1.1 	A bill for an act
1.2 	relating to the operation of state government; making changes to provisions 
1.3 	relating to the Department of Health, Northstar Care for Children program, 
1.4 	continuing care, community first services and supports, health care, and 
1.5 	chemical dependency; modifying the hospital payment system; modifying 
1.6 	provisions governing background studies and home and community-based 
1.7 	services standards; setting fees; providing rate increases;amending Minnesota 
1.8 	Statutes 2012, sections 13.46, subdivision 4; 245C.03, by adding a subdivision; 
1.9 	245C.04, by adding a subdivision; 245C.05, subdivision 5; 245C.10, by adding 
1.10 	a subdivision; 245C.33, subdivisions 1, 4; 252.451, subdivision 2; 254B.12; 
1.11 	256.01, by adding a subdivision; 256.9685, subdivisions 1, 1a; 256.9686, 
1.12 	subdivision 2; 256.969, subdivisions 1, 2, 2b, 2c, 3a, 3b, 6a, 9, 10, 14, 17, 30, 
1.13 	by adding subdivisions; 256B.0625, subdivision 30; 256B.199; 256B.5012, by 
1.14 	adding a subdivision; 256I.05, subdivision 2; 257.85, subdivision 11; 260C.212, 
1.15 	subdivision 1; 260C.515, subdivision 4; 260C.611; Minnesota Statutes 2013 
1.16 	Supplement, sections 245.8251; 245A.042, subdivision 3; 245C.08, subdivision 
1.17 	1; 245D.02, subdivisions 3, 4b, 8b, 11, 15b, 29, 34, 34a, by adding a subdivision; 
1.18 	245D.03, subdivisions 1, 2, 3, by adding a subdivision; 245D.04, subdivision 
1.19 	3; 245D.05, subdivisions 1, 1a, 1b, 2, 4, 5; 245D.051; 245D.06, subdivisions 2, 
1.20 	4, 6, 7, 8; 245D.071, subdivisions 3, 4, 5; 245D.081, subdivision 2; 245D.09, 
1.21 	subdivisions 3, 4a; 245D.091, subdivisions 2, 3, 4; 245D.10, subdivision 3; 
1.22 	245D.11, subdivision 2; 256B.04, subdivision 21; 256B.055, subdivision 1; 
1.23 	256B.439, subdivisions 1, 7; 256B.4912, subdivision 1; 256B.85, subdivisions 
1.24 	2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16, 17, 18, 23, 24, by adding subdivisions; 
1.25 	256N.02, by adding a subdivision; 256N.21, subdivision 2, by adding a 
1.26 	subdivision; 256N.22, subdivisions 1, 2, 4, 6; 256N.23, subdivisions 1, 4; 
1.27 	256N.24, subdivisions 9, 10; 256N.25, subdivisions 2, 3; 256N.26, subdivision 1; 
1.28 	256N.27, subdivision 4; Laws 2013, chapter 108, article 7, section 49; article 14, 
1.29 	section 2, subdivision 6; proposing coding for new law in Minnesota Statutes, 
1.30 	chapter 144A; repealing Minnesota Statutes 2012, sections 245.825, subdivisions 
1.31 	1, 1b; 256.969, subdivisions 8b, 9a, 9b, 11, 13, 20, 21, 22, 25, 26, 27, 28; 
1.32 	256.9695, subdivisions 3, 4; Minnesota Statutes 2013 Supplement, sections 
1.33 	245D.02, subdivisions 2b, 2c, 3b, 5a, 8a, 15a, 15b, 23b, 28, 29, 34a; 245D.06, 
1.34 	subdivisions 5, 6, 7, 8; 245D.061, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9; 256N.26, 
1.35 	subdivision 7; Minnesota Rules, parts 9525.2700; 9525.2810.
1.36 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.1 	ARTICLE 1
2.2 	HEALTH DEPARTMENT

2.3 	Section 1. [144A.484] INTEGRATED LICENSURE; HOME AND 
2.4 	COMMUNITY-BASED SERVICES DESIGNATION.
2.5 		Subdivision 1.Integrated licensing established. (a) From January 1, 2014, to 
2.6 	June 30, 2015, the commissioner of health shall enforce the home and community-based 
2.7 	services standards under chapter 245D for those providers who also have a home care 
2.8 	license pursuant to chapter 144A as required under Laws 2013, chapter 108, article 11, 
2.9 	section 31, and article 8, section 60.
2.10 	(b) Beginning July 1, 2015, a home care provider applicant or license holder may 
2.11 	apply to the commissioner of health for a home and community-based services designation 
2.12 	for the provision of basic home and community-based services identified under section 
2.13 	245D.03, subdivision 1, paragraph (b). The designation allows the license holder to 
2.14 	provide basic home and community-based services that would otherwise require licensure 
2.15 	under chapter 245D, under the license holder's home care license governed by sections 
2.16 	144A.43 to 144A.481.
2.17 		Subd. 2.Application for home and community-based services designation. An 
2.18 	application for a home and community-based services designation must be made on the 
2.19 	forms and in the manner prescribed by the commissioner. The commissioner shall provide 
2.20 	the applicant with instruction for completing the application and provide information 
2.21 	about the requirements of other state agencies that affect the applicant. Application for 
2.22 	the home and community-based services designation is subject to the requirements under 
2.23 	section 144A.473.
2.24 		Subd. 3.Home and community-based services designation fees. A home care 
2.25 	provider applicant or licensee applying for the home and community-based services 
2.26 	designation or renewal of a home and community-based services designation must submit 
2.27 	a fee in the amount specified in subdivision 8.
2.28 		Subd. 4.Applicability of home and community-based services requirements. A 
2.29 	home care provider with a home and community-based services designation must comply 
2.30 	with the requirements for home care services governed by this chapter. For the provision 
2.31 	of basic home and community-based services, the home care provider must also comply 
2.32 	with the following home and community-based services licensing requirements:
2.33 	(1) person-centered planning requirements in section 245D.07;
2.34 	(2) protection standards in section 245D.06;
2.35 	(3) emergency use of manual restraints in section 245D.061; and
3.1 	(4) service recipient rights in section 245D.04, subdivision 3, paragraph (a), clauses 
3.2 	(5), (7), (8), (12), and (13), and paragraph (b).
3.3 	A home care provider with the integrated license-HCBS designation may utilize a bill of 
3.4 	rights which incorporates the service recipient rights in section 245D.04, subdivision 3, 
3.5 	paragraph (a), clauses (5), (7), (8), (12), and (13), and paragraph (b) with the home care 
3.6 	bill of rights in section 144A.44.
3.7 		Subd. 5.Monitoring and enforcement. (a) The commissioner shall monitor for 
3.8 	compliance with the home and community-based services requirements identified in 
3.9 	subdivision 5, in accordance with this section and any agreements by the commissioners 
3.10 	of health and human services.
3.11 	(b) The commissioner shall enforce compliance with applicable home and 
3.12 	community-based services licensing requirements as follows:
3.13 	(1) the commissioner may deny a home and community-based services designation 
3.14 	in accordance with section 144A.473 or 144A.475; and
3.15 	(2) if the commissioner finds that the applicant or license holder has failed to comply 
3.16 	with the applicable home and community-based services designation requirements the 
3.17 	commissioner may issue:
3.18 	(i) a correction order in accordance with section 144A.474;
3.19 	(ii) an order of conditional license in accordance with section 144A.475;
3.20 	(iii) a sanction in accordance with section 144A.475; or
3.21 	(iv) any combination of clauses (i) to (iii).
3.22 		Subd. 6.Appeals. A home care provider applicant that has been denied a temporary 
3.23 	license will also be denied their application for the home and community-based services 
3.24 	designation. The applicant may request reconsideration in accordance with section 
3.25 	144A.473, subdivision 3. A licensed home care provider whose application for a home 
3.26 	and community-based services designation has been denied or whose designation has been 
3.27 	suspended or revoked may appeal the denial, suspension, revocation, or refusal to renew a 
3.28 	home and community-based services designation in accordance with section 144A.475. 
3.29 	A license holder may request reconsideration of a correction order in accordance with 
3.30 	section 144A.474, subdivision 12.
3.31 		Subd. 7.Agreements. The commissioners of health and human services shall enter 
3.32 	into any agreements necessary to implement this section.
3.33 		Subd. 8.Fees; home and community-based services designation. (a) The initial 
3.34 	fee for a basic home and community-based services designation is $155. A home care 
3.35 	provider who is seeking to renew the provider's home and community-based services 
3.36 	designation must pay an annual nonrefundable fee with the annual home care license 
4.1 	fee according to the following schedule and based on revenues from the home and 
4.2 	community-based services:

4.3
4.4	Provider Annual Revenue from HCBS
	HCBS 
Designation

4.5	greater than $1,500,000
	$320
	
4.6	greater than $1,275,000 and no more than $1,500,000
	$300
	
4.7	greater than $1,100,000 and no more than $1,275,000
	$280
	
4.8	greater than $950,000 and no more than $1,100,000
	$260
	
4.9	greater than $850,000 and no more than $950,000
	$240
	
4.10	greater than $750,000 and no more than $850,000
	$220
	
4.11	greater than $650,000 and no more than $750,000
	$200
	
4.12	greater than $550,000 and no more than $650,000
	$180
	
4.13	greater than $450,000 and no more than $550,000
	$160
	
4.14	greater than $350,000 and no more than $450,000
	$140
	
4.15	greater than $250,000 and no more than $350,000
	$120
	
4.16	greater than $100,000 and no more than $250,000
	$100
	
4.17	greater than $50,000 and no more than $100,000
	$80
	
4.18	greater than $25,000 and no more than $50,000
	$60
	
4.19	no more than $25,000
	$40
	
4.20 	(b) Fees and penalties collected under this section shall be deposited in the state 
4.21 	treasury and credited to the state government special revenue fund.

4.22 	EFFECTIVE DATE. Minnesota Statutes, section 144A.484, subdivisions 2 to 8, 
4.23 	are effective July 1, 2015.

4.24 	Sec. 2. Minnesota Statutes 2013 Supplement, section 256B.04, subdivision 21, is 
4.25 	amended to read:
4.26 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for 
4.27 	Medicare and Medicaid Services determines that a provider is designated "high-risk," the 
4.28 	commissioner may withhold payment from providers within that category upon initial 
4.29 	enrollment for a 90-day period. The withholding for each provider must begin on the date 
4.30 	of the first submission of a claim.
4.31 	(b) An enrolled provider that is also licensed by the commissioner under chapter 
4.32 	245A or that is licensed by the Department of Health under chapter 144A and has a 
4.33 	HCBS designation on the home care license must designate an individual as the entity's 
4.34 	compliance officer. The compliance officer must:
4.35 	(1) develop policies and procedures to assure adherence to medical assistance laws 
4.36 	and regulations and to prevent inappropriate claims submissions;
5.1 	(2) train the employees of the provider entity, and any agents or subcontractors of 
5.2 	the provider entity including billers, on the policies and procedures under clause (1);
5.3 	(3) respond to allegations of improper conduct related to the provision or billing of 
5.4 	medical assistance services, and implement action to remediate any resulting problems;
5.5 	(4) use evaluation techniques to monitor compliance with medical assistance laws 
5.6 	and regulations;
5.7 	(5) promptly report to the commissioner any identified violations of medical 
5.8 	assistance laws or regulations; and
5.9 	(6) within 60 days of discovery by the provider of a medical assistance 
5.10 	reimbursement overpayment, report the overpayment to the commissioner and make 
5.11 	arrangements with the commissioner for the commissioner's recovery of the overpayment.
5.12 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
5.13 	provider within a particular industry sector or category establish a compliance program that 
5.14 	contains the core elements established by the Centers for Medicare and Medicaid Services.
5.15 	(c) The commissioner may revoke the enrollment of an ordering or rendering 
5.16 	provider for a period of not more than one year, if the provider fails to maintain and, upon 
5.17 	request from the commissioner, provide access to documentation relating to written orders 
5.18 	or requests for payment for durable medical equipment, certifications for home health 
5.19 	services, or referrals for other items or services written or ordered by such provider, when 
5.20 	the commissioner has identified a pattern of a lack of documentation. A pattern means a 
5.21 	failure to maintain documentation or provide access to documentation on more than one 
5.22 	occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a 
5.23 	provider under the provisions of section 256B.064.
5.24 	(d) The commissioner shall terminate or deny the enrollment of any individual or 
5.25 	entity if the individual or entity has been terminated from participation in Medicare or 
5.26 	under the Medicaid program or Children's Health Insurance Program of any other state.
5.27 	(e) As a condition of enrollment in medical assistance, the commissioner shall 
5.28 	require that a provider designated "moderate" or "high-risk" by the Centers for Medicare 
5.29 	and Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
5.30 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
5.31 	designated contractors to conduct unannounced on-site inspections of any provider location. 
5.32 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
5.33 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
5.34 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
5.35 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
5.36 	The commissioner's designations are not subject to administrative appeal.
6.1 	(f) As a condition of enrollment in medical assistance, the commissioner shall 
6.2 	require that a high-risk provider, or a person with a direct or indirect ownership interest in 
6.3 	the provider of five percent or higher, consent to criminal background checks, including 
6.4 	fingerprinting, when required to do so under state law or by a determination by the 
6.5 	commissioner or the Centers for Medicare and Medicaid Services that a provider is 
6.6 	designated high-risk for fraud, waste, or abuse.
6.7 	(g)(1) Upon initial enrollment, reenrollment, and revalidation, all durable medical 
6.8 	equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers operating in 
6.9 	Minnesota and receiving Medicaid funds must purchase a surety bond that is annually 
6.10 	renewed and designates the Minnesota Department of Human Services as the obligee, and 
6.11 	must be submitted in a form approved by the commissioner.
6.12 	(2) At the time of initial enrollment or reenrollment, the provider agency must 
6.13 	purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue 
6.14 	in the previous calendar year is up to and including $300,000, the provider agency must 
6.15 	purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue 
6.16 	in the previous calendar year is over $300,000, the provider agency must purchase a 
6.17 	performance bond of $100,000. The performance bond must allow for recovery of costs 
6.18 	and fees in pursuing a claim on the bond.
6.19 	(h) The Department of Human Services may require a provider to purchase a 
6.20 	performance surety bond as a condition of initial enrollment, reenrollment, reinstatement, 
6.21 	or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the 
6.22 	department determines there is significant evidence of or potential for fraud and abuse by 
6.23 	the provider, or (3) the provider or category of providers is designated high-risk pursuant 
6.24 	to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450. The 
6.25 	performance bond must be in an amount of $100,000 or ten percent of the provider's 
6.26 	payments from Medicaid during the immediately preceding 12 months, whichever is 
6.27 	greater. The performance bond must name the Department of Human Services as an 
6.28 	obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.

6.29 	ARTICLE 2
6.30 	HEALTH CARE

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

7.3 	Sec. 2. Minnesota Statutes 2012, section 256.9685, subdivision 1, is amended to read:
7.4 		Subdivision 1.Authority. (a) The commissioner shall establish procedures for 
7.5 	determining medical assistance and general assistance medical care payment rates under 
7.6 	a prospective payment system for inpatient hospital services in hospitals that qualify as 
7.7 	vendors of medical assistance. The commissioner shall establish, by rule, procedures for 
7.8 	implementing this section and sections 256.9686, 256.969, and 256.9695. Services must 
7.9 	meet the requirements of section 256B.04, subdivision 15, or 256D.03, subdivision 7, 
7.10 	paragraph (b), to be eligible for payment.
7.11 	(b) The commissioner may reduce the types of inpatient hospital admissions that 
7.12 	are required to be certified as medically necessary after notice in the State Register and a 
7.13 	30-day comment period.

7.14 	Sec. 3. Minnesota Statutes 2012, section 256.9685, subdivision 1a, is amended to read:
7.15 		Subd. 1a.Administrative reconsideration. Notwithstanding sections section
7.16 	256B.04, subdivision 15, and 256D.03, subdivision 7, the commissioner shall establish 
7.17 	an administrative reconsideration process for appeals of inpatient hospital services 
7.18 	determined to be medically unnecessary. A physician or hospital may request a 
7.19 	reconsideration of the decision that inpatient hospital services are not medically necessary 
7.20 	by submitting a written request for review to the commissioner within 30 days after 
7.21 	receiving notice of the decision. The reconsideration process shall take place prior to the 
7.22 	procedures of subdivision 1b and shall be conducted by physicians that are independent 
7.23 	of the case under reconsideration. A majority decision by the physicians is necessary to 
7.24 	make a determination that the services were not medically necessary.

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

7.31 	Sec. 5. Minnesota Statutes 2012, section 256.969, subdivision 1, is amended to read:
8.1 		Subdivision 1.Hospital cost index. (a) The hospital cost index shall be the change 
8.2 	in the Consumer Price Index-All Items (United States city average) (CPI-U) forecasted 
8.3 	by Data Resources, Inc. The commissioner shall use the indices as forecasted in the 
8.4 	third quarter of the calendar year prior to the rate year. The hospital cost index may be 
8.5 	used to adjust the base year operating payment rate through the rate year on an annually 
8.6 	compounded basis.
8.7 	(b) For fiscal years beginning on or after July 1, 1993, the commissioner of human 
8.8 	services shall not provide automatic annual inflation adjustments for hospital payment 
8.9 	rates under medical assistance, nor under general assistance medical care, except that 
8.10 	the inflation adjustments under paragraph (a) for medical assistance, excluding general 
8.11 	assistance medical care, shall apply through calendar year 2001. The index for calendar 
8.12 	year 2000 shall be reduced 2.5 percentage points to recover overprojections of the index 
8.13 	from 1994 to 1996. The commissioner of management and budget shall include as a 
8.14 	budget change request in each biennial detailed expenditure budget submitted to the 
8.15 	legislature under section 16A.11 annual adjustments in hospital payment rates under 
8.16 	medical assistance and general assistance medical care, based upon the hospital cost index.

8.17 	Sec. 6. Minnesota Statutes 2012, section 256.969, subdivision 2, is amended to read:
8.18 		Subd. 2.Diagnostic categories. The commissioner shall use to the extent possible 
8.19 	existing diagnostic classification systems, including the system used by the Medicare 
8.20 	program created by 3M for all patient refined diagnosis-related groups (APR-DRGs) to 
8.21 	determine the relative values of inpatient services and case mix indices. The commissioner 
8.22 	may combine diagnostic classifications into diagnostic categories and may establish 
8.23 	separate categories and numbers of categories based on program eligibility or hospital 
8.24 	peer group. Relative values shall be recalculated when the base year is changed. Relative 
8.25 	value determinations shall include paid claims for admissions during each hospital's base 
8.26 	year. The commissioner may extend the time period forward to obtain sufficiently valid 
8.27 	information to establish relative values supplement the APR-DRG data with national 
8.28 	averages. Relative value determinations shall not include property cost data, Medicare 
8.29 	crossover data, and data on admissions that are paid a per day transfer rate under 
8.30 	subdivision 14. The computation of the base year cost per admission must include identified 
8.31 	outlier cases and their weighted costs up to the point that they become outlier cases, but 
8.32 	must exclude costs recognized in outlier payments beyond that point. The commissioner 
8.33 	may recategorize the diagnostic classifications and recalculate relative values and case mix 
8.34 	indices to reflect actual hospital practices, the specific character of specialty hospitals, or 
8.35 	to reduce variances within the diagnostic categories after notice in the State Register and a 
9.1 	30-day comment period. The commissioner shall recategorize the diagnostic classifications 
9.2 	and recalculate relative values and case mix indices based on the two-year schedule in 
9.3 	effect prior to January 1, 2013, reflected in subdivision 2b. The first recategorization shall 
9.4 	occur January 1, 2013, and shall occur every two years after. When rates are not rebased 
9.5 	under subdivision 2b, the commissioner may establish relative values and case mix indices 
9.6 	based on charge data and may update the base year to the most recent data available.

9.7 	Sec. 7. Minnesota Statutes 2012, section 256.969, subdivision 2b, is amended to read:
9.8 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
9.9 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
9.10 	years after, or more frequently as determined by the commissioner, the commissioner shall 
9.11 	obtain operating data from an updated base year and establish operating payment rates 
9.12 	per admission for each hospital based on the cost-finding methods and allowable costs of 
9.13 	the Medicare program in effect during the base year. Rates under the general assistance 
9.14 	medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 
9.15 	more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 
9.16 	rebased period beginning January 1, 2009. For the rebased period beginning January 1, 
9.17 	2011, rates shall not be rebased, except that a Minnesota long-term hospital shall be 
9.18 	rebased effective January 1, 2011, based on its most recent Medicare cost report ending on 
9.19 	or before September 1, 2008, with the provisions under subdivisions 9 and 23, based on 
9.20 	the rates in effect on December 31, 2010. For subsequent rate setting periods in which the 
9.21 	base years are updated, a Minnesota long-term hospital's base year shall remain within 
9.22 	the same period as other hospitals. Effective January 1, 2013, and after, rates shall not be 
9.23 	rebased. The base year operating payment rate per admission is standardized by the case 
9.24 	mix index and adjusted by the hospital cost index, relative values, and disproportionate 
9.25 	population adjustment. The cost and charge data used to establish operating rates shall 
9.26 	only reflect inpatient services covered by medical assistance and shall not include property 
9.27 	cost information and costs recognized in outlier payments. In determining operating 
9.28 	payment rates for admissions occurring on or after the rate year beginning January 1, 
9.29 	2011, through December 31, 2012, the operating payment rate per admission must be 
9.30 	based on the cost-finding methods and allowable costs of the Medicare program in effect 
9.31 	during the base year or years.

9.32 	Sec. 8. Minnesota Statutes 2012, section 256.969, subdivision 2c, is amended to read:
9.33 		Subd. 2c.Property payment rates. For each hospital's first two consecutive 
9.34 	fiscal years beginning on or after July 1, 1988, the commissioner shall limit the annual 
10.1 	increase in property payment rates for depreciation, rents and leases, and interest expense 
10.2 	to the annual growth in the hospital cost index derived from the methodology in effect 
10.3 	on the day before July 1, 1989. When computing budgeted and settlement property 
10.4 	payment rates, the commissioner shall use the annual increase in the hospital cost index 
10.5 	forecasted by Data Resources, Inc., consistent with the quarter of the hospital's fiscal year 
10.6 	end. For admissions occurring on or after the rate year beginning January 1, 1991, the 
10.7 	commissioner shall obtain property data from an updated base year and establish property 
10.8 	payment rates per admission for each hospital. Property payment rates shall be derived 
10.9 	from data from the same base year that is used to establish operating payment rates. The 
10.10 	property information shall include cost categories not subject to the hospital cost index 
10.11 	and shall reflect the cost-finding methods and allowable costs of the Medicare program. 
10.12 	The base year property payment rates shall be adjusted for increases in the property cost 
10.13 	by increasing the base year property payment rate 85 percent of the percentage change 
10.14 	from the base year through the year for which a Medicare cost report has been submitted 
10.15 	to the Medicare program and filed with the department by the October 1 before the rate 
10.16 	year. The property rates shall only reflect inpatient services covered by medical assistance. 
10.17 	The commissioner shall adjust rates for the rate year beginning January 1, 1991, to ensure 
10.18 	that all hospitals are subject to the hospital cost index limitation for two complete years.

10.19 	Sec. 9. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
10.20 	to read:
10.21 		Subd. 2d.Budget neutrality factor. For the rebased period effective September 1, 
10.22 	2014, when rebasing rates under subdivisions 2b and 2c, the commissioner must apply a 
10.23 	budget neutrality factor (BNF) to a hospital's conversion factor to ensure that total DRG 
10.24 	payments to hospitals do not exceed total DRG payments that would have been made to 
10.25 	hospitals if the relative rates and weights had not been recalibrated. For the purposes of 
10.26 	this section, BNF equals the percentage change from total aggregate payments calculated 
10.27 	under a new payment system to total aggregate payments calculated under the old system.

10.28 	Sec. 10. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
10.29 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
10.30 	assistance program must not be submitted until the recipient is discharged. However, 
10.31 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
10.32 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
10.33 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
10.34 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
11.1 	hospital payments established under this section and sections 256.9685, 256.9686, and 
11.2 	256.9695, in addition to third-party and recipient liability, for discharges occurring during 
11.3 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
11.4 	inpatient services paid for the same period of time to the hospital. This payment limitation 
11.5 	shall be calculated separately for medical assistance and general assistance medical 
11.6 	care services. The limitation on general assistance medical care shall be effective for 
11.7 	admissions occurring on or after July 1, 1991. Services that have rates established under 
11.8 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
11.9 	the affected hospitals, the commissioner may consider related hospitals one entity and may 
11.10 	merge the payment rates while maintaining separate provider numbers. The operating and 
11.11 	property base rates per admission or per day shall be derived from the best Medicare and 
11.12 	claims data available when rates are established. The commissioner shall determine the 
11.13 	best Medicare and claims data, taking into consideration variables of recency of the data, 
11.14 	audit disposition, settlement status, and the ability to set rates in a timely manner. The 
11.15 	commissioner shall notify hospitals of payment rates by December 1 of the year preceding 
11.16 	the rate year 30 days prior to implementation. The rate setting data must reflect the 
11.17 	admissions data used to establish relative values. Base year changes from 1981 to the base 
11.18 	year established for the rate year beginning January 1, 1991, and for subsequent rate years, 
11.19 	shall not be limited to the limits ending June 30, 1987, on the maximum rate of increase 
11.20 	under subdivision 1. The commissioner may adjust base year cost, relative value, and case 
11.21 	mix index data to exclude the costs of services that have been discontinued by the October 
11.22 	1 of the year preceding the rate year or that are paid separately from inpatient services. 
11.23 	Inpatient stays that encompass portions of two or more rate years shall have payments 
11.24 	established based on payment rates in effect at the time of admission unless the date of 
11.25 	admission preceded the rate year in effect by six months or more. In this case, operating 
11.26 	payment rates for services rendered during the rate year in effect and established based on 
11.27 	the date of admission shall be adjusted to the rate year in effect by the hospital cost index.
11.28 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
11.29 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
11.30 	services is reduced by .5 percent from the current statutory rates.
11.31 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
11.32 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
11.33 	before third-party liability and spenddown, is reduced five percent from the current 
11.34 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
11.35 	facilities defined under subdivision 16 are excluded from this paragraph.
12.1 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
12.2 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
12.3 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
12.4 	from the current statutory rates. Mental health services within diagnosis related groups 
12.5 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
12.6 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
12.7 	assistance does not include general assistance medical care. Payments made to managed 
12.8 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
12.9 	this reduction.
12.10 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
12.11 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
12.12 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
12.13 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
12.14 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
12.15 	paragraph. Payments made to managed care plans shall be reduced for services provided 
12.16 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
12.17 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
12.18 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
12.19 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
12.20 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
12.21 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
12.22 	paragraph. Payments made to managed care plans shall be reduced for services provided 
12.23 	on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
12.24 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
12.25 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
12.26 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
12.27 	from the current statutory rates. Mental health services with diagnosis related groups 
12.28 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
12.29 	Payments made to managed care plans shall be reduced for services provided on or after 
12.30 	July 1, 2011, to reflect this reduction.
12.31 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
12.32 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
12.33 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
12.34 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
12.35 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
12.36 	services provided on or after October 1, 2009, to reflect this reduction.
13.1 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total 
13.2 	payment for fee-for-service admissions occurring on or after July 1, 2011, made to 
13.3 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
13.4 	1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are 
13.5 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
13.6 	services provided on or after January 1, 2011, to reflect this reduction.

