1.1 	A bill for an act
1.2 	relating to state government; making adjustments to health and human services 
1.3 	appropriations; making changes to provisions governing the Department of 
1.4 	Health, Department of Human Services, Northstar Care for Children program, 
1.5 	continuing care, community first services and supports, health care, public 
1.6 	assistance programs, and chemical dependency; modifying the hospital payment 
1.7 	system; modifying provisions governing background studies and home and 
1.8 	community-based services standards; modifying rulemaking authority; setting 
1.9 	fees; providing rate increases; establishing grant programs; modifying medical 
1.10 	assistance provisions; modifying the use of positive support strategies and 
1.11 	emergency manual restraint; requiring certain studies and reports; appropriating 
1.12 	money;amending Minnesota Statutes 2012, sections 13.46, subdivision 4; 
1.13 	144.0724, as amended; 144.551, subdivision 1; 245C.03, by adding a subdivision; 
1.14 	245C.04, by adding a subdivision; 245C.05, subdivision 5; 245C.10, by adding a 
1.15 	subdivision; 245C.33, subdivisions 1, 4; 252.451, subdivision 2; 254B.12; 256.01, 
1.16 	by adding a subdivision; 256.9685, subdivisions 1, 1a; 256.9686, subdivision 2; 
1.17 	256.969, subdivisions 1, 2, 2b, 2c, 3a, 3b, 3c, 6a, 9, 10, 14, 17, 30, by adding 
1.18 	subdivisions; 256.9752, subdivision 2; 256B.04, by adding a subdivision; 
1.19 	256B.0625, subdivision 30; 256B.0751, by adding a subdivision; 256B.199; 
1.20 	256B.35, subdivision 1; 256B.441, by adding a subdivision; 256B.5012, by 
1.21 	adding a subdivision; 256I.04, subdivision 2b; 256I.05, subdivision 2; 256J.49, 
1.22 	subdivision 13; 256J.53, subdivisions 1, 2, 5; 256J.531; 257.85, subdivision 11; 
1.23 	260C.212, subdivision 1; 260C.515, subdivision 4; 260C.611; Minnesota Statutes 
1.24 	2013 Supplement, sections 16A.724, subdivision 2; 145.4716, subdivision 
1.25 	2; 245.8251; 245A.03, subdivision 7; 245A.042, subdivision 3; 245A.16, 
1.26 	subdivision 1; 245C.08, subdivision 1; 245D.02, subdivisions 3, 4b, 8b, 11, 15b, 
1.27 	29, 34, 34a, by adding a subdivision; 245D.03, subdivisions 1, 2, 3, by adding a 
1.28 	subdivision; 245D.04, subdivision 3; 245D.05, subdivisions 1, 1a, 1b, 2, 4, 5; 
1.29 	245D.051; 245D.06, subdivisions 1, 2, 4, 6, 7, 8; 245D.071, subdivisions 3, 4, 5; 
1.30 	245D.081, subdivision 2; 245D.09, subdivisions 3, 4a; 245D.091, subdivisions 2, 
1.31 	3, 4; 245D.10, subdivisions 3, 4; 245D.11, subdivision 2; 256B.04, subdivision 
1.32 	21; 256B.056, subdivision 5c; 256B.0949, subdivision 4; 256B.439, subdivisions 
1.33 	1, 7; 256B.441, subdivision 53; 256B.4912, subdivision 1; 256B.492; 256B.69, 
1.34 	subdivision 34; 256B.85, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16, 
1.35 	17, 18, 23, 24, by adding subdivisions; 256N.22, subdivisions 1, 2, 4; 256N.23, 
1.36 	subdivision 4; 256N.25, subdivisions 2, 3; 256N.26, subdivision 1; 256N.27, 
1.37 	subdivision 4; Laws 2013, chapter 1, section 6, as amended; Laws 2013, 
1.38 	chapter 108, article 3, section 48; article 7, sections 14; 49; article 14, sections 
1.39 	2, subdivisions 1, 4, as amended, 5, 6, as amended, 6; 3, subdivisions 1, 4; 4, 
2.1 	subdivision 8; 12; proposing coding for new law in Minnesota Statutes, chapters 
2.2 	144; 144A; repealing Minnesota Statutes 2012, sections 256.969, subdivisions 
2.3 	8b, 9a, 9b, 11, 13, 20, 21, 22, 25, 26, 27, 28; 256.9695, subdivisions 3, 4; 
2.4 	Minnesota Statutes 2013 Supplement, section 256N.26, subdivision 7.
2.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.6 	ARTICLE 1
2.7 	HEALTH DEPARTMENT

2.8 	Section 1. Minnesota Statutes 2012, section 144.551, subdivision 1, is amended to read:
2.9 		Subdivision 1.Restricted construction or modification. (a) The following 
2.10 	construction or modification may not be commenced:
2.11 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
2.12 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
2.13 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
2.14 	to another, or otherwise results in an increase or redistribution of hospital beds within 
2.15 	the state; and
2.16 	(2) the establishment of a new hospital.
2.17 	(b) This section does not apply to:
2.18 	(1) construction or relocation within a county by a hospital, clinic, or other health 
2.19 	care facility that is a national referral center engaged in substantial programs of patient 
2.20 	care, medical research, and medical education meeting state and national needs that 
2.21 	receives more than 40 percent of its patients from outside the state of Minnesota;
2.22 	(2) a project for construction or modification for which a health care facility held 
2.23 	an approved certificate of need on May 1, 1984, regardless of the date of expiration of 
2.24 	the certificate;
2.25 	(3) a project for which a certificate of need was denied before July 1, 1990, if a 
2.26 	timely appeal results in an order reversing the denial;
2.27 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 
2.28 	200, section 2;
2.29 	(5) a project involving consolidation of pediatric specialty hospital services within 
2.30 	the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the 
2.31 	number of pediatric specialty hospital beds among the hospitals being consolidated;
2.32 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds 
2.33 	to an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
2.34 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
2.35 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
2.36 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
3.1 	(7) the relocation or redistribution of hospital beds within a hospital building or 
3.2 	identifiable complex of buildings provided the relocation or redistribution does not result 
3.3 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds 
3.4 	from one physical site or complex to another; or (iii) redistribution of hospital beds within 
3.5 	the state or a region of the state;
3.6 	(8) relocation or redistribution of hospital beds within a hospital corporate system 
3.7 	that involves the transfer of beds from a closed facility site or complex to an existing site 
3.8 	or complex provided that: (i) no more than 50 percent of the capacity of the closed facility 
3.9 	is transferred; (ii) the capacity of the site or complex to which the beds are transferred 
3.10 	does not increase by more than 50 percent; (iii) the beds are not transferred outside of a 
3.11 	federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or 
3.12 	redistribution does not involve the construction of a new hospital building;
3.13 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in 
3.14 	Rice County that primarily serves adolescents and that receives more than 70 percent of its 
3.15 	patients from outside the state of Minnesota;
3.16 	(10) a project to replace a hospital or hospitals with a combined licensed capacity 
3.17 	of 130 beds or less if: (i) the new hospital site is located within five miles of the current 
3.18 	site; and (ii) the total licensed capacity of the replacement hospital, either at the time of 
3.19 	construction of the initial building or as the result of future expansion, will not exceed 70 
3.20 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
3.21 	(11) the relocation of licensed hospital beds from an existing state facility operated 
3.22 	by the commissioner of human services to a new or existing facility, building, or complex 
3.23 	operated by the commissioner of human services; from one regional treatment center 
3.24 	site to another; or from one building or site to a new or existing building or site on the 
3.25 	same campus;
3.26 	(12) the construction or relocation of hospital beds operated by a hospital having a 
3.27 	statutory obligation to provide hospital and medical services for the indigent that does not 
3.28 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
3.29 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
3.30 	Medical Center to Regions Hospital under this clause;
3.31 	(13) a construction project involving the addition of up to 31 new beds in an existing 
3.32 	nonfederal hospital in Beltrami County;
3.33 	(14) a construction project involving the addition of up to eight new beds in an 
3.34 	existing nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
3.35 	(15) a construction project involving the addition of 20 new hospital beds 
3.36 	used for rehabilitation services in an existing hospital in Carver County serving the 
4.1 	southwest suburban metropolitan area. Beds constructed under this clause shall not be 
4.2 	eligible for reimbursement under medical assistance, general assistance medical care, 
4.3 	or MinnesotaCare;
4.4 	(16) a project for the construction or relocation of up to 20 hospital beds for the 
4.5 	operation of up to two psychiatric facilities or units for children provided that the operation 
4.6 	of the facilities or units have received the approval of the commissioner of human services;
4.7 	(17) a project involving the addition of 14 new hospital beds to be used for 
4.8 	rehabilitation services in an existing hospital in Itasca County;
4.9 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin 
4.10 	County that closed 20 rehabilitation beds in 2002, provided that the beds are used only 
4.11 	for rehabilitation in the hospital's current rehabilitation building. If the beds are used for 
4.12 	another purpose or moved to another location, the hospital's licensed capacity is reduced 
4.13 	by 20 beds;
4.14 	(19) a critical access hospital established under section 144.1483, clause (9), and 
4.15 	section 1820 of the federal Social Security Act, United States Code, title 42, section 
4.16 	1395i-4, that delicensed beds since enactment of the Balanced Budget Act of 1997, Public 
4.17 	Law 105-33, to the extent that the critical access hospital does not seek to exceed the 
4.18 	maximum number of beds permitted such hospital under federal law;
4.19 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
4.20 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
4.21 	(i) the project, including each hospital or health system that will own or control the 
4.22 	entity that will hold the new hospital license, is approved by a resolution of the Maple 
4.23 	Grove City Council as of March 1, 2006;
4.24 	(ii) the entity that will hold the new hospital license will be owned or controlled by 
4.25 	one or more not-for-profit hospitals or health systems that have previously submitted a 
4.26 	plan or plans for a project in Maple Grove as required under section 144.552, and the 
4.27 	plan or plans have been found to be in the public interest by the commissioner of health 
4.28 	as of April 1, 2005;
4.29 	(iii) the new hospital's initial inpatient services must include, but are not limited 
4.30 	to, medical and surgical services, obstetrical and gynecological services, intensive 
4.31 	care services, orthopedic services, pediatric services, noninvasive cardiac diagnostics, 
4.32 	behavioral health services, and emergency room services;
4.33 	(iv) the new hospital:
4.34 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
4.35 	needs of the Maple Grove service area and the surrounding communities currently being 
5.1 	served by the hospital or health system that will own or control the entity that will hold 
5.2 	the new hospital license;
5.3 	(B) will provide uncompensated care;
5.4 	(C) will provide mental health services, including inpatient beds;
5.5 	(D) will be a site for workforce development for a broad spectrum of 
5.6 	health-care-related occupations and have a commitment to providing clinical training 
5.7 	programs for physicians and other health care providers;
5.8 	(E) will demonstrate a commitment to quality care and patient safety;
5.9 	(F) will have an electronic medical records system, including physician order entry;
5.10 	(G) will provide a broad range of senior services;
5.11 	(H) will provide emergency medical services that will coordinate care with regional 
5.12 	providers of trauma services and licensed emergency ambulance services in order to 
5.13 	enhance the continuity of care for emergency medical patients; and
5.14 	(I) will be completed by December 31, 2009, unless delayed by circumstances 
5.15 	beyond the control of the entity holding the new hospital license; and
5.16 	(v) as of 30 days following submission of a written plan, the commissioner of health 
5.17 	has not determined that the hospitals or health systems that will own or control the entity 
5.18 	that will hold the new hospital license are unable to meet the criteria of this clause;
5.19 	(21) a project approved under section 144.553;
5.20 	(22) a project for the construction of a hospital with up to 25 beds in Cass County 
5.21 	within a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's 
5.22 	license holder is approved by the Cass County Board;
5.23 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed 
5.24 	capacity from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 
5.25 	and closing a separately licensed 13-bed skilled nursing facility; or
5.26 	(24) notwithstanding section 144.552, a project for the construction and expansion 
5.27 	of a specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for 
5.28 	patients who are under 21 years of age on the date of admission. The commissioner 
5.29 	conducted a public interest review of the mental health needs of Minnesota and the Twin 
5.30 	Cities metropolitan area in 2008. No further public interest review shall be conducted for 
5.31 	the construction or expansion project under this clause; or
5.32 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if 
5.33 	the commissioner finds the project is in the public interest after the public interest review 
5.34 	conducted under section 144.552 is complete.

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

6.1 	Sec. 2. [144.9513] HEALTHY HOUSING GRANTS.
6.2 		Subdivision 1.Definitions. For purposes of this section and sections 144.9501 to 
6.3 	144.9512, the following terms have the meanings given.
6.4 	(a) "Housing" means a room or group of rooms located within a dwelling forming 
6.5 	a single habitable unit with facilities used or intended to be used for living, sleeping, 
6.6 	cooking, and eating.
6.7 	(b) "Healthy housing" means housing that is sited, designed, built, renovated, and 
6.8 	maintained in ways that supports the health of residents.
6.9 	(c) "Housing-based health threat" means a chemical, biologic, or physical agent in 
6.10 	the immediate housing environment which constitutes a potential or actual hazard to 
6.11 	human health at acute or chronic exposure levels.
6.12 	(d) "Primary prevention" means preventing exposure to housing-based health threats 
6.13 	before seeing clinical symptoms or a diagnosis.
6.14 		Subd. 2.Grants; administration. Grant applicants shall submit applications to 
6.15 	the commissioner as directed by a request for proposals. Grants must be competitively 
6.16 	awarded and recipients of a grant under this section must prepare and submit a quarterly 
6.17 	progress report to the commissioner beginning three months after receipt of the grant. The 
6.18 	commissioner shall provide technical assistance and program support as needed to ensure 
6.19 	that housing-based health threats are effectively identified, mitigated, and evaluated by 
6.20 	grantees.
6.21 		Subd. 3.Education and training grant; eligible activities. (a) Within the limits of 
6.22 	available appropriations, the commissioner shall make grants to nonprofit organizations, 
6.23 	community health boards, and community action agencies under section 256E.31 with 
6.24 	expertise in providing outreach, education, and training on healthy homes subjects and in 
6.25 	providing comprehensive healthy homes assessments and interventions to provide healthy 
6.26 	housing education, training, and technical assistance services for persons engaged in 
6.27 	addressing housing-based health threats and other individuals impacted by housing-based 
6.28 	health threats. 
6.29 	(b) The grantee may conduct the following activities: 
6.30 	(1) implement and maintain primary prevention programs to reduce housing-based 
6.31 	health threats that include the following:
6.32 	(i) providing education materials to the general public and to property owners, 
6.33 	contractors, code officials, health care providers, public health professionals, health 
6.34 	educators, nonprofit organizations, and other persons and organizations engaged in 
6.35 	housing and health issues; 
6.36 	(ii) promoting awareness of community, legal, and housing resources; and 
7.1 	(iii) promoting the use of hazard reduction measures in new housing construction 
7.2 	and housing rehabilitation programs;
7.3 	(2) provide training on identifying and addressing housing-based health threats;  
7.4 	(3) provide technical assistance on the implementation of mitigation measures;
7.5 	(4) promote adoption of evidence-based best practices for mitigation of 
7.6 	housing-based health threats; or 
7.7 	(5) develop work practices for addressing specific housing-based health threats.

7.8 	Sec. 3. [144A.484] INTEGRATED LICENSURE; HOME AND 
7.9 	COMMUNITY-BASED SERVICES DESIGNATION.
7.10 		Subdivision 1.Integrated licensing established. (a) From January 1, 2014, to June 
7.11 	30, 2015, the commissioner of health shall enforce the home and community-based services 
7.12 	standards under chapter 245D for those providers who also have a home care license 
7.13 	pursuant to chapter 144A as required under Laws 2013, chapter 108, article 11, section 31, 
7.14 	and article 8, section 60. During this period, the commissioner shall provide technical 
7.15 	assistance on how to achieve and maintain compliance with applicable law or rules 
7.16 	governing the provision of home and community-based services, including complying with 
7.17 	the service recipient rights notice in subdivision 4, clause (4). If, during the survey, the 
7.18 	commissioner finds that the licensee has failed to achieve compliance with an applicable 
7.19 	law or rule under chapter 245D and this failure does not imminently endanger the health, 
7.20 	safety, or rights of the persons served by the program, the commissioner may issue a 
7.21 	licensing survey report with recommendations for achieving and maintaining compliance.
7.22 	(b) Beginning July 1, 2015, a home care provider applicant or license holder may 
7.23 	apply to the commissioner of health for a home and community-based services designation 
7.24 	for the provision of basic home and community-based services identified under section 
7.25 	245D.03, subdivision 1, paragraph (b). The designation allows the license holder to 
7.26 	provide basic home and community-based services that would otherwise require licensure 
7.27 	under chapter 245D, under the license holder's home care license governed by sections 
7.28 	144A.43 to 144A.481.
7.29 		Subd. 2.Application for home and community-based services designation. An 
7.30 	application for a home and community-based services designation must be made on the 
7.31 	forms and in the manner prescribed by the commissioner. The commissioner shall provide 
7.32 	the applicant with instruction for completing the application and provide information 
7.33 	about the requirements of other state agencies that affect the applicant. Application for 
7.34 	the home and community-based services designation is subject to the requirements under 
7.35 	section 144A.473.
8.1 		Subd. 3.Home and community-based services designation fees. A home care 
8.2 	provider applicant or licensee applying for the home and community-based services 
8.3 	designation or renewal of a home and community-based services designation must submit 
8.4 	a fee in the amount specified in subdivision 8.
8.5 		Subd. 4.Applicability of home and community-based services requirements. A 
8.6 	home care provider with a home and community-based services designation must comply 
8.7 	with the requirements for home care services governed by this chapter. For the provision 
8.8 	of basic home and community-based services, the home care provider must also comply 
8.9 	with the following home and community-based services licensing requirements:
8.10 	(1) person-centered planning requirements in section 245D.07;
8.11 	(2) protection standards in section 245D.06;
8.12 	(3) emergency use of manual restraints in section 245D.061; and
8.13 	(4) service recipient rights in section 245D.04, subdivision 3, paragraph (a), clauses 
8.14 	(5), (7), (8), (12), and (13), and paragraph (b).
8.15 	A home care provider with the integrated license-HCBS designation may utilize a bill of 
8.16 	rights which incorporates the service recipient rights in section 245D.04, subdivision 3, 
8.17 	paragraph (a), clauses (5), (7), (8), (12), and (13), and paragraph (b) with the home care 
8.18 	bill of rights in section 144A.44.
8.19 		Subd. 5.Monitoring and enforcement. (a) The commissioner shall monitor for 
8.20 	compliance with the home and community-based services requirements identified in 
8.21 	subdivision 5, in accordance with this section and any agreements by the commissioners 
8.22 	of health and human services.
8.23 	(b) The commissioner shall enforce compliance with applicable home and 
8.24 	community-based services licensing requirements as follows:
8.25 	(1) the commissioner may deny a home and community-based services designation 
8.26 	in accordance with section 144A.473 or 144A.475; and
8.27 	(2) if the commissioner finds that the applicant or license holder has failed to comply 
8.28 	with the applicable home and community-based services designation requirements the 
8.29 	commissioner may issue:
8.30 	(i) a correction order in accordance with section 144A.474;
8.31 	(ii) an order of conditional license in accordance with section 144A.475;
8.32 	(iii) a sanction in accordance with section 144A.475; or
8.33 	(iv) any combination of clauses (i) to (iii).
8.34 		Subd. 6.Appeals. A home care provider applicant that has been denied a temporary 
8.35 	license will also be denied their application for the home and community-based services 
8.36 	designation. The applicant may request reconsideration in accordance with section 
9.1 	144A.473, subdivision 3. A licensed home care provider whose application for a home 
9.2 	and community-based services designation has been denied or whose designation has been 
9.3 	suspended or revoked may appeal the denial, suspension, revocation, or refusal to renew a 
9.4 	home and community-based services designation in accordance with section 144A.475. 
9.5 	A license holder may request reconsideration of a correction order in accordance with 
9.6 	section 144A.474, subdivision 12.
9.7 		Subd. 7.Agreements. The commissioners of health and human services shall enter 
9.8 	into any agreements necessary to implement this section.
9.9 		Subd. 8.Fees; home and community-based services designation. (a) The initial 
9.10 	fee for a basic home and community-based services designation is $155. A home care 
9.11 	provider who is seeking to renew the provider's home and community-based services 
9.12 	designation must pay an annual nonrefundable fee with the annual home care license 
9.13 	fee according to the following schedule and based on revenues from the home and 
9.14 	community-based services:

9.15
9.16	Provider Annual Revenue from HCBS
	HCBS 
Designation

9.17	greater than $1,500,000
	$320
	
9.18	greater than $1,275,000 and no more than $1,500,000
	$300
	
9.19	greater than $1,100,000 and no more than $1,275,000
	$280
	
9.20	greater than $950,000 and no more than $1,100,000
	$260
	
9.21	greater than $850,000 and no more than $950,000
	$240
	
9.22	greater than $750,000 and no more than $850,000
	$220
	
9.23	greater than $650,000 and no more than $750,000
	$200
	
9.24	greater than $550,000 and no more than $650,000
	$180
	
9.25	greater than $450,000 and no more than $550,000
	$160
	
9.26	greater than $350,000 and no more than $450,000
	$140
	
9.27	greater than $250,000 and no more than $350,000
	$120
	
9.28	greater than $100,000 and no more than $250,000
	$100
	
9.29	greater than $50,000 and no more than $100,000
	$80
	
9.30	greater than $25,000 and no more than $50,000
	$60
	
9.31	no more than $25,000
	$40
	
9.32 	(b) Fees and penalties collected under this section shall be deposited in the state 
9.33 	treasury and credited to the state government special revenue fund.
9.34 		Subd. 9.Study and report about client bill of rights. The commissioner shall 
9.35 	consult with Aging Services of Minnesota, Care Providers of Minnesota, Minnesota Home 
9.36 	Care Association, Department of Human Services, the Ombudsman for Long-Term Care, 
9.37 	and other stakeholders to review how to streamline the client bill of rights requirements 
9.38 	in sections 144A.44, 144A.441, and 245D.04 for providers whose practices fit into one 
9.39 	or several of these practice areas, while assuring and maintaining the health and safety 
10.1 	of clients. The evaluation shall consider the federal client bill of rights requirements for 
10.2 	Medicare-certified home care providers. The evaluation must determine whether there 
10.3 	are duplications or conflicts of client rights, evaluate how to reduce the complexity of the 
10.4 	client bill of rights requirements for providers and consumers, determine which of the 
10.5 	rights must be included in a client bill of rights document, and evaluate whether there are 
10.6 	other ways to ensure that consumers know their rights. The commissioner shall report to 
10.7 	the chairs of the health and human services committees of the legislature no later than 
10.8 	February 15, 2015, along with any recommendations for legislative changes.

10.9 	EFFECTIVE DATE. Minnesota Statutes, section 144A.484, subdivisions 2 to 9, 
10.10 	are effective July 1, 2015.

10.11 	Sec. 4. Minnesota Statutes 2013 Supplement, section 145.4716, subdivision 2, is 
10.12 	amended to read:
10.13 		Subd. 2.Duties of director. The director of child sex trafficking prevention is 
10.14 	responsible for the following:
10.15 	(1) developing and providing comprehensive training on sexual exploitation of 
10.16 	youth for social service professionals, medical professionals, public health workers, and 
10.17 	criminal justice professionals;
10.18 	(2) collecting, organizing, maintaining, and disseminating information on sexual 
10.19 	exploitation and services across the state, including maintaining a list of resources on the 
10.20 	Department of Health Web site;
10.21 	(3) monitoring and applying for federal funding for antitrafficking efforts that may 
10.22 	benefit victims in the state;
10.23 	(4) managing grant programs established under sections 145.4716 to 145.4718;
10.24 	(5) managing the request for proposals for grants for comprehensive services, 
10.25 	including trauma-informed, culturally specific services;
10.26 	(6) identifying best practices in serving sexually exploited youth, as defined in 
10.27 	section 260C.007, subdivision 31;
10.28 	(6)(7) providing oversight of and technical support to regional navigators pursuant 
10.29 	to section 145.4717;
10.30 	(7)(8) conducting a comprehensive evaluation of the statewide program for safe 
10.31 	harbor of sexually exploited youth; and
10.32 	(8)(9) developing a policy consistent with the requirements of chapter 13 for sharing 
10.33 	data related to sexually exploited youth, as defined in section 260C.007, subdivision 31, 
10.34 	among regional navigators and community-based advocates.

11.1 	Sec. 5. Minnesota Statutes 2013 Supplement, section 256B.04, subdivision 21, is 
11.2 	amended to read:
11.3 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for 
11.4 	Medicare and Medicaid Services determines that a provider is designated "high-risk," the 
11.5 	commissioner may withhold payment from providers within that category upon initial 
11.6 	enrollment for a 90-day period. The withholding for each provider must begin on the date 
11.7 	of the first submission of a claim.
11.8 	(b) An enrolled provider that is also licensed by the commissioner under chapter 
11.9 	245A or that is licensed by the Department of Health under chapter 144A and has a 
11.10 	HCBS designation on the home care license must designate an individual as the entity's 
11.11 	compliance officer. The compliance officer must:
11.12 	(1) develop policies and procedures to assure adherence to medical assistance laws 
11.13 	and regulations and to prevent inappropriate claims submissions;
11.14 	(2) train the employees of the provider entity, and any agents or subcontractors of 
11.15 	the provider entity including billers, on the policies and procedures under clause (1);
11.16 	(3) respond to allegations of improper conduct related to the provision or billing of 
11.17 	medical assistance services, and implement action to remediate any resulting problems;
11.18 	(4) use evaluation techniques to monitor compliance with medical assistance laws 
11.19 	and regulations;
11.20 	(5) promptly report to the commissioner any identified violations of medical 
11.21 	assistance laws or regulations; and
11.22 	(6) within 60 days of discovery by the provider of a medical assistance 
11.23 	reimbursement overpayment, report the overpayment to the commissioner and make 
11.24 	arrangements with the commissioner for the commissioner's recovery of the overpayment.
11.25 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
11.26 	provider within a particular industry sector or category establish a compliance program that 
11.27 	contains the core elements established by the Centers for Medicare and Medicaid Services.
11.28 	(c) The commissioner may revoke the enrollment of an ordering or rendering 
11.29 	provider for a period of not more than one year, if the provider fails to maintain and, upon 
11.30 	request from the commissioner, provide access to documentation relating to written orders 
11.31 	or requests for payment for durable medical equipment, certifications for home health 
11.32 	services, or referrals for other items or services written or ordered by such provider, when 
11.33 	the commissioner has identified a pattern of a lack of documentation. A pattern means a 
11.34 	failure to maintain documentation or provide access to documentation on more than one 
11.35 	occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a 
11.36 	provider under the provisions of section 256B.064.
12.1 	(d) The commissioner shall terminate or deny the enrollment of any individual or 
12.2 	entity if the individual or entity has been terminated from participation in Medicare or 
12.3 	under the Medicaid program or Children's Health Insurance Program of any other state.
12.4 	(e) As a condition of enrollment in medical assistance, the commissioner shall 
12.5 	require that a provider designated "moderate" or "high-risk" by the Centers for Medicare 
12.6 	and Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
12.7 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
12.8 	designated contractors to conduct unannounced on-site inspections of any provider location. 
12.9 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
12.10 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
12.11 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
12.12 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
12.13 	The commissioner's designations are not subject to administrative appeal.
12.14 	(f) As a condition of enrollment in medical assistance, the commissioner shall 
12.15 	require that a high-risk provider, or a person with a direct or indirect ownership interest in 
12.16 	the provider of five percent or higher, consent to criminal background checks, including 
12.17 	fingerprinting, when required to do so under state law or by a determination by the 
12.18 	commissioner or the Centers for Medicare and Medicaid Services that a provider is 
12.19 	designated high-risk for fraud, waste, or abuse.
12.20 	(g)(1) Upon initial enrollment, reenrollment, and revalidation, all durable medical 
12.21 	equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers operating in 
12.22 	Minnesota and receiving Medicaid funds must purchase a surety bond that is annually 
12.23 	renewed and designates the Minnesota Department of Human Services as the obligee, and 
12.24 	must be submitted in a form approved by the commissioner.
12.25 	(2) At the time of initial enrollment or reenrollment, the provider agency must 
12.26 	purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue 
12.27 	in the previous calendar year is up to and including $300,000, the provider agency must 
12.28 	purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue 
12.29 	in the previous calendar year is over $300,000, the provider agency must purchase a 
12.30 	performance bond of $100,000. The performance bond must allow for recovery of costs 
12.31 	and fees in pursuing a claim on the bond.
12.32 	(h) The Department of Human Services may require a provider to purchase a 
12.33 	performance surety bond as a condition of initial enrollment, reenrollment, reinstatement, 
12.34 	or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the 
12.35 	department determines there is significant evidence of or potential for fraud and abuse by 
12.36 	the provider, or (3) the provider or category of providers is designated high-risk pursuant 
13.1 	to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450. The 
13.2 	performance bond must be in an amount of $100,000 or ten percent of the provider's 
13.3 	payments from Medicaid during the immediately preceding 12 months, whichever is 
13.4 	greater. The performance bond must name the Department of Human Services as an 
13.5 	obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.

13.6 	Sec. 6. LEGISLATIVE HEALTH CARE WORKFORCE COMMISSION.
 13.7 		Subdivision 1.Legislative oversight. The Legislative Health Care Workforce 
13.8 	Commission is created to study and make recommendations to the legislature on how to 
13.9 	achieve the goal of strengthening the workforce in healthcare.
13.10 		Subd. 2.Membership. The Legislative Health Care Workforce Commission 
13.11 	consists of five members of the senate appointed by the Subcommittee on Committees 
13.12 	of the Committee on Rules and Administration and five members of the house of 
13.13 	representatives appointed by the speaker of the house. The Legislative Health Care 
13.14 	Workforce Commission must include three members of the majority party and two 
13.15 	members of the minority party in each house.
13.16 		Subd. 3.Report to the legislature. The Legislative Health Care Workforce 
13.17 	Commission must provide a report making recommendations to the legislature by 
13.18 	December 31, 2014. The report must:
13.19 	(1) identify current and anticipated health care workforce shortages, by both 
13.20 	provider type and geography;
13.21 	(2) evaluate the effectiveness of incentives currently available to develop, attract, 
13.22 	and retain a highly skilled health care workforce;
13.23 	(3) study alternative incentives to develop, attract, and retain a highly skilled and 
13.24 	diverse health care workforce; and
13.25 	(4) identify current causes and potential solutions to barriers related to the primary 
13.26 	care workforce, including, but not limited to:
13.27 	(i) training and residency shortages;
13.28 	(ii) disparities in income between primary care and other providers; and
13.29 	(iii) negative perceptions of primary care among students.
13.30 		Subd. 4.Assistance to the commission. The commissioners of health, human 
13.31 	services, commerce, and other state agencies shall provide assistance and technical 
13.32 	support to the commission at the request of the commission. The commission may 
13.33 	convene subcommittees to provide additional assistance and advice to the commission.
13.34 		Subd. 5.Expiration. The Legislative Health Care Workforce Commission expires 
13.35 	on January 1, 2015.

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

14.2 	Sec. 7. GRANT PROGRAMS TO ADDRESS MINORITY HEALTH 
14.3 	DISPARITIES.
 14.4 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
14.5 	have the meanings given.
14.6 	(b) "Dementia" means a condition ascribed within the brain that leads to confusion, 
14.7 	lack of focus, and decreased memory.
14.8 	(c) "Education activities" means providing materials related to health care topics 
14.9 	in ethnic-specific languages through materials including, but not limited to, Web sites, 
14.10 	brochures, flyers, and other similar vehicles.
14.11 	(d) "Minority populations" means racial and ethnic groups including, but not limited 
14.12 	to, African-Americans, Native Americans, Hmong, Asians, and other similar groups.
14.13 	(e) "Outreach" means the active pursuit of people within the minority groups 
14.14 	through specific and targeted activities to contact individuals who may not regularly 
14.15 	be contacted by health care professionals.
14.16 		Subd. 2.Grants; distribution. The commissioner of health shall distribute grant 
14.17 	funds to grantees for the following purposes:
14.18 	(1) dementia education and training to specific minority and under-represented 
14.19 	groups;
14.20 	(2) a training conference related to immigrant and refugee mental health issues; and 
14.21 	(3) other programs, as prioritized by the commissioner, relating to health disparities 
14.22 	in minority populations, including, but not limited to, a Somali women-led prevention 
14.23 	health care agency located in Minnesota focused on minority women's health disparities.
14.24 		Subd. 3.Grants; administration. Grant applicants shall submit applications 
14.25 	to the commissioner of health as directed by a request for proposals. Grants must be 
14.26 	competitively awarded and recipients of a grant under this section must prepare and 
14.27 	submit a quarterly progress report to the commissioner beginning three months after 
14.28 	receipt of the grant. The commissioner shall provide technical assistance and program 
14.29 	support as needed, including, but not limited to, assurance that minority individuals with 
14.30 	dementia are effectively identified, mitigated, and evaluated by grantees.
14.31 		Subd. 4.Dementia education and training grant; eligible activities for dementia 
14.32 	outreach. (a) Within the limits of available appropriations, the commissioner shall make 
14.33 	a grant to a nonprofit organization with expertise in providing outreach, education, and 
14.34 	training on dementia, Alzheimer's, and other related disabilities within specific minority 
14.35 	and under-represented groups.
15.1 	(b) The grantee must conduct the following activities:
15.2 	(1) providing and making available educational materials to the general public 
15.3 	as well as specific minority populations;
15.4 	(2) promoting awareness of dementia-related resources and educational materials; 
15.5 	and
15.6 	(3) promoting the use of materials within health care organizations.

15.7 	Sec. 8. FULL-TIME EMPLOYEE RESTRICTION.
 15.8 	No more than one full-time employee may be hired by the Department of Health to 
15.9 	administer the grants under Minnesota Statutes, section 144.9513.

15.10 	ARTICLE 2
15.11 	HEALTH CARE

15.12 	Section 1. Minnesota Statutes 2012, section 256.01, is amended by adding a 
15.13 	subdivision to read:
15.14 		Subd. 38.Contract to match recipient third-party liability information. The 
15.15 	commissioner may enter into a contract with a national organization to match recipient 
15.16 	third-party liability information and provide coverage and insurance primacy information 
15.17 	to the department at no charge to providers and the clearinghouses.

15.18 	Sec. 2. Minnesota Statutes 2012, section 256.9685, subdivision 1, is amended to read:
15.19 		Subdivision 1.Authority. (a) The commissioner shall establish procedures for 
15.20 	determining medical assistance and general assistance medical care payment rates under 
15.21 	a prospective payment system for inpatient hospital services in hospitals that qualify as 
15.22 	vendors of medical assistance. The commissioner shall establish, by rule, procedures for 
15.23 	implementing this section and sections 256.9686, 256.969, and 256.9695. Services must 
15.24 	meet the requirements of section 256B.04, subdivision 15, or 256D.03, subdivision 7, 
15.25 	paragraph (b), to be eligible for payment.
15.26 	(b) The commissioner may reduce the types of inpatient hospital admissions that 
15.27 	are required to be certified as medically necessary after notice in the State Register and a 
15.28 	30-day comment period.

15.29 	Sec. 3. Minnesota Statutes 2012, section 256.9685, subdivision 1a, is amended to read:
15.30 		Subd. 1a.Administrative reconsideration. Notwithstanding sections section
15.31 	256B.04, subdivision 15, and 256D.03, subdivision 7, the commissioner shall establish 
15.32 	an administrative reconsideration process for appeals of inpatient hospital services 
16.1 	determined to be medically unnecessary. A physician or hospital may request a 
16.2 	reconsideration of the decision that inpatient hospital services are not medically necessary 
16.3 	by submitting a written request for review to the commissioner within 30 days after 
16.4 	receiving notice of the decision. The reconsideration process shall take place prior to the 
16.5 	procedures of subdivision 1b and shall be conducted by physicians that are independent 
16.6 	of the case under reconsideration. A majority decision by the physicians is necessary to 
16.7 	make a determination that the services were not medically necessary.

16.8 	Sec. 4. Minnesota Statutes 2012, section 256.9686, subdivision 2, is amended to read:
16.9 		Subd. 2.Base year. "Base year" means a hospital's fiscal year or years that 
16.10 	is recognized by the Medicare program or a hospital's fiscal year specified by the 
16.11 	commissioner if a hospital is not required to file information by the Medicare program 
16.12 	from which cost and statistical data are used to establish medical assistance and general 
16.13 	assistance medical care payment rates.

16.14 	Sec. 5. Minnesota Statutes 2012, section 256.969, subdivision 1, is amended to read:
16.15 		Subdivision 1.Hospital cost index. (a) The hospital cost index shall be the change 
16.16 	in the Consumer Price Index-All Items (United States city average) (CPI-U) forecasted 
16.17 	by Data Resources, Inc. The commissioner shall use the indices as forecasted in the 
16.18 	third quarter of the calendar year prior to the rate year. The hospital cost index may be 
16.19 	used to adjust the base year operating payment rate through the rate year on an annually 
16.20 	compounded basis.
16.21 	(b) For fiscal years beginning on or after July 1, 1993, the commissioner of human 
16.22 	services shall not provide automatic annual inflation adjustments for hospital payment 
16.23 	rates under medical assistance, nor under general assistance medical care, except that 
16.24 	the inflation adjustments under paragraph (a) for medical assistance, excluding general 
16.25 	assistance medical care, shall apply through calendar year 2001. The index for calendar 
16.26 	year 2000 shall be reduced 2.5 percentage points to recover overprojections of the index 
16.27 	from 1994 to 1996. The commissioner of management and budget shall include as a 
16.28 	budget change request in each biennial detailed expenditure budget submitted to the 
16.29 	legislature under section 16A.11 annual adjustments in hospital payment rates under 
16.30 	medical assistance and general assistance medical care, based upon the hospital cost index.

16.31 	Sec. 6. Minnesota Statutes 2012, section 256.969, subdivision 2, is amended to read:
16.32 		Subd. 2.Diagnostic categories. The commissioner shall use to the extent possible 
16.33 	existing diagnostic classification systems, including the system used by the Medicare 
17.1 	program created by 3M for all patient refined diagnosis-related groups (APR-DRGs) to 
17.2 	determine the relative values of inpatient services and case mix indices. The commissioner 
17.3 	may combine diagnostic classifications into diagnostic categories and may establish 
17.4 	separate categories and numbers of categories based on program eligibility or hospital 
17.5 	peer group. Relative values shall be recalculated when the base year is changed. Relative 
17.6 	value determinations shall include paid claims for admissions during each hospital's base 
17.7 	year. The commissioner may extend the time period forward to obtain sufficiently valid 
17.8 	information to establish relative values supplement the APR-DRG data with national 
17.9 	averages. Relative value determinations shall not include property cost data, Medicare 
17.10 	crossover data, and data on admissions that are paid a per day transfer rate under 
17.11 	subdivision 14. The computation of the base year cost per admission must include identified 
17.12 	outlier cases and their weighted costs up to the point that they become outlier cases, but 
17.13 	must exclude costs recognized in outlier payments beyond that point. The commissioner 
17.14 	may recategorize the diagnostic classifications and recalculate relative values and case mix 
17.15 	indices to reflect actual hospital practices, the specific character of specialty hospitals, or 
17.16 	to reduce variances within the diagnostic categories after notice in the State Register and a 
17.17 	30-day comment period. The commissioner shall recategorize the diagnostic classifications 
17.18 	and recalculate relative values and case mix indices based on the two-year schedule in 
17.19 	effect prior to January 1, 2013, reflected in subdivision 2b. The first recategorization shall 
17.20 	occur January 1, 2013, and shall occur every two years after. When rates are not rebased 
17.21 	under subdivision 2b, the commissioner may establish relative values and case mix indices 
17.22 	based on charge data and may update the base year to the most recent data available.

17.23 	Sec. 7. Minnesota Statutes 2012, section 256.969, subdivision 2b, is amended to read:
17.24 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
17.25 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
17.26 	years after, or more frequently as determined by the commissioner, the commissioner shall 
17.27 	obtain operating data from an updated base year and establish operating payment rates 
17.28 	per admission for each hospital based on the cost-finding methods and allowable costs of 
17.29 	the Medicare program in effect during the base year. Rates under the general assistance 
17.30 	medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 
17.31 	more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 
17.32 	rebased period beginning January 1, 2009. For the rebased period beginning January 1, 
17.33 	2011, rates shall not be rebased, except that a Minnesota long-term hospital shall be 
17.34 	rebased effective January 1, 2011, based on its most recent Medicare cost report ending on 
17.35 	or before September 1, 2008, with the provisions under subdivisions 9 and 23, based on 
18.1 	the rates in effect on December 31, 2010. For subsequent rate setting periods in which the 
18.2 	base years are updated, a Minnesota long-term hospital's base year shall remain within 
18.3 	the same period as other hospitals. Effective January 1, 2013, and after, rates shall not be 
18.4 	rebased. The base year operating payment rate per admission is standardized by the case 
18.5 	mix index and adjusted by the hospital cost index, relative values, and disproportionate 
18.6 	population adjustment. The cost and charge data used to establish operating rates shall 
18.7 	only reflect inpatient services covered by medical assistance and shall not include property 
18.8 	cost information and costs recognized in outlier payments. In determining operating 
18.9 	payment rates for admissions occurring on or after the rate year beginning January 1, 
18.10 	2011, through December 31, 2012, the operating payment rate per admission must be 
18.11 	based on the cost-finding methods and allowable costs of the Medicare program in effect 
18.12 	during the base year or years.

18.13 	Sec. 8. Minnesota Statutes 2012, section 256.969, subdivision 2c, is amended to read:
18.14 		Subd. 2c.Property payment rates. For each hospital's first two consecutive 
18.15 	fiscal years beginning on or after July 1, 1988, the commissioner shall limit the annual 
18.16 	increase in property payment rates for depreciation, rents and leases, and interest expense 
18.17 	to the annual growth in the hospital cost index derived from the methodology in effect 
18.18 	on the day before July 1, 1989. When computing budgeted and settlement property 
18.19 	payment rates, the commissioner shall use the annual increase in the hospital cost index 
18.20 	forecasted by Data Resources, Inc., consistent with the quarter of the hospital's fiscal year 
18.21 	end. For admissions occurring on or after the rate year beginning January 1, 1991, the 
18.22 	commissioner shall obtain property data from an updated base year and establish property 
18.23 	payment rates per admission for each hospital. Property payment rates shall be derived 
18.24 	from data from the same base year that is used to establish operating payment rates. The 
18.25 	property information shall include cost categories not subject to the hospital cost index 
18.26 	and shall reflect the cost-finding methods and allowable costs of the Medicare program. 
18.27 	The base year property payment rates shall be adjusted for increases in the property cost 
18.28 	by increasing the base year property payment rate 85 percent of the percentage change 
18.29 	from the base year through the year for which a Medicare cost report has been submitted 
18.30 	to the Medicare program and filed with the department by the October 1 before the rate 
18.31 	year. The property rates shall only reflect inpatient services covered by medical assistance. 
18.32 	The commissioner shall adjust rates for the rate year beginning January 1, 1991, to ensure 
18.33 	that all hospitals are subject to the hospital cost index limitation for two complete years.

19.1 	Sec. 9. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
19.2 	to read:
19.3 		Subd. 2d.Budget neutrality factor. For the rebased period effective September 1, 
19.4 	2014, when rebasing rates under subdivisions 2b and 2c, the commissioner must apply a 
19.5 	budget neutrality factor (BNF) to a hospital's conversion factor to ensure that total DRG 
19.6 	payments to hospitals do not exceed total DRG payments that would have been made to 
19.7 	hospitals if the relative rates and weights had not been recalibrated. For the purposes of 
19.8 	this section, BNF equals the percentage change from total aggregate payments calculated 
19.9 	under a new payment system to total aggregate payments calculated under the old system.

19.10 	Sec. 10. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
19.11 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
19.12 	assistance program must not be submitted until the recipient is discharged. However, 
19.13 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
19.14 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
19.15 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
19.16 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
19.17 	hospital payments established under this section and sections 256.9685, 256.9686, and 
19.18 	256.9695, in addition to third-party and recipient liability, for discharges occurring during 
19.19 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
19.20 	inpatient services paid for the same period of time to the hospital. This payment limitation 
19.21 	shall be calculated separately for medical assistance and general assistance medical 
19.22 	care services. The limitation on general assistance medical care shall be effective for 
19.23 	admissions occurring on or after July 1, 1991. Services that have rates established under 
19.24 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
19.25 	the affected hospitals, the commissioner may consider related hospitals one entity and may 
19.26 	merge the payment rates while maintaining separate provider numbers. The operating and 
19.27 	property base rates per admission or per day shall be derived from the best Medicare and 
19.28 	claims data available when rates are established. The commissioner shall determine the 
19.29 	best Medicare and claims data, taking into consideration variables of recency of the data, 
19.30 	audit disposition, settlement status, and the ability to set rates in a timely manner. The 
19.31 	commissioner shall notify hospitals of payment rates by December 1 of the year preceding 
19.32 	the rate year 30 days prior to implementation. The rate setting data must reflect the 
19.33 	admissions data used to establish relative values. Base year changes from 1981 to the base 
19.34 	year established for the rate year beginning January 1, 1991, and for subsequent rate years, 
19.35 	shall not be limited to the limits ending June 30, 1987, on the maximum rate of increase 
20.1 	under subdivision 1. The commissioner may adjust base year cost, relative value, and case 
20.2 	mix index data to exclude the costs of services that have been discontinued by the October 
20.3 	1 of the year preceding the rate year or that are paid separately from inpatient services. 
20.4 	Inpatient stays that encompass portions of two or more rate years shall have payments 
20.5 	established based on payment rates in effect at the time of admission unless the date of 
20.6 	admission preceded the rate year in effect by six months or more. In this case, operating 
20.7 	payment rates for services rendered during the rate year in effect and established based on 
20.8 	the date of admission shall be adjusted to the rate year in effect by the hospital cost index.
20.9 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
20.10 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
20.11 	services is reduced by .5 percent from the current statutory rates.
20.12 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
20.13 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
20.14 	before third-party liability and spenddown, is reduced five percent from the current 
20.15 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
20.16 	facilities defined under subdivision 16 are excluded from this paragraph.
20.17 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
20.18 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
20.19 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
20.20 	from the current statutory rates. Mental health services within diagnosis related groups 
20.21 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
20.22 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
20.23 	assistance does not include general assistance medical care. Payments made to managed 
20.24 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
20.25 	this reduction.
20.26 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
20.27 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
20.28 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
20.29 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
20.30 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
20.31 	paragraph. Payments made to managed care plans shall be reduced for services provided 
20.32 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
20.33 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
20.34 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
20.35 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
20.36 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
21.1 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
21.2 	paragraph. Payments made to managed care plans shall be reduced for services provided 
21.3 	on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
21.4 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
21.5 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
21.6 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
21.7 	from the current statutory rates. Mental health services with diagnosis related groups 
21.8 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
21.9 	Payments made to managed care plans shall be reduced for services provided on or after 
21.10 	July 1, 2011, to reflect this reduction.
21.11 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
21.12 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
21.13 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
21.14 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
21.15 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
21.16 	services provided on or after October 1, 2009, to reflect this reduction.
21.17 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total 
21.18 	payment for fee-for-service admissions occurring on or after July 1, 2011, made to 
21.19 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
21.20 	1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are 
21.21 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
21.22 	services provided on or after January 1, 2011, to reflect this reduction.

21.23 	Sec. 11. Minnesota Statutes 2012, section 256.969, subdivision 3b, is amended to read:
21.24 		Subd. 3b.Nonpayment for hospital-acquired conditions and for certain 
21.25 	treatments. (a) The commissioner must not make medical assistance payments to a 
21.26 	hospital for any costs of care that result from a condition listed in paragraph (c), if the 
21.27 	condition was hospital acquired.
21.28 	(b) For purposes of this subdivision, a condition is hospital acquired if it is not 
21.29 	identified by the hospital as present on admission. For purposes of this subdivision, 
21.30 	medical assistance includes general assistance medical care and MinnesotaCare.
21.31 	(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired 
21.32 	condition listed in this paragraph that is represented by an ICD-9-CM ICD-10-CM
21.33 	 diagnosis code and is designated as a complicating condition or a major complicating 
21.34 	condition:. The list of conditions is defined by the Centers for Medicare and Medicaid 
21.35 	Services on an annual basis with the hospital-acquired conditions (HAC) list:
22.1 	(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
22.2 	(2) air embolism (ICD-9-CM code 999.1);
22.3 	(3) blood incompatibility (ICD-9-CM code 999.6);
22.4 	(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
22.5 	(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing 
22.6 	injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating 
22.7 	condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929; 
22.8 	940-949; and 991-994);
22.9 	(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
22.10 	(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
22.11 	(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11; 
22.12 	249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and 
22.13 	251.0);
22.14 	(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain 
22.15 	orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07; 
22.16 	81.08; 81.23; 81.24; 81.31; 81.32; 81.33; 81.34; 81.35; 81.36; 81.37; 81.38; 81.83; and 
22.17 	81.85);
22.18 	(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery 
22.19 	(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity 
22.20 	(ICD-9-CM code 278.01);
22.21 	(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary 
22.22 	artery bypass graft (procedure codes 36.10 to 36.19); and
22.23 	(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary 
22.24 	embolism (ICD-9-CM codes 415.11 or 415.19) following total knee replacement 
22.25 	(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51 
22.26 	to 81.52).
22.27 	(d) The prohibition in paragraph (a) applies to any additional payments that result 
22.28 	from a hospital-acquired condition listed in paragraph (c), including, but not limited to, 
22.29 	additional treatment or procedures, readmission to the facility after discharge, increased 
22.30 	length of stay, change to a higher diagnostic category, or transfer to another hospital. In 
22.31 	the event of a transfer to another hospital, the hospital where the condition listed under 
22.32 	paragraph (c) was acquired is responsible for any costs incurred at the hospital to which 
22.33 	the patient is transferred.
22.34 	(e) A hospital shall not bill a recipient of services for any payment disallowed under 
22.35 	this subdivision.

23.1 	Sec. 12. Minnesota Statutes 2012, section 256.969, subdivision 3c, is amended to read:
23.2 		Subd. 3c.Rateable reduction and readmissions reduction. (a) The total payment 
23.3 	for fee for service admissions occurring on or after September 1, 2011, through June 30, 
23.4 	2015, made to hospitals for inpatient services before third-party liability and spenddown, 
23.5 	is reduced ten percent from the current statutory rates. Facilities defined under subdivision 
23.6 	16, long-term hospitals as determined under the Medicare program, children's hospitals 
23.7 	whose inpatients are predominantly under 18 years of age, and payments under managed 
23.8 	care are excluded from this paragraph.
23.9 	(b) Effective for admissions occurring during calendar year 2010 and each year 
23.10 	after, the commissioner shall calculate a regional readmission rate for admissions to all 
23.11 	hospitals occurring within 30 days of a previous discharge. The commissioner may 
23.12 	adjust the readmission rate taking into account factors such as the medical relationship, 
23.13 	complicating conditions, and sequencing of treatment between the initial admission and 
23.14 	subsequent readmissions.
23.15 	(c) Effective for payments to all hospitals on or after July 1, 2013, through June 30, 
23.16 	2015, the reduction in paragraph (a) is reduced one percentage point for every percentage 
23.17 	point reduction in the overall readmissions rate between the two previous calendar years 
23.18 	to a maximum of five percent.
23.19 	(d) A hospital with at least 1,700 licensed beds on January 1, 2012, located in 
23.20 	Hennepin County is excluded from the reduction in paragraph (a) for admissions occurring 
23.21 	on or after September 1, 2011, through August 30, 2013, but is subject to the reduction 
23.22 	in paragraph (a) for admissions occurring on or after September 1, 2013, through June 
23.23 	30, 2015.

23.24 	EFFECTIVE DATE. This section is effectively retroactively from September 1, 
23.25 	2011.

23.26 	Sec. 13. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
23.27 	to read:
23.28 		Subd. 4b.Medical assistance cost reports for services. (a) A hospital that meets 
23.29 	one of the following criteria must annually file medical assistance cost reports within six 
23.30 	months of the end of the hospital's fiscal year:
23.31 	(1) a hospital designated as a critical access hospital that receives medical assistance 
23.32 	payments; or
23.33 	(2) a Minnesota hospital or out-of-state hospital located within a Minnesota local 
23.34 	trade area that receives a disproportionate population adjustment under subdivision 9.
24.1 	For purposes of this subdivision, local trade area has the meaning given in 
24.2 	subdivision 17.
24.3 	(b) The Department of Human Services must suspend payments to any hospital that 
24.4 	fails to file a report required under this subdivision. Payments must remain suspended 
24.5 	until the report has been filed with and accepted by the Department of Human Services 
24.6 	inpatient rates unit.

24.7 	Sec. 14. Minnesota Statutes 2012, section 256.969, subdivision 6a, is amended to read:
24.8 		Subd. 6a.Special considerations. In determining the payment rates, the 
24.9 	commissioner shall consider whether the circumstances in subdivisions 7 8 to 14 exist.

24.10 	Sec. 15. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
24.11 	to read:
24.12 		Subd. 8c.Hospital residents. Payments for hospital residents shall be made 
24.13 	as follows:
24.14 	(1) payments for the first 180 days of inpatient care shall be the APR-DRG payment 
24.15 	plus any appropriate outliers; and
24.16 	(2) payment for all medically necessary patient care subsequent to 180 days shall 
24.17 	be reimbursed at a rate computed by multiplying the statewide average cost-to-charge 
24.18 	ratio by the usual and customary charges.

