in section 144.212, 
536.9 	subdivision 10 means an individual designated by the county board of commissioners to 
536.10 	register marriages.

536.11 	Sec. 96. FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.
 536.12 	The commissioner of health shall review the statutory requirements for preparation 
536.13 	and embalming rooms and develop legislation with input from stakeholders that provides 
536.14 	appropriate health and safety protection for funeral home locations where deceased bodies 
536.15 	are present, but are branch locations associated through a majority ownership of a licensed 
536.16 	funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50 
536.17 	and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance 
536.18 	between the main location and branch, and other health and safety issues.

536.19 	Sec. 97. REVISOR'S INSTRUCTION.
 536.20 	The revisor shall substitute the term "vertical heat exchangers" or "vertical 
536.21 	heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat 
536.22 	exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions 
536.23 	2 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208, 
536.24 	subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

536.25 	Sec. 98.  REPEALER.
 536.26 	(a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025; 
536.27 	149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, 
536.28 	subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; 
536.29 	149A.53, subdivision 9; and 485.14, are repealed.
536.30 	(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective 
536.31 	July 1, 2014.

537.1 	ARTICLE 13
537.2 	PAYMENT METHODOLOGIES FOR HOME AND 
537.3 	COMMUNITY-BASED SERVICES

537.4 	Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to 
537.5 	read:
537.6 		Subd. 2.Payment methodologies. (a) The commissioner shall establish, as defined 
537.7 	under section 256B.4914, statewide payment methodologies that meet federal waiver 
537.8 	requirements for home and community-based waiver services for individuals with 
537.9 	disabilities. The payment methodologies must abide by the principles of transparency 
537.10 	and equitability across the state. The methodologies must involve a uniform process of 
537.11 	structuring rates for each service and must promote quality and participant choice.
537.12 	(b) As of January 1, 2012, counties shall not implement changes to established 
537.13 	processes for rate-setting methodologies for individuals using components of or data 
537.14 	from research rates.

537.15 	Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
537.16 		Subd. 3.Payment requirements. The payment methodologies established under 
537.17 	this section shall accommodate:
537.18 	(1) supervision costs;
537.19 	(2) staffing patterns staff compensation;
537.20 	(3) staffing and supervisory patterns;
537.21 	(3) (4) program-related expenses;
537.22 	(4) (5) general and administrative expenses; and
537.23 	(5) (6) consideration of recipient intensity.

537.24 	Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended by adding a 
537.25 	subdivision to read:
537.26 		Subd. 4a.Rate stabilization adjustment. (a) The commissioner of human services 
537.27 	shall adjust individual reimbursement rates by no more than 1.0 percent per year effective 
537.28 	January 1, 2016. Rates determined under section 256B.4914 must be adjusted so that 
537.29 	the unit rate varies no more than 1.0 percent per year from the rate effective December 
537.30 	1 of the prior calendar year. This adjustment is made annually for three calendar years 
537.31 	from the date of implementation.
537.32 	(b) Rate stabilization adjustment applies to services that are authorized in a 
537.33 	recipient's service plan prior to January 1, 2016.
538.1 	(c) Exemptions shall be made only when there is a significant change in the 
538.2 	recipient's assessed needs that results in a service authorization change. Exemption 
538.3 	adjustments shall be limited to the difference in the authorized framework rate specific to 
538.4 	change in assessed need. Exemptions shall be managed within lead agencies' budgets per 
538.5 	existing allocation procedures.
538.6 	(d) This subdivision expires January 1, 2019.

538.7 	Sec. 4. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:
538.8 		Subd. 5.Stakeholder consultation. The commissioner shall continue consultation 
538.9 	on regular intervals with the existing stakeholder group established as part of the 
538.10 	rate-setting methodology process and others, to gather input, concerns, and data, and 
538.11 	exchange ideas for the legislative proposals for to assist in the full implementation of
538.12 	 the new rate payment system and to make pertinent information available to the public 
538.13 	through the department's Web site.

538.14 	Sec. 5. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:
538.15 		Subd. 6.Implementation. (a) The commissioner may shall implement changes 
538.16 	no sooner than on January 1, 2014, to payment rates for individuals receiving home and 
538.17 	community-based waivered services after the enactment of legislation that establishes 
538.18 	specific payment methodology frameworks, processes for rate calculations, and specific 
538.19 	values to populate the payment methodology frameworks disability waiver rates system.
538.20 	(b) On January 1, 2014, all new service authorizations must use the disability waiver 
538.21 	rates system. Beginning January 1, 2014, all renewing individual service plans must use the 
538.22 	disability waiver rates system as reassessment and reauthorization occurs. By December 
538.23 	31, 2014, data for all recipients must be entered into the disability waiver rates system.

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

552.25 	Sec. 7.  REPEALER.
 552.26 	Minnesota Statutes 2012, section 256B.4913, subdivisions 1, 2, 3, and 4, is repealed.

552.27 	ARTICLE 14
552.28 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

552.29	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
552.30 	The sums shown in the columns marked "Appropriations" are appropriated to the 
552.31 	agencies and for the purposes specified in this article. The appropriations are from the 
552.32 	general fund, or another named fund, and are available for the fiscal years indicated 
552.33 	for each purpose. The figures "2014" and "2015" used in this article mean that the 
552.34 	appropriations listed under them are available for the fiscal year ending June 30, 2014, or 
553.1 	June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal 
553.2 	year 2015. "The biennium" is fiscal years 2014 and 2015.