13.7 	Sec. 11. Minnesota Statutes 2012, section 256.969, subdivision 3b, is amended to read:
13.8 		Subd. 3b.Nonpayment for hospital-acquired conditions and for certain 
13.9 	treatments. (a) The commissioner must not make medical assistance payments to a 
13.10 	hospital for any costs of care that result from a condition listed in paragraph (c), if the 
13.11 	condition was hospital acquired.
13.12 	(b) For purposes of this subdivision, a condition is hospital acquired if it is not 
13.13 	identified by the hospital as present on admission. For purposes of this subdivision, 
13.14 	medical assistance includes general assistance medical care and MinnesotaCare.
13.15 	(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired 
13.16 	condition listed in this paragraph that is represented by an ICD-9-CM ICD-10-CM
13.17 	 diagnosis code and is designated as a complicating condition or a major complicating 
13.18 	condition:. The list of conditions is defined by the Centers for Medicare and Medicaid 
13.19 	Services on an annual basis with the hospital-acquired conditions (HAC) list:
13.20 	(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
13.21 	(2) air embolism (ICD-9-CM code 999.1);
13.22 	(3) blood incompatibility (ICD-9-CM code 999.6);
13.23 	(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
13.24 	(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing 
13.25 	injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating 
13.26 	condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929; 
13.27 	940-949; and 991-994);
13.28 	(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
13.29 	(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
13.30 	(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11; 
13.31 	249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and 
13.32 	251.0);
13.33 	(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain 
13.34 	orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07; 
14.1 	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 
14.2 	81.85);
14.3 	(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery 
14.4 	(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity 
14.5 	(ICD-9-CM code 278.01);
14.6 	(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary 
14.7 	artery bypass graft (procedure codes 36.10 to 36.19); and
14.8 	(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary 
14.9 	embolism (ICD-9-CM codes 415.11 or 415.19) following total knee replacement 
14.10 	(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51 
14.11 	to 81.52).
14.12 	(d) The prohibition in paragraph (a) applies to any additional payments that result 
14.13 	from a hospital-acquired condition listed in paragraph (c), including, but not limited to, 
14.14 	additional treatment or procedures, readmission to the facility after discharge, increased 
14.15 	length of stay, change to a higher diagnostic category, or transfer to another hospital. In 
14.16 	the event of a transfer to another hospital, the hospital where the condition listed under 
14.17 	paragraph (c) was acquired is responsible for any costs incurred at the hospital to which 
14.18 	the patient is transferred.
14.19 	(e) A hospital shall not bill a recipient of services for any payment disallowed under 
14.20 	this subdivision.

14.21 	Sec. 12. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
14.22 	to read:
14.23 		Subd. 4b.Medical assistance cost reports for services. (a) A hospital that meets 
14.24 	one of the following criteria must annually file medical assistance cost reports within six 
14.25 	months of the end of the hospital's fiscal year:
14.26 	(1) a hospital designated as a critical access hospital that receives medical assistance 
14.27 	payments; or
14.28 	(2) a Minnesota hospital or out-of-state hospital located within a Minnesota local 
14.29 	trade area that receives a disproportionate population adjustment under subdivision 9.
14.30 	For purposes of this subdivision, local trade area has the meaning given in 
14.31 	subdivision 17.
14.32 	(b) The Department of Human Services must suspend payments to any hospital that 
14.33 	fails to file a report required under this subdivision. Payments must remain suspended 
14.34 	until the report has been filed with and accepted by the Department of Human Services 
14.35 	inpatient rates unit.

15.1 	Sec. 13. Minnesota Statutes 2012, section 256.969, subdivision 6a, is amended to read:
15.2 		Subd. 6a.Special considerations. In determining the payment rates, the 
15.3 	commissioner shall consider whether the circumstances in subdivisions 7 8 to 14 exist.

15.4 	Sec. 14. Minnesota Statutes 2012, section 256.969, is amended by adding a subdivision 
15.5 	to read:
15.6 		Subd. 8c.Hospital residents. Payments for hospital residents shall be made 
15.7 	as follows:
15.8 	(1) payments for the first 180 days of inpatient care shall be the APR-DRG payment 
15.9 	plus any appropriate outliers; and
15.10 	(2) payment for all medically necessary patient care subsequent to 180 days shall 
15.11 	be reimbursed at a rate computed by multiplying the statewide average cost-to-charge 
15.12 	ratio by the usual and customary charges.

15.13 	Sec. 15. Minnesota Statutes 2012, section 256.969, subdivision 9, is amended to read:
15.14 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For 
15.15 	admissions occurring on or after October 1, 1992, through December 31, 1992, the 
15.16 	medical assistance disproportionate population adjustment shall comply with federal law 
15.17 	and shall be paid to a hospital, excluding regional treatment centers and facilities of the 
15.18 	federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 
15.19 	of the arithmetic mean. The adjustment must be determined as follows:
15.20 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
15.21 	arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 
15.22 	federal Indian Health Service but less than or equal to one standard deviation above the 
15.23 	mean, the adjustment must be determined by multiplying the total of the operating and 
15.24 	property payment rates by the difference between the hospital's actual medical assistance 
15.25 	inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 
15.26 	treatment centers and facilities of the federal Indian Health Service; and
15.27 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
15.28 	standard deviation above the mean, the adjustment must be determined by multiplying 
15.29 	the adjustment that would be determined under clause (1) for that hospital by 1.1. If 
15.30 	federal matching funds are not available for all adjustments under this subdivision, the 
15.31 	commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 
15.32 	federal match. The commissioner may establish a separate disproportionate population 
15.33 	operating payment rate adjustment under the general assistance medical care program. 
15.34 	For purposes of this subdivision medical assistance does not include general assistance 
16.1 	medical care. The commissioner shall report annually on the number of hospitals likely to 
16.2 	receive the adjustment authorized by this paragraph. The commissioner shall specifically 
16.3 	report on the adjustments received by public hospitals and public hospital corporations 
16.4 	located in cities of the first class.
16.5 	(b) For admissions occurring on or after July 1, 1993, the medical assistance 
16.6 	disproportionate population adjustment shall comply with federal law and shall be paid to 
16.7 	a hospital, excluding regional treatment centers, critical access hospitals, and facilities of 
16.8 	the federal Indian Health Service, with a medical assistance inpatient utilization rate in 
16.9 	excess of the arithmetic mean. The adjustment must be determined as follows:
16.10 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
16.11 	arithmetic mean for all hospitals excluding regional treatment centers, critical access 
16.12 	hospitals, and facilities of the federal Indian Health Service but less than or equal to one 
16.13 	standard deviation above the mean, the adjustment must be determined by multiplying the 
16.14 	total of the operating and property payment rates by the difference between the hospital's 
16.15 	actual medical assistance inpatient utilization rate and the arithmetic mean for all hospitals 
16.16 	excluding regional treatment centers and facilities of the federal Indian Health Service; and
16.17 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
16.18 	standard deviation above the mean, the adjustment must be determined by multiplying 
16.19 	the adjustment that would be determined under clause (1) for that hospital by 1.1. The 
16.20 	commissioner may establish a separate disproportionate population operating payment 
16.21 	rate adjustment under the general assistance medical care program. For purposes of this 
16.22 	subdivision, medical assistance does not include general assistance medical care. The 
16.23 	commissioner shall report annually on the number of hospitals likely to receive the 
16.24 	adjustment authorized by this paragraph. The commissioner shall specifically report on 
16.25 	the adjustments received by public hospitals and public hospital corporations located in 
16.26 	cities of the first class;.
16.27 	(3) for a hospital that had medical assistance fee-for-service payment volume during 
16.28 	calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 
16.29 	payment volume, a medical assistance disproportionate population adjustment shall be 
16.30 	paid in addition to any other disproportionate payment due under this subdivision as 
16.31 	follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 
16.32 	For a hospital that had medical assistance fee-for-service payment volume during calendar 
16.33 	year 1991 in excess of eight percent of total medical assistance fee-for-service payment 
16.34 	volume and was the primary hospital affiliated with the University of Minnesota, a 
16.35 	medical assistance disproportionate population adjustment shall be paid in addition to any 
17.1 	other disproportionate payment due under this subdivision as follows: $505,000 due on 
17.2 	the 15th of each month after noon, beginning July 15, 1995; and
17.3 	(4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 
17.4 	reduced to zero.
17.5 	(c) The commissioner shall adjust rates paid to a health maintenance organization 
17.6 	under contract with the commissioner to reflect rate increases provided in paragraph (b), 
17.7 	clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 
17.8 	rates to reflect payments provided in clause (3).
17.9 	(d) If federal matching funds are not available for all adjustments under paragraph 
17.10 	(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 
17.11 	pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
17.12 	(e) For purposes of this subdivision, medical assistance does not include general 
17.13 	assistance medical care.
17.14 	(f) For hospital services occurring on or after July 1, 2005, to June 30, 2007:
17.15 	(1) general assistance medical care expenditures for fee-for-service inpatient and 
17.16 	outpatient hospital payments made by the department shall be considered Medicaid 
17.17 	disproportionate share hospital payments, except as limited below:
17.18 	 (i) only the portion of Minnesota's disproportionate share hospital allotment under 
17.19 	section 1923(f) of the Social Security Act that is not spent on the disproportionate 
17.20 	population adjustments in paragraph (b), clauses (1) and (2), may be used for general 
17.21 	assistance medical care expenditures;
17.22 	 (ii) only those general assistance medical care expenditures made to hospitals that 
17.23 	qualify for disproportionate share payments under section 1923 of the Social Security Act 
17.24 	and the Medicaid state plan may be considered disproportionate share hospital payments;
17.25 	 (iii) only those general assistance medical care expenditures made to an individual 
17.26 	hospital that would not cause the hospital to exceed its individual hospital limits under 
17.27 	section 1923 of the Social Security Act may be considered; and
17.28 	 (iv) general assistance medical care expenditures may be considered only to the 
17.29 	extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
17.30 	All hospitals and prepaid health plans participating in general assistance medical care 
17.31 	must provide any necessary expenditure, cost, and revenue information required by the 
17.32 	commissioner as necessary for purposes of obtaining federal Medicaid matching funds for 
17.33 	general assistance medical care expenditures; and
17.34 	(2) (c) Certified public expenditures made by Hennepin County Medical Center shall 
17.35 	be considered Medicaid disproportionate share hospital payments. Hennepin County 
17.36 	and Hennepin County Medical Center shall report by June 15, 2007, on payments made 
18.1 	beginning July 1, 2005, or another date specified by the commissioner, that may qualify 
18.2 	for reimbursement under federal law. Based on these reports, the commissioner shall 
18.3 	apply for federal matching funds.
18.4 	(g) (d) Upon federal approval of the related state plan amendment, paragraph (f) (c)
18.5 	 is effective retroactively from July 1, 2005, or the earliest effective date approved by the 
18.6 	Centers for Medicare and Medicaid Services.

18.7 	Sec. 16. Minnesota Statutes 2012, section 256.969, subdivision 10, is amended to read:
18.8 		Subd. 10.Separate billing by certified registered nurse anesthetists. Hospitals 
18.9 	may must exclude certified registered nurse anesthetist costs from the operating payment 
18.10 	rate as allowed by section 256B.0625, subdivision 11. To be eligible, a hospital must 
18.11 	notify the commissioner in writing by October 1 of even-numbered years to exclude 
18.12 	certified registered nurse anesthetist costs. The hospital must agree that all hospital 
18.13 	claims for the cost and charges of certified registered nurse anesthetist services will not 
18.14 	be included as part of the rates for inpatient services provided during the rate year. In 
18.15 	this case, the operating payment rate shall be adjusted to exclude the cost of certified 
18.16 	registered nurse anesthetist services.
18.17 	For admissions occurring on or after July 1, 1991, and until the expiration date of 
18.18 	section 256.9695, subdivision 3, services of certified registered nurse anesthetists provided 
18.19 	on an inpatient basis may be paid as allowed by section 256B.0625, subdivision 11, when 
18.20 	the hospital's base year did not include the cost of these services. To be eligible, a hospital 
18.21 	must notify the commissioner in writing by July 1, 1991, of the request and must comply 
18.22 	with all other requirements of this subdivision.

18.23 	Sec. 17. Minnesota Statutes 2012, section 256.969, subdivision 14, is amended to read:
18.24 		Subd. 14.Transfers. Except as provided in subdivisions 11 and 13, Operating 
18.25 	and property payment rates for admissions that result in transfers and transfers shall be 
18.26 	established on a per day payment system. The per day payment rate shall be the sum of 
18.27 	the adjusted operating and property payment rates determined under this subdivision and 
18.28 	subdivisions 2, 2b, 2c, 3a, 4a, 5a, and 7 8 to 12, divided by the arithmetic mean length 
18.29 	of stay for the diagnostic category. Each admission that results in a transfer and each 
18.30 	transfer is considered a separate admission to each hospital, and the total of the admission 
18.31 	and transfer payments to each hospital must not exceed the total per admission payment 
18.32 	that would otherwise be made to each hospital under this subdivision and subdivisions 
18.33 	2, 2b, 2c, 3a, 4a, 5a, and 7 to 13 8 to 12.

19.1 	Sec. 18. Minnesota Statutes 2012, section 256.969, subdivision 17, is amended to read:
19.2 		Subd. 17.Out-of-state hospitals in local trade areas. Out-of-state hospitals that 
19.3 	are located within a Minnesota local trade area and that have more than 20 admissions in 
19.4 	the base year or years shall have rates established using the same procedures and methods 
19.5 	that apply to Minnesota hospitals. For this subdivision and subdivision 18, local trade area 
19.6 	means a county contiguous to Minnesota and located in a metropolitan statistical area as 
19.7 	determined by Medicare for October 1 prior to the most current rebased rate year. Hospitals 
19.8 	that are not required by law to file information in a format necessary to establish rates shall 
19.9 	have rates established based on the commissioner's estimates of the information. Relative 
19.10 	values of the diagnostic categories shall not be redetermined under this subdivision until 
19.11 	required by rule statute. Hospitals affected by this subdivision shall then be included in 
19.12 	determining relative values. However, hospitals that have rates established based upon 
19.13 	the commissioner's estimates of information shall not be included in determining relative 
19.14 	values. This subdivision is effective for hospital fiscal years beginning on or after July 
19.15 	1, 1988. A hospital shall provide the information necessary to establish rates under this 
19.16 	subdivision at least 90 days before the start of the hospital's fiscal year.

19.17 	Sec. 19. Minnesota Statutes 2012, section 256.969, subdivision 30, is amended to read:
19.18 		Subd. 30.Payment rates for births. (a) For admissions occurring on or after 
19.19 	October 1, 2009 September 1, 2014, the total operating and property payment rate, 
19.20 	excluding disproportionate population adjustment, for the following diagnosis-related 
19.21 	groups, as they fall within the diagnostic APR-DRG categories: (1) 371 cesarean section 
19.22 	without complicating diagnosis 5601, 5602, 5603, 5604 vaginal delivery; and (2) 372 
19.23 	vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without 
19.24 	complicating diagnosis 5401, 5402, 5403, 5404 cesarean section, shall be no greater 
19.25 	than $3,528.
19.26 	(b) The rates described in this subdivision do not include newborn care.
19.27 	(c) Payments to managed care and county-based purchasing plans under section 
19.28 	256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October 
19.29 	1, 2009, to reflect the adjustments in paragraph (a).
19.30 	(d) Prior authorization shall not be required before reimbursement is paid for a 
19.31 	cesarean section delivery.

19.32 	Sec. 20. Minnesota Statutes 2012, section 256B.0625, subdivision 30, is amended to 
19.33 	read:
20.1 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic 
20.2 	services, federally qualified health center services, nonprofit community health clinic 
20.3 	services, and public health clinic services. Rural health clinic services and federally 
20.4 	qualified health center services mean services defined in United States Code, title 42, 
20.5 	section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified 
20.6 	health center services shall be made according to applicable federal law and regulation.
20.7 	(b) A federally qualified health center that is beginning initial operation shall submit 
20.8 	an estimate of budgeted costs and visits for the initial reporting period in the form and 
20.9 	detail required by the commissioner. A federally qualified health center that is already in 
20.10 	operation shall submit an initial report using actual costs and visits for the initial reporting 
20.11 	period. Within 90 days of the end of its reporting period, a federally qualified health 
20.12 	center shall submit, in the form and detail required by the commissioner, a report of 
20.13 	its operations, including allowable costs actually incurred for the period and the actual 
20.14 	number of visits for services furnished during the period, and other information required 
20.15 	by the commissioner. Federally qualified health centers that file Medicare cost reports 
20.16 	shall provide the commissioner with a copy of the most recent Medicare cost report filed 
20.17 	with the Medicare program intermediary for the reporting year which support the costs 
20.18 	claimed on their cost report to the state.
20.19 	(c) In order to continue cost-based payment under the medical assistance program 
20.20 	according to paragraphs (a) and (b), a federally qualified health center or rural health clinic 
20.21 	must apply for designation as an essential community provider within six months of final 
20.22 	adoption of rules by the Department of Health according to section 62Q.19, subdivision 
20.23 	7. For those federally qualified health centers and rural health clinics that have applied 
20.24 	for essential community provider status within the six-month time prescribed, medical 
20.25 	assistance payments will continue to be made according to paragraphs (a) and (b) for the 
20.26 	first three years after application. For federally qualified health centers and rural health 
20.27 	clinics that either do not apply within the time specified above or who have had essential 
20.28 	community provider status for three years, medical assistance payments for health services 
20.29 	provided by these entities shall be according to the same rates and conditions applicable 
20.30 	to the same service provided by health care providers that are not federally qualified 
20.31 	health centers or rural health clinics.
20.32 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally 
20.33 	qualified health center or a rural health clinic to make application for an essential 
20.34 	community provider designation in order to have cost-based payments made according 
20.35 	to paragraphs (a) and (b) no longer apply.
21.1 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) 
21.2 	shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
21.3 	(f) Effective January 1, 2001, each federally qualified health center and rural health 
21.4 	clinic may elect to be paid either under the prospective payment system established 
21.5 	in United States Code, title 42, section 1396a(aa), or under an alternative payment 
21.6 	methodology consistent with the requirements of United States Code, title 42, section 
21.7 	1396a(aa), and approved by the Centers for Medicare and Medicaid Services. The 
21.8 	alternative payment methodology shall be 100 percent of cost as determined according to 
21.9 	Medicare cost principles.
21.10 	(g) For purposes of this section, "nonprofit community clinic" is a clinic that:
21.11 	(1) has nonprofit status as specified in chapter 317A;
21.12 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
21.13 	(3) is established to provide health services to low-income population groups, 
21.14 	uninsured, high-risk and special needs populations, underserved and other special needs 
21.15 	populations;
21.16 	(4) employs professional staff at least one-half of which are familiar with the 
21.17 	cultural background of their clients;
21.18 	(5) charges for services on a sliding fee scale designed to provide assistance to 
21.19 	low-income clients based on current poverty income guidelines and family size; and
21.20 	(6) does not restrict access or services because of a client's financial limitations or 
21.21 	public assistance status and provides no-cost care as needed.
21.22 	(h) By July 1 of each year, the commissioner shall notify federally qualified health 
21.23 	centers and rural health clinics enrolled in medical assistance of the commissioner's intent 
21.24 	to close out payment rates and claims processing for services provided during the calendar 
21.25 	year two years prior to the year in which notification is provided. If the commissioner 
21.26 	and federally qualified health center or rural health clinic do not mutually agree to close 
21.27 	out these rates and claims processing within 90 days following the commissioner's 
21.28 	notification, the matter shall be submitted to an arbiter to determine whether to extend the 
21.29 	closeout deadline.

21.30 	Sec. 21. Minnesota Statutes 2012, section 256B.199, is amended to read:
21.31 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
21.32 	(a) Effective July 1, 2007, The commissioner shall apply for federal matching 
21.33 	funds for the expenditures in paragraphs (b) and (c). Effective September 1, 2011, the 
21.34 	commissioner shall apply for matching funds for expenditures in paragraph (e).
22.1 	(b) The commissioner shall apply for federal matching funds for certified public 
22.2 	expenditures as follows:.
22.3 	(1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions 
22.4 	Hospital, the University of Minnesota, and Fairview-University Medical Center shall 
22.5 	report quarterly to the commissioner beginning June 1, 2007, payments made during the 
22.6 	second previous quarter that may qualify for reimbursement under federal law;
22.7 	 (2) based on these reports, the commissioner shall apply for federal matching 
22.8 	funds. These funds are appropriated to the commissioner for the payments under section 
22.9 	256.969, subdivision 27; and
22.10 	(3) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
22.11 	the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
22.12 	hospital payment money expected to be available in the current federal fiscal year.
22.13 	(c) The commissioner shall apply for federal matching funds for general assistance 
22.14 	medical care expenditures as follows:
22.15 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
22.16 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
22.17 	the department shall be used to apply for federal matching funds, except as limited below:
22.18 	(i) only those general assistance medical care expenditures made to an individual 
22.19 	hospital that would not cause the hospital to exceed its individual hospital limits under 
22.20 	section 1923 of the Social Security Act may be considered; and
22.21 	(ii) general assistance medical care expenditures may be considered only to the extent 
22.22 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
22.23 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
22.24 	information required by the commissioner as necessary for purposes of obtaining federal 
22.25 	Medicaid matching funds for general assistance medical care expenditures.
22.26 	(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 
22.27 	apply for additional federal matching funds available as disproportionate share hospital 
22.28 	payments under the American Recovery and Reinvestment Act of 2009. These funds shall 
22.29 	be made available as the state share of payments under section 256.969, subdivision 28. 
22.30 	The entities required to report certified public expenditures under paragraph (b), clause 
22.31 	(1), shall report additional certified public expenditures as necessary under this paragraph.
22.32 	(e) (c) For services provided on or after September 1, 2011, the commissioner shall 
22.33 	apply for additional federal matching funds available as disproportionate share hospital 
22.34 	payments under the MinnesotaCare program according to the requirements and conditions 
22.35 	of paragraph (c). A hospital may elect on an annual basis to not be a disproportionate 
23.1 	share hospital for purposes of this paragraph, if the hospital does not qualify for a payment 
23.2 	under section 256.969, subdivision 9, paragraph (b).

23.3 	Sec. 22. REPEALER.
 23.4 	Minnesota Statutes 2012, sections 256.969, subdivisions 8b, 9a, 9b, 11, 13, 20, 21, 
23.5 	22, 25, 26, 27, and 28; and 256.9695, subdivisions 3 and 4, are repealed.

23.6 	ARTICLE 3
23.7 	NORTHSTAR CARE FOR CHILDREN

23.8 	Section 1. Minnesota Statutes 2012, section 245C.05, subdivision 5, is amended to read:
23.9 		Subd. 5.Fingerprints. (a) Except as provided in paragraph (c), for any background 
23.10 	study completed under this chapter, when the commissioner has reasonable cause to 
23.11 	believe that further pertinent information may exist on the subject of the background 
23.12 	study, the subject shall provide the commissioner with a set of classifiable fingerprints 
23.13 	obtained from an authorized agency.
23.14 	(b) For purposes of requiring fingerprints, the commissioner has reasonable cause 
23.15 	when, but not limited to, the:
23.16 	(1) information from the Bureau of Criminal Apprehension indicates that the subject 
23.17 	is a multistate offender;
23.18 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
23.19 	offender status is undetermined; or
23.20 	(3) commissioner has received a report from the subject or a third party indicating 
23.21 	that the subject has a criminal history in a jurisdiction other than Minnesota.
23.22 	(c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for 
23.23 	background studies conducted by the commissioner for child foster care or, adoptions, or a 
23.24 	transfer of permanent legal and physical custody of a child, the subject of the background 
23.25 	study, who is 18 years of age or older, shall provide the commissioner with a set of 
23.26 	classifiable fingerprints obtained from an authorized agency.

23.27 	Sec. 2. Minnesota Statutes 2013 Supplement, section 245C.08, subdivision 1, is 
23.28 	amended to read:
23.29 		Subdivision 1.Background studies conducted by Department of Human 
23.30 	Services. (a) For a background study conducted by the Department of Human Services, 
23.31 	the commissioner shall review:
24.1 	(1) information related to names of substantiated perpetrators of maltreatment of 
24.2 	vulnerable adults that has been received by the commissioner as required under section 
24.3 	626.557, subdivision 9c, paragraph (j);
24.4 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
24.5 	programs, and from findings of maltreatment of minors as indicated through the social 
24.6 	service information system;
24.7 	(3) information from juvenile courts as required in subdivision 4 for individuals 
24.8 	listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
24.9 	(4) information from the Bureau of Criminal Apprehension, including information 
24.10 	regarding a background study subject's registration in Minnesota as a predatory offender 
24.11 	under section 243.166;
24.12 	(5) except as provided in clause (6), information from the national crime information 
24.13 	system when the commissioner has reasonable cause as defined under section 245C.05, 
24.14 	subdivision 5; and
24.15 	(6) for a background study related to a child foster care application for licensure, a 
24.16 	transfer of permanent legal and physical custody of a child under sections 260C.503 to 
24.17 	260C.515, or adoptions, the commissioner shall also review:
24.18 	(i) information from the child abuse and neglect registry for any state in which the 
24.19 	background study subject has resided for the past five years; and
24.20 	(ii) information from national crime information databases, when the background 
24.21 	study subject is 18 years of age or older.
24.22 	(b) Notwithstanding expungement by a court, the commissioner may consider 
24.23 	information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 
24.24 	received notice of the petition for expungement and the court order for expungement is 
24.25 	directed specifically to the commissioner.
24.26 	(c) The commissioner shall also review criminal case information received according 
24.27 	to section 245C.04, subdivision 4a, from the Minnesota court information system that 
24.28 	relates to individuals who have already been studied under this chapter and who remain 
24.29 	affiliated with the agency that initiated the background study.

24.30 	Sec. 3. Minnesota Statutes 2012, section 245C.33, subdivision 1, is amended to read:
24.31 		Subdivision 1.Background studies conducted by commissioner. (a) Before 
24.32 	placement of a child for purposes of adoption, the commissioner shall conduct a 
24.33 	background study on individuals listed in section sections259.41, subdivision 3, and 
24.34 	260C.611, for county agencies and private agencies licensed to place children for adoption.
24.35 	 When a prospective adoptive parent is seeking to adopt a child who is currently placed in 
25.1 	the prospective adoptive parent's home and is under the guardianship of the commissioner 
25.2 	according to section 260C.325, subdivision 1, paragraph (b), and the prospective adoptive 
25.3 	parent holds a child foster care license, a new background study is not required when:
25.4 	(1) a background study was completed on persons required to be studied under section 
25.5 	245C.03 in connection with the application for child foster care licensure after July 1, 2007;
25.6 	(2) the background study included a review of the information in section 245C.08, 
25.7 	subdivisions 1, 3, and 4; and
25.8 	(3) as a result of the background study, the individual was either not disqualified 
25.9 	or, if disqualified, the disqualification was set aside under section 245C.22, or a variance 
25.10 	was issued under section 245C.30.
25.11 	(b) Before the kinship placement agreement is signed for the purpose of transferring 
25.12 	permanent legal and physical custody to a relative under sections 260C.503 to 260C.515, 
25.13 	the commissioner shall conduct a background study on each person age 13 or older living 
25.14 	in the home. When a prospective relative custodian has a child foster care license, a new 
25.15 	background study is not required when:
25.16 	(1) a background study was completed on persons required to be studied under section 
25.17 	245C.03 in connection with the application for child foster care licensure after July 1, 2007;
25.18 	(2) the background study included a review of the information in section 245C.08, 
25.19 	subdivisions 1, 3, and 4; and
25.20 	(3) as a result of the background study, the individual was either not disqualified or, 
25.21 	if disqualified, the disqualification was set aside under section 245C.22, or a variance was 
25.22 	issued under section 245C.30. The commissioner and the county agency shall expedite any 
25.23 	request for a set aside or variance for a background study required under chapter 256N.