24.19 	Sec. 16. Minnesota Statutes 2012, section 256.969, subdivision 9, is amended to read:
24.20 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For 
24.21 	admissions occurring on or after October 1, 1992, through December 31, 1992, the 
24.22 	medical assistance disproportionate population adjustment shall comply with federal law 
24.23 	and shall be paid to a hospital, excluding regional treatment centers and facilities of the 
24.24 	federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 
24.25 	of the arithmetic mean. The adjustment must be determined as follows:
24.26 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
24.27 	arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 
24.28 	federal Indian Health Service but less than or equal to one standard deviation above the 
24.29 	mean, the adjustment must be determined by multiplying the total of the operating and 
24.30 	property payment rates by the difference between the hospital's actual medical assistance 
24.31 	inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 
24.32 	treatment centers and facilities of the federal Indian Health Service; and
25.1 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
25.2 	standard deviation above the mean, the adjustment must be determined by multiplying 
25.3 	the adjustment that would be determined under clause (1) for that hospital by 1.1. If 
25.4 	federal matching funds are not available for all adjustments under this subdivision, the 
25.5 	commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 
25.6 	federal match. The commissioner may establish a separate disproportionate population 
25.7 	operating payment rate adjustment under the general assistance medical care program. 
25.8 	For purposes of this subdivision medical assistance does not include general assistance 
25.9 	medical care. The commissioner shall report annually on the number of hospitals likely to 
25.10 	receive the adjustment authorized by this paragraph. The commissioner shall specifically 
25.11 	report on the adjustments received by public hospitals and public hospital corporations 
25.12 	located in cities of the first class.
25.13 	(b) For admissions occurring on or after July 1, 1993, the medical assistance 
25.14 	disproportionate population adjustment shall comply with federal law and shall be paid to 
25.15 	a hospital, excluding regional treatment centers, critical access hospitals, and facilities of 
25.16 	the federal Indian Health Service, with a medical assistance inpatient utilization rate in 
25.17 	excess of the arithmetic mean. The adjustment must be determined as follows:
25.18 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
25.19 	arithmetic mean for all hospitals excluding regional treatment centers, critical access 
25.20 	hospitals, and facilities of the federal Indian Health Service but less than or equal to one 
25.21 	standard deviation above the mean, the adjustment must be determined by multiplying the 
25.22 	total of the operating and property payment rates by the difference between the hospital's 
25.23 	actual medical assistance inpatient utilization rate and the arithmetic mean for all hospitals 
25.24 	excluding regional treatment centers and facilities of the federal Indian Health Service; and
25.25 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
25.26 	standard deviation above the mean, the adjustment must be determined by multiplying 
25.27 	the adjustment that would be determined under clause (1) for that hospital by 1.1. The 
25.28 	commissioner may establish a separate disproportionate population operating payment 
25.29 	rate adjustment under the general assistance medical care program. For purposes of this 
25.30 	subdivision, medical assistance does not include general assistance medical care. The 
25.31 	commissioner shall report annually on the number of hospitals likely to receive the 
25.32 	adjustment authorized by this paragraph. The commissioner shall specifically report on 
25.33 	the adjustments received by public hospitals and public hospital corporations located in 
25.34 	cities of the first class;.
25.35 	(3) for a hospital that had medical assistance fee-for-service payment volume during 
25.36 	calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 
26.1 	payment volume, a medical assistance disproportionate population adjustment shall be 
26.2 	paid in addition to any other disproportionate payment due under this subdivision as 
26.3 	follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 
26.4 	For a hospital that had medical assistance fee-for-service payment volume during calendar 
26.5 	year 1991 in excess of eight percent of total medical assistance fee-for-service payment 
26.6 	volume and was the primary hospital affiliated with the University of Minnesota, a 
26.7 	medical assistance disproportionate population adjustment shall be paid in addition to any 
26.8 	other disproportionate payment due under this subdivision as follows: $505,000 due on 
26.9 	the 15th of each month after noon, beginning July 15, 1995; and
26.10 	(4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 
26.11 	reduced to zero.
26.12 	(c) The commissioner shall adjust rates paid to a health maintenance organization 
26.13 	under contract with the commissioner to reflect rate increases provided in paragraph (b), 
26.14 	clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 
26.15 	rates to reflect payments provided in clause (3).
26.16 	(d) If federal matching funds are not available for all adjustments under paragraph 
26.17 	(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 
26.18 	pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
26.19 	(e) For purposes of this subdivision, medical assistance does not include general 
26.20 	assistance medical care.
26.21 	(f) For hospital services occurring on or after July 1, 2005, to June 30, 2007:
26.22 	(1) general assistance medical care expenditures for fee-for-service inpatient and 
26.23 	outpatient hospital payments made by the department shall be considered Medicaid 
26.24 	disproportionate share hospital payments, except as limited below:
26.25 	 (i) only the portion of Minnesota's disproportionate share hospital allotment under 
26.26 	section 1923(f) of the Social Security Act that is not spent on the disproportionate 
26.27 	population adjustments in paragraph (b), clauses (1) and (2), may be used for general 
26.28 	assistance medical care expenditures;
26.29 	 (ii) only those general assistance medical care expenditures made to hospitals that 
26.30 	qualify for disproportionate share payments under section 1923 of the Social Security Act 
26.31 	and the Medicaid state plan may be considered disproportionate share hospital payments;
26.32 	 (iii) only those general assistance medical care expenditures made to an individual 
26.33 	hospital that would not cause the hospital to exceed its individual hospital limits under 
26.34 	section 1923 of the Social Security Act may be considered; and
26.35 	 (iv) general assistance medical care expenditures may be considered only to the 
26.36 	extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
27.1 	All hospitals and prepaid health plans participating in general assistance medical care 
27.2 	must provide any necessary expenditure, cost, and revenue information required by the 
27.3 	commissioner as necessary for purposes of obtaining federal Medicaid matching funds for 
27.4 	general assistance medical care expenditures; and
27.5 	(2) (c) Certified public expenditures made by Hennepin County Medical Center shall 
27.6 	be considered Medicaid disproportionate share hospital payments. Hennepin County 
27.7 	and Hennepin County Medical Center shall report by June 15, 2007, on payments made 
27.8 	beginning July 1, 2005, or another date specified by the commissioner, that may qualify 
27.9 	for reimbursement under federal law. Based on these reports, the commissioner shall 
27.10 	apply for federal matching funds.
27.11 	(g) (d) Upon federal approval of the related state plan amendment, paragraph (f) (c)
27.12 	 is effective retroactively from July 1, 2005, or the earliest effective date approved by the 
27.13 	Centers for Medicare and Medicaid Services.

27.14 	Sec. 17. Minnesota Statutes 2012, section 256.969, subdivision 10, is amended to read:
27.15 		Subd. 10.Separate billing by certified registered nurse anesthetists. Hospitals 
27.16 	may must exclude certified registered nurse anesthetist costs from the operating payment 
27.17 	rate as allowed by section 256B.0625, subdivision 11. To be eligible, a hospital must 
27.18 	notify the commissioner in writing by October 1 of even-numbered years to exclude 
27.19 	certified registered nurse anesthetist costs. The hospital must agree that all hospital 
27.20 	claims for the cost and charges of certified registered nurse anesthetist services will not 
27.21 	be included as part of the rates for inpatient services provided during the rate year. In 
27.22 	this case, the operating payment rate shall be adjusted to exclude the cost of certified 
27.23 	registered nurse anesthetist services.
27.24 	For admissions occurring on or after July 1, 1991, and until the expiration date of 
27.25 	section 256.9695, subdivision 3, services of certified registered nurse anesthetists provided 
27.26 	on an inpatient basis may be paid as allowed by section 256B.0625, subdivision 11, when 
27.27 	the hospital's base year did not include the cost of these services. To be eligible, a hospital 
27.28 	must notify the commissioner in writing by July 1, 1991, of the request and must comply 
27.29 	with all other requirements of this subdivision.

27.30 	Sec. 18. Minnesota Statutes 2012, section 256.969, subdivision 14, is amended to read:
27.31 		Subd. 14.Transfers. Except as provided in subdivisions 11 and 13, Operating 
27.32 	and property payment rates for admissions that result in transfers and transfers shall be 
27.33 	established on a per day payment system. The per day payment rate shall be the sum of 
27.34 	the adjusted operating and property payment rates determined under this subdivision and 
28.1 	subdivisions 2, 2b, 2c, 3a, 4a, 5a, and 7 8 to 12, divided by the arithmetic mean length 
28.2 	of stay for the diagnostic category. Each admission that results in a transfer and each 
28.3 	transfer is considered a separate admission to each hospital, and the total of the admission 
28.4 	and transfer payments to each hospital must not exceed the total per admission payment 
28.5 	that would otherwise be made to each hospital under this subdivision and subdivisions 
28.6 	2, 2b, 2c, 3a, 4a, 5a, and 7 to 13 8 to 12.

28.7 	Sec. 19. Minnesota Statutes 2012, section 256.969, subdivision 17, is amended to read:
28.8 		Subd. 17.Out-of-state hospitals in local trade areas. Out-of-state hospitals that 
28.9 	are located within a Minnesota local trade area and that have more than 20 admissions in 
28.10 	the base year or years shall have rates established using the same procedures and methods 
28.11 	that apply to Minnesota hospitals. For this subdivision and subdivision 18, local trade area 
28.12 	means a county contiguous to Minnesota and located in a metropolitan statistical area as 
28.13 	determined by Medicare for October 1 prior to the most current rebased rate year. Hospitals 
28.14 	that are not required by law to file information in a format necessary to establish rates shall 
28.15 	have rates established based on the commissioner's estimates of the information. Relative 
28.16 	values of the diagnostic categories shall not be redetermined under this subdivision until 
28.17 	required by rule statute. Hospitals affected by this subdivision shall then be included in 
28.18 	determining relative values. However, hospitals that have rates established based upon 
28.19 	the commissioner's estimates of information shall not be included in determining relative 
28.20 	values. This subdivision is effective for hospital fiscal years beginning on or after July 
28.21 	1, 1988. A hospital shall provide the information necessary to establish rates under this 
28.22 	subdivision at least 90 days before the start of the hospital's fiscal year.

28.23 	Sec. 20. Minnesota Statutes 2012, section 256.969, subdivision 30, is amended to read:
28.24 		Subd. 30.Payment rates for births. (a) For admissions occurring on or after 
28.25 	October 1, 2009 September 1, 2014, the total operating and property payment rate, 
28.26 	excluding disproportionate population adjustment, for the following diagnosis-related 
28.27 	groups, as they fall within the diagnostic APR-DRG categories: (1) 371 cesarean section 
28.28 	without complicating diagnosis 5601, 5602, 5603, 5604 vaginal delivery; and (2) 372 
28.29 	vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without 
28.30 	complicating diagnosis 5401, 5402, 5403, 5404 cesarean section, shall be no greater 
28.31 	than $3,528.
28.32 	(b) The rates described in this subdivision do not include newborn care.
29.1 	(c) Payments to managed care and county-based purchasing plans under section 
29.2 	256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October 
29.3 	1, 2009, to reflect the adjustments in paragraph (a).
29.4 	(d) Prior authorization shall not be required before reimbursement is paid for a 
29.5 	cesarean section delivery.

29.6 	Sec. 21. Minnesota Statutes 2012, section 256B.04, is amended by adding a 
29.7 	subdivision to read:
29.8 		Subd. 24.Medicaid waiver requests and state plan amendments. Prior to 
29.9 	submitting any Medicaid waiver request or Medicaid state plan amendment to the federal 
29.10 	government for approval, the commissioner shall publish the text of the waiver request or 
29.11 	state plan amendment, and a summary of and explanation of the need for the request, on 
29.12 	the agency's Web site and provide a 30-day public comment period. The commissioner 
29.13 	shall notify the public of the availability of this information through the agency's electronic 
29.14 	subscription service. The commissioner shall consider public comments when preparing 
29.15 	the final waiver request or state plan amendment that is to be submitted to the federal 
29.16 	government for approval. The commissioner shall also publish on the agency's Web site 
29.17 	notice of any federal decision related to the state request for approval, within 30 days of 
29.18 	the decision. This notice must describe any modifications to the state request that have 
29.19 	been agreed to by the commissioner as a condition of receiving federal approval.

29.20 	Sec. 22. Minnesota Statutes 2013 Supplement, section 256B.056, subdivision 5c, 
29.21 	is amended to read:
29.22 		Subd. 5c.Excess income standard. (a) The excess income standard for parents 
29.23 	and caretaker relatives, pregnant women, infants, and children ages two through 20 is the 
29.24 	standard specified in subdivision 4, paragraph (b).
29.25 	(b) The excess income standard for a person whose eligibility is based on blindness, 
29.26 	disability, or age of 65 or more years shall equal 75 percent of the federal poverty 
29.27 	guidelines. The excess income standard under this paragraph shall equal 80 percent of 
29.28 	the federal poverty guidelines, effective January 1, 2017.

29.29 	Sec. 23. Minnesota Statutes 2012, section 256B.0625, subdivision 30, is amended to 
29.30 	read:
29.31 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic 
29.32 	services, federally qualified health center services, nonprofit community health clinic 
29.33 	services, and public health clinic services. Rural health clinic services and federally 
30.1 	qualified health center services mean services defined in United States Code, title 42, 
30.2 	section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified 
30.3 	health center services shall be made according to applicable federal law and regulation.
30.4 	(b) A federally qualified health center that is beginning initial operation shall submit 
30.5 	an estimate of budgeted costs and visits for the initial reporting period in the form and 
30.6 	detail required by the commissioner. A federally qualified health center that is already in 
30.7 	operation shall submit an initial report using actual costs and visits for the initial reporting 
30.8 	period. Within 90 days of the end of its reporting period, a federally qualified health 
30.9 	center shall submit, in the form and detail required by the commissioner, a report of 
30.10 	its operations, including allowable costs actually incurred for the period and the actual 
30.11 	number of visits for services furnished during the period, and other information required 
30.12 	by the commissioner. Federally qualified health centers that file Medicare cost reports 
30.13 	shall provide the commissioner with a copy of the most recent Medicare cost report filed 
30.14 	with the Medicare program intermediary for the reporting year which support the costs 
30.15 	claimed on their cost report to the state.
30.16 	(c) In order to continue cost-based payment under the medical assistance program 
30.17 	according to paragraphs (a) and (b), a federally qualified health center or rural health clinic 
30.18 	must apply for designation as an essential community provider within six months of final 
30.19 	adoption of rules by the Department of Health according to section 62Q.19, subdivision 
30.20 	7. For those federally qualified health centers and rural health clinics that have applied 
30.21 	for essential community provider status within the six-month time prescribed, medical 
30.22 	assistance payments will continue to be made according to paragraphs (a) and (b) for the 
30.23 	first three years after application. For federally qualified health centers and rural health 
30.24 	clinics that either do not apply within the time specified above or who have had essential 
30.25 	community provider status for three years, medical assistance payments for health services 
30.26 	provided by these entities shall be according to the same rates and conditions applicable 
30.27 	to the same service provided by health care providers that are not federally qualified 
30.28 	health centers or rural health clinics.
30.29 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally 
30.30 	qualified health center or a rural health clinic to make application for an essential 
30.31 	community provider designation in order to have cost-based payments made according 
30.32 	to paragraphs (a) and (b) no longer apply.
30.33 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) 
30.34 	shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
30.35 	(f) Effective January 1, 2001, each federally qualified health center and rural health 
30.36 	clinic may elect to be paid either under the prospective payment system established 
31.1 	in United States Code, title 42, section 1396a(aa), or under an alternative payment 
31.2 	methodology consistent with the requirements of United States Code, title 42, section 
31.3 	1396a(aa), and approved by the Centers for Medicare and Medicaid Services. The 
31.4 	alternative payment methodology shall be 100 percent of cost as determined according to 
31.5 	Medicare cost principles.
31.6 	(g) For purposes of this section, "nonprofit community clinic" is a clinic that:
31.7 	(1) has nonprofit status as specified in chapter 317A;
31.8 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
31.9 	(3) is established to provide health services to low-income population groups, 
31.10 	uninsured, high-risk and special needs populations, underserved and other special needs 
31.11 	populations;
31.12 	(4) employs professional staff at least one-half of which are familiar with the 
31.13 	cultural background of their clients;
31.14 	(5) charges for services on a sliding fee scale designed to provide assistance to 
31.15 	low-income clients based on current poverty income guidelines and family size; and
31.16 	(6) does not restrict access or services because of a client's financial limitations or 
31.17 	public assistance status and provides no-cost care as needed.
31.18 	(h) Effective for dates of service on and after January 1, 2015, all claims for payment 
31.19 	of clinic services provided by federally qualified health centers and rural health clinics 
31.20 	shall be submitted directly to the commissioner and paid by the commissioner. The 
31.21 	commissioner shall provide claims information received by the commissioner under 
31.22 	this paragraph for recipients enrolled in managed care to managed care organizations 
31.23 	on a regular basis.
31.24 	(i) For clinic services provided prior to January 1, 2015, the commissioner shall 
31.25 	calculate and pay monthly the proposed managed care supplemental payments to clinics 
31.26 	and clinics shall conduct a timely review of the payment calculation data in order to 
31.27 	finalize all supplemental payments in accordance with federal law. Any issues arising 
31.28 	from a clinic's review must be reported to the commissioner by January 1, 2017. Upon 
31.29 	final agreement between the commissioner and a clinic on issues identified under this 
31.30 	subdivision, and in accordance with United States Code, title 42, section 1396a(bb), no 
31.31 	supplemental payments for managed care claims for dates of service prior to January 1, 
31.32 	2015, shall be made after June 30, 2017. If the commissioner and clinics are unable to 
31.33 	resolve issues under this subdivision, the parties shall submit the dispute to the arbitration 
31.34 	process under section 14.57.

32.1 	Sec. 24. Minnesota Statutes 2012, section 256B.0751, is amended by adding a 
32.2 	subdivision to read:
32.3 		Subd. 10.Health care homes advisory committee. (a) The commissioners of 
32.4 	health and human services shall establish a health care homes advisory committee to 
32.5 	advise the commissioners on the ongoing statewide implementation of the health care 
32.6 	homes program authorized in this section.
32.7 	(b) The commissioners shall establish an advisory committee that includes 
32.8 	representatives of the health care professions such as primary care providers; mental 
32.9 	health providers; nursing and care coordinators; certified health care home clinics with 
32.10 	statewide representation; health plan companies; state agencies; employers; academic 
32.11 	researchers; consumers; and organizations that work to improve health care quality in 
32.12 	Minnesota. At least 25 percent of the committee members must be consumers or patients 
32.13 	in health care homes. The commissioners, in making appointments to the committee, shall 
32.14 	ensure geographic representation of all regions of the state.
32.15 	(c) The advisory committee shall advise the commissioners on ongoing 
32.16 	implementation of the health care homes program, including, but not limited to, the 
32.17 	following activities:
32.18 	(1) implementation of certified health care homes across the state on performance 
32.19 	management and implementation of benchmarking;
32.20 	(2) implementation of modifications to the health care homes program based on 
32.21 	results of the legislatively mandated health care home evaluation;
32.22 	(3) statewide solutions for engagement of employers and commercial payers;
32.23 	(4) potential modifications of the health care home rules or statutes;
32.24 	(5) consumer engagement, including patient and family-centered care, patient 
32.25 	activation in health care, and shared decision making;
32.26 	(6) oversight for health care home subject matter task forces or workgroups; and
32.27 	(7) other related issues as requested by the commissioners.
32.28 	(d) The advisory committee shall have the ability to establish subcommittees on 
32.29 	specific topics. The advisory committee is governed by section 15.059. Notwithstanding 
32.30 	section 15.059, the advisory committee does not expire.

32.31 	Sec. 25. Minnesota Statutes 2012, section 256B.199, is amended to read:
32.32 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
32.33 	(a) Effective July 1, 2007, The commissioner shall apply for federal matching 
32.34 	funds for the expenditures in paragraphs (b) and (c). Effective September 1, 2011, the 
32.35 	commissioner shall apply for matching funds for expenditures in paragraph (e).
33.1 	(b) The commissioner shall apply for federal matching funds for certified public 
33.2 	expenditures as follows:.
33.3 	(1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions 
33.4 	Hospital, the University of Minnesota, and Fairview-University Medical Center shall 
33.5 	report quarterly to the commissioner beginning June 1, 2007, payments made during the 
33.6 	second previous quarter that may qualify for reimbursement under federal law;
33.7 	 (2) based on these reports, the commissioner shall apply for federal matching 
33.8 	funds. These funds are appropriated to the commissioner for the payments under section 
33.9 	256.969, subdivision 27; and
33.10 	(3) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
33.11 	the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
33.12 	hospital payment money expected to be available in the current federal fiscal year.
33.13 	(c) The commissioner shall apply for federal matching funds for general assistance 
33.14 	medical care expenditures as follows:
33.15 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
33.16 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
33.17 	the department shall be used to apply for federal matching funds, except as limited below:
33.18 	(i) only those general assistance medical care expenditures made to an individual 
33.19 	hospital that would not cause the hospital to exceed its individual hospital limits under 
33.20 	section 1923 of the Social Security Act may be considered; and
33.21 	(ii) general assistance medical care expenditures may be considered only to the extent 
33.22 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
33.23 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
33.24 	information required by the commissioner as necessary for purposes of obtaining federal 
33.25 	Medicaid matching funds for general assistance medical care expenditures.
33.26 	(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 
33.27 	apply for additional federal matching funds available as disproportionate share hospital 
33.28 	payments under the American Recovery and Reinvestment Act of 2009. These funds shall 
33.29 	be made available as the state share of payments under section 256.969, subdivision 28. 
33.30 	The entities required to report certified public expenditures under paragraph (b), clause 
33.31 	(1), shall report additional certified public expenditures as necessary under this paragraph.
33.32 	(e) (c) For services provided on or after September 1, 2011, the commissioner shall 
33.33 	apply for additional federal matching funds available as disproportionate share hospital 
33.34 	payments under the MinnesotaCare program according to the requirements and conditions 
33.35 	of paragraph (c). A hospital may elect on an annual basis to not be a disproportionate 
34.1 	share hospital for purposes of this paragraph, if the hospital does not qualify for a payment 
34.2 	under section 256.969, subdivision 9, paragraph (b).

34.3 	Sec. 26. Minnesota Statutes 2012, section 256B.35, subdivision 1, is amended to read:
34.4 		Subdivision 1.Personal needs allowance. (a) Notwithstanding any law to the 
34.5 	contrary, welfare allowances for clothing and personal needs for individuals receiving 
34.6 	medical assistance while residing in any skilled nursing home, intermediate care facility, 
34.7 	or medical institution including recipients of Supplemental Security Income, in this state 
34.8 	shall not be less than $45 per month from all sources. When benefit amounts for Social 
34.9 	Security or Supplemental Security Income recipients are increased pursuant to United 
34.10 	States Code, title 42, sections 415(i) and 1382f, the commissioner shall, effective in the 
34.11 	month in which the increase takes effect, increase by the same percentage to the nearest 
34.12 	whole dollar the clothing and personal needs allowance for individuals receiving medical 
34.13 	assistance while residing in any skilled nursing home, medical institution, or intermediate 
34.14 	care facility. The commissioner shall provide timely notice to local agencies, providers, 
34.15 	and recipients of increases under this provision.
34.16 	(b) The personal needs allowance may be paid as part of the Minnesota supplemental 
34.17 	aid program, and payments to recipients of Minnesota supplemental aid may be made once 
34.18 	each three months covering liabilities that accrued during the preceding three months.
34.19 	(c) The personal needs allowance shall be increased to include income garnished 
34.20 	for child support under a court order, up to a maximum of $250 per month but only to 
34.21 	the extent that the amount garnished is not deducted as a monthly allowance for children 
34.22 	under section 256B.0575, paragraph (a), clause (5).
34.23 	(d) Solely for the purpose of section 256B.0575, subdivision 1, paragraph (a), clause 
34.24 	(1), the personal needs allowance shall be increased to include income garnished for 
34.25 	spousal maintenance under a judgment and decree for dissolution of marriage, and any 
34.26 	administrative fees garnished for collection efforts.

34.27 	Sec. 27. Minnesota Statutes 2013 Supplement, section 256B.69, subdivision 34, 
34.28 	is amended to read:
34.29 		Subd. 34.Supplemental recovery program. The commissioner shall conduct a 
34.30 	supplemental recovery program for third-party liabilities, identified through coordination 
34.31 	of benefits,  not recovered by managed care plans and county-based purchasing plans for 
34.32 	state public health programs. Any third-party liability identified through coordination 
34.33 	of benefits, and recovered by the commissioner more than six eight  months after the 
34.34 	date a managed care plan or county-based purchasing plan receives adjudicates a health 
35.1 	care claim, based on accurate and timely coordination of benefits information from the 
35.2 	commissioner, shall be retained by the commissioner and deposited in the general fund. 
35.3 	The commissioner shall establish a mechanism, including a reconciliation process,  for 
35.4 	managed care plans and county-based purchasing plans to coordinate third-party liability 
35.5 	collections efforts resulting from coordination of benefits under this subdivision with the 
35.6 	commissioner to ensure there is no duplication of efforts. The coordination mechanism 
35.7 	must be consistent with the reporting requirements in subdivision 9c.

35.8 	Sec. 28. MEDICAL ASSISTANCE SPENDDOWN REQUIREMENTS.
 35.9 	The commissioner of human services, in consultation with interested stakeholders, 
35.10 	shall review medical assistance spenddown requirements and processes, including those 
35.11 	used in other states, for individuals with disabilities and seniors age 65 years of age or 
35.12 	older. Based on this review, the commissioner shall recommend alternative medical 
35.13 	assistance spenddown payment requirements and processes that:
35.14 	(1) are practical for current and potential medical assistance recipients, providers, 
35.15 	and the Department of Human Services;
35.16 	(2) improve the medical assistance payment process for providers; and
35.17 	(3) allow current and potential medical assistance recipients to obtain consistent 
35.18 	and affordable medical coverage.
35.19 	The commissioner shall report these recommendations, along with the projected cost, 
35.20 	to the chairs and ranking minority members of the legislative committees and divisions 
35.21 	with jurisdiction over health and human services policy and finance by November 15, 2015.

35.22 	Sec. 29. REPEALER.
 35.23 	Minnesota Statutes 2012, sections 256.969, subdivisions 8b, 9a, 9b, 11, 13, 20, 21, 
35.24 	22, 25, 26, 27, and 28; and 256.9695, subdivisions 3 and 4, are repealed.

35.25 	ARTICLE 3
35.26 	NORTHSTAR CARE FOR CHILDREN

35.27 	Section 1. Minnesota Statutes 2012, section 245C.05, subdivision 5, is amended to read:
35.28 		Subd. 5.Fingerprints. (a) Except as provided in paragraph (c), for any background 
35.29 	study completed under this chapter, when the commissioner has reasonable cause to 
35.30 	believe that further pertinent information may exist on the subject of the background 
35.31 	study, the subject shall provide the commissioner with a set of classifiable fingerprints 
35.32 	obtained from an authorized agency.
36.1 	(b) For purposes of requiring fingerprints, the commissioner has reasonable cause 
36.2 	when, but not limited to, the:
36.3 	(1) information from the Bureau of Criminal Apprehension indicates that the subject 
36.4 	is a multistate offender;
36.5 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
36.6 	offender status is undetermined; or
36.7 	(3) commissioner has received a report from the subject or a third party indicating 
36.8 	that the subject has a criminal history in a jurisdiction other than Minnesota.
36.9 	(c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for 
36.10 	background studies conducted by the commissioner for child foster care or, adoptions, or a 
36.11 	transfer of permanent legal and physical custody of a child, the subject of the background 
36.12 	study, who is 18 years of age or older, shall provide the commissioner with a set of 
36.13 	classifiable fingerprints obtained from an authorized agency.

36.14 	Sec. 2. Minnesota Statutes 2013 Supplement, section 245C.08, subdivision 1, is 
36.15 	amended to read:
36.16 		Subdivision 1.Background studies conducted by Department of Human 
36.17 	Services. (a) For a background study conducted by the Department of Human Services, 
36.18 	the commissioner shall review:
36.19 	(1) information related to names of substantiated perpetrators of maltreatment of 
36.20 	vulnerable adults that has been received by the commissioner as required under section 
36.21 	626.557, subdivision 9c, paragraph (j);
36.22 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
36.23 	programs, and from findings of maltreatment of minors as indicated through the social 
36.24 	service information system;
36.25 	(3) information from juvenile courts as required in subdivision 4 for individuals 
36.26 	listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
36.27 	(4) information from the Bureau of Criminal Apprehension, including information 
36.28 	regarding a background study subject's registration in Minnesota as a predatory offender 
36.29 	under section 243.166;
36.30 	(5) except as provided in clause (6), information from the national crime information 
36.31 	system when the commissioner has reasonable cause as defined under section 245C.05, 
36.32 	subdivision 5; and
36.33 	(6) for a background study related to a child foster care application for licensure, a 
36.34 	transfer of permanent legal and physical custody of a child under sections 260C.503 to 
36.35 	260C.515, or adoptions, the commissioner shall also review:
37.1 	(i) information from the child abuse and neglect registry for any state in which the 
37.2 	background study subject has resided for the past five years; and
37.3 	(ii) information from national crime information databases, when the background 
37.4 	study subject is 18 years of age or older.
37.5 	(b) Notwithstanding expungement by a court, the commissioner may consider 
37.6 	information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 
37.7 	received notice of the petition for expungement and the court order for expungement is 
37.8 	directed specifically to the commissioner.
37.9 	(c) The commissioner shall also review criminal case information received according 
37.10 	to section 245C.04, subdivision 4a, from the Minnesota court information system that 
37.11 	relates to individuals who have already been studied under this chapter and who remain 
37.12 	affiliated with the agency that initiated the background study.

37.13 	Sec. 3. Minnesota Statutes 2012, section 245C.33, subdivision 1, is amended to read:
37.14 		Subdivision 1.Background studies conducted by commissioner. (a) Before 
37.15 	placement of a child for purposes of adoption, the commissioner shall conduct a 
37.16 	background study on individuals listed in section sections259.41, subdivision 3, and 
37.17 	260C.611, for county agencies and private agencies licensed to place children for adoption.
37.18 	 When a prospective adoptive parent is seeking to adopt a child who is currently placed in 
37.19 	the prospective adoptive parent's home and is under the guardianship of the commissioner 
37.20 	according to section 260C.325, subdivision 1, paragraph (b), and the prospective adoptive 
37.21 	parent holds a child foster care license, a new background study is not required when:
37.22 	(1) a background study was completed on persons required to be studied under section 
37.23 	245C.03 in connection with the application for child foster care licensure after July 1, 2007;
37.24 	(2) the background study included a review of the information in section 245C.08, 
37.25 	subdivisions 1, 3, and 4; and
37.26 	(3) as a result of the background study, the individual was either not disqualified 
37.27 	or, if disqualified, the disqualification was set aside under section 245C.22, or a variance 
37.28 	was issued under section 245C.30.
37.29 	(b) Before the kinship placement agreement is signed for the purpose of transferring 
37.30 	permanent legal and physical custody to a relative under sections 260C.503 to 260C.515, 
37.31 	the commissioner shall conduct a background study on each person age 13 or older living 
37.32 	in the home. When a prospective relative custodian has a child foster care license, a new 
37.33 	background study is not required when:
37.34 	(1) a background study was completed on persons required to be studied under section 
37.35 	245C.03 in connection with the application for child foster care licensure after July 1, 2007;
38.1 	(2) the background study included a review of the information in section 245C.08, 
38.2 	subdivisions 1, 3, and 4; and
38.3 	(3) as a result of the background study, the individual was either not disqualified or, 
38.4 	if disqualified, the disqualification was set aside under section 245C.22, or a variance was 
38.5 	issued under section 245C.30. The commissioner and the county agency shall expedite any 
38.6 	request for a set aside or variance for a background study required under chapter 256N.

38.7 	Sec. 4. Minnesota Statutes 2012, section 245C.33, subdivision 4, is amended to read:
38.8 		Subd. 4.Information commissioner reviews. (a) The commissioner shall review 
38.9 	the following information regarding the background study subject:
38.10 	(1) the information under section 245C.08, subdivisions 1, 3, and 4;
38.11 	(2) information from the child abuse and neglect registry for any state in which the 
38.12 	subject has resided for the past five years; and
38.13 	(3) information from national crime information databases, when required under 
38.14 	section 245C.08.
38.15 	(b) The commissioner shall provide any information collected under this subdivision 
38.16 	to the county or private agency that initiated the background study. The commissioner 
38.17 	shall also provide the agency:
38.18 	(1) notice whether the information collected shows that the subject of the background 
38.19 	study has a conviction listed in United States Code, title 42, section 671(a)(20)(A); and
38.20 	(2) for background studies conducted under subdivision 1, paragraph (a), the date of 
38.21 	all adoption-related background studies completed on the subject by the commissioner 
38.22 	after June 30, 2007, and the name of the county or private agency that initiated the 
38.23 	adoption-related background study.

38.24 	Sec. 5. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 1, is 
38.25 	amended to read:
38.26 		Subdivision 1.General eligibility requirements. (a) To be eligible for guardianship 
38.27 	assistance under this section, there must be a judicial determination under section 
38.28 	260C.515, subdivision 4, that a transfer of permanent legal and physical custody to a 
38.29 	relative is in the child's best interest. For a child under jurisdiction of a tribal court, a 
38.30 	judicial determination under a similar provision in tribal code indicating that a relative 
38.31 	will assume the duty and authority to provide care, control, and protection of a child who 
38.32 	is residing in foster care, and to make decisions regarding the child's education, health 
38.33 	care, and general welfare until adulthood, and that this is in the child's best interest is 
38.34 	considered equivalent. Additionally, a child must:
39.1 	(1) have been removed from the child's home pursuant to a voluntary placement 
39.2 	agreement or court order;
39.3 	(2)(i) have resided in with the prospective relative custodian who has been a 
39.4 	licensed child foster care parent for at least six consecutive months in the home of the 
39.5 	prospective relative custodian; or
39.6 	(ii) have received from the commissioner an exemption from the requirement in item 
39.7 	(i) from the court that the prospective relative custodian has been a licensed child foster 
39.8 	parent for at least six consecutive months, based on a determination that:
39.9 	(A) an expedited move to permanency is in the child's best interest;
39.10 	(B) expedited permanency cannot be completed without provision of guardianship 
39.11 	assistance; and
39.12 	(C) the prospective relative custodian is uniquely qualified to meet the child's needs, 
39.13 	as defined in section 260C.212, subdivision 2, on a permanent basis;
39.14 	(D) the child and prospective relative custodian meet the eligibility requirements 
39.15 	of this section; and
39.16 	(E) efforts were made by the legally responsible agency to place the child with the 
39.17 	prospective relative custodian as a licensed child foster parent for six consecutive months 
39.18 	before permanency, or an explanation why these efforts were not in the child's best interests;
39.19 	(3) meet the agency determinations regarding permanency requirements in 
39.20 	subdivision 2;
39.21 	(4) meet the applicable citizenship and immigration requirements in subdivision 3;
39.22 	(5) have been consulted regarding the proposed transfer of permanent legal and 
39.23 	physical custody to a relative, if the child is at least 14 years of age or is expected to attain 
39.24 	14 years of age prior to the transfer of permanent legal and physical custody; and
39.25 	(6) have a written, binding agreement under section 256N.25 among the caregiver or 
39.26 	caregivers, the financially responsible agency, and the commissioner established prior to 
39.27 	transfer of permanent legal and physical custody.
39.28 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
39.29 	custodian or custodians must meet the applicable background study requirements in 
39.30 	subdivision 4.
39.31 	(c) To be eligible for title IV-E guardianship assistance, a child must also meet any 
39.32 	additional criteria in section 473(d) of the Social Security Act. The sibling of a child 
39.33 	who meets the criteria for title IV-E guardianship assistance in section 473(d) of the 
39.34 	Social Security Act is eligible for title IV-E guardianship assistance if the child and 
39.35 	sibling are placed with the same prospective relative custodian or custodians, and the 
39.36 	legally responsible agency, relatives, and commissioner agree on the appropriateness of 
40.1 	the arrangement for the sibling. A child who meets all eligibility criteria except those 
40.2 	specific to title IV-E guardianship assistance is entitled to guardianship assistance paid 
40.3 	through funds other than title IV-E.

40.4 	Sec. 6. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 2, is 
40.5 	amended to read:
40.6 		Subd. 2.Agency determinations regarding permanency. (a) To be eligible for 
40.7 	guardianship assistance, the legally responsible agency must complete the following 
40.8 	determinations regarding permanency for the child prior to the transfer of permanent 
40.9 	legal and physical custody:
40.10 	(1) a determination that reunification and adoption are not appropriate permanency 
40.11 	options for the child; and
40.12 	(2) a determination that the child demonstrates a strong attachment to the prospective 
40.13 	relative custodian and the prospective relative custodian has a strong commitment to 
40.14 	caring permanently for the child.
40.15 	(b) The legally responsible agency shall document the determinations in paragraph 
40.16 	(a) and the eligibility requirements in this section that comply with United States Code, 
40.17 	title 42, sections 673(d) and 675(1)(F). These determinations must be documented in a 
40.18 	kinship placement agreement, which must be in the format prescribed by the commissioner 
40.19 	and must be signed by the prospective relative custodian and the legally responsible 
40.20 	agency. In the case of a Minnesota tribe, the determinations and eligibility requirements 
40.21 	in this section may be provided in an alternative format approved by the commissioner.
40.22 	 Supporting information for completing each determination must be documented in the 
40.23 	legally responsible agency's case file and make them available for review as requested 
40.24 	by the financially responsible agency and the commissioner during the guardianship 
40.25 	assistance eligibility determination process.

40.26 	Sec. 7. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 4, is 
40.27 	amended to read:
40.28 		Subd. 4.Background study. (a) A background study under section 245C.33 must be 
40.29 	completed on each prospective relative custodian and any other adult residing in the home 
40.30 	of the prospective relative custodian. The background study must meet the requirements of 
40.31 	United States Code, title 42, section 671(a)(20). A study completed under section 245C.33 
40.32 	meets this requirement. A background study on the prospective relative custodian or adult 
40.33 	residing in the household previously completed under section 245C.04 chapter 245C for the 
40.34 	purposes of child foster care licensure may under chapter 245A or licensure by a Minnesota 
41.1 	tribe, shall be used for the purposes of this section, provided that the background study is 
41.2 	current meets the requirements of this subdivision and the prospective relative custodian is 
41.3 	a licensed child foster parent at the time of the application for guardianship assistance.
41.4 	(b) If the background study reveals:
41.5 	(1) a felony conviction at any time for:
41.6 	(i) child abuse or neglect;
41.7 	(ii) spousal abuse;
41.8 	(iii) a crime against a child, including child pornography; or
41.9 	(iv) a crime involving violence, including rape, sexual assault, or homicide, but not 
41.10 	including other physical assault or battery; or
41.11 	(2) a felony conviction within the past five years for:
41.12 	(i) physical assault;
41.13 	(ii) battery; or
41.14 	(iii) a drug-related offense;
41.15 	the prospective relative custodian is prohibited from receiving guardianship assistance 
41.16 	on behalf of an otherwise eligible child.

41.17 	Sec. 8. Minnesota Statutes 2013 Supplement, section 256N.23, subdivision 4, is 
41.18 	amended to read:
41.19 		Subd. 4.Background study. (a) A background study under section 259.41 must be 
41.20 	completed on each prospective adoptive parent. and all other adults residing in the home. 
41.21 	A background study must meet the requirements of United States Code, title 42, section 
41.22 	671(a)(20). A study completed under section 245C.33 meets this requirement. If the 
41.23 	prospective adoptive parent is a licensed child foster parent licensed under chapter 245A 
41.24 	or by a Minnesota tribe, the background study previously completed for the purposes of 
41.25 	child foster care licensure shall be used for the purpose of this section, provided that the 
41.26 	background study meets all other requirements of this subdivision and the prospective 
41.27 	adoptive parent is a licensed child foster parent at the time of the application for adoption 
41.28 	assistance.
41.29 	(b) If the background study reveals:
41.30 	(1) a felony conviction at any time for:
41.31 	(i) child abuse or neglect;
41.32 	(ii) spousal abuse;
41.33 	(iii) a crime against a child, including child pornography; or
41.34 	(iv) a crime involving violence, including rape, sexual assault, or homicide, but not 
41.35 	including other physical assault or battery; or
42.1 	(2) a felony conviction within the past five years for:
42.2 	(i) physical assault;
42.3 	(ii) battery; or
42.4 	(iii) a drug-related offense;
42.5 	the adoptive parent is prohibited from receiving adoption assistance on behalf of an 
42.6 	otherwise eligible child.

42.7 	Sec. 9. Minnesota Statutes 2013 Supplement, section 256N.25, subdivision 2, is 
42.8 	amended to read:
42.9 		Subd. 2.Negotiation of agreement. (a) When a child is determined to be eligible 
42.10 	for guardianship assistance or adoption assistance, the financially responsible agency, or, 
42.11 	if there is no financially responsible agency, the agency designated by the commissioner, 
42.12 	must negotiate with the caregiver to develop an agreement under subdivision 1. If and when 
42.13 	the caregiver and agency reach concurrence as to the terms of the agreement, both parties 
42.14 	shall sign the agreement. The agency must submit the agreement, along with the eligibility 
42.15 	determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to 
42.16 	the commissioner for final review, approval, and signature according to subdivision 1.
42.17 	(b) A monthly payment is provided as part of the adoption assistance or guardianship 
42.18 	assistance agreement to support the care of children unless the child is eligible for adoption 
42.19 	assistance and determined to be an at-risk child, in which case the special at-risk monthly 
42.20 	payment under section 256N.26, subdivision 7, must no payment will be made unless and 
42.21 	until the caregiver obtains written documentation from a qualified expert that the potential 
42.22 	disability upon which eligibility for the agreement was based has manifested itself.
42.23 	(1) The amount of the payment made on behalf of a child eligible for guardianship 
42.24 	assistance or adoption assistance is determined through agreement between the prospective 
42.25 	relative custodian or the adoptive parent and the financially responsible agency, or, if there 
42.26 	is no financially responsible agency, the agency designated by the commissioner, using 
42.27 	the assessment tool established by the commissioner in section 256N.24, subdivision 2, 
42.28 	and the associated benefit and payments outlined in section 256N.26. Except as provided 
42.29 	under section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes 
42.30 	the monthly benefit level for a child under foster care. The monthly payment under a 
42.31 	guardianship assistance agreement or adoption assistance agreement may be negotiated up 
42.32 	to the monthly benefit level under foster care. In no case may the amount of the payment 
42.33 	under a guardianship assistance agreement or adoption assistance agreement exceed the 
42.34 	foster care maintenance payment which would have been paid during the month if the 
43.1 	child with respect to whom the guardianship assistance or adoption assistance payment is 
43.2 	made had been in a foster family home in the state.
43.3 	(2) The rate schedule for the agreement is determined based on the age of the 
43.4 	child on the date that the prospective adoptive parent or parents or relative custodian or 
43.5 	custodians sign the agreement.
43.6 	(3) The income of the relative custodian or custodians or adoptive parent or parents 
43.7 	must not be taken into consideration when determining eligibility for guardianship 
43.8 	assistance or adoption assistance or the amount of the payments under section 256N.26.
43.9 	(4) With the concurrence of the relative custodian or adoptive parent, the amount of 
43.10 	the payment may be adjusted periodically using the assessment tool established by the 
43.11 	commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under 
43.12 	subdivision 3 when there is a change in the child's needs or the family's circumstances.
43.13 	(5) The guardianship assistance or adoption assistance agreement of a child who is 
43.14 	identified as at-risk receives the special at-risk monthly payment under section 256N.26, 
43.15 	subdivision 7, unless and until the potential disability manifests itself, as documented by 
43.16 	an appropriate professional, and the commissioner authorizes commencement of payment 
43.17 	by modifying the agreement accordingly. A relative custodian or An adoptive parent 
43.18 	of an at-risk child with a guardianship assistance or an adoption assistance agreement 
43.19 	may request a reassessment of the child under section 256N.24, subdivision 9 10, and 
43.20 	renegotiation of the guardianship assistance or adoption assistance agreement under 
43.21 	subdivision 3 to include a monthly payment, if the caregiver has written documentation 
43.22 	from a qualified expert that the potential disability upon which eligibility for the agreement 
43.23 	was based has manifested itself. Documentation of the disability must be limited to 
43.24 	evidence deemed appropriate by the commissioner.
43.25 	(c) For guardianship assistance agreements:
43.26 	(1) the initial amount of the monthly guardianship assistance payment must be 
43.27 	equivalent to the foster care rate in effect at the time that the agreement is signed less any 
43.28 	offsets under section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to 
43.29 	by the prospective relative custodian and specified in that agreement, unless the child is 
43.30 	identified as at-risk or the guardianship assistance agreement is entered into when a child 
43.31 	is under the age of six; and
43.32 	(2) an at-risk child must be assigned level A as outlined in section 256N.26 and 
43.33 	receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless 
43.34 	and until the potential disability manifests itself, as documented by a qualified expert, and 
43.35 	the commissioner authorizes commencement of payment by modifying the agreement 
43.36 	accordingly; and
44.1 	(3) (2) the amount of the monthly payment for a guardianship assistance agreement 
44.2 	for a child, other than an at-risk child, who is under the age of six must be as specified in 
44.3 	section 256N.26, subdivision 5.
44.4 	(d) For adoption assistance agreements:
44.5 	(1) for a child in foster care with the prospective adoptive parent immediately prior 
44.6 	to adoptive placement, the initial amount of the monthly adoption assistance payment 
44.7 	must be equivalent to the foster care rate in effect at the time that the agreement is signed 
44.8 	less any offsets in section 256N.26, subdivision 11, or a lesser negotiated amount if agreed 
44.9 	to by the prospective adoptive parents and specified in that agreement, unless the child is 
44.10 	identified as at-risk or the adoption assistance agreement is entered into when a child is 
44.11 	under the age of six;
44.12 	(2) for an at-risk child who must be assigned level A as outlined in section 
44.13 	256N.26and receive the special at-risk monthly payment under section 256N.26, 
44.14 	subdivision 7, no payment will be made  unless and until the potential disability manifests 
44.15 	itself, as documented by an appropriate professional, and the commissioner authorizes 
44.16 	commencement of payment by modifying the agreement accordingly;
44.17 	(3) the amount of the monthly payment for an adoption assistance agreement for 
44.18 	a child under the age of six, other than an at-risk child, must be as specified in section 
44.19 	256N.26, subdivision 5;
44.20 	(4) for a child who is in the guardianship assistance program immediately prior 
44.21 	to adoptive placement, the initial amount of the adoption assistance payment must be 
44.22 	equivalent to the guardianship assistance payment in effect at the time that the adoption 
44.23 	assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive 
44.24 	parent and specified in that agreement, unless the child is identified as an at-risk child; and
44.25 	(5) for a child who is not in foster care placement or the guardianship assistance 
44.26 	program immediately prior to adoptive placement or negotiation of the adoption assistance 
44.27 	agreement, the initial amount of the adoption assistance agreement must be determined 
44.28 	using the assessment tool and process in this section and the corresponding payment 
44.29 	amount outlined in section 256N.26.

44.30 	Sec. 10. Minnesota Statutes 2013 Supplement, section 256N.25, subdivision 3, is 
44.31 	amended to read:
44.32 		Subd. 3.Renegotiation of agreement. (a) A relative custodian or adoptive 
44.33 	parent of a child with a guardianship assistance or adoption assistance agreement may 
44.34 	request renegotiation of the agreement when there is a change in the needs of the child 
44.35 	or in the family's circumstances. When a relative custodian or adoptive parent requests 
45.1 	renegotiation of the agreement, a reassessment of the child must be completed consistent 
45.2 	with section 256N.24, subdivisions 9 and 10. If the reassessment indicates that the 
45.3 	child's level has changed, the financially responsible agency or, if there is no financially 
45.4 	responsible agency, the agency designated by the commissioner or the commissioner's 
45.5 	designee, and the caregiver must renegotiate the agreement to include a payment with 
45.6 	the level determined through the reassessment process. The agreement must not be 
45.7 	renegotiated unless the commissioner, the financially responsible agency, and the caregiver 
45.8 	mutually agree to the changes. The effective date of any renegotiated agreement must be 
45.9 	determined by the commissioner.
45.10 	(b) A relative custodian or An adoptive parent of an at-risk child with a guardianship 
45.11 	assistance or an adoption assistance agreement may request renegotiation of the agreement 
45.12 	to include a monthly payment higher than the special at-risk monthly payment under 
45.13 	section 256N.26, subdivision 7, if the caregiver has written documentation from a 
45.14 	qualified expert that the potential disability upon which eligibility for the agreement 
45.15 	was based has manifested itself. Documentation of the disability must be limited to 
45.16 	evidence deemed appropriate by the commissioner. Prior to renegotiating the agreement, a 
45.17 	reassessment of the child must be conducted as outlined in section 256N.24, subdivision 
45.18 	9. The reassessment must be used to renegotiate the agreement to include an appropriate 
45.19 	monthly payment. The agreement must not be renegotiated unless the commissioner, the 
45.20 	financially responsible agency, and the caregiver mutually agree to the changes. The 
45.21 	effective date of any renegotiated agreement must be determined by the commissioner.
45.22 	(c) Renegotiation of a guardianship assistance or adoption assistance agreement is 
45.23 	required when one of the circumstances outlined in section 256N.26, subdivision 13, 
45.24 	occurs.

45.25 	Sec. 11. Minnesota Statutes 2013 Supplement, section 256N.26, subdivision 1, is 
45.26 	amended to read:
45.27 		Subdivision 1.Benefits. (a) There are three benefits under Northstar Care for 
45.28 	Children: medical assistance, basic payment, and supplemental difficulty of care payment.
45.29 	(b) A child is eligible for medical assistance under subdivision 2.
45.30 	(c) A child is eligible for the basic payment under subdivision 3, except for a child 
45.31 	assigned level A under section 256N.24, subdivision 1, because the child is determined to 
45.32 	be an at-risk child receiving guardianship assistance or adoption assistance.
45.33 	(d) A child, including a foster child age 18 to 21, is eligible for an additional 
45.34 	supplemental difficulty of care payment under subdivision 4, as determined by the 
45.35 	assessment under section 256N.24.
46.1 	(e) An eligible child entering guardianship assistance or adoption assistance under 
46.2 	the age of six receives a basic payment and supplemental difficulty of care payment as 
46.3 	specified in subdivision 5.
46.4 	(f) A child transitioning in from a pre-Northstar Care for Children program under 
46.5 	section 256N.28, subdivision 7, shall receive basic and difficulty of care supplemental 
46.6 	payments according to those provisions.

46.7 	Sec. 12. Minnesota Statutes 2013 Supplement, section 256N.27, subdivision 4, is 
46.8 	amended to read:
46.9 		Subd. 4.Nonfederal share. (a) The commissioner shall establish a percentage share 
46.10 	of the maintenance payments, reduced by federal reimbursements under title IV-E of the 
46.11 	Social Security Act, to be paid by the state and to be paid by the financially responsible 
46.12 	agency.
46.13 	(b) These state and local shares must initially be calculated based on the ratio of the 
46.14 	average appropriate expenditures made by the state and all financially responsible agencies 
46.15 	during calendar years 2011, 2012, 2013, and 2014. For purposes of this calculation, 
46.16 	appropriate expenditures for the financially responsible agencies must include basic and 
46.17 	difficulty of care payments for foster care reduced by federal reimbursements, but not 
46.18 	including any initial clothing allowance, administrative payments to child care agencies 
46.19 	specified in section 317A.907, child care, or other support or ancillary expenditures. For 
46.20 	purposes of this calculation, appropriate expenditures for the state shall include adoption 
46.21 	assistance and relative custody assistance, reduced by federal reimbursements.
46.22 	(c) For each of the periods January 1, 2015, to June 30, 2016, and fiscal years 2017, 
46.23 	2018, and 2019, the commissioner shall adjust this initial percentage of state and local 
46.24 	shares to reflect the relative expenditure trends during calendar years 2011, 2012, 2013, and 
46.25 	2014, taking into account appropriations for Northstar Care for Children and the turnover 
46.26 	rates of the components. In making these adjustments, the commissioner's goal shall be to 
46.27 	make these state and local expenditures other than the appropriations for Northstar Care 
46.28 	for Children to be the same as they would have been had Northstar Care for Children not 
46.29 	been implemented, or if that is not possible, proportionally higher or lower, as appropriate. 
46.30 	Except for adjustments so that the costs of the phase-in are borne by the state, the state and 
46.31 	local share percentages for fiscal year 2019 must be used for all subsequent years.

46.32 	Sec. 13. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
46.33 		Subd. 11.Financial considerations. (a) Payment of relative custody assistance 
46.34 	under a relative custody assistance agreement is subject to the availability of state funds 
47.1 	and payments may be reduced or suspended on order of the commissioner if insufficient 
47.2 	funds are available.
47.3 	(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner 
47.4 	shall reimburse the local agency in an amount equal to 100 percent of the relative custody 
47.5 	assistance payments provided to relative custodians. The A local agency may not seek and 
47.6 	the commissioner shall not provide reimbursement for the administrative costs associated 
47.7 	with performing the duties described in subdivision 4.
47.8 	(c) For the purposes of determining eligibility or payment amounts under MFIP, 
47.9 	relative custody assistance payments shall be excluded in determining the family's 
47.10 	available income.
47.11 	(d) For expenditures made on or before December 31, 2014, upon receipt from a 
47.12 	local agency of a claim for reimbursement, the commissioner shall reimburse the local 
47.13 	agency in an amount equal to 100 percent of the relative custody assistance payments 
47.14 	provided to relative custodians.
47.15 	(e) For expenditures made on or after January 1, 2015, upon receipt from a local 
47.16 	agency of a claim for reimbursement, the commissioner shall reimburse the local agency as 
47.17 	part of the Northstar Care for Children fiscal reconciliation process under section 256N.27.