553.3				APPROPRIATIONS
	
553.4				Available for the Year
	
553.5				Ending June 30
	
553.6					2014
		2015

553.7
553.8	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

553.9	Subdivision 1.Total Appropriation
 	$
	 6,411,182,000
	$
	 6,392,303,000

553.10	Appropriations by Fund
	
553.11		2014
	2015
	
553.12	General
	 5,807,515,000
	 5,831,770,000
	
553.13
553.14	State Government 
Special Revenue
	3,815,000
	4,915,000
	
553.15	Health Care Access
	 340,047,000
	 298,915,000
	
553.16	Federal TANF
	257,915,000
	254,813,000
	
553.17	Lottery Prize Fund
	1,890,000
	1,890,000
	
553.18 	Receipts for Systems Projects. 
553.19 	Appropriations and federal receipts for 
553.20 	information systems projects for MAXIS, 
553.21 	PRISM, MMIS, and SSIS must be deposited 
553.22 	in the state system account authorized 
553.23 	in Minnesota Statutes, section 256.014. 
553.24 	Money appropriated for computer projects 
553.25 	approved by the commissioner of Minnesota 
553.26 	information technology services, funded 
553.27 	by the legislature, and approved by the 
553.28 	commissioner of management and budget, 
553.29 	may be transferred from one project to 
553.30 	another and from development to operations 
553.31 	as the commissioner of human services 
553.32 	considers necessary. Any unexpended 
553.33 	balance in the appropriation for these 
553.34 	projects does not cancel but is available for 
553.35 	ongoing development and operations.
553.36 	Nonfederal Share Transfers. The 
553.37 	nonfederal share of activities for which 
554.1 	federal administrative reimbursement is 
554.2 	appropriated to the commissioner may be 
554.3 	transferred to the special revenue fund.
554.4 	ARRA Supplemental Nutrition Assistance 
554.5 	Benefit Increases. The funds provided for 
554.6 	food support benefit increases under the 
554.7 	Supplemental Nutrition Assistance Program 
554.8 	provisions of the American Recovery and 
554.9 	Reinvestment Act (ARRA) of 2009 must be 
554.10 	used for benefit increases beginning July 1, 
554.11 	2009.
554.12 	Supplemental Nutrition Assistance 
554.13 	Program Employment and Training. 
554.14 	(1) Notwithstanding Minnesota Statutes, 
554.15 	sections 256D.051, subdivisions 1a, 6b, 
554.16 	and 6c, and 256J.626, federal Supplemental 
554.17 	Nutrition Assistance employment and 
554.18 	training funds received as reimbursement of 
554.19 	MFIP consolidated fund grant expenditures 
554.20 	for diversionary work program participants 
554.21 	and child care assistance program 
554.22 	expenditures must be deposited in the general 
554.23 	fund. The amount of funds must be limited to 
554.24 	$4,900,000 per year in fiscal years 2014 and 
554.25 	2015, and to $4,400,000 per year in fiscal 
554.26 	years 2016 and 2017, contingent on approval 
554.27 	by the federal Food and Nutrition Service.
554.28 	(2) Consistent with the receipt of the federal 
554.29 	funds, the commissioner may adjust the 
554.30 	level of working family credit expenditures 
554.31 	claimed as TANF maintenance of effort. 
554.32 	Notwithstanding any contrary provision in 
554.33 	this article, this rider expires June 30, 2017.
554.34 	TANF Maintenance of Effort. (a) In order 
554.35 	to meet the basic maintenance of effort 
555.1 	(MOE) requirements of the TANF block grant 
555.2 	specified under Code of Federal Regulations, 
555.3 	title 45, section 263.1, the commissioner may 
555.4 	only report nonfederal money expended for 
555.5 	allowable activities listed in the following 
555.6 	clauses as TANF/MOE expenditures:
555.7 	(1) MFIP cash, diversionary work program, 
555.8 	and food assistance benefits under Minnesota 
555.9 	Statutes, chapter 256J;
555.10 	(2) the child care assistance programs 
555.11 	under Minnesota Statutes, sections 119B.03 
555.12 	and 119B.05, and county child care 
555.13 	administrative costs under Minnesota 
555.14 	Statutes, section 119B.15;
555.15 	(3) state and county MFIP administrative 
555.16 	costs under Minnesota Statutes, chapters 
555.17 	256J and 256K;
555.18 	(4) state, county, and tribal MFIP 
555.19 	employment services under Minnesota 
555.20 	Statutes, chapters 256J and 256K;
555.21 	(5) expenditures made on behalf of legal 
555.22 	noncitizen MFIP recipients who qualify for 
555.23 	the MinnesotaCare program under Minnesota 
555.24 	Statutes, chapter 256L;
555.25 	(6) qualifying working family credit 
555.26 	expenditures under Minnesota Statutes, 
555.27 	section 290.0671;
555.28 	(7) qualifying Minnesota education credit 
555.29 	expenditures under Minnesota Statutes, 
555.30 	section 290.0674; and
555.31 	(8) qualifying Head Start expenditures under 
555.32 	Minnesota Statutes, section 119A.50.
555.33 	(b) The commissioner shall ensure that 
555.34 	sufficient qualified nonfederal expenditures 
556.1 	are made each year to meet the state's 
556.2 	TANF/MOE requirements. For the activities 
556.3 	listed in paragraph (a), clauses (2) to 
556.4 	(8), the commissioner may only report 
556.5 	expenditures that are excluded from the 
556.6 	definition of assistance under Code of 
556.7 	Federal Regulations, title 45, section 260.31.
556.8 	(c) For fiscal years beginning with state fiscal 
556.9 	year 2003, the commissioner shall ensure 
556.10 	that the maintenance of effort used by the 
556.11 	commissioner of management and budget 
556.12 	for the February and November forecasts 
556.13 	required under Minnesota Statutes, section 
556.14 	16A.103, contains expenditures under 
556.15 	paragraph (a), clause (1), equal to at least 16 
556.16 	percent of the total required under Code of 
556.17 	Federal Regulations, title 45, section 263.1.
556.18 	(d) The requirement in Minnesota Statutes, 
556.19 	section 256.011, subdivision 3, that federal 
556.20 	grants or aids secured or obtained under that 
556.21 	subdivision be used to reduce any direct 
556.22 	appropriations provided by law, do not apply 
556.23 	if the grants or aids are federal TANF funds.
556.24 	(e) For the federal fiscal years beginning on 
556.25 	or after October 1, 2007, the commissioner 
556.26 	may not claim an amount of TANF/MOE in 
556.27 	excess of the 75 percent standard in Code 
556.28 	of Federal Regulations, title 45, section 
556.29 	263.1(a)(2), except:
556.30 	(1) to the extent necessary to meet the 80 
556.31 	percent standard under Code of Federal 
556.32 	Regulations, title 45, section 263.1(a)(1), 
556.33 	if it is determined by the commissioner 
556.34 	that the state will not meet the TANF work 
556.35 	participation target rate for the current year;
557.1 	(2) to provide any additional amounts 
557.2 	under Code of Federal Regulations, title 45, 
557.3 	section 264.5, that relate to replacement of 
557.4 	TANF funds due to the operation of TANF 
557.5 	penalties; and
557.6 	(3) to provide any additional amounts that 
557.7 	may contribute to avoiding or reducing 
557.8 	TANF work participation penalties through 
557.9 	the operation of the excess MOE provisions 
557.10 	of Code of Federal Regulations, title 45, 
557.11 	section 261.43(a)(2).
557.12 	For the purposes of clauses (1) to (3), 
557.13 	the commissioner may supplement the 
557.14 	MOE claim with working family credit 
557.15 	expenditures or other qualified expenditures 
557.16 	to the extent such expenditures are otherwise 
557.17 	available after considering the expenditures 
557.18 	allowed in this subdivision and subdivisions 
557.19 	2 and 3.
557.20 	(f) Notwithstanding any contrary provision 
557.21 	in this article, paragraphs (a) to (e) expire 
557.22 	June 30, 2017.
557.23 	Working Family Credit Expenditures 
557.24 	as TANF/MOE. The commissioner may 
557.25 	claim as TANF maintenance of effort up to 
557.26 	$6,707,000 per year of working family credit 
557.27 	expenditures in each fiscal year.

557.28
557.29	Subd. 2.Working Family Credit to be Claimed 
for TANF/MOE
 					
557.30 	The commissioner may count the following 
557.31 	amounts of working family credit 
557.32 	expenditures as TANF/MOE:
557.33 	(1) fiscal year 2014, $45,196,000;
557.34 	(2) fiscal year 2015, $41,885,000;
558.1 	(3) fiscal year 2016, $8,869,000; and
558.2 	(4) fiscal year 2017, $11,181,000.

558.3
558.4	Subd. 3.TANF Transfer to Federal Child Care 
and Development Fund
 					
558.5 	(a) The following TANF fund amounts 
558.6 	are appropriated to the commissioner for 
558.7 	purposes of MFIP/transition year child care 
558.8 	assistance under Minnesota Statutes, section 
558.9 	119B.05:
558.10 	(1) fiscal year 2014; $14,020,000; and
558.11 	(2) fiscal year 2015, $14,020,000.
558.12 	(b) The commissioner shall authorize the 
558.13 	transfer of sufficient TANF funds to the 
558.14 	federal child care and development fund to 
558.15 	meet this appropriation and shall ensure that 
558.16 	all transferred funds are expended according 
558.17 	to federal child care and development fund 
558.18 	regulations.