25.24 	Sec. 4. Minnesota Statutes 2012, section 245C.33, subdivision 4, is amended to read:
25.25 		Subd. 4.Information commissioner reviews. (a) The commissioner shall review 
25.26 	the following information regarding the background study subject:
25.27 	(1) the information under section 245C.08, subdivisions 1, 3, and 4;
25.28 	(2) information from the child abuse and neglect registry for any state in which the 
25.29 	subject has resided for the past five years; and
25.30 	(3) information from national crime information databases, when required under 
25.31 	section 245C.08.
25.32 	(b) The commissioner shall provide any information collected under this subdivision 
25.33 	to the county or private agency that initiated the background study. The commissioner 
25.34 	shall also provide the agency:
26.1 	(1) notice whether the information collected shows that the subject of the background 
26.2 	study has a conviction listed in United States Code, title 42, section 671(a)(20)(A); and
26.3 	(2) for background studies conducted under subdivision 1, paragraph (a), the date of 
26.4 	all adoption-related background studies completed on the subject by the commissioner 
26.5 	after June 30, 2007, and the name of the county or private agency that initiated the 
26.6 	adoption-related background study.

26.7 	Sec. 5. Minnesota Statutes 2013 Supplement, section 256B.055, subdivision 1, is 
26.8 	amended to read:
26.9 		Subdivision 1.Children eligible for subsidized adoption assistance. Medical 
26.10 	assistance may be paid for a child eligible for or receiving adoption assistance payments 
26.11 	under title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 
26.12 	676, and to any child who is not title IV-E eligible but who was determined eligible for 
26.13 	adoption assistance under chapter 256N or section 259A.10, subdivision 2, and has a 
26.14 	special need for medical or rehabilitative care.

26.15 	Sec. 6. Minnesota Statutes 2013 Supplement, section 256N.02, is amended by adding a 
26.16 	subdivision to read:
26.17 		Subd. 14a.Licensed child foster parent. "Licensed child foster parent" means a 
26.18 	person who is licensed for child foster care under Minnesota Rules, parts 2960.3000 to 
26.19 	2960.3340, or licensed by a Minnesota tribe in accordance with tribal standards.

26.20 	Sec. 7. Minnesota Statutes 2013 Supplement, section 256N.21, subdivision 2, is 
26.21 	amended to read:
26.22 		Subd. 2.Placement in foster care. To be eligible for foster care benefits under this 
26.23 	section, the child must be in placement away from the child's legal parent or, guardian, or 
26.24 	Indian custodian as defined in section 260.755, subdivision 10, and all of the following 
26.25 	criteria must be met must meet one of the criteria in clause (1) and either clause (2) or (3):
26.26 	(1) the legally responsible agency must have placement authority and care 
26.27 	responsibility, including for a child 18 years old or older and under age 21, who maintains 
26.28 	eligibility for foster care consistent with section 260C.451;
26.29 	(2) (1) the legally responsible agency must have placement authority to place the 
26.30 	child with: (i) a voluntary placement agreement or a court order, consistent with sections 
26.31 	260B.198, 260C.001, and260D.01, or continued eligibility consistent with section 
26.32 	260C.451 for a child 18 years old or older and under age 21 who maintains eligibility for 
27.1 	foster care; or (ii) a voluntary placement agreement or court order by a Minnesota tribe 
27.2 	that is consistent with United States Code, title 42, section 672(a)(2); and
27.3 	(3) (2) the child must be is placed in an emergency relative placement under section 
27.4 	245A.035, with  a licensed foster family setting, foster residence setting, or treatment 
27.5 	foster care setting licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, a 
27.6 	family foster home licensed or approved by a tribal agency or, for a child 18 years old or 
27.7 	older and under age 21, child foster parent; or
27.8 	(3) the child is placed in one of the following unlicensed child foster care settings:
27.9 	(i) an emergency relative placement under tribal licensing regulations or section 
27.10 	245A.035, with the legally responsible agency ensuring the relative completes the required 
27.11 	child foster care application process;
27.12 	(ii) a licensed adult foster home with an approved age variance under section 
27.13 	245A.16 for no more than six months;
27.14 	(iii) for a child 18 years old or older and under age 21 who is eligible for extended 
27.15 	foster care under section 260C.451,  an unlicensed supervised independent living setting 
27.16 	approved by the agency responsible for the youth's child's care.; or
27.17 	(iv) a preadoptive placement in a home specified in section 245A.03, subdivision 
27.18 	2, paragraph (a), clause (9), with an approved adoption home study and signed adoption 
27.19 	placement agreement.

27.20 	Sec. 8. Minnesota Statutes 2013 Supplement, section 256N.21, is amended by adding a 
27.21 	subdivision to read:
27.22 		Subd. 7.Background study. (a) A county or private agency conducting a 
27.23 	background study for purposes of child foster care licensing or approval must conduct 
27.24 	the study in accordance with chapter 245C and must meet the requirements in United 
27.25 	States Code, title 42, section 671(a)(20).
27.26 	(b) A Minnesota tribe conducting a background study for purposes of child foster 
27.27 	care licensing or approval must conduct the study in accordance with the requirements in 
27.28 	United States Code, title 42, section 671(a)(20), when applicable.

27.29 	Sec. 9. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 1, is 
27.30 	amended to read:
27.31 		Subdivision 1.General eligibility requirements. (a) To be eligible for guardianship 
27.32 	assistance under this section, there must be a judicial determination under section 
27.33 	260C.515, subdivision 4, that a transfer of permanent legal and physical custody to a 
27.34 	relative is in the child's best interest. For a child under jurisdiction of a tribal court, a 
28.1 	judicial determination under a similar provision in tribal code indicating that a relative 
28.2 	will assume the duty and authority to provide care, control, and protection of a child who 
28.3 	is residing in foster care, and to make decisions regarding the child's education, health 
28.4 	care, and general welfare until adulthood, and that this is in the child's best interest is 
28.5 	considered equivalent. Additionally, a child must:
28.6 	(1) have been removed from the child's home pursuant to a voluntary placement 
28.7 	agreement or court order;
28.8 	(2)(i) have resided in with the prospective relative custodian who has been a 
28.9 	licensed child foster care parent for at least six consecutive months in the home of the 
28.10 	prospective relative custodian; or
28.11 	(ii) have received from the commissioner an exemption from the requirement in item 
28.12 	(i) from the court that the prospective relative custodian has been a licensed child foster 
28.13 	parent for at least six consecutive months, based on a determination that:
28.14 	(A) an expedited move to permanency is in the child's best interest;
28.15 	(B) expedited permanency cannot be completed without provision of guardianship 
28.16 	assistance; and
28.17 	(C) the prospective relative custodian is uniquely qualified to meet the child's needs, 
28.18 	as defined in section 260C.212, subdivision 2, on a permanent basis;
28.19 	(D) the child and prospective relative custodian meet the eligibility requirements 
28.20 	of this section; and
28.21 	(E) efforts were made by the legally responsible agency to place the child with the 
28.22 	prospective relative custodian as a licensed child foster parent for six consecutive months 
28.23 	before permanency, or an explanation why these efforts were not in the child's best interests;
28.24 	(3) meet the agency determinations regarding permanency requirements in 
28.25 	subdivision 2;
28.26 	(4) meet the applicable citizenship and immigration requirements in subdivision 3;
28.27 	(5) have been consulted regarding the proposed transfer of permanent legal and 
28.28 	physical custody to a relative, if the child is at least 14 years of age or is expected to attain 
28.29 	14 years of age prior to the transfer of permanent legal and physical custody; and
28.30 	(6) have a written, binding agreement under section 256N.25 among the caregiver or 
28.31 	caregivers, the financially responsible agency, and the commissioner established prior to 
28.32 	transfer of permanent legal and physical custody.
28.33 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
28.34 	custodian or custodians must meet the applicable background study requirements in 
28.35 	subdivision 4.
29.1 	(c) To be eligible for title IV-E guardianship assistance, a child must also meet any 
29.2 	additional criteria in section 473(d) of the Social Security Act. The sibling of a child 
29.3 	who meets the criteria for title IV-E guardianship assistance in section 473(d) of the 
29.4 	Social Security Act is eligible for title IV-E guardianship assistance if the child and 
29.5 	sibling are placed with the same prospective relative custodian or custodians, and the 
29.6 	legally responsible agency, relatives, and commissioner agree on the appropriateness of 
29.7 	the arrangement for the sibling. A child who meets all eligibility criteria except those 
29.8 	specific to title IV-E guardianship assistance is entitled to guardianship assistance paid 
29.9 	through funds other than title IV-E.

29.10 	Sec. 10. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 2, is 
29.11 	amended to read:
29.12 		Subd. 2.Agency determinations regarding permanency. (a) To be eligible for 
29.13 	guardianship assistance, the legally responsible agency must complete the following 
29.14 	determinations regarding permanency for the child prior to the transfer of permanent 
29.15 	legal and physical custody:
29.16 	(1) a determination that reunification and adoption are not appropriate permanency 
29.17 	options for the child; and
29.18 	(2) a determination that the child demonstrates a strong attachment to the prospective 
29.19 	relative custodian and the prospective relative custodian has a strong commitment to 
29.20 	caring permanently for the child.
29.21 	(b) The legally responsible agency shall document the determinations in paragraph 
29.22 	(a) and the eligibility requirements in this section that comply with United States Code, 
29.23 	title 42, sections 673(d) and 675(1)(F). These determinations must be documented in a 
29.24 	kinship placement agreement, which must be in the format prescribed by the commissioner 
29.25 	and must be signed by the prospective relative custodian and the legally responsible 
29.26 	agency. In the case of a Minnesota tribe, the determinations and eligibility requirements 
29.27 	in this section may be provided in an alternative format approved by the commissioner.
29.28 	 Supporting information for completing each determination must be documented in the 
29.29 	legally responsible agency's case file and make them available for review as requested 
29.30 	by the financially responsible agency and the commissioner during the guardianship 
29.31 	assistance eligibility determination process.

29.32 	Sec. 11. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 4, is 
29.33 	amended to read:
30.1 		Subd. 4.Background study. (a) A background study under section 245C.33 must be 
30.2 	completed on each prospective relative custodian and any other adult residing in the home 
30.3 	of the prospective relative custodian. The background study must meet the requirements of 
30.4 	United States Code, title 42, section 671(a)(20). A study completed under section 245C.33 
30.5 	meets this requirement. A background study on the prospective relative custodian or adult 
30.6 	residing in the household previously completed under section 245C.04 chapter 245C for the 
30.7 	purposes of child foster care licensure may under chapter 245A or licensure by a Minnesota 
30.8 	tribe, shall be used for the purposes of this section, provided that the background study is 
30.9 	current meets the requirements of this subdivision and the prospective relative custodian is 
30.10 	a licensed child foster parent at the time of the application for guardianship assistance.
30.11 	(b) If the background study reveals:
30.12 	(1) a felony conviction at any time for:
30.13 	(i) child abuse or neglect;
30.14 	(ii) spousal abuse;
30.15 	(iii) a crime against a child, including child pornography; or
30.16 	(iv) a crime involving violence, including rape, sexual assault, or homicide, but not 
30.17 	including other physical assault or battery; or
30.18 	(2) a felony conviction within the past five years for:
30.19 	(i) physical assault;
30.20 	(ii) battery; or
30.21 	(iii) a drug-related offense;
30.22 	the prospective relative custodian is prohibited from receiving guardianship assistance 
30.23 	on behalf of an otherwise eligible child.

30.24 	Sec. 12. Minnesota Statutes 2013 Supplement, section 256N.22, subdivision 6, is 
30.25 	amended to read:
30.26 		Subd. 6.Exclusions. (a) A child with a guardianship assistance agreement under 
30.27 	Northstar Care for Children is not eligible for the Minnesota family investment program 
30.28 	child-only grant under chapter 256J.
30.29 	(b) The commissioner shall not enter into a guardianship assistance agreement with:
30.30 	(1) a child's biological parent or stepparent;
30.31 	(2) an individual assuming permanent legal and physical custody of a child or the 
30.32 	equivalent under tribal code without involvement of the child welfare system; or
30.33 	(3) an individual assuming permanent legal and physical custody of a child who was 
30.34 	placed in Minnesota by another state or a tribe outside of Minnesota.

31.1 	Sec. 13. Minnesota Statutes 2013 Supplement, section 256N.23, subdivision 1, is 
31.2 	amended to read:
31.3 		Subdivision 1.General eligibility requirements. (a) To be eligible for Northstar 
31.4 	adoption assistance under this section, a child must:
31.5 	(1) be determined to be a child with special needs under subdivision 2;
31.6 	(2) meet the applicable citizenship and immigration requirements in subdivision 3;
31.7 	(3)(i) meet the criteria in section 473 of the Social Security Act; or
31.8 	(ii) have had foster care payments paid on the child's behalf while in out-of-home 
31.9 	placement through the county social service agency or tribe and be either under the
31.10 	 tribal social service agency prior to the issuance of a court order transferring the child's
31.11 	 guardianship of to the commissioner or under the jurisdiction of a Minnesota tribe and 
31.12 	adoption, according to tribal law, is in the child's documented permanency plan making 
31.13 	the child a ward of the tribe; and
31.14 	(4) have a written, binding agreement under section 256N.25 among the adoptive 
31.15 	parent, the financially responsible agency, or, if there is no financially responsible agency, 
31.16 	the agency designated by the commissioner, and the commissioner established prior to 
31.17 	finalization of the adoption.
31.18 	(b) In addition to the requirements in paragraph (a), an eligible child's adoptive parent 
31.19 	or parents must meet the applicable background study requirements in subdivision 4.
31.20 	(c) A child who meets all eligibility criteria except those specific to title IV-E adoption 
31.21 	assistance shall receive adoption assistance paid through funds other than title IV-E.
31.22 	(d) A child receiving Northstar kinship assistance payments under section 256N.22 
31.23 	is eligible for Northstar adoption assistance when the criteria in paragraph (a) are met and 
31.24 	the child's legal custodian is adopting the child.

31.25 	Sec. 14. Minnesota Statutes 2013 Supplement, section 256N.23, subdivision 4, is 
31.26 	amended to read:
31.27 		Subd. 4.Background study. (a) A background study under section 259.41 must be 
31.28 	completed on each prospective adoptive parent. and all other adults residing in the home. 
31.29 	A background study must meet the requirements of United States Code, title 42, section 
31.30 	671(a)(20). A study completed under section 245C.33 meets this requirement. If the 
31.31 	prospective adoptive parent is a licensed child foster parent licensed under chapter 245A 
31.32 	or by a Minnesota tribe, the background study previously completed for the purposes of 
31.33 	child foster care licensure shall be used for the purpose of this section, provided that the 
31.34 	background study meets all other requirements of this subdivision and the prospective 
32.1 	adoptive parent is a licensed child foster parent at the time of the application for adoption 
32.2 	assistance.
32.3 	(b) If the background study reveals:
32.4 	(1) a felony conviction at any time for:
32.5 	(i) child abuse or neglect;
32.6 	(ii) spousal abuse;
32.7 	(iii) a crime against a child, including child pornography; or
32.8 	(iv) a crime involving violence, including rape, sexual assault, or homicide, but not 
32.9 	including other physical assault or battery; or
32.10 	(2) a felony conviction within the past five years for:
32.11 	(i) physical assault;
32.12 	(ii) battery; or
32.13 	(iii) a drug-related offense;
32.14 	the adoptive parent is prohibited from receiving adoption assistance on behalf of an 
32.15 	otherwise eligible child.

32.16 	Sec. 15. Minnesota Statutes 2013 Supplement, section 256N.24, subdivision 9, is 
32.17 	amended to read:
32.18 		Subd. 9.Timing of and requests for reassessments. Reassessments for an eligible 
32.19 	child must be completed within 30 days of any of the following events:
32.20 	(1) for a child in continuous foster care, when six months have elapsed since 
32.21 	completion of the last assessment the initial assessment, and annually thereafter;
32.22 	(2) for a child in continuous foster care, change of placement location;
32.23 	(3) for a child in foster care, at the request of the financially responsible agency or 
32.24 	legally responsible agency;
32.25 	(4) at the request of the commissioner; or
32.26 	(5) at the request of the caregiver under subdivision 9 10.

32.27 	Sec. 16. Minnesota Statutes 2013 Supplement, section 256N.24, subdivision 10, 
32.28 	is amended to read:
32.29 		Subd. 10.Caregiver requests for reassessments. (a) A caregiver may initiate 
32.30 	a reassessment request for an eligible child in writing to the financially responsible 
32.31 	agency or, if there is no financially responsible agency, the agency designated by the 
32.32 	commissioner. The written request must include the reason for the request and the 
32.33 	name, address, and contact information of the caregivers. For an eligible child with a 
32.34 	guardianship assistance or adoption assistance agreement, The caregiver may request a 
33.1 	reassessment if at least six months have elapsed since any previously requested review
33.2 	 previous assessment or reassessment. For an eligible foster child, a foster parent may 
33.3 	request reassessment in less than six months with written documentation that there have 
33.4 	been significant changes in the child's needs that necessitate an earlier reassessment.
33.5 	(b) A caregiver may request a reassessment of an at-risk child for whom a 
33.6 	guardianship assistance or an adoption assistance agreement has been executed if the 
33.7 	caregiver has satisfied the commissioner with written documentation from a qualified 
33.8 	expert that the potential disability upon which eligibility for the agreement was based has 
33.9 	manifested itself, consistent with section 256N.25, subdivision 3, paragraph (b).
33.10 	(c) If the reassessment cannot be completed within 30 days of the caregiver's request, 
33.11 	the agency responsible for reassessment must notify the caregiver of the reason for the 
33.12 	delay and a reasonable estimate of when the reassessment can be completed.
33.13 	(d) Notwithstanding any provision to the contrary in paragraph (a) or subdivision 9, 
33.14 	when a Northstar kinship assistance agreement or adoption assistance agreement under 
33.15 	section 256N.25 has been signed by all parties, no reassessment may be requested or 
33.16 	conducted until the court finalizes the transfer of permanent legal and physical custody or 
33.17 	finalizes the adoption, or the assistance agreement expires according to section 256N.25, 
33.18 	subdivision 1.

33.19 	Sec. 17. Minnesota Statutes 2013 Supplement, section 256N.25, subdivision 2, is 
33.20 	amended to read:
33.21 		Subd. 2.Negotiation of agreement. (a) When a child is determined to be eligible 
33.22 	for guardianship assistance or adoption assistance, the financially responsible agency, or, 
33.23 	if there is no financially responsible agency, the agency designated by the commissioner, 
33.24 	must negotiate with the caregiver to develop an agreement under subdivision 1. If and when 
33.25 	the caregiver and agency reach concurrence as to the terms of the agreement, both parties 
33.26 	shall sign the agreement. The agency must submit the agreement, along with the eligibility 
33.27 	determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to 
33.28 	the commissioner for final review, approval, and signature according to subdivision 1.
33.29 	(b) A monthly payment is provided as part of the adoption assistance or guardianship 
33.30 	assistance agreement to support the care of children unless the child is eligible for adoption 
33.31 	assistance and determined to be an at-risk child, in which case the special at-risk monthly 
33.32 	payment under section 256N.26, subdivision 7, must no payment will be made unless and 
33.33 	until the caregiver obtains written documentation from a qualified expert that the potential 
33.34 	disability upon which eligibility for the agreement was based has manifested itself.
34.1 	(1) The amount of the payment made on behalf of a child eligible for guardianship 
34.2 	assistance or adoption assistance is determined through agreement between the prospective 
34.3 	relative custodian or the adoptive parent and the financially responsible agency, or, if there 
34.4 	is no financially responsible agency, the agency designated by the commissioner, using 
34.5 	the assessment tool established by the commissioner in section 256N.24, subdivision 2, 
34.6 	and the associated benefit and payments outlined in section 256N.26. Except as provided 
34.7 	under section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes 
34.8 	the monthly benefit level for a child under foster care. The monthly payment under a 
34.9 	guardianship assistance agreement or adoption assistance agreement may be negotiated up 
34.10 	to the monthly benefit level under foster care. In no case may the amount of the payment 
34.11 	under a guardianship assistance agreement or adoption assistance agreement exceed the 
34.12 	foster care maintenance payment which would have been paid during the month if the 
34.13 	child with respect to whom the guardianship assistance or adoption assistance payment is 
34.14 	made had been in a foster family home in the state.
34.15 	(2) The rate schedule for the agreement is determined based on the age of the 
34.16 	child on the date that the prospective adoptive parent or parents or relative custodian or 
34.17 	custodians sign the agreement.
34.18 	(3) The income of the relative custodian or custodians or adoptive parent or parents 
34.19 	must not be taken into consideration when determining eligibility for guardianship 
34.20 	assistance or adoption assistance or the amount of the payments under section 256N.26.
34.21 	(4) With the concurrence of the relative custodian or adoptive parent, the amount of 
34.22 	the payment may be adjusted periodically using the assessment tool established by the 
34.23 	commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under 
34.24 	subdivision 3 when there is a change in the child's needs or the family's circumstances.
34.25 	(5) The guardianship assistance or adoption assistance agreement of a child who is 
34.26 	identified as at-risk receives the special at-risk monthly payment under section 256N.26, 
34.27 	subdivision 7, unless and until the potential disability manifests itself, as documented by 
34.28 	an appropriate professional, and the commissioner authorizes commencement of payment 
34.29 	by modifying the agreement accordingly. A relative custodian or An adoptive parent 
34.30 	of an at-risk child with a guardianship assistance or an adoption assistance agreement 
34.31 	may request a reassessment of the child under section 256N.24, subdivision 9 10, and 
34.32 	renegotiation of the guardianship assistance or adoption assistance agreement under 
34.33 	subdivision 3 to include a monthly payment, if the caregiver has written documentation 
34.34 	from a qualified expert that the potential disability upon which eligibility for the agreement 
34.35 	was based has manifested itself. Documentation of the disability must be limited to 
34.36 	evidence deemed appropriate by the commissioner.
35.1 	(c) For guardianship assistance agreements:
35.2 	(1) the initial amount of the monthly guardianship assistance payment must be 
35.3 	equivalent to the foster care rate in effect at the time that the agreement is signed less any 
35.4 	offsets under section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to 
35.5 	by the prospective relative custodian and specified in that agreement, unless the child is 
35.6 	identified as at-risk or the guardianship assistance agreement is entered into when a child 
35.7 	is under the age of six; and
35.8 	(2) an at-risk child must be assigned level A as outlined in section 256N.26 and 
35.9 	receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless 
35.10 	and until the potential disability manifests itself, as documented by a qualified expert, and 
35.11 	the commissioner authorizes commencement of payment by modifying the agreement 
35.12 	accordingly; and
35.13 	(3) (2) the amount of the monthly payment for a guardianship assistance agreement 
35.14 	for a child, other than an at-risk child, who is under the age of six must be as specified in 
35.15 	section 256N.26, subdivision 5.
35.16 	(d) For adoption assistance agreements:
35.17 	(1) for a child in foster care with the prospective adoptive parent immediately prior 
35.18 	to adoptive placement, the initial amount of the monthly adoption assistance payment 
35.19 	must be equivalent to the foster care rate in effect at the time that the agreement is signed 
35.20 	less any offsets in section 256N.26, subdivision 11, or a lesser negotiated amount if agreed 
35.21 	to by the prospective adoptive parents and specified in that agreement, unless the child is 
35.22 	identified as at-risk or the adoption assistance agreement is entered into when a child is 
35.23 	under the age of six;
35.24 	(2) for an at-risk child who must be assigned level A as outlined in section 
35.25 	256N.26and receive the special at-risk monthly payment under section 256N.26, 
35.26 	subdivision 7, no payment will be made  unless and until the potential disability manifests 
35.27 	itself, as documented by an appropriate professional, and the commissioner authorizes 
35.28 	commencement of payment by modifying the agreement accordingly;
35.29 	(3) the amount of the monthly payment for an adoption assistance agreement for 
35.30 	a child under the age of six, other than an at-risk child, must be as specified in section 
35.31 	256N.26, subdivision 5;
35.32 	(4) for a child who is in the guardianship assistance program immediately prior 
35.33 	to adoptive placement, the initial amount of the adoption assistance payment must be 
35.34 	equivalent to the guardianship assistance payment in effect at the time that the adoption 
35.35 	assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive 
35.36 	parent and specified in that agreement, unless the child is identified as an at-risk child; and
36.1 	(5) for a child who is not in foster care placement or the guardianship assistance 
36.2 	program immediately prior to adoptive placement or negotiation of the adoption assistance 
36.3 	agreement, the initial amount of the adoption assistance agreement must be determined 
36.4 	using the assessment tool and process in this section and the corresponding payment 
36.5 	amount outlined in section 256N.26.

36.6 	Sec. 18. Minnesota Statutes 2013 Supplement, section 256N.25, subdivision 3, is 
36.7 	amended to read:
36.8 		Subd. 3.Renegotiation of agreement. (a) A relative custodian or adoptive 
36.9 	parent of a child with a guardianship assistance or adoption assistance agreement may 
36.10 	request renegotiation of the agreement when there is a change in the needs of the child 
36.11 	or in the family's circumstances. When a relative custodian or adoptive parent requests 
36.12 	renegotiation of the agreement, a reassessment of the child must be completed consistent 
36.13 	with section 256N.24, subdivisions 9 and 10. If the reassessment indicates that the 
36.14 	child's level has changed, the financially responsible agency or, if there is no financially 
36.15 	responsible agency, the agency designated by the commissioner or the commissioner's 
36.16 	designee, and the caregiver must renegotiate the agreement to include a payment with 
36.17 	the level determined through the reassessment process. The agreement must not be 
36.18 	renegotiated unless the commissioner, the financially responsible agency, and the caregiver 
36.19 	mutually agree to the changes. The effective date of any renegotiated agreement must be 
36.20 	determined by the commissioner.
36.21 	(b) A relative custodian or An adoptive parent of an at-risk child with a guardianship 
36.22 	assistance or an adoption assistance agreement may request renegotiation of the agreement 
36.23 	to include a monthly payment higher than the special at-risk monthly payment under 
36.24 	section 256N.26, subdivision 7, if the caregiver has written documentation from a 
36.25 	qualified expert that the potential disability upon which eligibility for the agreement 
36.26 	was based has manifested itself. Documentation of the disability must be limited to 
36.27 	evidence deemed appropriate by the commissioner. Prior to renegotiating the agreement, a 
36.28 	reassessment of the child must be conducted as outlined in section 256N.24, subdivision 
36.29 	9. The reassessment must be used to renegotiate the agreement to include an appropriate 
36.30 	monthly payment. The agreement must not be renegotiated unless the commissioner, the 
36.31 	financially responsible agency, and the caregiver mutually agree to the changes. The 
36.32 	effective date of any renegotiated agreement must be determined by the commissioner.
36.33 	(c) Renegotiation of a guardianship assistance or adoption assistance agreement is 
36.34 	required when one of the circumstances outlined in section 256N.26, subdivision 13, 
36.35 	occurs.