47.18 	Sec. 14. Minnesota Statutes 2012, section 260C.212, subdivision 1, is amended to read:
47.19 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan 
47.20 	shall be prepared within 30 days after any child is placed in foster care by court order or a 
47.21 	voluntary placement agreement between the responsible social services agency and the 
47.22 	child's parent pursuant to section 260C.227 or chapter 260D.
47.23 	(b) An out-of-home placement plan means a written document which is prepared 
47.24 	by the responsible social services agency jointly with the parent or parents or guardian 
47.25 	of the child and in consultation with the child's guardian ad litem, the child's tribe, if the 
47.26 	child is an Indian child, the child's foster parent or representative of the foster care facility, 
47.27 	and, where appropriate, the child. For a child in voluntary foster care for treatment under 
47.28 	chapter 260D, preparation of the out-of-home placement plan shall additionally include 
47.29 	the child's mental health treatment provider. As appropriate, the plan shall be:
47.30 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
47.31 	(2) ordered by the court, either as presented or modified after hearing, under section 
47.32 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
47.33 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad 
47.34 	litem, a representative of the child's tribe, the responsible social services agency, and, if 
47.35 	possible, the child.
48.1 	(c) The out-of-home placement plan shall be explained to all persons involved in its 
48.2 	implementation, including the child who has signed the plan, and shall set forth:
48.3 	(1) a description of the foster care home or facility selected, including how the 
48.4 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
48.5 	least restrictive, most family-like, setting available which is in close proximity to the home 
48.6 	of the parent or parents or guardian of the child when the case plan goal is reunification, 
48.7 	and how the placement is consistent with the best interests and special needs of the child 
48.8 	according to the factors under subdivision 2, paragraph (b);
48.9 	(2) the specific reasons for the placement of the child in foster care, and when 
48.10 	reunification is the plan, a description of the problems or conditions in the home of the 
48.11 	parent or parents which necessitated removal of the child from home and the changes the 
48.12 	parent or parents must make in order for the child to safely return home;
48.13 	(3) a description of the services offered and provided to prevent removal of the child 
48.14 	from the home and to reunify the family including:
48.15 	(i) the specific actions to be taken by the parent or parents of the child to eliminate 
48.16 	or correct the problems or conditions identified in clause (2), and the time period during 
48.17 	which the actions are to be taken; and
48.18 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 
48.19 	to achieve a safe and stable home for the child including social and other supportive 
48.20 	services to be provided or offered to the parent or parents or guardian of the child, the 
48.21 	child, and the residential facility during the period the child is in the residential facility;
48.22 	(4) a description of any services or resources that were requested by the child or the 
48.23 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
48.24 	in the residential facility, and whether those services or resources were provided and if 
48.25 	not, the basis for the denial of the services or resources;
48.26 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined 
48.27 	in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed 
48.28 	together in foster care, and whether visitation is consistent with the best interest of the 
48.29 	child, during the period the child is in foster care;
48.30 	(6) when a child cannot return to or be in the care of either parent, documentation of 
48.31 	steps to finalize the permanency plan for the child, including:
48.32 	(i) reasonable efforts to place the child for adoption or legal guardianship of the child 
48.33 	if the court has issued an order terminating the rights of both parents of the child or of the 
48.34 	only known, living parent of the child. At a minimum, the documentation must include 
48.35 	consideration of whether adoption is in the best interests of the child, child-specific 
48.36 	recruitment efforts such as relative search and the use of state, regional, and national 
49.1 	adoption exchanges to facilitate orderly and timely placements in and outside of the state. 
49.2 	A copy of this documentation shall be provided to the court in the review required under 
49.3 	section 260C.317, subdivision 3, paragraph (b); and
49.4 	(ii) documentation necessary to support the requirements of the kinship placement 
49.5 	agreement under section 256N.22 when adoption is determined not to be in the child's 
49.6 	best interest;
49.7 	(7) efforts to ensure the child's educational stability while in foster care, including:
49.8 	(i) efforts to ensure that the child remains in the same school in which the child was 
49.9 	enrolled prior to placement or upon the child's move from one placement to another, 
49.10 	including efforts to work with the local education authorities to ensure the child's 
49.11 	educational stability; or
49.12 	(ii) if it is not in the child's best interest to remain in the same school that the child 
49.13 	was enrolled in prior to placement or move from one placement to another, efforts to 
49.14 	ensure immediate and appropriate enrollment for the child in a new school;
49.15 	(8) the educational records of the child including the most recent information 
49.16 	available regarding:
49.17 	(i) the names and addresses of the child's educational providers;
49.18 	(ii) the child's grade level performance;
49.19 	(iii) the child's school record;
49.20 	(iv) a statement about how the child's placement in foster care takes into account 
49.21 	proximity to the school in which the child is enrolled at the time of placement; and
49.22 	(v) any other relevant educational information;
49.23 	(9) the efforts by the local agency to ensure the oversight and continuity of health 
49.24 	care services for the foster child, including:
49.25 	(i) the plan to schedule the child's initial health screens;
49.26 	(ii) how the child's known medical problems and identified needs from the screens, 
49.27 	including any known communicable diseases, as defined in section 144.4172, subdivision 
49.28 	2, will be monitored and treated while the child is in foster care;
49.29 	(iii) how the child's medical information will be updated and shared, including 
49.30 	the child's immunizations;
49.31 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
49.32 	including the role of the parent, the agency, and the foster parent;
49.33 	(v) who is responsible for oversight of the child's prescription medications;
49.34 	(vi) how physicians or other appropriate medical and nonmedical professionals 
49.35 	will be consulted and involved in assessing the health and well-being of the child and 
49.36 	determine the appropriate medical treatment for the child; and
50.1 	(vii) the responsibility to ensure that the child has access to medical care through 
50.2 	either medical insurance or medical assistance;
50.3 	(10) the health records of the child including information available regarding:
50.4 	(i) the names and addresses of the child's health care and dental care providers;
50.5 	(ii) a record of the child's immunizations;
50.6 	(iii) the child's known medical problems, including any known communicable 
50.7 	diseases as defined in section 144.4172, subdivision 2;
50.8 	(iv) the child's medications; and
50.9 	(v) any other relevant health care information such as the child's eligibility for 
50.10 	medical insurance or medical assistance;
50.11 	(11) an independent living plan for a child age 16 or older. The plan should include, 
50.12 	but not be limited to, the following objectives:
50.13 	(i) educational, vocational, or employment planning;
50.14 	(ii) health care planning and medical coverage;
50.15 	(iii) transportation including, where appropriate, assisting the child in obtaining a 
50.16 	driver's license;
50.17 	(iv) money management, including the responsibility of the agency to ensure that 
50.18 	the youth annually receives, at no cost to the youth, a consumer report as defined under 
50.19 	section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;
50.20 	(v) planning for housing;
50.21 	(vi) social and recreational skills; and
50.22 	(vii) establishing and maintaining connections with the child's family and 
50.23 	community; and
50.24 	(12) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
50.25 	and assessment information, specific services relating to meeting the mental health care 
50.26 	needs of the child, and treatment outcomes.
50.27 	(d) The parent or parents or guardian and the child each shall have the right to legal 
50.28 	counsel in the preparation of the case plan and shall be informed of the right at the time 
50.29 	of placement of the child. The child shall also have the right to a guardian ad litem. 
50.30 	If unable to employ counsel from their own resources, the court shall appoint counsel 
50.31 	upon the request of the parent or parents or the child or the child's legal guardian. The 
50.32 	parent or parents may also receive assistance from any person or social services agency 
50.33 	in preparation of the case plan.
50.34 	After the plan has been agreed upon by the parties involved or approved or ordered 
50.35 	by the court, the foster parents shall be fully informed of the provisions of the case plan 
50.36 	and shall be provided a copy of the plan.
51.1 	Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 
51.2 	physical custodian, as appropriate, and the child, if appropriate, must be provided with 
51.3 	a current copy of the child's health and education record.

51.4 	Sec. 15. Minnesota Statutes 2012, section 260C.515, subdivision 4, is amended to read:
51.5 		Subd. 4.Custody to relative. The court may order permanent legal and physical 
51.6 	custody to a fit and willing relative in the best interests of the child according to the 
51.7 	following conditions requirements:
51.8 	(1) an order for transfer of permanent legal and physical custody to a relative shall 
51.9 	only be made after the court has reviewed the suitability of the prospective legal and 
51.10 	physical custodian;
51.11 	(2) in transferring permanent legal and physical custody to a relative, the juvenile 
51.12 	court shall follow the standards applicable under this chapter and chapter 260, and the 
51.13 	procedures in the Minnesota Rules of Juvenile Protection Procedure;
51.14 	(3) a transfer of legal and physical custody includes responsibility for the protection, 
51.15 	education, care, and control of the child and decision making on behalf of the child;
51.16 	(4) a permanent legal and physical custodian may not return a child to the permanent 
51.17 	care of a parent from whom the court removed custody without the court's approval and 
51.18 	without notice to the responsible social services agency;
51.19 	(5) the social services agency may file a petition naming a fit and willing relative as 
51.20 	a proposed permanent legal and physical custodian. A petition for transfer of permanent 
51.21 	legal and physical custody to a relative who is not a parent shall be accompanied by a 
51.22 	kinship placement agreement under section 256N.22, subdivision 2, between the agency 
51.23 	and proposed permanent legal and physical custodian;
51.24 	(6) another party to the permanency proceeding regarding the child may file a 
51.25 	petition to transfer permanent legal and physical custody to a relative, but the. The petition 
51.26 	must include facts upon which the court can make the determination required under clause 
51.27 	(7) and must be filed not later than the date for the required admit-deny hearing under 
51.28 	section 260C.507; or if the agency's petition is filed under section 260C.503, subdivision 
51.29 	2, the petition must be filed not later than 30 days prior to the trial required under section 
51.30 	260C.509; and
51.31 	(7) where a petition is for transfer of permanent legal and physical custody to a 
51.32 	relative who is not a parent, the court must find that:
51.33 	(i) transfer of permanent legal and physical custody and receipt of Northstar kinship 
51.34 	assistance under chapter 256N, when requested and the child is eligible, is in the child's 
51.35 	best interests;
52.1 	(ii) adoption is not in the child's best interests based on the determinations in the 
52.2 	kinship placement agreement required under section 256N.22, subdivision 2;
52.3 	(iii) the agency made efforts to discuss adoption with the child's parent or parents, 
52.4 	or the agency did not make efforts to discuss adoption and the reasons why efforts were 
52.5 	not made; and
52.6 	(iv) there are reasons to separate siblings during placement, if applicable;
52.7 	(8) the court may defer finalization of an order transferring permanent legal and 
52.8 	physical custody to a relative when deferring finalization is necessary to determine 
52.9 	eligibility for Northstar kinship assistance under chapter 256N; 
52.10 	(9) the court may finalize a permanent transfer of physical and legal custody to a 
52.11 	relative regardless of eligibility for Northstar kinship assistance under chapter 256N; and
52.12 	(7) (10) the juvenile court may maintain jurisdiction over the responsible social 
52.13 	services agency, the parents or guardian of the child, the child, and the permanent legal 
52.14 	and physical custodian for purposes of ensuring appropriate services are delivered to the 
52.15 	child and permanent legal custodian for the purpose of ensuring conditions ordered by the 
52.16 	court related to the care and custody of the child are met.

52.17 	Sec. 16. Minnesota Statutes 2012, section 260C.611, is amended to read:
52.18 	260C.611 ADOPTION STUDY REQUIRED.
52.19 	(a) An adoption study under section 259.41 approving placement of the child in the 
52.20 	home of the prospective adoptive parent shall be completed before placing any child under 
52.21 	the guardianship of the commissioner in a home for adoption. If a prospective adoptive 
52.22 	parent has a current child foster care license under chapter 245A and is seeking to adopt 
52.23 	a foster child who is placed in the prospective adoptive parent's home and is under the 
52.24 	guardianship of the commissioner according to section 260C.325, subdivision 1, the child 
52.25 	foster care home study meets the requirements of this section for an approved adoption 
52.26 	home study if:
52.27 	(1) the written home study on which the foster care license was based is completed 
52.28 	in the commissioner's designated format, consistent with the requirements in sections 
52.29 	260C.215, subdivision 4, clause (5); and 259.41, subdivision 2; and Minnesota Rules, 
52.30 	part 2960.3060, subpart 4;
52.31 	(2) the background studies on each prospective adoptive parent and all required 
52.32 	household members were completed according to section 245C.33;
52.33 	(3) the commissioner has not issued, within the last three years, a sanction on the 
52.34 	license under section 245A.07 or an order of a conditional license under section 245A.06; 
52.35 	and
53.1 	(4) the legally responsible agency determines that the individual needs of the child 
53.2 	are being met by the prospective adoptive parent through an assessment under section 
53.3 	256N.24, subdivision 2, or a documented placement decision consistent with section 
53.4 	260C.212, subdivision 2.
53.5 	(b) If a prospective adoptive parent has previously held a foster care license or 
53.6 	adoptive home study, any update necessary to the foster care license, or updated or new 
53.7 	adoptive home study, if not completed by the licensing authority responsible for the 
53.8 	previous license or home study, shall include collateral information from the previous 
53.9 	licensing or approving agency, if available.

53.10 	Sec. 17. REVISOR'S INSTRUCTION.
 53.11 	The revisor of statutes shall change the term "guardianship assistance" to "Northstar 
53.12 	kinship assistance" wherever it appears in Minnesota Statutes and Minnesota Rules to 
53.13 	refer to the program components related to Northstar Care for Children under Minnesota 
53.14 	Statutes, chapter 256N.

53.15 	Sec. 18.  REPEALER.
 53.16 	Minnesota Statutes 2013 Supplement, section 256N.26, subdivision 7, is repealed.

53.17 	ARTICLE 4
53.18 	COMMUNITY FIRST SERVICES AND SUPPORTS

53.19 	Section 1. Minnesota Statutes 2012, section 245C.03, is amended by adding a 
53.20 	subdivision to read:
53.21 		Subd. 8.Community first services and supports organizations. The 
53.22 	commissioner shall conduct background studies on any individual required under section 
53.23 	256B.85 to have a background study completed under this chapter.

53.24 	Sec. 2. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision 
53.25 	to read:
53.26 		Subd. 7.Community first services and supports organizations. (a) The 
53.27 	commissioner shall conduct a background study of an individual required to be studied 
53.28 	under section 245C.03, subdivision 8, at least upon application for initial enrollment 
53.29 	under section 256B.85.
53.30 	(b) Before an individual described in section 245C.03, subdivision 8, begins a 
53.31 	position allowing direct contact with a person served by an organization required to initiate 
54.1 	a background study under section 256B.85, the organization must receive a notice from 
54.2 	the commissioner that the support worker is:
54.3 	(1) not disqualified under section 245C.14; or
54.4 	(2) disqualified, but the individual has received a set-aside of the disqualification 
54.5 	under section 245C.22.

54.6 	Sec. 3. Minnesota Statutes 2012, section 245C.10, is amended by adding a subdivision 
54.7 	to read:
54.8 		Subd. 10.Community first services and supports organizations. The 
54.9 	commissioner shall recover the cost of background studies initiated by an agency-provider 
54.10 	delivering services under section 256B.85, subdivision 11, or a financial management 
54.11 	services contractor providing service functions under section 256B.85, subdivision 13, 
54.12 	through a fee of no more than $20 per study, charged to the organization responsible for 
54.13 	submitting the background study form. The fees collected under this subdivision are 
54.14 	appropriated to the commissioner for the purpose of conducting background studies.

54.15 	Sec. 4. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 2, is 
54.16 	amended to read:
54.17 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in 
54.18 	this subdivision have the meanings given.
54.19 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, 
54.20 	dressing, bathing, mobility, positioning, and transferring.
54.21 	(c) "Agency-provider model" means a method of CFSS under which a qualified 
54.22 	agency provides services and supports through the agency's own employees and policies. 
54.23 	The agency must allow the participant to have a significant role in the selection and 
54.24 	dismissal of support workers of their choice for the delivery of their specific services 
54.25 	and supports.
54.26 	(d) "Behavior" means a description of a need for services and supports used to 
54.27 	determine the home care rating and additional service units. The presence of Level I 
54.28 	behavior is used to determine the home care rating. "Level I behavior" means physical 
54.29 	aggression towards self or others or destruction of property that requires the immediate 
54.30 	response of another person. If qualified for a home care rating as described in subdivision 
54.31 	8, additional service units can be added as described in subdivision 8, paragraph (f), for 
54.32 	the following behaviors:
54.33 	(1) Level I behavior;
55.1 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
55.2 	behavior; or
55.3 	(3) increased need for assistance for recipients participants who are verbally 
55.4 	aggressive or resistive to care so that time needed to perform activities of daily living is 
55.5 	increased.
55.6 	(e) "Budget model" means a service delivery method of CFSS that allows the 
55.7 	use of a service budget and assistance from a vendor fiscal/employer agent financial 
55.8 	management services (FMS) contractor for a participant to directly employ support 
55.9 	workers and purchase supports and goods.
55.10 	(e) (f) "Complex health-related needs" means an intervention listed in clauses (1) 
55.11 	to (8) that has been ordered by a physician, and is specified in a community support 
55.12 	plan, including:
55.13 	(1) tube feedings requiring:
55.14 	(i) a gastrojejunostomy tube; or
55.15 	(ii) continuous tube feeding lasting longer than 12 hours per day;
55.16 	(2) wounds described as:
55.17 	(i) stage III or stage IV;
55.18 	(ii) multiple wounds;
55.19 	(iii) requiring sterile or clean dressing changes or a wound vac; or
55.20 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
55.21 	specialized care;
55.22 	(3) parenteral therapy described as:
55.23 	(i) IV therapy more than two times per week lasting longer than four hours for 
55.24 	each treatment; or
55.25 	(ii) total parenteral nutrition (TPN) daily;
55.26 	(4) respiratory interventions, including:
55.27 	(i) oxygen required more than eight hours per day;
55.28 	(ii) respiratory vest more than one time per day;
55.29 	(iii) bronchial drainage treatments more than two times per day;
55.30 	(iv) sterile or clean suctioning more than six times per day;
55.31 	(v) dependence on another to apply respiratory ventilation augmentation devices 
55.32 	such as BiPAP and CPAP; and
55.33 	(vi) ventilator dependence under section 256B.0652;
55.34 	(5) insertion and maintenance of catheter, including:
55.35 	(i) sterile catheter changes more than one time per month;
56.1 	(ii) clean intermittent catheterization, and including self-catheterization more than 
56.2 	six times per day; or
56.3 	(iii) bladder irrigations;
56.4 	(6) bowel program more than two times per week requiring more than 30 minutes to 
56.5 	perform each time;
56.6 	(7) neurological intervention, including:
56.7 	(i) seizures more than two times per week and requiring significant physical 
56.8 	assistance to maintain safety; or
56.9 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
56.10 	assistance from another on a daily basis; and
56.11 	(8) other congenital or acquired diseases creating a need for significantly increased 
56.12 	direct hands-on assistance and interventions in six to eight activities of daily living.
56.13 	(f) (g) "Community first services and supports" or "CFSS" means the assistance and 
56.14 	supports program under this section needed for accomplishing activities of daily living, 
56.15 	instrumental activities of daily living, and health-related tasks through hands-on assistance 
56.16 	to accomplish the task or constant supervision and cueing to accomplish the task, or the 
56.17 	purchase of goods as defined in subdivision 7, paragraph (a), clause (3), that replace 
56.18 	the need for human assistance.
56.19 	(g) (h) "Community first services and supports service delivery plan" or "service 
56.20 	delivery plan" means a written summary of document detailing the services and supports 
56.21 	chosen by the participant to meet assessed needs that is are within the approved CFSS 
56.22 	service authorization amount. Services and supports are based on the community support 
56.23 	plan identified in section 256B.0911 and coordinated services and support plan and budget 
56.24 	identified in section 256B.0915, subdivision 6, if applicable, that is determined by the 
56.25 	participant to meet the assessed needs, using a person-centered planning process.
56.26 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
56.27 	organization that is under contract with the department and has the knowledge, skills, 
56.28 	and ability to assist CFSS participants in using either the agency-provider model under 
56.29 	subdivision 11 or the budget model under subdivision 13.
56.30 	(h) (j) "Critical activities of daily living" means transferring, mobility, eating, and 
56.31 	toileting.
56.32 	(i) (k) "Dependency" in activities of daily living means a person requires hands-on 
56.33 	assistance or constant supervision and cueing to accomplish one or more of the activities 
56.34 	of daily living every day or on the days during the week that the activity is performed; 
56.35 	however, a child may not be found to be dependent in an activity of daily living if, 
56.36 	because of the child's age, an adult would either perform the activity for the child or assist 
57.1 	the child with the activity and the assistance needed is the assistance appropriate for 
57.2 	a typical child of the same age.
57.3 	(j) (l) "Extended CFSS" means CFSS services and supports under the 
57.4 	agency-provider model included in a service plan through one of the home and 
57.5 	community-based services waivers and as approved and authorized under sections 
57.6 	256B.0915; 256B.092, subdivision 5; and 256B.49, which exceed the amount, duration, 
57.7 	and frequency of the state plan CFSS services for participants.
57.8 	(k) (m) "Financial management services contractor or vendor" or "FMS contractor"
57.9 	 means a qualified organization having necessary to use the budget model under subdivision 
57.10 	13 that has a written contract with the department to provide vendor fiscal/employer agent 
57.11 	financial management services necessary to use the budget model under subdivision 13 
57.12 	that (FMS). Services include but are not limited to: participant education and technical 
57.13 	assistance; CFSS service delivery planning and budgeting;filing and payment of federal 
57.14 	and state payroll taxes on behalf of the participant; initiating criminal background 
57.15 	checks; billing, making payments, and for approved CFSS services with authorized 
57.16 	funds; monitoring of spending expenditures; accounting for and disbursing CFSS funds; 
57.17 	providing assistance in obtaining and filing for liability, workers' compensation, and 
57.18 	unemployment coverage; and assisting participant instruction and technical assistance to
57.19 	 the participant in fulfilling employer-related requirements in accordance with Section 
57.20 	3504 of the Internal Revenue Code and the Internal Revenue Service Revenue Procedure 
57.21 	70-6 related regulations and interpretations, including Code of Federal Regulations, title 
57.22 	26, section 31.3504-1.
57.23 	(l) "Budget model" means a service delivery method of CFSS that allows the use of 
57.24 	an individualized CFSS service delivery plan and service budget and provides assistance 
57.25 	from the financial management services contractor to facilitate participant employment of 
57.26 	support workers and the acquisition of supports and goods.
57.27 	(m) (n) "Health-related procedures and tasks" means procedures and tasks related 
57.28 	to the specific needs of an individual that can be delegated taught or assigned by a 
57.29 	state-licensed healthcare or mental health professional and performed by a support worker.
57.30 	(n) (o) "Instrumental activities of daily living" means activities related to 
57.31 	living independently in the community, including but not limited to: meal planning, 
57.32 	preparation, and cooking; shopping for food, clothing, or other essential items; laundry; 
57.33 	housecleaning; assistance with medications; managing finances; communicating needs 
57.34 	and preferences during activities; arranging supports; and assistance with traveling around 
57.35 	and participating in the community.
58.1 	(o) (p) "Legal representative" means parent of a minor, a court-appointed guardian, 
58.2 	or another representative with legal authority to make decisions about services and 
58.3 	supports for the participant. Other representatives with legal authority to make decisions 
58.4 	include but are not limited to a health care agent or an attorney-in-fact authorized through 
58.5 	a health care directive or power of attorney.
58.6 	(p) (q) "Medication assistance" means providing verbal or visual reminders to take 
58.7 	regularly scheduled medication, and includes any of the following supports listed in clauses 
58.8 	(1) to (3) and other types of assistance, except that a support worker may not determine 
58.9 	medication dose or time for medication or inject medications into veins, muscles, or skin:
58.10 	(1) under the direction of the participant or the participant's representative, bringing 
58.11 	medications to the participant including medications given through a nebulizer, opening a 
58.12 	container of previously set-up medications, emptying the container into the participant's 
58.13 	hand, opening and giving the medication in the original container to the participant, or 
58.14 	bringing to the participant liquids or food to accompany the medication;
58.15 	(2) organizing medications as directed by the participant or the participant's 
58.16 	representative; and
58.17 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
58.18 	(q) (r) "Participant's representative" means a parent, family member, advocate, 
58.19 	or other adult authorized by the participant to serve as a representative in connection 
58.20 	with the provision of CFSS. This authorization must be in writing or by another method 
58.21 	that clearly indicates the participant's free choice. The participant's representative must 
58.22 	have no financial interest in the provision of any services included in the participant's 
58.23 	service delivery plan and must be capable of providing the support necessary to assist 
58.24 	the participant in the use of CFSS. If through the assessment process described in 
58.25 	subdivision 5 a participant is determined to be in need of a participant's representative, one 
58.26 	must be selected. If the participant is unable to assist in the selection of a participant's 
58.27 	representative, the legal representative shall appoint one. Two persons may be designated 
58.28 	as a participant's representative for reasons such as divided households and court-ordered 
58.29 	custodies. Duties of a participant's representatives may include:
58.30 	(1) being available while care is services are provided in a method agreed upon by 
58.31 	the participant or the participant's legal representative and documented in the participant's 
58.32 	CFSS service delivery plan;
58.33 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery 
58.34 	plan is being followed; and
58.35 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
58.36 	verification of the CFSS services.
59.1 	(r) (s) "Person-centered planning process" means a process that is directed by the 
59.2 	participant to plan for services and supports. The person-centered planning process must:
59.3 	(1) include people chosen by the participant;
59.4 	(2) provide necessary information and support to ensure that the participant directs 
59.5 	the process to the maximum extent possible, and is enabled to make informed choices 
59.6 	and decisions;
59.7 	(3) be timely and occur at time and locations of convenience to the participant;
59.8 	(4) reflect cultural considerations of the participant;
59.9 	(5) include strategies for solving conflict or disagreement within the process, 
59.10 	including clear conflict-of-interest guidelines for all planning;
59.11 	(6) provide the participant choices of the services and supports they receive and the 
59.12 	staff providing those services and supports;
59.13 	(7) include a method for the participant to request updates to the plan; and
59.14 	(8) record the alternative home and community-based settings that were considered 
59.15 	by the participant.
59.16 	(s) (t) "Shared services" means the provision of CFSS services by the same CFSS 
59.17 	support worker to two or three participants who voluntarily enter into an agreement to 
59.18 	receive services at the same time and in the same setting by the same provider employer.
59.19 	(t) "Support specialist" means a professional with the skills and ability to assist the 
59.20 	participant using either the agency-provider model under subdivision 11 or the flexible 
59.21 	spending model under subdivision 13, in services including but not limited to assistance 
59.22 	regarding:
59.23 	(1) the development, implementation, and evaluation of the CFSS service delivery 
59.24 	plan under subdivision 6;
59.25 	(2) recruitment, training, or supervision, including supervision of health-related tasks 
59.26 	or behavioral supports appropriately delegated or assigned by a health care professional, 
59.27 	and evaluation of support workers; and
59.28 	(3) facilitating the use of informal and community supports, goods, or resources.
59.29 	(u) "Support worker" means an a qualified and trained employee of the agency 
59.30 	provider agency-provider or of the participant employer under the budget model who 
59.31 	has direct contact with the participant and provides services as specified within the 
59.32 	participant's service delivery plan.
59.33 	(v) "Wages and benefits" means the hourly wages and salaries, the employer's 
59.34 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' 
59.35 	compensation, mileage reimbursement, health and dental insurance, life insurance, 
60.1 	disability insurance, long-term care insurance, uniform allowance, contributions to 
60.2 	employee retirement accounts, or other forms of employee compensation and benefits.
60.3 	(w) "Worker training and development" means services for developing workers' 
60.4 	skills as required by the participant's individual CFSS delivery plan that are arranged for 
60.5 	or provided by the agency-provider or purchased by the participant employer. These 
60.6 	services include training, education, direct observation and supervision, and evaluation 
60.7 	and coaching of job skills and tasks, including supervision of health-related tasks or 
60.8 	behavioral supports.

60.9 	Sec. 5. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 3, is 
60.10 	amended to read:
60.11 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the 
60.12 	following:
60.13 	(1) is a recipient an enrollee of medical assistance as determined under section 
60.14 	256B.055, 256B.056, or 256B.057, subdivisions 5 and 9;
60.15 	(2) is a recipient of participant in the alternative care program under section 
60.16 	256B.0913;
60.17 	(3) is a waiver recipient participant as defined under section 256B.0915, 256B.092, 
60.18 	256B.093, or 256B.49; or
60.19 	(4) has medical services identified in a participant's individualized education 
60.20 	program and is eligible for services as determined in section 256B.0625, subdivision 26.
60.21 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
60.22 	meet all of the following:
60.23 	(1) require assistance and be determined dependent in one activity of daily living or 
60.24 	Level I behavior based on assessment under section 256B.0911; and
60.25 	(2) is not a recipient of participant under a family support grant under section 252.32;.
60.26 	(3) lives in the person's own apartment or home including a family foster care setting 
60.27 	licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a 
60.28 	noncertified boarding care home or a boarding and lodging establishment under chapter 
60.29 	157.

60.30 	Sec. 6. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 5, is 
60.31 	amended to read:
60.32 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
60.33 	(1) be conducted by a certified assessor according to the criteria established in 
60.34 	section 256B.0911, subdivision 3a;
61.1 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there 
61.2 	is a significant change in the participant's condition or a change in the need for services 
61.3 	and supports, or at the request of the participant when there is a change in condition or a 
61.4 	change in the need for services or supports; and
61.5 	(3) be completed using the format established by the commissioner.
61.6 	(b) A participant who is residing in a facility may be assessed and choose CFSS for 
61.7 	the purpose of using CFSS to return to the community as described in subdivisions 3 
61.8 	and 7, paragraph (a), clause (5).
61.9 	(c) (b) The results of the assessment and any recommendations and authorizations 
61.10 	for CFSS must be determined and communicated in writing by the lead agency's certified 
61.11 	assessor as defined in section 256B.0911 to the participant and the agency-provider or 
61.12 	financial management services provider FMS contractor chosen by the participant within 
61.13 	40 calendar days and must include the participant's right to appeal under section 256.045, 
61.14 	subdivision 3.
61.15 	(d) (c) The lead agency assessor may request authorize a temporary authorization 
61.16 	for CFSS services to be provided under the agency-provider model. Authorization for 
61.17 	a temporary level of CFSS services under the agency-provider model is limited to the 
61.18 	time specified by the commissioner, but shall not exceed 45 days. The level of services 
61.19 	authorized under this provision paragraph shall have no bearing on a future authorization.

61.20 	Sec. 7. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 6, is 
61.21 	amended to read:
61.22 		Subd. 6.Community first services and support service delivery plan. (a) The 
61.23 	CFSS service delivery plan must be developed, implemented, and evaluated through a 
61.24 	person-centered planning process by the participant, or the participant's representative 
61.25 	or legal representative who may be assisted by a support specialist consultation services 
61.26 	provider. The CFSS service delivery plan must reflect the services and supports that 
61.27 	are important to the participant and for the participant to meet the needs assessed 
61.28 	by the certified assessor and identified in the community support plan under section 
61.29 	256B.0911, subdivision 3, or the coordinated services and support plan identified in 
61.30 	section 256B.0915, subdivision 6, if applicable. The CFSS service delivery plan must be 
61.31 	reviewed by the participant, the consultation services provider, and the agency-provider 
61.32 	or financial management services FMS contractor prior to starting services and at least 
61.33 	annually upon reassessment, or when there is a significant change in the participant's 
61.34 	condition, or a change in the need for services and supports.
62.1 	(b) The commissioner shall establish the format and criteria for the CFSS service 
62.2 	delivery plan.
62.3 	(c) The CFSS service delivery plan must be person-centered and:
62.4 	(1) specify the consultation services provider, agency-provider, or financial 
62.5 	management services FMS contractor selected by the participant;
62.6 	(2) reflect the setting in which the participant resides that is chosen by the participant;
62.7 	(3) reflect the participant's strengths and preferences;
62.8 	(4) include the means to address the clinical and support needs as identified through 
62.9 	an assessment of functional needs;
62.10 	(5) include individually identified goals and desired outcomes;
62.11 	(6) reflect the services and supports, paid and unpaid, that will assist the participant 
62.12 	to achieve identified goals, including the costs of the services and supports, and the 
62.13 	providers of those services and supports, including natural supports;
62.14 	(7) identify the amount and frequency of face-to-face supports and amount and 
62.15 	frequency of remote supports and technology that will be used;
62.16 	(8) identify risk factors and measures in place to minimize them, including 
62.17 	individualized backup plans;
62.18 	(9) be understandable to the participant and the individuals providing support;
62.19 	(10) identify the individual or entity responsible for monitoring the plan;
62.20 	(11) be finalized and agreed to in writing by the participant and signed by all 
62.21 	individuals and providers responsible for its implementation;
62.22 	(12) be distributed to the participant and other people involved in the plan; and
62.23 	(13) prevent the provision of unnecessary or inappropriate care.;
62.24 	(14) include a detailed budget for expenditures for budget model participants or 
62.25 	participants under the agency-provider model if purchasing goods; and
62.26 	(15) include a plan for worker training and development detailing what service 
62.27 	components will be used, when the service components will be used, how they will be 
62.28 	provided, and how these service components relate to the participant's individual needs 
62.29 	and CFSS support worker services.
62.30 	(d) The total units of agency-provider services or the service budget allocation
62.31 	 amount for the budget model include both annual totals and a monthly average amount 
62.32 	that cover the number of months of the service authorization. The amount used each 
62.33 	month may vary, but additional funds must not be provided above the annual service 
62.34 	authorization amount unless a change in condition is assessed and authorized by the 
62.35 	certified assessor and documented in the community support plan, coordinated services 
62.36 	and supports plan, and CFSS service delivery plan.
63.1 	(e) In assisting with the development or modification of the plan during the 
63.2 	authorization time period, the consultation services provider shall:
63.3 	(1) consult with the FMS contractor on the spending budget when applicable; and
63.4 	(2) consult with the participant or participant's representative, agency-provider, and 
63.5 	case manager/care coordinator.
63.6 	(f) The service plan must be approved by the consultation services provider for 
63.7 	participants without a case manager/care coordinator. A case manager/care coordinator 
63.8 	must approve the plan for a waiver or alternative care program participant.

63.9 	Sec. 8. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 7, is 
63.10 	amended to read:
63.11 		Subd. 7.Community first services and supports; covered services. Within the 
63.12 	service unit authorization or service budget allocation amount, services and supports 
63.13 	covered under CFSS include:
63.14 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities 
63.15 	of daily living (IADLs), and health-related procedures and tasks through hands-on 
63.16 	assistance to accomplish the task or constant supervision and cueing to accomplish the task;
63.17 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant 
63.18 	to accomplish activities of daily living, instrumental activities of daily living, or 
63.19 	health-related tasks;
63.20 	(3) expenditures for items, services, supports, environmental modifications, or 
63.21 	goods, including assistive technology. These expenditures must:
63.22 	(i) relate to a need identified in a participant's CFSS service delivery plan;
63.23 	(ii) increase independence or substitute for human assistance to the extent that 
63.24 	expenditures would otherwise be made for human assistance for the participant's assessed 
63.25 	needs;
63.26 	(4) observation and redirection for behavior or symptoms where there is a need for 
63.27 	assistance. An assessment of behaviors must meet the criteria in this clause. A recipient
63.28 	 participant qualifies as having a need for assistance due to behaviors if the recipient's
63.29 	 participant's behavior requires assistance at least four times per week and shows one or 
63.30 	more of the following behaviors:
63.31 	(i) physical aggression towards self or others, or destruction of property that requires 
63.32 	the immediate response of another person;
63.33 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate 
63.34 	behavior; or
64.1 	(iii) increased need for assistance for recipients participants who are verbally 
64.2 	aggressive or resistive to care so that time needed to perform activities of daily living is 
64.3 	increased;
64.4 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic 
64.5 	devices, to ensure continuity of the participant's services and supports;
64.6 	(6) transition costs, including:
64.7 	(i) deposits for rent and utilities;
64.8 	(ii) first month's rent and utilities;
64.9 	(iii) bedding;
64.10 	(iv) basic kitchen supplies;
64.11 	(v) other necessities, to the extent that these necessities are not otherwise covered 
64.12 	under any other funding that the participant is eligible to receive; and
64.13 	(vi) other required necessities for an individual to make the transition from a nursing 
64.14 	facility, institution for mental diseases, or intermediate care facility for persons with 
64.15 	developmental disabilities to a community-based home setting where the participant 
64.16 	resides; and
64.17 	(7) (6) services provided by a support specialist consultation services provider under 
64.18 	contract with the department and enrolled as a Minnesota health care program provider as 
64.19 	 defined under subdivision 2 that are chosen by the participant. 17;
64.20 	(7) services provided by an FMS contractor under contract with the department 
64.21 	as defined under subdivision 13;
64.22 	(8) CFSS services provided by a qualified support worker who is a parent, stepparent, 
64.23 	or legal guardian of a participant under age 18, or who is the participant's spouse. These 
64.24 	support workers shall not provide any medical assistance home and community-based 
64.25 	services in excess of 40 hours per seven-day period regardless of the number of parents, 
64.26 	combination of parents and spouses, or number of children who receive medical assistance 
64.27 	services; and
64.28 	(9) worker training and development services as defined in subdivision 2, paragraph 
64.29 	(w), and described in subdivision 18a.

64.30 	Sec. 9. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 8, is 
64.31 	amended to read:
64.32 		Subd. 8.Determination of CFSS service methodology. (a) All community first 
64.33 	services and supports must be authorized by the commissioner or the commissioner's 
64.34 	designee before services begin, except for the assessments established in section 
65.1 	256B.0911. The authorization for CFSS must be completed as soon as possible following 
65.2 	an assessment but no later than 40 calendar days from the date of the assessment.
65.3 	(b) The amount of CFSS authorized must be based on the recipient's participant's
65.4 	 home care rating described in paragraphs (d) and (e) and any additional service units for 
65.5 	which the person participant qualifies as described in paragraph (f).
65.6 	(c) The home care rating shall be determined by the commissioner or the 
65.7 	commissioner's designee based on information submitted to the commissioner identifying 
65.8 	the following for a recipient participant:
65.9 	(1) the total number of dependencies of activities of daily living as defined in 
65.10 	subdivision 2, paragraph (b);
65.11 	(2) the presence of complex health-related needs as defined in subdivision 2, 
65.12 	paragraph (e); and
65.13 	(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d), 
65.14 	clause (1).
65.15 	(d) The methodology to determine the total service units for CFSS for each home 
65.16 	care rating is based on the median paid units per day for each home care rating from 
65.17 	fiscal year 2007 data for the PCA program.
65.18 	(e) Each home care rating is designated by the letters P through Z and EN and has 
65.19 	the following base number of service units assigned:
65.20 	(1) P home care rating requires Level I behavior or one to three dependencies in 
65.21 	ADLs and qualifies one for five service units;
65.22 	(2) Q home care rating requires Level I behavior and one to three dependencies in 
65.23 	ADLs and qualifies one for six service units;
65.24 	(3) R home care rating requires a complex health-related need and one to three 
65.25 	dependencies in ADLs and qualifies one for seven service units;
65.26 	(4) S home care rating requires four to six dependencies in ADLs and qualifies 
65.27 	one for ten service units;
65.28 	(5) T home care rating requires four to six dependencies in ADLs and Level I 
65.29 	behavior and qualifies one for 11 service units;
65.30 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
65.31 	health-related need and qualifies one for 14 service units;
65.32 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies 
65.33 	one for 17 service units;
65.34 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
65.35 	behavior and qualifies one for 20 service units;
66.1 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
66.2 	health-related need and qualifies one for 30 service units; and
66.3 	(10) EN home care rating includes ventilator dependency as defined in section 
66.4 	256B.0651, subdivision 1, paragraph (g). Recipients Participants who meet the definition 
66.5 	of ventilator-dependent and the EN home care rating and utilize a combination of 
66.6 	CFSS and other home care services are limited to a total of 96 service units per day for 
66.7 	those services in combination. Additional units may be authorized when a recipient's
66.8 	 participant's assessment indicates a need for two staff to perform activities. Additional 
66.9 	time is limited to 16 service units per day.
66.10 	(f) Additional service units are provided through the assessment and identification of 
66.11 	the following:
66.12 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
66.13 	living as defined in subdivision 2, paragraph (h) (j);
66.14 	(2) 30 additional minutes per day for each complex health-related function as 
66.15 	defined in subdivision 2, paragraph (e) (f); and
66.16 	(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2, 
66.17 	paragraph (d).
66.18 	(g) The service budget for budget model participants shall be based on:
66.19 	(1) assessed units as determined by the home care rating; and
66.20 	(2) an adjustment needed for administrative expenses.

66.21 	Sec. 10. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 9, is 
66.22 	amended to read:
66.23 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for 
66.24 	payment under this section include those that:
66.25 	(1) are not authorized by the certified assessor or included in the written service 
66.26 	delivery plan;
66.27 	(2) are provided prior to the authorization of services and the approval of the written 
66.28 	CFSS service delivery plan;
66.29 	(3) are duplicative of other paid services in the written service delivery plan;
66.30 	(4) supplant natural unpaid supports that appropriately meet a need in the service 
66.31 	plan, are provided voluntarily to the participant, and are selected by the participant in lieu 
66.32 	of other services and supports;
66.33 	(5) are not effective means to meet the participant's needs; and
66.34 	(6) are available through other funding sources, including, but not limited to, funding 
66.35 	through title IV-E of the Social Security Act.
67.1 	(b) Additional services, goods, or supports that are not covered include:
67.2 	(1) those that are not for the direct benefit of the participant, except that services for 
67.3 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
67.4 	benefit the participant if chosen by the participant and approved in the support plan;
67.5 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
67.6 	and co-pays, legal fees, or costs related to advocate agencies;
67.7 	(3) insurance, except for insurance costs related to employee coverage;
67.8 	(4) room and board costs for the participant with the exception of allowable 
67.9 	transition costs in subdivision 7, clause (6);
67.10 	(5) services, supports, or goods that are not related to the assessed needs;
67.11 	(6) special education and related services provided under the Individuals with 
67.12 	Disabilities Education Act and vocational rehabilitation services provided under the 
67.13 	Rehabilitation Act of 1973;
67.14 	(7) assistive technology devices and assistive technology services other than those 
67.15 	for back-up systems or mechanisms to ensure continuity of service and supports listed in 
67.16 	subdivision 7;
67.17 	(8) medical supplies and equipment covered under medical assistance;
67.18 	(9) environmental modifications, except as specified in subdivision 7;
67.19 	(10) expenses for travel, lodging, or meals related to training the participant, or the 
67.20 	participant's representative,or legal representative, or paid or unpaid caregivers that 
67.21 	exceed $500 in a 12-month period;
67.22 	(11) experimental treatments;
67.23 	(12) any service or good covered by other medical assistance state plan services, 
67.24 	including prescription and over-the-counter medications, compounds, and solutions and 
67.25 	related fees, including premiums and co-payments;
67.26 	(13) membership dues or costs, except when the service is necessary and appropriate 
67.27 	to treat a physical health condition or to improve or maintain the participant's physical
67.28 	 health condition. The condition must be identified in the participant's CFSS plan and 
67.29 	monitored by a physician enrolled in a Minnesota health care program enrolled physician;
67.30 	(14) vacation expenses other than the cost of direct services;
67.31 	(15) vehicle maintenance or modifications not related to the disability, health 
67.32 	condition, or physical need; and
67.33 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
67.34 	events.;
67.35 	(17) services provided and billed by a provider who is not an enrolled CFSS provider;
67.36 	(18) CFSS provided by a participant's representative or paid legal guardian;
68.1 	(19) services that are used solely as a child care or babysitting service;
68.2 	(20) services that are the responsibility or in the daily rate of a residential or program 
68.3 	license holder under the terms of a service agreement and administrative rules;
68.4 	(21) sterile procedures;
68.5 	(22) giving of injections into veins, muscles, or skin;
68.6 	(23) homemaker services that are not an integral part of the assessed CFSS service;
68.7 	(24) home maintenance or chore services;
68.8 	(25) home care services, including hospice services if elected by the participant, 
68.9 	covered by Medicare or any other insurance held by the participant;
68.10 	(26) services to other members of the participant's household;
68.11 	(27) services not specified as covered under medical assistance as CFSS;
68.12 	(28) application of restraints or implementation of deprivation procedures;
68.13 	(29) assessments by CFSS provider organizations or by independently enrolled 
68.14 	registered nurses;
68.15 	(30) services provided in lieu of legally required staffing in a residential or child 
68.16 	care setting; and
68.17 	(31) services provided by the residential or program license holder in a residence for 
68.18 	more than four persons.

68.19 	Sec. 11. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 10, 
68.20 	is amended to read:
68.21 		Subd. 10.Provider Agency-provider and FMS contractor qualifications and,
68.22 	 general requirements, and duties. (a) Agency-providers delivering services under the 
68.23 	agency-provider model under subdivision 11 or financial management service (FMS)
68.24 	 FMS contractors under subdivision 13 shall:
68.25 	(1) enroll as a medical assistance Minnesota health care programs provider and meet 
68.26 	all applicable provider standards and requirements;
68.27 	(2) comply with medical assistance provider enrollment requirements;
68.28 	(3) (2) demonstrate compliance with law federal and state laws and policies of for
68.29 	 CFSS as determined by the commissioner;
68.30 	(4) (3) comply with background study requirements under chapter 245C and 
68.31 	maintain documentation of background study requests and results;
68.32 	(5) (4) verify and maintain records of all services and expenditures by the participant, 
68.33 	including hours worked by support workers and support specialists;
69.1 	(6) (5) not engage in any agency-initiated direct contact or marketing in person, by 
69.2 	telephone, or other electronic means to potential participants, guardians, family members, 
69.3 	or participants' representatives;
69.4 	(6) directly provide services and not use a subcontractor or reporting agent;
69.5 	(7) meet the financial requirements established by the commissioner for financial 
69.6 	solvency;
69.7 	(8) have never had a lead agency contract or provider agreement discontinued due to 
69.8 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
69.9 	criminal background check while enrolled or seeking enrollment as a Minnesota health 
69.10 	care programs provider;
69.11 	(9) have established business practices that include written policies and procedures, 
69.12 	internal controls, and a system that demonstrates the organization's ability to deliver 
69.13 	quality CFSS; and
69.14 	(10) have an office located in Minnesota.
69.15 	(b) In conducting general duties, agency-providers and FMS contractors shall:
69.16 	(7) (1) pay support workers and support specialists based upon actual hours of 
69.17 	services provided;
69.18 	(2) pay for worker training and development services based upon actual hours of 
69.19 	services provided or the unit cost of the training session purchased;
69.20 	(8) (3) withhold and pay all applicable federal and state payroll taxes;
69.21 	(9) (4) make arrangements and pay unemployment insurance, taxes, workers' 
69.22 	compensation, liability insurance, and other benefits, if any;
69.23 	(10) (5) enter into a written agreement with the participant, participant's 
69.24 	representative, or legal representative that assigns roles and responsibilities to be 
69.25 	performed before services, supports, or goods are provided using a format established by 
69.26 	the commissioner;
69.27 	(11) (6) report maltreatment as required under sections 626.556 and 626.557; and
69.28 	(12) (7) provide the participant with a copy of the service-related rights under 
69.29 	subdivision 20 at the start of services and supports.; and
69.30 	(8) comply with any data requests from the department consistent with the 
69.31 	Minnesota Government Data Practices Act under chapter 13.

69.32 	Sec. 12. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 11, 
69.33 	is amended to read:
69.34 		Subd. 11.Agency-provider model. (a) The agency-provider model is limited to 
69.35 	the includes services provided by support workers and support specialists staff providing 
70.1 	worker training and development services who are employed by an agency-provider 
70.2 	that is licensed according to chapter 245A or meets other criteria established by the 
70.3 	commissioner, including required training.
70.4 	(b) The agency-provider shall allow the participant to have a significant role in the 
70.5 	selection and dismissal of the support workers for the delivery of the services and supports 
70.6 	specified in the participant's service delivery plan.
70.7 	(c) A participant may use authorized units of CFSS services as needed within a 
70.8 	service authorization that is not greater than 12 months. Using authorized units in a 
70.9 	flexible manner in either the agency-provider model or the budget model does not increase 
70.10 	the total amount of services and supports authorized for a participant or included in the 
70.11 	participant's service delivery plan.
70.12 	(d) A participant may share CFSS services. Two or three CFSS participants may 
70.13 	share services at the same time provided by the same support worker.
70.14 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue 
70.15 	generated by the medical assistance payment for CFSS for support worker wages and 
70.16 	benefits. The agency-provider must document how this requirement is being met. The 
70.17 	revenue generated by the support specialist worker training and development services
70.18 	 and the reasonable costs associated with the support specialist worker training and 
70.19 	development services must not be used in making this calculation.
70.20 	(f) The agency-provider model must be used by individuals who have been restricted 
70.21 	by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 
70.22 	to 9505.2245.
70.23 	(g) Participants purchasing goods under this model, along with support worker 
70.24 	services, must:
70.25 	(1) specify the goods in the service delivery plan and detailed budget for 
70.26 	expenditures that must be approved by the consultation services provider or the case 
70.27 	manager/care coordinator; and
70.28 	(2) use the FMS contractor for the billing and payment of such goods.

70.29 	Sec. 13. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 12, 
70.30 	is amended to read:
70.31 		Subd. 12.Requirements for enrollment of CFSS provider agency-provider
70.32 	 agencies. (a) All CFSS provider agencies agency-providers must provide, at the time of 
70.33 	enrollment, reenrollment, and revalidation as a CFSS provider agency agency-provider in 
70.34 	a format determined by the commissioner, information and documentation that includes, 
70.35 	but is not limited to, the following:
71.1 	(1) the CFSS provider agency's agency-provider's current contact information 
71.2 	including address, telephone number, and e-mail address;
71.3 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider agency's
71.4 	 agency-provider's Medicaid revenue in the previous calendar year is less than or equal 
71.5 	to $300,000, the provider agency agency-provider must purchase a performance bond of 
71.6 	$50,000. If the provider agency's agency-provider's Medicaid revenue in the previous 
71.7 	calendar year is greater than $300,000, the provider agency agency-provider must 
71.8 	purchase a performance bond of $100,000. The performance bond must be in a form 
71.9 	approved by the commissioner, must be renewed annually, and must allow for recovery of 
71.10 	costs and fees in pursuing a claim on the bond;
71.11 	(3) proof of fidelity bond coverage in the amount of $20,000;
71.12 	(4) proof of workers' compensation insurance coverage;
71.13 	(5) proof of liability insurance;
71.14 	(6) a description of the CFSS provider agency's agency-provider's organization 
71.15 	identifying the names of all owners, managing employees, staff, board of directors, and 
71.16 	the affiliations of the directors, and owners, or staff to other service providers;
71.17 	(7) a copy of the CFSS provider agency's agency-provider's written policies and 
71.18 	procedures including: hiring of employees; training requirements; service delivery; 
71.19 	and employee and consumer safety including process for notification and resolution 
71.20 	of consumer grievances, identification and prevention of communicable diseases, and 
71.21 	employee misconduct;
71.22 	(8) copies of all other forms the CFSS provider agency agency-provider uses in the 
71.23 	course of daily business including, but not limited to:
71.24 	(i) a copy of the CFSS provider agency's agency-provider's time sheet if the time 
71.25 	sheet varies from the standard time sheet for CFSS services approved by the commissioner, 
71.26 	and a letter requesting approval of the CFSS provider agency's agency-provider's
71.27 	 nonstandard time sheet; and
71.28 	(ii) the a copy of the participant's individual CFSS provider agency's template for the 
71.29 	CFSS care service delivery plan;
71.30 	(9) a list of all training and classes that the CFSS provider agency agency-provider
71.31 	 requires of its staff providing CFSS services;
71.32 	(10) documentation that the CFSS provider agency agency-provider and staff have 
71.33 	successfully completed all the training required by this section;
71.34 	(11) documentation of the agency's agency-provider's marketing practices;
71.35 	(12) disclosure of ownership, leasing, or management of all residential properties 
71.36 	that are used or could be used for providing home care services;
72.1 	(13) documentation that the agency agency-provider will use at least the following 
72.2 	percentages of revenue generated from the medical assistance rate paid for CFSS services 
72.3 	for employee personal care assistant CFSS support worker wages and benefits: 72.5 
72.4 	percent of revenue from CFSS providers. The revenue generated by the support specialist
72.5 	 worker training and development services and the reasonable costs associated with the 
72.6 	support specialist worker training and development services shall not be used in making 
72.7 	this calculation; and
72.8 	(14) documentation that the agency agency-provider does not burden recipients'
72.9 	 participants' free exercise of their right to choose service providers by requiring personal 
72.10 	care assistants CFSS support workers to sign an agreement not to work with any particular 
72.11 	CFSS recipient participant or for another CFSS provider agency agency-provider after 
72.12 	leaving the agency and that the agency is not taking action on any such agreements or 
72.13 	requirements regardless of the date signed.
72.14 	(b) CFSS provider agencies agency-providers shall provide to the commissioner 
72.15 	the information specified in paragraph (a).
72.16 	(c) All CFSS provider agencies agency-providers shall require all employees in 
72.17 	management and supervisory positions and owners of the agency who are active in the 
72.18 	day-to-day management and operations of the agency to complete mandatory training as 
72.19 	determined by the commissioner. Employees in management and supervisory positions 
72.20 	and owners who are active in the day-to-day operations of an agency who have completed 
72.21 	the required training as an employee with a CFSS provider agency agency-provider do 
72.22 	not need to repeat the required training if they are hired by another agency, if they have 
72.23 	completed the training within the past three years. CFSS provider agency agency-provider
72.24 	 billing staff shall complete training about CFSS program financial management. Any new 
72.25 	owners or employees in management and supervisory positions involved in the day-to-day 
72.26 	operations are required to complete mandatory training as a requisite of working for the 
72.27 	agency. CFSS provider agencies certified for participation in Medicare as home health 
72.28 	agencies are exempt from the training required in this subdivision.
72.29 	(d) The commissioner shall send annual review notifications to agency-providers 30 
72.30 	days prior to renewal. The notification must:
72.31 	(1) list the materials and information the agency-provider is required to submit;
72.32 	(2) provide instructions on submitting information to the commissioner; and
72.33 	(3) provide a due date by which the commissioner must receive the requested 
72.34 	information.
73.1 	Agency-providers shall submit the required documentation for annual review within 
73.2 	30 days of notification from the commissioner. If no documentation is submitted, the 
73.3 	agency-provider enrollment number must be terminated or suspended.