558.19	Subd. 4.Central Office
 					
558.20 	The amounts that may be spent from this 
558.21 	appropriation for each purpose are as follows:

558.22	(a) Operations

558.23	Appropriations by Fund
	
558.24	General
	88,876,000
	91,189,000
	
558.25
558.26	State Government 
Special Revenue
	3,690,000
	4,790,000
	
558.27	Health Care Access
	 13,177,000
	13,004,000
	
558.28	Federal TANF
	100,000
	100,000
	
558.29 	DHS Receipt Center Accounting. The 
558.30 	commissioner is authorized to transfer 
558.31 	appropriations to, and account for DHS 
558.32 	receipt center operations in, the special 
558.33 	revenue fund.
559.1 	Administrative Recovery; Set-Aside. The 
559.2 	commissioner may invoice local entities 
559.3 	through the SWIFT accounting system as an 
559.4 	alternative means to recover the actual cost 
559.5 	of administering the following provisions:
559.6 	(1) Minnesota Statutes, section 125A.744, 
559.7 	subdivision 3;
559.8 	(2) Minnesota Statutes, section 245.495, 
559.9 	paragraph (b);
559.10 	(3) Minnesota Statutes, section 256B.0625, 
559.11 	subdivision 20, paragraph (k);
559.12 	(4) Minnesota Statutes, section 256B.0924, 
559.13 	subdivision 6, paragraph (g);
559.14 	(5) Minnesota Statutes, section 256B.0945, 
559.15 	subdivision 4, paragraph (d); and
559.16 	(6) Minnesota Statutes, section 256F.10, 
559.17 	subdivision 6, paragraph (b).
559.18 	Systems Modernization. The following 
559.19 	amounts are appropriated for transfer to 
559.20 	the state systems account authorized in 
559.21 	Minnesota Statutes, section 256.014:
559.22 	(1) $1,825,000 in fiscal year 2014 and 
559.23 	$2,502,000 in fiscal year 2015 is for the 
559.24 	state share of Medicaid-allocated costs of 
559.25 	the health insurance exchange information 
559.26 	technology and operational structure. The 
559.27 	funding base is $3,222,000 in fiscal year 2016 
559.28 	and $3,037,000 in fiscal year 2017 but shall 
559.29 	not be included in the base thereafter; and
559.30 	(2) $1,000,000 in fiscal year 2014 and 
559.31 	$2,000,000 in fiscal year 2015 are for the 
559.32 	modernization and streamlining of agency 
559.33 	eligibility and child support systems. The 
559.34 	funding base is $2,000,000 in fiscal year 
560.1 	2016 and $2,000,000 in fiscal year 2017 but 
560.2 	shall not be included in the base thereafter.
560.3 	The unexpended balance of the $1,000,000 
560.4 	appropriation in fiscal year 2014 and the 
560.5 	$2,000,000 appropriation in fiscal year 2015 
560.6 	must be transferred from the Department of 
560.7 	Human Services state systems account to 
560.8 	the Office of Enterprise Technology when 
560.9 	the Office of Enterprise Technology has 
560.10 	negotiated a federally approved internal 
560.11 	service fund rates and billing process with 
560.12 	sufficient internal accounting controls to 
560.13 	properly maximize federal reimbursement 
560.14 	to Minnesota for human services system 
560.15 	modernization projects, but not later than 
560.16 	June 30, 2015.
560.17 	If contingent funding is fully or partially 
560.18 	disbursed under article.., section .., and 
560.19 	transferred to the state systems account, the 
560.20 	unexpended balance of that appropriation 
560.21 	must be transferred to the Office of Enterprise 
560.22 	Technology in accordance with this clause. 
560.23 	Contingent funding must not exceed 
560.24 	$14,297,000 for the biennium.
560.25 	Base Adjustment. The general fund base 
560.26 	is increased by $646,000 in fiscal year 2016 
560.27 	and $461,000 in fiscal year 2017. The health 
560.28 	access fund base is decreased by $551,000 in 
560.29 	fiscal years 2016 and 2017.

560.30	(b) Children and Families

560.31	Appropriations by Fund
	
560.32	General
	7,569,000
	7,519,000
	
560.33	Federal TANF
	2,282,000
	2,282,000
	
560.34 	Financial Institution Data Match and 
560.35 	Payment of Fees. The commissioner is 
561.1 	authorized to allocate up to $310,000 each 
561.2 	year in fiscal years 2014 and 2015 from the 
561.3 	PRISM special revenue account to make 
561.4 	payments to financial institutions in exchange 
561.5 	for performing data matches between account 
561.6 	information held by financial institutions 
561.7 	and the public authority's database of child 
561.8 	support obligors as authorized by Minnesota 
561.9 	Statutes, section 13B.06, subdivision 7.

561.10	(c) Health Care

561.11	Appropriations by Fund
	
561.12	General
	 13,643,000
	 13,227,000
	
561.13	Health Care Access
	24,602,000
	26,728,000
	
561.14 	Base Adjustment.  The general fund base 
561.15 	is decreased by $86,000 in fiscal year 2016 
561.16 	and by $86,000 in fiscal year 2017. The 
561.17 	health care access fund base is increased 
561.18 	by $7,956,000 in fiscal year 2016 and by 
561.19 	$6,354,000 in fiscal year 2017.

561.20	(d) Continuing Care

561.21	Appropriations by Fund
	
561.22	General
	17,361,000
	17,426,000
	
561.23
561.24	State Government 
Special Revenue
	125,000
	125,000
	
561.25 	Base Adjustment. The general fund base is 
561.26 	decreased by $1,000 in fiscal year 2016 and 
561.27 	by $1,000 in fiscal year 2017.

561.28	(e) Chemical and Mental Health

561.29	Appropriations by Fund
	
561.30	General
	4,313,000
	4,179,000
	
561.31	Lottery Prize Fund
	157,000
	157,000

561.32	Subd. 5.Forecasted Programs
 					
561.33 	The amounts that may be spent from this 
561.34 	appropriation for each purpose are as follows:

562.1	(a) MFIP/DWP

562.2	Appropriations by Fund
	
562.3	General
	73,742,000
	79,302,000
	
562.4	Federal TANF
	80,342,000
	76,851,000

562.5	(b) MFIP Child Care Assistance
		62,030,000
		64,731,000

562.6	(c) General Assistance
		54,787,000
		56,068,000
	
562.7 	General Assistance Standard. The 
562.8 	commissioner shall set the monthly standard 
562.9 	of assistance for general assistance units 
562.10 	consisting of an adult recipient who is 
562.11 	childless and unmarried or living apart 
562.12 	from parents or a legal guardian at $203. 
562.13 	The commissioner may reduce this amount 
562.14 	according to Laws 1997, chapter 85, article 
562.15 	3, section 54.
562.16 	Emergency General Assistance. The 
562.17 	amount appropriated for emergency general 
562.18 	assistance funds is limited to no more 
562.19 	than $6,729,812 in fiscal year 2014 and 
562.20 	$6,729,812 in fiscal year 2015. Funds 
562.21 	to counties shall be allocated by the 
562.22 	commissioner using the allocation method in 
562.23 	Minnesota Statutes, section 256D.06.

562.24	(d) MN Supplemental Assistance
		38,646,000
		39,821,000

562.25	(e) Group Residential Housing
		140,447,000
		149,984,000

562.26	(f) MinnesotaCare
		 299,290,000
		 257,020,000
	
562.27 	This appropriation is from the health care 
562.28 	access fund.

562.29	(g) Medical Assistance
		 4,609,672,000
		 4,615,440,000
	
562.30 	Medical Eligibility for Inmates in Medical 
562.31 	Institutions. The commissioner of human 
562.32 	services shall execute an interagency 
562.33 	agreement with the commissioner of 
563.1 	corrections to recover the medical assistance 
563.2 	cost attributable to medical assistance 
563.3 	eligibility for inmates of public institutions 
563.4 	admitted to hospitals on an inpatient basis. 
563.5 	The amount that must be recovered from 
563.6 	the Department of Corrections shall include 
563.7 	all state medical assistance costs, including 
563.8 	administrative costs, attributable to inmates 
563.9 	under state and county jurisdiction admitted 
563.10 	to hospitals on an inpatient basis.
563.11 	Support Services for Deaf and 
563.12 	Hard-of-Hearing. $121,000 in fiscal 
563.13 	year 2014 and $141,000 in fiscal year 2015; 
563.14 	and $10,000 in fiscal year 2014 and $13,000 
563.15 	in fiscal year 2015 are from the health care 
563.16 	access fund for the hospital reimbursement 
563.17 	increase in Minnesota Statutes, section 
563.18 	256.969, subdivision 29, paragraph (b).

563.19	(h) Alternative Care
		47,058,000
		47,078,000
	
563.20 	Alternative Care Transfer. Any money 
563.21 	allocated to the alternative care program that 
563.22 	is not spent for the purposes indicated does 
563.23 	not cancel but shall be transferred to the 
563.24 	medical assistance account.

563.25	(i) CD Treatment Fund
		81,440,000
		74,875,000
	
563.26 	Balance Transfer. The commissioner must 
563.27 	transfer $18,188,000 from the consolidated 
563.28 	chemical dependency treatment fund to the 
563.29 	general fund by September 30, 2013.

563.30	Subd. 6.Grant Programs
 					
563.31 	The amounts that may be spent from this 
563.32 	appropriation for each purpose are as follows:

563.33	(a) Support Services Grants

564.1	Appropriations by Fund
	
564.2	General
	11,333,000
	11,133,000
	
564.3	Federal TANF
	94,611,000
	94,611,000
	
564.4 	Paid Work Experience. $1,159,000 in fiscal 
564.5 	year 2014, and $1,009,000 in fiscal year 
564.6 	2015 is from the general fund for paid work 
564.7 	experience for long-term MFIP recipients. 
564.8 	Paid work includes full and partial wage 
564.9 	subsidies and other related services such as 
564.10 	job development, marketing, preworksite 
564.11 	training, job coaching, and postplacement 
564.12 	services. Unexpended funds for fiscal year 
564.13 	2014 do not cancel but are available for this 
564.14 	purpose in fiscal year 2015.
564.15 	Work Study Funding for MFIP 
564.16 	Participants. $250,000 each year is from 
564.17 	the general fund to pilot work study jobs for 
564.18 	MFIP recipients in approved postsecondary 
564.19 	education programs. This is a onetime 
564.20 	appropriation. Unexpended funds for fiscal 
564.21 	year 2014 do not cancel but are available for 
564.22 	this purpose in fiscal year 2015.
564.23 	Base Adjustment. The general fund base is 
564.24 	decreased by $2,418,000 in fiscal years 2016 
564.25 	and 2017.