37.1 	Sec. 19. Minnesota Statutes 2013 Supplement, section 256N.26, subdivision 1, is 
37.2 	amended to read:
37.3 		Subdivision 1.Benefits. (a) There are three benefits under Northstar Care for 
37.4 	Children: medical assistance, basic payment, and supplemental difficulty of care payment.
37.5 	(b) A child is eligible for medical assistance under subdivision 2.
37.6 	(c) A child is eligible for the basic payment under subdivision 3, except for a child 
37.7 	assigned level A under section 256N.24, subdivision 1, because the child is determined to 
37.8 	be an at-risk child receiving guardianship assistance or adoption assistance.
37.9 	(d) A child, including a foster child age 18 to 21, is eligible for an additional 
37.10 	supplemental difficulty of care payment under subdivision 4, as determined by the 
37.11 	assessment under section 256N.24.
37.12 	(e) An eligible child entering guardianship assistance or adoption assistance under 
37.13 	the age of six receives a basic payment and supplemental difficulty of care payment as 
37.14 	specified in subdivision 5.
37.15 	(f) A child transitioning in from a pre-Northstar Care for Children program under 
37.16 	section 256N.28, subdivision 7, shall receive basic and difficulty of care supplemental 
37.17 	payments according to those provisions.

37.18 	Sec. 20. Minnesota Statutes 2013 Supplement, section 256N.27, subdivision 4, is 
37.19 	amended to read:
37.20 		Subd. 4.Nonfederal share. (a) The commissioner shall establish a percentage share 
37.21 	of the maintenance payments, reduced by federal reimbursements under title IV-E of the 
37.22 	Social Security Act, to be paid by the state and to be paid by the financially responsible 
37.23 	agency.
37.24 	(b) These state and local shares must initially be calculated based on the ratio of the 
37.25 	average appropriate expenditures made by the state and all financially responsible agencies 
37.26 	during calendar years 2011, 2012, 2013, and 2014. For purposes of this calculation, 
37.27 	appropriate expenditures for the financially responsible agencies must include basic and 
37.28 	difficulty of care payments for foster care reduced by federal reimbursements, but not 
37.29 	including any initial clothing allowance, administrative payments to child care agencies 
37.30 	specified in section 317A.907, child care, or other support or ancillary expenditures. For 
37.31 	purposes of this calculation, appropriate expenditures for the state shall include adoption 
37.32 	assistance and relative custody assistance, reduced by federal reimbursements.
37.33 	(c) For each of the periods January 1, 2015, to June 30, 2016, and fiscal years 2017, 
37.34 	2018, and 2019, the commissioner shall adjust this initial percentage of state and local 
37.35 	shares to reflect the relative expenditure trends during calendar years 2011, 2012, 2013, and 
38.1 	2014, taking into account appropriations for Northstar Care for Children and the turnover 
38.2 	rates of the components. In making these adjustments, the commissioner's goal shall be to 
38.3 	make these state and local expenditures other than the appropriations for Northstar Care 
38.4 	for Children to be the same as they would have been had Northstar Care for Children not 
38.5 	been implemented, or if that is not possible, proportionally higher or lower, as appropriate. 
38.6 	Except for adjustments so that the costs of the phase-in are borne by the state, the state and 
38.7 	local share percentages for fiscal year 2019 must be used for all subsequent years.

38.8 	Sec. 21. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
38.9 		Subd. 11.Financial considerations. (a) Payment of relative custody assistance 
38.10 	under a relative custody assistance agreement is subject to the availability of state funds 
38.11 	and payments may be reduced or suspended on order of the commissioner if insufficient 
38.12 	funds are available.
38.13 	(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner 
38.14 	shall reimburse the local agency in an amount equal to 100 percent of the relative custody 
38.15 	assistance payments provided to relative custodians. The A local agency may not seek and 
38.16 	the commissioner shall not provide reimbursement for the administrative costs associated 
38.17 	with performing the duties described in subdivision 4.
38.18 	(c) For the purposes of determining eligibility or payment amounts under MFIP, 
38.19 	relative custody assistance payments shall be excluded in determining the family's 
38.20 	available income.
38.21 	(d) For expenditures made on or before December 31, 2014, upon receipt from a 
38.22 	local agency of a claim for reimbursement, the commissioner shall reimburse the local 
38.23 	agency in an amount equal to 100 percent of the relative custody assistance payments 
38.24 	provided to relative custodians.
38.25 	(e) For expenditures made on or after January 1, 2015, upon receipt from a local 
38.26 	agency of a claim for reimbursement, the commissioner shall reimburse the local agency as 
38.27 	part of the Northstar Care for Children fiscal reconciliation process under section 256N.27.

38.28 	Sec. 22. Minnesota Statutes 2012, section 260C.212, subdivision 1, is amended to read:
38.29 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan 
38.30 	shall be prepared within 30 days after any child is placed in foster care by court order or a 
38.31 	voluntary placement agreement between the responsible social services agency and the 
38.32 	child's parent pursuant to section 260C.227 or chapter 260D.
38.33 	(b) An out-of-home placement plan means a written document which is prepared 
38.34 	by the responsible social services agency jointly with the parent or parents or guardian 
39.1 	of the child and in consultation with the child's guardian ad litem, the child's tribe, if the 
39.2 	child is an Indian child, the child's foster parent or representative of the foster care facility, 
39.3 	and, where appropriate, the child. For a child in voluntary foster care for treatment under 
39.4 	chapter 260D, preparation of the out-of-home placement plan shall additionally include 
39.5 	the child's mental health treatment provider. As appropriate, the plan shall be:
39.6 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
39.7 	(2) ordered by the court, either as presented or modified after hearing, under section 
39.8 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
39.9 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad 
39.10 	litem, a representative of the child's tribe, the responsible social services agency, and, if 
39.11 	possible, the child.
39.12 	(c) The out-of-home placement plan shall be explained to all persons involved in its 
39.13 	implementation, including the child who has signed the plan, and shall set forth:
39.14 	(1) a description of the foster care home or facility selected, including how the 
39.15 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
39.16 	least restrictive, most family-like, setting available which is in close proximity to the home 
39.17 	of the parent or parents or guardian of the child when the case plan goal is reunification, 
39.18 	and how the placement is consistent with the best interests and special needs of the child 
39.19 	according to the factors under subdivision 2, paragraph (b);
39.20 	(2) the specific reasons for the placement of the child in foster care, and when 
39.21 	reunification is the plan, a description of the problems or conditions in the home of the 
39.22 	parent or parents which necessitated removal of the child from home and the changes the 
39.23 	parent or parents must make in order for the child to safely return home;
39.24 	(3) a description of the services offered and provided to prevent removal of the child 
39.25 	from the home and to reunify the family including:
39.26 	(i) the specific actions to be taken by the parent or parents of the child to eliminate 
39.27 	or correct the problems or conditions identified in clause (2), and the time period during 
39.28 	which the actions are to be taken; and
39.29 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 
39.30 	to achieve a safe and stable home for the child including social and other supportive 
39.31 	services to be provided or offered to the parent or parents or guardian of the child, the 
39.32 	child, and the residential facility during the period the child is in the residential facility;
39.33 	(4) a description of any services or resources that were requested by the child or the 
39.34 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
39.35 	in the residential facility, and whether those services or resources were provided and if 
39.36 	not, the basis for the denial of the services or resources;
40.1 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined 
40.2 	in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed 
40.3 	together in foster care, and whether visitation is consistent with the best interest of the 
40.4 	child, during the period the child is in foster care;
40.5 	(6) when a child cannot return to or be in the care of either parent, documentation of 
40.6 	steps to finalize the permanency plan for the child, including:
40.7 	(i) reasonable efforts to place the child for adoption or legal guardianship of the child 
40.8 	if the court has issued an order terminating the rights of both parents of the child or of the 
40.9 	only known, living parent of the child. At a minimum, the documentation must include 
40.10 	consideration of whether adoption is in the best interests of the child, child-specific 
40.11 	recruitment efforts such as relative search and the use of state, regional, and national 
40.12 	adoption exchanges to facilitate orderly and timely placements in and outside of the state. 
40.13 	A copy of this documentation shall be provided to the court in the review required under 
40.14 	section 260C.317, subdivision 3, paragraph (b); and
40.15 	(ii) documentation necessary to support the requirements of the kinship placement 
40.16 	agreement under section 256N.22 when adoption is determined not to be in the child's 
40.17 	best interest;
40.18 	(7) efforts to ensure the child's educational stability while in foster care, including:
40.19 	(i) efforts to ensure that the child remains in the same school in which the child was 
40.20 	enrolled prior to placement or upon the child's move from one placement to another, 
40.21 	including efforts to work with the local education authorities to ensure the child's 
40.22 	educational stability; or
40.23 	(ii) if it is not in the child's best interest to remain in the same school that the child 
40.24 	was enrolled in prior to placement or move from one placement to another, efforts to 
40.25 	ensure immediate and appropriate enrollment for the child in a new school;
40.26 	(8) the educational records of the child including the most recent information 
40.27 	available regarding:
40.28 	(i) the names and addresses of the child's educational providers;
40.29 	(ii) the child's grade level performance;
40.30 	(iii) the child's school record;
40.31 	(iv) a statement about how the child's placement in foster care takes into account 
40.32 	proximity to the school in which the child is enrolled at the time of placement; and
40.33 	(v) any other relevant educational information;
40.34 	(9) the efforts by the local agency to ensure the oversight and continuity of health 
40.35 	care services for the foster child, including:
40.36 	(i) the plan to schedule the child's initial health screens;
41.1 	(ii) how the child's known medical problems and identified needs from the screens, 
41.2 	including any known communicable diseases, as defined in section 144.4172, subdivision 
41.3 	2, will be monitored and treated while the child is in foster care;
41.4 	(iii) how the child's medical information will be updated and shared, including 
41.5 	the child's immunizations;
41.6 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
41.7 	including the role of the parent, the agency, and the foster parent;
41.8 	(v) who is responsible for oversight of the child's prescription medications;
41.9 	(vi) how physicians or other appropriate medical and nonmedical professionals 
41.10 	will be consulted and involved in assessing the health and well-being of the child and 
41.11 	determine the appropriate medical treatment for the child; and
41.12 	(vii) the responsibility to ensure that the child has access to medical care through 
41.13 	either medical insurance or medical assistance;
41.14 	(10) the health records of the child including information available regarding:
41.15 	(i) the names and addresses of the child's health care and dental care providers;
41.16 	(ii) a record of the child's immunizations;
41.17 	(iii) the child's known medical problems, including any known communicable 
41.18 	diseases as defined in section 144.4172, subdivision 2;
41.19 	(iv) the child's medications; and
41.20 	(v) any other relevant health care information such as the child's eligibility for 
41.21 	medical insurance or medical assistance;
41.22 	(11) an independent living plan for a child age 16 or older. The plan should include, 
41.23 	but not be limited to, the following objectives:
41.24 	(i) educational, vocational, or employment planning;
41.25 	(ii) health care planning and medical coverage;
41.26 	(iii) transportation including, where appropriate, assisting the child in obtaining a 
41.27 	driver's license;
41.28 	(iv) money management, including the responsibility of the agency to ensure that 
41.29 	the youth annually receives, at no cost to the youth, a consumer report as defined under 
41.30 	section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;
41.31 	(v) planning for housing;
41.32 	(vi) social and recreational skills; and
41.33 	(vii) establishing and maintaining connections with the child's family and 
41.34 	community; and
42.1 	(12) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
42.2 	and assessment information, specific services relating to meeting the mental health care 
42.3 	needs of the child, and treatment outcomes.
42.4 	(d) The parent or parents or guardian and the child each shall have the right to legal 
42.5 	counsel in the preparation of the case plan and shall be informed of the right at the time 
42.6 	of placement of the child. The child shall also have the right to a guardian ad litem. 
42.7 	If unable to employ counsel from their own resources, the court shall appoint counsel 
42.8 	upon the request of the parent or parents or the child or the child's legal guardian. The 
42.9 	parent or parents may also receive assistance from any person or social services agency 
42.10 	in preparation of the case plan.
42.11 	After the plan has been agreed upon by the parties involved or approved or ordered 
42.12 	by the court, the foster parents shall be fully informed of the provisions of the case plan 
42.13 	and shall be provided a copy of the plan.
42.14 	Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 
42.15 	physical custodian, as appropriate, and the child, if appropriate, must be provided with 
42.16 	a current copy of the child's health and education record.

42.17 	Sec. 23. Minnesota Statutes 2012, section 260C.515, subdivision 4, is amended to read:
42.18 		Subd. 4.Custody to relative. The court may order permanent legal and physical 
42.19 	custody to a fit and willing relative in the best interests of the child according to the 
42.20 	following conditions requirements:
42.21 	(1) an order for transfer of permanent legal and physical custody to a relative shall 
42.22 	only be made after the court has reviewed the suitability of the prospective legal and 
42.23 	physical custodian;
42.24 	(2) in transferring permanent legal and physical custody to a relative, the juvenile 
42.25 	court shall follow the standards applicable under this chapter and chapter 260, and the 
42.26 	procedures in the Minnesota Rules of Juvenile Protection Procedure;
42.27 	(3) a transfer of legal and physical custody includes responsibility for the protection, 
42.28 	education, care, and control of the child and decision making on behalf of the child;
42.29 	(4) a permanent legal and physical custodian may not return a child to the permanent 
42.30 	care of a parent from whom the court removed custody without the court's approval and 
42.31 	without notice to the responsible social services agency;
42.32 	(5) the social services agency may file a petition naming a fit and willing relative as 
42.33 	a proposed permanent legal and physical custodian. A petition for transfer of permanent 
42.34 	legal and physical custody to a relative who is not a parent shall be accompanied by a 
43.1 	kinship placement agreement under section 256N.22, subdivision 2, between the agency 
43.2 	and proposed permanent legal and physical custodian;
43.3 	(6) another party to the permanency proceeding regarding the child may file a 
43.4 	petition to transfer permanent legal and physical custody to a relative, but the. The petition 
43.5 	must include facts upon which the court can make the determination required under clause 
43.6 	(7) and must be filed not later than the date for the required admit-deny hearing under 
43.7 	section 260C.507; or if the agency's petition is filed under section 260C.503, subdivision 
43.8 	2, the petition must be filed not later than 30 days prior to the trial required under section 
43.9 	260C.509; and
43.10 	(7) where a petition is for transfer of permanent legal and physical custody to a 
43.11 	relative who is not a parent, the court must find that:
43.12 	(i) transfer of permanent legal and physical custody and receipt of Northstar kinship 
43.13 	assistance under chapter 256N, when requested and the child is eligible, is in the child's 
43.14 	best interests;
43.15 	(ii) adoption is not in the child's best interests based on the determinations in the 
43.16 	kinship placement agreement required under section 256N.22, subdivision 2;
43.17 	(iii) the agency made efforts to discuss adoption with the child's parent or parents, 
43.18 	or the agency did not make efforts to discuss adoption and the reasons why efforts were 
43.19 	not made; and
43.20 	(iv) there are reasons to separate siblings during placement, if applicable;
43.21 	(8) the court may defer finalization of an order transferring permanent legal and 
43.22 	physical custody to a relative when deferring finalization is necessary to determine 
43.23 	eligibility for Northstar kinship assistance under chapter 256N; 
43.24 	(9) the court may finalize a permanent transfer of physical and legal custody to a 
43.25 	relative regardless of eligibility for Northstar kinship assistance under chapter 256N; and
43.26 	(7) (10) the juvenile court may maintain jurisdiction over the responsible social 
43.27 	services agency, the parents or guardian of the child, the child, and the permanent legal 
43.28 	and physical custodian for purposes of ensuring appropriate services are delivered to the 
43.29 	child and permanent legal custodian for the purpose of ensuring conditions ordered by the 
43.30 	court related to the care and custody of the child are met.

43.31 	Sec. 24. Minnesota Statutes 2012, section 260C.611, is amended to read:
43.32 	260C.611 ADOPTION STUDY REQUIRED.
43.33 	(a) An adoption study under section 259.41 approving placement of the child in the 
43.34 	home of the prospective adoptive parent shall be completed before placing any child under 
43.35 	the guardianship of the commissioner in a home for adoption. If a prospective adoptive 
44.1 	parent has a current child foster care license under chapter 245A and is seeking to adopt 
44.2 	a foster child who is placed in the prospective adoptive parent's home and is under the 
44.3 	guardianship of the commissioner according to section 260C.325, subdivision 1, the child 
44.4 	foster care home study meets the requirements of this section for an approved adoption 
44.5 	home study if:
44.6 	(1) the written home study on which the foster care license was based is completed 
44.7 	in the commissioner's designated format, consistent with the requirements in sections 
44.8 	260C.215, subdivision 4, clause (5); and 259.41, subdivision 2; and Minnesota Rules, 
44.9 	part 2960.3060, subpart 4;
44.10 	(2) the background studies on each prospective adoptive parent and all required 
44.11 	household members were completed according to section 245C.33;
44.12 	(3) the commissioner has not issued, within the last three years, a sanction on the 
44.13 	license under section 245A.07 or an order of a conditional license under section 245A.06; 
44.14 	and
44.15 	(4) the legally responsible agency determines that the individual needs of the child 
44.16 	are being met by the prospective adoptive parent through an assessment under section 
44.17 	256N.24, subdivision 2, or a documented placement decision consistent with section 
44.18 	260C.212, subdivision 2.
44.19 	(b) If a prospective adoptive parent has previously held a foster care license or 
44.20 	adoptive home study, any update necessary to the foster care license, or updated or new 
44.21 	adoptive home study, if not completed by the licensing authority responsible for the 
44.22 	previous license or home study, shall include collateral information from the previous 
44.23 	licensing or approving agency, if available.

44.24 	Sec. 25. REVISOR'S INSTRUCTION.
 44.25 	The revisor of statutes shall change the term "guardianship assistance" to "Northstar 
44.26 	kinship assistance" wherever it appears in Minnesota Statutes and Minnesota Rules to 
44.27 	refer to the program components related to Northstar Care for Children under Minnesota 
44.28 	Statutes, chapter 256N.

44.29 	Sec. 26.  REPEALER.
 44.30 	Minnesota Statutes 2013 Supplement, section 256N.26, subdivision 7, is repealed.

45.1 	ARTICLE 4
45.2 	COMMUNITY FIRST SERVICES AND SUPPORTS

45.3 	Section 1. Minnesota Statutes 2012, section 245C.03, is amended by adding a 
45.4 	subdivision to read:
45.5 		Subd. 8.Community first services and supports organizations. The 
45.6 	commissioner shall conduct background studies on any individual required under section 
45.7 	256B.85 to have a background study completed under this chapter.

45.8 	Sec. 2. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision 
45.9 	to read:
45.10 		Subd. 7.Community first services and supports organizations. (a) The 
45.11 	commissioner shall conduct a background study of an individual required to be studied 
45.12 	under section 245C.03, subdivision 8, at least upon application for initial enrollment 
45.13 	under section 256B.85.
45.14 	(b) Before an individual described in section 245C.03, subdivision 8, begins a 
45.15 	position allowing direct contact with a person served by an organization required to initiate 
45.16 	a background study under section 256B.85, the organization must receive a notice from 
45.17 	the commissioner that the support worker is:
45.18 	(1) not disqualified under section 245C.14; or
45.19 	(2) disqualified, but the individual has received a set-aside of the disqualification 
45.20 	under section 245C.22.

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

45.30 	Sec. 4. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 2, is 
45.31 	amended to read:
46.1 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in 
46.2 	this subdivision have the meanings given.
46.3 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, 
46.4 	dressing, bathing, mobility, positioning, and transferring.
46.5 	(c) "Agency-provider model" means a method of CFSS under which a qualified 
46.6 	agency provides services and supports through the agency's own employees and policies. 
46.7 	The agency must allow the participant to have a significant role in the selection and 
46.8 	dismissal of support workers of their choice for the delivery of their specific services 
46.9 	and supports.
46.10 	(d) "Behavior" means a description of a need for services and supports used to 
46.11 	determine the home care rating and additional service units. The presence of Level I 
46.12 	behavior is used to determine the home care rating. "Level I behavior" means physical 
46.13 	aggression towards self or others or destruction of property that requires the immediate 
46.14 	response of another person. If qualified for a home care rating as described in subdivision 
46.15 	8, additional service units can be added as described in subdivision 8, paragraph (f), for 
46.16 	the following behaviors:
46.17 	(1) Level I behavior;
46.18 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
46.19 	behavior; or
46.20 	(3) increased need for assistance for recipients participants who are verbally 
46.21 	aggressive or resistive to care so that time needed to perform activities of daily living is 
46.22 	increased.
46.23 	(e) "Budget model" means a service delivery method of CFSS that allows the 
46.24 	use of a service budget and assistance from a vendor fiscal/employer agent financial 
46.25 	management services (FMS) contractor for a participant to directly employ support 
46.26 	workers and purchase supports and goods.
46.27 	(e) (f) "Complex health-related needs" means an intervention listed in clauses (1) 
46.28 	to (8) that has been ordered by a physician, and is specified in a community support 
46.29 	plan, including:
46.30 	(1) tube feedings requiring:
46.31 	(i) a gastrojejunostomy tube; or
46.32 	(ii) continuous tube feeding lasting longer than 12 hours per day;
46.33 	(2) wounds described as:
46.34 	(i) stage III or stage IV;
46.35 	(ii) multiple wounds;
46.36 	(iii) requiring sterile or clean dressing changes or a wound vac; or
47.1 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
47.2 	specialized care;
47.3 	(3) parenteral therapy described as:
47.4 	(i) IV therapy more than two times per week lasting longer than four hours for 
47.5 	each treatment; or
47.6 	(ii) total parenteral nutrition (TPN) daily;
47.7 	(4) respiratory interventions, including:
47.8 	(i) oxygen required more than eight hours per day;
47.9 	(ii) respiratory vest more than one time per day;
47.10 	(iii) bronchial drainage treatments more than two times per day;
47.11 	(iv) sterile or clean suctioning more than six times per day;
47.12 	(v) dependence on another to apply respiratory ventilation augmentation devices 
47.13 	such as BiPAP and CPAP; and
47.14 	(vi) ventilator dependence under section 256B.0652;
47.15 	(5) insertion and maintenance of catheter, including:
47.16 	(i) sterile catheter changes more than one time per month;
47.17 	(ii) clean intermittent catheterization, and including self-catheterization more than 
47.18 	six times per day; or
47.19 	(iii) bladder irrigations;
47.20 	(6) bowel program more than two times per week requiring more than 30 minutes to 
47.21 	perform each time;
47.22 	(7) neurological intervention, including:
47.23 	(i) seizures more than two times per week and requiring significant physical 
47.24 	assistance to maintain safety; or
47.25 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
47.26 	assistance from another on a daily basis; and
47.27 	(8) other congenital or acquired diseases creating a need for significantly increased 
47.28 	direct hands-on assistance and interventions in six to eight activities of daily living.
47.29 	(f) (g) "Community first services and supports" or "CFSS" means the assistance and 
47.30 	supports program under this section needed for accomplishing activities of daily living, 
47.31 	instrumental activities of daily living, and health-related tasks through hands-on assistance 
47.32 	to accomplish the task or constant supervision and cueing to accomplish the task, or the 
47.33 	purchase of goods as defined in subdivision 7, paragraph (a), clause (3), that replace 
47.34 	the need for human assistance.
47.35 	(g) (h) "Community first services and supports service delivery plan" or "service 
47.36 	delivery plan" means a written summary of document detailing the services and supports 
48.1 	chosen by the participant to meet assessed needs that is are within the approved CFSS 
48.2 	service authorization amount. Services and supports are based on the community support 
48.3 	plan identified in section 256B.0911 and coordinated services and support plan and budget 
48.4 	identified in section 256B.0915, subdivision 6, if applicable, that is determined by the 
48.5 	participant to meet the assessed needs, using a person-centered planning process.
48.6 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
48.7 	organization that is under contract with the department and has the knowledge, skills, 
48.8 	and ability to assist CFSS participants in using either the agency-provider model under 
48.9 	subdivision 11 or the budget model under subdivision 13.
48.10 	(h) (j) "Critical activities of daily living" means transferring, mobility, eating, and 
48.11 	toileting.
48.12 	(i) (k) "Dependency" in activities of daily living means a person requires hands-on 
48.13 	assistance or constant supervision and cueing to accomplish one or more of the activities 
48.14 	of daily living every day or on the days during the week that the activity is performed; 
48.15 	however, a child may not be found to be dependent in an activity of daily living if, 
48.16 	because of the child's age, an adult would either perform the activity for the child or assist 
48.17 	the child with the activity and the assistance needed is the assistance appropriate for 
48.18 	a typical child of the same age.
48.19 	(j) (l) "Extended CFSS" means CFSS services and supports under the 
48.20 	agency-provider model included in a service plan through one of the home and 
48.21 	community-based services waivers and approved and authorized under sections 
48.22 	256B.0915; 256B.092, subdivision 5; and 256B.49, which exceed the amount, duration, 
48.23 	and frequency of the state plan CFSS services for participants.
48.24 	(k) (m) "Financial management services contractor or vendor" or "FMS contractor"
48.25 	 means a qualified organization having necessary to use the budget model under subdivision 
48.26 	13 that has a written contract with the department to provide vendor fiscal/employer agent 
48.27 	financial management services necessary to use the budget model under subdivision 13 
48.28 	that (FMS). Services include but are not limited to: participant education and technical 
48.29 	assistance; CFSS service delivery planning and budgeting;filing and payment of federal 
48.30 	and state payroll taxes on behalf of the participant; initiating criminal background 
48.31 	checks; billing, making payments, and for approved CFSS funds; monitoring of 
48.32 	spending expenditures; accounting and disbursing CFSS funds; providing assistance in 
48.33 	obtaining liability, workers' compensation, and unemployment coverage and filings; and 
48.34 	assisting participant instruction and technical assistance to the participant in fulfilling 
48.35 	employer-related requirements in accordance with Section 3504 of the Internal Revenue 
49.1 	Code and the Internal Revenue Service Revenue Procedure 70-6 related regulations and 
49.2 	interpretations, including Code of Federal Regulations, title 26, section 31.3504-1.
49.3 	(l) "Budget model" means a service delivery method of CFSS that allows the use of 
49.4 	an individualized CFSS service delivery plan and service budget and provides assistance 
49.5 	from the financial management services contractor to facilitate participant employment of 
49.6 	support workers and the acquisition of supports and goods.
49.7 	(m) (n) "Health-related procedures and tasks" means procedures and tasks related 
49.8 	to the specific needs of an individual that can be delegated taught or assigned by a 
49.9 	state-licensed healthcare or mental health professional and performed by a support worker.
49.10 	(n) (o) "Instrumental activities of daily living" means activities related to 
49.11 	living independently in the community, including but not limited to: meal planning, 
49.12 	preparation, and cooking; shopping for food, clothing, or other essential items; laundry; 
49.13 	housecleaning; assistance with medications; managing finances; communicating needs 
49.14 	and preferences during activities; arranging supports; and assistance with traveling around 
49.15 	and participating in the community.
49.16 	(o) (p) "Legal representative" means parent of a minor, a court-appointed guardian, 
49.17 	or another representative with legal authority to make decisions about services and 
49.18 	supports for the participant. Other representatives with legal authority to make decisions 
49.19 	include but are not limited to a health care agent or an attorney-in-fact authorized through 
49.20 	a health care directive or power of attorney.
49.21 	(p) (q) "Medication assistance" means providing verbal or visual reminders to take 
49.22 	regularly scheduled medication, and includes any of the following supports listed in clauses 
49.23 	(1) to (3) and other types of assistance, except that a support worker may not determine 
49.24 	medication dose or time for medication or inject medications into veins, muscles, or skin:
49.25 	(1) under the direction of the participant or the participant's representative, bringing 
49.26 	medications to the participant including medications given through a nebulizer, opening a 
49.27 	container of previously set-up medications, emptying the container into the participant's 
49.28 	hand, opening and giving the medication in the original container to the participant, or 
49.29 	bringing to the participant liquids or food to accompany the medication;
49.30 	(2) organizing medications as directed by the participant or the participant's 
49.31 	representative; and
49.32 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
49.33 	(q) (r) "Participant's representative" means a parent, family member, advocate, 
49.34 	or other adult authorized by the participant to serve as a representative in connection 
49.35 	with the provision of CFSS. This authorization must be in writing or by another method 
49.36 	that clearly indicates the participant's free choice. The participant's representative must 
50.1 	have no financial interest in the provision of any services included in the participant's 
50.2 	service delivery plan and must be capable of providing the support necessary to assist 
50.3 	the participant in the use of CFSS. If through the assessment process described in 
50.4 	subdivision 5 a participant is determined to be in need of a participant's representative, one 
50.5 	must be selected. If the participant is unable to assist in the selection of a participant's 
50.6 	representative, the legal representative shall appoint one. Two persons may be designated 
50.7 	as a participant's representative for reasons such as divided households and court-ordered 
50.8 	custodies. Duties of a participant's representatives may include:
50.9 	(1) being available while care is services are provided in a method agreed upon by 
50.10 	the participant or the participant's legal representative and documented in the participant's 
50.11 	CFSS service delivery plan;
50.12 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery 
50.13 	plan is being followed; and
50.14 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
50.15 	verification of the CFSS services.
50.16 	(r) (s) "Person-centered planning process" means a process that is directed by the 
50.17 	participant to plan for services and supports. The person-centered planning process must:
50.18 	(1) include people chosen by the participant;
50.19 	(2) provide necessary information and support to ensure that the participant directs 
50.20 	the process to the maximum extent possible, and is enabled to make informed choices 
50.21 	and decisions;
50.22 	(3) be timely and occur at time and locations of convenience to the participant;
50.23 	(4) reflect cultural considerations of the participant;
50.24 	(5) include strategies for solving conflict or disagreement within the process, 
50.25 	including clear conflict-of-interest guidelines for all planning;
50.26 	(6) provide the participant choices of the services and supports they receive and the 
50.27 	staff providing those services and supports;
50.28 	(7) include a method for the participant to request updates to the plan; and
50.29 	(8) record the alternative home and community-based settings that were considered 
50.30 	by the participant.
50.31 	(s) (t) "Shared services" means the provision of CFSS services by the same CFSS 
50.32 	support worker to two or three participants who voluntarily enter into an agreement 
50.33 	to receive services at the same time and in the same setting by the same provider
50.34 	 agency-provider.
50.35 	(t) "Support specialist" means a professional with the skills and ability to assist the 
50.36 	participant using either the agency-provider model under subdivision 11 or the flexible 
51.1 	spending model under subdivision 13, in services including but not limited to assistance 
51.2 	regarding:
51.3 	(1) the development, implementation, and evaluation of the CFSS service delivery 
51.4 	plan under subdivision 6;
51.5 	(2) recruitment, training, or supervision, including supervision of health-related tasks 
51.6 	or behavioral supports appropriately delegated or assigned by a health care professional, 
51.7 	and evaluation of support workers; and
51.8 	(3) facilitating the use of informal and community supports, goods, or resources.
51.9 	(u) "Support worker" means an a qualified and trained employee of the agency 
51.10 	provider agency-provider or of the participant employer under the budget model who 
51.11 	has direct contact with the participant and provides services as specified within the 
51.12 	participant's service delivery plan.
51.13 	(v) "Wages and benefits" means the hourly wages and salaries, the employer's 
51.14 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' 
51.15 	compensation, mileage reimbursement, health and dental insurance, life insurance, 
51.16 	disability insurance, long-term care insurance, uniform allowance, contributions to 
51.17 	employee retirement accounts, or other forms of employee compensation and benefits.
51.18 	(w) "Worker training and development" means services for developing workers' 
51.19 	skills as required by the participant's individual CFSS delivery plan that are arranged for 
51.20 	or provided by the agency-provider or purchased by the participant employer. These 
51.21 	services include training, education, direct observation and supervision, and evaluation 
51.22 	and coaching of job skills and tasks, including supervision of health-related tasks or 
51.23 	behavioral supports.