73.4 	Sec. 14. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 13, 
73.5 	is amended to read:
73.6 		Subd. 13.Budget model. (a) Under the budget model participants can may exercise 
73.7 	more responsibility and control over the services and supports described and budgeted 
73.8 	within the CFSS service delivery plan. Participants must use services provided by an FMS 
73.9 	contractor as defined in subdivision 2, paragraph (m). Under this model, participants may 
73.10 	use their approved service budget allocation to:
73.11 	(1) directly employ support workers, and pay wages, federal and state payroll taxes, 
73.12 	and premiums for workers' compensation, liability, and health insurance coverage; and
73.13 	(2) obtain supports and goods as defined in subdivision 7; and.
73.14 	(3) choose a range of support assistance services from the financial management 
73.15 	services (FMS) contractor related to:
73.16 	(i) assistance in managing the budget to meet the service delivery plan needs, 
73.17 	consistent with federal and state laws and regulations;
73.18 	(ii) the employment, training, supervision, and evaluation of workers by the 
73.19 	participant;
73.20 	(iii) acquisition and payment for supports and goods; and
73.21 	(iv) evaluation of individual service outcomes as needed for the scope of the 
73.22 	participant's degree of control and responsibility.
73.23 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) 
73.24 	may authorize a legal representative or participant's representative to do so on their behalf.
73.25 	(c) The commissioner shall disenroll or exclude participants from the budget model 
73.26 	and transfer them to the agency-provider model under the following circumstances that 
73.27 	include but are not limited to:
73.28 	(1) when a participant has been restricted by the Minnesota restricted recipient 
73.29 	program, in which case the participant may be excluded for a specified time period under 
73.30 	Minnesota Rules, parts 9505.2160 to 9505.2245;
73.31 	(2) when a participant exits the budget model during the participant's service plan 
73.32 	year. Upon transfer, the participant shall not access the budget model for the remainder of 
73.33 	that service plan year; or
73.34 	(3) when the department determines that the participant or participant's representative 
73.35 	or legal representative cannot manage participant responsibilities under the budget model. 
74.1 	The commissioner must develop policies for determining if a participant is unable to 
74.2 	manage responsibilities under the budget model.
74.3 	(d) A participant may appeal in writing to the department under section 256.045, 
74.4 	subdivision 3, to contest the department's decision under paragraph (c), clause (3), to 
74.5 	disenroll or exclude the participant from the budget model.
74.6 	(c) (e) The FMS contractor shall not provide CFSS services and supports under the 
74.7 	agency-provider service model. 
74.8 	(f) The FMS contractor shall provide service functions as determined by the 
74.9 	commissioner for budget model participants that include but are not limited to:
74.10 	(1) information and consultation about CFSS;
74.11 	(2) (1) assistance with the development of the detailed budget for expenditures 
74.12 	portion of the service delivery plan and budget model as requested by the consultation 
74.13 	services provider or participant;
74.14 	(3) (2) billing and making payments for budget model expenditures;
74.15 	(4) (3) assisting participants in fulfilling employer-related requirements according to 
74.16 	Internal Revenue Service Revenue Procedure 70-6, section 3504, Agency Employer Tax 
74.17 	Liability, regulation 137036-08 section 3504 of the Internal Revenue Code and related 
74.18 	regulations and interpretations, including Code of Federal Regulations, title 26, section 
74.19 	31.3504-1, which includes assistance with filing and paying payroll taxes, and obtaining 
74.20 	worker compensation coverage;
74.21 	(5) (4) data recording and reporting of participant spending; and
74.22 	(6) (5) other duties established in the contract with the department, including with 
74.23 	respect to providing assistance to the participant, participant's representative, or legal 
74.24 	representative in performing their employer responsibilities regarding support workers. 
74.25 	The support worker shall not be considered the employee of the financial management 
74.26 	services FMS contractor.; and
74.27 	(6) billing, payment, and accounting of approved expenditures for goods for 
74.28 	agency-provider participants.
74.29 	(d) A participant who requests to purchase goods and supports along with support 
74.30 	worker services under the agency-provider model must use the budget model with 
74.31 	a service delivery plan that specifies the amount of services to be authorized to the 
74.32 	agency-provider and the expenditures to be paid by the FMS contractor.
74.33 	(e) (g) The FMS contractor shall:
74.34 	(1) not limit or restrict the participant's choice of service or support providers or 
74.35 	service delivery models consistent with any applicable state and federal requirements;
75.1 	(2) provide the participant, consultation services provider, and the targeted case 
75.2 	manager, if applicable, with a monthly written summary of the spending for services and 
75.3 	supports that were billed against the spending budget;
75.4 	(3) be knowledgeable of state and federal employment regulations, including those 
75.5 	under the Fair Labor Standards Act of 1938, and comply with the requirements under the 
75.6 	Internal Revenue Service Revenue Procedure 70-6, Section 3504, section 3504 of the 
75.7 	Internal Revenue Code and related regulations and interpretations, including Code of 
75.8 	Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability 
75.9 	for vendor or fiscal employer agent, and any requirements necessary to process employer 
75.10 	and employee deductions, provide appropriate and timely submission of employer tax 
75.11 	liabilities, and maintain documentation to support medical assistance claims;
75.12 	(4) have current and adequate liability insurance and bonding and sufficient cash 
75.13 	flow as determined by the commissioner and have on staff or under contract a certified 
75.14 	public accountant or an individual with a baccalaureate degree in accounting;
75.15 	(5) assume fiscal accountability for state funds designated for the program and be 
75.16 	held liable for any overpayments or violations of applicable statutes or rules, including 
75.17 	but not limited to the Minnesota False Claims Act; and
75.18 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
75.19 	supports expenditures for any goods purchased and maintain time records of support 
75.20 	workers. The documentation and time records must be maintained for a minimum of 
75.21 	five years from the claim date and be available for audit or review upon request by the 
75.22 	commissioner. Claims submitted by the FMS contractor to the commissioner for payment 
75.23 	must correspond with services, amounts, and time periods as authorized in the participant's 
75.24 	spending service budget and service plan and must contain specific identifying information 
75.25 	as determined by the commissioner.
75.26 	(f) (h) The commissioner of human services shall:
75.27 	(1) establish rates and payment methodology for the FMS contractor;
75.28 	(2) identify a process to ensure quality and performance standards for the FMS 
75.29 	contractor and ensure statewide access to FMS contractors; and
75.30 	(3) establish a uniform protocol for delivering and administering CFSS services 
75.31 	to be used by eligible FMS contractors.
75.32 	(g) The commissioner of human services shall disenroll or exclude participants from 
75.33 	the budget model and transfer them to the agency-provider model under the following 
75.34 	circumstances that include but are not limited to:
76.1 	(1) when a participant has been restricted by the Minnesota restricted recipient 
76.2 	program, the participant may be excluded for a specified time period under Minnesota 
76.3 	Rules, parts 9505.2160 to 9505.2245;
76.4 	(2) when a participant exits the budget model during the participant's service plan 
76.5 	year. Upon transfer, the participant shall not access the budget model for the remainder of 
76.6 	that service plan year; or
76.7 	(3) when the department determines that the participant or participant's representative 
76.8 	or legal representative cannot manage participant responsibilities under the budget model. 
76.9 	The commissioner must develop policies for determining if a participant is unable to 
76.10 	manage responsibilities under a budget model.
76.11 	(h) A participant may appeal under section 256.045, subdivision 3, in writing to the 
76.12 	department to contest the department's decision under paragraph (c), clause (3), to remove 
76.13 	or exclude the participant from the budget model.

76.14 	Sec. 15. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 15, 
76.15 	is amended to read:
76.16 		Subd. 15.Documentation of support services provided. (a) Support services 
76.17 	provided to a participant by a support worker employed by either an agency-provider 
76.18 	or the participant acting as the employer must be documented daily by each support 
76.19 	worker, on a time sheet form approved by the commissioner. All documentation may be 
76.20 	Web-based, electronic, or paper documentation. The completed form must be submitted 
76.21 	on a monthly regular basis to the provider or the participant and the FMS contractor 
76.22 	selected by the participant to provide assistance with meeting the participant's employer 
76.23 	obligations and kept in the recipient's health participant's record.
76.24 	(b) The activity documentation must correspond to the written service delivery plan 
76.25 	and be reviewed by the agency-provider or the participant and the FMS contractor when 
76.26 	the participant is acting as the employer of the support worker.
76.27 	(c) The time sheet must be on a form approved by the commissioner documenting 
76.28 	time the support worker provides services in the home to the participant. The following 
76.29 	criteria must be included in the time sheet:
76.30 	(1) full name of the support worker and individual provider number;
76.31 	(2) provider agency-provider name and telephone numbers, if an agency-provider is
76.32 	 responsible for delivery services under the written service plan;
76.33 	(3) full name of the participant;
76.34 	(4) consecutive dates, including month, day, and year, and arrival and departure 
76.35 	times with a.m. or p.m. notations;
77.1 	(5) signatures of the participant or the participant's representative;
77.2 	(6) personal signature of the support worker;
77.3 	(7) any shared care provided, if applicable;
77.4 	(8) a statement that it is a federal crime to provide false information on CFSS 
77.5 	billings for medical assistance payments; and
77.6 	(9) dates and location of recipient participant stays in a hospital, care facility, or 
77.7 	incarceration.

77.8 	Sec. 16. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 16, 
77.9 	is amended to read:
77.10 		Subd. 16.Support workers requirements. (a) Support workers shall:
77.11 	(1) enroll with the department as a support worker after a background study under 
77.12 	chapter 245C has been completed and the support worker has received a notice from the 
77.13 	commissioner that:
77.14 	(i) the support worker is not disqualified under section 245C.14; or
77.15 	(ii) is disqualified, but the support worker has received a set-aside of the 
77.16 	disqualification under section 245C.22;
77.17 	(2) have the ability to effectively communicate with the participant or the 
77.18 	participant's representative;
77.19 	(3) have the skills and ability to provide the services and supports according to 
77.20 	the person's participant's CFSS service delivery plan and respond appropriately to the 
77.21 	participant's needs;
77.22 	(4) not be a participant of CFSS, unless the support services provided by the support 
77.23 	worker differ from those provided to the support worker;
77.24 	(5) complete the basic standardized training as determined by the commissioner 
77.25 	before completing enrollment. The training must be available in languages other than 
77.26 	English and to those who need accommodations due to disabilities. Support worker 
77.27 	training must include successful completion of the following training components: basic 
77.28 	first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles 
77.29 	and responsibilities of support workers including information about basic body mechanics, 
77.30 	emergency preparedness, orientation to positive behavioral practices, orientation to 
77.31 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
77.32 	overview of person-centered planning and self-direction. Upon completion of the training 
77.33 	components, the support worker must pass the certification test to provide assistance 
77.34 	to participants;
77.35 	(6) complete training and orientation on the participant's individual needs; and
78.1 	(7) maintain the privacy and confidentiality of the participant, and not independently 
78.2 	determine the medication dose or time for medications for the participant.
78.3 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
78.4 	and provider number if the support worker:
78.5 	(1) lacks the skills, knowledge, or ability to adequately or safely perform the 
78.6 	required work;
78.7 	(2) fails to provide the authorized services required by the participant employer;
78.8 	(3) has been intoxicated by alcohol or drugs while providing authorized services to 
78.9 	the participant or while in the participant's home;
78.10 	(4) has manufactured or distributed drugs while providing authorized services to the 
78.11 	participant or while in the participant's home; or
78.12 	(5) has been excluded as a provider by the commissioner of human services, or the 
78.13 	United States Department of Health and Human Services, Office of Inspector General, 
78.14 	from participation in Medicaid, Medicare, or any other federal health care program.
78.15 	(c) A support worker may appeal in writing to the commissioner to contest the 
78.16 	decision to terminate the support worker's provider enrollment and provider number.
78.17 	(d) A support worker must not provide or be paid for more than 275 hours of 
78.18 	CFSS per month, regardless of the number of participants the support worker serves or 
78.19 	the number of agency-providers or participant employers by which the support worker 
78.20 	is employed. The department shall not disallow the number of hours per day a support 
78.21 	worker works unless it violates other law.

78.22 	Sec. 17. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
78.23 	a subdivision to read:
78.24 		Subd. 16a.Exception to support worker requirements for continuity of services.
 78.25 	The support worker for a participant may be allowed to enroll with a different CFSS 
78.26 	agency-provider or FMS contractor upon initiation, rather than completion, of a new 
78.27 	background study according to chapter 245C, if the following conditions are met:
78.28 	(1) the commissioner determines that the support worker's change in enrollment or 
78.29 	affiliation is needed to ensure continuity of services and protect the health and safety 
78.30 	of the participant;
78.31 	(2) the chosen agency-provider or FMS contractor has been continuously enrolled as 
78.32 	a CFSS agency-provider or FMS contractor for at least two years or since the inception of 
78.33 	the CFSS program, whichever is shorter;
78.34 	(3) the participant served by the support worker chooses to transfer to the CFSS 
78.35 	agency-provider or the FMS contractor to which the support worker is transferring;
79.1 	(4) the support worker has been continuously enrolled with the former CFSS 
79.2 	agency-provider or FMS contractor since the support worker's last background study 
79.3 	was completed; and
79.4 	(5) the support worker continues to meet requirements of subdivision 16, excluding 
79.5 	paragraph (a), clause (1). 

79.6 	Sec. 18. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 17, 
79.7 	is amended to read:
79.8 		Subd. 17.Support specialist requirements and payments Consultation services 
79.9 	description and duties. The commissioner shall develop qualifications, scope of 
79.10 	functions, and payment rates and service limits for a support specialist that may provide 
79.11 	additional or specialized assistance necessary to plan, implement, arrange, augment, or 
79.12 	evaluate services and supports.
79.13 	(a) Consultation services means providing assistance to the participant in making 
79.14 	informed choices regarding CFSS services in general and self-directed tasks in particular 
79.15 	and in developing a person-centered service delivery plan to achieve quality service 
79.16 	outcomes.
79.17 	(b) Consultation services is a required service that may include but is not limited to:
79.18 	(1) an initial and annual orientation to CFSS information and policies, including 
79.19 	selecting a service model;
79.20 	(2) assistance with the development, implementation, management, and evaluation 
79.21 	of the person-centered service delivery plan;
79.22 	(3) consultation on recruiting, selecting, training, managing, directing, evaluating, 
79.23 	and supervising support workers;
79.24 	(4) reviewing the use of and access to informal and community supports, goods, or 
79.25 	resources;
79.26 	(5) assistance with fulfilling responsibilities and requirements of CFSS including 
79.27 	modifying service delivery plans and changing service models; and
79.28 	(6) assistance with accessing FMS contractors or agency-providers.
79.29 	(c) Duties of a consultation services provider shall include but are not limited to:
79.30 	(1) review and finalization of the CFSS service delivery plan by the consultation 
79.31 	services provider organization;
79.32 	(2) distribution of copies of the final service delivery plan to the participant and 
79.33 	to the agency-provider or FMS contractor, case manager/care coordinator, and other 
79.34 	designated parties;
80.1 	(3) an evaluation of services upon receiving information from an FMS contractor 
80.2 	indicating spending or participant employer concerns;
80.3 	(4) a semiannual review of services if the participant does not have a case 
80.4 	manager/care coordinator and when the support worker is a paid parent of a minor 
80.5 	participant or the participant's spouse;
80.6 	(5) collection and reporting of data as required by the department; and
80.7 	(6) providing the participant with a copy of the service-related rights under 
80.8 	subdivision 20 at the start of consultation services.

80.9 	Sec. 19. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
80.10 	a subdivision to read:
80.11 		Subd. 17a.Consultation service provider qualifications and requirements.
 80.12 	The commissioner shall develop the qualifications and requirements for providers of 
80.13 	consultation services under subdivision 17. These providers must satisfy at least the 
80.14 	following qualifications and requirements:
80.15 	(1) are under contract with the department;
80.16 	(2) are not the FMS contractor as defined in subdivision 2, paragraph (m), the CFSS 
80.17 	or HCBS waiver agency-provider or vendor to the participant, or a lead agency;
80.18 	(3) meet the service standards as established by the commissioner;
80.19 	(4) employ lead professional staff with a minimum of three years of experience 
80.20 	in providing support planning, support broker, or consultation services and consumer 
80.21 	education to participants using a self-directed program using FMS under medical 
80.22 	assistance;
80.23 	(5) are knowledgeable about CFSS roles and responsibilities including those of the 
80.24 	certified assessor, FMS contractor, agency-provider, and case manager/care coordinator;
80.25 	(6) comply with medical assistance provider requirements;
80.26 	(7) understand the CFSS program and its policies;
80.27 	(8) are knowledgeable about self-directed principles and the application of the 
80.28 	person-centered planning process;
80.29 	(9) have general knowledge of the FMS contractor duties and participant 
80.30 	employment model, including all applicable federal, state, and local laws and regulations 
80.31 	regarding tax, labor, employment, and liability and workers' compensation coverage for 
80.32 	household workers; and
80.33 	(10) have all employees, including lead professional staff, staff in management 
80.34 	and supervisory positions, and owners of the agency who are active in the day-to-day 
81.1 	management and operations of the agency, complete training as specified in the contract 
81.2 	with the department.

81.3 	Sec. 20. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 18, 
81.4 	is amended to read:
81.5 		Subd. 18.Service unit and budget allocation requirements and limits. (a) For the 
81.6 	agency-provider model, services will be authorized in units of service. The total service 
81.7 	unit amount must be established based upon the assessed need for CFSS services, and must 
81.8 	not exceed the maximum number of units available as determined under subdivision 8.
81.9 	(b) For the budget model, the service budget allocation allowed for services and 
81.10 	supports is established by multiplying the number of units authorized under subdivision 8 
81.11 	by the payment rate established by the commissioner defined in subdivision 8, paragraph 
81.12 	(g).

81.13 	Sec. 21. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
81.14 	a subdivision to read:
81.15 		Subd. 18a.Worker training and development services. (a) The commissioner 
81.16 	shall develop the scope of tasks and functions, service standards, and service limits for 
81.17 	worker training and development services.
81.18 	(b) Worker training and development services are in addition to the participant's 
81.19 	assessed service units or service budget. Services provided according to this subdivision 
81.20 	must:
81.21 	(1) help support workers obtain and expand the skills and knowledge necessary to 
81.22 	ensure competency in providing quality services as needed and defined in the participant's 
81.23 	service delivery plan;
81.24 	(2) be provided or arranged for by the agency-provider under subdivision 11 or 
81.25 	purchased by the participant employer under the budget model under subdivision 13; and
81.26 	(3) be described in the participant's CFSS service delivery plan and documented in 
81.27 	the participant's file.
81.28 	(c) Services covered under worker training and development shall include:
81.29 	(1) support worker training on the participant's individual assessed needs, condition, 
81.30 	or both, provided individually or in a group setting by a skilled and knowledgeable trainer 
81.31 	beyond any training the participant or participant's representative provides;
81.32 	(2) tuition for professional classes and workshops for the participant's support 
81.33 	workers that relate to the participant's assessed needs, condition, or both;
82.1 	(3) direct observation, monitoring, coaching, and documentation of support worker 
82.2 	job skills and tasks, beyond any training the participant or participant's representative 
82.3 	provides, including supervision of health-related tasks or behavioral supports that is 
82.4 	conducted by an appropriate professional based on the participant's assessed needs. These 
82.5 	services must be provided within 14 days of the start of services or the start of a new 
82.6 	support worker and must be specified in the participant's service delivery plan; and
82.7 	(4) reporting service and support concerns to the appropriate provider.
82.8 	(d) Worker training and development services shall not include:
82.9 	(1) general agency training, worker orientation, or training on CFSS self-directed 
82.10 	models;
82.11 	(2) payment for preparation or development time for the trainer or presenter;
82.12 	(3) payment of the support worker's salary or compensation during the training;
82.13 	(4) training or supervision provided by the participant, the participant's support 
82.14 	worker, or the participant's informal supports, including the participant's representative; or
82.15 	(5) services in excess of 96 units per annual service authorization, unless approved 
82.16 	by the department.

82.17 	Sec. 22. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 23, 
82.18 	is amended to read:
82.19 		Subd. 23.Commissioner's access. When the commissioner is investigating a 
82.20 	possible overpayment of Medicaid funds, the commissioner must be given immediate 
82.21 	access without prior notice to the agency provider agency-provider or FMS contractor's 
82.22 	office during regular business hours and to documentation and records related to services 
82.23 	provided and submission of claims for services provided. Denying the commissioner 
82.24 	access to records is cause for immediate suspension of payment and terminating the agency 
82.25 	provider's enrollment according to section 256B.064 or terminating the FMS contract.

82.26 	Sec. 23. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 24, 
82.27 	is amended to read:
82.28 		Subd. 24.CFSS agency-providers; background studies. CFSS agency-providers 
82.29 	enrolled to provide personal care assistance CFSS services under the medical assistance 
82.30 	program shall comply with the following:
82.31 	(1) owners who have a five percent interest or more and all managing employees 
82.32 	are subject to a background study as provided in chapter 245C. This applies to currently 
82.33 	enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS 
83.1 	agency-provider. "Managing employee" has the same meaning as Code of Federal 
83.2 	Regulations, title 42, section 455. An organization is barred from enrollment if:
83.3 	(i) the organization has not initiated background studies on owners managing 
83.4 	employees; or
83.5 	(ii) the organization has initiated background studies on owners and managing 
83.6 	employees, but the commissioner has sent the organization a notice that an owner or 
83.7 	managing employee of the organization has been disqualified under section 245C.14, and 
83.8 	the owner or managing employee has not received a set-aside of the disqualification 
83.9 	under section 245C.22;
83.10 	(2) a background study must be initiated and completed for all support specialists
83.11 	 staff who will have direct contact with the participant to provide worker training and 
83.12 	development; and
83.13 	(3) a background study must be initiated and completed for all support workers.

83.14 	Sec. 24. Laws 2013, chapter 108, article 7, section 49, the effective date, is amended to 
83.15 	read:

83.16 	EFFECTIVE DATE. This section is effective upon federal approval but no earlier 
83.17 	than April 1, 2014. The service will begin 90 days after federal approval or April 1, 
83.18 	2014, whichever is later. The commissioner of human services shall notify the revisor of 
83.19 	statutes when this occurs.

83.20 	ARTICLE 5
83.21 	CONTINUING CARE

83.22 	Section 1. Minnesota Statutes 2012, section 13.46, subdivision 4, is amended to read:
83.23 		Subd. 4.Licensing data. (a) As used in this subdivision:
83.24 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
83.25 	welfare system pertaining to persons licensed or registered or who apply for licensure 
83.26 	or registration or who formerly were licensed or registered under the authority of the 
83.27 	commissioner of human services;
83.28 	(2) "client" means a person who is receiving services from a licensee or from an 
83.29 	applicant for licensure; and
83.30 	(3) "personal and personal financial data" are Social Security numbers, identity 
83.31 	of and letters of reference, insurance information, reports from the Bureau of Criminal 
83.32 	Apprehension, health examination reports, and social/home studies.
84.1 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, 
84.2 	license holders, and former licensees are public: name, address, telephone number of 
84.3 	licensees, date of receipt of a completed application, dates of licensure, licensed capacity, 
84.4 	type of client preferred, variances granted, record of training and education in child care 
84.5 	and child development, type of dwelling, name and relationship of other family members, 
84.6 	previous license history, class of license, the existence and status of complaints, and the 
84.7 	number of serious injuries to or deaths of individuals in the licensed program as reported 
84.8 	to the commissioner of human services, the local social services agency, or any other 
84.9 	county welfare agency. For purposes of this clause, a serious injury is one that is treated 
84.10 	by a physician.
84.11 	(ii) When a correction order, an order to forfeit a fine, an order of license suspension, 
84.12 	an order of temporary immediate suspension, an order of license revocation, an order 
84.13 	of license denial, or an order of conditional license has been issued, or a complaint is 
84.14 	resolved, the following data on current and former licensees and applicants are public: the 
84.15 	substance and investigative findings of the licensing or maltreatment complaint, licensing 
84.16 	violation, or substantiated maltreatment; the record of informal resolution of a licensing 
84.17 	violation; orders of hearing; findings of fact; conclusions of law; specifications of the final 
84.18 	correction order, fine, suspension, temporary immediate suspension, revocation, denial, or 
84.19 	conditional license contained in the record of licensing action; whether a fine has been 
84.20 	paid; and the status of any appeal of these actions.
84.21 	(iii) When a license denial under section 245A.05 or a sanction under section 
84.22 	245A.07 is based on a determination that the license holder or applicant is responsible for 
84.23 	maltreatment under section 626.556 or 626.557, the identity of the applicant or license 
84.24 	holder as the individual responsible for maltreatment is public data at the time of the 
84.25 	issuance of the license denial or sanction.
84.26 	(iv) When a license denial under section 245A.05 or a sanction under section 
84.27 	245A.07 is based on a determination that the license holder or applicant is disqualified 
84.28 	under chapter 245C, the identity of the license holder or applicant as the disqualified 
84.29 	individual and the reason for the disqualification are public data at the time of the 
84.30 	issuance of the licensing sanction or denial. If the applicant or license holder requests 
84.31 	reconsideration of the disqualification and the disqualification is affirmed, the reason for 
84.32 	the disqualification and the reason to not set aside the disqualification are public data.
84.33 	(2) Notwithstanding sections 626.556, subdivision 11, and 626.557, subdivision 12b, 
84.34 	when any person subject to disqualification under section 245C.14 in connection with a 
84.35 	license to provide family day care for children, child care center services, foster care for 
84.36 	children in the provider's home, or foster care or day care services for adults in the provider's 
85.1 	home is a substantiated perpetrator of maltreatment, and the substantiated maltreatment is 
85.2 	a reason for a licensing action, the identity of the substantiated perpetrator of maltreatment 
85.3 	is public data. For purposes of this clause, a person is a substantiated perpetrator if the 
85.4 	maltreatment determination has been upheld under section 256.045; 626.556, subdivision 
85.5 	10i; 626.557, subdivision 9d; or chapter 14, or if an individual or facility has not timely 
85.6 	exercised appeal rights under these sections, except as provided under clause (1).
85.7 	(3) For applicants who withdraw their application prior to licensure or denial of a 
85.8 	license, the following data are public: the name of the applicant, the city and county in 
85.9 	which the applicant was seeking licensure, the dates of the commissioner's receipt of the 
85.10 	initial application and completed application, the type of license sought, and the date 
85.11 	of withdrawal of the application.
85.12 	(4) For applicants who are denied a license, the following data are public: the name 
85.13 	and address of the applicant, the city and county in which the applicant was seeking 
85.14 	licensure, the dates of the commissioner's receipt of the initial application and completed 
85.15 	application, the type of license sought, the date of denial of the application, the nature of 
85.16 	the basis for the denial, the record of informal resolution of a denial, orders of hearings, 
85.17 	findings of fact, conclusions of law, specifications of the final order of denial, and the 
85.18 	status of any appeal of the denial.
85.19 	(5) The following data on persons subject to disqualification under section 245C.14 in 
85.20 	connection with a license to provide family day care for children, child care center services, 
85.21 	foster care for children in the provider's home, or foster care or day care services for adults 
85.22 	in the provider's home, are public: the nature of any disqualification set aside under section 
85.23 	245C.22, subdivisions 2 and 4, and the reasons for setting aside the disqualification; the 
85.24 	nature of any disqualification for which a variance was granted under sections 245A.04, 
85.25 	subdivision 9; and 245C.30, and the reasons for granting any variance under section 
85.26 	245A.04, subdivision 9; and, if applicable, the disclosure that any person subject to 
85.27 	a background study under section 245C.03, subdivision 1, has successfully passed a 
85.28 	background study. If a licensing sanction under section 245A.07, or a license denial under 
85.29 	section 245A.05, is based on a determination that an individual subject to disqualification 
85.30 	under chapter 245C is disqualified, the disqualification as a basis for the licensing sanction 
85.31 	or denial is public data. As specified in clause (1), item (iv), if the disqualified individual 
85.32 	is the license holder or applicant, the identity of the license holder or applicant and the 
85.33 	reason for the disqualification are public data; and, if the license holder or applicant 
85.34 	requested reconsideration of the disqualification and the disqualification is affirmed, the 
85.35 	reason for the disqualification and the reason to not set aside the disqualification are 
86.1 	public data. If the disqualified individual is an individual other than the license holder or 
86.2 	applicant, the identity of the disqualified individual shall remain private data.
86.3 	(6) When maltreatment is substantiated under section 626.556 or 626.557 and the 
86.4 	victim and the substantiated perpetrator are affiliated with a program licensed under 
86.5 	chapter 245A, the commissioner of human services, local social services agency, or 
86.6 	county welfare agency may inform the license holder where the maltreatment occurred of 
86.7 	the identity of the substantiated perpetrator and the victim.
86.8 	(7) Notwithstanding clause (1), for child foster care, only the name of the license 
86.9 	holder and the status of the license are public if the county attorney has requested that data 
86.10 	otherwise classified as public data under clause (1) be considered private data based on the 
86.11 	best interests of a child in placement in a licensed program.
86.12 	(c) The following are private data on individuals under section 13.02, subdivision 
86.13 	12, or nonpublic data under section 13.02, subdivision 9: personal and personal financial 
86.14 	data on family day care program and family foster care program applicants and licensees 
86.15 	and their family members who provide services under the license.
86.16 	(d) The following are private data on individuals: the identity of persons who have 
86.17 	made reports concerning licensees or applicants that appear in inactive investigative data, 
86.18 	and the records of clients or employees of the licensee or applicant for licensure whose 
86.19 	records are received by the licensing agency for purposes of review or in anticipation of a 
86.20 	contested matter. The names of reporters of complaints or alleged violations of licensing 
86.21 	standards under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged 
86.22 	maltreatment under sections 626.556 and 626.557, are confidential data and may be 
86.23 	disclosed only as provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
86.24 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under 
86.25 	this subdivision become public data if submitted to a court or administrative law judge as 
86.26 	part of a disciplinary proceeding in which there is a public hearing concerning a license 
86.27 	which has been suspended, immediately suspended, revoked, or denied.
86.28 	(f) Data generated in the course of licensing investigations that relate to an alleged 
86.29 	violation of law are investigative data under subdivision 3.
86.30 	(g) Data that are not public data collected, maintained, used, or disseminated under 
86.31 	this subdivision that relate to or are derived from a report as defined in section 626.556, 
86.32 	subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of 
86.33 	sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
86.34 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
86.35 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
86.36 	defined in section 626.556 or 626.557 may be exchanged with the Department of Health 
87.1 	for purposes of completing background studies pursuant to section 144.057 and with 
87.2 	the Department of Corrections for purposes of completing background studies pursuant 
87.3 	to section 241.021.
87.4 	(i) Data on individuals collected according to licensing activities under chapters 
87.5 	245A and 245C, data on individuals collected by the commissioner of human services 
87.6 	according to investigations under chapters 245A, 245B, and 245C, and 245D, and 
87.7 	sections 626.556 and 626.557 may be shared with the Department of Human Rights, the 
87.8 	Department of Health, the Department of Corrections, the ombudsman for mental health 
87.9 	and developmental disabilities, and the individual's professional regulatory board when 
87.10 	there is reason to believe that laws or standards under the jurisdiction of those agencies may 
87.11 	have been violated or the information may otherwise be relevant to the board's regulatory 
87.12 	jurisdiction. Background study data on an individual who is the subject of a background 
87.13 	study under chapter 245C for a licensed service for which the commissioner of human 
87.14 	services is the license holder may be shared with the commissioner and the commissioner's 
87.15 	delegate by the licensing division. Unless otherwise specified in this chapter, the identity 
87.16 	of a reporter of alleged maltreatment or licensing violations may not be disclosed.
87.17 	(j) In addition to the notice of determinations required under section 626.556, 
87.18 	subdivision 10f, if the commissioner or the local social services agency has determined 
87.19 	that an individual is a substantiated perpetrator of maltreatment of a child based on sexual 
87.20 	abuse, as defined in section 626.556, subdivision 2, and the commissioner or local social 
87.21 	services agency knows that the individual is a person responsible for a child's care in 
87.22 	another facility, the commissioner or local social services agency shall notify the head 
87.23 	of that facility of this determination. The notification must include an explanation of the 
87.24 	individual's available appeal rights and the status of any appeal. If a notice is given under 
87.25 	this paragraph, the government entity making the notification shall provide a copy of the 
87.26 	notice to the individual who is the subject of the notice.
87.27 	(k) All not public data collected, maintained, used, or disseminated under this 
87.28 	subdivision and subdivision 3 may be exchanged between the Department of Human 
87.29 	Services, Licensing Division, and the Department of Corrections for purposes of 
87.30 	regulating services for which the Department of Human Services and the Department 
87.31 	of Corrections have regulatory authority.

87.32 	Sec. 2. Minnesota Statutes 2012, section 144.0724, as amended by Laws 2014, chapter 
87.33 	147, section 1, is amended to read:
87.34 	144.0724 RESIDENT REIMBURSEMENT CLASSIFICATION.
88.1 		Subdivision 1.Resident reimbursement case mix classifications. The 
88.2 	commissioner of health shall establish resident reimbursement classifications based upon 
88.3 	the assessments of residents of nursing homes and boarding care homes conducted under 
88.4 	this section and according to section 256B.438. 
88.5 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
88.6 	meanings given.
88.7 	(a) "Assessment reference date" or "ARD" means the specific end point for 
88.8 	look-back periods in the MDS assessment process. This look-back period is also called 
88.9 	the observation or assessment period.
88.10 	(b) "Case mix index" means the weighting factors assigned to the RUG-IV 
88.11 	classifications.
88.12 	(c) "Index maximization" means classifying a resident who could be assigned to 
88.13 	more than one category, to the category with the highest case mix index.
88.14 	(d) "Minimum data set" or "MDS" means a core set of screening, clinical assessment, 
88.15 	and functional status elements, that include common definitions and coding categories 
88.16 	specified by the Centers for Medicare and Medicaid Services and designated by the 
88.17 	Minnesota Department of Health.
88.18 	(e) "Representative" means a person who is the resident's guardian or conservator, 
88.19 	the person authorized to pay the nursing home expenses of the resident, a representative of 
88.20 	the Office of Ombudsman for Long-Term Care whose assistance has been requested, or 
88.21 	any other individual designated by the resident.
88.22 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
88.23 	facility's residents according to their clinical and functional status identified in data 
88.24 	supplied by the facility's minimum data set.
88.25 	(g) "Activities of daily living" means grooming, dressing, bathing, transferring, 
88.26 	mobility, positioning, eating, and toileting.
88.27 	(h) "Nursing facility level of care determination" means the assessment process 
88.28 	that results in a determination of a resident's or prospective resident's need for nursing 
88.29 	facility level of care as established in subdivision 11 for purposes of medical assistance 
88.30 	payment of long-term care services for:
88.31 	(1) nursing facility services under section 256B.434 or 256B.441;
88.32 	(2) elderly waiver services under section 256B.0915;
88.33 	(3) CADI and BI waiver services under section 256B.49; and
88.34 	(4) state payment of alternative care services under section 256B.0913.
88.35 		Subd. 3a.Resident reimbursement classifications beginning January 1, 2012.
 88.36 	(a) Beginning January 1, 2012, resident reimbursement classifications shall be based 
89.1 	on the minimum data set, version 3.0 assessment instrument, or its successor version 
89.2 	mandated by the Centers for Medicare and Medicaid Services that nursing facilities are 
89.3 	required to complete for all residents. The commissioner of health shall establish resident 
89.4 	classifications according to the RUG-IV, 48 group, resource utilization groups. Resident 
89.5 	classification must be established based on the individual items on the minimum data set, 
89.6 	which must be completed according to the Long Term Care Facility Resident Assessment 
89.7 	Instrument User's Manual Version 3.0 or its successor issued by the Centers for Medicare 
89.8 	and Medicaid Services.
89.9 	(b) Each resident must be classified based on the information from the minimum 
89.10 	data set according to general categories as defined in the Case Mix Classification Manual 
89.11 	for Nursing Facilities issued by the Minnesota Department of Health.
89.12 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
89.13 	electronically submit to the commissioner of health MDS assessments that conform with 
89.14 	the assessment schedule defined by Code of Federal Regulations, title 42, section 483.20, 
89.15 	and published by the United States Department of Health and Human Services, Centers for 
89.16 	Medicare and Medicaid Services, in the Long Term Care Assessment Instrument User's 
89.17 	Manual, version 3.0, and subsequent updates when issued by the Centers for Medicare 
89.18 	and Medicaid Services. The commissioner of health may substitute successor manuals or 
89.19 	question and answer documents published by the United States Department of Health and 
89.20 	Human Services, Centers for Medicare and Medicaid Services, to replace or supplement 
89.21 	the current version of the manual or document.
89.22 	(b) The assessments used to determine a case mix classification for reimbursement 
89.23 	include the following:
89.24 	(1) a new admission assessment;
89.25 	(2) an annual assessment which must have an assessment reference date (ARD) 
89.26 	within 92 days of the previous assessment and within 366 days of the ARD of the previous 
89.27 	comprehensive assessment;
89.28 	(3) a significant change in status assessment must be completed within 14 days of 
89.29 	the identification of a significant change; 
89.30 	(4) all quarterly assessments must have an assessment reference date (ARD) within 
89.31 	92 days of the ARD of the previous assessment;
89.32 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
89.33 	being corrected is the current one being used for RUG classification; and
89.34 	(6) any significant correction to a prior quarterly assessment, if the assessment being 
89.35 	corrected is the current one being used for RUG classification.
90.1 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
90.2 	determine nursing facility level of care include the following:
90.3 	(1) preadmission screening completed under section 256B.0911, subdivision 4a, 
90.4 	by a county, tribe, or managed care organization under contract with the Department 
90.5 	of Human Services; and
90.6 	(2) a face-to-face long-term care consultation assessment completed under section 
90.7 	256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization 
90.8 	under contract with the Department of Human Services.
90.9 		Subd. 5.Short stays. (a) A facility must submit to the commissioner of health an 
90.10 	admission assessment for all residents who stay in the facility 14 days or less.
90.11 	(b) Notwithstanding the admission assessment requirements of paragraph (a), a 
90.12 	facility may elect to accept a short stay rate with a case mix index of 1.0 for all facility 
90.13 	residents who stay 14 days or less in lieu of submitting an admission assessment. Facilities 
90.14 	shall make this election annually.
90.15 	(c) Nursing facilities must elect one of the options described in paragraphs (a) and 
90.16 	(b) by reporting to the commissioner of health, as prescribed by the commissioner. The 
90.17 	election is effective on July 1 each year.
90.18 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete 
90.19 	or submit an assessment according to subdivisions 4 and 5 for a RUG-IV classification 
90.20 	within seven days of the time requirements listed in the Long-Term Care Facility Resident 
90.21 	Assessment Instrument User's Manual is subject to a reduced rate for that resident. The 
90.22 	reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the 
90.23 	day of admission for new admission assessments, on the ARD for significant change in 
90.24 	status assessments, or on the day that the assessment was due for all other assessments and 
90.25 	continues in effect until the first day of the month following the date of submission and 
90.26 	acceptance of the resident's assessment.
90.27 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
90.28 	are equal to or greater than 1.0 percent of the total operating costs on the facility's most 
90.29 	recent annual statistical and cost report, a facility may apply to the commissioner of 
90.30 	human services for a reduction in the total penalty amount. The commissioner of human 
90.31 	services, in consultation with the commissioner of health, may, at the sole discretion of 
90.32 	the commissioner of human services, limit the penalty for residents covered by medical 
90.33 	assistance to 15 days.
90.34 		Subd. 7.Notice of resident reimbursement classification. (a) The commissioner 
90.35 	of health shall provide to a nursing facility a notice for each resident of the reimbursement 
90.36 	classification established under subdivision 1. The notice must inform the resident of the 
91.1 	classification that was assigned, the opportunity to review the documentation supporting 
91.2 	the classification, the opportunity to obtain clarification from the commissioner, and the 
91.3 	opportunity to request a reconsideration of the classification and the address and telephone 
91.4 	number of the Office of Ombudsman for Long-Term Care. The commissioner must 
91.5 	transmit the notice of resident classification by electronic means to the nursing facility. 
91.6 	A nursing facility is responsible for the distribution of the notice to each resident, to the 
91.7 	person responsible for the payment of the resident's nursing home expenses, or to another 
91.8 	person designated by the resident. This notice must be distributed within three working 
91.9 	days after the facility's receipt of the electronic file of notice of case mix classifications 
91.10 	from the commissioner of health.
91.11 	(b) If a facility submits a modification to the most recent assessment used to establish 
91.12 	a case mix classification conducted under subdivision 3 that results in a change in case 
91.13 	mix classification, the facility shall give written notice to the resident or the resident's 
91.14 	representative about the item that was modified and the reason for the modification. The 
91.15 	notice of modified assessment may be provided at the same time that the resident or 
91.16 	resident's representative is provided the resident's modified notice of classification.
91.17 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, 
91.18 	or resident's representative, or the nursing facility or boarding care home may request that 
91.19 	the commissioner of health reconsider the assigned reimbursement classification. The 
91.20 	request for reconsideration must be submitted in writing to the commissioner within 
91.21 	30 days of the day the resident or the resident's representative receives the resident 
91.22 	classification notice. The request for reconsideration must include the name of the 
91.23 	resident, the name and address of the facility in which the resident resides, the reasons 
91.24 	for the reconsideration, and documentation supporting the request. The documentation 
91.25 	accompanying the reconsideration request is limited to a copy of the MDS that determined 
91.26 	the classification and other documents that would support or change the MDS findings.
91.27 	(b) Upon request, the nursing facility must give the resident or the resident's 
91.28 	representative a copy of the assessment form and the other documentation that was given 
91.29 	to the commissioner of health to support the assessment findings. The nursing facility 
91.30 	shall also provide access to and a copy of other information from the resident's record that 
91.31 	has been requested by or on behalf of the resident to support a resident's reconsideration 
91.32 	request. A copy of any requested material must be provided within three working days of 
91.33 	receipt of a written request for the information. Notwithstanding any law to the contrary, 
91.34 	the facility may not charge a fee for providing copies of the requested documentation. 
91.35 	If a facility fails to provide the material within this time, it is subject to the issuance 
91.36 	of a correction order and penalty assessment under sections 144.653 and 144A.10. 
92.1 	Notwithstanding those sections, any correction order issued under this subdivision must 
92.2 	require that the nursing facility immediately comply with the request for information and 
92.3 	that as of the date of the issuance of the correction order, the facility shall forfeit to the 
92.4 	state a $100 fine for the first day of noncompliance, and an increase in the $100 fine by 
92.5 	$50 increments for each day the noncompliance continues.
92.6 	(c) In addition to the information required under paragraphs (a) and (b), a 
92.7 	reconsideration request from a nursing facility must contain the following information: (i) 
92.8 	the date the reimbursement classification notices were received by the facility; (ii) the date 
92.9 	the classification notices were distributed to the resident or the resident's representative; 
92.10 	and (iii) a copy of a notice sent to the resident or to the resident's representative. This 
92.11 	notice must inform the resident or the resident's representative that a reconsideration 
92.12 	of the resident's classification is being requested, the reason for the request, that the 
92.13 	resident's rate will change if the request is approved by the commissioner, the extent of the 
92.14 	change, that copies of the facility's request and supporting documentation are available 
92.15 	for review, and that the resident also has the right to request a reconsideration. If the 
92.16 	facility fails to provide the required information listed in item (iii) with the reconsideration 
92.17 	request, the commissioner may request that the facility provide the information within 14 
92.18 	calendar days. The reconsideration request must be denied if the information is then not 
92.19 	provided, and the facility may not make further reconsideration requests on that specific 
92.20 	reimbursement classification.
92.21 	(d) Reconsideration by the commissioner must be made by individuals not 
92.22 	involved in reviewing the assessment, audit, or reconsideration that established the 
92.23 	disputed classification. The reconsideration must be based upon the assessment that 
92.24 	determined the classification and upon the information provided to the commissioner 
92.25 	under paragraphs (a) and (b). If necessary for evaluating the reconsideration request, the 
92.26 	commissioner may conduct on-site reviews. Within 15 working days of receiving the 
92.27 	request for reconsideration, the commissioner shall affirm or modify the original resident 
92.28 	classification. The original classification must be modified if the commissioner determines 
92.29 	that the assessment resulting in the classification did not accurately reflect characteristics 
92.30 	of the resident at the time of the assessment. The resident and the nursing facility or 
92.31 	boarding care home shall be notified within five working days after the decision is made. 
92.32 	A decision by the commissioner under this subdivision is the final administrative decision 
92.33 	of the agency for the party requesting reconsideration.
92.34 	(e) The resident classification established by the commissioner shall be the 
92.35 	classification that applies to the resident while the request for reconsideration is pending. 
92.36 	If a request for reconsideration applies to an assessment used to determine nursing facility 
93.1 	level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible 
93.2 	for nursing facility level of care while the request for reconsideration is pending.
93.3 	(f) The commissioner may request additional documentation regarding a 
93.4 	reconsideration necessary to make an accurate reconsideration determination.
93.5 		Subd. 9.Audit authority. (a) The commissioner shall audit the accuracy of resident 
93.6 	assessments performed under section 256B.438 through any of the following: desk 
93.7 	audits; on-site review of residents and their records; and interviews with staff, residents, 
93.8 	or residents' families. The commissioner shall reclassify a resident if the commissioner 
93.9 	determines that the resident was incorrectly classified.
93.10 	(b) The commissioner is authorized to conduct on-site audits on an unannounced 
93.11 	basis.
93.12 	(c) A facility must grant the commissioner access to examine the medical records 
93.13 	relating to the resident assessments selected for audit under this subdivision. The 
93.14 	commissioner may also observe and speak to facility staff and residents.
93.15 	(d) The commissioner shall consider documentation under the time frames for 
93.16 	coding items on the minimum data set as set out in the Long-Term Care Facility Resident 
93.17 	Assessment Instrument User's Manual published by the Centers for Medicare and 
93.18 	Medicaid Services.
93.19 	(e) The commissioner shall develop an audit selection procedure that includes the 
93.20 	following factors:
93.21 	(1) Each facility shall be audited annually. If a facility has two successive audits in 
93.22 	which the percentage of change is five percent or less and the facility has not been the 
93.23 	subject of a special audit in the past 36 months, the facility may be audited biannually. 
93.24 	A stratified sample of 15 percent, with a minimum of ten assessments, of the most 
93.25 	current assessments shall be selected for audit. If more than 20 percent of the RUG-IV 
93.26 	classifications are changed as a result of the audit, the audit shall be expanded to a second 
93.27 	15 percent sample, with a minimum of ten assessments. If the total change between 
93.28 	the first and second samples is 35 percent or greater, the commissioner may expand the 
93.29 	audit to all of the remaining assessments.
93.30 	(2) If a facility qualifies for an expanded audit, the commissioner may audit the 
93.31 	facility again within six months. If a facility has two expanded audits within a 24-month 
93.32 	period, that facility will be audited at least every six months for the next 18 months.
93.33 	(3) The commissioner may conduct special audits if the commissioner determines 
93.34 	that circumstances exist that could alter or affect the validity of case mix classifications of 
93.35 	residents. These circumstances include, but are not limited to, the following:
93.36 	(i) frequent changes in the administration or management of the facility;
94.1 	(ii) an unusually high percentage of residents in a specific case mix classification;
94.2 	(iii) a high frequency in the number of reconsideration requests received from 
94.3 	a facility;
94.4 	(iv) frequent adjustments of case mix classifications as the result of reconsiderations 
94.5 	or audits;
94.6 	(v) a criminal indictment alleging provider fraud; 
94.7 	(vi) other similar factors that relate to a facility's ability to conduct accurate 
94.8 	assessments;
94.9 	(vii) an atypical pattern of scoring minimum data set items;
94.10 	(viii) nonsubmission of assessments;
94.11 	(ix) late submission of assessments; or
94.12 	(x) a previous history of audit changes of 35 percent or greater.
94.13 	(f) Within 15 working days of completing the audit process, the commissioner shall 
94.14 	make available electronically the results of the audit to the facility. If the results of the 
94.15 	audit reflect a change in the resident's case mix classification, a case mix classification 
94.16 	notice will be made available electronically to the facility, using the procedure in 
94.17 	subdivision 7, paragraph (a). The notice must contain the resident's classification and a 
94.18 	statement informing the resident, the resident's authorized representative, and the facility 
94.19 	of their right to review the commissioner's documents supporting the classification and to 
94.20 	request a reconsideration of the classification. This notice must also include the address 
94.21 	and telephone number of the Office of Ombudsman for Long-Term Care.
94.22 		Subd. 10.Transition. After implementation of this section, reconsiderations 
94.23 	requested for classifications made under section 144.0722, subdivision 1, shall be 
94.24 	determined under section 144.0722, subdivision 3.
94.25 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
94.26 	payment of long-term care services, a recipient must be determined, using assessments 
94.27 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
94.28 	(1) the person requires formal clinical monitoring at least once per day;
94.29 	(2) the person needs the assistance of another person or constant supervision to begin 
94.30 	and complete at least four of the following activities of living: bathing, bed mobility, 
94.31 	dressing, eating, grooming, toileting, transferring, and walking;
94.32 	(3) the person needs the assistance of another person or constant supervision to begin 
94.33 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
94.34 	(4) the person has significant difficulty with memory, using information, daily 
94.35 	decision making, or behavioral needs that require intervention;
94.36 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
95.1 	(6) the person meets the nursing facility level of care criteria determined 90 days 
95.2 	after admission or on the first quarterly assessment after admission, whichever is later; or
95.3 	(7) the person is determined to be at risk for nursing facility admission or 
95.4 	readmission through a face-to-face long-term care consultation assessment as specified 
95.5 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
95.6 	organization under contract with the Department of Human Services. The person is 
95.7 	considered at risk under this clause if the person currently lives alone or will live alone 
95.8 	upon discharge or be homeless without the person's current housing type and also meets 
95.9 	one of the following criteria:
95.10 	(i) the person has experienced a fall resulting in a fracture;
95.11 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
95.12 	including self-neglect; or
95.13 	(iii) the person has a sensory impairment that substantially impacts functional ability 
95.14 	and maintenance of a community residence.
95.15 	(b) The assessment used to establish medical assistance payment for nursing facility 
95.16 	services must be the most recent assessment performed under subdivision 4, paragraph 
95.17 	(b), that occurred no more than 90 calendar days before the effective date of medical 
95.18 	assistance eligibility for payment of long-term care services. In no case shall medical 
95.19 	assistance payment for long-term care services occur prior to the date of the determination 
95.20 	of nursing facility level of care.
95.21 	(c) The assessment used to establish medical assistance payment for long-term care 
95.22 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
95.23 	for services provided under section 256B.0913 must be the most recent face-to-face 
95.24 	assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d, that occurred 
95.25 	no more than 60 calendar days before the effective date of medical assistance eligibility 
95.26 	for payment of long-term care services.
95.27 		Subd. 12.Appeal of nursing facility level of care determination. A resident or 
95.28 	prospective resident whose level of care determination results in a denial of long-term care 
95.29 	services can appeal the determination as outlined in section 256B.0911, subdivision 3a, 
95.30 	paragraph (h), clause (9). The commissioner of human services shall ensure that notice of 
95.31 	changes in eligibility due to a nursing facility level of care determination is provided to 
95.32 	each affected recipient or the recipient's guardian at least 30 days before the effective date 
95.33 	of the change. The notice shall include the following information:
95.34 	(1) how to obtain further information on the changes;
95.35 	(2) how to receive assistance in obtaining other services;
95.36 	(3) a list of community resources; and
96.1 	(4) appeal rights.
96.2 	A recipient who meets the criteria in section 256B.0922, subdivision 2, paragraph (a), 
96.3 	clauses (1) and (2), may request continued services pending appeal within the time period 
96.4 	allowed to request an appeal under section 256.045, subdivision 3, paragraph (h).

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

96.6 	Sec. 3. Minnesota Statutes 2013 Supplement, section 245.8251, is amended to read:
96.7 	245.8251 POSITIVE SUPPORT STRATEGIES AND EMERGENCY 
96.8 	MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
96.9 		Subdivision 1.Rules governing the use of positive support strategies and 
96.10 	restricting or prohibiting restrictive interventions. The commissioner of human 
96.11 	services shall, within 24 months of May 23, 2013 by August 31, 2015, adopt rules 
96.12 	governing the use of positive support strategies, safety interventions, and emergency use 
96.13 	of manual restraint, and restricting or prohibiting the use of restrictive interventions,  in 
96.14 	all facilities and services licensed under chapter 245D., and in all licensed facilities and 
96.15 	licensed services serving persons with a developmental disability or related condition. 
96.16 	For the purposes of this section, "developmental disability or related condition" has the 
96.17 	meaning given in Minnesota Rules, part 9525.0016, subpart 2, items A to E.
96.18 		Subd. 2.Data collection. (a) The commissioner shall, with stakeholder input, 
96.19 	develop identify data collection elements specific to incidents of emergency use of 
96.20 	manual restraint and positive support transition plans for persons receiving services from 
96.21 	providers governed licensed facilities and licensed services  under chapter 245D and in 
96.22 	licensed facilities and licensed services serving persons with a developmental disability 
96.23 	or related condition as defined in Minnesota Rules, part 9525.0016, subpart 2, effective 
96.24 	January 1, 2014. Providers Licensed facilities and licensed services shall report the data in 
96.25 	a format and at a frequency determined by the commissioner of human services. Providers 
96.26 	shall submit the data to the commissioner and the Office of the Ombudsman for Mental 
96.27 	Health and Developmental Disabilities.
96.28 	(b) Beginning July 1, 2013, providers licensed facilities and licensed services
96.29 	 regulated under Minnesota Rules, parts 9525.2700 to 9525.2810, shall submit data 
96.30 	regarding the use of all controlled procedures identified in Minnesota Rules, part 
96.31 	9525.2740, in a format and at a frequency determined by the commissioner. Providers 
96.32 	shall submit the data to the commissioner and the Office of the Ombudsman for Mental 
96.33 	Health and Developmental Disabilities.
97.1 		Subd. 3.External program review committee. Rules adopted according to this 
97.2 	section shall establish requirements for an external program review committee appointed 
97.3 	by the commissioner to monitor implementation of the rules and make recommendations 
97.4 	to the commissioner about any needed policy changes after adoption of the rules.
97.5 		Subd. 4.Interim review panel. (a) The commissioner shall establish an interim 
97.6 	review panel by August 15, 2014, for the purpose of reviewing requests for emergency 
97.7 	use of procedures that have been part of an approved positive support transition plan 
97.8 	when necessary to protect a person from imminent risk of serious injury as defined in 
97.9 	section 245.91, subdivision 6, due to self-injurious behavior. The panel must make 
97.10 	recommendations to the commissioner to approve or deny these requests based on criteria 
97.11 	to be established by the interim review panel. The interim review panel shall operate until 
97.12 	the external program review committee is established as required under subdivision 3.
97.13 	(b) Members of the interim review panel shall be selected based on their expertise 
97.14 	and knowledge related to the use of positive support strategies as alternatives to the use 
97.15 	of restrictive interventions. The commissioner shall seek input and recommendations in 
97.16 	establishing the interim review panel. Members of the interim review panel shall include 
97.17 	the following representatives:
97.18 	(1) an expert in positive supports;
97.19 	(2) a mental health professional, as defined in section 245.462;
97.20 	(3) a licensed health professional as defined in section 245D.02, subdivision 14; and
97.21 	(4) a representative of the Department of Health.