564.26
564.27	(b) Basic Sliding Fee Child Care Assistance 
Grants
		39,039,000
		40,391,000

564.28	(c) Child Care Development Grants
		1,487,000
		1,487,000

564.29	(d) Child Support Enforcement Grants
		50,000
		50,000
	
564.30 	Federal Child Support Demonstration 
564.31 	Grants. Federal administrative 
564.32 	reimbursement resulting from the federal 
564.33 	child support grant expenditures authorized 
564.34 	under United States Code, title 42, section 
565.1 	1315, is appropriated to the commissioner 
565.2 	for this activity.

565.3	(e) Children's Services Grants

565.4	Appropriations by Fund
	
565.5	General
	49,810,000
	50,260,000
	
565.6	Federal TANF
	140,000
	140,000
	
565.7 	Adoption Assistance and Relative Custody 
565.8 	Assistance. The commissioner may transfer 
565.9 	unencumbered appropriation balances for 
565.10 	adoption assistance and relative custody 
565.11 	assistance between fiscal years and between 
565.12 	programs.
565.13 	Title IV-E Adoption Assistance. Additional 
565.14 	federal reimbursements to the state as a result 
565.15 	of the Fostering Connections to Success 
565.16 	and Increasing Adoptions Act's expanded 
565.17 	eligibility for Title IV-E adoption assistance 
565.18 	are appropriated for postadoption services, 
565.19 	including a parent-to-parent support network.
565.20 	Privatized Adoption Grants. Federal 
565.21 	reimbursement for privatized adoption grant 
565.22 	and foster care recruitment grant expenditures 
565.23 	is appropriated to the commissioner for 
565.24 	adoption grants and foster care and adoption 
565.25 	administrative purposes.
565.26 	Adoption Assistance Incentive Grants.
565.27 	 Federal funds available during fiscal years 
565.28 	2014 and 2015 for adoption incentive grants 
565.29 	are appropriated for postadoption services, 
565.30 	including a parent-to-parent support network.
565.31 	Base Adjustment. The general fund base is 
565.32 	decreased by $466,000 in fiscal year 2016 
565.33 	and by $822,000 in fiscal year 2017.

565.34	(f) Child and Community Service Grants
		53,301,000
		53,301,000

566.1	(g) Child and Economic Support Grants
		20,972,000
		20,973,000
	
566.2 	Minnesota Food Assistance Program. 
566.3 	Unexpended funds for the Minnesota food 
566.4 	assistance program for fiscal year 2014 do 
566.5 	not cancel but are available for this purpose 
566.6 	in fiscal year 2015.
566.7 	Family Assets for Independence. $250,000 
566.8 	each year is for the Family Assets for 
566.9 	Independence Minnesota program. This 
566.10 	appropriation is available in either year of the 
566.11 	biennium and may be transferred between 
566.12 	fiscal years. 
566.13 	Food Shelf Programs. $500,000 in fiscal 
566.14 	year 2014 and $500,000 in fiscal year 
566.15 	2015 are for food shelf programs under 
566.16 	Minnesota Statutes, section 256E.34. If the 
566.17 	appropriation for either year is insufficient, 
566.18 	the appropriation for the other year is 
566.19 	available for it.
566.20 	Homeless Youth Act. $4,000,000 is for 
566.21 	purposes of Minnesota Statutes, section 
566.22 	256K.45.
566.23 	Safe Harbor Shelter and Housing. 
566.24 	$2,000,000 in fiscal year 2014 and 
566.25 	$2,000,000 in fiscal year 2015 is for a safe 
566.26 	harbor shelter and housing fund for housing 
566.27 	and supportive services for youth who are 
566.28 	sexually exploited. 

566.29	(h) Health Care Grants

566.30	Appropriations by Fund
	
566.31	General
	190,000
	190,000
	
566.32	Health Care Access
	 2,228,000
	1,413,000
	
566.33 	Emergency Medical Assistance Referral 
566.34 	and Assistance Grants. (a) The 
567.1 	commissioner of human services shall 
567.2 	award grants to nonprofit programs that 
567.3 	provide immigration legal services based 
567.4 	on indigency to provide legal services for 
567.5 	immigration assistance to individuals with 
567.6 	emergency medical conditions or complex 
567.7 	and chronic health conditions who are not 
567.8 	currently eligible for medical assistance 
567.9 	or other public health care programs, but 
567.10 	who may meet eligibility requirements with 
567.11 	immigration assistance.
567.12 	(b) The grantees, in collaboration with 
567.13 	hospitals and safety net providers, shall 
567.14 	provide referral assistance to connect 
567.15 	individuals identified in paragraph (a) with 
567.16 	alternative resources and services to assist in 
567.17 	meeting their health care needs. $100,000 
567.18 	is appropriated in fiscal year 2014 and 
567.19 	$100,000 in fiscal year 2015. This is a 
567.20 	onetime appropriation.
567.21 	(c) The programs receiving grants under 
567.22 	paragraph (a) must report to the commissioner 
567.23 	of human services the number of individuals 
567.24 	who were provided immigration assistance 
567.25 	under the grants and who were eventually 
567.26 	determined to be eligible for medical 
567.27 	assistance or another public health care 
567.28 	program due to this assistance. The 
567.29 	commissioner shall report this information to 
567.30 	the chairs and ranking minority members of 
567.31 	the legislative committees with jurisdiction 
567.32 	over human services policy and finance by 
567.33 	January 1, 2015.
567.34 	Base Adjustment. The general fund is 
567.35 	decreased by $100,000 in fiscal year 2016 
568.1 	and $100,000 in fiscal year 2017. The health 
568.2 	care access fund is decreased by $1,223,000 
568.3 	in fiscal years 2016 and 2017.

568.4	(i) Aging and Adult Services Grants
		22,043,000
		22,910,000
	
568.5 	Base Adjustment. The general fund is 
568.6 	increased by $5,000 in fiscal year 2016 and 
568.7 	$5,000 in fiscal year 2017.

568.8	(j) Deaf and Hard-of-Hearing Grants
		1,767,000
		1,767,000

568.9	(k) Disabilities Grants
		17,844,000
		17,426,000
	
568.10 	Advocating Change Together. $310,000 in 
568.11 	fiscal year 2014 is for a grant to Advocating 
568.12 	Change Together (ACT) to maintain and 
568.13 	promote services for persons with intellectual 
568.14 	and developmental disabilities throughout 
568.15 	the state. Of this appropriation:
568.16 	(1) $120,000 is for direct costs associated 
568.17 	with the delivery and evaluation of 
568.18 	peer-to-peer training programs administered 
568.19 	throughout the state, focusing on education, 
568.20 	employment, housing, transportation, and 
568.21 	voting;
568.22 	(2) $100,000 is for delivery of statewide 
568.23 	conferences focusing on leadership and 
568.24 	skill development within the disability 
568.25 	community; and
568.26 	(3) $90,000 is for administrative and general 
568.27 	operating costs associated with managing 
568.28 	or maintaining facilities, program delivery, 
568.29 	staff, and technology. This is a onetime 
568.30 	appropriation.
568.31 	Base Adjustment. The general fund base 
568.32 	is increased by $448,000 in fiscal year 2016 
568.33 	and by $470,000 in fiscal year 2017.