51.24 	Sec. 5. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 3, is 
51.25 	amended to read:
51.26 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the 
51.27 	following:
51.28 	(1) is a recipient an enrollee of medical assistance as determined under section 
51.29 	256B.055, 256B.056, or 256B.057, subdivisions 5 and 9;
51.30 	(2) is a recipient of participant in the alternative care program under section 
51.31 	256B.0913;
51.32 	(3) is a waiver recipient participant as defined under section 256B.0915, 256B.092, 
51.33 	256B.093, or 256B.49; or
51.34 	(4) has medical services identified in a participant's individualized education 
51.35 	program and is eligible for services as determined in section 256B.0625, subdivision 26.
52.1 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
52.2 	meet all of the following:
52.3 	(1) require assistance and be determined dependent in one activity of daily living or 
52.4 	Level I behavior based on assessment under section 256B.0911; and
52.5 	(2) is not a recipient of participant under a family support grant under section 252.32;.
52.6 	(3) lives in the person's own apartment or home including a family foster care setting 
52.7 	licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a 
52.8 	noncertified boarding care home or a boarding and lodging establishment under chapter 
52.9 	157.

52.10 	Sec. 6. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 5, is 
52.11 	amended to read:
52.12 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
52.13 	(1) be conducted by a certified assessor according to the criteria established in 
52.14 	section 256B.0911, subdivision 3a;
52.15 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there 
52.16 	is a significant change in the participant's condition or a change in the need for services 
52.17 	and supports, or at the request of the participant; and
52.18 	(3) be completed using the format established by the commissioner.
52.19 	(b) A participant who is residing in a facility may be assessed and choose CFSS for 
52.20 	the purpose of using CFSS to return to the community as described in subdivisions 3 
52.21 	and 7, paragraph (a), clause (5).
52.22 	(c) (b) The results of the assessment and any recommendations and authorizations 
52.23 	for CFSS must be determined and communicated in writing by the lead agency's certified 
52.24 	assessor as defined in section 256B.0911 to the participant and the agency-provider or 
52.25 	financial management services provider FMS contractor chosen by the participant within 
52.26 	40 calendar days and must include the participant's right to appeal under section 256.045, 
52.27 	subdivision 3.
52.28 	(d) (c) The lead agency assessor may request authorize a temporary authorization 
52.29 	for CFSS services to be provided under the agency-provider model. Authorization for 
52.30 	a temporary level of CFSS services under the agency-provider model is limited to the 
52.31 	time specified by the commissioner, but shall not exceed 45 days. The level of services 
52.32 	authorized under this provision paragraph shall have no bearing on a future authorization.

52.33 	Sec. 7. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 6, is 
52.34 	amended to read:
53.1 		Subd. 6.Community first services and support service delivery plan. (a) The 
53.2 	CFSS service delivery plan must be developed, implemented, and evaluated through a 
53.3 	person-centered planning process by the participant, or the participant's representative 
53.4 	or legal representative who may be assisted by a support specialist consultation services 
53.5 	provider. The CFSS service delivery plan must reflect the services and supports that 
53.6 	are important to the participant and for the participant to meet the needs assessed 
53.7 	by the certified assessor and identified in the community support plan under section 
53.8 	256B.0911, subdivision 3, or the coordinated services and support plan identified in 
53.9 	section 256B.0915, subdivision 6, if applicable. The CFSS service delivery plan must be 
53.10 	reviewed by the participant, the consultation services provider, and the agency-provider 
53.11 	or financial management services FMS contractor prior to starting services and at least 
53.12 	annually upon reassessment, or when there is a significant change in the participant's 
53.13 	condition, or a change in the need for services and supports.
53.14 	(b) The commissioner shall establish the format and criteria for the CFSS service 
53.15 	delivery plan.
53.16 	(c) The CFSS service delivery plan must be person-centered and:
53.17 	(1) specify the consultation services provider, agency-provider, or financial 
53.18 	management services FMS contractor selected by the participant;
53.19 	(2) reflect the setting in which the participant resides that is chosen by the participant;
53.20 	(3) reflect the participant's strengths and preferences;
53.21 	(4) include the means to address the clinical and support needs as identified through 
53.22 	an assessment of functional needs;
53.23 	(5) include individually identified goals and desired outcomes;
53.24 	(6) reflect the services and supports, paid and unpaid, that will assist the participant 
53.25 	to achieve identified goals, including the costs of the services and supports, and the 
53.26 	providers of those services and supports, including natural supports;
53.27 	(7) identify the amount and frequency of face-to-face supports and amount and 
53.28 	frequency of remote supports and technology that will be used;
53.29 	(8) identify risk factors and measures in place to minimize them, including 
53.30 	individualized backup plans;
53.31 	(9) be understandable to the participant and the individuals providing support;
53.32 	(10) identify the individual or entity responsible for monitoring the plan;
53.33 	(11) be finalized and agreed to in writing by the participant and signed by all 
53.34 	individuals and providers responsible for its implementation;
53.35 	(12) be distributed to the participant and other people involved in the plan; and
53.36 	(13) prevent the provision of unnecessary or inappropriate care.;
54.1 	(14) include a detailed budget for expenditures for budget model participants or 
54.2 	participants under the agency-provider model if purchasing goods; and
54.3 	(15) include a plan for worker training and development detailing what service 
54.4 	components will be used, when the service components will be used, how they will be 
54.5 	provided, and how these service components relate to the participant's individual needs 
54.6 	and CFSS support worker services.
54.7 	(d) The total units of agency-provider services or the service budget allocation
54.8 	 amount for the budget model include both annual totals and a monthly average amount 
54.9 	that cover the number of months of the service authorization. The amount used each 
54.10 	month may vary, but additional funds must not be provided above the annual service 
54.11 	authorization amount unless a change in condition is assessed and authorized by the 
54.12 	certified assessor and documented in the community support plan, coordinated services 
54.13 	and supports plan, and CFSS service delivery plan.
54.14 	(e) In assisting with the development or modification of the plan during the 
54.15 	authorization time period, the consultation services provider shall:
54.16 	(1) consult with the FMS contractor on the spending budget when applicable; and
54.17 	(2) consult with the participant or participant's representative, agency-provider, and 
54.18 	case manager/care coordinator.
54.19 	(f) The service plan must be approved by the consultation services provider for 
54.20 	participants without a case manager/care coordinator. A case manager/care coordinator 
54.21 	must approve the plan for a waiver or alternative care program participant.

54.22 	Sec. 8. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 7, is 
54.23 	amended to read:
54.24 		Subd. 7.Community first services and supports; covered services. Within the 
54.25 	service unit authorization or service budget allocation amount, services and supports 
54.26 	covered under CFSS include:
54.27 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities 
54.28 	of daily living (IADLs), and health-related procedures and tasks through hands-on 
54.29 	assistance to accomplish the task or constant supervision and cueing to accomplish the task;
54.30 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant 
54.31 	to accomplish activities of daily living, instrumental activities of daily living, or 
54.32 	health-related tasks;
54.33 	(3) expenditures for items, services, supports, environmental modifications, or 
54.34 	goods, including assistive technology. These expenditures must:
54.35 	(i) relate to a need identified in a participant's CFSS service delivery plan;
55.1 	(ii) increase independence or substitute for human assistance to the extent that 
55.2 	expenditures would otherwise be made for human assistance for the participant's assessed 
55.3 	needs;
55.4 	(4) observation and redirection for behavior or symptoms where there is a need for 
55.5 	assistance. An assessment of behaviors must meet the criteria in this clause. A recipient
55.6 	 participant qualifies as having a need for assistance due to behaviors if the recipient's
55.7 	 participant's behavior requires assistance at least four times per week and shows one or 
55.8 	more of the following behaviors:
55.9 	(i) physical aggression towards self or others, or destruction of property that requires 
55.10 	the immediate response of another person;
55.11 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate 
55.12 	behavior; or
55.13 	(iii) increased need for assistance for recipients participants who are verbally 
55.14 	aggressive or resistive to care so that time needed to perform activities of daily living is 
55.15 	increased;
55.16 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic 
55.17 	devices, to ensure continuity of the participant's services and supports;
55.18 	(6) transition costs, including:
55.19 	(i) deposits for rent and utilities;
55.20 	(ii) first month's rent and utilities;
55.21 	(iii) bedding;
55.22 	(iv) basic kitchen supplies;
55.23 	(v) other necessities, to the extent that these necessities are not otherwise covered 
55.24 	under any other funding that the participant is eligible to receive; and
55.25 	(vi) other required necessities for an individual to make the transition from a nursing 
55.26 	facility, institution for mental diseases, or intermediate care facility for persons with 
55.27 	developmental disabilities to a community-based home setting where the participant 
55.28 	resides; and
55.29 	(7) (6) services provided by a support specialist consultation services provider 
55.30 	under contract with the department and defined under subdivision 2 that are chosen by 
55.31 	the participant. 17;
55.32 	(7) services provided by an FMS contractor under contract with the department 
55.33 	as defined under subdivision 13;
55.34 	(8) CFSS services that may be provided by a qualified support worker who is 
55.35 	a parent, stepparent, or legal guardian of a participant under age 18, or who is the 
55.36 	participant's spouse. These support workers shall not provide any medical assistance home 
56.1 	and community-based services in excess of 40 hours per seven-day period regardless of 
56.2 	the number of parents, combination of parents and spouses, or number of children who 
56.3 	receive medical assistance services; and
56.4 	(9) worker training and development services as defined in subdivision 2, paragraph 
56.5 	(w), and described in subdivision 18a.

56.6 	Sec. 9. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 8, is 
56.7 	amended to read:
56.8 		Subd. 8.Determination of CFSS service methodology. (a) All community first 
56.9 	services and supports must be authorized by the commissioner or the commissioner's 
56.10 	designee before services begin, except for the assessments established in section 
56.11 	256B.0911. The authorization for CFSS must be completed as soon as possible following 
56.12 	an assessment but no later than 40 calendar days from the date of the assessment.
56.13 	(b) The amount of CFSS authorized must be based on the recipient's participant's
56.14 	 home care rating described in paragraphs (d) and (e) and any additional service units for 
56.15 	which the person participant qualifies as described in paragraph (f).
56.16 	(c) The home care rating shall be determined by the commissioner or the 
56.17 	commissioner's designee based on information submitted to the commissioner identifying 
56.18 	the following for a recipient participant:
56.19 	(1) the total number of dependencies of activities of daily living as defined in 
56.20 	subdivision 2, paragraph (b);
56.21 	(2) the presence of complex health-related needs as defined in subdivision 2, 
56.22 	paragraph (e); and
56.23 	(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d), 
56.24 	clause (1).
56.25 	(d) The methodology to determine the total service units for CFSS for each home 
56.26 	care rating is based on the median paid units per day for each home care rating from 
56.27 	fiscal year 2007 data for the PCA program.
56.28 	(e) Each home care rating is designated by the letters P through Z and EN and has 
56.29 	the following base number of service units assigned:
56.30 	(1) P home care rating requires Level I behavior or one to three dependencies in 
56.31 	ADLs and qualifies one for five service units;
56.32 	(2) Q home care rating requires Level I behavior and one to three dependencies in 
56.33 	ADLs and qualifies one for six service units;
56.34 	(3) R home care rating requires a complex health-related need and one to three 
56.35 	dependencies in ADLs and qualifies one for seven service units;
57.1 	(4) S home care rating requires four to six dependencies in ADLs and qualifies 
57.2 	one for ten service units;
57.3 	(5) T home care rating requires four to six dependencies in ADLs and Level I 
57.4 	behavior and qualifies one for 11 service units;
57.5 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
57.6 	health-related need and qualifies one for 14 service units;
57.7 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies 
57.8 	one for 17 service units;
57.9 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
57.10 	behavior and qualifies one for 20 service units;
57.11 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
57.12 	health-related need and qualifies one for 30 service units; and
57.13 	(10) EN home care rating includes ventilator dependency as defined in section 
57.14 	256B.0651, subdivision 1, paragraph (g). Recipients Participants who meet the definition 
57.15 	of ventilator-dependent and the EN home care rating and utilize a combination of 
57.16 	CFSS and other home care services are limited to a total of 96 service units per day for 
57.17 	those services in combination. Additional units may be authorized when a recipient's
57.18 	 participant's assessment indicates a need for two staff to perform activities. Additional 
57.19 	time is limited to 16 service units per day.
57.20 	(f) Additional service units are provided through the assessment and identification of 
57.21 	the following:
57.22 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
57.23 	living as defined in subdivision 2, paragraph (h) (j);
57.24 	(2) 30 additional minutes per day for each complex health-related function as 
57.25 	defined in subdivision 2, paragraph (e) (f); and
57.26 	(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2, 
57.27 	paragraph (d).
57.28 	(g) The service budget for budget model participants shall be based on:
57.29 	(1) assessed units as determined by the home care rating; and
57.30 	(2) a multiplier established by the commissioner for administrative expenses.

57.31 	Sec. 10. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 9, is 
57.32 	amended to read:
57.33 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for 
57.34 	payment under this section include those that:
58.1 	(1) are not authorized by the certified assessor or included in the written service 
58.2 	delivery plan;
58.3 	(2) are provided prior to the authorization of services and the approval of the written 
58.4 	CFSS service delivery plan;
58.5 	(3) are duplicative of other paid services in the written service delivery plan;
58.6 	(4) supplant natural unpaid supports that appropriately meet a need in the service 
58.7 	plan, are provided voluntarily to the participant, and are selected by the participant in lieu 
58.8 	of other services and supports;
58.9 	(5) are not effective means to meet the participant's needs; and
58.10 	(6) are available through other funding sources, including, but not limited to, funding 
58.11 	through title IV-E of the Social Security Act.
58.12 	(b) Additional services, goods, or supports that are not covered include:
58.13 	(1) those that are not for the direct benefit of the participant, except that services for 
58.14 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
58.15 	benefit the participant if chosen by the participant and approved in the support plan;
58.16 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
58.17 	and co-pays, legal fees, or costs related to advocate agencies;
58.18 	(3) insurance, except for insurance costs related to employee coverage;
58.19 	(4) room and board costs for the participant with the exception of allowable 
58.20 	transition costs in subdivision 7, clause (6);
58.21 	(5) services, supports, or goods that are not related to the assessed needs;
58.22 	(6) special education and related services provided under the Individuals with 
58.23 	Disabilities Education Act and vocational rehabilitation services provided under the 
58.24 	Rehabilitation Act of 1973;
58.25 	(7) assistive technology devices and assistive technology services other than those 
58.26 	for back-up systems or mechanisms to ensure continuity of service and supports listed in 
58.27 	subdivision 7;
58.28 	(8) medical supplies and equipment;
58.29 	(9) environmental modifications, except as specified in subdivision 7;
58.30 	(10) expenses for travel, lodging, or meals related to training the participant, or the 
58.31 	participant's representative,or legal representative, or paid or unpaid caregivers that 
58.32 	exceed $500 in a 12-month period;
58.33 	(11) experimental treatments;
58.34 	(12) any service or good covered by other medical assistance state plan services, 
58.35 	including prescription and over-the-counter medications, compounds, and solutions and 
58.36 	related fees, including premiums and co-payments;
59.1 	(13) membership dues or costs, except when the service is necessary and appropriate 
59.2 	to treat a physical condition or to improve or maintain the participant's physical condition. 
59.3 	The condition must be identified in the participant's CFSS plan and monitored by a 
59.4 	physician enrolled in a Minnesota health care program;
59.5 	(14) vacation expenses other than the cost of direct services;
59.6 	(15) vehicle maintenance or modifications not related to the disability, health 
59.7 	condition, or physical need; and
59.8 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
59.9 	events.;
59.10 	(17) instrumental activities of daily living for children under the age of 18, except 
59.11 	when immediate attention is needed for health or hygiene reasons integral to CFSS 
59.12 	services and the assessor has listed the need in the service plan;
59.13 	(18) services provided and billed by a provider who is not an enrolled CFSS provider;
59.14 	(19) CFSS provided by a participant's representative or paid legal guardian;
59.15 	(20) services that are used solely as a child care or babysitting service;
59.16 	(21) services that are the responsibility or in the daily rate of a residential or program 
59.17 	license holder under the terms of a service agreement and administrative rules;
59.18 	(22) sterile procedures;
59.19 	(23) giving of injections into veins, muscles, or skin;
59.20 	(24) homemaker services that are not an integral part of the assessed CFSS service;
59.21 	(25) home maintenance or chore services;
59.22 	(26) home care services, including hospice services if elected by the participant, 
59.23 	covered by Medicare or any other insurance held by the participant;
59.24 	(27) services to other members of the participant's household;
59.25 	(28) services not specified as covered under medical assistance as CFSS;
59.26 	(29) application of restraints or implementation of deprivation procedures;
59.27 	(30) assessments by CFSS provider organizations or by independently enrolled 
59.28 	registered nurses;
59.29 	(31) services provided in lieu of legally required staffing in a residential or child 
59.30 	care setting; and
59.31 	(32) services provided by the residential or program license holder in a residence for 
59.32 	more than four persons.

59.33 	Sec. 11. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 10, 
59.34 	is amended to read:
60.1 		Subd. 10.Provider Agency-provider and FMS contractor qualifications and,
60.2 	 general requirements, and duties. (a) Agency-providers delivering services under the 
60.3 	agency-provider model under subdivision 11 or financial management service (FMS)
60.4 	 FMS contractors under subdivision 13 shall:
60.5 	(1) enroll as a medical assistance Minnesota health care programs provider and meet 
60.6 	all applicable provider standards and requirements;
60.7 	(2) comply with medical assistance provider enrollment requirements;
60.8 	(3) (2) demonstrate compliance with law federal and state laws and policies of for
60.9 	 CFSS as determined by the commissioner;
60.10 	(4) (3) comply with background study requirements under chapter 245C and 
60.11 	maintain documentation of background study requests and results;
60.12 	(5) (4) verify and maintain records of all services and expenditures by the participant, 
60.13 	including hours worked by support workers and support specialists;
60.14 	(6) (5) not engage in any agency-initiated direct contact or marketing in person, by 
60.15 	telephone, or other electronic means to potential participants, guardians, family members, 
60.16 	or participants' representatives;
60.17 	(6) directly provide services and not use a subcontractor or reporting agent;
60.18 	(7) meet the financial requirements established by the commissioner for financial 
60.19 	solvency;
60.20 	(8) have never had a lead agency contract or provider agreement discontinued due to 
60.21 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
60.22 	criminal background check while enrolled or seeking enrollment as a Minnesota health 
60.23 	care programs provider;
60.24 	(9) have established business practices that include written policies and procedures, 
60.25 	internal controls, and a system that demonstrates the organization's ability to deliver 
60.26 	quality CFSS; and
60.27 	(10) have an office located in Minnesota.
60.28 	(b) In conducting general duties, agency-providers and VF/EA financial management 
60.29 	services contractors shall:
60.30 	(7) (1) pay support workers and support specialists based upon actual hours of 
60.31 	services provided;
60.32 	(2) pay for worker training and development services based upon actual hours of 
60.33 	services provided or the unit cost of the training session purchased;
60.34 	(8) (3) withhold and pay all applicable federal and state payroll taxes;
60.35 	(9) (4) make arrangements and pay unemployment insurance, taxes, workers' 
60.36 	compensation, liability insurance, and other benefits, if any;
61.1 	(10) (5) enter into a written agreement with the participant, participant's 
61.2 	representative, or legal representative that assigns roles and responsibilities to be 
61.3 	performed before services, supports, or goods are provided using a format established by 
61.4 	the commissioner;
61.5 	(11) (6) report maltreatment as required under sections 626.556 and 626.557; and
61.6 	(12) (7) provide the participant with a copy of the service-related rights under 
61.7 	subdivision 20 at the start of services and supports.; and
61.8 	(8) comply with any data requests from the department.

61.9 	Sec. 12. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 11, 
61.10 	is amended to read:
61.11 		Subd. 11.Agency-provider model. (a) The agency-provider model is limited to 
61.12 	the includes services provided by support workers and support specialists staff providing 
61.13 	worker training and development services who are employed by an agency-provider 
61.14 	that is licensed according to chapter 245A or meets other criteria established by the 
61.15 	commissioner, including required training.
61.16 	(b) The agency-provider shall allow the participant to have a significant role in the 
61.17 	selection and dismissal of the support workers for the delivery of the services and supports 
61.18 	specified in the participant's service delivery plan.
61.19 	(c) A participant may use authorized units of CFSS services as needed within a 
61.20 	service authorization that is not greater than 12 months. Using authorized units in a 
61.21 	flexible manner in either the agency-provider model or the budget model does not increase 
61.22 	the total amount of services and supports authorized for a participant or included in the 
61.23 	participant's service delivery plan.
61.24 	(d) A participant may share CFSS services. Two or three CFSS participants may 
61.25 	share services at the same time provided by the same support worker.
61.26 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue 
61.27 	generated by the medical assistance payment for CFSS for support worker wages and 
61.28 	benefits. The agency-provider must document how this requirement is being met. The 
61.29 	revenue generated by the support specialist worker training and development services
61.30 	 and the reasonable costs associated with the support specialist worker training and 
61.31 	development services must not be used in making this calculation.
61.32 	(f) The agency-provider model must be used by individuals who have been restricted 
61.33 	by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 
61.34 	to 9505.2245.
62.1 	(g) Participants purchasing goods under this model, along with support worker 
62.2 	services, must:
62.3 	(1) specify the goods in the service delivery plan and detailed budget for 
62.4 	expenditures that must be approved by the consultation services provider or the case 
62.5 	manager/care coordinator; and
62.6 	(2) use the FMS contractor for the billing and payment of such goods.