97.22 	Sec. 4. Minnesota Statutes 2013 Supplement, section 245A.03, subdivision 7, is 
97.23 	amended to read:
97.24 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial 
97.25 	license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, 
97.26 	or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under 
97.27 	this chapter for a physical location that will not be the primary residence of the license 
97.28 	holder for the entire period of licensure. If a license is issued during this moratorium, and 
97.29 	the license holder changes the license holder's primary residence away from the physical 
97.30 	location of the foster care license, the commissioner shall revoke the license according 
97.31 	to section 245A.07. The commissioner shall not issue an initial license for a community 
97.32 	residential setting licensed under chapter 245D. Exceptions to the moratorium include:
97.33 	(1) foster care settings that are required to be registered under chapter 144D;
98.1 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
98.2 	community residential setting licenses replacing adult foster care licenses in existence on 
98.3 	December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
98.4 	(3) new foster care licenses or community residential setting licenses determined to 
98.5 	be needed by the commissioner under paragraph (b) for the closure of a nursing facility, 
98.6 	ICF/DD, or regional treatment center; restructuring of state-operated services that limits 
98.7 	the capacity of state-operated facilities; or allowing movement to the community for 
98.8 	people who no longer require the level of care provided in state-operated facilities as 
98.9 	provided under section 256B.092, subdivision 13, or 256B.49, subdivision 24;
98.10 	(4) new foster care licenses or community residential setting licenses determined 
98.11 	to be needed by the commissioner under paragraph (b) for persons requiring hospital 
98.12 	level care; or
98.13 	(5) new foster care licenses or community residential setting licenses determined to 
98.14 	be needed by the commissioner for the transition of people from personal care assistance 
98.15 	to the home and community-based services.
98.16 	(b) The commissioner shall determine the need for newly licensed foster care 
98.17 	homes or community residential settings as defined under this subdivision. As part of the 
98.18 	determination, the commissioner shall consider the availability of foster care capacity in 
98.19 	the area in which the licensee seeks to operate, and the recommendation of the local 
98.20 	county board. The determination by the commissioner must be final. A determination of 
98.21 	need is not required for a change in ownership at the same address.
98.22 	(c) When an adult resident served by the program moves out of a foster home 
98.23 	that is not the primary residence of the license holder according to section 256B.49, 
98.24 	subdivision 15, paragraph (f), or the adult community residential setting, the county 
98.25 	shall immediately inform the Department of Human Services Licensing Division. The 
98.26 	department shall decrease the statewide licensed capacity for adult foster care settings 
98.27 	where the physical location is not the primary residence of the license holder, or for adult 
98.28 	community residential settings, if the voluntary changes described in paragraph (e) are 
98.29 	not sufficient to meet the savings required by reductions in licensed bed capacity under 
98.30 	Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), 
98.31 	and maintain statewide long-term care residential services capacity within budgetary 
98.32 	limits. Implementation of the statewide licensed capacity reduction shall begin on July 
98.33 	1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the 
98.34 	needs determination process. Prior to any involuntary reduction of licensed capacity, the 
98.35 	commissioner shall consult with lead agencies and license holders to determine which 
98.36 	adult foster care settings where the physical location is not the primary residence of the 
99.1 	license holder, or community residential settings, are licensed for up to five beds but have 
99.2 	operated at less than full capacity for 12 or more months as of March 1, 2014. The settings 
99.3 	that meet these criteria shall be the first to be considered for any involuntary decrease 
99.4 	in statewide licensed capacity, up to a maximum of 35 beds. If more than 35 beds are 
99.5 	identified that meet these criteria, the commissioner shall prioritize the selection of those 
99.6 	beds to be closed based on the length of time the beds have been vacant. The longer a bed 
99.7 	has been vacant, the higher priority it must be given for closure. Under this paragraph, 
99.8 	the commissioner has the authority to reduce unused licensed capacity of a current foster 
99.9 	care program, or the community residential settings, to accomplish the consolidation or 
99.10 	closure of settings. Under this paragraph, the commissioner has the authority to manage 
99.11 	statewide capacity, including adjusting the capacity available to each county and adjusting 
99.12 	statewide available capacity, to meet the statewide needs identified through the process in 
99.13 	paragraph (e). A decreased licensed capacity according to this paragraph is not subject to 
99.14 	appeal under this chapter.
99.15 	(d) Residential settings that would otherwise be subject to the decreased license 
99.16 	capacity established in paragraph (c) shall be exempt under the following circumstances:
99.17 	(1) until August 1, 2013, the license holder's beds occupied by residents whose 
99.18 	primary diagnosis is mental illness and the license holder is:
99.19 	(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 
99.20 	health services (ARMHS) as defined in section 256B.0623;
99.21 	(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 
99.22 	9520.0870;
99.23 	(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 
99.24 	9520.0870; or
99.25 	(iv) a provider of intensive residential treatment services (IRTS) licensed under 
99.26 	Minnesota Rules, parts 9520.0500 to 9520.0670; or
99.27 	(2) the license holder's beds occupied by residents whose primary diagnosis is 
99.28 	mental illness and the license holder is certified under the requirements in subdivision 6a 
99.29 	or section 245D.33.
99.30 	(e) A resource need determination process, managed at the state level, using the 
99.31 	available reports required by section 144A.351, and other data and information shall 
99.32 	be used to determine where the reduced capacity required under paragraph (c) will be 
99.33 	implemented. The commissioner shall consult with the stakeholders described in section 
99.34 	144A.351, and employ a variety of methods to improve the state's capacity to meet 
99.35 	long-term care service needs within budgetary limits, including seeking proposals from 
99.36 	service providers or lead agencies to change service type, capacity, or location to improve 
100.1 	services, increase the independence of residents, and better meet needs identified by the 
100.2 	long-term care services reports and statewide data and information. By February 1, 2013, 
100.3 	and August 1, 2014, and each following year, the commissioner shall provide information 
100.4 	and data on the overall capacity of licensed long-term care services, actions taken under 
100.5 	this subdivision to manage statewide long-term care services and supports resources, and 
100.6 	any recommendations for change to the legislative committees with jurisdiction over 
100.7 	health and human services budget.
100.8 	(f) At the time of application and reapplication for licensure, the applicant and the 
100.9 	license holder that are subject to the moratorium or an exclusion established in paragraph 
100.10 	(a) are required to inform the commissioner whether the physical location where the foster 
100.11 	care will be provided is or will be the primary residence of the license holder for the entire 
100.12 	period of licensure. If the primary residence of the applicant or license holder changes, the 
100.13 	applicant or license holder must notify the commissioner immediately. The commissioner 
100.14 	shall print on the foster care license certificate whether or not the physical location is the 
100.15 	primary residence of the license holder.
100.16 	(g) License holders of foster care homes identified under paragraph (f) that are not 
100.17 	the primary residence of the license holder and that also provide services in the foster care 
100.18 	home that are covered by a federally approved home and community-based services 
100.19 	waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the 
100.20 	human services licensing division that the license holder provides or intends to provide 
100.21 	these waiver-funded services.

100.22 	Sec. 5. Minnesota Statutes 2013 Supplement, section 245A.042, subdivision 3, is 
100.23 	amended to read:
100.24 		Subd. 3.Implementation. (a) The commissioner shall implement the 
100.25 	responsibilities of this chapter according to the timelines in paragraphs (b) and (c) 
100.26 	only within the limits of available appropriations or other administrative cost recovery 
100.27 	methodology.
100.28 	(b) The licensure of home and community-based services according to this section 
100.29 	shall be implemented January 1, 2014. License applications shall be received and 
100.30 	processed on a phased-in schedule as determined by the commissioner beginning July 
100.31 	1, 2013. Licenses will be issued thereafter upon the commissioner's determination that 
100.32 	the application is complete according to section 245A.04.
100.33 	(c) Within the limits of available appropriations or other administrative cost recovery 
100.34 	methodology, implementation of compliance monitoring must be phased in after January 
100.35 	1, 2014.
101.1 	(1) Applicants who do not currently hold a license issued under chapter 245B must 
101.2 	receive an initial compliance monitoring visit after 12 months of the effective date of the 
101.3 	initial license for the purpose of providing technical assistance on how to achieve and 
101.4 	maintain compliance with the applicable law or rules governing the provision of home and 
101.5 	community-based services under chapter 245D. If during the review the commissioner 
101.6 	finds that the license holder has failed to achieve compliance with an applicable law or 
101.7 	rule and this failure does not imminently endanger the health, safety, or rights of the 
101.8 	persons served by the program, the commissioner may issue a licensing review report with 
101.9 	recommendations for achieving and maintaining compliance.
101.10 	(2) Applicants who do currently hold a license issued under this chapter must receive 
101.11 	a compliance monitoring visit after 24 months of the effective date of the initial license.
101.12 	(d) Nothing in this subdivision shall be construed to limit the commissioner's 
101.13 	authority to suspend or revoke a license or issue a fine at any time under section 245A.07, 
101.14 	or issue correction orders and make a license conditional for failure to comply with 
101.15 	applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity 
101.16 	of the violation of law or rule and the effect of the violation on the health, safety, or 
101.17 	rights of persons served by the program.
101.18 	(e) License holders governed under chapter 245D must ensure compliance with the 
101.19 	following requirements within the stated timelines:
101.20 	(1) service initiation and service planning requirements must be met at the next 
101.21 	annual meeting of the person's support team or by January 1, 2015, whichever is later, 
101.22 	for the following:
101.23 	(i) provision of a written notice that identifies the service recipient rights and an 
101.24 	explanation of those rights as required under section 245D.04, subdivision 1;
101.25 	(ii) service planning for basic support services as required under section 245D.07, 
101.26 	subdivision 2; and
101.27 	(iii) service planning for intensive support services under section 245D.071, 
101.28 	subdivisions 3 and 4;
101.29 	(2) staff orientation to program requirements as required under section 245D.09, 
101.30 	subdivision 4, for staff hired before January 1, 2014, must be met by January 1, 2015. 
101.31 	The license holder may otherwise provide documentation verifying these requirements 
101.32 	were met before January 1, 2014;
101.33 	(3) development of policy and procedures as required under section 245D.11, must 
101.34 	be completed no later than August 31, 2014;
101.35 	(4) written or electronic notice and copies of policies and procedures must be 
101.36 	provided to all persons or their legal representatives and case managers as required under 
102.1 	section 245D.10, subdivision 4, paragraphs (b) and (c), by September 15, 2014, or within 
102.2 	30 days of development of the required policies and procedures, whichever is earlier; and
102.3 	(5) all employees must be informed of the revisions and training must be provided on 
102.4 	implementation of the revised policies and procedures as required under section 245D.10, 
102.5 	subdivision 4, paragraph (d), by September 15, 2014, or within 30 days of development of 
102.6 	the required policies and procedures, whichever is earlier.

102.7 	Sec. 6. Minnesota Statutes 2013 Supplement, section 245A.16, subdivision 1, is 
102.8 	amended to read:
102.9 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and 
102.10 	private agencies that have been designated or licensed by the commissioner to perform 
102.11 	licensing functions and activities under section 245A.04 and background studies for family 
102.12 	child care under chapter 245C; to recommend denial of applicants under section 245A.05; 
102.13 	to issue correction orders, to issue variances, and recommend a conditional license under 
102.14 	section 245A.06, or to recommend suspending or revoking a license or issuing a fine under 
102.15 	section 245A.07, shall comply with rules and directives of the commissioner governing 
102.16 	those functions and with this section. The following variances are excluded from the 
102.17 	delegation of variance authority and may be issued only by the commissioner:
102.18 	(1) dual licensure of family child care and child foster care, dual licensure of child 
102.19 	and adult foster care, and adult foster care and family child care;
102.20 	(2) adult foster care maximum capacity;
102.21 	(3) adult foster care minimum age requirement;
102.22 	(4) child foster care maximum age requirement;
102.23 	(5) variances regarding disqualified individuals except that county agencies may 
102.24 	issue variances under section 245C.30 regarding disqualified individuals when the county 
102.25 	is responsible for conducting a consolidated reconsideration according to sections 245C.25 
102.26 	and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 
102.27 	and a disqualification based on serious or recurring maltreatment;
102.28 	(6) the required presence of a caregiver in the adult foster care residence during 
102.29 	normal sleeping hours; and
102.30 	(7) variances for community residential setting licenses under chapter 245D.
102.31 	Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency 
102.32 	must not grant a license holder a variance to exceed the maximum allowable family child 
102.33 	care license capacity of 14 children.
102.34 	(b) County agencies must report information about disqualification reconsiderations 
102.35 	under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances 
103.1 	granted under paragraph (a), clause (5), to the commissioner at least monthly in a format 
103.2 	prescribed by the commissioner.
103.3 	(c) For family day care programs, the commissioner may authorize licensing reviews 
103.4 	every two years after a licensee has had at least one annual review.
103.5 	(d) For family adult day services programs, the commissioner may authorize 
103.6 	licensing reviews every two years after a licensee has had at least one annual review.
103.7 	(e) A license issued under this section may be issued for up to two years.
103.8 	(f) During implementation of chapter 245D, the commissioner shall consider:
103.9 	(1) the role of counties in quality assurance;
103.10 	(2) the duties of county licensing staff; and
103.11 	(3) the possible use of joint powers agreements, according to section 471.59, with 
103.12 	counties through which some licensing duties under chapter 245D may be delegated by 
103.13 	the commissioner to the counties.
103.14 	Any consideration related to this paragraph must meet all of the requirements of the 
103.15 	corrective action plan ordered by the federal Centers for Medicare and Medicaid Services.
103.16 	(g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
103.17 	successor provisions; and section 245D.061 or successor provisions, for family child 
103.18 	foster care programs providing out-of-home respite, as identified in section 245D.03, 
103.19 	subdivision 1, paragraph (b), clause (1), is excluded from the delegation of authority 
103.20 	to county and private agencies.

103.21 	Sec. 7. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 3, is 
103.22 	amended to read:
103.23 		Subd. 3.Case manager. "Case manager" means the individual designated 
103.24 	to provide waiver case management services, care coordination, or long-term care 
103.25 	consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, 
103.26 	or successor provisions. For purposes of this chapter, "case manager" includes case 
103.27 	management services as defined in Minnesota Rules, part 9520.0902, subpart 3.

103.28 	Sec. 8. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 4b, is 
103.29 	amended to read:
103.30 		Subd. 4b.Coordinated service and support plan. "Coordinated service and 
103.31 	support plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, 
103.32 	subdivision 6; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor 
103.33 	provisions. For purposes of this chapter, "coordinated service and support plan" includes 
104.1 	the individual program plan or individual treatment plan as defined in Minnesota Rules, 
104.2 	part 9520.0510, subpart 12.

104.3 	Sec. 9. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 8b, is 
104.4 	amended to read:
104.5 		Subd. 8b.Expanded support team. "Expanded support team" means the members 
104.6 	of the support team defined in subdivision 46 34 and a licensed health or mental health 
104.7 	professional or other licensed, certified, or qualified professionals or consultants working 
104.8 	with the person and included in the team at the request of the person or the person's legal 
104.9 	representative.

104.10 	Sec. 10. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 11, 
104.11 	is amended to read:
104.12 		Subd. 11.Incident. "Incident" means an occurrence which involves a person and 
104.13 	requires the program to make a response that is not a part of the program's ordinary 
104.14 	provision of services to that person, and includes:
104.15 	(1) serious injury of a person as determined by section 245.91, subdivision 6;
104.16 	(2) a person's death;
104.17 	(3) any medical emergency, unexpected serious illness, or significant unexpected 
104.18 	change in an illness or medical condition of a person that requires the program to call 
104.19 	911, physician treatment, or hospitalization;
104.20 	(4) any mental health crisis that requires the program to call 911 or, a mental 
104.21 	health crisis intervention team, or a similar mental health response team or service when 
104.22 	available and appropriate;
104.23 	(5) an act or situation involving a person that requires the program to call 911, 
104.24 	law enforcement, or the fire department;
104.25 	(6) a person's unauthorized or unexplained absence from a program;
104.26 	(7) conduct by a person receiving services against another person receiving services 
104.27 	that:
104.28 	(i) is so severe, pervasive, or objectively offensive that it substantially interferes with 
104.29 	a person's opportunities to participate in or receive service or support;
104.30 	(ii) places the person in actual and reasonable fear of harm;
104.31 	(iii) places the person in actual and reasonable fear of damage to property of the 
104.32 	person; or
104.33 	(iv) substantially disrupts the orderly operation of the program;
105.1 	(8) any sexual activity between persons receiving services involving force or 
105.2 	coercion as defined under section 609.341, subdivisions 3 and 14;
105.3 	(9) any emergency use of manual restraint as identified in section 245D.061 or 
105.4 	successor provisions; or
105.5 	(10) a report of alleged or suspected child or vulnerable adult maltreatment under 
105.6 	section 626.556 or 626.557.

105.7 	Sec. 11. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 15b, 
105.8 	is amended to read:
105.9 		Subd. 15b.Mechanical restraint. (a) Except for devices worn by the person that 
105.10 	trigger electronic alarms to warn staff that a person is leaving a room or area, which 
105.11 	do not, in and of themselves, restrict freedom of movement, or the use of adaptive aids 
105.12 	or equipment or orthotic devices ordered by a health care professional used to treat or 
105.13 	manage a medical condition, "Mechanical restraint" means the use of devices, materials, 
105.14 	or equipment attached or adjacent to the person's body, or the use of practices that are 
105.15 	intended to restrict freedom of movement or normal access to one's body or body parts, 
105.16 	or limits a person's voluntary movement or holds a person immobile as an intervention 
105.17 	precipitated by a person's behavior. The term applies to the use of mechanical restraint 
105.18 	used to prevent injury with persons who engage in self-injurious behaviors, such as 
105.19 	head-banging, gouging, or other actions resulting in tissue damage that have caused or 
105.20 	could cause medical problems resulting from the self-injury.
105.21 	(b) Mechanical restraint does not include the following:
105.22 	(1) devices worn by the person that trigger electronic alarms to warn staff that a 
105.23 	person is leaving a room or area, which do not, in and of themselves, restrict freedom of 
105.24 	movement; or
105.25 	(2) the use of adaptive aids or equipment or orthotic devices ordered by a health care 
105.26 	professional used to treat or manage a medical condition.

105.27 	Sec. 12. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 29, 
105.28 	is amended to read:
105.29 		Subd. 29.Seclusion. "Seclusion" means the placement of a person alone in: (1) 
105.30 	removing a person involuntarily to a room from which exit is prohibited by a staff person 
105.31 	or a mechanism such as a lock, a device, or an object positioned to hold the door closed 
105.32 	or otherwise prevent the person from leaving the room.; or (2) otherwise involuntarily 
105.33 	removing or separating a person from an area, activity, situation, or social contact with 
105.34 	others and blocking or preventing the person's return.

106.1 	Sec. 13. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 34, 
106.2 	is amended to read:
106.3 		Subd. 34.Support team. "Support team" means the service planning team 
106.4 	identified in section 256B.49, subdivision 15, or; the interdisciplinary team identified in 
106.5 	Minnesota Rules, part 9525.0004, subpart 14; or the case management team as defined in 
106.6 	Minnesota Rules, part 9520.0902, subpart 6.

106.7 	Sec. 14. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 34a, 
106.8 	is amended to read:
106.9 		Subd. 34a.Time out. "Time out" means removing a person involuntarily from an 
106.10 	ongoing activity to a room, either locked or unlocked, or otherwise separating a person 
106.11 	from others in a way that prevents social contact and prevents the person from leaving the 
106.12 	situation if the person chooses the involuntary removal of a person for a period of time to 
106.13 	a designated area from which the person is not prevented from leaving. For the purpose of 
106.14 	this chapter, "time out" does not mean voluntary removal or self-removal for the purpose 
106.15 	of calming, prevention of escalation, or de-escalation of behavior for a period of up to 15 
106.16 	minutes. "Time out" does not include a person voluntarily moving from an ongoing activity 
106.17 	to an unlocked room or otherwise separating from a situation or social contact with others 
106.18 	if the person chooses. For the purposes of this definition, "voluntarily" means without 
106.19 	being forced, compelled, or coerced.; nor does it mean taking a brief "break" or "rest" from 
106.20 	an activity for the purpose of providing the person an opportunity to regain self-control. 

106.21 	Sec. 15. Minnesota Statutes 2013 Supplement, section 245D.02, is amended by adding 
106.22 	a subdivision to read:
106.23 		Subd. 35b.Unlicensed staff. "Unlicensed staff" means individuals not otherwise 
106.24 	licensed or certified by a governmental health board or agency.

106.25 	Sec. 16. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 1, is 
106.26 	amended to read:
106.27 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of 
106.28 	home and community-based services to persons with disabilities and persons age 65 and 
106.29 	older pursuant to this chapter. The licensing standards in this chapter govern the provision 
106.30 	of basic support services and intensive support services.
106.31 	(b) Basic support services provide the level of assistance, supervision, and care that 
106.32 	is necessary to ensure the health and safety of the person and do not include services that 
107.1 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of 
107.2 	the person. Basic support services include:
107.3 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
107.4 	subdivision 15, and under the brain injury, community alternative care, community 
107.5 	alternatives for disabled individuals, developmental disability, and elderly waiver plans, 
107.6 	excluding out-of-home respite care provided to children in a family child foster care home 
107.7 	licensed under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care 
107.8 	license holder complies with the requirements under section 245D.06, subdivisions 5, 6, 
107.9 	7, and 8, or successor provisions; and section 245D.061 or successor provisions, which 
107.10 	must be stipulated in the statement of intended use required under Minnesota Rules, 
107.11 	part 2960.3000, subpart 4;
107.12 	(2) adult companion services as defined under the brain injury, community 
107.13 	alternatives for disabled individuals, and elderly waiver plans, excluding adult companion 
107.14 	services provided under the Corporation for National and Community Services Senior 
107.15 	Companion Program established under the Domestic Volunteer Service Act of 1973, 
107.16 	Public Law 98-288;
107.17 	(3) personal support as defined under the developmental disability waiver plan;
107.18 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
107.19 	community alternatives for disabled individuals and developmental disability waiver plans;
107.20 	(5) night supervision services as defined under the brain injury waiver plan; and
107.21 	(6) homemaker services as defined under the community alternatives for disabled 
107.22 	individuals, brain injury, community alternative care, developmental disability, and elderly 
107.23 	waiver plans, excluding providers licensed by the Department of Health under chapter 
107.24 	144A and those providers providing cleaning services only.
107.25 	(c) Intensive support services provide assistance, supervision, and care that is 
107.26 	necessary to ensure the health and safety of the person and services specifically directed 
107.27 	toward the training, habilitation, or rehabilitation of the person. Intensive support services 
107.28 	include:
107.29 	(1) intervention services, including:
107.30 	(i) behavioral support services as defined under the brain injury and community 
107.31 	alternatives for disabled individuals waiver plans;
107.32 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
107.33 	disability waiver plan; and
107.34 	(iii) specialist services as defined under the current developmental disability waiver 
107.35 	plan;
107.36 	(2) in-home support services, including:
108.1 	(i) in-home family support and supported living services as defined under the 
108.2 	developmental disability waiver plan;
108.3 	(ii) independent living services training as defined under the brain injury and 
108.4 	community alternatives for disabled individuals waiver plans; and
108.5 	(iii) semi-independent living services;
108.6 	(3) residential supports and services, including:
108.7 	(i) supported living services as defined under the developmental disability waiver 
108.8 	plan provided in a family or corporate child foster care residence, a family adult foster 
108.9 	care residence, a community residential setting, or a supervised living facility;
108.10 	(ii) foster care services as defined in the brain injury, community alternative care, 
108.11 	and community alternatives for disabled individuals waiver plans provided in a family or 
108.12 	corporate child foster care residence, a family adult foster care residence, or a community 
108.13 	residential setting; and
108.14 	(iii) residential services provided to more than four persons with developmental 
108.15 	disabilities in a supervised living facility that is certified by the Department of Health as 
108.16 	an ICF/DD, including ICFs/DD;
108.17 	(4) day services, including:
108.18 	(i) structured day services as defined under the brain injury waiver plan;
108.19 	(ii) day training and habilitation services under sections 252.40 to 252.46, and as 
108.20 	defined under the developmental disability waiver plan; and
108.21 	(iii) prevocational services as defined under the brain injury and community 
108.22 	alternatives for disabled individuals waiver plans; and
108.23 	(5) supported employment as defined under the brain injury, developmental 
108.24 	disability, and community alternatives for disabled individuals waiver plans.

108.25 	Sec. 17. Minnesota Statutes 2013 Supplement, section 245D.03, is amended by adding 
108.26 	a subdivision to read:
108.27 		Subd. 1a.Effect. The home and community-based services standards establish 
108.28 	health, safety, welfare, and rights protections for persons receiving services governed by 
108.29 	this chapter. The standards recognize the diversity of persons receiving these services and 
108.30 	require that these services are provided in a manner that meets each person's individual 
108.31 	needs and ensures continuity in service planning, care, and coordination between the 
108.32 	license holder and members of each person's support team or expanded support team.

108.33 	Sec. 18. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 2, is 
108.34 	amended to read:
109.1 		Subd. 2.Relationship to other standards governing home and community-based 
109.2 	services. (a) A license holder governed by this chapter is also subject to the licensure 
109.3 	requirements under chapter 245A.
109.4 	(b) A corporate or family child foster care site controlled by a license holder and 
109.5 	providing services governed by this chapter is exempt from compliance with section 
109.6 	245D.04. This exemption applies to foster care homes where at least one resident is 
109.7 	receiving residential supports and services licensed according to this chapter. This chapter 
109.8 	does not apply to corporate or family child foster care homes that do not provide services 
109.9 	licensed under this chapter.
109.10 	(c) A family adult foster care site controlled by a license holder and providing 
109.11 	services governed by this chapter is exempt from compliance with Minnesota Rules, 
109.12 	parts 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 9555.6265. These 
109.13 	exemptions apply to family adult foster care homes where at least one resident is receiving 
109.14 	residential supports and services licensed according to this chapter. This chapter does 
109.15 	not apply to family adult foster care homes that do not provide services licensed under 
109.16 	this chapter.
109.17 	(d) A license holder providing services licensed according to this chapter in a 
109.18 	supervised living facility is exempt from compliance with sectionssection 245D.04; 
109.19 	245D.05, subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
109.20 	(e) A license holder providing residential services to persons in an ICF/DD is exempt 
109.21 	from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision 
109.22 	2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, 
109.23 	subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
109.24 	(f) A license holder providing homemaker services licensed according to this chapter 
109.25 	and registered according to chapter 144A is exempt from compliance with section 245D.04.
109.26 	(g) Nothing in this chapter prohibits a license holder from concurrently serving 
109.27 	persons without disabilities or people who are or are not age 65 and older, provided this 
109.28 	chapter's standards are met as well as other relevant standards.
109.29 	(h) The documentation required under sections 245D.07 and 245D.071 must meet 
109.30 	the individual program plan requirements identified in section 256B.092 or successor 
109.31 	provisions.

109.32 	Sec. 19. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 3, is 
109.33 	amended to read:
109.34 		Subd. 3.Variance. If the conditions in section 245A.04, subdivision 9, are met, 
109.35 	the commissioner may grant a variance to any of the requirements in this chapter, except 
110.1 	sections 245D.04; 245D.06, subdivision 4, paragraph (b), and subdivision 6, or successor 
110.2 	provisions; and 245D.061, subdivision 3, or provisions governing data practices and 
110.3 	information rights of persons.

110.4 	Sec. 20. Minnesota Statutes 2013 Supplement, section 245D.04, subdivision 3, is 
110.5 	amended to read:
110.6 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include 
110.7 	the right to:
110.8 	(1) have personal, financial, service, health, and medical information kept private, 
110.9 	and be advised of disclosure of this information by the license holder;
110.10 	(2) access records and recorded information about the person in accordance with 
110.11 	applicable state and federal law, regulation, or rule;
110.12 	(3) be free from maltreatment;
110.13 	(4) be free from restraint, time out, or seclusion, restrictive intervention, or other 
110.14 	prohibited procedure identified in section 245D.06, subdivision 5, or successor provisions,
110.15 	 except for: (i) emergency use of manual restraint to protect the person from imminent 
110.16 	danger to self or others according to the requirements in section 245D.06; 245D.061 or 
110.17 	successor provisions; or (ii) the use of safety interventions as part of a positive support 
110.18 	transition plan under section 245D.06, subdivision 8, or successor provisions;
110.19 	(5) receive services in a clean and safe environment when the license holder is the 
110.20 	owner, lessor, or tenant of the service site;
110.21 	(6) be treated with courtesy and respect and receive respectful treatment of the 
110.22 	person's property;
110.23 	(7) reasonable observance of cultural and ethnic practice and religion;
110.24 	(8) be free from bias and harassment regarding race, gender, age, disability, 
110.25 	spirituality, and sexual orientation;
110.26 	(9) be informed of and use the license holder's grievance policy and procedures, 
110.27 	including knowing how to contact persons responsible for addressing problems and to 
110.28 	appeal under section 256.045;
110.29 	(10) know the name, telephone number, and the Web site, e-mail, and street 
110.30 	addresses of protection and advocacy services, including the appropriate state-appointed 
110.31 	ombudsman, and a brief description of how to file a complaint with these offices;
110.32 	(11) assert these rights personally, or have them asserted by the person's family, 
110.33 	authorized representative, or legal representative, without retaliation;
110.34 	(12) give or withhold written informed consent to participate in any research or 
110.35 	experimental treatment;
111.1 	(13) associate with other persons of the person's choice;
111.2 	(14) personal privacy; and
111.3 	(15) engage in chosen activities.
111.4 	(b) For a person residing in a residential site licensed according to chapter 245A, 
111.5 	or where the license holder is the owner, lessor, or tenant of the residential service site, 
111.6 	protection-related rights also include the right to:
111.7 	(1) have daily, private access to and use of a non-coin-operated telephone for local 
111.8 	calls and long-distance calls made collect or paid for by the person;
111.9 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
111.10 	correspondence or communication;
111.11 	(3) have use of and free access to common areas in the residence; and
111.12 	(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious 
111.13 	advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including 
111.14 	privacy in the person's bedroom.
111.15 	(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a), 
111.16 	clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure 
111.17 	the health, safety, and well-being of the person. Any restriction of those rights must be 
111.18 	documented in the person's coordinated service and support plan or coordinated service 
111.19 	and support plan addendum. The restriction must be implemented in the least restrictive 
111.20 	alternative manner necessary to protect the person and provide support to reduce or 
111.21 	eliminate the need for the restriction in the most integrated setting and inclusive manner. 
111.22 	The documentation must include the following information:
111.23 	(1) the justification for the restriction based on an assessment of the person's 
111.24 	vulnerability related to exercising the right without restriction;
111.25 	(2) the objective measures set as conditions for ending the restriction;
111.26 	(3) a schedule for reviewing the need for the restriction based on the conditions 
111.27 	for ending the restriction to occur semiannually from the date of initial approval, at a 
111.28 	minimum, or more frequently if requested by the person, the person's legal representative, 
111.29 	if any, and case manager; and
111.30 	(4) signed and dated approval for the restriction from the person, or the person's 
111.31 	legal representative, if any. A restriction may be implemented only when the required 
111.32 	approval has been obtained. Approval may be withdrawn at any time. If approval is 
111.33 	withdrawn, the right must be immediately and fully restored.

111.34 	Sec. 21. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1, is 
111.35 	amended to read:
112.1 		Subdivision 1.Health needs. (a) The license holder is responsible for meeting 
112.2 	health service needs assigned in the coordinated service and support plan or the 
112.3 	coordinated service and support plan addendum, consistent with the person's health needs. 
112.4 	The license holder is responsible for promptly notifying the person's legal representative, 
112.5 	if any, and the case manager of changes in a person's physical and mental health needs 
112.6 	affecting health service needs assigned to the license holder in the coordinated service and 
112.7 	support plan or the coordinated service and support plan addendum, when discovered by 
112.8 	the license holder, unless the license holder has reason to know the change has already 
112.9 	been reported. The license holder must document when the notice is provided.
112.10 	(b) If responsibility for meeting the person's health service needs has been assigned 
112.11 	to the license holder in the coordinated service and support plan or the coordinated service 
112.12 	and support plan addendum, the license holder must maintain documentation on how the 
112.13 	person's health needs will be met, including a description of the procedures the license 
112.14 	holder will follow in order to:
112.15 	(1) provide medication setup, assistance, or medication administration according 
112.16 	to this chapter. Unlicensed staff responsible for medication setup or medication 
112.17 	administration under this section must complete training according to section 245D.09, 
112.18 	subdivision 4a, paragraph (d);
112.19 	(2) monitor health conditions according to written instructions from a licensed 
112.20 	health professional;
112.21 	(3) assist with or coordinate medical, dental, and other health service appointments; or
112.22 	(4) use medical equipment, devices, or adaptive aides or technology safely and 
112.23 	correctly according to written instructions from a licensed health professional.

112.24 	Sec. 22. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1a, 
112.25 	is amended to read:
112.26 		Subd. 1a.Medication setup. (a) For the purposes of this subdivision, "medication 
112.27 	setup" means the arranging of medications according to instructions from the pharmacy, 
112.28 	the prescriber, or a licensed nurse, for later administration when the license holder 
112.29 	is assigned responsibility for medication assistance or medication administration in 
112.30 	the coordinated service and support plan or the coordinated service and support plan 
112.31 	addendum. A prescription label or the prescriber's written or electronically recorded order 
112.32 	for the prescription is sufficient to constitute written instructions from the prescriber.
112.33 	(b) If responsibility for medication setup is assigned to the license holder in 
112.34 	the coordinated service and support plan or the coordinated service and support plan 
112.35 	addendum, or if the license holder provides it as part of medication assistance or 
113.1 	medication administration, the license holder must document in the person's medication 
113.2 	administration record: dates of setup, name of medication, quantity of dose, times to be 
113.3 	administered, and route of administration at time of setup; and, when the person will be 
113.4 	away from home, to whom the medications were given.

113.5 	Sec. 23. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1b, 
113.6 	is amended to read:
113.7 		Subd. 1b.Medication assistance. (a) For purposes of this subdivision, "medication 
113.8 	assistance" means any of the following:
113.9 	(1) bringing to the person and opening a container of previously set up medications, 
113.10 	emptying the container into the person's hand, or opening and giving the medications in 
113.11 	the original container to the person under the direction of the person;
113.12 	(2) bringing to the person liquids or food to accompany the medication; or
113.13 	(3) providing reminders to take regularly scheduled medication or perform regularly 
113.14 	scheduled treatments and exercises.
113.15 	(b) If responsibility for medication assistance is assigned to the license holder 
113.16 	in the coordinated service and support plan or the coordinated service and support 
113.17 	plan addendum, the license holder must ensure that the requirements of subdivision 2, 
113.18 	paragraph (b), have been met when staff provides medication assistance to enableis 
113.19 	provided in a manner that enables a person to self-administer medication or treatment 
113.20 	when the person is capable of directing the person's own care, or when the person's legal 
113.21 	representative is present and able to direct care for the person. For the purposes of this 
113.22 	subdivision, "medication assistance" means any of the following:
113.23 	(1) bringing to the person and opening a container of previously set up medications, 
113.24 	emptying the container into the person's hand, or opening and giving the medications in 
113.25 	the original container to the person;
113.26 	(2) bringing to the person liquids or food to accompany the medication; or
113.27 	(3) providing reminders to take regularly scheduled medication or perform regularly 
113.28 	scheduled treatments and exercises.

113.29 	Sec. 24. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 2, is 
113.30 	amended to read:
113.31 		Subd. 2.Medication administration. (a) If responsibility for medication 
113.32 	administration is assigned to the license holder in the coordinated service and support 
113.33 	plan or the coordinated service and support plan addendum, the license holder must 
113.34 	implement the following medication administration procedures to ensure a person takes 
114.1 	medications and treatments as prescribed For purposes of this subdivision, "medication 
114.2 	administration" means:
114.3 	(1) checking the person's medication record;
114.4 	(2) preparing the medication as necessary;
114.5 	(3) administering the medication or treatment to the person;
114.6 	(4) documenting the administration of the medication or treatment or the reason for 
114.7 	not administering the medication or treatment; and
114.8 	(5) reporting to the prescriber or a nurse any concerns about the medication or 
114.9 	treatment, including side effects, effectiveness, or a pattern of the person refusing to 
114.10 	take the medication or treatment as prescribed. Adverse reactions must be immediately 
114.11 	reported to the prescriber or a nurse.
114.12 	(b)(1) If responsibility for medication administration is assigned to the license holder 
114.13 	in the coordinated service and support plan or the coordinated service and support plan 
114.14 	addendum, the license holder must implement medication administration procedures 
114.15 	to ensure a person takes medications and treatments as prescribed. The license holder 
114.16 	must ensure that the requirements in clauses (2) to (4) and (3) have been met before 
114.17 	administering medication or treatment.
114.18 	(2) The license holder must obtain written authorization from the person or the 
114.19 	person's legal representative to administer medication or treatment and must obtain 
114.20 	reauthorization annually as needed. This authorization shall remain in effect unless it is 
114.21 	withdrawn in writing and may be withdrawn at any time. If the person or the person's 
114.22 	legal representative refuses to authorize the license holder to administer medication, the 
114.23 	medication must not be administered. The refusal to authorize medication administration 
114.24 	must be reported to the prescriber as expediently as possible.
114.25 	(3) The staff person responsible for administering the medication or treatment must 
114.26 	complete medication administration training according to section 245D.09, subdivision
114.27 	 4a, paragraphs (a) and (c), and, as applicable to the person, paragraph (d).
114.28 	(4) (3) For a license holder providing intensive support services, the medication or 
114.29 	treatment must be administered according to the license holder's medication administration 
114.30 	policy and procedures as required under section 245D.11, subdivision 2, clause (3).
114.31 	(c) The license holder must ensure the following information is documented in the 
114.32 	person's medication administration record:
114.33 	(1) the information on the current prescription label or the prescriber's current 
114.34 	written or electronically recorded order or prescription that includes the person's name, 
114.35 	description of the medication or treatment to be provided, and the frequency and other 
115.1 	information needed to safely and correctly administer the medication or treatment to 
115.2 	ensure effectiveness;
115.3 	(2) information on any risks or other side effects that are reasonable to expect, and 
115.4 	any contraindications to its use. This information must be readily available to all staff 
115.5 	administering the medication;
115.6 	(3) the possible consequences if the medication or treatment is not taken or 
115.7 	administered as directed;
115.8 	(4) instruction on when and to whom to report the following:
115.9 	(i) if a dose of medication is not administered or treatment is not performed as 
115.10 	prescribed, whether by error by the staff or the person or by refusal by the person; and
115.11 	(ii) the occurrence of possible adverse reactions to the medication or treatment;
115.12 	(5) notation of any occurrence of a dose of medication not being administered or 
115.13 	treatment not performed as prescribed, whether by error by the staff or the person or by 
115.14 	refusal by the person, or of adverse reactions, and when and to whom the report was 
115.15 	made; and
115.16 	(6) notation of when a medication or treatment is started, administered, changed, or 
115.17 	discontinued.

115.18 	Sec. 25. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 4, is 
115.19 	amended to read:
115.20 		Subd. 4.Reviewing and reporting medication and treatment issues. (a) When 
115.21 	assigned responsibility for medication administration, the license holder must ensure 
115.22 	that the information maintained in the medication administration record is current and 
115.23 	is regularly reviewed to identify medication administration errors. At a minimum, the 
115.24 	review must be conducted every three months, or more frequently as directed in the 
115.25 	coordinated service and support plan or coordinated service and support plan addendum 
115.26 	or as requested by the person or the person's legal representative. Based on the review, 
115.27 	the license holder must develop and implement a plan to correct patterns of medication 
115.28 	administration errors when identified.
115.29 	(b) If assigned responsibility for medication assistance or medication administration, 
115.30 	the license holder must report the following to the person's legal representative and case 
115.31 	manager as they occur or as otherwise directed in the coordinated service and support plan 
115.32 	or the coordinated service and support plan addendum:
115.33 	(1) any reports made to the person's physician or prescriber required under 
115.34 	subdivision 2, paragraph (c), clause (4);
116.1 	(2) a person's refusal or failure to take or receive medication or treatment as 
116.2 	prescribed; or
116.3 	(3) concerns about a person's self-administration of medication or treatment.

116.4 	Sec. 26. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 5, is 
116.5 	amended to read:
116.6 		Subd. 5.Injectable medications. Injectable medications may be administered 
116.7 	according to a prescriber's order and written instructions when one of the following 
116.8 	conditions has been met:
116.9 	(1) a registered nurse or licensed practical nurse will administer the subcutaneous or 
116.10 	intramuscular injection;
116.11 	(2) a supervising registered nurse with a physician's order has delegated the 
116.12 	administration of subcutaneous injectable medication to an unlicensed staff member 
116.13 	and has provided the necessary training; or
116.14 	(3) there is an agreement signed by the license holder, the prescriber, and the 
116.15 	person or the person's legal representative specifying what subcutaneous injections may 
116.16 	be given, when, how, and that the prescriber must retain responsibility for the license 
116.17 	holder's giving the injections. A copy of the agreement must be placed in the person's 
116.18 	service recipient record.
116.19 	Only licensed health professionals are allowed to administer psychotropic 
116.20 	medications by injection.

116.21 	Sec. 27. Minnesota Statutes 2013 Supplement, section 245D.051, is amended to read:
116.22 	245D.051 PSYCHOTROPIC MEDICATION USE AND MONITORING.
116.23 		Subdivision 1.Conditions for psychotropic medication administration. (a) 
116.24 	When a person is prescribed a psychotropic medication and the license holder is assigned 
116.25 	responsibility for administration of the medication in the person's coordinated service 
116.26 	and support plan or the coordinated service and support plan addendum, the license 
116.27 	holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05, 
116.28 	subdivision 2, are met.
116.29 	(b) Use of the medication must be included in the person's coordinated service and 
116.30 	support plan or in the coordinated service and support plan addendum and based on a 
116.31 	prescriber's current written or electronically recorded prescription.
116.32 	(c) (b) The license holder must develop, implement, and maintain the following 
116.33 	documentation in the person's coordinated service and support plan addendum according 
116.34 	to the requirements in sections 245D.07 and 245D.071:
117.1 	(1) a description of the target symptoms that the psychotropic medication is to 
117.2 	alleviate; and
117.3 	(2) documentation methods the license holder will use to monitor and measure 
117.4 	changes in the target symptoms that are to be alleviated by the psychotropic medication if 
117.5 	required by the prescriber. The license holder must collect and report on medication and 
117.6 	symptom-related data as instructed by the prescriber. The license holder must provide 
117.7 	the monitoring data to the expanded support team for review every three months, or as 
117.8 	otherwise requested by the person or the person's legal representative.
117.9 	For the purposes of this section, "target symptom" refers to any perceptible 
117.10 	diagnostic criteria for a person's diagnosed mental disorder, as defined by the Diagnostic 
117.11 	and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or 
117.12 	successive editions, that has been identified for alleviation.
117.13 		Subd. 2.Refusal to authorize psychotropic medication. If the person or the 
117.14 	person's legal representative refuses to authorize the administration of a psychotropic 
117.15 	medication as ordered by the prescriber, the license holder must follow the requirement in 
117.16 	section 245D.05, subdivision 2, paragraph (b), clause (2). not administer the medication. 
117.17 	The refusal to authorize medication administration must be reported to the prescriber as 
117.18 	expediently as possible. After reporting the refusal to the prescriber, the license holder 
117.19 	must follow any directives or orders given by the prescriber. A court order must be 
117.20 	obtained to override the refusal.A refusal may not be overridden without a court order. 
117.21 	Refusal to authorize administration of a specific psychotropic medication is not grounds 
117.22 	for service termination and does not constitute an emergency. A decision to terminate 
117.23 	services must be reached in compliance with section 245D.10, subdivision 3.

117.24 	Sec. 28. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 1, is 
117.25 	amended to read:
117.26 		Subdivision 1.Incident response and reporting.  (a) The license holder must 
117.27 	respond to incidents under section 245D.02, subdivision 11, that occur while providing 
117.28 	services to protect the health and safety of and minimize risk of harm to the person.
117.29 	(b) The license holder must maintain information about and report incidents to the 
117.30 	person's legal representative or designated emergency contact and case manager within 
117.31 	24 hours of an incident occurring while services are being provided, within 24 hours of 
117.32 	discovery or receipt of information that an incident occurred, unless the license holder 
117.33 	has reason to know that the incident has already been reported, or as otherwise directed 
117.34 	in a person's coordinated service and support plan or coordinated service and support 
117.35 	plan addendum. An incident of suspected or alleged maltreatment must be reported as 
118.1 	required under paragraph (d), and an incident of serious injury or death must be reported 
118.2 	as required under paragraph (e).
118.3 	(c) When the incident involves more than one person, the license holder must not 
118.4 	disclose personally identifiable information about any other person when making the report 
118.5 	to each person and case manager unless the license holder has the consent of the person.
118.6 	(d) Within 24 hours of reporting maltreatment as required under section 626.556 
118.7 	or 626.557, the license holder must inform the case manager of the report unless there is 
118.8 	reason to believe that the case manager is involved in the suspected maltreatment. The 
118.9 	license holder must disclose the nature of the activity or occurrence reported and the 
118.10 	agency that received the report.
118.11 	(e) The license holder must report the death or serious injury of the person as 
118.12 	required in paragraph (b) and to the Department of Human Services Licensing Division, 
118.13 	and the Office of Ombudsman for Mental Health and Developmental Disabilities as 
118.14 	required under section 245.94, subdivision 2a, within 24 hours of the death, or receipt of 
118.15 	information that the death occurred, unless the license holder has reason to know that the 
118.16 	death has already been reported.
118.17 	(f) When a death or serious injury occurs in a facility certified as an intermediate 
118.18 	care facility for persons with developmental disabilities, the death or serious injury must 
118.19 	be reported to the Department of Health, Office of Health Facility Complaints, and the 
118.20 	Office of Ombudsman for Mental Health and Developmental Disabilities, as required 
118.21 	under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to 
118.22 	know that the death has already been reported.
118.23 	(g) The license holder must conduct an internal review of incident reports of deaths 
118.24 	and serious injuries that occurred while services were being provided and that were not 
118.25 	reported by the program as alleged or suspected maltreatment, for identification of incident 
118.26 	patterns, and implementation of corrective action as necessary to reduce occurrences. 
118.27 	The review must include an evaluation of whether related policies and procedures were 
118.28 	followed, whether the policies and procedures were adequate, whether there is a need for 
118.29 	additional staff training, whether the reported event is similar to past events with the 
118.30 	persons or the services involved, and whether there is a need for corrective action by the 
118.31 	license holder to protect the health and safety of persons receiving services. Based on 
118.32 	the results of this review, the license holder must develop, document, and implement a 
118.33 	corrective action plan designed to correct current lapses and prevent future lapses in 
118.34 	performance by staff or the license holder, if any.
118.35 	(h) The license holder must verbally report the emergency use of manual restraint 
118.36 	of a person as required in paragraph (b) within 24 hours of the occurrence. The license 
119.1 	holder must ensure the written report and internal review of all incident reports of the 
119.2 	emergency use of manual restraints are completed according to the requirements in section 
119.3 	245D.061 or successor provisions.

119.4 	Sec. 29. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 2, is 
119.5 	amended to read:
119.6 		Subd. 2.Environment and safety. The license holder must:
119.7 	(1) ensure the following when the license holder is the owner, lessor, or tenant 
119.8 	of the service site:
119.9 	(i) the service site is a safe and hazard-free environment;
119.10 	(ii) that toxic substances or dangerous items are inaccessible to persons served by 
119.11 	the program only to protect the safety of a person receiving services when a known safety 
119.12 	threat exists and not as a substitute for staff supervision or interactions with a person who 
119.13 	is receiving services. If toxic substances or dangerous items are made inaccessible, the 
119.14 	license holder must document an assessment of the physical plant, its environment, and its 
119.15 	population identifying the risk factors which require toxic substances or dangerous items 
119.16 	to be inaccessible and a statement of specific measures to be taken to minimize the safety 
119.17 	risk to persons receiving services and to restore accessibility to all persons receiving 
119.18 	services at the service site;
119.19 	(iii) doors are locked from the inside to prevent a person from exiting only when 
119.20 	necessary to protect the safety of a person receiving services and not as a substitute for 
119.21 	staff supervision or interactions with the person. If doors are locked from the inside, the 
119.22 	license holder must document an assessment of the physical plant, the environment and 
119.23 	the population served, identifying the risk factors which require the use of locked doors, 
119.24 	and a statement of specific measures to be taken to minimize the safety risk to persons 
119.25 	receiving services at the service site; and
119.26 	(iv) a staff person is available at the service site who is trained in basic first aid and, 
119.27 	when required in a person's coordinated service and support plan or coordinated service 
119.28 	and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are 
119.29 	present and staff are required to be at the site to provide direct support service. The CPR 
119.30 	training must include in-person instruction, hands-on practice, and an observed skills 
119.31 	assessment under the direct supervision of a CPR instructor;
119.32 	(2) maintain equipment, vehicles, supplies, and materials owned or leased by the 
119.33 	license holder in good condition when used to provide services;
120.1 	(3) follow procedures to ensure safe transportation, handling, and transfers of the 
120.2 	person and any equipment used by the person, when the license holder is responsible for 
120.3 	transportation of a person or a person's equipment;
120.4 	(4) be prepared for emergencies and follow emergency response procedures to 
120.5 	ensure the person's safety in an emergency; and
120.6 	(5) follow universal precautions and sanitary practices, including hand washing, for 
120.7 	infection prevention and control, and to prevent communicable diseases.

120.8 	Sec. 30. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 4, is 
120.9 	amended to read:
120.10 		Subd. 4.Funds and property; legal representative restrictions. (a) Whenever the 
120.11 	license holder assists a person with the safekeeping of funds or other property according 
120.12 	to section 245A.04, subdivision 13, the license holder must obtain written authorization 
120.13 	to do so from the person or the person's legal representative and the case manager. 
120.14 	Authorization must be obtained within five working days of service initiation and renewed 
120.15 	annually thereafter. At the time initial authorization is obtained, the license holder must 
120.16 	survey, document, and implement the preferences of the person or the person's legal 
120.17 	representative and the case manager for frequency of receiving a statement that itemizes 
120.18 	receipts and disbursements of funds or other property. The license holder must document 
120.19 	changes to these preferences when they are requested.
120.20 	(b) A license holder or staff person may not accept powers-of-attorney from a person 
120.21 	receiving services from the license holder for any purpose. This does not apply to license 
120.22 	holders that are Minnesota counties or other units of government or to staff persons 
120.23 	employed by license holders who were acting as attorney-in-fact for specific individuals 
120.24 	prior to implementation of this chapter. The license holder must maintain documentation 
120.25 	of the power-of-attorney in the service recipient record.
120.26 	(c) A license holder or staff person is restricted from accepting an appointment 
120.27 	as a guardian as follows:
120.28 	(1) under section 524.5-309 of the Uniform Probate Code, any individual or agency 
120.29 	that provides residence, custodial care, medical care, employment training, or other care 
120.30 	or services for which the individual or agency receives a fee may not be appointed as 
120.31 	guardian unless related to the respondent by blood, marriage, or adoption; and
120.32 	(2) under section 245A.03, subdivision 2, paragraph (a), clause (1), a related 
120.33 	individual as defined under section 245A.02, subdivision 13, is excluded from licensure. 
120.34 	Services provided by a license holder to a person under the license holder's guardianship 
120.35 	are not licensed services.
121.1 	(c) (d) Upon the transfer or death of a person, any funds or other property of the 
121.2 	person must be surrendered to the person or the person's legal representative, or given to 
121.3 	the executor or administrator of the estate in exchange for an itemized receipt.

121.4 	Sec. 31. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 6, is 
121.5 	amended to read:
121.6 		Subd. 6.Restricted procedures. (a) The following procedures are allowed when 
121.7 	the procedures are implemented in compliance with the standards governing their use as 
121.8 	identified in clauses (1) to (3). Allowed but restricted procedures include:
121.9 	(1) permitted actions and procedures subject to the requirements in subdivision 7;
121.10 	(2) procedures identified in a positive support transition plan subject to the 
121.11 	requirements in subdivision 8; or
121.12 	(3) emergency use of manual restraint subject to the requirements in section 
121.13 	245D.061.
121.14 	For purposes of this chapter, this section supersedes the requirements identified in 
121.15 	Minnesota Rules, part 9525.2740.
121.16 	(b) A restricted procedure identified in paragraph (a) must not:
121.17 	(1) be implemented with a child in a manner that constitutes sexual abuse, neglect, 
121.18 	physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
121.19 	(2) be implemented with an adult in a manner that constitutes abuse or neglect as 
121.20 	defined in section 626.5572, subdivision 2 or 17;
121.21 	(3) be implemented in a manner that violates a person's rights identified in section 
121.22 	245D.04;
121.23 	(4) restrict a person's normal access to a nutritious diet, drinking water, adequate 
121.24 	ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping 
121.25 	conditions, necessary clothing, or any protection required by state licensing standards or 
121.26 	federal regulations governing the program;
121.27 	(5) deny the person visitation or ordinary contact with legal counsel, a legal 
121.28 	representative, or next of kin;
121.29 	(6) be used for the convenience of staff, as punishment, as a substitute for adequate 
121.30 	staffing, or as a consequence if the person refuses to participate in the treatment or services 
121.31 	provided by the program;
121.32 	(7) use prone restraint. For purposes of this section, "prone restraint" means use 
121.33 	of manual restraint that places a person in a face-down position. Prone restraint does 
121.34 	not include brief physical holding of a person who, during an emergency use of manual 
122.1 	restraint, rolls into a prone position, if the person is restored to a standing, sitting, or 
122.2 	side-lying position as quickly as possible;
122.3 	(8) apply back or chest pressure while a person is in a prone position as identified in 
122.4 	clause (7), supine position, or side-lying position; or
122.5 	(9) be implemented in a manner that is contraindicated for any of the person's known 
122.6 	medical or psychological limitations.

122.7 	Sec. 32. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 7, is 
122.8 	amended to read:
122.9 		Subd. 7.Permitted actions and procedures. (a) Use of the instructional techniques 
122.10 	and intervention procedures as identified in paragraphs (b) and (c) is permitted when used 
122.11 	on an intermittent or continuous basis. When used on a continuous basis, it must be 
122.12 	addressed in a person's coordinated service and support plan addendum as identified in 
122.13 	sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this 
122.14 	subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
122.15 	(b) Physical contact or instructional techniques must use the least restrictive 
122.16 	alternative possible to meet the needs of the person and may be used:
122.17 	(1) to calm or comfort a person by holding that person with no resistance from 
122.18 	that person;
122.19 	(2) to protect a person known to be at risk or of  injury due to frequent falls as a result 
122.20 	of a medical condition;
122.21 	(3) to facilitate the person's completion of a task or response when the person does 
122.22 	not resist or the person's resistance is minimal in intensity and duration; or
122.23 	(4) to briefly block or redirect a person's limbs or body without holding the person or 
122.24 	limiting the person's movement to interrupt the person's behavior that may result in injury 
122.25 	to self or others. with less than 60 seconds of physical contact by staff; or
122.26 	(5) to redirect a person's behavior when the behavior does not pose a serious threat 
122.27 	to the person or others and the behavior is effectively redirected with less than 60 seconds 
122.28 	of physical contact by staff.
122.29 	(c) Restraint may be used as an intervention procedure to:
122.30 	(1) allow a licensed health care professional to safely conduct a medical examination 
122.31 	or to provide medical treatment ordered by a licensed health care professional to a person 
122.32 	necessary to promote healing or recovery from an acute, meaning short-term, medical 
122.33 	condition;
122.34 	(2) assist in the safe evacuation or redirection of a person in the event of an 
122.35 	emergency and the person is at imminent risk of harm.; or
123.1 	Any use of manual restraint as allowed in this paragraph must comply with the restrictions 
123.2 	identified in section 245D.061, subdivision 3; or
123.3 	(3) position a person with physical disabilities in a manner specified in the person's 
123.4 	coordinated service and support plan addendum.
123.5 	Any use of manual restraint as allowed in this paragraph must comply with the restrictions 
123.6 	identified in subdivision 6, paragraph (b).
123.7 	(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment 
123.8 	ordered by a licensed health professional to treat a diagnosed medical condition do not in 
123.9 	and of themselves constitute the use of mechanical restraint.
123.10 	(e) Use of an auxiliary device to ensure a person does not unfasten a seat belt when 
123.11 	being transported in a vehicle in accordance with seat belt use requirements in section 
123.12 	169.686 does not constitute the use of mechanical restraint.

123.13 	Sec. 33. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 8, is 
123.14 	amended to read:
123.15 		Subd. 8.Positive support transition plan. (a) License holders must develop 
123.16 	a positive support transition plan on the forms and in the manner prescribed by the 
123.17 	commissioner for a person who requires intervention in order to maintain safety when 
123.18 	it is known that the person's behavior poses an immediate risk of physical harm to self 
123.19 	or others. The positive support transition plan forms and instructions will supersede the 
123.20 	requirements in Minnesota Rules, parts 9525.2750; 9525.2760; and 9525.2780. The 
123.21 	positive support transition plan must phase out any existing plans for the emergency 
123.22 	or programmatic use of aversive or deprivation procedures restrictive interventions
123.23 	 prohibited under this chapter within the following timelines:
123.24 	(1) for persons receiving services from the license holder before January 1, 2014, 
123.25 	the plan must be developed and implemented by February 1, 2014, and phased out no 
123.26 	later than December 31, 2014; and
123.27 	(2) for persons admitted to the program on or after January 1, 2014, the plan must be 
123.28 	developed and implemented within 30 calendar days of service initiation and phased out 
123.29 	no later than 11 months from the date of plan implementation.
123.30 	(b) The commissioner has limited authority to grant approval for the emergency use 
123.31 	of procedures identified in subdivision 6 that had been part of an approved positive support 
123.32 	transition plan when a person is at imminent risk of serious injury as defined in section 
123.33 	245.91, subdivision 6, due to self-injurious behavior and the following conditions are met:
123.34 	(1) the person's expanded support team approves the emergency use of the 
123.35 	procedures; and
124.1 	(2) the interim review panel established in section 245.8251, subdivision 4, 
124.2 	recommends commissioner approval of the emergency use of the procedures.
124.3 	(c) Written requests for the emergency use of the procedures must be developed 
124.4 	and submitted to the commissioner by the designated coordinator with input from the 
124.5 	person's expanded support team in accordance with the requirements set by the interim 
124.6 	review panel, in addition to the following:
124.7 	(1) a copy of the person's current positive support transition plan and copies of 
124.8 	each positive support transition plan review containing data on the progress of the plan 
124.9 	from the previous year;
124.10 	(2) documentation of a good faith effort to eliminate the use of the procedures that 
124.11 	had been part of an approved positive support transition plan;
124.12 	(3) justification for the continued use of the procedures that identifies the imminent 
124.13 	risk of serious injury due to the person's self-injurious behavior if the procedures were 
124.14 	eliminated;
124.15 	(4) documentation of the clinicians consulted in creating and maintaining the 
124.16 	positive support transition plan; and
124.17 	(5) documentation of the expanded support team's approval and the recommendation 
124.18 	from the interim panel required under paragraph (b).
124.19 	(d) A copy of the written request, supporting documentation, and the commissioner's 
124.20 	final determination on the request must be maintained in the person's service recipient 
124.21 	record.