569.1	(l) Adult Mental Health Grants

569.2	Appropriations by Fund
	
569.3	General
	70,777,000
	69,108,000
	
569.4	Health Care Access
	750,000
	750,000
	
569.5	Lottery Prize
	1,733,000
	1,733,000
	
569.6 	Problem Gambling. $225,000 in fiscal year 
569.7 	2014 and $225,000 in fiscal year 2015 is 
569.8 	appropriated from the lottery prize fund for a 
569.9 	grant to the state affiliate recognized by the 
569.10 	National Council on Problem Gambling. The 
569.11 	affiliate must provide services to increase 
569.12 	public awareness of problem gambling, 
569.13 	education and training for individuals and 
569.14 	organizations providing effective treatment 
569.15 	services to problem gamblers and their 
569.16 	families, and research relating to problem 
569.17 	gambling. 
569.18 	Funding Usage. Up to 75 percent of a fiscal 
569.19 	year's appropriations for adult mental health 
569.20 	grants may be used to fund allocations in that 
569.21 	portion of the fiscal year ending December 
569.22 	31.
569.23 	Base Adjustment. The general fund base is 
569.24 	decreased by $4,197,000 in fiscal year 2016 
569.25 	and by $4,197,000 in fiscal year 2017.

569.26	(m) Child Mental Health Grants
		15,233,000
		15,234,000
	
569.27 	Mental Health First Aid Training. $45,000 
569.28 	for the biennium ending June 30, 2015, is 
569.29 	to train teachers, social service personnel, 
569.30 	law enforcement, and others who come into 
569.31 	contact with children with mental illnesses, 
569.32 	in children and adolescents mental health 
569.33 	first aid training.
570.1 	Funding Usage. Up to 75 percent of a fiscal 
570.2 	year's appropriation for child mental health 
570.3 	grants may be used to fund allocations in that 
570.4 	portion of the fiscal year ending December 
570.5 	31.

570.6	(n) CD Treatment Support Grants
		1,996,000
		1,636,000
	
570.7 	SBIRT Training. $300,000 each year is 
570.8 	for grants to train primary care clinicians to 
570.9 	provide substance abuse brief intervention 
570.10 	and referral to treatment (SBIRT). This is a 
570.11 	onetime appropriation.
570.12 	Fetal Alcohol Syndrome Grant. (a) 
570.13 	$360,000 is appropriated in fiscal year 2014 
570.14 	to the commissioner of human services for 
570.15 	a grant to the Minnesota Organization on 
570.16 	Fetal Alcohol Syndrome (MOFAS). This is a 
570.17 	onetime appropriation.
570.18 	(b) Grant money must be used to reduce the 
570.19 	incidence of FASD and other prenatal drug 
570.20 	related effects in children in Minnesota by 
570.21 	identifying and serving pregnant women 
570.22 	suspected of or known to use or abuse 
570.23 	alcohol or other drugs. The grant recipient 
570.24 	must provide intensive services to chemically 
570.25 	dependent women in order to increase 
570.26 	positive birth outcomes and report to the 
570.27 	commissioner necessary data to prepare 
570.28 	the required report to the legislature. The 
570.29 	organization may retain two percent of the 
570.30 	grant money for administrative costs. 
570.31 	(c) A grant recipient must report to the 
570.32 	commissioner of human services annually 
570.33 	by January 15 on the services and programs 
570.34 	funded by the appropriation. The report must 
570.35 	include measurable outcomes, including 
571.1 	the number of pregnant women served and 
571.2 	toxic-free babies born in the previous year.
571.3 	Base Adjustment. The general fund base is 
571.4 	decreased by $300,000 in fiscal year 2016 
571.5 	and $300,000 in fiscal year 2017.

571.6	Subd. 7.State-Operated Services
 					
571.7 	Transfer Authority Related to 
571.8 	State-Operated Services. Money 
571.9 	appropriated for state-operated services 
571.10 	may be transferred between fiscal years 
571.11 	of the biennium with the approval of the 
571.12 	commissioner of management and budget.
571.13 	The amounts that may be spent from the 
571.14 	appropriation for each purpose are as follows:

571.15	(a) SOS Mental Health
		115,738,000
		115,738,000
	
571.16 	Dedicated Receipts Available. Of the 
571.17 	revenue received under Minnesota Statutes, 
571.18 	section 246.18, subdivision 8, paragraph 
571.19 	(a), $1,000,000 each year is available for 
571.20 	the purposes of paragraph (b), clause (1), 
571.21 	of that subdivision, $1,000,000 each year 
571.22 	is available to transfer to the adult mental 
571.23 	health budget activity for the purposes of 
571.24 	paragraph (b), clause (2), of that subdivision, 
571.25 	and up to $2,713,000 each year is available 
571.26 	for the purposes of paragraph (b), clause (3), 
571.27 	of that subdivision.

571.28	(b) SOS MN Security Hospital
		69,582,000
		69,582,000

571.29	Subd. 8.Sex Offender Program
 		76,769,000
		79,745,000
	
571.30 	Transfer Authority Related to Minnesota 
571.31 	Sex Offender Program. Money 
571.32 	appropriated for the Minnesota sex offender 
571.33 	program may be transferred between fiscal 
572.1 	years of the biennium with the approval of the 
572.2 	commissioner of management and budget.

572.3	Subd. 9.Technical Activities
 		80,440,000
		80,829,000
	
572.4 	This appropriation is from the federal TANF 
572.5 	fund.
572.6 	Base Adjustment. The federal TANF fund 
572.7 	base is increased by $278,000 in fiscal year 
572.8 	2016 and increased by $651,000 in fiscal 
572.9 	year 2017.