62.7 	Sec. 13. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 12, 
62.8 	is amended to read:
62.9 		Subd. 12.Requirements for enrollment of CFSS provider agency-provider
62.10 	 agencies. (a) All CFSS provider agencies agency-providers must provide, at the time of 
62.11 	enrollment, reenrollment, and revalidation as a CFSS provider agency agency-provider in 
62.12 	a format determined by the commissioner, information and documentation that includes, 
62.13 	but is not limited to, the following:
62.14 	(1) the CFSS provider agency's agency-provider's current contact information 
62.15 	including address, telephone number, and e-mail address;
62.16 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider agency's
62.17 	 agency-provider's Medicaid revenue in the previous calendar year is less than or equal 
62.18 	to $300,000, the provider agency agency-provider must purchase a performance bond of 
62.19 	$50,000. If the provider agency's agency-provider's Medicaid revenue in the previous 
62.20 	calendar year is greater than $300,000, the provider agency agency-provider must 
62.21 	purchase a performance bond of $100,000. The performance bond must be in a form 
62.22 	approved by the commissioner, must be renewed annually, and must allow for recovery of 
62.23 	costs and fees in pursuing a claim on the bond;
62.24 	(3) proof of fidelity bond coverage in the amount of $20,000;
62.25 	(4) proof of workers' compensation insurance coverage;
62.26 	(5) proof of liability insurance;
62.27 	(6) a description of the CFSS provider agency's agency-provider's organization 
62.28 	identifying the names of all owners, managing employees, staff, board of directors, and 
62.29 	the affiliations of the directors, and owners, or staff to other service providers;
62.30 	(7) a copy of the CFSS provider agency's agency-provider's written policies and 
62.31 	procedures including: hiring of employees; training requirements; service delivery; 
62.32 	and employee and consumer safety including process for notification and resolution 
62.33 	of consumer grievances, identification and prevention of communicable diseases, and 
62.34 	employee misconduct;
63.1 	(8) copies of all other forms the CFSS provider agency agency-provider uses in the 
63.2 	course of daily business including, but not limited to:
63.3 	(i) a copy of the CFSS provider agency's agency-provider's time sheet if the time 
63.4 	sheet varies from the standard time sheet for CFSS services approved by the commissioner, 
63.5 	and a letter requesting approval of the CFSS provider agency's agency-provider's
63.6 	 nonstandard time sheet; and
63.7 	(ii) the a copy of the participant's individual CFSS provider agency's template for the 
63.8 	CFSS care service delivery plan;
63.9 	(9) a list of all training and classes that the CFSS provider agency agency-provider
63.10 	 requires of its staff providing CFSS services;
63.11 	(10) documentation that the CFSS provider agency agency-provider and staff have 
63.12 	successfully completed all the training required by this section;
63.13 	(11) documentation of the agency's agency-provider's marketing practices;
63.14 	(12) disclosure of ownership, leasing, or management of all residential properties 
63.15 	that are used or could be used for providing home care services;
63.16 	(13) documentation that the agency agency-provider will use at least the following 
63.17 	percentages of revenue generated from the medical assistance rate paid for CFSS services 
63.18 	for employee personal care assistant CFSS support worker wages and benefits: 72.5 
63.19 	percent of revenue from CFSS providers. The revenue generated by the support specialist
63.20 	 worker training and development services and the reasonable costs associated with the 
63.21 	support specialist worker training and development services shall not be used in making 
63.22 	this calculation; and
63.23 	(14) documentation that the agency agency-provider does not burden recipients'
63.24 	 participants' free exercise of their right to choose service providers by requiring personal 
63.25 	care assistants CFSS support workers to sign an agreement not to work with any particular 
63.26 	CFSS recipient participant or for another CFSS provider agency agency-provider after 
63.27 	leaving the agency and that the agency is not taking action on any such agreements or 
63.28 	requirements regardless of the date signed.
63.29 	(b) CFSS provider agencies agency-providers shall provide to the commissioner 
63.30 	the information specified in paragraph (a).
63.31 	(c) All CFSS provider agencies agency-providers shall require all employees in 
63.32 	management and supervisory positions and owners of the agency who are active in the 
63.33 	day-to-day management and operations of the agency to complete mandatory training as 
63.34 	determined by the commissioner. Employees in management and supervisory positions 
63.35 	and owners who are active in the day-to-day operations of an agency who have completed 
63.36 	the required training as an employee with a CFSS provider agency agency-provider do 
64.1 	not need to repeat the required training if they are hired by another agency, if they have 
64.2 	completed the training within the past three years. CFSS provider agency agency-provider
64.3 	 billing staff shall complete training about CFSS program financial management. Any new 
64.4 	owners or employees in management and supervisory positions involved in the day-to-day 
64.5 	operations are required to complete mandatory training as a requisite of working for the 
64.6 	agency. CFSS provider agencies certified for participation in Medicare as home health 
64.7 	agencies are exempt from the training required in this subdivision.
64.8 	(d) The commissioner shall send annual review notifications to agency-providers 30 
64.9 	days prior to renewal. The notification must:
64.10 	(1) list the materials and information the agency-provider is required to submit;
64.11 	(2) provide instructions on submitting information to the commissioner; and
64.12 	(3) provide a due date by which the commissioner must receive the requested 
64.13 	information.
64.14 	Agency-providers shall submit the required documentation for annual review within 
64.15 	30 days of notification from the commissioner. If no documentation is submitted, the 
64.16 	agency-provider enrollment number must be terminated or suspended.

64.17 	Sec. 14. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 13, 
64.18 	is amended to read:
64.19 		Subd. 13.Budget model. (a) Under the budget model participants can may exercise 
64.20 	more responsibility and control over the services and supports described and budgeted 
64.21 	within the CFSS service delivery plan. Participants must use services provided by an FMS 
64.22 	contractor as defined in subdivision 2, paragraph (m). Under this model, participants may 
64.23 	use their approved service budget allocation to:
64.24 	(1) directly employ support workers, and pay wages, federal and state payroll taxes, 
64.25 	and premiums for workers' compensation, liability, and health insurance coverage; and
64.26 	(2) obtain supports and goods as defined in subdivision 7; and.
64.27 	(3) choose a range of support assistance services from the financial management 
64.28 	services (FMS) contractor related to:
64.29 	(i) assistance in managing the budget to meet the service delivery plan needs, 
64.30 	consistent with federal and state laws and regulations;
64.31 	(ii) the employment, training, supervision, and evaluation of workers by the 
64.32 	participant;
64.33 	(iii) acquisition and payment for supports and goods; and
64.34 	(iv) evaluation of individual service outcomes as needed for the scope of the 
64.35 	participant's degree of control and responsibility.
65.1 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) 
65.2 	may authorize a legal representative or participant's representative to do so on their behalf.
65.3 	(c) The commissioner shall disenroll or exclude participants from the budget model 
65.4 	and transfer them to the agency-provider model under the following circumstances that 
65.5 	include but are not limited to:
65.6 	(1) when a participant has been restricted by the Minnesota restricted recipient 
65.7 	program, in which case the participant may be excluded for a specified time period under 
65.8 	Minnesota Rules, parts 9505.2160 to 9505.2245;
65.9 	(2) when a participant exits the budget model during the participant's service plan 
65.10 	year. Upon transfer, the participant shall not access the budget model for the remainder of 
65.11 	that service plan year; or
65.12 	(3) when the department determines that the participant or participant's representative 
65.13 	or legal representative cannot manage participant responsibilities under the budget model. 
65.14 	The commissioner must develop policies for determining if a participant is unable to 
65.15 	manage responsibilities under the budget model.
65.16 	(d) A participant may appeal in writing to the department under section 256.045, 
65.17 	subdivision 3, to contest the department's decision under paragraph (c), clause (3), to 
65.18 	disenroll or exclude the participant from the budget model.
65.19 	(c) (e) The FMS contractor shall not provide CFSS services and supports under the 
65.20 	agency-provider service model. 
65.21 	(f) The FMS contractor shall provide service functions as determined by the 
65.22 	commissioner for budget model participants that include but are not limited to:
65.23 	(1) information and consultation about CFSS;
65.24 	(2) (1) assistance with the development of the detailed budget for expenditures 
65.25 	portion of the service delivery plan and budget model as requested by the consultation 
65.26 	services provider or participant;
65.27 	(3) (2) billing and making payments for budget model expenditures;
65.28 	(4) (3) assisting participants in fulfilling employer-related requirements according to 
65.29 	Internal Revenue Service Revenue Procedure 70-6, section 3504, Agency Employer Tax 
65.30 	Liability, regulation 137036-08 section 3504 of the Internal Revenue Code and related 
65.31 	regulations and interpretations, including Code of Federal Regulations, title 26, section 
65.32 	31.3504-1, which includes assistance with filing and paying payroll taxes, and obtaining 
65.33 	worker compensation coverage;
65.34 	(5) (4) data recording and reporting of participant spending; and
65.35 	(6) (5) other duties established in the contract with the department, including with 
65.36 	respect to providing assistance to the participant, participant's representative, or legal 
66.1 	representative in performing their employer responsibilities regarding support workers. 
66.2 	The support worker shall not be considered the employee of the financial management 
66.3 	services FMS contractor.; and
66.4 	(6) billing, payment, and accounting of approved expenditures for goods for 
66.5 	agency-provider participants.
66.6 	(d) A participant who requests to purchase goods and supports along with support 
66.7 	worker services under the agency-provider model must use the budget model with 
66.8 	a service delivery plan that specifies the amount of services to be authorized to the 
66.9 	agency-provider and the expenditures to be paid by the FMS contractor.
66.10 	(e) (g) The FMS contractor shall:
66.11 	(1) not limit or restrict the participant's choice of service or support providers or 
66.12 	service delivery models consistent with any applicable state and federal requirements;
66.13 	(2) provide the participant, consultation services provider, and the targeted case 
66.14 	manager, if applicable, with a monthly written summary of the spending for services and 
66.15 	supports that were billed against the spending budget;
66.16 	(3) be knowledgeable of state and federal employment regulations, including those 
66.17 	under the Fair Labor Standards Act of 1938, and comply with the requirements under the 
66.18 	Internal Revenue Service Revenue Procedure 70-6, Section 3504, section 3504 of the 
66.19 	Internal Revenue Code and related regulations and interpretations, including Code of 
66.20 	Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability 
66.21 	for vendor or fiscal employer agent, and any requirements necessary to process employer 
66.22 	and employee deductions, provide appropriate and timely submission of employer tax 
66.23 	liabilities, and maintain documentation to support medical assistance claims;
66.24 	(4) have current and adequate liability insurance and bonding and sufficient cash 
66.25 	flow as determined by the commissioner and have on staff or under contract a certified 
66.26 	public accountant or an individual with a baccalaureate degree in accounting;
66.27 	(5) assume fiscal accountability for state funds designated for the program and be 
66.28 	held liable for any overpayments or violations of applicable statutes or rules, including 
66.29 	but not limited to the Minnesota False Claims Act; and
66.30 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
66.31 	supports expenditures for any goods purchased and maintain time records of support 
66.32 	workers. The documentation and time records must be maintained for a minimum of 
66.33 	five years from the claim date and be available for audit or review upon request by the 
66.34 	commissioner. Claims submitted by the FMS contractor to the commissioner for payment 
66.35 	must correspond with services, amounts, and time periods as authorized in the participant's 
67.1 	spending service budget and service plan and must contain specific identifying information 
67.2 	as determined by the commissioner.
67.3 	(f) (h) The commissioner of human services shall:
67.4 	(1) establish rates and payment methodology for the FMS contractor;
67.5 	(2) identify a process to ensure quality and performance standards for the FMS 
67.6 	contractor and ensure statewide access to FMS contractors; and
67.7 	(3) establish a uniform protocol for delivering and administering CFSS services 
67.8 	to be used by eligible FMS contractors.
67.9 	(g) The commissioner of human services shall disenroll or exclude participants from 
67.10 	the budget model and transfer them to the agency-provider model under the following 
67.11 	circumstances that include but are not limited to:
67.12 	(1) when a participant has been restricted by the Minnesota restricted recipient 
67.13 	program, the participant may be excluded for a specified time period under Minnesota 
67.14 	Rules, parts 9505.2160 to 9505.2245;
67.15 	(2) when a participant exits the budget model during the participant's service plan 
67.16 	year. Upon transfer, the participant shall not access the budget model for the remainder of 
67.17 	that service plan year; or
67.18 	(3) when the department determines that the participant or participant's representative 
67.19 	or legal representative cannot manage participant responsibilities under the budget model. 
67.20 	The commissioner must develop policies for determining if a participant is unable to 
67.21 	manage responsibilities under a budget model.
67.22 	(h) A participant may appeal under section 256.045, subdivision 3, in writing to the 
67.23 	department to contest the department's decision under paragraph (c), clause (3), to remove 
67.24 	or exclude the participant from the budget model.

67.25 	Sec. 15. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 15, 
67.26 	is amended to read:
67.27 		Subd. 15.Documentation of support services provided. (a) Support services 
67.28 	provided to a participant by a support worker employed by either an agency-provider 
67.29 	or the participant acting as the employer must be documented daily by each support 
67.30 	worker, on a time sheet form approved by the commissioner. All documentation may be 
67.31 	Web-based, electronic, or paper documentation. The completed form must be submitted 
67.32 	on a monthly regular basis to the provider or the participant and the FMS contractor 
67.33 	selected by the participant to provide assistance with meeting the participant's employer 
67.34 	obligations and kept in the recipient's health participant's record.
68.1 	(b) The activity documentation must correspond to the written service delivery plan 
68.2 	and be reviewed by the agency-provider or the participant and the FMS contractor when 
68.3 	the participant is acting as the employer of the support worker.
68.4 	(c) The time sheet must be on a form approved by the commissioner documenting 
68.5 	time the support worker provides services in the home to the participant. The following 
68.6 	criteria must be included in the time sheet:
68.7 	(1) full name of the support worker and individual provider number;
68.8 	(2) provider agency-provider name and telephone numbers, if an agency-provider is
68.9 	 responsible for delivery services under the written service plan;
68.10 	(3) full name of the participant;
68.11 	(4) consecutive dates, including month, day, and year, and arrival and departure 
68.12 	times with a.m. or p.m. notations;
68.13 	(5) signatures of the participant or the participant's representative;
68.14 	(6) personal signature of the support worker;
68.15 	(7) any shared care provided, if applicable;
68.16 	(8) a statement that it is a federal crime to provide false information on CFSS 
68.17 	billings for medical assistance payments; and
68.18 	(9) dates and location of recipient participant stays in a hospital, care facility, or 
68.19 	incarceration.

68.20 	Sec. 16. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 16, 
68.21 	is amended to read:
68.22 		Subd. 16.Support workers requirements. (a) Support workers shall:
68.23 	(1) enroll with the department as a support worker after a background study under 
68.24 	chapter 245C has been completed and the support worker has received a notice from the 
68.25 	commissioner that:
68.26 	(i) the support worker is not disqualified under section 245C.14; or
68.27 	(ii) is disqualified, but the support worker has received a set-aside of the 
68.28 	disqualification under section 245C.22;
68.29 	(2) have the ability to effectively communicate with the participant or the 
68.30 	participant's representative;
68.31 	(3) have the skills and ability to provide the services and supports according to 
68.32 	the person's participant's CFSS service delivery plan and respond appropriately to the 
68.33 	participant's needs;
68.34 	(4) not be a participant of CFSS, unless the support services provided by the support 
68.35 	worker differ from those provided to the support worker;
69.1 	(5) complete the basic standardized training as determined by the commissioner 
69.2 	before completing enrollment. The training must be available in languages other than 
69.3 	English and to those who need accommodations due to disabilities. Support worker 
69.4 	training must include successful completion of the following training components: basic 
69.5 	first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles 
69.6 	and responsibilities of support workers including information about basic body mechanics, 
69.7 	emergency preparedness, orientation to positive behavioral practices, orientation to 
69.8 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
69.9 	overview of person-centered planning and self-direction. Upon completion of the training 
69.10 	components, the support worker must pass the certification test to provide assistance 
69.11 	to participants;
69.12 	(6) complete training and orientation on the participant's individual needs; and
69.13 	(7) maintain the privacy and confidentiality of the participant, and not independently 
69.14 	determine the medication dose or time for medications for the participant.
69.15 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
69.16 	and provider number if the support worker:
69.17 	(1) lacks the skills, knowledge, or ability to adequately or safely perform the 
69.18 	required work;
69.19 	(2) fails to provide the authorized services required by the participant employer;
69.20 	(3) has been intoxicated by alcohol or drugs while providing authorized services to 
69.21 	the participant or while in the participant's home;
69.22 	(4) has manufactured or distributed drugs while providing authorized services to the 
69.23 	participant or while in the participant's home; or
69.24 	(5) has been excluded as a provider by the commissioner of human services, or the 
69.25 	United States Department of Health and Human Services, Office of Inspector General, 
69.26 	from participation in Medicaid, Medicare, or any other federal health care program.
69.27 	(c) A support worker may appeal in writing to the commissioner to contest the 
69.28 	decision to terminate the support worker's provider enrollment and provider number.
69.29 	(d) A support worker must not provide or be paid for more than 275 hours of 
69.30 	CFSS per month, regardless of the number of participants the support worker serves or 
69.31 	the number of agency-providers or participant employers by which the support worker 
69.32 	is employed. The department shall not disallow the number of hours per day a support 
69.33 	worker works unless it violates other law.

69.34 	Sec. 17. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
69.35 	a subdivision to read:
70.1 		Subd. 16a.Exception to support worker requirements. The support worker for a 
70.2 	participant may be allowed to enroll with a different CFSS agency-provider or FMS 
70.3 	contractor upon initiation of a new background study according to chapter 245C, if the 
70.4 	following conditions are met:
70.5 	(1) the commissioner determines that the support worker's change in enrollment or 
70.6 	affiliation is needed to ensure continuity of services and protect the health and safety 
70.7 	of the participant;
70.8 	(2) the chosen agency-provider or FMS contractor has been continuously enrolled as 
70.9 	a CFSS agency-provider or FMS contractor for at least two years or since the inception of 
70.10 	the CFSS program, whichever is shorter;
70.11 	(3) the participant served by the support worker chooses to transfer to the CFSS 
70.12 	agency-provider or the FMS contractor to which the support worker is transferring;
70.13 	(4) the support worker has been continuously enrolled with the former CFSS 
70.14 	agency-provider or FMS contractor since the support worker's last background study 
70.15 	was completed; and
70.16 	(5) the support worker continues to meet requirements of subdivision 16, excluding 
70.17 	paragraph (a), clause (1). 

70.18 	Sec. 18. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 17, 
70.19 	is amended to read:
70.20 		Subd. 17.Support specialist requirements and payments Consultation services 
70.21 	description and duties. The commissioner shall develop qualifications, scope of 
70.22 	functions, and payment rates and service limits for a support specialist that may provide 
70.23 	additional or specialized assistance necessary to plan, implement, arrange, augment, or 
70.24 	evaluate services and supports.
70.25 	(a) Consultation services means providing assistance to the participant in making 
70.26 	informed choices regarding CFSS services in general and self-directed tasks in particular 
70.27 	and in developing a person-centered service delivery plan to achieve quality service 
70.28 	outcomes.
70.29 	(b) Consultation services is a required service that may include but is not limited to:
70.30 	(1) an initial and annual orientation to CFSS information and policies, including 
70.31 	selecting a service model;
70.32 	(2) assistance with the development, implementation, management, and evaluation 
70.33 	of the person-centered service delivery plan;
70.34 	(3) consultation on recruiting, selecting, training, managing, directing, evaluating, 
70.35 	and supervising support workers;
71.1 	(4) reviewing the use of and access to informal and community supports, goods, or 
71.2 	resources;
71.3 	(5) remediation support; and
71.4 	(6) assistance with accessing FMS contractors or agency-providers.
71.5 	(c) Duties of a consultation services provider shall include but are not limited to:
71.6 	(1) review and finalization of the CFSS service delivery plan by the consultation 
71.7 	services provider organization;
71.8 	(2) distribution of copies of the final service delivery plan to the participant and 
71.9 	to the agency-provider or FMS contractor, case manager/care coordinator, and other 
71.10 	designated parties;
71.11 	(3) an evaluation of services upon receiving information from an FMS contractor 
71.12 	indicating spending or participant employer concerns;
71.13 	(4) a biannual review of services if the participant does not have a case manager/care 
71.14 	coordinator and when the support worker is a paid parent of a minor participant or the 
71.15 	participant's spouse;
71.16 	(5) collection and reporting of data as required by the department; and
71.17 	(6) providing the participant with a copy of the service-related rights under 
71.18 	subdivision 20 at the start of consultation services.

71.19 	Sec. 19. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
71.20 	a subdivision to read:
71.21 		Subd. 17a.Consultation service provider qualifications and requirements.
 71.22 	The commissioner shall develop the qualifications and requirements for providers of 
71.23 	consultation services under subdivision 17. These providers must satisfy at least the 
71.24 	following qualifications and requirements:
71.25 	(1) are under contract with the department;
71.26 	(2) are not the FMS contractor as defined in subdivision 2, paragraph (m), the CFSS 
71.27 	or HCBS waiver agency-provider or vendor to the participant, or a lead agency;
71.28 	(3) meet the service standards as established by the commissioner;
71.29 	(4) employ lead professional staff with a minimum of three years' experience 
71.30 	in providing support planning, support broker, or consultation services and consumer 
71.31 	education to participants using a self-directed program using FMS under medical 
71.32 	assistance;
71.33 	(5) are knowledgeable about CFSS roles and responsibilities including those of the 
71.34 	certified assessor, FMS contractor, agency-provider, and case manager/care coordinator;
71.35 	(6) comply with medical assistance provider requirements;
72.1 	(7) understand the CFSS program and its policies;
72.2 	(8) are knowledgeable about self-directed principles and the application of the 
72.3 	person-centered planning process;
72.4 	(9) have general knowledge of the FMS contractor duties and participant 
72.5 	employment model, including all applicable federal, state, and local laws and regulations 
72.6 	regarding tax, labor, employment, and liability and workers' compensation coverage for 
72.7 	household workers; and
72.8 	(10) have all employees, including lead professional staff, staff in management 
72.9 	and supervisory positions, and owners of the agency who are active in the day-to-day 
72.10 	management and operations of the agency, complete training as specified in the contract 
72.11 	with the department.

72.12 	Sec. 20. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
72.13 	a subdivision to read:
72.14 		Subd. 17b.Financial management services and consultation services payment 
72.15 	methodology. The commissioner shall establish a cost-neutral funding mechanism for 
72.16 	FMS and consultation services.

72.17 	Sec. 21. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 18, 
72.18 	is amended to read:
72.19 		Subd. 18.Service unit and budget allocation requirements and limits. (a) For the 
72.20 	agency-provider model, services will be authorized in units of service. The total service 
72.21 	unit amount must be established based upon the assessed need for CFSS services, and must 
72.22 	not exceed the maximum number of units available as determined under subdivision 8.
72.23 	(b) For the budget model, the service budget allocation allowed for services and 
72.24 	supports is established by multiplying the number of units authorized under subdivision 8 
72.25 	by the payment rate established by the commissioner defined in subdivision 8, paragraph 
72.26 	(g).

72.27 	Sec. 22. Minnesota Statutes 2013 Supplement, section 256B.85, is amended by adding 
72.28 	a subdivision to read:
72.29 		Subd. 18a.Worker training and development services. (a) The commissioner 
72.30 	shall develop the scope of tasks and functions, service standards, and service limits for 
72.31 	worker training and development services.
73.1 	(b) Worker training and development services are in addition to the participant's 
73.2 	assessed service units or service budget. Services provided according to this subdivision 
73.3 	must:
73.4 	(1) help support workers obtain and expand the skills and knowledge necessary to 
73.5 	ensure competency in providing quality services as needed and defined in the participant's 
73.6 	service delivery plan;
73.7 	(2) be provided or arranged for by the agency-provider under subdivision 11 or 
73.8 	purchased by the participant employer under the budget model under subdivision 13; and
73.9 	(3) be described in the participant's CFSS service delivery plan and documented in 
73.10 	the participant's file.
73.11 	(c) Services covered under worker training and development shall include:
73.12 	(1) support worker training on the participant's individual assessed needs, condition, 
73.13 	or both, provided individually or in a group setting by a skilled and knowledgeable trainer 
73.14 	beyond any training the participant or participant's representative provides;
73.15 	(2) tuition for professional classes and workshops for the participant's support 
73.16 	workers that relate to the participant's assessed needs, condition, or both;
73.17 	(3) direct observation, monitoring, coaching, and documentation of support worker 
73.18 	job skills and tasks, beyond any training the participant or participant's representative 
73.19 	provides, including supervision of health-related tasks or behavioral supports that is 
73.20 	conducted by an appropriate professional based on the participant's assessed needs. These 
73.21 	services must be provided within 14 days of the start of services or the start of a new 
73.22 	support worker and must be specified in the participant's service delivery plan; and
73.23 	(4) reporting service and support concerns to the appropriate provider.
73.24 	(d) Worker training and development services shall not include:
73.25 	(1) general agency training, worker orientation, or training on CFSS self-directed 
73.26 	models;
73.27 	(2) payment for preparation or development time for the trainer or presenter;
73.28 	(3) payment of the support worker's salary or compensation during the training;
73.29 	(4) training or supervision provided by the participant, the participant's support 
73.30 	worker, or the participant's informal supports, including the participant's representative; or
73.31 	(5) services in excess of 96 units per annual service authorization, unless approved 
73.32 	by the department.

73.33 	Sec. 23. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 23, 
73.34 	is amended to read:
74.1 		Subd. 23.Commissioner's access. When the commissioner is investigating a 
74.2 	possible overpayment of Medicaid funds, the commissioner must be given immediate 
74.3 	access without prior notice to the agency provider agency-provider or FMS contractor's 
74.4 	office during regular business hours and to documentation and records related to services 
74.5 	provided and submission of claims for services provided. Denying the commissioner 
74.6 	access to records is cause for immediate suspension of payment and terminating the agency 
74.7 	provider's enrollment according to section 256B.064 or terminating the FMS contract.

74.8 	Sec. 24. Minnesota Statutes 2013 Supplement, section 256B.85, subdivision 24, 
74.9 	is amended to read:
74.10 		Subd. 24.CFSS agency-providers; background studies. CFSS agency-providers 
74.11 	enrolled to provide personal care assistance CFSS services under the medical assistance 
74.12 	program shall comply with the following:
74.13 	(1) owners who have a five percent interest or more and all managing employees 
74.14 	are subject to a background study as provided in chapter 245C. This applies to currently 
74.15 	enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS 
74.16 	agency-provider. "Managing employee" has the same meaning as Code of Federal 
74.17 	Regulations, title 42, section 455. An organization is barred from enrollment if:
74.18 	(i) the organization has not initiated background studies on owners managing 
74.19 	employees; or
74.20 	(ii) the organization has initiated background studies on owners and managing 
74.21 	employees, but the commissioner has sent the organization a notice that an owner or 
74.22 	managing employee of the organization has been disqualified under section 245C.14, and 
74.23 	the owner or managing employee has not received a set-aside of the disqualification 
74.24 	under section 245C.22;
74.25 	(2) a background study must be initiated and completed for all support specialists
74.26 	 staff providing worker training and development employed by the agency-provider; and
74.27 	(3) a background study must be initiated and completed for all support workers.

74.28 	Sec. 25. Laws 2013, chapter 108, article 7, section 49, the effective date, is amended to 
74.29 	read:

74.30 	EFFECTIVE DATE. This section is effective upon federal approval but no earlier 
74.31 	than April 1, 2014. The service will begin 90 days after federal approval or April 1, 
74.32 	2014, whichever is later. The commissioner of human services shall notify the revisor of 
74.33 	statutes when this occurs.