124.22 	Sec. 34. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 3, 
124.23 	is amended to read:
124.24 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service 
124.25 	initiation the license holder must complete a preliminary coordinated service and support 
124.26 	plan addendum based on the coordinated service and support plan.
124.27 	(b) Within 45 days of service initiation the license holder must meet with the person, 
124.28 	the person's legal representative, the case manager, and other members of the support team 
124.29 	or expanded support team to assess and determine the following based on the person's 
124.30 	coordinated service and support plan and the requirements in subdivision 4 and section 
124.31 	245D.07, subdivision 1a:
124.32 	(1) the scope of the services to be provided to support the person's daily needs 
124.33 	and activities;
124.34 	(2) the person's desired outcomes and the supports necessary to accomplish the 
124.35 	person's desired outcomes;
125.1 	(3) the person's preferences for how services and supports are provided;
125.2 	(4) whether the current service setting is the most integrated setting available and 
125.3 	appropriate for the person; and
125.4 	(5) how services must be coordinated across other providers licensed under this 
125.5 	chapter serving the same person to ensure continuity of care for the person.
125.6 	(c) Within the scope of services, the license holder must, at a minimum, assess 
125.7 	the following areas:
125.8 	(1) the person's ability to self-manage health and medical needs to maintain or 
125.9 	improve physical, mental, and emotional well-being, including, when applicable, allergies, 
125.10 	seizures, choking, special dietary needs, chronic medical conditions, self-administration 
125.11 	of medication or treatment orders, preventative screening, and medical and dental 
125.12 	appointments;
125.13 	(2) the person's ability to self-manage personal safety to avoid injury or accident in 
125.14 	the service setting, including, when applicable, risk of falling, mobility, regulating water 
125.15 	temperature, community survival skills, water safety skills, and sensory disabilities; and
125.16 	(3) the person's ability to self-manage symptoms or behavior that may otherwise 
125.17 	result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to 
125.18 	(7), suspension or termination of services by the license holder, or other symptoms 
125.19 	or behaviors that may jeopardize the health and safety of the person or others. The 
125.20 	assessments must produce information about the person that is descriptive of the person's 
125.21 	overall strengths, functional skills and abilities, and behaviors or symptoms.
125.22 	(b) Within the scope of services, the license holder must, at a minimum, complete 
125.23 	assessments in the following areas before the 45-day planning meeting:
125.24 	(1) the person's ability to self-manage health and medical needs to maintain or 
125.25 	improve physical, mental, and emotional well-being, including, when applicable, allergies, 
125.26 	seizures, choking, special dietary needs, chronic medical conditions, self-administration 
125.27 	of medication or treatment orders, preventative screening, and medical and dental 
125.28 	appointments;
125.29 	(2) the person's ability to self-manage personal safety to avoid injury or accident in 
125.30 	the service setting, including, when applicable, risk of falling, mobility, regulating water 
125.31 	temperature, community survival skills, water safety skills, and sensory disabilities; and
125.32 	(3) the person's ability to self-manage symptoms or behavior that may otherwise 
125.33 	result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), 
125.34 	suspension or termination of services by the license holder, or other symptoms or 
125.35 	behaviors that may jeopardize the health and safety of the person or others.
126.1 	Assessments must produce information about the person that describes the person's overall 
126.2 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must 
126.3 	be based on the person's status within the last 12 months at the time of service initiation. 
126.4 	Assessments based on older information must be documented and justified. Assessments 
126.5 	must be conducted annually at a minimum or within 30 days of a written request from the 
126.6 	person or the person's legal representative or case manager. The results must be reviewed 
126.7 	by the support team or expanded support team as part of a service plan review.
126.8 	(c) Within 45 days of service initiation, the license holder must meet with the 
126.9 	person, the person's legal representative, the case manager, and other members of the 
126.10 	support team or expanded support team to determine the following based on information 
126.11 	obtained from the assessments identified in paragraph (b), the person's identified needs 
126.12 	in the coordinated service and support plan, and the requirements in subdivision 4 and 
126.13 	section 245D.07, subdivision 1a:
126.14 	(1) the scope of the services to be provided to support the person's daily needs 
126.15 	and activities;
126.16 	(2) the person's desired outcomes and the supports necessary to accomplish the 
126.17 	person's desired outcomes;
126.18 	(3) the person's preferences for how services and supports are provided;
126.19 	(4) whether the current service setting is the most integrated setting available and 
126.20 	appropriate for the person; and
126.21 	(5) how services must be coordinated across other providers licensed under this 
126.22 	chapter serving the person and members of the support team or expanded support team to 
126.23 	ensure continuity of care and coordination of services for the person.

126.24 	Sec. 35. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 4, 
126.25 	is amended to read:
126.26 		Subd. 4.Service outcomes and supports. (a) Within ten working days of the 
126.27 	45-day planning meeting, the license holder must develop and document a service plan that 
126.28 	documents the service outcomes and supports based on the assessments completed under 
126.29 	subdivision 3 and the requirements in section 245D.07, subdivision 1a. The outcomes and 
126.30 	supports must be included in the coordinated service and support plan addendum.
126.31 	(b) The license holder must document the supports and methods to be implemented 
126.32 	to support the accomplishment of person and accomplish outcomes related to acquiring, 
126.33 	retaining, or improving skills and physical, mental, and emotional health and well-being. 
126.34 	The documentation must include:
127.1 	(1) the methods or actions that will be used to support the person and to accomplish 
127.2 	the service outcomes, including information about:
127.3 	(i) any changes or modifications to the physical and social environments necessary 
127.4 	when the service supports are provided;
127.5 	(ii) any equipment and materials required; and
127.6 	(iii) techniques that are consistent with the person's communication mode and 
127.7 	learning style;
127.8 	(2) the measurable and observable criteria for identifying when the desired outcome 
127.9 	has been achieved and how data will be collected;
127.10 	(3) the projected starting date for implementing the supports and methods and 
127.11 	the date by which progress towards accomplishing the outcomes will be reviewed and 
127.12 	evaluated; and
127.13 	(4) the names of the staff or position responsible for implementing the supports 
127.14 	and methods.
127.15 	(c) Within 20 working days of the 45-day meeting, the license holder must obtain 
127.16 	dated signatures from the person or the person's legal representative and case manager 
127.17 	to document completion and approval of the assessment and coordinated service and 
127.18 	support plan addendum.

127.19 	Sec. 36. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 5, 
127.20 	is amended to read:
127.21 		Subd. 5.Progress reviews Service plan review and evaluation. (a) The license 
127.22 	holder must give the person or the person's legal representative and case manager an 
127.23 	opportunity to participate in the ongoing review and development of the service plan 
127.24 	and the methods used to support the person and accomplish outcomes identified in 
127.25 	subdivisions 3 and 4. The license holder, in coordination with the person's support team 
127.26 	or expanded support team, must meet with the person, the person's legal representative, 
127.27 	and the case manager, and participate in progress service plan review meetings following 
127.28 	stated timelines established in the person's coordinated service and support plan or 
127.29 	coordinated service and support plan addendum or within 30 days of a written request 
127.30 	by the person, the person's legal representative, or the case manager, at a minimum of 
127.31 	once per year. The purpose of the service plan review is to determine whether changes 
127.32 	are needed to the service plan based on the assessment information, the license holder's 
127.33 	evaluation of progress towards accomplishing outcomes, or other information provided by 
127.34 	the support team or expanded support team.
128.1 	(b) The license holder must summarize the person's status and progress toward 
128.2 	achieving the identified outcomes and make recommendations and identify the rationale 
128.3 	for changing, continuing, or discontinuing implementation of supports and methods 
128.4 	identified in subdivision 4 in a written report sent to the person or the person's legal 
128.5 	representative and case manager five working days prior to the review meeting, unless 
128.6 	the person, the person's legal representative, or the case manager requests to receive the 
128.7 	report at the time of the meeting.
128.8 	(c) Within ten working days of the progress review meeting, the license holder 
128.9 	must obtain dated signatures from the person or the person's legal representative and 
128.10 	the case manager to document approval of any changes to the coordinated service and 
128.11 	support plan addendum.

128.12 	Sec. 37. Minnesota Statutes 2013 Supplement, section 245D.081, subdivision 2, 
128.13 	is amended to read:
128.14 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
128.15 	and evaluation of services provided by the license holder must be coordinated by a 
128.16 	designated staff person. The designated coordinator must provide supervision, support, 
128.17 	and evaluation of activities that include:
128.18 	(1) oversight of the license holder's responsibilities assigned in the person's 
128.19 	coordinated service and support plan and the coordinated service and support plan 
128.20 	addendum;
128.21 	(2) taking the action necessary to facilitate the accomplishment of the outcomes 
128.22 	according to the requirements in section 245D.07;
128.23 	(3) instruction and assistance to direct support staff implementing the coordinated 
128.24 	service and support plan and the service outcomes, including direct observation of service 
128.25 	delivery sufficient to assess staff competency; and
128.26 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
128.27 	the person's outcomes based on the measurable and observable criteria for identifying when 
128.28 	the desired outcome has been achieved according to the requirements in section 245D.07.
128.29 	(b) The license holder must ensure that the designated coordinator is competent to 
128.30 	perform the required duties identified in paragraph (a) through education and, training 
128.31 	in human services and disability-related fields, and work experience in providing direct 
128.32 	care services and supports to persons with disabilities relevant to the needs of the general 
128.33 	population of persons served by the license holder and the individual persons for whom 
128.34 	the designated coordinator is responsible. The designated coordinator must have the 
128.35 	skills and ability necessary to develop effective plans and to design and use data systems 
129.1 	to measure effectiveness of services and supports. The license holder must verify and 
129.2 	document competence according to the requirements in section 245D.09, subdivision 3. 
129.3 	The designated coordinator must minimally have:
129.4 	(1) a baccalaureate degree in a field related to human services, and one year of 
129.5 	full-time work experience providing direct care services to persons with disabilities or 
129.6 	persons age 65 and older;
129.7 	(2) an associate degree in a field related to human services, and two years of 
129.8 	full-time work experience providing direct care services to persons with disabilities or 
129.9 	persons age 65 and older;
129.10 	(3) a diploma in a field related to human services from an accredited postsecondary 
129.11 	institution and three years of full-time work experience providing direct care services to 
129.12 	persons with disabilities or persons age 65 and older; or
129.13 	(4) a minimum of 50 hours of education and training related to human services 
129.14 	and disabilities; and
129.15 	(5) four years of full-time work experience providing direct care services to persons 
129.16 	with disabilities or persons age 65 and older under the supervision of a staff person who 
129.17 	meets the qualifications identified in clauses (1) to (3).

129.18 	Sec. 38. Minnesota Statutes 2013 Supplement, section 245D.09, subdivision 3, is 
129.19 	amended to read:
129.20 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff providing 
129.21 	direct support, or staff who have responsibilities related to supervising or managing the 
129.22 	provision of direct support service, are competent as demonstrated through skills and 
129.23 	knowledge training, experience, and education to meet the person's needs and additional 
129.24 	requirements as written in the coordinated service and support plan or coordinated 
129.25 	service and support plan addendum, or when otherwise required by the case manager or 
129.26 	the federal waiver plan. The license holder must verify and maintain evidence of staff 
129.27 	competency, including documentation of:
129.28 	(1) education and experience qualifications relevant to the job responsibilities 
129.29 	assigned to the staff and to the needs of the general population of persons served by the 
129.30 	program, including a valid degree and transcript, or a current license, registration, or 
129.31 	certification, when a degree or licensure, registration, or certification is required by this 
129.32 	chapter or in the coordinated service and support plan or coordinated service and support 
129.33 	plan addendum;
129.34 	(2) demonstrated competency in the orientation and training areas required under 
129.35 	this chapter, and when applicable, completion of continuing education required to 
130.1 	maintain professional licensure, registration, or certification requirements. Competency in 
130.2 	these areas is determined by the license holder through knowledge testing and or observed 
130.3 	skill assessment conducted by the trainer or instructor; and
130.4 	(3) except for a license holder who is the sole direct support staff, periodic 
130.5 	performance evaluations completed by the license holder of the direct support staff 
130.6 	person's ability to perform the job functions based on direct observation.
130.7 	(b) Staff under 18 years of age may not perform overnight duties or administer 
130.8 	medication.

130.9 	Sec. 39. Minnesota Statutes 2013 Supplement, section 245D.09, subdivision 4a, 
130.10 	is amended to read:
130.11 		Subd. 4a.Orientation to individual service recipient needs. (a) Before having 
130.12 	unsupervised direct contact with a person served by the program, or for whom the staff 
130.13 	person has not previously provided direct support, or any time the plans or procedures 
130.14 	identified in paragraphs (b) to (f) (g) are revised, the staff person must review and receive 
130.15 	instruction on the requirements in paragraphs (b) to (f) (g) as they relate to the staff 
130.16 	person's job functions for that person.
130.17 	(b) Training and competency evaluations must include the following:
130.18 	(1) appropriate and safe techniques in personal hygiene and grooming, including 
130.19 	hair care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of 
130.20 	daily living (ADLs) as defined under section 256B.0659, subdivision 1;
130.21 	(2) an understanding of what constitutes a healthy diet according to data from the 
130.22 	Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
130.23 	(3) skills necessary to provide appropriate support in instrumental activities of daily 
130.24 	living (IADLs) as defined under section 256B.0659, subdivision 1; and
130.25 	(4) demonstrated competence in providing first aid.
130.26 	(c) The staff person must review and receive instruction on the person's coordinated 
130.27 	service and support plan or coordinated service and support plan addendum as it relates 
130.28 	to the responsibilities assigned to the license holder, and when applicable, the person's 
130.29 	individual abuse prevention plan, to achieve and demonstrate an understanding of the 
130.30 	person as a unique individual, and how to implement those plans.
130.31 	(d) The staff person must review and receive instruction on medication setup, 
130.32 	assistance, or administration procedures established for the person when medication 
130.33 	administration is assigned to the license holder according to section 245D.05, subdivision 
130.34 	1, paragraph (b). Unlicensed staff may administer medications perform medication setup 
130.35 	or medication administration only after successful completion of a medication setup or 
131.1 	medication administration training, from a training curriculum developed by a registered 
131.2 	nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse 
131.3 	practitioner, physician's assistant, or physician or appropriate licensed health professional. 
131.4 	The training curriculum must incorporate an observed skill assessment conducted by the 
131.5 	trainer to ensure unlicensed staff demonstrate the ability to safely and correctly follow 
131.6 	medication procedures.
131.7 	Medication administration must be taught by a registered nurse, clinical nurse 
131.8 	specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of 
131.9 	service initiation or any time thereafter, the person has or develops a health care condition 
131.10 	that affects the service options available to the person because the condition requires:
131.11 	(1) specialized or intensive medical or nursing supervision; and
131.12 	(2) nonmedical service providers to adapt their services to accommodate the health 
131.13 	and safety needs of the person.
131.14 	(e) The staff person must review and receive instruction on the safe and correct 
131.15 	operation of medical equipment used by the person to sustain life, including but not 
131.16 	limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided 
131.17 	by a licensed health care professional or a manufacturer's representative and incorporate 
131.18 	an observed skill assessment to ensure staff demonstrate the ability to safely and correctly 
131.19 	operate the equipment according to the treatment orders and the manufacturer's instructions.
131.20 	(f) The staff person must review and receive instruction on what constitutes use of 
131.21 	restraints, time out, and seclusion, including chemical restraint, and staff responsibilities 
131.22 	related to the prohibitions of their use according to the requirements in section 245D.06, 
131.23 	subdivision 5 or successor provisions, why such procedures are not effective for reducing 
131.24 	or eliminating symptoms or undesired behavior and why they are not safe, and the safe 
131.25 	and correct use of manual restraint on an emergency basis according to the requirements 
131.26 	in section 245D.061or successor provisions.
131.27 	(g) The staff person must review and receive instruction on mental health crisis 
131.28 	response, de-escalation techniques, and suicide intervention when providing direct support 
131.29 	to a person with a serious mental illness.
131.30 	(g)(h) In the event of an emergency service initiation, the license holder must ensure 
131.31 	the training required in this subdivision occurs within 72 hours of the direct support staff 
131.32 	person first having unsupervised contact with the person receiving services. The license 
131.33 	holder must document the reason for the unplanned or emergency service initiation and 
131.34 	maintain the documentation in the person's service recipient record.
131.35 	(h)(i) License holders who provide direct support services themselves must 
131.36 	complete the orientation required in subdivision 4, clauses (3) to (7).

132.1 	Sec. 40. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 2, 
132.2 	is amended to read:
132.3 		Subd. 2.Behavior professional qualifications. A behavior professional providing 
132.4 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c), 
132.5 	clause (1), item (i), as defined in the brain injury and community alternatives for disabled 
132.6 	individuals waiver plans or successor plans, must have competencies in the following 
132.7 	areas related to as required under the brain injury and community alternatives for disabled 
132.8 	individuals waiver plans or successor plans:
132.9 	(1) ethical considerations;
132.10 	(2) functional assessment;
132.11 	(3) functional analysis;
132.12 	(4) measurement of behavior and interpretation of data;
132.13 	(5) selecting intervention outcomes and strategies;
132.14 	(6) behavior reduction and elimination strategies that promote least restrictive 
132.15 	approved alternatives;
132.16 	(7) data collection;
132.17 	(8) staff and caregiver training;
132.18 	(9) support plan monitoring;
132.19 	(10) co-occurring mental disorders or neurocognitive disorder;
132.20 	(11) demonstrated expertise with populations being served; and
132.21 	(12) must be a:
132.22 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the 
132.23 	Board of Psychology competencies in the above identified areas;
132.24 	(ii) clinical social worker licensed as an independent clinical social worker under 
132.25 	chapter 148D, or a person with a master's degree in social work from an accredited college 
132.26 	or university, with at least 4,000 hours of post-master's supervised experience in the 
132.27 	delivery of clinical services in the areas identified in clauses (1) to (11);
132.28 	(iii) physician licensed under chapter 147 and certified by the American Board 
132.29 	of Psychiatry and Neurology or eligible for board certification in psychiatry with 
132.30 	competencies in the areas identified in clauses (1) to (11);
132.31 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 
132.32 	148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery 
132.33 	of clinical services who has demonstrated competencies in the areas identified in clauses 
132.34 	(1) to (11);
132.35 	(v) person with a master's degree from an accredited college or university in one 
132.36 	of the behavioral sciences or related fields, with at least 4,000 hours of post-master's 
133.1 	supervised experience in the delivery of clinical services with demonstrated competencies 
133.2 	in the areas identified in clauses (1) to (11); or
133.3 	(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
133.4 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
133.5 	mental health nursing by a national nurse certification organization, or who has a master's 
133.6 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
133.7 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
133.8 	experience in the delivery of clinical services.

133.9 	Sec. 41. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 3, 
133.10 	is amended to read:
133.11 		Subd. 3.Behavior analyst qualifications. (a) A behavior analyst providing 
133.12 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph 
133.13 	(c), clause (1), item (i), as defined in the brain injury and community alternatives for 
133.14 	disabled individuals waiver plans or successor plans, must have competencies in the 
133.15 	following areas as required under the brain injury and community alternatives for disabled 
133.16 	individuals waiver plans or successor plans:
133.17 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
133.18 	discipline; or
133.19 	(2) meet the qualifications of a mental health practitioner as defined in section 
133.20 	245.462, subdivision 17.
133.21 	(b) In addition, a behavior analyst must:
133.22 	(1) have four years of supervised experience working with individuals who exhibit 
133.23 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder;
133.24 	(2) have received ten hours of instruction in functional assessment and functional 
133.25 	analysis;
133.26 	(3) have received 20 hours of instruction in the understanding of the function of 
133.27 	behavior;
133.28 	(4) have received ten hours of instruction on design of positive practices behavior 
133.29 	support strategies;
133.30 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
133.31 	strategies used only in combination with behavior positive practices strategies;
133.32 	(6) be determined by a behavior professional to have the training and prerequisite 
133.33 	skills required to provide positive practice strategies as well as behavior reduction 
133.34 	approved and permitted intervention to the person who receives behavioral support; and
133.35 	(7) be under the direct supervision of a behavior professional.

134.1 	Sec. 42. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 4, 
134.2 	is amended to read:
134.3 		Subd. 4.Behavior specialist qualifications. (a) A behavior specialist providing 
134.4 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c), 
134.5 	clause (1), item (i), as defined in the brain injury and community alternatives for disabled 
134.6 	individuals waiver plans or successor plans, must meet the following qualifications have 
134.7 	competencies in the following areas as required under the brain injury and community 
134.8 	alternatives for disabled individuals waiver plans or successor plans:
134.9 	(1) have an associate's degree in a social services discipline; or
134.10 	(2) have two years of supervised experience working with individuals who exhibit 
134.11 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
134.12 	(b) In addition, a behavior specialist must:
134.13 	(1) have received a minimum of four hours of training in functional assessment;
134.14 	(2) have received 20 hours of instruction in the understanding of the function of 
134.15 	behavior;
134.16 	(3) have received ten hours of instruction on design of positive practices behavioral 
134.17 	support strategies;
134.18 	(4) be determined by a behavior professional to have the training and prerequisite 
134.19 	skills required to provide positive practices strategies as well as behavior reduction 
134.20 	approved intervention to the person who receives behavioral support; and
134.21 	(5) be under the direct supervision of a behavior professional.

134.22 	Sec. 43. Minnesota Statutes 2013 Supplement, section 245D.10, subdivision 3, is 
134.23 	amended to read:
134.24 		Subd. 3.Service suspension and service termination. (a) The license holder must 
134.25 	establish policies and procedures for temporary service suspension and service termination 
134.26 	that promote continuity of care and service coordination with the person and the case 
134.27 	manager and with other licensed caregivers, if any, who also provide support to the person.
134.28 	(b) The policy must include the following requirements:
134.29 	(1) the license holder must notify the person or the person's legal representative and 
134.30 	case manager in writing of the intended termination or temporary service suspension, and 
134.31 	the person's right to seek a temporary order staying the termination of service according to 
134.32 	the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
134.33 	(2) notice of the proposed termination of services, including those situations that 
134.34 	began with a temporary service suspension, must be given at least 60 days before the 
134.35 	proposed termination is to become effective when a license holder is providing intensive 
135.1 	supports and services identified in section 245D.03, subdivision 1, paragraph (c), and 30 
135.2 	days prior to termination for all other services licensed under this chapter. This notice 
135.3 	may be given in conjunction with a notice of temporary service suspension;
135.4 	(3) notice of temporary service suspension must be given on the first day of the 
135.5 	service suspension;
135.6 	(3) (4) the license holder must provide information requested by the person or case 
135.7 	manager when services are temporarily suspended or upon notice of termination;
135.8 	(4) (5) prior to giving notice of service termination or temporary service suspension, 
135.9 	the license holder must document actions taken to minimize or eliminate the need for 
135.10 	service suspension or termination;
135.11 	(5) (6) during the temporary service suspension or service termination notice period, 
135.12 	the license holder will must work with the appropriate county agency support team or 
135.13 	expanded support team to develop reasonable alternatives to protect the person and others;
135.14 	(6) (7) the license holder must maintain information about the service suspension or 
135.15 	termination, including the written termination notice, in the service recipient record; and
135.16 	(7) (8) the license holder must restrict temporary service suspension to situations in 
135.17 	which the person's conduct poses an imminent risk of physical harm to self or others and 
135.18 	less restrictive or positive support strategies would not achieve and maintain safety.

135.19 	Sec. 44. Minnesota Statutes 2013 Supplement, section 245D.10, subdivision 4, is 
135.20 	amended to read:
135.21 		Subd. 4.Availability of current written policies and procedures. (a) The license 
135.22 	holder must review and update, as needed, the written policies and procedures required 
135.23 	under this chapter.
135.24 	(b) (1) The license holder must inform the person and case manager of the policies 
135.25 	and procedures affecting a person's rights under section 245D.04, and provide copies of 
135.26 	those policies and procedures, within five working days of service initiation.
135.27 	(2) If a license holder only provides basic services and supports, this includes the:
135.28 	(i) grievance policy and procedure required under subdivision 2; and
135.29 	(ii) service suspension and termination policy and procedure required under 
135.30 	subdivision 3.
135.31 	(3) For all other license holders this includes the:
135.32 	(i) policies and procedures in clause (2);
135.33 	(ii) emergency use of manual restraints policy and procedure required under section 
135.34 	245D.061, subdivision 10, or successor provisions; and
135.35 	(iii) data privacy requirements under section 245D.11, subdivision 3.
136.1 	(c) The license holder must provide a written notice to all persons or their legal 
136.2 	representatives and case managers at least 30 days before implementing any procedural 
136.3 	revisions to policies affecting a person's service-related or protection-related rights under 
136.4 	section 245D.04 and maltreatment reporting policies and procedures. The notice must 
136.5 	explain the revision that was made and include a copy of the revised policy and procedure. 
136.6 	The license holder must document the reasonable cause for not providing the notice at 
136.7 	least 30 days before implementing the revisions.
136.8 	(d) Before implementing revisions to required policies and procedures, the license 
136.9 	holder must inform all employees of the revisions and provide training on implementation 
136.10 	of the revised policies and procedures.
136.11 	(e) The license holder must annually notify all persons, or their legal representatives, 
136.12 	and case managers of any procedural revisions to policies required under this chapter, 
136.13 	other than those in paragraph (c). Upon request, the license holder must provide the 
136.14 	person, or the person's legal representative, and case manager with copies of the revised 
136.15 	policies and procedures.

136.16 	Sec. 45. Minnesota Statutes 2013 Supplement, section 245D.11, subdivision 2, is 
136.17 	amended to read:
136.18 		Subd. 2.Health and safety. The license holder must establish policies and 
136.19 	procedures that promote health and safety by ensuring:
136.20 	(1) use of universal precautions and sanitary practices in compliance with section 
136.21 	245D.06, subdivision 2, clause (5);
136.22 	(2) if the license holder operates a residential program, health service coordination 
136.23 	and care according to the requirements in section 245D.05, subdivision 1;
136.24 	(3) safe medication assistance and administration according to the requirements 
136.25 	in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in 
136.26 	consultation with a registered nurse, nurse practitioner, physician's assistant, or medical 
136.27 	doctor and require completion of medication administration training according to the 
136.28 	requirements in section 245D.09, subdivision 4a, paragraph (d). Medication assistance 
136.29 	and administration includes, but is not limited to:
136.30 	(i) providing medication-related services for a person;
136.31 	(ii) medication setup;
136.32 	(iii) medication administration;
136.33 	(iv) medication storage and security;
136.34 	(v) medication documentation and charting;
137.1 	(vi) verification and monitoring of effectiveness of systems to ensure safe medication 
137.2 	handling and administration;
137.3 	(vii) coordination of medication refills;
137.4 	(viii) handling changes to prescriptions and implementation of those changes;
137.5 	(ix) communicating with the pharmacy; and
137.6 	(x) coordination and communication with prescriber;
137.7 	(4) safe transportation, when the license holder is responsible for transportation of 
137.8 	persons, with provisions for handling emergency situations according to the requirements 
137.9 	in section 245D.06, subdivision 2, clauses (2) to (4);
137.10 	(5) a plan for ensuring the safety of persons served by the program in emergencies as 
137.11 	defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies 
137.12 	to the license holder. A license holder with a community residential setting or a day service 
137.13 	facility license must ensure the policy and procedures comply with the requirements in 
137.14 	section 245D.22, subdivision 4;
137.15 	(6) a plan for responding to all incidents as defined in section 245D.02, subdivision 
137.16 	11; and reporting all incidents required to be reported according to section 245D.06, 
137.17 	subdivision 1. The plan must:
137.18 	(i) provide the contact information of a source of emergency medical care and 
137.19 	transportation; and
137.20 	(ii) require staff to first call 911 when the staff believes a medical emergency may 
137.21 	be life threatening, or to call the mental health crisis intervention team or similar mental 
137.22 	health response team or service when such a team is available and appropriate when the 
137.23 	person is experiencing a mental health crisis; and
137.24 	(7) a procedure for the review of incidents and emergencies to identify trends or 
137.25 	patterns, and corrective action if needed. The license holder must establish and maintain 
137.26 	a record-keeping system for the incident and emergency reports. Each incident and 
137.27 	emergency report file must contain a written summary of the incident. The license holder 
137.28 	must conduct a review of incident reports for identification of incident patterns, and 
137.29 	implementation of corrective action as necessary to reduce occurrences. Each incident 
137.30 	report must include:
137.31 	(i) the name of the person or persons involved in the incident. It is not necessary 
137.32 	to identify all persons affected by or involved in an emergency unless the emergency 
137.33 	resulted in an incident;
137.34 	(ii) the date, time, and location of the incident or emergency;
137.35 	(iii) a description of the incident or emergency;
138.1 	(iv) a description of the response to the incident or emergency and whether a person's 
138.2 	coordinated service and support plan addendum or program policies and procedures were 
138.3 	implemented as applicable;
138.4 	(v) the name of the staff person or persons who responded to the incident or 
138.5 	emergency; and
138.6 	(vi) the determination of whether corrective action is necessary based on the results 
138.7 	of the review.

138.8 	Sec. 46. Minnesota Statutes 2012, section 252.451, subdivision 2, is amended to read:
138.9 		Subd. 2.Vendor participation and reimbursement. Notwithstanding requirements 
138.10 	in chapter chapters 245A and 245D, and sections 252.28, 252.40 to 252.46, and 256B.501, 
138.11 	vendors of day training and habilitation services may enter into written agreements with 
138.12 	qualified businesses to provide additional training and supervision needed by individuals 
138.13 	to maintain their employment.

138.14 	Sec. 47. Minnesota Statutes 2012, section 256.9752, subdivision 2, is amended to read:
138.15 		Subd. 2.Authority. The Minnesota Board on Aging shall allocate to area agencies 
138.16 	on aging the state and federal funds which are received for the senior nutrition programs 
138.17 	of congregate dining and home-delivered meals in a manner consistent with federal 
138.18 	requirements.

138.19 	Sec. 48. Minnesota Statutes 2013 Supplement, section 256B.0949, subdivision 4, 
138.20 	is amended to read:
138.21 		Subd. 4.Diagnosis. (a) A diagnosis must:
138.22 	(1) be based upon current DSM criteria including direct observations of the child 
138.23 	and reports from parents or primary caregivers; and
138.24 	(2) be completed by both either (i) a licensed physician or advanced practice 
138.25 	registered nurse and or (ii) a mental health professional.
138.26 	(b) Additional diagnostic assessment information may be considered including from 
138.27 	special education evaluations and licensed school personnel, and from professionals 
138.28 	licensed in the fields of medicine, speech and language, psychology, occupational therapy, 
138.29 	and physical therapy.
138.30 	(c) If the commissioner determines there are access problems or delays in diagnosis 
138.31 	for a geographic area due to the lack of qualified professionals, the commissioner shall 
138.32 	waive the requirement in paragraph (a), clause (2), for two professionals and allow a 
138.33 	diagnosis to be made by one professional for that geographic area. This exception must be 
139.1 	limited to a specific period of time until, with stakeholder input as described in subdivision 
139.2 	8, there is a determination of an adequate number of professionals available to require two 
139.3 	professionals for each diagnosis.

139.4 	Sec. 49. Minnesota Statutes 2013 Supplement, section 256B.439, subdivision 1, 
139.5 	is amended to read:
139.6 		Subdivision 1.Development and implementation of quality profiles. (a) The 
139.7 	commissioner of human services, in cooperation with the commissioner of health, shall 
139.8 	develop and implement quality profiles for nursing facilities and, beginning not later than 
139.9 	July 1, 2014, for home and community-based services providers, except when the quality 
139.10 	profile system would duplicate requirements under section 256B.5011, 256B.5012, or 
139.11 	256B.5013. For purposes of this section, home and community-based services providers 
139.12 	are defined as providers of home and community-based services under sections 256B.0625, 
139.13 	subdivisions 6a, 7, and 19a; 256B.0913,;256B.0915,;256B.092, and;256B.49,; and 
139.14 	256B.85, and intermediate care facilities for persons with developmental disabilities 
139.15 	providers under section 256B.5013. To the extent possible, quality profiles must be 
139.16 	developed for providers of services to older adults and people with disabilities, regardless 
139.17 	of payor source, for the purposes of providing information to consumers. The quality 
139.18 	profiles must be developed using existing data sets maintained by the commissioners of 
139.19 	health and human services to the extent possible. The profiles must incorporate or be 
139.20 	coordinated with information on quality maintained by area agencies on aging, long-term 
139.21 	care trade associations, the ombudsman offices, counties, tribes, health plans, and other 
139.22 	entities and the long-term care database maintained under section 256.975, subdivision 7. 
139.23 	The profiles must be designed to provide information on quality to:
139.24 	(1) consumers and their families to facilitate informed choices of service providers;
139.25 	(2) providers to enable them to measure the results of their quality improvement 
139.26 	efforts and compare quality achievements with other service providers; and
139.27 	(3) public and private purchasers of long-term care services to enable them to 
139.28 	purchase high-quality care.
139.29 	(b) The profiles must be developed in consultation with the long-term care task 
139.30 	force, area agencies on aging, and representatives of consumers, providers, and labor 
139.31 	unions. Within the limits of available appropriations, the commissioners may employ 
139.32 	consultants to assist with this project.

139.33 	EFFECTIVE DATE. This section is effective retroactively from February 1, 2014.

140.1 	Sec. 50. Minnesota Statutes 2013 Supplement, section 256B.439, subdivision 7, 
140.2 	is amended to read:
140.3 		Subd. 7.Calculation of home and community-based services quality add-on. 
 140.4 	Effective On July 1, 2015, the commissioner shall determine the quality add-on rate 
140.5 	change and adjust payment rates for participating all home and community-based services 
140.6 	providers for services rendered on or after that date. The adjustment to a provider payment 
140.7 	rate determined under this subdivision shall become part of the ongoing rate paid to that 
140.8 	provider. The payment rate for the quality add-on shall be a variable amount based on 
140.9 	each provider's quality score as determined in subdivisions 1 and 2a. All home and 
140.10 	community-based services providers shall receive a minimum rate increase under this 
140.11 	subdivision. In addition to a minimum rate increase, a home and community-based 
140.12 	services provider shall receive a quality add-on payment. The commissioner shall limit 
140.13 	the types of home and community-based services providers that may receive the quality 
140.14 	add-on and based on availability of quality measures and outcome data. The commissioner 
140.15 	shall limit the amount of the minimum rate increase and quality add-on payments to 
140.16 	operate the quality add-on within funds appropriated for this purpose and based on the 
140.17 	availability of the quality measures the equivalent of a one percent rate increase for all 
140.18 	home and community-based services providers.

140.19 	Sec. 51. Minnesota Statutes 2013 Supplement, section 256B.441, subdivision 53, 
140.20 	is amended to read:
140.21 		Subd. 53.Calculation of payment rate for external fixed costs. The commissioner 
140.22 	shall calculate a payment rate for external fixed costs.
140.23 	(a) For a facility licensed as a nursing home, the portion related to section 256.9657 
140.24 	shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 
140.25 	home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 
140.26 	result of its number of nursing home beds divided by its total number of licensed beds.
140.27 	(b) The portion related to the licensure fee under section 144.122, paragraph (d), 
140.28 	shall be the amount of the fee divided by actual resident days.
140.29 	(c) The portion related to scholarships shall be determined under section 256B.431, 
140.30 	subdivision 36.
140.31 	(d) Until September 30, 2013, the portion related to long-term care consultation shall 
140.32 	be determined according to section 256B.0911, subdivision 6.
140.33 	(e) The portion related to development and education of resident and family advisory 
140.34 	councils under section 144A.33 shall be $5 divided by 365.
141.1 	(f) The portion related to planned closure rate adjustments shall be as determined 
141.2 	under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436. 
141.3 	Planned closure rate adjustments that take effect before October 1, 2014, shall no longer 
141.4 	be included in the payment rate for external fixed costs beginning October 1, 2016. 
141.5 	Planned closure rate adjustments that take effect on or after October 1, 2014, shall no 
141.6 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
141.7 	the first year not less than two years after their effective date.
141.8 	(g) The portions related to property insurance, real estate taxes, special assessments, 
141.9 	and payments made in lieu of real estate taxes directly identified or allocated to the nursing 
141.10 	facility shall be the actual amounts divided by actual resident days.
141.11 	(h) The portion related to the Public Employees Retirement Association shall be 
141.12 	actual costs divided by resident days.
141.13 	(i) The single bed room incentives shall be as determined under section 256B.431, 
141.14 	subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall 
141.15 	no longer be included in the payment rate for external fixed costs beginning October 1, 
141.16 	2016. Single bed room incentives that take effect on or after October 1, 2014, shall no 
141.17 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
141.18 	the first year not less than two years after their effective date.
141.19 	(j)  The portion related to the rate adjustment as provided in subdivision 64.
141.20 	(k) The payment rate for external fixed costs shall be the sum of the amounts in 
141.21 	paragraphs (a) to (i) (j).

141.22 	Sec. 52. Minnesota Statutes 2012, section 256B.441, is amended by adding a 
141.23 	subdivision to read:
141.24 		Subd. 64.Rate adjustment for compensation-related costs. (a) Total payment 
141.25 	rates of all nursing facilities that are reimbursed under this section or section 256B.434 
141.26 	shall be increased effective October 1, 2014, to address compensation costs for nursing 
141.27 	facility employees paid less than $14.00 per hour.
141.28 	(b) Based on the application in paragraph (d), the commissioner shall calculate 
141.29 	the annualized compensation costs by adding the totals of clauses (1), (2), and (3). The 
141.30 	result must be divided by the resident days from the most recently available cost report to 
141.31 	determine a per diem amount, which must be included in the external fixed cost portion of 
141.32 	the total payment rate under subdivision 53: 
141.33 	(1) the sum of the difference between $9.50 and any hourly wage rate of less than 
141.34 	$9.50, multiplied by the number of compensated hours at that wage rate;
141.35 	(2) the sum of items (i) to (viii):
142.1 	(i) for all compensated hours from $8.00 to $8.49 per hour, the number of 
142.2 	compensated hours is multiplied by $0.13;
142.3 	(ii) for all compensated hours from $8.50 to $8.99 per hour, the number of 
142.4 	compensated hours is multiplied by $0.25;
142.5 	(iii) for all compensated hours from $9.00 to $9.49 per hour, the number of 
142.6 	compensated hours is multiplied by $0.38;
142.7 	(iv) for all compensated hours from $9.50 to $10.49 per hour, the number of 
142.8 	compensated hours is multiplied by $0.50;
142.9 	(v) for all compensated hours from $10.50 to $10.99 per hour, the number of 
142.10 	compensated hours is multiplied by $0.40;
142.11 	(vi) for all compensated hours from $11.00 to $11.49 per hour, the number of 
142.12 	compensated hours is multiplied by $0.30;
142.13 	(vii) for all compensated hours from $11.50 to $11.99 per hour, the number of 
142.14 	compensated hours is multiplied by $0.20; and
142.15 	(viii) for all compensated hours from $12.00 to $13.00 per hour, the number of 
142.16 	compensated hours is multiplied by $0.10; and
142.17 	(3) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal 
142.18 	unemployment taxes, workers' compensation, pensions, and contributions to employee 
142.19 	retirement accounts attributable to the amounts in clauses (1) and (2).
142.20 	(c) For the rate year beginning October 1, 2014, nursing facilities that receive 
142.21 	approval of the application in paragraph (d) must receive a rate adjustment according to 
142.22 	paragraph (b). The rate adjustment must be used to pay compensation costs for nursing 
142.23 	facility employees paid less than $14.00 per hour. The rate adjustment must continue to 
142.24 	be included in the total payment rate in subsequent years.
142.25 	(d) To receive a rate adjustment, nursing facilities must submit an application to the 
142.26 	commissioner in a form and manner determined by the commissioner. The application 
142.27 	shall include data for a period beginning with the first pay period after January 1, 2014, 
142.28 	including at least three months of employee compensated hours by wage rate, and a 
142.29 	spending plan that describes how the funds from the rate adjustment will be allocated 
142.30 	for compensation to employees paid less than $14.00 per hour. The application must 
142.31 	be submitted by December 31, 2014. The commissioner may request any additional 
142.32 	information needed to determine the rate adjustment within three weeks of receiving 
142.33 	a complete application. The nursing facility must provide any additional information 
142.34 	requested by the commissioner by March 31, 2015. The commissioner may waive the 
142.35 	deadlines in this subdivision under extraordinary circumstances.
143.1 	(e) For nursing facilities in which employees are represented by an exclusive 
143.2 	bargaining representative, the commissioner shall approve the application submitted under 
143.3 	this subdivision only upon receipt of a letter of acceptance of the spending plan in regard 
143.4 	to members of the bargaining unit, signed by the exclusive bargaining agent and dated 
143.5 	after May 31, 2014. Upon receipt of the letter of acceptance, the commissioner shall 
143.6 	deem all requirements of this subdivision as having been met in regard to the members of 
143.7 	the bargaining unit.

143.8 	Sec. 53. Minnesota Statutes 2013 Supplement, section 256B.4912, subdivision 1, 
143.9 	is amended to read:
143.10 		Subdivision 1.Provider qualifications. (a) For the home and community-based 
143.11 	waivers providing services to seniors and individuals with disabilities under sections 
143.12 	256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
143.13 	(1) agreements with enrolled waiver service providers to ensure providers meet 
143.14 	Minnesota health care program requirements;
143.15 	(2) regular reviews of provider qualifications, and including requests of proof of 
143.16 	documentation; and
143.17 	(3) processes to gather the necessary information to determine provider qualifications.
143.18 	(b) Beginning July 1, 2012, staff that provide direct contact, as defined in section 
143.19 	245C.02, subdivision 11, for services specified in the federally approved waiver plans 
143.20 	must meet the requirements of chapter 245C prior to providing waiver services and as 
143.21 	part of ongoing enrollment. Upon federal approval, this requirement must also apply to 
143.22 	consumer-directed community supports.
143.23 	(c) Beginning January 1, 2014, service owners and managerial officials overseeing 
143.24 	the management or policies of services that provide direct contact as specified in the 
143.25 	federally approved waiver plans must meet the requirements of chapter 245C prior to 
143.26 	reenrollment or revalidation or, for new providers, prior to initial enrollment if they have 
143.27 	not already done so as a part of service licensure requirements.

143.28 	Sec. 54. Minnesota Statutes 2013 Supplement, section 256B.492, is amended to read:
143.29 	256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE 
143.30 	WITH DISABILITIES.
143.31 		Subdivision 1.Home and community-based waivers. (a) Individuals receiving 
143.32 	services under a home and community-based waiver under section 256B.092 or 256B.49
143.33 	may receive services in the following settings:
143.34 	(1) an individual's own home or family home;
144.1 	(2) a licensed adult foster care or child foster care setting of up to five people; and
144.2 	(3) community living settings as defined in section 256B.49, subdivision 23, where 
144.3 	individuals with disabilities who are receiving services under a home and community-based 
144.4 	waiver may reside in all of the units in a building of four or fewer units, and no more than 
144.5 	the greater of four or 25 percent of the units in a multifamily building of more than four 
144.6 	units, unless required by the Housing Opportunities for Persons with AIDS Program.
144.7 	(b) The settings in paragraph (a) must not:
144.8 	(1) be located in a building that is a publicly or privately operated facility that 
144.9 	provides institutional treatment or custodial care;
144.10 	(2) be located in a building on the grounds of or adjacent to a public or private 
144.11 	institution;
144.12 	(3) be a housing complex designed expressly around an individual's diagnosis or 
144.13 	disability, unless required by the Housing Opportunities for Persons with AIDS Program;
144.14 	(4) be segregated based on a disability, either physically or because of setting 
144.15 	characteristics, from the larger community; and
144.16 	(5) have the qualities of an institution which include, but are not limited to: 
144.17 	regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions 
144.18 	agreed to and documented in the person's individual service plan shall not result in a 
144.19 	residence having the qualities of an institution as long as the restrictions for the person are 
144.20 	not imposed upon others in the same residence and are the least restrictive alternative, 
144.21 	imposed for the shortest possible time to meet the person's needs.
144.22 	(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which 
144.23 	individuals receive services under a home and community-based waiver as of July 1, 
144.24 	2012, and the setting does not meet the criteria of this section.
144.25 	(d) Notwithstanding paragraph (c), a program in Hennepin County established as 
144.26 	part of a Hennepin County demonstration project is qualified for the exception allowed 
144.27 	under paragraph (c).
144.28 	(e) The commissioner shall submit an amendment to the waiver plan no later than 
144.29 	December 31, 2012.
144.30 		Subd. 2.Exceptions for home and community-based waiver housing programs.
 144.31 	(a) Beginning no later than January 2015, based on the consultation with interested 
144.32 	stakeholders as specified in subdivision 3, the commissioner shall accept and process 
144.33 	applications for exceptions to subdivision 1 based on the criteria in this subdivision.
144.34 	(b) An owner, operator, or developer of a community living setting may apply to 
144.35 	the commissioner for the granting of an exception from the requirement in subdivision 
144.36 	1, paragraph (a), clause (3), that individuals receiving services under a home and 
145.1 	community-based waiver under section 256B.092 or 256B.49 may only reside in all 
145.2 	of the units in a building of four or fewer units, and no more than the greater of four 
145.3 	or 25 percent of the units in a multifamily building of more than four units and from 
145.4 	the requirement in subdivision 1, paragraph (b), clause (3), that a setting cannot be a 
145.5 	housing complex designed expressly around an individual's diagnosis or disability. Such 
145.6 	an exception from the requirements in subdivision 1, paragraphs (a), clause (3), and (b), 
145.7 	clause (3), may be granted when the organization requesting the exception submits to the 
145.8 	commissioner an application providing the information requested in paragraph (c). The 
145.9 	exception shall require that housing costs be separated from service costs and allow the 
145.10 	client to choose the vendor who provides personal services under the client's waiver. 
145.11 	(c) A community living setting application for an exemption must provide the 
145.12 	following information and affirmations:
145.13 	(1) affirms the community living setting materially meets all the requirements for 
145.14 	home and community-based settings in subdivision 1, paragraph (b), other than clause (3);
145.15 	(2) explains the scope and necessity of the exception, including documentation of 
145.16 	the characteristics of the population to be served and the demand for the number of units 
145.17 	the applicant anticipates will be occupied by individuals receiving services under a home 
145.18 	and community-based waiver in the proposed setting; 
145.19 	(3) explains how the community living setting supports all individuals receiving 
145.20 	services under a home and community-based waiver in choosing the setting from 
145.21 	among other options and the availability of those other options in the community for 
145.22 	the specific population the program proposes to serve, and outlines the proposed rents 
145.23 	and service costs, if any, of services to be provided by the applicant and addresses the 
145.24 	cost-effectiveness of the model proposed; and
145.25 	(4) includes a quality assurance plan affirming that the organization requesting 
145.26 	the exception:
145.27 	(i) supports or develops scattered-site alternatives to the setting for which the 
145.28 	exception is requested;
145.29 	(ii) supports the transition of individuals receiving services under a home and 
145.30 	community-based waiver to the most integrated setting appropriate to the individual's 
145.31 	needs;
145.32 	(iii) has a history of meeting recognized quality standards for the population it serves 
145.33 	or is targeting, or that it will meet recognized quality standards; 
145.34 	(iv) provides and facilitates for tenants receiving services under a home and 
145.35 	community-based waiver unlimited access to the community, including opportunities to 
145.36 	interact with nonstaff people without disabilities, appropriate to the individual's needs; and
146.1 	(v) supports a safe and healthy environment for all individuals living in the setting.
146.2 	(d) In assessing whether to grant the applicant's exception request, the commissioner 
146.3 	shall:
146.4 	(1) evaluate all of the assertions in the application, verify the assertions are accurate, 
146.5 	and ensure that the application is complete; 
146.6 	(2) consult with all divisions in the Department of Human Services relevant to the 
146.7 	specific populations being served by the applicant and the Minnesota Housing Finance 
146.8 	Agency;
146.9 	(3) within 30 days of receiving the application notify the city, county, and local press 
146.10 	of the 14-day public comment period to consider community input on the application, 
146.11 	including input from tenants, potential tenants, and other interested stakeholders;
146.12 	(4) within 60 days of receiving the application issue an approval, conditional 
146.13 	approval, or denial of the exception sought; and
146.14 	(5) accept and process applications from settings throughout the calendar year. 
146.15 	If conditional approval is granted under this section, the commissioner must specify 
146.16 	the reasons for conditional approval of the exception and allow the applicant 30 days 
146.17 	to amend the application and issue a renewed decision within 15 days of receiving the 
146.18 	amended application. If the commissioner denies an exception under this section, the 
146.19 	commissioner must specify reasons for denial of the exception.
146.20 	(e) After an applicant's exception is approved, any material change in the population 
146.21 	to be served or the services to be offered must be submitted to the commissioner who shall 
146.22 	decide if it is consistent with the basis on which the exception was granted or if another 
146.23 	exception request needs to be submitted.
146.24 	(f) If an exception is approved and later revoked, no tenant shall be displaced as a 
146.25 	result of this revocation until a relocation plan has been implemented that provides for an 
146.26 	acceptable alternative placement.
146.27 	(g) Notwithstanding the above provision, no organization that meets the requirements 
146.28 	under subdivision 1 shall be required to apply for an exception described in this subdivision.
146.29 		Subd. 3.Public input on exception process.  The commissioner shall consult with 
146.30 	interested stakeholders to develop a plan for implementing the exceptions process described 
146.31 	in subdivision 2. The implementation plan for the applications shall be based upon the 
146.32 	criteria in subdivision 2 and any other information necessary to manage the exceptions 
146.33 	process. The commissioner must consult with representatives from each relevant division 
146.34 	of the Department of Human Services, The Coalition for Choice in Housing, NAMI, The 
146.35 	Arc Minnesota, Mental Health Association of Minnesota, Minnesota Disability Law 
147.1 	Center, and other provider organizations, counties, municipalities, disability advocates, 
147.2 	and individuals with disabilities or family members of an individual with disabilities.

147.3 	Sec. 55. Minnesota Statutes 2012, section 256B.5012, is amended by adding a 
147.4 	subdivision to read:
147.5 		Subd. 16.ICF/DD rate increases effective July 1, 2014. (a) For each facility 
147.6 	reimbursed under this section, for the rate period beginning July 1, 2014, the commissioner 
147.7 	shall increase operating payments equal to four percent of the operating payment rates in 
147.8 	effect on July 1, 2014. For each facility, the commissioner shall apply the rate increase 
147.9 	based on occupied beds, using the percentage specified in this subdivision multiplied by 
147.10 	the total payment rate, including the variable rate but excluding the property-related 
147.11 	payment rate in effect on the preceding date.
147.12 	(b) To receive the rate increase under paragraph (a), each facility reimbursed under 
147.13 	this section must submit to the commissioner documentation that identifies a quality 
147.14 	improvement project the facility will implement by June 30, 2015. Documentation must 
147.15 	be provided in a format specified by the commissioner. Projects must:
147.16 	(1) improve the quality of life of intermediate care facility residents in a meaningful 
147.17 	way;
147.18 	(2) improve the quality of services in a measurable way; or
147.19 	(3) deliver good quality service more efficiently while using the savings to enhance 
147.20 	services for the participants served.
147.21 	(c) For a facility that fails to submit the documentation described in paragraph (b) 
147.22 	by a date or in a format specified by the commissioner, the commissioner shall reduce 
147.23 	the facility's rate by one percent effective January 1, 2015.
147.24 	(d) Facilities that receive a rate increase under this subdivision shall use 75 percent 
147.25 	of the rate increase to increase compensation-related costs for employees directly 
147.26 	employed by the facility on or after the effective date of the rate adjustments, except:
147.27 	(1) persons employed in the central office of a corporation or entity that has an 
147.28 	ownership interest in the facility or exercises control over the facility; and
147.29 	(2) persons paid by the facility under a management contract.
147.30 	This requirement is subject to audit by the commissioner.
147.31 	(e) Compensation-related costs include:
147.32 	(1) wages and salaries;
147.33 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
147.34 	unemployment taxes, workers' compensation, and mileage reimbursement;
148.1 	(3) the employer's share of health and dental insurance, life insurance, disability 
148.2 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
148.3 	employee retirement accounts; and
148.4 	(4) other benefits provided and workforce needs, including the recruiting and 
148.5 	training of employees as specified in the distribution plan required under paragraph (f).
148.6 	(f) A facility that receives a rate adjustment under paragraph (a) that is subject to 
148.7 	paragraphs (d) and (e) shall prepare and produce for the commissioner, upon request, a 
148.8 	plan that specifies the amount of money the provider expects to receive that is subject to 
148.9 	the requirements of paragraphs (d) and (e), as well as how that money will be distributed 
148.10 	to increase compensation for employees. The commissioner may recover funds from a 
148.11 	facility that fails to comply with this requirement.
148.12 	(g) Within six months after the effective date of the rate adjustment, the facility shall 
148.13 	post the distribution plan required under paragraph (f) for a period of at least six weeks in 
148.14 	an area of the facility's operation to which all eligible employees have access, and shall 
148.15 	provide instructions for employees who believe they have not received the wage and other 
148.16 	compensation-related increases specified in the distribution plan. These instructions must 
148.17 	include a mailing address, e-mail address, and telephone number that an employee may 
148.18 	use to contact the commissioner or the commissioner's representative. Facilities shall 
148.19 	make assurances to the commissioner of compliance with this subdivision using forms 
148.20 	prescribed by the commissioner.
148.21 	(h) For public employees, the increase for wages and benefits for certain staff is 
148.22 	available and pay rates must be increased only to the extent that the increases comply with 
148.23 	laws governing public employees' collective bargaining. Money received by a provider for 
148.24 	pay increases for public employees under this subdivision may be used only for increases 
148.25 	implemented within one month of the effective date of the rate increase and must not be 
148.26 	used for increases implemented prior to that date.
148.27 	(i) For a provider that has employees that are represented by an exclusive bargaining 
148.28 	representative, the provider shall obtain a letter of acceptance of the distribution plan, in 
148.29 	regard to the members of the bargaining unit, signed by the exclusive bargaining agent. 
148.30 	Upon receipt of the letter of acceptance, the provider shall be deemed to have met all the 
148.31 	requirements of this subdivision in regard to the members of the bargaining unit. The 
148.32 	provider shall produce the letter of acceptance for the commissioner upon request.