572.10	Subd. 10.Transfer.

572.11	Sec. 3. COMMISSIONER OF HEALTH

572.12	Subdivision 1.Total Appropriation
 	$
	 158,912,000
	$
	 155,115,000

572.13	Appropriations by Fund
	
572.14		2014
	2015
	
572.15	General
	 79,476,000
	 74,256,000
	
572.16
572.17	State Government 
Special Revenue
	48,680,000
	50,703,000
	
572.18	Health Care Access
	18,743,000
	18,143,000
	
572.19	Federal TANF
	11,713,000
	11,713,000
	
572.20	Special Revenue
	300,000
	300,000
	
572.21 	The amounts that may be spent for each 
572.22 	purpose are specified in the following 
572.23 	subdivisions.

572.24	Subd. 2.Health Improvement

572.25	Appropriations by Fund
	
572.26	General
	 52,864,000
	 47,644,000
	
572.27
572.28	State Government 
Special Revenue
	1,033,000
	1,033,000
	
572.29	Health Care Access
	9,219,000
	9,219,000
	
572.30	Federal TANF
	11,713,000
	11,713,000
	
572.31 	Statewide Health Improvement Program. 
572.32 	$7,500,000 in fiscal year 2014 and 
572.33 	$7,500,000 in fiscal year 2015 is from the 
572.34 	health care access fund for the statewide 
573.1 	health improvement program under 
573.2 	Minnesota Statutes, section 145.986.
573.3 	Of the appropriation in fiscal year 2014, 
573.4 	$10,000 is for the commissioner of 
573.5 	management and budget to develop and 
573.6 	implement a return on taxpayer investment 
573.7 	(ROTI) methodology and practice related 
573.8 	to the state health improvement program. 
573.9 	In developing the methodology, the 
573.10 	commissioner shall assess ROTI initiatives 
573.11 	in other states, design implications for 
573.12 	Minnesota, and identify one or more 
573.13 	Minnesota institutions of higher education 
573.14 	capable of providing rigorous and consistent 
573.15 	nonpartisan institutional support for ROTI. 
573.16 	The commissioner shall consult with 
573.17 	representatives of other state agencies, 
573.18 	counties, legislative staff, Minnesota 
573.19 	institutions of higher education, and other 
573.20 	stakeholders in developing the methodology. 
573.21 	The commissioner shall report the results to 
573.22 	the chairs and ranking minority members of 
573.23 	the legislative committees and divisions with 
573.24 	jurisdiction over health and human services, 
573.25 	taxes, and finance by March 15, 2015.
573.26 	Statewide Cancer Surveillance System. Of 
573.27 	the general fund appropriation, $350,000 in 
573.28 	fiscal year 2014 and $350,000 in fiscal year 
573.29 	2015 is to develop and implement a new 
573.30 	cancer reporting system under Minnesota 
573.31 	Statutes, sections 144.671 to 144.69. Any 
573.32 	information technology development or 
573.33 	support costs necessary for the cancer 
573.34 	surveillance system must be incorporated 
573.35 	into the agency's service level agreement and 
573.36 	paid to the Office of Enterprise Technology.
574.1 	Minnesota Poison Information Center.
574.2 	 $250,000 in fiscal year 2014 and $250,000 
574.3 	in fiscal year 2015 from the general fund 
574.4 	is for regional poison information centers 
574.5 	according to Minnesota Statutes, section 
574.6 	145.93.
574.7 	Text Message Suicide Prevention Program.
574.8 	 $1,500,000 for the biennium ending June 30, 
574.9 	2015, is for a grant to a nonprofit organization 
574.10 	to establish and implement a statewide text 
574.11 	message suicide prevention program. The 
574.12 	program shall implement a suicide prevention 
574.13 	counseling text line designed to use text 
574.14 	messaging to connect with crisis counselors 
574.15 	and to obtain emergency information and 
574.16 	referrals to local resources in the local 
574.17 	community. The program shall include 
574.18 	training within schools and communities to 
574.19 	encourage the use of the program.
574.20 	Support Services for Deaf and 
574.21 	Hard-of-Hearing. (a) $365,000 in fiscal 
574.22 	year 2014 and $349,000 in fiscal year 2015 
574.23 	are for providing support services to families 
574.24 	as required under Minnesota Statutes, section 
574.25 	144.966, subdivision 3a.
574.26 	(b) $164,000 in fiscal year 2014 and $156,000 
574.27 	in fiscal year 2015 are for home-based 
574.28 	education in American Sign Language for 
574.29 	families with children who are deaf or have 
574.30 	hearing loss, as required under Minnesota 
574.31 	Statutes, section 144.966, subdivision 3a.
574.32 	Reproductive Health Strategic Plan to 
574.33 	Reduce Health Disparities for Somali 
574.34 	Women. To the extent funds are available 
574.35 	for fiscal years 2014 and 2015 for grants 
575.1 	provided pursuant to Minnesota Statutes, 
575.2 	section 145.928, the commissioner 
575.3 	shall provide a grant to a Somali-based 
575.4 	organization located in the metropolitan area 
575.5 	to develop a reproductive health strategic 
575.6 	plan to eliminate reproductive health 
575.7 	disparities for Somali women. The plan shall 
575.8 	develop initiatives to provide educational 
575.9 	and information resources to health care 
575.10 	providers, community organizations, and 
575.11 	Somali women to ensure effective interaction 
575.12 	with Somali culture and western medicine 
575.13 	and the delivery of appropriate health care 
575.14 	services, and the achievement of better health 
575.15 	outcomes for Somali women. The plan must 
575.16 	engage health care providers, the Somali 
575.17 	community, and Somali health-centered 
575.18 	organizations. The commissioner shall 
575.19 	submit a report to the chairs and ranking 
575.20 	minority members of the senate and house 
575.21 	committees with jurisdiction over health 
575.22 	policy on the strategic plan developed under 
575.23 	this grant for eliminating reproductive health 
575.24 	disparities for Somali women. The report 
575.25 	must be submitted by February 15, 2014.
575.26 	TANF Appropriations. (1) $1,156,000 of 
575.27 	the TANF funds is appropriated each year of 
575.28 	the biennium to the commissioner for family 
575.29 	planning grants under Minnesota Statutes, 
575.30 	section 145.925.
575.31 	(2) $3,579,000 of the TANF funds is 
575.32 	appropriated each year of the biennium to 
575.33 	the commissioner for home visiting and 
575.34 	nutritional services listed under Minnesota 
575.35 	Statutes, section 145.882, subdivision 7, 
575.36 	clauses (6) and (7). Funds must be distributed 
576.1 	to community health boards according to 
576.2 	Minnesota Statutes, section 145A.131, 
576.3 	subdivision 1.
576.4 	(3) $2,000,000 of the TANF funds is 
576.5 	appropriated each year of the biennium to 
576.6 	the commissioner for decreasing racial and 
576.7 	ethnic disparities in infant mortality rates 
576.8 	under Minnesota Statutes, section 145.928, 
576.9 	subdivision 7.
576.10 	(4) $4,978,000 of the TANF funds is 
576.11 	appropriated each year of the biennium to the 
576.12 	commissioner for the family home visiting 
576.13 	grant program according to Minnesota 
576.14 	Statutes, section 145A.17. $4,000,000 of the 
576.15 	funding must be distributed to community 
576.16 	health boards according to Minnesota 
576.17 	Statutes, section 145A.131, subdivision 1. 
576.18 	$978,000 of the funding must be distributed 
576.19 	to tribal governments based on Minnesota 
576.20 	Statutes, section 145A.14, subdivision 2a.
576.21 	(5) The commissioner may use up to 6.23 
576.22 	percent of the funds appropriated each fiscal 
576.23 	year to conduct the ongoing evaluations 
576.24 	required under Minnesota Statutes, section 
576.25 	145A.17, subdivision 7, and training and 
576.26 	technical assistance as required under 
576.27 	Minnesota Statutes, section 145A.17, 
576.28 	subdivisions 4 and 5.
576.29 	TANF Carryforward. Any unexpended 
576.30 	balance of the TANF appropriation in the 
576.31 	first year of the biennium does not cancel but 
576.32 	is available for the second year.

576.33	Subd. 3.Policy Quality and Compliance

576.34	Appropriations by Fund
	
576.35	General
	9,391,000
	9,391,000
	
577.1
577.2	State Government 
Special Revenue
	14,434,000
	16,454,000
	
577.3	Health Care Access
	9,524,000
	8,924,000
	
577.4 	Base Level Adjustment. The state 
577.5 	government special revenue fund base shall 
577.6 	be reduced by $2,000 in fiscal year 2017. The 
577.7 	health care access base shall be increased by 
577.8 	$600,000 in fiscal year 2016 and decreased 
577.9 	by $600,000 in fiscal year 2017.

577.10	Subd. 4.Health Protection

577.11	Appropriations by Fund
	
577.12	General
	9,449,000
	9,449,000
	
577.13
577.14	State Government 
Special Revenue
	33,213,000
	33,216,000
	
577.15	Special Revenue
	300,000
	300,000
	
577.16 	Infectious Disease Laboratory. Of the 
577.17 	general fund appropriation, $200,000 in 
577.18 	fiscal year 2014 and $200,000 in fiscal year 
577.19 	2015 are to monitor infectious disease trends 
577.20 	and investigate infectious disease outbreaks.
577.21 	Surveillance for Elevated Blood Lead 
577.22 	Levels. Of the general fund appropriation, 
577.23 	$100,000 in fiscal year 2014 and $100,000 
577.24 	in fiscal year 2015 are for the blood lead 
577.25 	surveillance system under Minnesota 
577.26 	Statutes, section 144.9502.
577.27 	Base Level Adjustment. The state 
577.28 	government special revenue base is increased 
577.29 	by $6,000 in fiscal year 2016 and by $13,000 
577.30 	in fiscal year 2017.

577.31	Subd. 5.Administrative Support Services
 		7,772,000
		7,772,000
	
577.32 	Regional Support for Local Public Health 
577.33 	Departments. $350,000 in fiscal year 
577.34 	2014 and $350,000 in fiscal year 2015 is 
578.1 	for regional staff who provide specialized 
578.2 	expertise to local public health departments.

578.3	Sec. 4. HEALTH-RELATED BOARDS

578.4	Subdivision 1.Total Appropriation
 	$
	 17,335,000
	$
	 17,285,000
	
578.5 	This appropriation is from the state 
578.6 	government special revenue fund.
578.7 	The amounts that may be spent for each 
578.8 	purpose are specified in the following 
578.9 	subdivisions.

578.10	Subd. 2.Board of Chiropractic Examiners
 		470,000
		470,000

578.11	Subd. 3.Board of Dentistry
 		1,820,000
		1,820,000
	
578.12 	Health Professional Services Program. Of 
578.13 	this appropriation, $704,000 in fiscal year 
578.14 	2014 and $704,000 in fiscal year 2015 from 
578.15 	the state government special revenue fund are 
578.16 	for the health professional services program.