75.1 	ARTICLE 5
75.2 	CONTINUING CARE

75.3 	Section 1. Minnesota Statutes 2012, section 13.46, subdivision 4, is amended to read:
75.4 		Subd. 4.Licensing data. (a) As used in this subdivision:
75.5 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
75.6 	welfare system pertaining to persons licensed or registered or who apply for licensure 
75.7 	or registration or who formerly were licensed or registered under the authority of the 
75.8 	commissioner of human services;
75.9 	(2) "client" means a person who is receiving services from a licensee or from an 
75.10 	applicant for licensure; and
75.11 	(3) "personal and personal financial data" are Social Security numbers, identity 
75.12 	of and letters of reference, insurance information, reports from the Bureau of Criminal 
75.13 	Apprehension, health examination reports, and social/home studies.
75.14 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, 
75.15 	license holders, and former licensees are public: name, address, telephone number of 
75.16 	licensees, date of receipt of a completed application, dates of licensure, licensed capacity, 
75.17 	type of client preferred, variances granted, record of training and education in child care 
75.18 	and child development, type of dwelling, name and relationship of other family members, 
75.19 	previous license history, class of license, the existence and status of complaints, and the 
75.20 	number of serious injuries to or deaths of individuals in the licensed program as reported 
75.21 	to the commissioner of human services, the local social services agency, or any other 
75.22 	county welfare agency. For purposes of this clause, a serious injury is one that is treated 
75.23 	by a physician.
75.24 	(ii) When a correction order, an order to forfeit a fine, an order of license suspension, 
75.25 	an order of temporary immediate suspension, an order of license revocation, an order 
75.26 	of license denial, or an order of conditional license has been issued, or a complaint is 
75.27 	resolved, the following data on current and former licensees and applicants are public: the 
75.28 	substance and investigative findings of the licensing or maltreatment complaint, licensing 
75.29 	violation, or substantiated maltreatment; the record of informal resolution of a licensing 
75.30 	violation; orders of hearing; findings of fact; conclusions of law; specifications of the final 
75.31 	correction order, fine, suspension, temporary immediate suspension, revocation, denial, or 
75.32 	conditional license contained in the record of licensing action; whether a fine has been 
75.33 	paid; and the status of any appeal of these actions.
75.34 	(iii) When a license denial under section 245A.05 or a sanction under section 
75.35 	245A.07 is based on a determination that the license holder or applicant is responsible for 
76.1 	maltreatment under section 626.556 or 626.557, the identity of the applicant or license 
76.2 	holder as the individual responsible for maltreatment is public data at the time of the 
76.3 	issuance of the license denial or sanction.
76.4 	(iv) When a license denial under section 245A.05 or a sanction under section 
76.5 	245A.07 is based on a determination that the license holder or applicant is disqualified 
76.6 	under chapter 245C, the identity of the license holder or applicant as the disqualified 
76.7 	individual and the reason for the disqualification are public data at the time of the 
76.8 	issuance of the licensing sanction or denial. If the applicant or license holder requests 
76.9 	reconsideration of the disqualification and the disqualification is affirmed, the reason for 
76.10 	the disqualification and the reason to not set aside the disqualification are public data.
76.11 	(2) Notwithstanding sections 626.556, subdivision 11, and 626.557, subdivision 12b, 
76.12 	when any person subject to disqualification under section 245C.14 in connection with a 
76.13 	license to provide family day care for children, child care center services, foster care for 
76.14 	children in the provider's home, or foster care or day care services for adults in the provider's 
76.15 	home is a substantiated perpetrator of maltreatment, and the substantiated maltreatment is 
76.16 	a reason for a licensing action, the identity of the substantiated perpetrator of maltreatment 
76.17 	is public data. For purposes of this clause, a person is a substantiated perpetrator if the 
76.18 	maltreatment determination has been upheld under section 256.045; 626.556, subdivision 
76.19 	10i; 626.557, subdivision 9d; or chapter 14, or if an individual or facility has not timely 
76.20 	exercised appeal rights under these sections, except as provided under clause (1).
76.21 	(3) For applicants who withdraw their application prior to licensure or denial of a 
76.22 	license, the following data are public: the name of the applicant, the city and county in 
76.23 	which the applicant was seeking licensure, the dates of the commissioner's receipt of the 
76.24 	initial application and completed application, the type of license sought, and the date 
76.25 	of withdrawal of the application.
76.26 	(4) For applicants who are denied a license, the following data are public: the name 
76.27 	and address of the applicant, the city and county in which the applicant was seeking 
76.28 	licensure, the dates of the commissioner's receipt of the initial application and completed 
76.29 	application, the type of license sought, the date of denial of the application, the nature of 
76.30 	the basis for the denial, the record of informal resolution of a denial, orders of hearings, 
76.31 	findings of fact, conclusions of law, specifications of the final order of denial, and the 
76.32 	status of any appeal of the denial.
76.33 	(5) The following data on persons subject to disqualification under section 245C.14 in 
76.34 	connection with a license to provide family day care for children, child care center services, 
76.35 	foster care for children in the provider's home, or foster care or day care services for adults 
76.36 	in the provider's home, are public: the nature of any disqualification set aside under section 
77.1 	245C.22, subdivisions 2 and 4, and the reasons for setting aside the disqualification; the 
77.2 	nature of any disqualification for which a variance was granted under sections 245A.04, 
77.3 	subdivision 9; and 245C.30, and the reasons for granting any variance under section 
77.4 	245A.04, subdivision 9; and, if applicable, the disclosure that any person subject to 
77.5 	a background study under section 245C.03, subdivision 1, has successfully passed a 
77.6 	background study. If a licensing sanction under section 245A.07, or a license denial under 
77.7 	section 245A.05, is based on a determination that an individual subject to disqualification 
77.8 	under chapter 245C is disqualified, the disqualification as a basis for the licensing sanction 
77.9 	or denial is public data. As specified in clause (1), item (iv), if the disqualified individual 
77.10 	is the license holder or applicant, the identity of the license holder or applicant and the 
77.11 	reason for the disqualification are public data; and, if the license holder or applicant 
77.12 	requested reconsideration of the disqualification and the disqualification is affirmed, the 
77.13 	reason for the disqualification and the reason to not set aside the disqualification are 
77.14 	public data. If the disqualified individual is an individual other than the license holder or 
77.15 	applicant, the identity of the disqualified individual shall remain private data.
77.16 	(6) When maltreatment is substantiated under section 626.556 or 626.557 and the 
77.17 	victim and the substantiated perpetrator are affiliated with a program licensed under 
77.18 	chapter 245A, the commissioner of human services, local social services agency, or 
77.19 	county welfare agency may inform the license holder where the maltreatment occurred of 
77.20 	the identity of the substantiated perpetrator and the victim.
77.21 	(7) Notwithstanding clause (1), for child foster care, only the name of the license 
77.22 	holder and the status of the license are public if the county attorney has requested that data 
77.23 	otherwise classified as public data under clause (1) be considered private data based on the 
77.24 	best interests of a child in placement in a licensed program.
77.25 	(c) The following are private data on individuals under section 13.02, subdivision 
77.26 	12, or nonpublic data under section 13.02, subdivision 9: personal and personal financial 
77.27 	data on family day care program and family foster care program applicants and licensees 
77.28 	and their family members who provide services under the license.
77.29 	(d) The following are private data on individuals: the identity of persons who have 
77.30 	made reports concerning licensees or applicants that appear in inactive investigative data, 
77.31 	and the records of clients or employees of the licensee or applicant for licensure whose 
77.32 	records are received by the licensing agency for purposes of review or in anticipation of a 
77.33 	contested matter. The names of reporters of complaints or alleged violations of licensing 
77.34 	standards under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged 
77.35 	maltreatment under sections 626.556 and 626.557, are confidential data and may be 
77.36 	disclosed only as provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
78.1 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under 
78.2 	this subdivision become public data if submitted to a court or administrative law judge as 
78.3 	part of a disciplinary proceeding in which there is a public hearing concerning a license 
78.4 	which has been suspended, immediately suspended, revoked, or denied.
78.5 	(f) Data generated in the course of licensing investigations that relate to an alleged 
78.6 	violation of law are investigative data under subdivision 3.
78.7 	(g) Data that are not public data collected, maintained, used, or disseminated under 
78.8 	this subdivision that relate to or are derived from a report as defined in section 626.556, 
78.9 	subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of 
78.10 	sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
78.11 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
78.12 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
78.13 	defined in section 626.556 or 626.557 may be exchanged with the Department of Health 
78.14 	for purposes of completing background studies pursuant to section 144.057 and with 
78.15 	the Department of Corrections for purposes of completing background studies pursuant 
78.16 	to section 241.021.
78.17 	(i) Data on individuals collected according to licensing activities under chapters 
78.18 	245A and 245C, data on individuals collected by the commissioner of human services 
78.19 	according to investigations under chapters 245A, 245B, and 245C, and 245D, and 
78.20 	sections 626.556 and 626.557 may be shared with the Department of Human Rights, the 
78.21 	Department of Health, the Department of Corrections, the ombudsman for mental health 
78.22 	and developmental disabilities, and the individual's professional regulatory board when 
78.23 	there is reason to believe that laws or standards under the jurisdiction of those agencies may 
78.24 	have been violated or the information may otherwise be relevant to the board's regulatory 
78.25 	jurisdiction. Background study data on an individual who is the subject of a background 
78.26 	study under chapter 245C for a licensed service for which the commissioner of human 
78.27 	services is the license holder may be shared with the commissioner and the commissioner's 
78.28 	delegate by the licensing division. Unless otherwise specified in this chapter, the identity 
78.29 	of a reporter of alleged maltreatment or licensing violations may not be disclosed.
78.30 	(j) In addition to the notice of determinations required under section 626.556, 
78.31 	subdivision 10f, if the commissioner or the local social services agency has determined 
78.32 	that an individual is a substantiated perpetrator of maltreatment of a child based on sexual 
78.33 	abuse, as defined in section 626.556, subdivision 2, and the commissioner or local social 
78.34 	services agency knows that the individual is a person responsible for a child's care in 
78.35 	another facility, the commissioner or local social services agency shall notify the head 
78.36 	of that facility of this determination. The notification must include an explanation of the 
79.1 	individual's available appeal rights and the status of any appeal. If a notice is given under 
79.2 	this paragraph, the government entity making the notification shall provide a copy of the 
79.3 	notice to the individual who is the subject of the notice.
79.4 	(k) All not public data collected, maintained, used, or disseminated under this 
79.5 	subdivision and subdivision 3 may be exchanged between the Department of Human 
79.6 	Services, Licensing Division, and the Department of Corrections for purposes of 
79.7 	regulating services for which the Department of Human Services and the Department 
79.8 	of Corrections have regulatory authority.

79.9 	Sec. 2. Minnesota Statutes 2013 Supplement, section 245.8251, is amended to read:
79.10 	245.8251 POSITIVE SUPPORT STRATEGIES AND EMERGENCY 
79.11 	MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
79.12 		Subdivision 1.Rules governing the use of positive support strategies and 
79.13 	restricting or prohibiting aversive and deprivation procedures. The commissioner 
79.14 	of human services shall, within 24 months of May 23, 2013 by August 31, 2015, adopt 
79.15 	rules governing the use of positive support strategies, safety interventions, and emergency 
79.16 	use of manual restraint, and restricting or prohibiting the use of aversive and deprivation 
79.17 	procedures,  in all facilities and services licensed under chapter 245D. and in all licensed 
79.18 	facilities and licensed services serving persons with a developmental disability or related 
79.19 	condition. For the purposes of this section, "developmental disability or related condition" 
79.20 	has the meaning given in Minnesota Rules, part 9525.0016, subpart 2, items A to E.
79.21 		Subd. 2.Data collection. (a) The commissioner shall, with stakeholder input, 
79.22 	develop identify data collection elements specific to incidents of emergency use of 
79.23 	manual restraint and positive support transition plans for persons receiving services from 
79.24 	providers governed licensed facilities and licensed services  under chapter 245D and in 
79.25 	licensed facilities and licensed services serving persons with a developmental disability 
79.26 	or related condition as defined in Minnesota Rules, part 9525.0016, subpart 2, effective 
79.27 	January 1, 2014. Providers Licensed facilities and licensed services shall report the data in 
79.28 	a format and at a frequency determined by the commissioner of human services. Providers 
79.29 	shall submit the data to the commissioner and the Office of the Ombudsman for Mental 
79.30 	Health and Developmental Disabilities.
79.31 	(b) Beginning July 1, 2013, providers licensed facilities and licensed services
79.32 	 regulated under Minnesota Rules, parts 9525.2700 to 9525.2810, shall submit data 
79.33 	regarding the use of all controlled procedures identified in Minnesota Rules, part 
79.34 	9525.2740, in a format and at a frequency determined by the commissioner. Providers 
80.1 	shall submit the data to the commissioner and the Office of the Ombudsman for Mental 
80.2 	Health and Developmental Disabilities.
80.3 		Subd. 3.External program review committee. Rules adopted according to this 
80.4 	section shall establish requirements for an external program review committee appointed 
80.5 	by the commissioner to monitor the rules after adoption of the rules.
80.6 		Subd. 4.Interim review panel. (a) The commissioner shall establish an interim 
80.7 	review panel by August 15, 2014, for the purpose of reviewing requests for emergency 
80.8 	use of procedures that have been part of an approved positive support transition plan 
80.9 	when necessary to protect a person from imminent risk of serious injury as defined in 
80.10 	section 245.91, subdivision 6, due to self-injurious behavior. The panel must make 
80.11 	recommendations to the commissioner to approve or deny these requests based on criteria 
80.12 	to be established by the interim review panel. The interim review panel shall operate until 
80.13 	the external program review committee is established as required under subdivision 3.
80.14 	(b) Members of the interim review panel shall be selected based on their expertise 
80.15 	and knowledge related to the use of positive support strategies as alternatives to 
80.16 	the use of aversive or deprivation procedures. The commissioner shall seek input 
80.17 	and recommendations from the Office of the Ombudsman for Mental Health and 
80.18 	Developmental Disabilities and the Minnesota Governor's Council on Developmental 
80.19 	Disabilities in establishing the interim review panel. Members of the interim review panel 
80.20 	shall include the following representatives:
80.21 	(1) an expert in positive supports;
80.22 	(2) a mental health professional, as defined in section 245.462;
80.23 	(3) a licensed health professional as defined in section 245D.02, subdivision 14;
80.24 	(4) a representative of the Department of Health;
80.25 	(5) a representative of the Office of the Ombudsman for Mental Health and 
80.26 	Developmental Disabilities; and
80.27 	(6) a representative of the Minnesota Disability Law Center.

80.28 	Sec. 3. Minnesota Statutes 2013 Supplement, section 245A.042, subdivision 3, is 
80.29 	amended to read:
80.30 		Subd. 3.Implementation. (a) The commissioner shall implement the 
80.31 	responsibilities of this chapter according to the timelines in paragraphs (b) and (c) 
80.32 	only within the limits of available appropriations or other administrative cost recovery 
80.33 	methodology.
80.34 	(b) The licensure of home and community-based services according to this section 
80.35 	shall be implemented January 1, 2014. License applications shall be received and 
81.1 	processed on a phased-in schedule as determined by the commissioner beginning July 
81.2 	1, 2013. Licenses will be issued thereafter upon the commissioner's determination that 
81.3 	the application is complete according to section 245A.04.
81.4 	(c) Within the limits of available appropriations or other administrative cost recovery 
81.5 	methodology, implementation of compliance monitoring must be phased in after January 
81.6 	1, 2014.
81.7 	(1) Applicants who do not currently hold a license issued under chapter 245B must 
81.8 	receive an initial compliance monitoring visit after 12 months of the effective date of the 
81.9 	initial license for the purpose of providing technical assistance on how to achieve and 
81.10 	maintain compliance with the applicable law or rules governing the provision of home and 
81.11 	community-based services under chapter 245D. If during the review the commissioner 
81.12 	finds that the license holder has failed to achieve compliance with an applicable law or 
81.13 	rule and this failure does not imminently endanger the health, safety, or rights of the 
81.14 	persons served by the program, the commissioner may issue a licensing review report with 
81.15 	recommendations for achieving and maintaining compliance.
81.16 	(2) Applicants who do currently hold a license issued under this chapter must receive 
81.17 	a compliance monitoring visit after 24 months of the effective date of the initial license.
81.18 	(d) Nothing in this subdivision shall be construed to limit the commissioner's 
81.19 	authority to suspend or revoke a license or issue a fine at any time under section 245A.07, 
81.20 	or issue correction orders and make a license conditional for failure to comply with 
81.21 	applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity 
81.22 	of the violation of law or rule and the effect of the violation on the health, safety, or 
81.23 	rights of persons served by the program.
81.24 	(e) License holders governed under chapter 245D must ensure compliance with the 
81.25 	following requirements within the stated timelines:
81.26 	(1) service initiation and service planning requirements must be met at the next 
81.27 	annual meeting of the person's support team or by January 1, 2015, whichever is later, 
81.28 	for the following:
81.29 	(i) provision of a written notice that identifies the service recipient rights and an 
81.30 	explanation of those rights as required under section 245D.04, subdivision 1;
81.31 	(ii) service planning for basic support services as required under section 245D.07, 
81.32 	subdivision 2; and
81.33 	(iii) service planning for intensive support services under section 245D.071, 
81.34 	subdivisions 3 and 4;
81.35 	(2) staff orientation to program requirements as required under section 245D.09, 
81.36 	subdivision 4, for staff hired before January 1, 2014, must be met by January 1, 2015. 
82.1 	The license holder may otherwise provide documentation verifying these requirements 
82.2 	were met before January 1, 2014;
82.3 	(3) development of policy and procedures as required under section 245D.11, must 
82.4 	be completed no later than August 31, 2014;
82.5 	(4) written notice and copies of policies and procedures must be provided to 
82.6 	all persons or their legal representatives and case managers as required under section 
82.7 	245D.10, subdivision 4, paragraphs (b) and (c), by September 15, 2014, or within 30 days 
82.8 	of development of the required policies and procedures, whichever is earlier; and
82.9 	(5) all employees must be informed of the revisions and training must be provided on 
82.10 	implementation of the revised policies and procedures as required under section 245D.10, 
82.11 	subdivision 4, paragraph (d), by September 15, 2014, or within 30 days of development of 
82.12 	the required policies and procedures, whichever is earlier.

82.13 	Sec. 4. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 3, is 
82.14 	amended to read:
82.15 		Subd. 3.Case manager. "Case manager" means the individual designated 
82.16 	to provide waiver case management services, care coordination, or long-term care 
82.17 	consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, 
82.18 	or successor provisions. For purposes of this chapter, "case manager" includes case 
82.19 	management services as defined in Minnesota Rules, part 9520.0902, subpart 3.

82.20 	Sec. 5. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 4b, is 
82.21 	amended to read:
82.22 		Subd. 4b.Coordinated service and support plan. "Coordinated service and 
82.23 	support plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, 
82.24 	subdivision 6; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor 
82.25 	provisions. For purposes of this chapter, "coordinated service and support plan" includes 
82.26 	the individual program plan or individual treatment plan as defined in Minnesota Rules, 
82.27 	part 9520.0510, subpart 12.

82.28 	Sec. 6. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 8b, is 
82.29 	amended to read:
82.30 		Subd. 8b.Expanded support team. "Expanded support team" means the members 
82.31 	of the support team defined in subdivision 46 34 and a licensed health or mental health 
82.32 	professional or other licensed, certified, or qualified professionals or consultants working 
83.1 	with the person and included in the team at the request of the person or the person's legal 
83.2 	representative.

83.3 	Sec. 7. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 11, is 
83.4 	amended to read:
83.5 		Subd. 11.Incident. "Incident" means an occurrence which involves a person and 
83.6 	requires the program to make a response that is not a part of the program's ordinary 
83.7 	provision of services to that person, and includes:
83.8 	(1) serious injury of a person as determined by section 245.91, subdivision 6;
83.9 	(2) a person's death;
83.10 	(3) any medical emergency, unexpected serious illness, or significant unexpected 
83.11 	change in an illness or medical condition of a person that requires the program to call 
83.12 	911, physician treatment, or hospitalization;
83.13 	(4) any mental health crisis that requires the program to call 911 or, a mental 
83.14 	health crisis intervention team, or a similar mental health response team or service when 
83.15 	available and appropriate;
83.16 	(5) an act or situation involving a person that requires the program to call 911, 
83.17 	law enforcement, or the fire department;
83.18 	(6) a person's unauthorized or unexplained absence from a program;
83.19 	(7) conduct by a person receiving services against another person receiving services 
83.20 	that:
83.21 	(i) is so severe, pervasive, or objectively offensive that it substantially interferes with 
83.22 	a person's opportunities to participate in or receive service or support;
83.23 	(ii) places the person in actual and reasonable fear of harm;
83.24 	(iii) places the person in actual and reasonable fear of damage to property of the 
83.25 	person; or
83.26 	(iv) substantially disrupts the orderly operation of the program;
83.27 	(8) any sexual activity between persons receiving services involving force or 
83.28 	coercion as defined under section 609.341, subdivisions 3 and 14;
83.29 	(9) any emergency use of manual restraint as identified in section 245D.061; or
83.30 	(10) a report of alleged or suspected child or vulnerable adult maltreatment under 
83.31 	section 626.556 or 626.557.

83.32 	Sec. 8. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 15b, 
83.33 	is amended to read:
84.1 		Subd. 15b.Mechanical restraint. (a) Except for devices worn by the person that 
84.2 	trigger electronic alarms to warn staff that a person is leaving a room or area, which 
84.3 	do not, in and of themselves, restrict freedom of movement, or the use of adaptive aids 
84.4 	or equipment or orthotic devices ordered by a health care professional used to treat or 
84.5 	manage a medical condition, "Mechanical restraint" means the use of devices, materials, 
84.6 	or equipment attached or adjacent to the person's body, or the use of practices that are 
84.7 	intended to restrict freedom of movement or normal access to one's body or body parts, 
84.8 	or limits a person's voluntary movement or holds a person immobile as an intervention 
84.9 	precipitated by a person's behavior. The term applies to the use of mechanical restraint 
84.10 	used to prevent injury with persons who engage in self-injurious behaviors, such as 
84.11 	head-banging, gouging, or other actions resulting in tissue damage that have caused or 
84.12 	could cause medical problems resulting from the self-injury.
84.13 	(b) Mechanical restraint does not include the following:
84.14 	(1) devices worn by the person that trigger electronic alarms to warn staff that a 
84.15 	person is leaving a room or area, which do not, in and of themselves, restrict freedom of 
84.16 	movement; or
84.17 	(2) the use of adaptive aids or equipment or orthotic devices ordered by a health care 
84.18 	professional used to treat or manage a medical condition.

84.19 	Sec. 9. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 29, is 
84.20 	amended to read:
84.21 		Subd. 29.Seclusion. "Seclusion" means the placement of a person alone in: (1) 
84.22 	removing a person involuntarily to a room from which exit is prohibited by a staff person 
84.23 	or a mechanism such as a lock, a device, or an object positioned to hold the door closed 
84.24 	or otherwise prevent the person from leaving the room.; or (2) otherwise involuntarily 
84.25 	removing or separating a person from an area, activity, situation, or social contact with 
84.26 	others and blocking or preventing the person's return.

84.27 	Sec. 10. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 34, 
84.28 	is amended to read:
84.29 		Subd. 34.Support team. "Support team" means the service planning team 
84.30 	identified in section 256B.49, subdivision 15, or; the interdisciplinary team identified in 
84.31 	Minnesota Rules, part 9525.0004, subpart 14; or the case management team as defined in 
84.32 	Minnesota Rules, part 9520.0902, subpart 6.

85.1 	Sec. 11. Minnesota Statutes 2013 Supplement, section 245D.02, subdivision 34a, 
85.2 	is amended to read:
85.3 		Subd. 34a.Time out. "Time out" means removing a person involuntarily from an 
85.4 	ongoing activity to a room, either locked or unlocked, or otherwise separating a person 
85.5 	from others in a way that prevents social contact and prevents the person from leaving the 
85.6 	situation if the person chooses the involuntary removal of a person for a period of time to 
85.7 	a designated area from which the person is not prevented from leaving. For the purpose of 
85.8 	this chapter, "time out" does not mean voluntary removal or self-removal for the purpose 
85.9 	of calming, prevention of escalation, or de-escalation of behavior for a period of up to 15 
85.10 	minutes. "Time out" does not include a person voluntarily moving from an ongoing activity 
85.11 	to an unlocked room or otherwise separating from a situation or social contact with others 
85.12 	if the person chooses. For the purposes of this definition, "voluntarily" means without 
85.13 	being forced, compelled, or coerced.; nor does it mean taking a brief "break" or "rest" from 
85.14 	an activity for the purpose of providing the person an opportunity to regain self-control. 
85.15 	For the purpose of this subdivision, "brief" means a duration of three minutes or less.

85.16 	Sec. 12. Minnesota Statutes 2013 Supplement, section 245D.02, is amended by adding 
85.17 	a subdivision to read:
85.18 		Subd. 35b.Unlicensed staff. "Unlicensed staff" means individuals not otherwise 
85.19 	licensed or certified by a governmental health board or agency.

85.20 	Sec. 13. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 1, is 
85.21 	amended to read:
85.22 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of 
85.23 	home and community-based services to persons with disabilities and persons age 65 and 
85.24 	older pursuant to this chapter. The licensing standards in this chapter govern the provision 
85.25 	of basic support services and intensive support services.
85.26 	(b) Basic support services provide the level of assistance, supervision, and care that 
85.27 	is necessary to ensure the health and safety of the person and do not include services that 
85.28 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of 
85.29 	the person. Basic support services include:
85.30 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
85.31 	subdivision 15, and under the brain injury, community alternative care, community 
85.32 	alternatives for disabled individuals, developmental disability, and elderly waiver plans;
85.33 	(2) adult companion services as defined under the brain injury, community 
85.34 	alternatives for disabled individuals, and elderly waiver plans, excluding adult companion 
86.1 	services provided under the Corporation for National and Community Services Senior 
86.2 	Companion Program established under the Domestic Volunteer Service Act of 1973, 
86.3 	Public Law 98-288;
86.4 	(3) personal support as defined under the developmental disability waiver plan;
86.5 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
86.6 	community alternatives for disabled individuals and developmental disability waiver plans;
86.7 	(5) night supervision services as defined under the brain injury waiver plan; and
86.8 	(6) homemaker services as defined under the community alternatives for disabled 
86.9 	individuals, brain injury, community alternative care, developmental disability, and elderly 
86.10 	waiver plans, excluding providers licensed by the Department of Health under chapter 
86.11 	144A and those providers providing cleaning services only.
86.12 	(c) Intensive support services provide assistance, supervision, and care that is 
86.13 	necessary to ensure the health and safety of the person and services specifically directed 
86.14 	toward the training, habilitation, or rehabilitation of the person. Intensive support services 
86.15 	include:
86.16 	(1) intervention services, including:
86.17 	(i) behavioral support services as defined under the brain injury and community 
86.18 	alternatives for disabled individuals waiver plans;
86.19 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
86.20 	disability waiver plan; and
86.21 	(iii) specialist services as defined under the current developmental disability waiver 
86.22 	plan;
86.23 	(2) in-home support services, including:
86.24 	(i) in-home family support and supported living services as defined under the 
86.25 	developmental disability waiver plan;
86.26 	(ii) independent living services training as defined under the brain injury and 
86.27 	community alternatives for disabled individuals waiver plans; and
86.28 	(iii) semi-independent living services;
86.29 	(3) residential supports and services, including:
86.30 	(i) supported living services as defined under the developmental disability waiver 
86.31 	plan provided in a family or corporate child foster care residence, a family adult foster 
86.32 	care residence, a community residential setting, or a supervised living facility;
86.33 	(ii) foster care services as defined in the brain injury, community alternative care, 
86.34 	and community alternatives for disabled individuals waiver plans provided in a family or 
86.35 	corporate child foster care residence, a family adult foster care residence, or a community 
86.36 	residential setting; and
87.1 	(iii) residential services provided to more than four persons with developmental 
87.2 	disabilities in a supervised living facility that is certified by the Department of Health as 
87.3 	an ICF/DD, including ICFs/DD;
87.4 	(4) day services, including:
87.5 	(i) structured day services as defined under the brain injury waiver plan;
87.6 	(ii) day training and habilitation services under sections 252.40 to 252.46, and as 
87.7 	defined under the developmental disability waiver plan; and
87.8 	(iii) prevocational services as defined under the brain injury and community 
87.9 	alternatives for disabled individuals waiver plans; and
87.10 	(5) supported employment as defined under the brain injury, developmental 
87.11 	disability, and community alternatives for disabled individuals waiver plans.

87.12 	Sec. 14. Minnesota Statutes 2013 Supplement, section 245D.03, is amended by adding 
87.13 	a subdivision to read:
87.14 		Subd. 1a.Effect. The home and community-based services standards establish 
87.15 	health, safety, welfare, and rights protections for persons receiving services governed by 
87.16 	this chapter. The standards recognize the diversity of persons receiving these services and 
87.17 	require that these services are provided in a manner that meets each person's individual 
87.18 	needs and ensures continuity in service planning, care, and coordination between the 
87.19 	license holder and members of each person's support team or expanded support team.