148.33 	Sec. 56. Laws 2013, chapter 108, article 7, section 14, the effective date, is amended to 
148.34 	read:

149.1 	EFFECTIVE DATE. Subdivisions 1 to 7 and 9, are effective upon federal approval 
149.2 	consistent with subdivision 11, but no earlier than March July 1, 2014. Subdivisions 
149.3 	8, 10, and 11 are effective July 1, 2013.

149.4 	Sec. 57. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY 
149.5 	1, 2014.
 149.6 	(a) The commissioner of human services shall increase reimbursement rates, grants, 
149.7 	allocations, individual limits, and rate limits, as applicable, by four percent for the rate 
149.8 	period beginning July 1, 2014, for services rendered on or after that date. County or tribal 
149.9 	contracts for services specified in this section must be amended to pass through these rate 
149.10 	increases within 60 days of the effective date.
149.11 	(b) The rate changes described in this section must be provided to:
149.12 	(1) home and community-based waiver services for persons with developmental 
149.13 	disabilities, including consumer-directed community supports, under Minnesota Statutes, 
149.14 	section 256B.092;
149.15 	(2) waiver services under community alternatives for disabled individuals, including 
149.16 	consumer-directed community supports, under Minnesota Statutes, section 256B.49;
149.17 	(3) community alternative care waiver services, including consumer-directed 
149.18 	community supports, under Minnesota Statutes, section 256B.49;
149.19 	(4) brain injury waiver services, including consumer-directed community supports, 
149.20 	under Minnesota Statutes, section 256B.49;
149.21 	(5) home and community-based waiver services for the elderly under Minnesota 
149.22 	Statutes, section 256B.0915;
149.23 	(6) nursing services and home health services under Minnesota Statutes, section 
149.24 	256B.0625, subdivision 6a;
149.25 	(7) personal care services and qualified professional supervision of personal care 
149.26 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
149.27 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
149.28 	subdivision 7;
149.29 	(9) community first services and supports under Minnesota Statutes, section 256B.85;
149.30 	(10) essential community supports under Minnesota Statutes, section 256B.0922;
149.31 	(11) day training and habilitation services for adults with developmental disabilities 
149.32 	or related conditions under Minnesota Statutes, sections 252.41 to 252.46, including the 
149.33 	additional cost to counties for rate adjustments to day training and habilitation services 
149.34 	provided as a social service;
149.35 	(12) alternative care services under Minnesota Statutes, section 256B.0913;
150.1 	(13) living skills training programs for persons with intractable epilepsy who need 
150.2 	assistance in the transition to independent living under Laws 1988, chapter 689;
150.3 	(14) consumer support grants under Minnesota Statutes, section 256.476;
150.4 	(15) semi-independent living services under Minnesota Statutes, section 252.275;
150.5 	(16) family support grants under Minnesota Statutes, section 252.32;
150.6 	(17) housing access grants under Minnesota Statutes, section 256B.0658;
150.7 	(18) self-advocacy grants under Laws 2009, chapter 101;
150.8 	(19) technology grants under Laws 2009, chapter 79;
150.9 	(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977 and 
150.10 	256B.0917;
150.11 	(21) deaf and hard-of-hearing grants, including community support services for deaf 
150.12 	and hard-of-hearing adults with mental illness who use or wish to use sign language as their 
150.13 	primary means of communication under Minnesota Statutes, section 256.01, subdivision 2;
150.14 	(22) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233, 
150.15 	256C.25, and 256C.261;
150.16 	(23) Disability Linkage Line grants under Minnesota Statutes, section 256.01, 
150.17 	subdivision 24;
150.18 	(24) transition initiative grants under Minnesota Statutes, section 256.478;
150.19 	(25) employment support grants under Minnesota Statutes, section 256B.021, 
150.20 	subdivision 6; and
150.21 	(26) grants provided to people who are eligible for the Housing Opportunities for 
150.22 	Persons with AIDS program under Minnesota Statutes, section 256B.492.
150.23 	(c) A managed care plan receiving state payments for the services in paragraph (b) 
150.24 	must include the increases in paragraph (a) in payments to providers. To implement the 
150.25 	rate increase in this section, capitation rates paid by the commissioner to managed care 
150.26 	organizations under Minnesota Statutes, section 256B.69, shall reflect a four percent 
150.27 	increase for the specified services for the period beginning July 1, 2014.
150.28 	(d) Counties shall increase the budget for each recipient of consumer-directed 
150.29 	community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).
150.30 	(e) To implement this section, the commissioner shall increase service rates in the 
150.31 	disability waiver payment system authorized in Minnesota Statutes, sections 256B.4913 
150.32 	and 256B.4914.
150.33 	(f) To receive the rate increase described in this section, providers under paragraphs 
150.34 	(a) and (b) must submit to the commissioner documentation that identifies a quality 
150.35 	improvement project that the provider will implement by June 30, 2015. Documentation 
150.36 	must be provided in a format specified by the commissioner. Projects must:
151.1 	(1) improve the quality of life of home and community-based services recipients in 
151.2 	a meaningful way;
151.3 	(2) improve the quality of services in a measurable way; or
151.4 	(3) deliver good quality service more efficiently while using the savings to enhance 
151.5 	services for the participants served.
151.6 	Providers listed in paragraph (b), clauses (7), (9), (10), and (13) to (26), are not subject 
151.7 	to this requirement.
151.8 	(g) For a provider that fails to submit documentation described in paragraph (f) by 
151.9 	a date or in a format specified by the commissioner, the commissioner shall reduce the 
151.10 	provider's rate by one percent effective January 1, 2015.
151.11 	(h) Providers that receive a rate increase under this subdivision shall use 75 percent 
151.12 	of the rate increase to increase compensation-related costs for employees directly 
151.13 	employed by the facility on or after the effective date of the rate adjustments, except:
151.14 	(1) persons employed in the central office of a corporation or entity that has an 
151.15 	ownership interest in the facility or exercises control over the facility; and
151.16 	(2) persons paid by the facility under a management contract.
151.17 	This requirement is subject to audit by the commissioner.
151.18 	(i) Compensation-related costs include:
151.19 	(1) wages and salaries;
151.20 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
151.21 	unemployment taxes, workers' compensation, and mileage reimbursement;
151.22 	(3) the employer's share of health and dental insurance, life insurance, disability 
151.23 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
151.24 	employee retirement accounts; and
151.25 	(4) other benefits provided and workforce needs, including the recruiting and 
151.26 	training of employees as specified in the distribution plan required under paragraph (l).
151.27 	(j) For public employees, the increase for wages and benefits for certain staff is 
151.28 	available and pay rates must be increased only to the extent that the increases comply with 
151.29 	laws governing public employees' collective bargaining. Money received by a provider 
151.30 	for pay increases for public employees under this section may be used only for increases 
151.31 	implemented within one month of the effective date of the rate increase and must not be 
151.32 	used for increases implemented prior to that date.
151.33 	(k) For a provider that has employees that are represented by an exclusive bargaining 
151.34 	representative, the provider shall obtain a letter of acceptance of the distribution plan, in 
151.35 	regard to the members of the bargaining unit, signed by the exclusive bargaining agent. 
151.36 	Upon receipt of the letter of acceptance, the provider shall be deemed to have met all the 
152.1 	requirements of this section in regard to the members of the bargaining unit. The provider 
152.2 	shall produce the letter of acceptance for the commissioner upon request.
152.3 	(l) A provider that receives a rate adjustment under paragraph (b) that is subject to 
152.4 	paragraphs (h) and (i) shall prepare and produce for the commissioner, upon request, a 
152.5 	plan that specifies the amount of money the provider expects to receive that is subject to 
152.6 	the requirements of paragraphs (h) and (i), as well as how that money will be distributed 
152.7 	to increase compensation for employees. The commissioner may recover funds from a 
152.8 	facility that fails to comply with this requirement.
152.9 	(m) Within six months after the effective date of the rate adjustment, the provider 
152.10 	shall post the distribution plan required under paragraph (l) for a period of at least six 
152.11 	weeks in an area of the provider's operation to which all eligible employees have access, 
152.12 	and shall provide instructions for employees who believe they have not received the 
152.13 	wage and other compensation-related increases specified in the distribution plan. These 
152.14 	instructions must include a mailing address, e-mail address, and telephone number that 
152.15 	an employee may use to contact the commissioner or the commissioner's representative. 
152.16 	Providers shall make assurances to the commissioner of compliance with this section 
152.17 	using forms prescribed by the commissioner.

152.18 	Sec. 58. REVISOR'S INSTRUCTION.
 152.19 	(a) In each section of Minnesota Statutes or part of Minnesota Rules referred to 
152.20 	in column A, the revisor of statutes shall delete the word or phrase in column B and 
152.21 	insert the phrase in column C. The revisor shall also make related grammatical changes 
152.22 	and changes in headnotes.

152.23	Column A
	Column B
	Column C
	
152.24
152.25	section 158.13
	defective persons
	persons with developmental 
disabilities
	
152.26
152.27	section 158.14
	defective persons
	persons with developmental 
disabilities
	
152.28
152.29	section 158.17
	defective persons
	persons with developmental 
disabilities
	
152.30
152.31	section 158.18
	persons not defective
	persons without 
developmental disabilities
	
152.32
152.33		defective person
	person with developmental 
disabilities
	
152.34
152.35		defective persons
	persons with developmental 
disabilities
	
152.36
152.37	section 158.19
	defective
	person with developmental 
disabilities
	
152.38
152.39	section 256.94
	defective
	children with developmental 
disabilities and
	
153.1
153.2	section 257.175
	defective
	children with developmental 
disabilities and
	
153.3	part 2911.1350
	retardation
	developmental disability
	
153.4 	(b) The revisor of statutes shall change the term "health and safety" to "health and 
153.5 	welfare" in the following statutes: Minnesota Statutes, sections 245D.03, 245D.061, 
153.6 	245D.071, 245D.10, 245D.11, 245D.31, 256B.0915, and 256B.092.

153.7 	ARTICLE 6
153.8 	MISCELLANEOUS

153.9 	Section 1. Minnesota Statutes 2013 Supplement, section 16A.724, subdivision 2, 
153.10 	is amended to read:
153.11 		Subd. 2.Transfers. (a) Notwithstanding section 295.581, to the extent available 
153.12 	resources in the health care access fund exceed expenditures in that fund, effective for 
153.13 	the biennium beginning July 1, 2007, the commissioner of management and budget shall 
153.14 	transfer the excess funds from the health care access fund to the general fund on June 30 
153.15 	of each year, provided that the amount transferred in any fiscal biennium shall not exceed 
153.16 	$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws 
153.17 	2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
153.18 	(b) For fiscal years 2006 to 2011 year 2018 and thereafter, MinnesotaCare shall be a 
153.19 	forecasted program, and, if necessary, the commissioner shall reduce these transfers from 
153.20 	the health care access fund to the general fund to meet annual MinnesotaCare expenditures 
153.21 	or, if necessary, transfer sufficient funds from the general fund to the health care access 
153.22 	fund to meet annual MinnesotaCare expenditures.
153.23 	(c) Notwithstanding section 295.581, to the extent available resources in the health 
153.24 	care access fund exceed expenditures in that fund after the transfer required in paragraph 
153.25 	(a), effective for the biennium beginning July 1, 2013, the commissioner of management 
153.26 	and budget shall transfer $1,000,000 each fiscal year from the health access fund to 
153.27 	the medical education and research costs fund established under section 62J.692, for 
153.28 	distribution under section 62J.692, subdivision 4, paragraph (c).

153.29 	Sec. 2. Minnesota Statutes 2012, section 254B.12, is amended to read:
153.30 	254B.12 RATE METHODOLOGY.
153.31 		Subdivision 1.CCDTF rate methodology established. The commissioner shall 
153.32 	establish a new rate methodology for the consolidated chemical dependency treatment 
153.33 	fund. The new methodology must replace county-negotiated rates with a uniform 
154.1 	statewide methodology that must include a graduated reimbursement scale based on the 
154.2 	patients' level of acuity and complexity. At least biennially, the commissioner shall review 
154.3 	the financial information provided by vendors to determine the need for rate adjustments.
154.4 		Subd. 2.Payment methodology for highly specialized vendors. (a) 
154.5 	Notwithstanding subdivision 1, the commissioner shall seek federal authority to develop 
154.6 	a separate payment methodology for chemical dependency treatment services provided 
154.7 	under the consolidated chemical dependency treatment fund for persons who have been 
154.8 	civilly committed to the commissioner, present the most complex and difficult care needs, 
154.9 	and are a potential threat to the community. This payment methodology is effective 
154.10 	for services provided on or after October 1, 2015, or on or after the receipt of federal 
154.11 	approval, whichever is later.
154.12 	(b) Before implementing an approved payment methodology under paragraph 
154.13 	(a), the commissioner must also receive any necessary legislative approval of required 
154.14 	changes to state law or funding.

154.15 	Sec. 3. Minnesota Statutes 2012, section 256I.04, subdivision 2b, is amended to read:
154.16 		Subd. 2b.Group residential housing agreements. (a) Agreements between county 
154.17 	agencies and providers of group residential housing must be in writing and must specify 
154.18 	the name and address under which the establishment subject to the agreement does 
154.19 	business and under which the establishment, or service provider, if different from the 
154.20 	group residential housing establishment, is licensed by the Department of Health or the 
154.21 	Department of Human Services; the specific license or registration from the Department 
154.22 	of Health or the Department of Human Services held by the provider and the number 
154.23 	of beds subject to that license; the address of the location or locations at which group 
154.24 	residential housing is provided under this agreement; the per diem and monthly rates that 
154.25 	are to be paid from group residential housing funds for each eligible resident at each 
154.26 	location; the number of beds at each location which are subject to the group residential 
154.27 	housing agreement; whether the license holder is a not-for-profit corporation under section 
154.28 	501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to 
154.29 	the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections. 
154.30 	Group residential housing agreements may be terminated with or without cause by either 
154.31 	the county or the provider with two calendar months prior notice.
154.32 	(b) The commissioner may enter directly into an agreement with a provider serving 
154.33 	veterans who meet the eligibility criteria of this section and reside in a setting according to 
154.34 	subdivision 2a, located in Stearns County. Responsibility for monitoring and oversight of 
154.35 	this setting shall remain with Stearns County. This agreement may be terminated with 
155.1 	or without cause by either the commissioner or the provider with two calendar months 
155.2 	prior notice. This agreement shall be subject to the requirements of county agreements 
155.3 	and negotiated rates in subdivisions 1, paragraphs (a) and (b), and 2, and sections 256I.05, 
155.4 	subdivisions 1 and 1c, and 256I.06, subdivision 7.

155.5 	EFFECTIVE DATE. This section is effective July 1, 2015.

155.6 	Sec. 4. Minnesota Statutes 2012, section 256I.05, subdivision 2, is amended to read:
155.7 		Subd. 2.Monthly rates; exemptions. The maximum group residential housing rate 
155.8 	does not apply This subdivision applies to a residence that on August 1, 1984, was licensed 
155.9 	by the commissioner of health only as a boarding care home, certified by the commissioner 
155.10 	of health as an intermediate care facility, and licensed by the commissioner of human 
155.11 	services under Minnesota Rules, parts 9520.0500 to 9520.0690. Notwithstanding the 
155.12 	provisions of subdivision 1c, the rate paid to a facility reimbursed under this subdivision 
155.13 	shall be determined under section 256B.431, or under section 256B.434 if the facility is 
155.14 	accepted by the commissioner for participation in the alternative payment demonstration 
155.15 	project. The rate paid to this facility shall also include adjustments to the group residential 
155.16 	housing rate according to subdivision 1, and any adjustments applicable to supplemental 
155.17 	service rates statewide.

155.18 	Sec. 5. Minnesota Statutes 2012, section 256J.49, subdivision 13, is amended to read:
155.19 		Subd. 13.Work activity. (a) "Work activity" means any activity in a participant's 
155.20 	approved employment plan that leads to employment. For purposes of the MFIP program, 
155.21 	this includes activities that meet the definition of work activity under the participation 
155.22 	requirements of TANF. Work activity includes:
155.23 	(1) unsubsidized employment, including work study and paid apprenticeships or 
155.24 	internships;
155.25 	(2) subsidized private sector or public sector employment, including grant diversion 
155.26 	as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid 
155.27 	work experience, and supported work when a wage subsidy is provided;
155.28 	(3) unpaid work experience, including community service, volunteer work, 
155.29 	the community work experience program as specified in section 256J.67, unpaid 
155.30 	apprenticeships or internships, and supported work when a wage subsidy is not provided. 
155.31 	Unpaid work experience is only an option if the participant has been unable to obtain or 
155.32 	maintain paid employment in the competitive labor market, and no paid work experience 
155.33 	programs are available to the participant. Prior to placing a participant in unpaid work, 
155.34 	the county must inform the participant that the participant will be notified if a paid work 
156.1 	experience or supported work position becomes available. Unless a participant consents in 
156.2 	writing to participate in unpaid work experience, the participant's employment plan may 
156.3 	only include unpaid work experience if including the unpaid work experience in the plan 
156.4 	will meet the following criteria:
156.5 	(i) the unpaid work experience will provide the participant specific skills or 
156.6 	experience that cannot be obtained through other work activity options where the 
156.7 	participant resides or is willing to reside; and
156.8 	(ii) the skills or experience gained through the unpaid work experience will result 
156.9 	in higher wages for the participant than the participant could earn without the unpaid 
156.10 	work experience;
156.11 	(4) job search including job readiness assistance, job clubs, job placement, 
156.12 	job-related counseling, and job retention services;
156.13 	(5) job readiness education, including English as a second language (ESL) or 
156.14 	functional work literacy classes as limited by the provisions of section 256J.531, 
156.15 	subdivision 2, general educational development (GED) or Minnesota adult diploma course 
156.16 	work, high school completion, and adult basic education as limited by the provisions of 
156.17 	section 256J.531, subdivision 1;
156.18 	(6) job skills training directly related to employment, including postsecondary 
156.19 	education and training that can reasonably be expected to lead to employment, as limited 
156.20 	by the provisions of section 256J.53;
156.21 	(7) providing child care services to a participant who is working in a community 
156.22 	service program;
156.23 	(8) activities included in the employment plan that is developed under section 
156.24 	256J.521, subdivision 3; and
156.25 	(9) preemployment activities including chemical and mental health assessments, 
156.26 	treatment, and services; learning disabilities services; child protective services; family 
156.27 	stabilization services; or other programs designed to enhance employability.
156.28 	(b) "Work activity" does not include activities done for political purposes as defined 
156.29 	in section 211B.01, subdivision 6.

156.30 	Sec. 6. Minnesota Statutes 2012, section 256J.53, subdivision 1, is amended to read:
156.31 		Subdivision 1.Length of program. (a) In order for a postsecondary education 
156.32 	or training program to be an approved work activity as defined in section 256J.49, 
156.33 	subdivision 13, clause (6), it must be a program lasting 24 monthsfour years or less, and 
156.34 	the participant must meet the requirements of subdivisions 2, 3, and 5.
157.1 	(b) Participants with a high school diploma, general educational development (GED) 
157.2 	credential, or Minnesota adult diploma must be informed of the opportunity to participate 
157.3 	in postsecondary education or training while in the Minnesota family investment program.

157.4 	Sec. 7. Minnesota Statutes 2012, section 256J.53, subdivision 2, is amended to read:
157.5 		Subd. 2.Approval of postsecondary education or training. (a) In order for a 
157.6 	postsecondary education or training program to be an approved activity in an employment 
157.7 	plan, the plan must include additional work activities if the education and training 
157.8 	activities do not meet the minimum hours required to meet the federal work participation 
157.9 	rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35.
157.10 	(b) Participants seeking approval of a who are interested in participating in
157.11 	 postsecondary education or training plan as part of their employment plan must provide 
157.12 	documentation that discuss their education plans with their job counselor. Job counselors 
157.13 	must work with participants to evaluate options by:
157.14 	(1) the employment goal can only be met with the additional education or training;
157.15 	(2)advising whether there are suitable employment opportunities that require the 
157.16 	specific education or training in the area in which the participant resides or is willing 
157.17 	to reside;
157.18 	(3) the education or training will result in significantly higher wages for the 
157.19 	participant than the participant could earn without the education or training;
157.20 	(4) (2)assisting the participant in exploring whether the participant can meet the 
157.21 	requirements for admission into the program; and
157.22 	(5) (3)there is a reasonable expectation that the participant will complete the training 
157.23 	program discussing the participant's strengths and challenges based on such factors as the 
157.24 	participant's MFIP assessment, previous education, training, and work history; current 
157.25 	motivation; and changes in previous circumstances.
157.26 	(b) The requirements of this subdivision do not apply to participants who are in:
157.27 	(1) a recognized career pathway program that leads to stackable credentials;
157.28 	(2) a training program lasting 12 weeks or less; or
157.29 	(3) the final year of a multi-year postsecondary education or training program.

157.30 	Sec. 8. Minnesota Statutes 2012, section 256J.53, subdivision 5, is amended to read:
157.31 		Subd. 5.Requirements after postsecondary education or training. Upon 
157.32 	completion of an approved education or training program, a participant who does not meet 
157.33 	the participation requirements in section 256J.55, subdivision 1, through unsubsidized 
157.34 	employment must participate in job search. If, after six12 weeks of job search, the 
158.1 	participant does not find a full-time job consistent with the employment goal, the 
158.2 	participant must accept any offer of full-time suitable employment, or meet with the job 
158.3 	counselor to revise the employment plan to include additional work activities necessary to 
158.4 	meet hourly requirements.

158.5 	Sec. 9. Minnesota Statutes 2012, section 256J.531, is amended to read:
158.6 	256J.531 BASIC EDUCATION; ENGLISH AS A SECOND LANGUAGE.
158.7 		Subdivision 1.Approval of adult basic education. With the exception of classes 
158.8 	related to obtaining a general educational development credential (GED), a participant 
158.9 	must have reading or mathematics proficiency below a ninth grade level in order for adult 
158.10 	basic education classes to be anA participant who lacks a high school diploma, general 
158.11 	educational development (GED) credential, or Minnesota adult diploma must be allowed 
158.12 	to pursue these credentials as an approved work activity, provided that the participant 
158.13 	is making satisfactory progress. Participants eligible to pursue a general educational 
158.14 	development (GED) credential or Minnesota adult diploma under this subdivision must 
158.15 	be informed of the opportunity to participate while in the Minnesota family investment 
158.16 	program. The employment plan must also specify that the participant fulfill no more than 
158.17 	one-half of the participation requirements in section 256J.55, subdivision 1, through 
158.18 	attending adult basic education or general educational development classes.
158.19 		Subd. 2.Approval of English as a second language. In order for English as a 
158.20 	second language (ESL) classes to be an approved work activity in an employment plan, a 
158.21 	participant must be below a spoken language proficiency level of SPL6 or its equivalent, 
158.22 	as measured by a nationally recognized test. In approving ESL as a work activity, the job 
158.23 	counselor must give preference to enrollment in a functional work literacy program, 
158.24 	if one is available, over a regular ESL program. A participant may not be approved 
158.25 	for more than a combined total of 24 months of ESL classes while participating in the 
158.26 	diversionary work program and the employment and training services component of 
158.27 	MFIP. The employment plan must also specify that the participant fulfill no more than 
158.28 	one-half of the participation requirements in section 256J.55, subdivision 1, through 
158.29 	attending ESL classes. For participants enrolled in functional work literacy classes, no 
158.30 	more than two-thirds of the participation requirements in section 256J.55, subdivision 1, 
158.31 	may be met through attending functional work literacy classes.

158.32 	Sec. 10. Laws 2013, chapter 108, article 3, section 48, is amended to read:
158.33 	Sec. 48. REPEALER.
 159.1 	(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed January
159.2 	 July 1, 2015 2014.
159.3 	(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following 
159.4 	final enactment.

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

159.6 	Sec. 11. PARENT AWARE QUALITY RATING AND IMPROVEMENT 
159.7 	SYSTEM ACCESSIBILITY REPORT.
 159.8 		Subdivision 1.Recommendations. The commissioner of human services, in 
159.9 	consultation with representatives from the child care and early childhood advocacy 
159.10 	community, child care provider organizations, child care providers, organizations 
159.11 	administering Parent Aware, the Departments of Education and Health, counties, 
159.12 	and parents, shall make recommendations to the legislature on increasing statewide 
159.13 	accessibility for child care providers to the Parent Aware quality rating and improvement 
159.14 	system and for increasing access to Parent Aware-rated programs for families with 
159.15 	children. The recommendations must address the following factors impacting accessibility:
159.16 	(1) availability of rated and nonrated programs by child care provider type, within 
159.17 	rural and underserved areas, and for different cultural and non-English-speaking groups;
159.18 	(2) time and resources necessary for child care providers to participate in Parent 
159.19 	Aware at various rating levels, including cultural and linguistic considerations;
159.20 	(3) federal child care development fund regulations; and
159.21 	(4) other factors as determined by the commissioner.
159.22 		Subd. 2.Report. By February 15, 2015, the commissioner of human services 
159.23 	shall report to the legislative committees with jurisdiction over the child care 
159.24 	assistance programs and the Parent Aware quality rating and improvement system with 
159.25 	recommendations to increase access for families and child care providers to Parent Aware, 
159.26 	including benchmarks for achieving the maximum participation in Parent Aware-rated 
159.27 	child care programs by families receiving child care assistance. 
159.28 	The recommendations may also include, but are not limited to, potential 
159.29 	modifications to Minnesota Statutes, sections 119B.09, subdivision 5; and 119B.125, 
159.30 	subdivision 1, if necessary, which may include a delayed effective date, different phase-in 
159.31 	process, or repealer.

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

159.33 	Sec. 12. DIRECTION TO COMMISSIONER.
 160.1 	The commissioner of human services shall implement the repeal of the MFIP 
160.2 	family cap July 1, 2014. The commissioner shall make every effort to complete systems 
160.3 	modifications by that date. If systems modifications cannot be completed in time, the 
160.4 	commissioner shall implement a manual procedure to implement the change.

160.5 	Sec. 13. CIVIL COMMITMENT TRAINING PROGRAM.
 160.6 	The commissioner of human services shall develop an online training program for 
160.7 	interested individuals and personnel, specifically county and hospital staff and mental 
160.8 	health providers, to understand, clarify, and interpret the Civil Commitment Act under 
160.9 	Minnesota Statutes, chapter 253B, as it pertains to persons with mental illnesses. The 
160.10 	training must be developed in collaboration with the ombudsman for mental health 
160.11 	and developmental disabilities, Minnesota County Attorneys Association, National 
160.12 	Alliance on Mental Illness of Minnesota, Mental Health Consumer/Survivor Network 
160.13 	of Minnesota, State Advisory Council on Mental Health, Mental Health Association, 
160.14 	Minnesota Psychiatric Society, Hennepin Commitment Defense Panel, Minnesota 
160.15 	Disability Law Center, Minnesota Association of Community Mental Health Programs, 
160.16 	Minnesota Hospital Association, and Minnesota Board of Public Defense. The purpose of 
160.17 	the training is to promote better clarity and interpretation of the civil commitment laws.

160.18 	Sec. 14. DIRECTION TO COMMISSIONER; REPORT ON PROGRAM 
160.19 	WAITING LISTS.
 160.20 	In preparing background materials for the 2016-2017 biennium, the commissioner 
160.21 	of human services shall prepare a listing of all of the waiting lists for services that the 
160.22 	department oversees and directs. The listing shall identify the number of persons on those 
160.23 	waiting lists as of October 1, 2014, an estimate of the cost of serving them based on 
160.24 	current average costs, and an estimate of the number of jobs that would be created given 
160.25 	current average levels of staffing if the waiting list were eliminated. The commissioner 
160.26 	is encouraged to engage postsecondary students in the assembly, analysis, and reporting 
160.27 	of this information. The information shall be provided to the governor, the chairs and 
160.28 	ranking minority members of the legislative committees with jurisdiction over health and 
160.29 	human services policy and finance, and the Legislative Reference Library in electronic 
160.30 	form by December 1, 2014.

160.31 	Sec. 15. MENTALLY ILL OFFENDERS ARRESTED OR SUBJECT TO 
160.32 	ARREST; WORKING GROUP.
 161.1 		Subdivision 1.Working group established; study and draft legislation required.
 161.2 	The commissioner of human services may convene a working group to address issues 
161.3 	related to offenders with mental illness who are arrested or subject to arrest. The working 
161.4 	group shall consider the special needs of these offenders and determine how best to 
161.5 	provide for these needs. Specifically, the group shall consider the efficacy of a facility 
161.6 	that would serve as a central point for accepting, assessing, and addressing the needs of 
161.7 	offenders with mental illness brought in by law enforcement as an alternative to arrest or 
161.8 	following arrest. The facility would consolidate and coordinate existing resources as well 
161.9 	as offer new resources that would provide a continuum of care addressing the immediate, 
161.10 	short-term, and long-term needs of these offenders. The facility would do the following for 
161.11 	these offenders: perform timely, credible, and useful mental health assessments; identify 
161.12 	community placement opportunities; coordinate community care; make recommendations 
161.13 	concerning pretrial release when appropriate; and, in some cases, provide direct services 
161.14 	to offenders at the facility or in nearby jails. The working group shall establish criteria 
161.15 	to determine which offenders may be admitted to the facility. The facility would be 
161.16 	located in the metropolitan region and serve the needs of nearby counties. The facility 
161.17 	would represent a partnership between the state, local units of government, and the private 
161.18 	sector. In addition, the working group may consider how similar facilities could function 
161.19 	in outstate areas. When studying this issue, the working group shall examine what other 
161.20 	states have done in this area to determine what programs have been successful and use 
161.21 	those programs as models in developing the program in Minnesota. The working group 
161.22 	may also study and make recommendations on other ways to improve the process for 
161.23 	addressing and assisting these offenders. The commissioner shall enter into an agreement 
161.24 	with NAMI Minnesota to carry out the work of the working group.
161.25 		Subd. 2.Membership. The commissioner shall ensure that the working group 
161.26 	has expertise and a broad range of interests represented, including, but not limited to: 
161.27 	prosecutors; law enforcement, including jail staff; correctional officials; probation 
161.28 	officials; criminal defense attorneys; judges; county and city officials; mental health 
161.29 	advocates; mental health professionals; and hospital and health care officials.
161.30 		Subd. 3.Administrative issues. (a) The commissioner shall convene the first 
161.31 	meeting of the working group by September 1, 2014. NAMI Minnesota shall provide 
161.32 	meeting space and administrative support to the working group. The working group shall 
161.33 	select a chair from among its members.
161.34 	(b) The commissioner may solicit in-kind support from work group member 
161.35 	agencies to accomplish its assigned duties.
162.1 		Subd. 4.Report required. By January 1, 2015, the working group shall submit a 
162.2 	report to the chairs and ranking minority members of the senate and house of representatives 
162.3 	committees and divisions having jurisdiction over human services and public safety. The 
162.4 	report must summarize the working group's activities and include its recommendations 
162.5 	and draft legislation. The recommendations must be specific and include estimates of the 
162.6 	costs involved in implementing the recommendations, including the funding sources that 
162.7 	might be used to pay for it. The working group shall explore potential funding sources 
162.8 	at the federal, local, and private levels, and provide this information in the report. In 
162.9 	addition, the report must include draft legislation to implement the recommendations.

162.10 	Sec. 16. DETOXIFICATION SERVICES; INSTRUCTIONS TO THE 
162.11 	COMMISSIONER.
 162.12 	The commissioner of human services shall develop a plan to include detoxification 
162.13 	services as a covered medical assistance benefit and present the plan to the legislature 
162.14 	by December 15, 2014.

162.15 	ARTICLE 7
162.16 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

162.17	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
162.18 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
162.19 	in parentheses, subtracted from the appropriations in Laws 2013, chapter 108, articles 14 
162.20 	and 15, to the agencies and for the purposes specified in this article. The appropriations 
162.21 	are from the general fund and are available for the fiscal years indicated for each purpose. 
162.22 	The figures "2014" and "2015" used in this article mean that the addition to or subtraction 
162.23 	from the appropriation listed under them is available for the fiscal year ending June 30, 
162.24 	2014, or June 30, 2015, respectively. Supplemental appropriations and reductions to 
162.25 	appropriations for the fiscal year ending June 30, 2014, are effective the day following 
162.26 	final enactment unless a different effective date is explicit.

162.27				APPROPRIATIONS
	
162.28				Available for the Year
	
162.29				Ending June 30
	
162.30					2014
		2015

162.31
162.32	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

162.33	Subdivision 1.Total Appropriation
 		785,000
		 73,849,000

163.1	Appropriations by Fund
	
163.2	General
	785,000
	 71,502,000
	
163.3	Federal TANF
	-0-
	 2,347,000
	
163.4 	The appropriation modifications for 
163.5 	each purpose are shown in the following 
163.6 	subdivisions.

163.7	Subd. 2.Central Office Operations

163.8	(a) Operations
		-0-
		 63,000
	
163.9 	Base adjustment. The general fund base is 
163.10 	decreased by $6,000 in fiscal years 2016 and 
163.11 	2017.

163.12	(b) Health Care
		-0-
		 113,000
	
163.13 	Base adjustment. The general fund base is 
163.14 	increased by $108,000 in fiscal years 2016 
163.15 	and 2017.

163.16	(c) Continuing Care
		-0-
		1,084,000
	
163.17 	Base adjustment. The general fund base is 
163.18 	increased by $156,000 in fiscal year 2016 
163.19 	and $19,000 in fiscal year 2017.

163.20	(d) Chemical and Mental Health
		-0-
		115,000

163.21	Subd. 3.Forecasted Programs

163.22	(a) MFIP/DWP

163.23	Appropriations by Fund
	
163.24	General
	-0-
	122,000
	
163.25	Federal TANF
	-0-
	 1,995,000

								

163.26	(b) Group Residential Housing
		-0-
		681,000

163.27	(c) Medical Assistance
		800,000
		63,744,000

163.28	(d) Alternative Care
		-0-
		772,000

163.29	Subd. 4.Grant Programs

164.1	(a) Children's Services Grants
		-0-
		(3,000)
	
164.2 	Base adjustment. The general fund base is 
164.3 	increased by $9,000 in fiscal year 2017.

164.4	(b) Child and Economic Support Grants
		-0-
		1,669,000
	
164.5 	Safe harbor.  $569,000 in fiscal year 2015 
164.6 	from the general fund is for housing and 
164.7 	supportive services for sexually exploited 
164.8 	youth.
164.9 	Homeless youth.  $1,100,000 in fiscal year 
164.10 	2015 is for purposes of Minnesota Statutes, 
164.11 	section 256K.45.

164.12	(c) Aging and Adult Services Grants
		(15,000)
		1,180,000
	
164.13 	Senior nutrition.  $425,000 in fiscal year 
164.14 	2015 from the general fund is for congregate 
164.15 	dining services under Minnesota Statutes, 
164.16 	section 256.9752.
164.17 	Base adjustment. The general fund base is 
164.18 	decreased by $429,000 in fiscal year 2016 
164.19 	and $419,000 in fiscal year 2017.

164.20	(d) Deaf and Hard-of-Hearing Grants
		-0-
		66,000
	
164.21 	Base adjustment. The general fund base is 
164.22 	increased by $6,000 in fiscal years 2016 and 
164.23 	2017.

164.24	(e) Disabilities Grants
		-0-
		1,015,000
	
164.25 	Base adjustment. The general fund base is 
164.26 	increased by $224,000 in fiscal year 2016 
164.27 	and $233,000 in fiscal year 2017.

164.28	Subd. 5.State-Operated Services

164.29	(a) SOS Mental Health
		-0-
		881,000
	
164.30 	Civil commitments. $35,000 in fiscal year 
164.31 	2015 is for developing an online training 
165.1 	program to help interested parties understand 
165.2 	the civil commitment process.
165.3 	Base adjustment. The general fund base is 
165.4 	increased by $213,000 in fiscal years 2016 
165.5 	and 2017.

165.6	(b) SOS Enterprise Services
		-0-
		-0-
	
165.7 	Community Addiction Recovery 
165.8 	Enterprise deficiency funding.
165.9 	Notwithstanding Minnesota Statutes, section 
165.10 	254B.06, subdivision 1, $4,000,000 is 
165.11 	transferred in fiscal years 2014 and 2015 
165.12 	from the consolidated chemical dependency 
165.13 	treatment fund administrative account in the 
165.14 	special revenue fund and deposited into the 
165.15 	enterprise fund for the Community Addiction 
165.16 	Recovery Enterprise. This clause is effective 
165.17 	the day following final enactment.

165.18	Subd. 6.Technical Activities

165.19	MFIP Child Care Assistance

165.20	Appropriations by Fund
	
165.21	Federal TANF
	-0-
	352,000

165.22	Sec. 3. COMMISSIONER OF HEALTH.

165.23	Subdivision 1.Total Appropriation
 	$
	967,000
	$
	 1,801,000

165.24	Appropriations by Fund
	
165.25		2014
	2015
	
165.26	General
	1,150,000
	 1,994,000
	
165.27
165.28	State Government 
Special Revenue
	817,000
	 807,000
	
165.29	Health Care Access
	(1,000,000)
	(1,000,000)

165.30	Subd. 2.Health Improvement

165.31	Appropriations by Fund
	
165.32	General
	75,000
	 1,819,000
	
165.33 	Poison information centers. $750,000 
165.34 	in fiscal year 2015 from the general fund 
166.1 	is for regional poison information centers 
166.2 	under Minnesota Statutes, section 145.93, 
166.3 	and is added to the base. The appropriation 
166.4 	is (1) to enhance staffing to meet national 
166.5 	accreditation standards; (2) for health care 
166.6 	provider education and training; (3) for 
166.7 	surveillance of emerging toxicology and 
166.8 	poison issues; and (4) to cooperate with local 
166.9 	public health officials on outreach efforts.
166.10 	Minority health disparity grants. $100,000 
166.11 	in fiscal year 2014 and $475,000 in fiscal 
166.12 	year 2015 are for the commissioner of health 
166.13 	to begin implementing recommendations of 
166.14 	the health equity report under Laws 2013, 
166.15 	chapter 108, article 12, section 102. This 
166.16 	funding is onetime and shall not become part 
166.17 	of base funding. Funds must be distributed 
166.18 	as follows:
166.19 	(1) $100,000 in fiscal year 2014 and 
166.20 	$100,000 in fiscal year 2015 are for dementia 
166.21 	outreach education and training grants 
166.22 	targeting minority communities under article 
166.23 	1, section 7;
166.24 	(2) $75,000 in fiscal year 2015 is for planning 
166.25 	and conducting a training conference on 
166.26 	immigrant and refugee mental health issues. 
166.27 	The conference shall include an emphasis 
166.28 	on mental health concerns in the Somali 
166.29 	community. Conference planning shall 
166.30 	include input from the Somali community 
166.31 	and other stakeholders. This is a onetime 
166.32 	appropriation;
166.33 	(3) up to $150,000 in fiscal year 2015 is 
166.34 	for additional grants, including but not 
166.35 	limited to a grant to a Somali women-led 
167.1 	health care agency. Grantees must use 
167.2 	community-based, participatory research to 
167.3 	address health inequities and provide services 
167.4 	through culturally specific, minority-centered 
167.5 	programs; and
167.6 	(4) remaining funds shall be used for 
167.7 	redesigning agency grant making to advance 
167.8 	health equity, ensuring that health equity and 
167.9 	the analysis of structural inequities become 
167.10 	integral aspects of all agency divisions and 
167.11 	programs, and awarding additional grants to 
167.12 	address health equity issues.
167.13 	Safe harbor. $569,000 in fiscal year 
167.14 	2015 from the general fund is for grants 
167.15 	for comprehensive services, including 
167.16 	trauma-informed, culturally specific 
167.17 	services, for sexually exploited youth. The 
167.18 	commissioner shall use no more than 6.67 
167.19 	percent of these funds for administration of 
167.20 	the grants.
167.21 	Base level adjustment. The general fund 
167.22 	base for fiscal year 2016 is $47,619,000. 
167.23 	The general fund base for fiscal year 2017 
167.24 	is $47,669,000.

167.25	Subd. 3.Policy Quality and Compliance

167.26	Appropriations by Fund
	
167.27	General
	-0-
	75,000
	
167.28
167.29	State Government 
Special Revenue
	-0-
	 143,000
	
167.30	Health Care Access
	(1,000,000)
	(1,000,000)
	
167.31 	Legislative health care workforce 
167.32 	commission. $75,000 in fiscal year 2015 is 
167.33 	for the health care workforce commission 
167.34 	in article 1, section 6. This is a onetime 
167.35 	appropriation.
168.1 	Spoken language health care interpreters. 
168.2 	$81,000 in fiscal year 2015 from the state 
168.3 	government special revenue fund is to 
168.4 	develop a proposal to promote health equity 
168.5 	and quality health outcomes through changes 
168.6 	to laws governing spoken language health 
168.7 	care interpreters.  The commissioner shall 
168.8 	consult with spoken language health care 
168.9 	interpreters, organizations that employ 
168.10 	these interpreters, organizations that pay for 
168.11 	interpreter services, health care providers 
168.12 	who use interpreters, clients who use 
168.13 	interpreters, and community organizations 
168.14 	serving non-English speaking populations.  
168.15 	The commissioner shall draft legislation 
168.16 	and submit a report that documents the 
168.17 	process followed and the rationale for 
168.18 	the recommendations to the committees 
168.19 	with jurisdiction over health and human 
168.20 	services by January 15, 2015.  In drafting the 
168.21 	legislation and report, the commissioner must 
168.22 	consider input received from individuals and 
168.23 	organizations consulted and must address 
168.24 	issues related to:
168.25 	(1) qualifications for spoken language health 
168.26 	care interpreters that assure quality service to 
168.27 	health care providers and their patients;
168.28 	(2) methods to support the education and 
168.29 	skills development of spoken language health 
168.30 	care interpreters serving Minnesotans;
168.31 	(3) the role of an advisory council in 
168.32 	maintaining a quality system for spoken 
168.33 	language health care interpreting in 
168.34 	Minnesota;
169.1 	(4) management of complaints regarding 
169.2 	spoken language health care interpreters, 
169.3 	including investigation and enforcement 
169.4 	actions;
169.5 	(5) an appropriate structure for oversight of 
169.6 	spoken language health care interpreters, 
169.7 	including administrative and technology 
169.8 	requirements; and
169.9 	(6) other issues that address qualifications, 
169.10 	quality, access, and affordability of spoken 
169.11 	language interpreter services.
169.12 	This is a onetime appropriation.
169.13 	Base level adjustment. The state 
169.14 	government special revenue fund base 
169.15 	for fiscal years 2016 and 2017 shall be 
169.16 	$16,529,000.

169.17	Subd. 4.Health Protection

169.18	Appropriations by Fund
	
169.19	General
	100,000
	100,000
	
169.20
169.21	State Government 
Special Revenue
	817,000
	648,000
	
169.22 	Healthy housing. $100,000 in fiscal years 
169.23 	2014 and 2015 from the general fund are 
169.24 	for education and training grants under 
169.25 	Minnesota Statutes, section 144.9513, 
169.26 	subdivision 3, and are added to the base.

169.27	Subd. 5.Administrative Support Services
 		975,000
		16,000

169.28	Appropriations by Fund
	
169.29	General
	975,000
	-0-
	
169.30
169.31	State Government 
Special Revenue
	-0-
	16,000
	
169.32 	Lawsuit settlement. In fiscal year 2014, 
169.33 	$975,000 from the general fund is a onetime 
169.34 	appropriation for the cost of settling the 
169.35 	lawsuit Bearder v. State.

170.1
170.2
170.3	Sec. 4. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	100,000
	$
	100,000

170.4 	Sec. 5. Laws 2013, chapter 1, section 6, as amended by Laws 2013, chapter 108, 
170.5 	article 6, section 32, is amended to read:
170.6 	Sec. 6. TRANSFER.
 170.7 	(a) The commissioner of management and budget shall transfer from the health care 
170.8 	access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000 
170.9 	in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal 
170.10 	year 2017.
170.11 	(b) The commissioner of human services shall determine the difference between the 
170.12 	actual or forecasted cost to the medical assistance program of adding 19- and 20-year-olds 
170.13 	and parents and relative caretaker populations with income between 100 and 138 percent of 
170.14 	the federal poverty guidelines and the cost of adding those populations that was estimated 
170.15 	during the 2013 legislative session based on the data from the February 2013 forecast.
170.16 	(c) For each fiscal year from 2014 to 2017, the commissioner of human services shall 
170.17 	certify and report to the commissioner of management and budget the actual or forecasted
170.18 	 estimated  cost difference of adding 19- and 20-year-olds and parents and relative caretaker 
170.19 	populations with income between 100 and 138 percent of the federal poverty guidelines, 
170.20 	as determined under paragraph (b), to the commissioner of management and budget at 
170.21 	least four weeks prior to the release of a forecast under Minnesota Statutes, section 
170.22 	16A.103, of each fiscal year.
170.23 	(d) No later than three weeks before the release of the forecast For fiscal years 2014 to 
170.24 	2017, forecasts  under Minnesota Statutes, section 16A.103, prepared by the commissioner 
170.25 	of management and budget shall reduce the include actual or estimated adjustments to 
170.26 	health care access fund transfer transfers  in paragraph (a), by the cumulative differences in 
170.27 	costs reported by the commissioner of human services under according to  paragraph (c)
170.28 	 (e). If, for any fiscal year, the amount of the cumulative cost differences determined under 
170.29 	paragraph (b) is positive, no change is made to the appropriation. If, for any fiscal year, 
170.30 	the amount of the cumulative cost differences determined under paragraph (b) is less than 
170.31 	the amount of the original appropriation, the appropriation for that year must be zero.
170.32 	(e) For each fiscal year from 2014 to 2017, the commissioner of management and 
170.33 	budget must adjust the transfer amounts in paragraph (a) by the cumulative difference in 
170.34 	costs reported by the commissioner of human services under paragraph (c). If, for any 
170.35 	fiscal year, the amount of the cumulative difference in costs reported under paragraph (c) 
170.36 	is positive, no adjustment shall be made.

171.1 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

171.2 	Sec. 6. Laws 2013, chapter 108, article 14, section 2, subdivision 5, is amended to read:

171.3	Subd. 5.Forecasted Programs
 					
171.4 	The amounts that may be spent from this 
171.5 	appropriation for each purpose are as follows:

171.6	(a) MFIP/DWP

171.7	Appropriations by Fund
	
171.8	General
	72,583,000
	76,927,000
	
171.9	Federal TANF
	80,342,000
	76,851,000

171.10	(b) MFIP Child Care Assistance
		61,701,000
		69,294,000

171.11	(c) General Assistance
		54,787,000
		56,068,000
	
171.12 	General Assistance Standard. The 
171.13 	commissioner shall set the monthly standard 
171.14 	of assistance for general assistance units 
171.15 	consisting of an adult recipient who is 
171.16 	childless and unmarried or living apart 
171.17 	from parents or a legal guardian at $203. 
171.18 	The commissioner may reduce this amount 
171.19 	according to Laws 1997, chapter 85, article 
171.20 	3, section 54.
171.21 	Emergency General Assistance. The 
171.22 	amount appropriated for emergency general 
171.23 	assistance funds is limited to no more 
171.24 	than $6,729,812 in fiscal year 2014 and 
171.25 	$6,729,812 in fiscal year 2015. Funds 
171.26 	to counties shall be allocated by the 
171.27 	commissioner using the allocation method in 
171.28 	Minnesota Statutes, section 256D.06.

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

171.30	(e) Group Residential Housing
		141,138,000
		150,988,000

171.31	(f) MinnesotaCare
		297,707,000
		247,284,000
	
172.1 	This appropriation is from the health care 
172.2 	access fund.

172.3	(g) Medical Assistance

172.4	Appropriations by Fund
	
172.5	General
	4,443,768,000
	4,431,612,000
	
172.6	Health Care Access
	179,550,000
	226,081,000
	
172.7 	Base Adjustment. The health care access 
172.8 	fund base is $221,035,000 in fiscal year 2016 
172.9 	and $221,035,000 in fiscal year 2017.
172.10 	Spending to be apportioned. The 
172.11 	commissioner shall apportion expenditures 
172.12 	under this paragraph consistent with the 
172.13 	requirements of section 12.
172.14 	Support Services for Deaf and 
172.15 	Hard-of-Hearing. $121,000 in fiscal 
172.16 	year 2014 and $141,000 in fiscal year 2015; 
172.17 	and $10,000 in fiscal year 2014 and $13,000 
172.18 	in fiscal year 2015 are from the health care 
172.19 	access fund for the hospital reimbursement 
172.20 	increase in Minnesota Statutes, section 
172.21 	256.969, subdivision 29, paragraph (b).
172.22 	Disproportionate Share Payments.
172.23 	Effective for services provided on or after 
172.24 	July 1, 2011, through June 30, 2015, the 
172.25 	commissioner of human services shall 
172.26 	deposit, in the health care access fund, 
172.27 	additional federal matching funds received 
172.28 	under Minnesota Statutes, section 256B.199, 
172.29 	paragraph (e), as disproportionate share 
172.30 	hospital payments for inpatient hospital 
172.31 	services provided under MinnesotaCare to 
172.32 	lawfully present noncitizens who are not 
172.33 	eligible for MinnesotaCare with federal 
172.34 	financial participation due to immigration 
173.1 	status. The amount deposited shall not exceed 
173.2 	$2,200,000 for the time period specified.
173.3 	Funding for Services Provided to EMA 
173.4 	Recipients. $2,200,000 in fiscal year 2014 is 
173.5 	from the health care access fund to provide 
173.6 	services to emergency medical assistance 
173.7 	recipients under Minnesota Statutes, section 
173.8 	256B.06, subdivision 4, paragraph (l). This 
173.9 	is a onetime appropriation and is available in 
173.10 	either year of the biennium.

173.11	(h) Alternative Care
		50,776,000
		54,922,000
	
173.12 	Alternative Care Transfer. Any money 
173.13 	allocated to the alternative care program that 
173.14 	is not spent for the purposes indicated does 
173.15 	not cancel but shall be transferred to the 
173.16 	medical assistance account.

173.17	(i) CD Treatment Fund
		81,440,000
		74,875,000
	
173.18 	Balance Transfer. The commissioner must 
173.19 	transfer $18,188,000 from the consolidated 
173.20 	chemical dependency treatment fund to the 
173.21 	general fund by September 30, 2013.

173.22 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

173.23 	Sec. 7. Laws 2013, chapter 108, article 14, section 2, subdivision 6, as amended by 
173.24 	Laws 2013, chapter 144, section 25, is amended to read:

173.25	Subd. 6.Grant Programs
 					
173.26 	The amounts that may be spent from this 
173.27 	appropriation for each purpose are as follows:

173.28	(a) Support Services Grants

173.29	Appropriations by Fund
	
173.30	General
	8,915,000
	13,333,000
	
173.31	Federal TANF
	94,611,000
	94,611,000
	
174.1 	Paid Work Experience. $2,168,000 
174.2 	each year in fiscal years 2015 and 2016 
174.3 	is from the general fund for paid work 
174.4 	experience for long-term MFIP recipients. 
174.5 	Paid work includes full and partial wage 
174.6 	subsidies and other related services such as 
174.7 	job development, marketing, preworksite 
174.8 	training, job coaching, and postplacement 
174.9 	services. These are onetime appropriations. 
174.10 	Unexpended funds for fiscal year 2015 do not 
174.11 	cancel, but are available to the commissioner 
174.12 	for this purpose in fiscal year 2016.
174.13 	Work Study Funding for MFIP 
174.14 	Participants. $250,000 each year in fiscal 
174.15 	years 2015 and 2016 is from the general fund 
174.16 	to pilot work study jobs for MFIP recipients 
174.17 	in approved postsecondary education 
174.18 	programs. This is a onetime appropriation. 
174.19 	Unexpended funds for fiscal year 2015 do 
174.20 	not cancel, but are available for this purpose 
174.21 	in fiscal year 2016.
174.22 	Local Strategies to Reduce Disparities.
174.23 	$2,000,000 each year in fiscal years 2015 
174.24 	and 2016 is from the general fund for 
174.25 	local projects that focus on services for 
174.26 	subgroups within the MFIP caseload 
174.27 	who are experiencing poor employment 
174.28 	outcomes. These are onetime appropriations. 
174.29 	Unexpended funds for fiscal year 2015 do not 
174.30 	cancel, but are available to the commissioner 
174.31 	for this purpose in fiscal year 2016.
174.32 	Home Visiting Collaborations for MFIP 
174.33 	Teen Parents. $200,000 per year in fiscal 
174.34 	years 2014 and 2015 is from the general fund 
174.35 	and $200,000 in fiscal year 2016 is from the 
175.1 	federal TANF fund for technical assistance 
175.2 	and training to support local collaborations 
175.3 	that provide home visiting services for 
175.4 	MFIP teen parents. The general fund 
175.5 	appropriation is onetime. The federal TANF 
175.6 	fund appropriation is added to the base.
175.7 	Performance Bonus Funds for Counties.
175.8 	The TANF fund base is increased by 
175.9 	$1,500,000 each year in fiscal years 2016 
175.10 	and 2017. The commissioner must allocate 
175.11 	this amount each year to counties that exceed 
175.12 	their expected range of performance on the 
175.13 	annualized three-year self-support index 
175.14 	as defined in Minnesota Statutes, section 
175.15 	256J.751, subdivision 2, clause (6). This is a 
175.16 	permanent base adjustment. Notwithstanding 
175.17 	any contrary provisions in this article, this 
175.18 	provision expires June 30, 2016.
175.19 	Base Adjustment. The general fund base is 
175.20 	decreased by $200,000 in fiscal year 2016 
175.21 	and $4,618,000 in fiscal year 2017. The 
175.22 	TANF fund base is increased by $1,700,000 
175.23 	in fiscal years 2016 and 2017.

175.24
175.25	(b) Basic Sliding Fee Child Care Assistance 
Grants
		36,836,000
		42,318,000
	
175.26 	Base Adjustment. The general fund base is 
175.27 	increased by $3,778,000 in fiscal year 2016 
175.28 	and by $3,849,000 in fiscal year 2017.

175.29	(c) Child Care Development Grants
		1,612,000
		1,737,000

175.30	(d) Child Support Enforcement Grants
		50,000
		50,000
	
175.31 	Federal Child Support Demonstration 
175.32 	Grants. Federal administrative 
175.33 	reimbursement resulting from the federal 
175.34 	child support grant expenditures authorized 
175.35 	under United States Code, title 42, section 
176.1 	1315, is appropriated to the commissioner 
176.2 	for this activity.