578.17
578.18	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		111,000
		111,000

578.19
578.20	Subd. 5.Board of Marriage and Family 
Therapy
 		168,000
		168,000

578.21	Subd. 6.Board of Medical Practice
 		3,867,000
		3,867,000

578.22	Subd. 7.Board of Nursing
 		3,637,000
		3,637,000

578.23
578.24	Subd. 8.Board of Nursing Home 
Administrators
 		 1,632,000
		 1,582,000
	
578.25 	Administrative Services Unit - Operating 
578.26 	Costs. Of this appropriation, $676,000 
578.27 	in fiscal year 2014 and $626,000 in 
578.28 	fiscal year 2015 are for operating costs 
578.29 	of the administrative services unit. The 
578.30 	administrative services unit may receive 
578.31 	and expend reimbursements for services 
578.32 	performed by other agencies.
579.1 	Administrative Services Unit - Volunteer 
579.2 	Health Care Provider Program. Of this 
579.3 	appropriation, $150,000 in fiscal year 2014 
579.4 	and $150,000 in fiscal year 2015 are to pay 
579.5 	for medical professional liability coverage 
579.6 	required under Minnesota Statutes, section 
579.7 	214.40.
579.8 	Administrative Services Unit - Contested 
579.9 	Cases and Other Legal Proceedings. Of 
579.10 	this appropriation, $200,000 in fiscal year 
579.11 	2014 and $200,000 in fiscal year 2015 are 
579.12 	for costs of contested case hearings and other 
579.13 	unanticipated costs of legal proceedings 
579.14 	involving health-related boards funded 
579.15 	under this section. Upon certification of a 
579.16 	health-related board to the administrative 
579.17 	services unit that the costs will be incurred 
579.18 	and that there is insufficient money available 
579.19 	to pay for the costs out of money currently 
579.20 	available to that board, the administrative 
579.21 	services unit is authorized to transfer money 
579.22 	from this appropriation to the board for 
579.23 	payment of those costs with the approval 
579.24 	of the commissioner of management and 
579.25 	budget.

579.26	Subd. 9.Board of Optometry
 		107,000
		107,000

579.27	Subd. 10.Board of Pharmacy
 		2,555,000
		2,555,000
	
579.28 	Prescription Electronic Reporting. Of 
579.29 	this appropriation, $356,000 in fiscal year 
579.30 	2014 and $356,000 in fiscal year 2015 from 
579.31 	the state government special revenue fund 
579.32 	are to the board to operate the prescription 
579.33 	monitoring program in Minnesota Statutes, 
579.34 	section 152.126.

579.35	Subd. 11.Board of Physical Therapy
 		346,000
		346,000

580.1	Subd. 12.Board of Podiatry
 		76,000
		76,000

580.2	Subd. 13.Board of Psychology
 		847,000
		847,000

580.3	Subd. 14.Board of Social Work
 		1,054,000
		1,054,000

580.4	Subd. 15.Board of Veterinary Medicine
 		230,000
		230,000

580.5
580.6	Subd. 16.Board of Behavioral Health and 
Therapy
 		415,000
		415,000

580.7
580.8	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	2,741,000
	$
	2,741,000
	
580.9 	Regional Grants. $585,000 in fiscal year 
580.10 	2014 and $585,000 in fiscal year 2015 are 
580.11 	for regional emergency medical services 
580.12 	programs, to be distributed equally to the 
580.13 	eight emergency medical service regions.
580.14 	Cooper/Sams Volunteer Ambulance 
580.15 	Program. $700,000 in fiscal year 2014 and 
580.16 	$700,000 in fiscal year 2015 are for the 
580.17 	Cooper/Sams volunteer ambulance program 
580.18 	under Minnesota Statutes, section 144E.40.
580.19 	(a) Of this amount, $611,000 in fiscal year 
580.20 	2014 and $611,000 in fiscal year 2015 
580.21 	are for the ambulance service personnel 
580.22 	longevity award and incentive program under 
580.23 	Minnesota Statutes, section 144E.40.
580.24 	(b) Of this amount, $89,000 in fiscal year 
580.25 	2014 and $89,000 in fiscal year 2015 are 
580.26 	for the operations of the ambulance service 
580.27 	personnel longevity award and incentive 
580.28 	program under Minnesota Statutes, section 
580.29 	144E.40.
580.30 	Ambulance Training Grant. $361,000 in 
580.31 	fiscal year 2014 and $361,000 in fiscal year 
580.32 	2015 are for training grants.
581.1 	EMSRB Board Operations. $1,095,000 in 
581.2 	fiscal year 2014 and $1,095,000 in fiscal year 
581.3 	2015 are for operations.

581.4	Sec. 6. COUNCIL ON DISABILITY
 	$
	614,000
	$
	614,000

581.5
581.6
581.7	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,654,000
	$
	1,654,000

581.8	Sec. 8. OMBUDSPERSON FOR FAMILIES
 	$
	333,000
	$
	334,000

581.9 	Sec. 9. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
581.10 		Subd. 34.Federal administrative reimbursement dedicated. Federal 
581.11 	administrative reimbursement resulting from the following activities is appropriated to the 
581.12 	commissioner for the designated purposes:
581.13 	(1) reimbursement for the Minnesota senior health options project; and
581.14 	(2) reimbursement related to prior authorization and inpatient admission certification 
581.15 	by a professional review organization. A portion of these funds must be used for activities 
581.16 	to decrease unnecessary pharmaceutical costs in medical assistance.; and
581.17 	(3) reimbursement resulting from the federal child support grant expenditures 
581.18 	authorized under United States Code, title 42, section 1315.

581.19 	Sec. 10. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision 
581.20 	to read:
581.21 		Subd. 35.Federal reimbursement for privatized adoption grants. Federal 
581.22 	reimbursement for privatized adoption grant and foster care recruitment grant expenditures 
581.23 	is appropriated to the commissioner for adoption grants and foster care and adoption 
581.24 	administrative purposes.

581.25 	Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision 
581.26 	to read:
581.27 		Subd. 36.DHS receipt center accounting. The commissioner may transfer 
581.28 	appropriations to, and account for DHS receipt center operations in, the special revenue 
581.29 	fund.

581.30 	Sec. 12. TRANSFERS AND ADJUSTMENTS.
 582.1 	(a) The appropriation in subdivision 5, paragraph (g), includes up to $53,391,000 
582.2 	in fiscal year 2014; $216,637,000 in fiscal year 2015; $261,660,000 in fiscal year 2016; 
582.3 	and $279,984,000 in fiscal year 2017, for medical assistance eligibility and administration 
582.4 	changes related to:
582.5 	(1) eligibility for children age two to 18 with income up to 275 percent of the federal 
582.6 	poverty guidelines;
582.7 	(2) eligibility for pregnant women with income up to 275 percent of the federal 
582.8 	poverty guidelines;
582.9 	(3) Affordable Care Act enrollment and renewal processes, including elimination 
582.10 	of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes 
582.11 	in verification requirements, and other changes in the eligibility determination and 
582.12 	enrollment and renewal process;
582.13 	(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;
582.14 	(5) eligibility related to spousal impoverishment provisions for waiver recipients; and
582.15 	(6) presumptive eligibility determinations by hospitals.
582.16 	(b) The commissioner of the Department of Human Services shall determine the 
582.17 	difference between the actual costs to the medical assistance program attributable to 
582.18 	the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a), 
582.19 	clauses (1) to (6), that were estimated during the 2013 legislative session based on data 
582.20 	from the 2013 February forecast. The costs in this paragraph must be calculated between 
582.21 	beginning January 1, 2014, and June 30, 2017.
582.22 	(c) For each fiscal year from 2014 to 2017, the commissioner of human services 
582.23 	shall certify the actual cost differences to the medical assistance program determined 
582.24 	under paragraph (b), and report the costs to the commissioner of management and budget 
582.25 	by June 30 of each fiscal year. In each fiscal year, the commissioner of management 
582.26 	and budget shall reduce the transfer from the health care access fund under section 3 
582.27 	by the amounts determined in paragraph (b). If for any fiscal year the amount of the 
582.28 	cost difference determined under paragraph (b) exceeds the amount of the transfer under 
582.29 	section 14, the transfer for that year must be zero.
582.30 	(d) This section expires on January 1, 2018.

582.31 	Sec. 13. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND 
582.32 	FOR MINNESOTACARE POPULATIONS.
 582.33 	(a) The commissioner of Minnesota management and budget shall transfer from the 
582.34 	health care access fund to the general fund $53,391,000 in fiscal year 2014; $216,637,000 
583.1 	in fiscal year 2015; $261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year 
583.2 	2017, for medical assistance changes in section 12.
583.3 	(b) This section expires on January 1, 2018.

583.4 	Sec. 14. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND.
 583.5 	(a) The commissioner of Minnesota management and budget shall transfer from the 
583.6 	health care access fund to the general fund $143,027,000 in fiscal year 2014; $14,631,000 
583.7 	in fiscal year 2015; $48,371,000 in fiscal year 2016; and $32,325,000 in fiscal year 2017. 
583.8 	For each fiscal year, the commissioner must reduce the amount of the transfer under this 
583.9 	section according to section 12, paragraph (c).
583.10 	(b) This section expires on January 1, 2018.

583.11 	Sec. 15. TRANSFERS.
 583.12 		Subdivision 1.Grants. The commissioner of human services, with the approval of 
583.13 	the commissioner of management and budget, may transfer unencumbered appropriation 
583.14 	balances for the biennium ending June 30, 2015, within fiscal years among the MFIP, 
583.15 	general assistance, general assistance medical care under Minnesota Statutes 2009 
583.16 	Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP 
583.17 	child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental 
583.18 	aid, group residential housing programs, the entitlement portion of the chemical 
583.19 	dependency consolidated treatment fund, and between fiscal years of the biennium. The 
583.20 	commissioner shall inform the chairs and ranking minority members of the senate Health 
583.21 	and Human Services Finance Division and the house of representatives Health and Human 
583.22 	Services Finance Committee quarterly about transfers made under this provision.
583.23 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
583.24 	money may be transferred within the Departments of Human Services and Health as the 
583.25 	commissioners consider necessary, with the advance approval of the commissioner of 
583.26 	management and budget. The commissioner shall inform the chairs and ranking minority 
583.27 	members of the senate Health and Human Services Finance Division and the house of 
583.28 	representatives Health and Human Services Finance Committee quarterly about transfers 
583.29 	made under this provision.

583.30 	Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
 583.31 	The commissioners of health and human services shall not use indirect cost 
583.32 	allocations to pay for the operational costs of any program for which they are responsible.

584.1 	Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
 584.2 	All uncodified language contained in this article expires on June 30, 2015, unless a 
584.3 	different expiration date is explicit.

584.4 	Sec. 18. EFFECTIVE DATE.
 584.5 	This article is effective July 1, 2013, unless a different effective date is specified.

584.6 	ARTICLE 15
584.7 	REFORM 2020 CONTINGENT APPROPRIATIONS

584.8	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
584.9 	The sums shown in the columns marked "Appropriations" are appropriated to the 
584.10 	agencies and for the purposes specified in this article. The appropriations are from the 
584.11 	general fund, or another named fund, and are available for the fiscal years indicated 
584.12 	for each purpose. The figures "2014" and "2015" used in this article mean that the 
584.13 	appropriations listed under them are available for the fiscal year ending June 30, 2014, or 
584.14 	June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal 
584.15 	year 2015. "The biennium" is fiscal years 2014 and 2015.

584.16				APPROPRIATIONS
	
584.17				Available for the Year
	
584.18				Ending June 30
	
584.19					2014
		2015

584.20
584.21	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

584.22	Subdivision 1.Total Appropriation
 		817,000
		895,000

584.23	Subd. 2.Central Office
 					
584.24 	The amounts that may be spent from this 
584.25 	appropriation for each purpose are as follows:

584.26	(a) Operations
		4,688,000
		11,643,000
	
584.27 	Base Adjustment. The general fund base is 
584.28 	decreased by $11,056,000 in fiscal year 2016 
584.29 	and $11,056,000 in fiscal year 2017.

584.30	(b) Continuing Care
		2,334,000
		2,556,000
	
585.1 	Base Adjustment. The general fund base is 
585.2 	decreased by $2,000 in fiscal year 2016 and 
585.3 	by $27,000,000 in fiscal year 2017.

585.4	(c) Group Residential Housing
		(1,166,000)
		(8,602,000)

585.5	(d) Medical Assistance
		(2,647,000)
		(2,627,000)

585.6	(e) Alternative Care
		(7,386,000)
		(6,851,000)

585.7	(f) Child and Community Service Grants
		3,000,000
		3,000,000

585.8	(g) Aging and Adult Services Grants
		1,430,000
		1,237,000
	
585.9 	Gaps Analysis. In fiscal year 2014, and 
585.10 	in each even-numbered year thereafter, 
585.11 	$435,000 is appropriated to conduct an 
585.12 	analysis of gaps in long-term care services 
585.13 	under Minnesota Statutes, section 144A.351. 
585.14 	This is a biennial appropriation. The base is 
585.15 	increased by $435,000 in fiscal year 2016. 
585.16 	Notwithstanding any contrary provisions in 
585.17 	this article, this provision does not expire.
585.18 	Base Adjustment. The general fund base is 
585.19 	increased by $597,000 in fiscal year 2016, 
585.20 	and by $100,000 in fiscal year 2017.

585.21	(h) Disabilities Grants
		(564,000)
		(539,000)
	
585.22 	Base Adjustment. The general fund base is 
585.23 	increased by $25,000 in fiscal year 2016 and 
585.24 	by $25,000 in fiscal year 2017.

585.25 	Sec. 3. FEDERAL APPROVAL.
 585.26 	(a) The implementation of this article is contingent on federal approval.
585.27 	(b) Upon full or partial approval of the waiver application, the commissioner of 
585.28 	human services shall submit to the commissioner of management and budget a plan for 
585.29 	implementing the provisions in this article that received federal approval as well as any 
585.30 	provisions that do not require federal approval. The plan must:
585.31 	(1) include fiscal estimates that, with federal administrative reimbursement, do 
585.32 	not increase the general fund appropriations to the commissioner of human services in 
585.33 	fiscal years 2014 and 2015; and
586.1 	(2) include a fiscal estimate for the systems modernization appropriation, which 
586.2 	cannot exceed $14,297,000 for the biennium ending June 30, 2015.
586.3 	(c) Upon approval by the commissioner of management and budget, the 
586.4 	commissioner of human services may implement the plan.
586.5 	(d) The commissioner of management and budget must notify the chairs and ranking 
586.6 	minority members of the legislative committees with jurisdiction over health and human 
586.7 	services finance when the plan is approved. The plan must be made publicly available.

586.8 	Sec. 4. IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS 
586.9 	AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES.
 586.10 	Upon approval of the plan in section 3, the commissioner of management and 
586.11 	budget shall make necessary adjustments to the appropriations in this article to reflect the 
586.12 	effective date of federal approval. The adjustments must include the nondedicated revenue 
586.13 	attributable to the provisions of this article and the related planning estimates for fiscal 
586.14 	years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions 
586.15 	in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included 
586.16 	in the forecast and must not increase the appropriations to the commissioner of human 
586.17 	services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for 
586.18 	fiscal years 2016 and 2017 result in increased general fund expenditure estimates for 
586.19 	the commissioner of human services attributable to the provisions in this article, when 
586.20 	compared to the planning estimates attributable to the provision in this article made in the 
586.21 	February 2013 forecast, none of the provisions in this article shall be implemented.

586.22 	ARTICLE 16
586.23 	HUMAN SERVICES FORECAST ADJUSTMENTS

586.24
586.25	Section 1. COMMISSIONER OF HUMAN 
SERVICES

586.26	Subdivision 1.Total Appropriation
 	$
	(161,031,000)

586.27	Appropriations by Fund
	
586.28		2013
		
586.29	General Fund
	(158,668,000)
		
586.30	Health Care Access
	(7,179,000)
		
586.31	TANF
	4,816,000

586.32	Subd. 2.Forecasted Programs
 					
586.33	(a) MFIP/DWP Grants

587.1	Appropriations by Fund
	
587.2	General Fund
	(8,211,000)
		
587.3	TANF
	4,399,000

587.4	(b) MFIP Child Care Assistance Grants
		10,113,000

587.5	(c) General Assistance Grants
		3,230,000

587.6	(d) Minnesota Supplemental Aid Grants
		(1,008,000)

587.7	(e) Group Residential Housing Grants
		(5,423,000)

587.8	(f) MinnesotaCare Grants
		(7,179,000)
			
587.9 	This appropriation is from the health care 
587.10 	access fund.

587.11	(g) Medical Assistance Grants
		(159,733,000)

587.12	(h) Alternative Care Grants
		-0-

587.13	(i) CD Entitlement Grants
		2,364,000

587.14	Subd. 3.Technical Activities
 		417,000
			
587.15 	This appropriation is from the TANF fund.

587.16 	EFFECTIVE DATE. This section is effective the day following final enactment.