176.3	(e) Children's Services Grants

176.4	Appropriations by Fund
	
176.5	General
	49,760,000
	52,961,000
	
176.6	Federal TANF
	140,000
	140,000
	
176.7 	Adoption Assistance and Relative Custody 
176.8 	Assistance.$37,453,000 $36,456,000
176.9 	 in fiscal year 2014 and $37,453,000
176.10 	 $36,855,000 in fiscal year 2015 is for the 
176.11 	adoption assistance and relative custody 
176.12 	assistance programs. The commissioner 
176.13 	shall determine with the commissioner of 
176.14 	Minnesota Management and Budget the 
176.15 	appropriation for Northstar Care for Children 
176.16 	effective January 1, 2015. The commissioner 
176.17 	may transfer appropriations for adoption 
176.18 	assistance, relative custody assistance, and 
176.19 	Northstar Care for Children between fiscal 
176.20 	years and among programs to adjust for 
176.21 	transfers across the programs.
176.22 	Title IV-E Adoption Assistance. Additional 
176.23 	federal reimbursements to the state as a result 
176.24 	of the Fostering Connections to Success 
176.25 	and Increasing Adoptions Act's expanded 
176.26 	eligibility for Title IV-E adoption assistance 
176.27 	are appropriated for postadoption services, 
176.28 	including a parent-to-parent support network.
176.29 	Privatized Adoption Grants. Federal 
176.30 	reimbursement for privatized adoption grant 
176.31 	and foster care recruitment grant expenditures 
176.32 	is appropriated to the commissioner for 
176.33 	adoption grants and foster care and adoption 
176.34 	administrative purposes.
177.1 	Adoption Assistance Incentive Grants.
177.2 	Federal funds available during fiscal years 
177.3 	2014 and 2015 for adoption incentive grants 
177.4 	are appropriated for postadoption services, 
177.5 	including a parent-to-parent support network.
177.6 	Base Adjustment. The general fund base is 
177.7 	increased by $5,913,000 in fiscal year 2016 
177.8 	and by $10,297,000 in fiscal year 2017.

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

177.10	(g) Child and Economic Support Grants
		21,047,000
		20,848,000
	
177.11 	Minnesota Food Assistance Program. 
177.12 	Unexpended funds for the Minnesota food 
177.13 	assistance program for fiscal year 2014 do 
177.14 	not cancel but are available for this purpose 
177.15 	in fiscal year 2015.
177.16 	Transitional Housing. $250,000 each year 
177.17 	is for the transitional housing programs under 
177.18 	Minnesota Statutes, section 256E.33.
177.19 	Emergency Services. $250,000 each year 
177.20 	is for emergency services grants under 
177.21 	Minnesota Statutes, section 256E.36.
177.22 	Family Assets for Independence. $250,000 
177.23 	each year is for the Family Assets for 
177.24 	Independence Minnesota program. This 
177.25 	appropriation is available in either year of the 
177.26 	biennium and may be transferred between 
177.27 	fiscal years.
177.28 	Food Shelf Programs. $375,000 in fiscal 
177.29 	year 2014 and $375,000 in fiscal year 
177.30 	2015 are for food shelf programs under 
177.31 	Minnesota Statutes, section 256E.34. If the 
177.32 	appropriation for either year is insufficient, 
177.33 	the appropriation for the other year is 
177.34 	available for it. Notwithstanding Minnesota 
178.1 	Statutes, section 256E.34, subdivision 4, no 
178.2 	portion of this appropriation may be used 
178.3 	by Hunger Solutions for its administrative 
178.4 	expenses, including but not limited to rent 
178.5 	and salaries.
178.6 	Homeless Youth Act. $2,000,000 in fiscal 
178.7 	year 2014 and $2,000,000 in fiscal year 2015 
178.8 	is for purposes of Minnesota Statutes, section 
178.9 	256K.45.
178.10 	Safe Harbor Shelter and Housing. 
178.11 	$500,000 in fiscal year 2014 and $500,000 in 
178.12 	fiscal year 2015 is for a safe harbor shelter 
178.13 	and housing fund for housing and supportive 
178.14 	services for youth who are sexually exploited.
178.15 	High-risk adults. $200,000 in fiscal 
178.16 	year 2014 is for a grant to the nonprofit 
178.17 	organization selected to administer the 
178.18 	demonstration project for high-risk adults 
178.19 	under Laws 2007, chapter 54, article 1, 
178.20 	section 19, in order to complete the project. 
178.21 	This is a onetime appropriation.

178.22	(h) Health Care Grants

178.23	Appropriations by Fund
	
178.24	General
	190,000
	190,000
	
178.25	Health Care Access
	190,000
	190,000
	
178.26 	Emergency Medical Assistance Referral 
178.27 	and Assistance Grants. (a) The 
178.28 	commissioner of human services shall 
178.29 	award grants to nonprofit programs that 
178.30 	provide immigration legal services based 
178.31 	on indigency to provide legal services for 
178.32 	immigration assistance to individuals with 
178.33 	emergency medical conditions or complex 
178.34 	and chronic health conditions who are not 
178.35 	currently eligible for medical assistance 
179.1 	or other public health care programs, but 
179.2 	who may meet eligibility requirements with 
179.3 	immigration assistance.
179.4 	(b) The grantees, in collaboration with 
179.5 	hospitals and safety net providers, shall 
179.6 	provide referral assistance to connect 
179.7 	individuals identified in paragraph (a) with 
179.8 	alternative resources and services to assist in 
179.9 	meeting their health care needs. $100,000 
179.10 	is appropriated in fiscal year 2014 and 
179.11 	$100,000 in fiscal year 2015. This is a 
179.12 	onetime appropriation.
179.13 	Base Adjustment. The general fund is 
179.14 	decreased by $100,000 in fiscal year 2016 
179.15 	and $100,000 in fiscal year 2017.

179.16	(i) Aging and Adult Services Grants
		14,827,000
		15,010,000
	
179.17 	Base Adjustment. The general fund is 
179.18 	increased by $1,150,000 in fiscal year 2016 
179.19 	and $1,151,000 in fiscal year 2017.
179.20 	Community Service Development 
179.21 	Grants and Community Services Grants.
179.22 	Community service development grants and 
179.23 	community services grants are reduced by 
179.24 	$1,150,000 each year. This is a onetime 
179.25 	reduction.

179.26	(j) Deaf and Hard-of-Hearing Grants
		1,771,000
		1,785,000

179.27	(k) Disabilities Grants
		18,605,000
		18,823,000
	
179.28 	Advocating Change Together. $310,000 in 
179.29 	fiscal year 2014 is for a grant to Advocating 
179.30 	Change Together (ACT) to maintain and 
179.31 	promote services for persons with intellectual 
179.32 	and developmental disabilities throughout 
179.33 	the state. This appropriation is onetime. Of 
179.34 	this appropriation:
180.1 	(1) $120,000 is for direct costs associated 
180.2 	with the delivery and evaluation of 
180.3 	peer-to-peer training programs administered 
180.4 	throughout the state, focusing on education, 
180.5 	employment, housing, transportation, and 
180.6 	voting;
180.7 	(2) $100,000 is for delivery of statewide 
180.8 	conferences focusing on leadership and 
180.9 	skill development within the disability 
180.10 	community; and
180.11 	(3) $90,000 is for administrative and general 
180.12 	operating costs associated with managing 
180.13 	or maintaining facilities, program delivery, 
180.14 	staff, and technology.
180.15 	Base Adjustment. The general fund base 
180.16 	is increased by $535,000 in fiscal year 2016 
180.17 	and by $709,000 in fiscal year 2017.

180.18	(l) Adult Mental Health Grants

180.19	Appropriations by Fund
	
180.20	General
	71,199,000
	69,530,000
	
180.21	Health Care Access
	750,000
	750,000
	
180.22	Lottery Prize
	1,733,000
	1,733,000
	
180.23 	Compulsive Gambling Treatment. Of the 
180.24 	general fund appropriation, $602,000 in 
180.25 	fiscal year 2014 and $747,000 in fiscal year 
180.26 	2015 are for compulsive gambling treatment 
180.27 	under Minnesota Statutes, section 297E.02, 
180.28 	subdivision 3, paragraph (c).
180.29 	Problem Gambling. $225,000 in fiscal year 
180.30 	2014 and $225,000 in fiscal year 2015 is 
180.31 	appropriated from the lottery prize fund for a 
180.32 	grant to the state affiliate recognized by the 
180.33 	National Council on Problem Gambling. The 
180.34 	affiliate must provide services to increase 
180.35 	public awareness of problem gambling, 
181.1 	education and training for individuals and 
181.2 	organizations providing effective treatment 
181.3 	services to problem gamblers and their 
181.4 	families, and research relating to problem 
181.5 	gambling.
181.6 	Funding Usage. Up to 75 percent of a fiscal 
181.7 	year's appropriations for adult mental health 
181.8 	grants may be used to fund allocations in that 
181.9 	portion of the fiscal year ending December 
181.10 	31.
181.11 	Base Adjustment. The general fund base is 
181.12 	decreased by $4,427,000 in fiscal years 2016 
181.13 	and 2017.
181.14 	Mental Health Pilot Project. $230,000 
181.15 	each year is for a grant to the Zumbro 
181.16 	Valley Mental Health Center. The grant 
181.17 	shall be used to implement a pilot project 
181.18 	to test an integrated behavioral health care 
181.19 	coordination model. The grant recipient must 
181.20 	report measurable outcomes and savings 
181.21 	to the commissioner of human services 
181.22 	by January 15, 2016. This is a onetime 
181.23 	appropriation.
181.24 	High-risk adults. $200,000 in fiscal 
181.25 	year 2014 is for a grant to the nonprofit 
181.26 	organization selected to administer the 
181.27 	demonstration project for high-risk adults 
181.28 	under Laws 2007, chapter 54, article 1, 
181.29 	section 19, in order to complete the project. 
181.30 	This is a onetime appropriation.

181.31	(m) Child Mental Health Grants
		18,246,000
		20,636,000
	
181.32 	Text Message Suicide Prevention 
181.33 	Program. $625,000 in fiscal year 2014 and 
181.34 	$625,000 in fiscal year 2015 is for a grant 
181.35 	to a nonprofit organization to establish and 
182.1 	implement a statewide text message suicide 
182.2 	prevention program. The program shall 
182.3 	implement a suicide prevention counseling 
182.4 	text line designed to use text messaging to 
182.5 	connect with crisis counselors and to obtain 
182.6 	emergency information and referrals to 
182.7 	local resources in the local community. The 
182.8 	program shall include training within schools 
182.9 	and communities to encourage the use of the 
182.10 	program.
182.11 	Mental Health First Aid Training. $22,000 
182.12 	in fiscal year 2014 and $23,000 in fiscal 
182.13 	year 2015 is to train teachers, social service 
182.14 	personnel, law enforcement, and others who 
182.15 	come into contact with children with mental 
182.16 	illnesses, in children and adolescents mental 
182.17 	health first aid training.
182.18 	Funding Usage. Up to 75 percent of a fiscal 
182.19 	year's appropriation for child mental health 
182.20 	grants may be used to fund allocations in that 
182.21 	portion of the fiscal year ending December 
182.22 	31.

182.23	(n) CD Treatment Support Grants
		1,816,000
		1,816,000
	
182.24 	SBIRT Training. (1) $300,000 each year is 
182.25 	for grants to train primary care clinicians to 
182.26 	provide substance abuse brief intervention 
182.27 	and referral to treatment (SBIRT). This is a 
182.28 	onetime appropriation. The commissioner of 
182.29 	human services shall apply to SAMHSA for 
182.30 	an SBIRT professional training grant.
182.31 	(2) If the commissioner of human services 
182.32 	receives a grant under clause (1) funds 
182.33 	appropriated under this clause, equal to 
182.34 	the grant amount, up to the available 
182.35 	appropriation, shall be transferred to the 
183.1 	Minnesota Organization on Fetal Alcohol 
183.2 	Syndrome (MOFAS). MOFAS must use 
183.3 	the funds for grants. Grant recipients must 
183.4 	be selected from communities that are 
183.5 	not currently served by federal Substance 
183.6 	Abuse Prevention and Treatment Block 
183.7 	Grant funds. Grant money must be used to 
183.8 	reduce the rates of fetal alcohol syndrome 
183.9 	and fetal alcohol effects, and the number of 
183.10 	drug-exposed infants. Grant money may be 
183.11 	used for prevention and intervention services 
183.12 	and programs, including, but not limited to, 
183.13 	community grants, professional eduction, 
183.14 	public awareness, and diagnosis.
183.15 	Fetal Alcohol Syndrome Grant. $180,000 
183.16 	each year from the general fund is for a 
183.17 	grant to the Minnesota Organization on Fetal 
183.18 	Alcohol Syndrome (MOFAS) to support 
183.19 	nonprofit Fetal Alcohol Spectrum Disorders 
183.20 	(FASD) outreach prevention programs 
183.21 	in Olmsted County. This is a onetime 
183.22 	appropriation.
183.23 	Base Adjustment. The general fund base is 
183.24 	decreased by $480,000 in fiscal year 2016 
183.25 	and $480,000 in fiscal year 2017.

183.26 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

183.27 	Sec. 8. Laws 2013, chapter 108, article 14, section 3, subdivision 1, is amended to read:

183.28
183.29	Subdivision 1.Total Appropriation
 	$
	169,326,000
 169,026,000
	$
	165,531,000
 165,231,000

183.30	Appropriations by Fund
	
183.31		2014
	2015
	
183.32	General
	79,476,000
	74,256,000
	
183.33
183.34	State Government 
Special Revenue
	48,094,000
	50,119,000
	
183.35	Health Care Access
	29,743,000
	29,143,000
	
184.1	Federal TANF
	11,713,000
	11,713,000
	
184.2	Special Revenue
	300,000
	300,000
	
184.3 	The amounts that may be spent for each 
184.4 	purpose are specified in the following 
184.5 	subdivisions.

184.6 	Sec. 9. Laws 2013, chapter 108, article 14, section 3, subdivision 4, is amended to read:

184.7	Subd. 4.Health Protection

184.8	Appropriations by Fund
	
184.9	General
	9,201,000
	9,201,000
	
184.10
184.11	State Government 
Special Revenue
	32,633,000
	32,636,000
	
184.12	Special Revenue
	300,000
	300,000
	
184.13 	Infectious Disease Laboratory. Of the 
184.14 	general fund appropriation, $200,000 in 
184.15 	fiscal year 2014 and $200,000 in fiscal year 
184.16 	2015 are to monitor infectious disease trends 
184.17 	and investigate infectious disease outbreaks.
184.18 	Surveillance for Elevated Blood Lead 
184.19 	Levels. Of the general fund appropriation, 
184.20 	$100,000 in fiscal year 2014 and $100,000 
184.21 	in fiscal year 2015 are for the blood lead 
184.22 	surveillance system under Minnesota 
184.23 	Statutes, section 144.9502.
184.24 	Base Level Adjustment. The state 
184.25 	government special revenue base is increased 
184.26 	by $6,000 in fiscal year 2016 and by $13,000 
184.27 	in fiscal year 2017.

184.28 	Sec. 10. Laws 2013, chapter 108, article 14, section 4, subdivision 8, is amended to read:

184.29
184.30	Subd. 8.Board of Nursing Home 
Administrators
 		3,742,000
		2,252,000
	
184.31 	Administrative Services Unit - Operating 
184.32 	Costs. Of this appropriation, $676,000 
184.33 	in fiscal year 2014 and $626,000 in 
185.1 	fiscal year 2015 are for operating costs 
185.2 	of the administrative services unit. The 
185.3 	administrative services unit may receive 
185.4 	and expend reimbursements for services 
185.5 	performed by other agencies.
185.6 	Administrative Services Unit - Volunteer 
185.7 	Health Care Provider Program. Of this 
185.8 	appropriation, $150,000 in fiscal year 2014 
185.9 	and $150,000 in fiscal year 2015 are to pay 
185.10 	for medical professional liability coverage 
185.11 	required under Minnesota Statutes, section 
185.12 	214.40.
185.13 	Administrative Services Unit - Contested 
185.14 	Cases and Other Legal Proceedings. Of 
185.15 	this appropriation, $200,000 in fiscal year 
185.16 	2014 and $200,000 in fiscal year 2015 are 
185.17 	for costs of contested case hearings and other 
185.18 	unanticipated costs of legal proceedings 
185.19 	involving health-related boards funded 
185.20 	under this section. Upon certification of a 
185.21 	health-related board to the administrative 
185.22 	services unit that the costs will be incurred 
185.23 	and that there is insufficient money available 
185.24 	to pay for the costs out of money currently 
185.25 	available to that board, the administrative 
185.26 	services unit is authorized to transfer money 
185.27 	from this appropriation to the board for 
185.28 	payment of those costs with the approval 
185.29 	of the commissioner of management and 
185.30 	budget. This appropriation does not cancel 
185.31 	and is available until expended.
185.32 	This appropriation includes $44,000 in 
185.33 	fiscal year 2014 for rulemaking. This is 
185.34 	a onetime appropriation. $1,441,000 in 
185.35 	fiscal year 2014 and $420,000 in fiscal year 
186.1 	2015 are for the development of a shared 
186.2 	disciplinary, regulatory, licensing, and 
186.3 	information management system. $391,000 
186.4 	in fiscal year 2014 is a onetime appropriation 
186.5 	for retirement costs in the health-related 
186.6 	boards. This funding may be transferred to 
186.7 	the health boards incurring retirement costs. 
186.8 	These funds are available either year of the 
186.9 	biennium.
186.10 	This appropriation includes $16,000 in fiscal 
186.11 	years 2014 and 2015 for evening security, 
186.12 	$2,000 in fiscal years 2014 and 2015 for a 
186.13 	state vehicle lease, and $18,000 in fiscal 
186.14 	years 2014 and 2015 for shared office space 
186.15 	and administrative support. $205,000 in 
186.16 	fiscal year 2014 and $221,000 in fiscal year 
186.17 	2015 are for shared information technology 
186.18 	services, equipment, and maintenance.
186.19 	The remaining balance of the state 
186.20 	government special revenue fund 
186.21 	appropriation in Laws 2011, First Special 
186.22 	Session chapter 9, article 10, section 8, 
186.23 	subdivision 8, for Board of Nursing Home 
186.24 	Administrators rulemaking, estimated to 
186.25 	be $44,000, is canceled, and the remaining 
186.26 	balance of the state government special 
186.27 	revenue fund appropriation in Laws 2011, 
186.28 	First Special Session chapter 9, article 10, 
186.29 	section 8, subdivision 8, for electronic 
186.30 	licensing system adaptors, estimated to be 
186.31 	$761,000, and for the development and 
186.32 	implementation of a disciplinary, regulatory, 
186.33 	licensing, and information management 
186.34 	system, estimated to be $1,100,000, are 
186.35 	canceled. This paragraph is effective the day 
186.36 	following final enactment.
187.1 	Base Adjustment. The base is decreased by 
187.2 	$370,000 in fiscal years 2016 and 2017.

187.3 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

187.4 	Sec. 11. Laws 2013, chapter 108, article 14, section 12, is amended to read:
187.5 	Sec. 12. APPROPRIATION ADJUSTMENTS.
 187.6 	(a) The general fund appropriation in section 2, subdivision 5, paragraph (g), 
187.7 	includes up to $53,391,000 in fiscal year 2014; $216,637,000 in fiscal year 2015; 
187.8 	$261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year 2017, for medical 
187.9 	assistance eligibility and administration changes related to:
187.10 	(1) eligibility for children age two to 18 with income up to 275 percent of the federal 
187.11 	poverty guidelines;
187.12 	(2) eligibility for pregnant women with income up to 275 percent of the federal 
187.13 	poverty guidelines;
187.14 	(3) Affordable Care Act enrollment and renewal processes, including elimination 
187.15 	of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes 
187.16 	in verification requirements, and other changes in the eligibility determination and 
187.17 	enrollment and renewal process;
187.18 	(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;
187.19 	(5) eligibility related to spousal impoverishment provisions for waiver recipients; and
187.20 	(6) presumptive eligibility determinations by hospitals.
187.21 	(b) the commissioner of human services shall determine the difference between the 
187.22 	actual or forecasted estimated  costs to the medical assistance program attributable to 
187.23 	the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a), 
187.24 	clauses (1) to (6), that were estimated during the 2013 legislative session based on data 
187.25 	from the 2013 February forecast. The costs in this paragraph must be calculated between 
187.26 	January 1, 2014, and June 30, 2017.
187.27 	(c) For each fiscal year from 2014 to 2017, the commissioner of human services 
187.28 	shall certify the actual or forecasted estimated  cost differences to the medical assistance 
187.29 	program determined under paragraph (b), and report the difference in costs to the 
187.30 	commissioner of management and budget at least four weeks prior to a forecast under 
187.31 	Minnesota Statutes, section 16A.103. No later than three weeks before the release of 
187.32 	the forecast For fiscal years 2014 to 2017, forecasts under Minnesota Statutes, section 
187.33 	16A.103, prepared by the commissioner of management and budget shall reduce include 
187.34 	actual or estimated adjustments to  the health care access fund appropriation in section 
187.35 	2, subdivision 5, paragraph (g), by the cumulative difference in costs determined in
188.1 	according to paragraph (b) (d). If for any fiscal year, the amount of the cumulative cost 
188.2 	differences determined under paragraph (b) is positive, no adjustment shall be made to the 
188.3 	health care access fund appropriation. If for any fiscal year, the amount of the cumulative 
188.4 	cost differences determined under paragraph (b) is less than the original appropriation, the 
188.5 	appropriation for that fiscal year is zero.
188.6 	(d) For each fiscal year from 2014 to 2017, the commissioner of management and 
188.7 	budget must adjust the health care access fund appropriation by the cumulative difference 
188.8 	in costs reported by the commissioner of human services under paragraph (b). If, for any 
188.9 	fiscal year, the amount of the cumulative difference in costs determined under paragraph 
188.10 	(b) is positive, no adjustment shall be made to the health care access fund appropriation.
188.11 	(e) This section expires on January 1, 2018.

188.12 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

188.13 	Sec. 12. EXPIRATION OF UNCODIFIED LANGUAGE.
 188.14 	All uncodified language in this article expires on June 30, 2015, unless a different 
188.15 	expiration date is specified.

188.16 	ARTICLE 8
188.17 	HUMAN SERVICES FORECAST ADJUSTMENT

188.18	Section 1. HUMAN SERVICES APPROPRIATION.
 	
188.19 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
188.20 	in parentheses, are subtracted from the appropriations in Laws 2013, chapter 108, article 
188.21 	14, from the general fund or any fund named to the Department of Human Services for 
188.22 	the purposes specified in this article, to be available for the fiscal year indicated for each 
188.23 	purpose. The figures "2014" and "2015" used in this article mean that the appropriations 
188.24 	listed under them are available for the fiscal years ending June 30, 2014, or June 30, 2015, 
188.25 	respectively. "The first year" is fiscal year 2014. "The second year" is fiscal year 2015. 
188.26 	"The biennium" is fiscal years 2014 and 2015.

188.27				APPROPRIATIONS
	
188.28				Available for the Year
	
188.29				Ending June 30
	
188.30					2014
		2015

188.31
188.32	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

188.33	Subdivision 1.Total Appropriation
 	$
	(196,927)
	$
	64,288

189.1	Appropriations by Fund
	
189.2	General Fund
	(153,497)
	(25,282)
	
189.3
189.4	Health Care Access 
Fund
	(36,533)
	91,294
	
189.5	Federal TANF
	(6,897)
	(1,724)

189.6	Subd. 2.Forecasted Programs

189.7	(a) MFIP/DWP

189.8	Appropriations by Fund
	
189.9	General Fund
	3,571
	173
	
189.10	Federal TANF
	(6,475)
	(1,298)

189.11	(b) MFIP Child Care Assistance
		(684)
		11,114

189.12	(c) General Assistance
		(2,569)
		(1,940)

189.13	(d) Minnesota Supplemental Aid
		(690)
		(614)

189.14	(e) Group Residential Housing
		250
		(1,740)

189.15	(f) MinnesotaCare
		(34,838)
		96,340
	
189.16 	These appropriations are from the health care 
189.17 	access fund.

189.18	(g) Medical Assistance

189.19	Appropriations by Fund
	
189.20	General Fund
	(149,494)
	(27,075)
	
189.21
189.22	Health Care Access 
Fund
	(1,695)
	(5,046)

189.23	(h) Alternative Care Program
		(6,936)
		(13,260)

189.24	(i) CCDTF Entitlements
		3,055
		8,060

189.25	Subd. 3.Technical Activities
 		(422)
		(426)
	
189.26 	These appropriations are from the federal 
189.27 	TANF fund.

189.28 	Sec. 3. Laws 2013, chapter 108, article 14, section 2, subdivision 1, is amended to read:

189.29
189.30	Subdivision 1.Total Appropriation
 	$
	6,438,485,000
 6,437,815,000
	$
	6,457,117,000
 6,456,311,000

189.31	Appropriations by Fund
	
189.32		2014
	2015
	
190.1
190.2	General
	5,654,765,000
 5,654,095,000
	5,677,458,000
 5,676,652,000
	
190.3
190.4	State Government 
Special Revenue
	4,099,000
	4,510,000
	
190.5	Health Care Access
	519,816,000
	518,446,000
	
190.6	Federal TANF
	257,915,000
	254,813,000
	
190.7	Lottery Prize Fund
	1,890,000
	1,890,000
	
190.8 	Receipts for Systems Projects. 
190.9 	Appropriations and federal receipts for 
190.10 	information systems projects for MAXIS, 
190.11 	PRISM, MMIS, and SSIS must be deposited 
190.12 	in the state system account authorized 
190.13 	in Minnesota Statutes, section 256.014. 
190.14 	Money appropriated for computer projects 
190.15 	approved by the commissioner of Minnesota 
190.16 	information technology services, funded 
190.17 	by the legislature, and approved by the 
190.18 	commissioner of management and budget, 
190.19 	may be transferred from one project to 
190.20 	another and from development to operations 
190.21 	as the commissioner of human services 
190.22 	considers necessary. Any unexpended 
190.23 	balance in the appropriation for these 
190.24 	projects does not cancel but is available for 
190.25 	ongoing development and operations.
190.26 	Nonfederal Share Transfers. The 
190.27 	nonfederal share of activities for which 
190.28 	federal administrative reimbursement is 
190.29 	appropriated to the commissioner may be 
190.30 	transferred to the special revenue fund.
190.31 	ARRA Supplemental Nutrition Assistance 
190.32 	Benefit Increases. The funds provided for 
190.33 	food support benefit increases under the 
190.34 	Supplemental Nutrition Assistance Program 
190.35 	provisions of the American Recovery and 
190.36 	Reinvestment Act (ARRA) of 2009 must be 
191.1 	used for benefit increases beginning July 1, 
191.2 	2009.
191.3 	Supplemental Nutrition Assistance 
191.4 	Program Employment and Training. 
191.5 	(1) Notwithstanding Minnesota Statutes, 
191.6 	sections 256D.051, subdivisions 1a, 6b, 
191.7 	and 6c, and 256J.626, federal Supplemental 
191.8 	Nutrition Assistance employment and 
191.9 	training funds received as reimbursement of 
191.10 	MFIP consolidated fund grant expenditures 
191.11 	for diversionary work program participants 
191.12 	and child care assistance program 
191.13 	expenditures must be deposited in the general 
191.14 	fund. The amount of funds must be limited to 
191.15 	$4,900,000 per year in fiscal years 2014 and 
191.16 	2015, and to $4,400,000 per year in fiscal 
191.17 	years 2016 and 2017, contingent on approval 
191.18 	by the federal Food and Nutrition Service.
191.19 	(2) Consistent with the receipt of the federal 
191.20 	funds, the commissioner may adjust the 
191.21 	level of working family credit expenditures 
191.22 	claimed as TANF maintenance of effort. 
191.23 	Notwithstanding any contrary provision in 
191.24 	this article, this rider expires June 30, 2017.
191.25 	TANF Maintenance of Effort. (a) In order 
191.26 	to meet the basic maintenance of effort 
191.27 	(MOE) requirements of the TANF block grant 
191.28 	specified under Code of Federal Regulations, 
191.29 	title 45, section 263.1, the commissioner may 
191.30 	only report nonfederal money expended for 
191.31 	allowable activities listed in the following 
191.32 	clauses as TANF/MOE expenditures:
191.33 	(1) MFIP cash, diversionary work program, 
191.34 	and food assistance benefits under Minnesota 
191.35 	Statutes, chapter 256J;
192.1 	(2) the child care assistance programs 
192.2 	under Minnesota Statutes, sections 119B.03
192.3 	and 119B.05, and county child care 
192.4 	administrative costs under Minnesota 
192.5 	Statutes, section 119B.15;
192.6 	(3) state and county MFIP administrative 
192.7 	costs under Minnesota Statutes, chapters 
192.8 	256J and 256K;
192.9 	(4) state, county, and tribal MFIP 
192.10 	employment services under Minnesota 
192.11 	Statutes, chapters 256J and 256K;
192.12 	(5) expenditures made on behalf of legal 
192.13 	noncitizen MFIP recipients who qualify for 
192.14 	the MinnesotaCare program under Minnesota 
192.15 	Statutes, chapter 256L;
192.16 	(6) qualifying working family credit 
192.17 	expenditures under Minnesota Statutes, 
192.18 	section 290.0671;
192.19 	(7) qualifying Minnesota education credit 
192.20 	expenditures under Minnesota Statutes, 
192.21 	section 290.0674; and
192.22 	(8) qualifying Head Start expenditures under 
192.23 	Minnesota Statutes, section 119A.50.
192.24 	(b) The commissioner shall ensure that 
192.25 	sufficient qualified nonfederal expenditures 
192.26 	are made each year to meet the state's 
192.27 	TANF/MOE requirements. For the activities 
192.28 	listed in paragraph (a), clauses (2) to 
192.29 	(8), the commissioner may only report 
192.30 	expenditures that are excluded from the 
192.31 	definition of assistance under Code of 
192.32 	Federal Regulations, title 45, section 260.31.
192.33 	(c) For fiscal years beginning with state fiscal 
192.34 	year 2003, the commissioner shall ensure 
193.1 	that the maintenance of effort used by the 
193.2 	commissioner of management and budget 
193.3 	for the February and November forecasts 
193.4 	required under Minnesota Statutes, section 
193.5 	16A.103, contains expenditures under 
193.6 	paragraph (a), clause (1), equal to at least 16 
193.7 	percent of the total required under Code of 
193.8 	Federal Regulations, title 45, section 263.1.
193.9 	(d) The requirement in Minnesota Statutes, 
193.10 	section 256.011, subdivision 3, that federal 
193.11 	grants or aids secured or obtained under that 
193.12 	subdivision be used to reduce any direct 
193.13 	appropriations provided by law, do not apply 
193.14 	if the grants or aids are federal TANF funds.
193.15 	(e) For the federal fiscal years beginning on 
193.16 	or after October 1, 2007, the commissioner 
193.17 	may not claim an amount of TANF/MOE in 
193.18 	excess of the 75 percent standard in Code 
193.19 	of Federal Regulations, title 45, section 
193.20 	263.1(a)(2), except:
193.21 	(1) to the extent necessary to meet the 80 
193.22 	percent standard under Code of Federal 
193.23 	Regulations, title 45, section 263.1(a)(1), 
193.24 	if it is determined by the commissioner 
193.25 	that the state will not meet the TANF work 
193.26 	participation target rate for the current year;
193.27 	(2) to provide any additional amounts 
193.28 	under Code of Federal Regulations, title 45, 
193.29 	section 264.5, that relate to replacement of 
193.30 	TANF funds due to the operation of TANF 
193.31 	penalties; and
193.32 	(3) to provide any additional amounts that 
193.33 	may contribute to avoiding or reducing 
193.34 	TANF work participation penalties through 
193.35 	the operation of the excess MOE provisions 
194.1 	of Code of Federal Regulations, title 45, 
194.2 	section 261.43 (a)(2).
194.3 	For the purposes of clauses (1) to (3), 
194.4 	the commissioner may supplement the 
194.5 	MOE claim with working family credit 
194.6 	expenditures or other qualified expenditures 
194.7 	to the extent such expenditures are otherwise 
194.8 	available after considering the expenditures 
194.9 	allowed in this subdivision and subdivisions 
194.10 	2 and 3.
194.11 	(f) Notwithstanding any contrary provision 
194.12 	in this article, paragraphs (a) to (e) expire 
194.13 	June 30, 2017.
194.14 	Working Family Credit Expenditures 
194.15 	as TANF/MOE. The commissioner may 
194.16 	claim as TANF maintenance of effort up to 
194.17 	$6,707,000 per year of working family credit 
194.18 	expenditures in each fiscal year.

194.19 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

194.20 	Sec. 4. Laws 2013, chapter 108, article 14, section 2, subdivision 4, as amended by 
194.21 	Laws 2013, chapter 144, section 24, is amended to read:

194.22	Subd. 4.Central Office
 					
194.23 	The amounts that may be spent from this 
194.24 	appropriation for each purpose are as follows:

194.25	(a) Operations

194.26	Appropriations by Fund
	
194.27	General
	101,979,000
	96,858,000
	
194.28
194.29	State Government 
Special Revenue
	3,974,000
	4,385,000
	
194.30	Health Care Access
	13,177,000
	13,004,000
	
194.31	Federal TANF
	100,000
	100,000
	
194.32 	DHS Receipt Center Accounting. The 
194.33 	commissioner is authorized to transfer 
194.34 	appropriations to, and account for DHS 
195.1 	receipt center operations in, the special 
195.2 	revenue fund.
195.3 	Administrative Recovery; Set-Aside. The 
195.4 	commissioner may invoice local entities 
195.5 	through the SWIFT accounting system as an 
195.6 	alternative means to recover the actual cost 
195.7 	of administering the following provisions:
195.8 	(1) Minnesota Statutes, section 125A.744, 
195.9 	subdivision 3;
195.10 	(2) Minnesota Statutes, section 245.495, 
195.11 	paragraph (b);
195.12 	(3) Minnesota Statutes, section 256B.0625, 
195.13 	subdivision 20, paragraph (k);
195.14 	(4) Minnesota Statutes, section 256B.0924, 
195.15 	subdivision 6, paragraph (g);
195.16 	(5) Minnesota Statutes, section 256B.0945, 
195.17 	subdivision 4, paragraph (d); and
195.18 	(6) Minnesota Statutes, section 256F.10, 
195.19 	subdivision 6, paragraph (b).
195.20 	Systems Modernization. The following 
195.21 	amounts are appropriated for transfer to 
195.22 	the state systems account authorized in 
195.23 	Minnesota Statutes, section 256.014:
195.24 	(1) $1,825,000 in fiscal year 2014 and 
195.25 	$2,502,000 in fiscal year 2015 is for the 
195.26 	state share of Medicaid-allocated costs of 
195.27 	the health insurance exchange information 
195.28 	technology and operational structure. The 
195.29 	funding base is $3,222,000 in fiscal year 2016 
195.30 	and $3,037,000 in fiscal year 2017 but shall 
195.31 	not be included in the base thereafter; and
195.32 	(2) $9,344,000 in fiscal year 2014 and 
195.33 	$3,660,000 in fiscal year 2015 are for the 
195.34 	modernization and streamlining of agency 
196.1 	eligibility and child support systems. The 
196.2 	funding base is $5,921,000 in fiscal year 
196.3 	2016 and $1,792,000 in fiscal year 2017 but 
196.4 	shall not be included in the base thereafter.
196.5 	The unexpended balance of the $9,344,000 
196.6 	appropriation in fiscal year 2014 and the 
196.7 	$3,660,000 appropriation in fiscal year 2015 
196.8 	must be transferred from the Department of 
196.9 	Human Services state systems account to 
196.10 	the Office of Enterprise Technology when 
196.11 	the Office of Enterprise Technology has 
196.12 	negotiated a federally approved internal 
196.13 	service fund rates and billing process with 
196.14 	sufficient internal accounting controls to 
196.15 	properly maximize federal reimbursement 
196.16 	to Minnesota for human services system 
196.17 	modernization projects, but not later than 
196.18 	June 30, 2015.
196.19 	If contingent funding is fully or partially 
196.20 	disbursed under article 15, section 3, and 
196.21 	transferred to the state systems account, the 
196.22 	unexpended balance of that appropriation 
196.23 	must be transferred to the Office of Enterprise 
196.24 	Technology in accordance with this clause. 
196.25 	Contingent funding must not exceed 
196.26 	$11,598,000 for the biennium.
196.27 	Base Adjustment. The general fund base 
196.28 	is increased by $2,868,000 in fiscal year 
196.29 	2016 and decreased by $1,206,000 in fiscal 
196.30 	year 2017. The health access fund base is 
196.31 	decreased by $551,000 in fiscal years 2016 
196.32 	and 2017. The state government special 
196.33 	revenue fund base is increased by $4,000 in 
196.34 	fiscal year 2016 and decreased by $236,000 
196.35 	in fiscal year 2017.

197.1	(b) Children and Families

197.2	Appropriations by Fund
	
197.3	General
	8,023,000
	8,015,000
	
197.4	Federal TANF
	2,282,000
	2,282,000
	
197.5 	Financial Institution Data Match and 
197.6 	Payment of Fees. The commissioner is 
197.7 	authorized to allocate up to $310,000 each 
197.8 	year in fiscal years 2014 and 2015 from the 
197.9 	PRISM special revenue account to make 
197.10 	payments to financial institutions in exchange 
197.11 	for performing data matches between account 
197.12 	information held by financial institutions 
197.13 	and the public authority's database of child 
197.14 	support obligors as authorized by Minnesota 
197.15 	Statutes, section 13B.06, subdivision 7.
197.16 	Base Adjustment. The general fund base is 
197.17 	decreased by $300,000 in fiscal years 2016 
197.18 	and 2017. The TANF fund base is increased 
197.19 	by $300,000 in fiscal years 2016 and 2017.

197.20	(c) Health Care

197.21	Appropriations by Fund
	
197.22	General
	14,028,000
	13,826,000
	
197.23	Health Care Access
	28,442,000
	31,137,000
	
197.24 	Base Adjustment. The general fund base 
197.25 	is decreased by $86,000 in fiscal year 2016 
197.26 	and by $86,000 in fiscal year 2017. The 
197.27 	health care access fund base is increased 
197.28 	by $6,954,000 in fiscal year 2016 and by 
197.29 	$5,489,000 in fiscal year 2017.

197.30	(d) Continuing Care

197.31	Appropriations by Fund
	
197.32	General
	20,993,000
	22,359,000
	
197.33
197.34	State Government 
Special Revenue
	125,000
	125,000
	
198.1 	Base Adjustment. The general fund base is 
198.2 	increased by $1,690,000 in fiscal year 2016 
198.3 	and by $798,000 in fiscal year 2017.

198.4	(e) Chemical and Mental Health

198.5	Appropriations by Fund
	
198.6
198.7	General
	4,639,000
 4,571,000
	4,490,000
 4,431,000
	
198.8	Lottery Prize Fund
	157,000
	157,000
	
198.9 	Of the general fund appropriation, $68,000 
198.10 	in fiscal year 2014 and $59,000 in fiscal year 
198.11 	2015 are for compulsive gambling treatment 
198.12 	under Minnesota Statutes, section 297E.02, 
198.13 	subdivision 3, paragraph (c).

198.14 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

198.15 	Sec. 5. Laws 2013, chapter 108, article 14, section 2, subdivision 6, as amended by 
198.16 	Laws 2013, chapter 144, section 25, is amended to read:

198.17	Subd. 6.Grant Programs
 					
198.18 	The amounts that may be spent from this 
198.19 	appropriation for each purpose are as follows:

198.20	(a) Support Services Grants

198.21	Appropriations by Fund
	
198.22	General
	8,915,000
	13,333,000
	
198.23	Federal TANF
	94,611,000
	94,611,000
	
198.24 	Paid Work Experience. $2,168,000 
198.25 	each year in fiscal years 2015 and 2016 
198.26 	is from the general fund for paid work 
198.27 	experience for long-term MFIP recipients. 
198.28 	Paid work includes full and partial wage 
198.29 	subsidies and other related services such as 
198.30 	job development, marketing, preworksite 
198.31 	training, job coaching, and postplacement 
198.32 	services. These are onetime appropriations. 
198.33 	Unexpended funds for fiscal year 2015 do not 
199.1 	cancel, but are available to the commissioner 
199.2 	for this purpose in fiscal year 2016.
199.3 	Work Study Funding for MFIP 
199.4 	Participants. $250,000 each year in fiscal 
199.5 	years 2015 and 2016 is from the general fund 
199.6 	to pilot work study jobs for MFIP recipients 
199.7 	in approved postsecondary education 
199.8 	programs. This is a onetime appropriation. 
199.9 	Unexpended funds for fiscal year 2015 do 
199.10 	not cancel, but are available for this purpose 
199.11 	in fiscal year 2016.
199.12 	Local Strategies to Reduce Disparities.
199.13 	$2,000,000 each year in fiscal years 2015 
199.14 	and 2016 is from the general fund for 
199.15 	local projects that focus on services for 
199.16 	subgroups within the MFIP caseload 
199.17 	who are experiencing poor employment 
199.18 	outcomes. These are onetime appropriations. 
199.19 	Unexpended funds for fiscal year 2015 do not 
199.20 	cancel, but are available to the commissioner 
199.21 	for this purpose in fiscal year 2016.
199.22 	Home Visiting Collaborations for MFIP 
199.23 	Teen Parents. $200,000 per year in fiscal 
199.24 	years 2014 and 2015 is from the general fund 
199.25 	and $200,000 in fiscal year 2016 is from the 
199.26 	federal TANF fund for technical assistance 
199.27 	and training to support local collaborations 
199.28 	that provide home visiting services for 
199.29 	MFIP teen parents. The general fund 
199.30 	appropriation is onetime. The federal TANF 
199.31 	fund appropriation is added to the base.
199.32 	Performance Bonus Funds for Counties.
199.33 	The TANF fund base is increased by 
199.34 	$1,500,000 each year in fiscal years 2016 
199.35 	and 2017. The commissioner must allocate 
200.1 	this amount each year to counties that exceed 
200.2 	their expected range of performance on the 
200.3 	annualized three-year self-support index 
200.4 	as defined in Minnesota Statutes, section 
200.5 	256J.751, subdivision 2, clause (6). This is a 
200.6 	permanent base adjustment. Notwithstanding 
200.7 	any contrary provisions in this article, this 
200.8 	provision expires June 30, 2016.
200.9 	Base Adjustment. The general fund base is 
200.10 	decreased by $200,000 in fiscal year 2016 
200.11 	and $4,618,000 in fiscal year 2017. The 
200.12 	TANF fund base is increased by $1,700,000 
200.13 	in fiscal years 2016 and 2017.

200.14
200.15	(b) Basic Sliding Fee Child Care Assistance 
Grants
		36,836,000
		42,318,000
	
200.16 	Base Adjustment. The general fund base is 
200.17 	increased by $3,778,000 in fiscal year 2016 
200.18 	and by $3,849,000 in fiscal year 2017.

200.19	(c) Child Care Development Grants
		1,612,000
		1,737,000

200.20	(d) Child Support Enforcement Grants
		50,000
		50,000
	
200.21 	Federal Child Support Demonstration 
200.22 	Grants. Federal administrative 
200.23 	reimbursement resulting from the federal 
200.24 	child support grant expenditures authorized 
200.25 	under United States Code, title 42, section 
200.26 	1315, is appropriated to the commissioner 
200.27 	for this activity.

200.28	(e) Children's Services Grants

200.29	Appropriations by Fund
	
200.30	General
	49,760,000
	52,961,000
	
200.31	Federal TANF
	140,000
	140,000
	
200.32 	Adoption Assistance and Relative Custody 
200.33 	Assistance. $37,453,000 in fiscal year 2014 
200.34 	and $37,453,000 in fiscal year 2015 is for 
201.1 	the adoption assistance and relative custody 
201.2 	assistance programs. The commissioner 
201.3 	shall determine with the commissioner of 
201.4 	Minnesota Management and Budget the 
201.5 	appropriation for Northstar Care for Children 
201.6 	effective January 1, 2015. The commissioner 
201.7 	may transfer appropriations for adoption 
201.8 	assistance, relative custody assistance, and 
201.9 	Northstar Care for Children between fiscal 
201.10 	years and among programs to adjust for 
201.11 	transfers across the programs.
201.12 	Title IV-E Adoption Assistance. Additional 
201.13 	federal reimbursements to the state as a result 
201.14 	of the Fostering Connections to Success 
201.15 	and Increasing Adoptions Act's expanded 
201.16 	eligibility for Title IV-E adoption assistance 
201.17 	are appropriated for postadoption services, 
201.18 	including a parent-to-parent support network.
201.19 	Privatized Adoption Grants. Federal 
201.20 	reimbursement for privatized adoption grant 
201.21 	and foster care recruitment grant expenditures 
201.22 	is appropriated to the commissioner for 
201.23 	adoption grants and foster care and adoption 
201.24 	administrative purposes.
201.25 	Adoption Assistance Incentive Grants.
201.26 	Federal funds available during fiscal years 
201.27 	2014 and 2015 for adoption incentive grants 
201.28 	are appropriated for postadoption services, 
201.29 	including a parent-to-parent support network.
201.30 	Base Adjustment. The general fund base is 
201.31 	increased by $5,913,000 in fiscal year 2016 
201.32 	and by $10,297,000 in fiscal year 2017.

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

201.34	(g) Child and Economic Support Grants
		21,047,000
		20,848,000
	
202.1 	Minnesota Food Assistance Program. 
202.2 	Unexpended funds for the Minnesota food 
202.3 	assistance program for fiscal year 2014 do 
202.4 	not cancel but are available for this purpose 
202.5 	in fiscal year 2015.
202.6 	Transitional Housing. $250,000 each year 
202.7 	is for the transitional housing programs under 
202.8 	Minnesota Statutes, section 256E.33.
202.9 	Emergency Services. $250,000 each year 
202.10 	is for emergency services grants under 
202.11 	Minnesota Statutes, section 256E.36.
202.12 	Family Assets for Independence. $250,000 
202.13 	each year is for the Family Assets for 
202.14 	Independence Minnesota program. This 
202.15 	appropriation is available in either year of the 
202.16 	biennium and may be transferred between 
202.17 	fiscal years.
202.18 	Food Shelf Programs. $375,000 in fiscal 
202.19 	year 2014 and $375,000 in fiscal year 
202.20 	2015 are for food shelf programs under 
202.21 	Minnesota Statutes, section 256E.34. If the 
202.22 	appropriation for either year is insufficient, 
202.23 	the appropriation for the other year is 
202.24 	available for it. Notwithstanding Minnesota 
202.25 	Statutes, section 256E.34, subdivision 4, no 
202.26 	portion of this appropriation may be used 
202.27 	by Hunger Solutions for its administrative 
202.28 	expenses, including but not limited to rent 
202.29 	and salaries.
202.30 	Homeless Youth Act. $2,000,000 in fiscal 
202.31 	year 2014 and $2,000,000 in fiscal year 2015 
202.32 	is for purposes of Minnesota Statutes, section 
202.33 	256K.45.
202.34 	Safe Harbor Shelter and Housing. 
202.35 	$500,000 in fiscal year 2014 and $500,000 in 
203.1 	fiscal year 2015 is for a safe harbor shelter 
203.2 	and housing fund for housing and supportive 
203.3 	services for youth who are sexually exploited. 

203.4	(h) Health Care Grants

203.5	Appropriations by Fund
	
203.6	General
	190,000
	190,000
	
203.7	Health Care Access
	190,000
	190,000
	
203.8 	Emergency Medical Assistance Referral 
203.9 	and Assistance Grants. (a) The 
203.10 	commissioner of human services shall 
203.11 	award grants to nonprofit programs that 
203.12 	provide immigration legal services based 
203.13 	on indigency to provide legal services for 
203.14 	immigration assistance to individuals with 
203.15 	emergency medical conditions or complex 
203.16 	and chronic health conditions who are not 
203.17 	currently eligible for medical assistance 
203.18 	or other public health care programs, but 
203.19 	who may meet eligibility requirements with 
203.20 	immigration assistance.
203.21 	(b) The grantees, in collaboration with 
203.22 	hospitals and safety net providers, shall 
203.23 	provide referral assistance to connect 
203.24 	individuals identified in paragraph (a) with 
203.25 	alternative resources and services to assist in 
203.26 	meeting their health care needs. $100,000 
203.27 	is appropriated in fiscal year 2014 and 
203.28 	$100,000 in fiscal year 2015. This is a 
203.29 	onetime appropriation.
203.30 	Base Adjustment. The general fund is 
203.31 	decreased by $100,000 in fiscal year 2016 
203.32 	and $100,000 in fiscal year 2017.

203.33	(i) Aging and Adult Services Grants
		14,827,000
		15,010,000
	
204.1 	Base Adjustment. The general fund is 
204.2 	increased by $1,150,000 in fiscal year 2016 
204.3 	and $1,151,000 in fiscal year 2017.
204.4 	Community Service Development 
204.5 	Grants and Community Services Grants.
204.6 	Community service development grants and 
204.7 	community services grants are reduced by 
204.8 	$1,150,000 each year. This is a onetime 
204.9 	reduction.

204.10	(j) Deaf and Hard-of-Hearing Grants
		1,771,000
		1,785,000

204.11	(k) Disabilities Grants
		18,605,000
		18,823,000
	
204.12 	Advocating Change Together. $310,000 in 
204.13 	fiscal year 2014 is for a grant to Advocating 
204.14 	Change Together (ACT) to maintain and 
204.15 	promote services for persons with intellectual 
204.16 	and developmental disabilities throughout 
204.17 	the state. This appropriation is onetime. Of 
204.18 	this appropriation:
204.19 	(1) $120,000 is for direct costs associated 
204.20 	with the delivery and evaluation of 
204.21 	peer-to-peer training programs administered 
204.22 	throughout the state, focusing on education, 
204.23 	employment, housing, transportation, and 
204.24 	voting;
204.25 	(2) $100,000 is for delivery of statewide 
204.26 	conferences focusing on leadership and 
204.27 	skill development within the disability 
204.28 	community; and
204.29 	(3) $90,000 is for administrative and general 
204.30 	operating costs associated with managing 
204.31 	or maintaining facilities, program delivery, 
204.32 	staff, and technology.
205.1 	Base Adjustment. The general fund base 
205.2 	is increased by $535,000 in fiscal year 2016 
205.3 	and by $709,000 in fiscal year 2017.

205.4	(l) Adult Mental Health Grants

205.5	Appropriations by Fund
	
205.6
205.7	General
	71,199,000
 70,597,000
	69,530,000
 68,783,000
	
205.8	Health Care Access
	750,000
	750,000
	
205.9	Lottery Prize
	1,733,000
	1,733,000
	
205.10 	Compulsive Gambling Treatment. Of the 
205.11 	general fund appropriation, $602,000 in 
205.12 	fiscal year 2014 and $747,000 in fiscal year 
205.13 	2015 are for compulsive gambling treatment 
205.14 	under Minnesota Statutes, section 297E.02, 
205.15 	subdivision 3, paragraph (c).
205.16 	Problem Gambling. $225,000 in fiscal year 
205.17 	2014 and $225,000 in fiscal year 2015 is 
205.18 	appropriated from the lottery prize fund for a 
205.19 	grant to the state affiliate recognized by the 
205.20 	National Council on Problem Gambling. The 
205.21 	affiliate must provide services to increase 
205.22 	public awareness of problem gambling, 
205.23 	education and training for individuals and 
205.24 	organizations providing effective treatment 
205.25 	services to problem gamblers and their 
205.26 	families, and research relating to problem 
205.27 	gambling. 
205.28 	Funding Usage. Up to 75 percent of a fiscal 
205.29 	year's appropriations for adult mental health 
205.30 	grants may be used to fund allocations in that 
205.31 	portion of the fiscal year ending December 
205.32 	31.
205.33 	Base Adjustment. The general fund base is 
205.34 	decreased by $4,427,000 $4,441,000  in fiscal 
205.35 	years 2016 and 2017.
206.1 	Mental Health Pilot Project. $230,000 
206.2 	each year is for a grant to the Zumbro 
206.3 	Valley Mental Health Center. The grant 
206.4 	shall be used to implement a pilot project 
206.5 	to test an integrated behavioral health care 
206.6 	coordination model. The grant recipient must 
206.7 	report measurable outcomes and savings 
206.8 	to the commissioner of human services 
206.9 	by January 15, 2016. This is a onetime 
206.10 	appropriation.
206.11 	High-risk adults. $200,000 in fiscal 
206.12 	year 2014 is for a grant to the nonprofit 
206.13 	organization selected to administer the 
206.14 	demonstration project for high-risk adults 
206.15 	under Laws 2007, chapter 54, article 1, 
206.16 	section 19, in order to complete the project. 
206.17 	This is a onetime appropriation.

206.18	(m) Child Mental Health Grants
		18,246,000
		20,636,000
	
206.19 	Text Message Suicide Prevention 
206.20 	Program. $625,000 in fiscal year 2014 and 
206.21 	$625,000 in fiscal year 2015 is for a grant 
206.22 	to a nonprofit organization to establish and 
206.23 	implement a statewide text message suicide 
206.24 	prevention program. The program shall 
206.25 	implement a suicide prevention counseling 
206.26 	text line designed to use text messaging to 
206.27 	connect with crisis counselors and to obtain 
206.28 	emergency information and referrals to 
206.29 	local resources in the local community. The 
206.30 	program shall include training within schools 
206.31 	and communities to encourage the use of the 
206.32 	program.
206.33 	Mental Health First Aid Training. $22,000 
206.34 	in fiscal year 2014 and $23,000 in fiscal 
206.35 	year 2015 is to train teachers, social service 
207.1 	personnel, law enforcement, and others who 
207.2 	come into contact with children with mental 
207.3 	illnesses, in children and adolescents mental 
207.4 	health first aid training.
207.5 	Funding Usage. Up to 75 percent of a fiscal 
207.6 	year's appropriation for child mental health 
207.7 	grants may be used to fund allocations in that 
207.8 	portion of the fiscal year ending December 
207.9 	31.

207.10	(n) CD Treatment Support Grants
		1,816,000
		1,816,000
	
207.11 	SBIRT Training. (1) $300,000 each year is 
207.12 	for grants to train primary care clinicians to 
207.13 	provide substance abuse brief intervention 
207.14 	and referral to treatment (SBIRT). This is a 
207.15 	onetime appropriation. The commissioner of 
207.16 	human services shall apply to SAMHSA for 
207.17 	an SBIRT professional training grant.
207.18 	(2) If the commissioner of human services 
207.19 	receives a grant under clause (1) funds 
207.20 	appropriated under this clause, equal to 
207.21 	the grant amount, up to the available 
207.22 	appropriation, shall be transferred to the 
207.23 	Minnesota Organization on Fetal Alcohol 
207.24 	Syndrome (MOFAS). MOFAS must use 
207.25 	the funds for grants. Grant recipients must 
207.26 	be selected from communities that are 
207.27 	not currently served by federal Substance 
207.28 	Abuse Prevention and Treatment Block 
207.29 	Grant funds. Grant money must be used to 
207.30 	reduce the rates of fetal alcohol syndrome 
207.31 	and fetal alcohol effects, and the number of 
207.32 	drug-exposed infants. Grant money may be 
207.33 	used for prevention and intervention services 
207.34 	and programs, including, but not limited to, 
208.1 	community grants, professional eduction, 
208.2 	public awareness, and diagnosis.
208.3 	Fetal Alcohol Syndrome Grant. $180,000 
208.4 	each year from the general fund is for a 
208.5 	grant to the Minnesota Organization on Fetal 
208.6 	Alcohol Syndrome (MOFAS) to support 
208.7 	nonprofit Fetal Alcohol Spectrum Disorders 
208.8 	(FASD) outreach prevention programs 
208.9 	in Olmsted County. This is a onetime 
208.10 	appropriation.
208.11 	Base Adjustment. The general fund base is 
208.12 	decreased by $480,000 in fiscal year 2016 
208.13 	and $480,000 in fiscal year 2017.

208.14 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2013.

208.15 	Sec. 6. EFFECTIVE DATE.
 208.16 	Sections 1 and 2 are effective the day following final enactment.