87.20 	Sec. 15. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 2, is 
87.21 	amended to read:
87.22 		Subd. 2.Relationship to other standards governing home and community-based 
87.23 	services. (a) A license holder governed by this chapter is also subject to the licensure 
87.24 	requirements under chapter 245A.
87.25 	(b) A corporate or family child foster care site controlled by a license holder and 
87.26 	providing services governed by this chapter is exempt from compliance with section 
87.27 	245D.04. This exemption applies to foster care homes where at least one resident is 
87.28 	receiving residential supports and services licensed according to this chapter. This chapter 
87.29 	does not apply to corporate or family child foster care homes that do not provide services 
87.30 	licensed under this chapter.
87.31 	(c) A family adult foster care site controlled by a license holder and providing 
87.32 	services governed by this chapter is exempt from compliance with Minnesota Rules, 
87.33 	parts 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 9555.6265. These 
87.34 	exemptions apply to family adult foster care homes where at least one resident is receiving 
88.1 	residential supports and services licensed according to this chapter. This chapter does 
88.2 	not apply to family adult foster care homes that do not provide services licensed under 
88.3 	this chapter.
88.4 	(d) A license holder providing services licensed according to this chapter in a 
88.5 	supervised living facility is exempt from compliance with sectionssection 245D.04; 
88.6 	245D.05, subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
88.7 	(e) A license holder providing residential services to persons in an ICF/DD is exempt 
88.8 	from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision 
88.9 	2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, 
88.10 	subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
88.11 	(f) A license holder providing homemaker services licensed according to this chapter 
88.12 	and registered according to chapter 144A is exempt from compliance with section 245D.04.
88.13 	(g) Nothing in this chapter prohibits a license holder from concurrently serving 
88.14 	persons without disabilities or people who are or are not age 65 and older, provided this 
88.15 	chapter's standards are met as well as other relevant standards.
88.16 	(h) The documentation required under sections 245D.07 and 245D.071 must meet 
88.17 	the individual program plan requirements identified in section 256B.092 or successor 
88.18 	provisions.

88.19 	Sec. 16. Minnesota Statutes 2013 Supplement, section 245D.03, subdivision 3, is 
88.20 	amended to read:
88.21 		Subd. 3.Variance. If the conditions in section 245A.04, subdivision 9, are met, 
88.22 	the commissioner may grant a variance to any of the requirements in this chapter, except 
88.23 	sections 245D.04; 245D.06, subdivision 4, paragraph (b), and subdivision 6; and 245D.061, 
88.24 	subdivision 3, or provisions governing data practices and information rights of persons.

88.25 	Sec. 17. Minnesota Statutes 2013 Supplement, section 245D.04, subdivision 3, is 
88.26 	amended to read:
88.27 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include 
88.28 	the right to:
88.29 	(1) have personal, financial, service, health, and medical information kept private, 
88.30 	and be advised of disclosure of this information by the license holder;
88.31 	(2) access records and recorded information about the person in accordance with 
88.32 	applicable state and federal law, regulation, or rule;
88.33 	(3) be free from maltreatment;
89.1 	(4) be free from restraint, time out, or seclusion, or any aversive, deprivation, or 
89.2 	other prohibited procedure identified in section 245D.06, subdivision 5, except for: (i)
89.3 	 emergency use of manual restraint to protect the person from imminent danger to self or 
89.4 	others according to the requirements in section 245D.06; 245D.061; or (ii) the use of 
89.5 	safety interventions as part of a positive support transition plan under section 245D.06, 
89.6 	subdivision 8;
89.7 	(5) receive services in a clean and safe environment when the license holder is the 
89.8 	owner, lessor, or tenant of the service site;
89.9 	(6) be treated with courtesy and respect and receive respectful treatment of the 
89.10 	person's property;
89.11 	(7) reasonable observance of cultural and ethnic practice and religion;
89.12 	(8) be free from bias and harassment regarding race, gender, age, disability, 
89.13 	spirituality, and sexual orientation;
89.14 	(9) be informed of and use the license holder's grievance policy and procedures, 
89.15 	including knowing how to contact persons responsible for addressing problems and to 
89.16 	appeal under section 256.045;
89.17 	(10) know the name, telephone number, and the Web site, e-mail, and street 
89.18 	addresses of protection and advocacy services, including the appropriate state-appointed 
89.19 	ombudsman, and a brief description of how to file a complaint with these offices;
89.20 	(11) assert these rights personally, or have them asserted by the person's family, 
89.21 	authorized representative, or legal representative, without retaliation;
89.22 	(12) give or withhold written informed consent to participate in any research or 
89.23 	experimental treatment;
89.24 	(13) associate with other persons of the person's choice;
89.25 	(14) personal privacy; and
89.26 	(15) engage in chosen activities.
89.27 	(b) For a person residing in a residential site licensed according to chapter 245A, 
89.28 	or where the license holder is the owner, lessor, or tenant of the residential service site, 
89.29 	protection-related rights also include the right to:
89.30 	(1) have daily, private access to and use of a non-coin-operated telephone for local 
89.31 	calls and long-distance calls made collect or paid for by the person;
89.32 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
89.33 	correspondence or communication;
89.34 	(3) have use of and free access to common areas in the residence; and
90.1 	(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious 
90.2 	advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including 
90.3 	privacy in the person's bedroom.
90.4 	(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a), 
90.5 	clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure 
90.6 	the health, safety, and well-being of the person. Any restriction of those rights must be 
90.7 	documented in the person's coordinated service and support plan or coordinated service 
90.8 	and support plan addendum. The restriction must be implemented in the least restrictive 
90.9 	alternative manner necessary to protect the person and provide support to reduce or 
90.10 	eliminate the need for the restriction in the most integrated setting and inclusive manner. 
90.11 	The documentation must include the following information:
90.12 	(1) the justification for the restriction based on an assessment of the person's 
90.13 	vulnerability related to exercising the right without restriction;
90.14 	(2) the objective measures set as conditions for ending the restriction;
90.15 	(3) a schedule for reviewing the need for the restriction based on the conditions 
90.16 	for ending the restriction to occur semiannually from the date of initial approval, at a 
90.17 	minimum, or more frequently if requested by the person, the person's legal representative, 
90.18 	if any, and case manager; and
90.19 	(4) signed and dated approval for the restriction from the person, or the person's 
90.20 	legal representative, if any. A restriction may be implemented only when the required 
90.21 	approval has been obtained. Approval may be withdrawn at any time. If approval is 
90.22 	withdrawn, the right must be immediately and fully restored.

90.23 	Sec. 18. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1, is 
90.24 	amended to read:
90.25 		Subdivision 1.Health needs. (a) The license holder is responsible for meeting 
90.26 	health service needs assigned in the coordinated service and support plan or the 
90.27 	coordinated service and support plan addendum, consistent with the person's health needs. 
90.28 	The license holder is responsible for promptly notifying the person's legal representative, 
90.29 	if any, and the case manager of changes in a person's physical and mental health needs 
90.30 	affecting health service needs assigned to the license holder in the coordinated service and 
90.31 	support plan or the coordinated service and support plan addendum, when discovered by 
90.32 	the license holder, unless the license holder has reason to know the change has already 
90.33 	been reported. The license holder must document when the notice is provided.
90.34 	(b) If responsibility for meeting the person's health service needs has been assigned 
90.35 	to the license holder in the coordinated service and support plan or the coordinated service 
91.1 	and support plan addendum, the license holder must maintain documentation on how the 
91.2 	person's health needs will be met, including a description of the procedures the license 
91.3 	holder will follow in order to:
91.4 	(1) provide medication setup, assistance, or medication administration according 
91.5 	to this chapter. Unlicensed staff responsible for medication setup or medication 
91.6 	administration under this section must complete training according to section 245D.09, 
91.7 	subdivision 4a, paragraph (d);
91.8 	(2) monitor health conditions according to written instructions from a licensed 
91.9 	health professional;
91.10 	(3) assist with or coordinate medical, dental, and other health service appointments; or
91.11 	(4) use medical equipment, devices, or adaptive aides or technology safely and 
91.12 	correctly according to written instructions from a licensed health professional.

91.13 	Sec. 19. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1a, 
91.14 	is amended to read:
91.15 		Subd. 1a.Medication setup. (a) For the purposes of this subdivision, "medication 
91.16 	setup" means the arranging of medications according to instructions from the pharmacy, 
91.17 	the prescriber, or a licensed nurse, for later administration when the license holder 
91.18 	is assigned responsibility for medication assistance or medication administration in 
91.19 	the coordinated service and support plan or the coordinated service and support plan 
91.20 	addendum. A prescription label or the prescriber's written or electronically recorded order 
91.21 	for the prescription is sufficient to constitute written instructions from the prescriber.
91.22 	(b) If responsibility for medication setup is assigned to the license holder in 
91.23 	the coordinated service and support plan or the coordinated service and support plan 
91.24 	addendum, or if the license holder provides it as part of medication assistance or 
91.25 	medication administration, the license holder must document in the person's medication 
91.26 	administration record: dates of setup, name of medication, quantity of dose, times to be 
91.27 	administered, and route of administration at time of setup; and, when the person will be 
91.28 	away from home, to whom the medications were given.

91.29 	Sec. 20. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 1b, 
91.30 	is amended to read:
91.31 		Subd. 1b.Medication assistance. (a) For purposes of this subdivision, "medication 
91.32 	assistance" means any of the following:
92.1 	(1) bringing to the person and opening a container of previously set up medications, 
92.2 	emptying the container into the person's hand, or opening and giving the medications in 
92.3 	the original container to the person under the direction of the person;
92.4 	(2) bringing to the person liquids or food to accompany the medication; or
92.5 	(3) providing reminders to take regularly scheduled medication or perform regularly 
92.6 	scheduled treatments and exercises.
92.7 	(b) If responsibility for medication assistance is assigned to the license holder 
92.8 	in the coordinated service and support plan or the coordinated service and support 
92.9 	plan addendum, the license holder must ensure that the requirements of subdivision 2, 
92.10 	paragraph (b), have been met when staff provides medication assistance to enableis 
92.11 	provided in a manner that enables a person to self-administer medication or treatment 
92.12 	when the person is capable of directing the person's own care, or when the person's legal 
92.13 	representative is present and able to direct care for the person. For the purposes of this 
92.14 	subdivision, "medication assistance" means any of the following:
92.15 	(1) bringing to the person and opening a container of previously set up medications, 
92.16 	emptying the container into the person's hand, or opening and giving the medications in 
92.17 	the original container to the person;
92.18 	(2) bringing to the person liquids or food to accompany the medication; or
92.19 	(3) providing reminders to take regularly scheduled medication or perform regularly 
92.20 	scheduled treatments and exercises.

92.21 	Sec. 21. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 2, is 
92.22 	amended to read:
92.23 		Subd. 2.Medication administration. (a) If responsibility for medication 
92.24 	administration is assigned to the license holder in the coordinated service and support 
92.25 	plan or the coordinated service and support plan addendum, the license holder must 
92.26 	implement the following medication administration procedures to ensure a person takes 
92.27 	medications and treatments as prescribed For purposes of this subdivision, "medication 
92.28 	administration" means:
92.29 	(1) checking the person's medication record;
92.30 	(2) preparing the medication as necessary;
92.31 	(3) administering the medication or treatment to the person;
92.32 	(4) documenting the administration of the medication or treatment or the reason for 
92.33 	not administering the medication or treatment; and
92.34 	(5) reporting to the prescriber or a nurse any concerns about the medication or 
92.35 	treatment, including side effects, effectiveness, or a pattern of the person refusing to 
93.1 	take the medication or treatment as prescribed. Adverse reactions must be immediately 
93.2 	reported to the prescriber or a nurse.
93.3 	(b)(1) If responsibility for medication administration is assigned to the license holder 
93.4 	in the coordinated service and support plan or the coordinated service and support plan 
93.5 	addendum, the license holder must implement medication administration procedures 
93.6 	to ensure a person takes medications and treatments as prescribed. The license holder 
93.7 	must ensure that the requirements in clauses (2) to (4) and (3) have been met before 
93.8 	administering medication or treatment.
93.9 	(2) The license holder must obtain written authorization from the person or the 
93.10 	person's legal representative to administer medication or treatment and must obtain 
93.11 	reauthorization annually as needed. This authorization shall remain in effect unless it is 
93.12 	withdrawn in writing and may be withdrawn at any time. If the person or the person's 
93.13 	legal representative refuses to authorize the license holder to administer medication, the 
93.14 	medication must not be administered. The refusal to authorize medication administration 
93.15 	must be reported to the prescriber as expediently as possible.
93.16 	(3) The staff person responsible for administering the medication or treatment must 
93.17 	complete medication administration training according to section 245D.09, subdivision
93.18 	 4a, paragraphs (a) and (c), and, as applicable to the person, paragraph (d).
93.19 	(4) (3) For a license holder providing intensive support services, the medication or 
93.20 	treatment must be administered according to the license holder's medication administration 
93.21 	policy and procedures as required under section 245D.11, subdivision 2, clause (3).
93.22 	(c) The license holder must ensure the following information is documented in the 
93.23 	person's medication administration record:
93.24 	(1) the information on the current prescription label or the prescriber's current 
93.25 	written or electronically recorded order or prescription that includes the person's name, 
93.26 	description of the medication or treatment to be provided, and the frequency and other 
93.27 	information needed to safely and correctly administer the medication or treatment to 
93.28 	ensure effectiveness;
93.29 	(2) information on any risks or other side effects that are reasonable to expect, and 
93.30 	any contraindications to its use. This information must be readily available to all staff 
93.31 	administering the medication;
93.32 	(3) the possible consequences if the medication or treatment is not taken or 
93.33 	administered as directed;
93.34 	(4) instruction on when and to whom to report the following:
93.35 	(i) if a dose of medication is not administered or treatment is not performed as 
93.36 	prescribed, whether by error by the staff or the person or by refusal by the person; and
94.1 	(ii) the occurrence of possible adverse reactions to the medication or treatment;
94.2 	(5) notation of any occurrence of a dose of medication not being administered or 
94.3 	treatment not performed as prescribed, whether by error by the staff or the person or by 
94.4 	refusal by the person, or of adverse reactions, and when and to whom the report was 
94.5 	made; and
94.6 	(6) notation of when a medication or treatment is started, administered, changed, or 
94.7 	discontinued.

94.8 	Sec. 22. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 4, is 
94.9 	amended to read:
94.10 		Subd. 4.Reviewing and reporting medication and treatment issues. (a) When 
94.11 	assigned responsibility for medication administration, the license holder must ensure 
94.12 	that the information maintained in the medication administration record is current and 
94.13 	is regularly reviewed to identify medication administration errors. At a minimum, the 
94.14 	review must be conducted every three months, or more frequently as directed in the 
94.15 	coordinated service and support plan or coordinated service and support plan addendum 
94.16 	or as requested by the person or the person's legal representative. Based on the review, 
94.17 	the license holder must develop and implement a plan to correct patterns of medication 
94.18 	administration errors when identified.
94.19 	(b) If assigned responsibility for medication assistance or medication administration, 
94.20 	the license holder must report the following to the person's legal representative and case 
94.21 	manager as they occur or as otherwise directed in the coordinated service and support plan 
94.22 	or the coordinated service and support plan addendum:
94.23 	(1) any reports made to the person's physician or prescriber required under 
94.24 	subdivision 2, paragraph (c), clause (4);
94.25 	(2) a person's refusal or failure to take or receive medication or treatment as 
94.26 	prescribed; or
94.27 	(3) concerns about a person's self-administration of medication or treatment.

94.28 	Sec. 23. Minnesota Statutes 2013 Supplement, section 245D.05, subdivision 5, is 
94.29 	amended to read:
94.30 		Subd. 5.Injectable medications. Injectable medications may be administered 
94.31 	according to a prescriber's order and written instructions when one of the following 
94.32 	conditions has been met:
94.33 	(1) a registered nurse or licensed practical nurse will administer the subcutaneous or 
94.34 	intramuscular injection;
95.1 	(2) a supervising registered nurse with a physician's order has delegated the 
95.2 	administration of subcutaneous injectable medication to an unlicensed staff member 
95.3 	and has provided the necessary training; or
95.4 	(3) there is an agreement signed by the license holder, the prescriber, and the 
95.5 	person or the person's legal representative specifying what subcutaneous injections may 
95.6 	be given, when, how, and that the prescriber must retain responsibility for the license 
95.7 	holder's giving the injections. A copy of the agreement must be placed in the person's 
95.8 	service recipient record.
95.9 	Only licensed health professionals are allowed to administer psychotropic 
95.10 	medications by injection.

95.11 	Sec. 24. Minnesota Statutes 2013 Supplement, section 245D.051, is amended to read:
95.12 	245D.051 PSYCHOTROPIC MEDICATION USE AND MONITORING.
95.13 		Subdivision 1.Conditions for psychotropic medication administration. (a) 
95.14 	When a person is prescribed a psychotropic medication and the license holder is assigned 
95.15 	responsibility for administration of the medication in the person's coordinated service 
95.16 	and support plan or the coordinated service and support plan addendum, the license 
95.17 	holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05, 
95.18 	subdivision 2, are met.
95.19 	(b) Use of the medication must be included in the person's coordinated service and 
95.20 	support plan or in the coordinated service and support plan addendum and based on a 
95.21 	prescriber's current written or electronically recorded prescription.
95.22 	(c) (b) The license holder must develop, implement, and maintain the following 
95.23 	documentation in the person's coordinated service and support plan addendum according 
95.24 	to the requirements in sections 245D.07 and 245D.071:
95.25 	(1) a description of the target symptoms that the psychotropic medication is to 
95.26 	alleviate; and
95.27 	(2) documentation methods the license holder will use to monitor and measure 
95.28 	changes in the target symptoms that are to be alleviated by the psychotropic medication if 
95.29 	required by the prescriber. The license holder must collect and report on medication and 
95.30 	symptom-related data as instructed by the prescriber. The license holder must provide 
95.31 	the monitoring data to the expanded support team for review every three months, or as 
95.32 	otherwise requested by the person or the person's legal representative.
95.33 	For the purposes of this section, "target symptom" refers to any perceptible 
95.34 	diagnostic criteria for a person's diagnosed mental disorder, as defined by the Diagnostic 
96.1 	and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or 
96.2 	successive editions, that has been identified for alleviation.
96.3 		Subd. 2.Refusal to authorize psychotropic medication. If the person or the 
96.4 	person's legal representative refuses to authorize the administration of a psychotropic 
96.5 	medication as ordered by the prescriber, the license holder must follow the requirement in 
96.6 	section 245D.05, subdivision 2, paragraph (b), clause (2). not administer the medication. 
96.7 	The refusal to authorize medication administration must be reported to the prescriber as 
96.8 	expediently as possible. After reporting the refusal to the prescriber, the license holder 
96.9 	must follow any directives or orders given by the prescriber. A court order must be 
96.10 	obtained to override the refusal.A refusal may not be overridden without a court order. 
96.11 	Refusal to authorize administration of a specific psychotropic medication is not grounds 
96.12 	for service termination and does not constitute an emergency. A decision to terminate 
96.13 	services must be reached in compliance with section 245D.10, subdivision 3.

96.14 	Sec. 25. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 2, is 
96.15 	amended to read:
96.16 		Subd. 2.Environment and safety. The license holder must:
96.17 	(1) ensure the following when the license holder is the owner, lessor, or tenant 
96.18 	of the service site:
96.19 	(i) the service site is a safe and hazard-free environment;
96.20 	(ii) that toxic substances or dangerous items are inaccessible to persons served by 
96.21 	the program only to protect the safety of a person receiving services when a known safety 
96.22 	threat exists and not as a substitute for staff supervision or interactions with a person who 
96.23 	is receiving services. If toxic substances or dangerous items are made inaccessible, the 
96.24 	license holder must document an assessment of the physical plant, its environment, and its 
96.25 	population identifying the risk factors which require toxic substances or dangerous items 
96.26 	to be inaccessible and a statement of specific measures to be taken to minimize the safety 
96.27 	risk to persons receiving services and to restore accessibility to all persons receiving 
96.28 	services at the service site;
96.29 	(iii) doors are locked from the inside to prevent a person from exiting only when 
96.30 	necessary to protect the safety of a person receiving services and not as a substitute for 
96.31 	staff supervision or interactions with the person. If doors are locked from the inside, the 
96.32 	license holder must document an assessment of the physical plant, the environment and 
96.33 	the population served, identifying the risk factors which require the use of locked doors, 
96.34 	and a statement of specific measures to be taken to minimize the safety risk to persons 
96.35 	receiving services at the service site; and
97.1 	(iv) a staff person is available at the service site who is trained in basic first aid and, 
97.2 	when required in a person's coordinated service and support plan or coordinated service 
97.3 	and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are 
97.4 	present and staff are required to be at the site to provide direct support service. The CPR 
97.5 	training must include in-person instruction, hands-on practice, and an observed skills 
97.6 	assessment under the direct supervision of a CPR instructor;
97.7 	(2) maintain equipment, vehicles, supplies, and materials owned or leased by the 
97.8 	license holder in good condition when used to provide services;
97.9 	(3) follow procedures to ensure safe transportation, handling, and transfers of the 
97.10 	person and any equipment used by the person, when the license holder is responsible for 
97.11 	transportation of a person or a person's equipment;
97.12 	(4) be prepared for emergencies and follow emergency response procedures to 
97.13 	ensure the person's safety in an emergency; and
97.14 	(5) follow universal precautions and sanitary practices, including hand washing, for 
97.15 	infection prevention and control, and to prevent communicable diseases.

97.16 	Sec. 26. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 4, is 
97.17 	amended to read:
97.18 		Subd. 4.Funds and property. (a) Whenever the license holder assists a person 
97.19 	with the safekeeping of funds or other property according to section 245A.04, subdivision 
97.20 	13, the license holder must obtain written authorization to do so from the person or the 
97.21 	person's legal representative and the case manager. Authorization must be obtained within 
97.22 	five working days of service initiation and renewed annually thereafter. At the time initial 
97.23 	authorization is obtained, the license holder must survey, document, and implement the 
97.24 	preferences of the person or the person's legal representative and the case manager for 
97.25 	frequency of receiving a statement that itemizes receipts and disbursements of funds or 
97.26 	other property. The license holder must document changes to these preferences when 
97.27 	they are requested.
97.28 	(b) A license holder or staff person may not accept powers-of-attorney from a person 
97.29 	receiving services from the license holder for any purpose. This does not apply to license 
97.30 	holders that are Minnesota counties or other units of government or to staff persons 
97.31 	employed by license holders who were acting as attorney-in-fact for specific individuals 
97.32 	prior to implementation of this chapter. The license holder must maintain documentation 
97.33 	of the power-of-attorney in the service recipient record.
97.34 	(c) A license holder or staff person is restricted from accepting an appointment 
97.35 	as a guardian as follows:
98.1 	(1) under section 524.5-309 of the Uniform Probate Code, any individual or agency 
98.2 	that provides residence, custodial care, medical care, employment training, or other care 
98.3 	or services for which the individual or agency receives a fee may not be appointed as 
98.4 	guardian unless related to the respondent by blood, marriage, or adoption; and
98.5 	(2) under section 245A.03, subdivision 2, paragraph (a), clause (1), a related 
98.6 	individual as defined under section 245A.02, subdivision 13, is excluded from licensure. 
98.7 	Services provided by a license holder to a person under the license holder's guardianship 
98.8 	are not licensed services.
98.9 	(c) (d) Upon the transfer or death of a person, any funds or other property of the 
98.10 	person must be surrendered to the person or the person's legal representative, or given to 
98.11 	the executor or administrator of the estate in exchange for an itemized receipt.

98.12 	Sec. 27. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 6, is 
98.13 	amended to read:
98.14 		Subd. 6.Restricted procedures. (a) The following procedures are allowed when 
98.15 	the procedures are implemented in compliance with the standards governing their use as 
98.16 	identified in clauses (1) to (3). Allowed but restricted procedures include:
98.17 	(1) permitted actions and procedures subject to the requirements in subdivision 7;
98.18 	(2) procedures identified in a positive support transition plan subject to the 
98.19 	requirements in subdivision 8; or
98.20 	(3) emergency use of manual restraint subject to the requirements in section 
98.21 	245D.061.
98.22 	For purposes of this chapter, this section supersedes the requirements identified in 
98.23 	Minnesota Rules, part 9525.2740.
98.24 	(b) A restricted procedure identified in paragraph (a) must not:
98.25 	(1) be implemented with a child in a manner that constitutes sexual abuse, neglect, 
98.26 	physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
98.27 	(2) be implemented with an adult in a manner that constitutes abuse or neglect as 
98.28 	defined in section 626.5572, subdivision 2 or 17;
98.29 	(3) be implemented in a manner that violates a person's rights identified in section 
98.30 	245D.04;
98.31 	(4) restrict a person's normal access to a nutritious diet, drinking water, adequate 
98.32 	ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping 
98.33 	conditions, necessary clothing, or any protection required by state licensing standards or 
98.34 	federal regulations governing the program;
99.1 	(5) deny the person visitation or ordinary contact with legal counsel, a legal 
99.2 	representative, or next of kin;
99.3 	(6) be used for the convenience of staff, as punishment, as a substitute for adequate 
99.4 	staffing, or as a consequence if the person refuses to participate in the treatment or services 
99.5 	provided by the program;
99.6 	(7) use prone restraint. For purposes of this section, "prone restraint" means use 
99.7 	of manual restraint that places a person in a face-down position. Prone restraint does 
99.8 	not include brief physical holding of a person who, during an emergency use of manual 
99.9 	restraint, rolls into a prone position, if the person is restored to a standing, sitting, or 
99.10 	side-lying position as quickly as possible;
99.11 	(8) apply back or chest pressure while a person is in a prone position as identified in 
99.12 	clause (7), supine position, or side-lying position; or
99.13 	(9) be implemented in a manner that is contraindicated for any of the person's known 
99.14 	medical or psychological limitations.

99.15 	Sec. 28. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 7, is 
99.16 	amended to read:
99.17 		Subd. 7.Permitted actions and procedures. (a) Use of the instructional techniques 
99.18 	and intervention procedures as identified in paragraphs (b) and (c) is permitted when used 
99.19 	on an intermittent or continuous basis. When used on a continuous basis, it must be 
99.20 	addressed in a person's coordinated service and support plan addendum as identified in 
99.21 	sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this 
99.22 	subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
99.23 	(b) Physical contact or instructional techniques must use the least restrictive 
99.24 	alternative possible to meet the needs of the person and may be used:
99.25 	(1) to calm or comfort a person by holding that person with no resistance from 
99.26 	that person;
99.27 	(2) to protect a person known to be at risk or of  injury due to frequent falls as a result 
99.28 	of a medical condition;
99.29 	(3) to facilitate the person's completion of a task or response when the person does 
99.30 	not resist or the person's resistance is minimal in intensity and duration; or
99.31 	(4) to briefly block or redirect a person's limbs or body without holding the person or 
99.32 	limiting the person's movement to interrupt the person's behavior that may result in injury 
99.33 	to self or others. with less than 60 seconds of physical contact by staff; or
100.1 	(5) to redirect a person's behavior when the behavior does not pose a serious threat 
100.2 	to the person or others and the behavior is effectively redirected with less than 60 seconds 
100.3 	of physical contact by staff.
100.4 	(c) Restraint may be used as an intervention procedure to:
100.5 	(1) allow a licensed health care professional to safely conduct a medical examination 
100.6 	or to provide medical treatment ordered by a licensed health care professional to a person 
100.7 	necessary to promote healing or recovery from an acute, meaning short-term, medical 
100.8 	condition;
100.9 	(2) assist in the safe evacuation or redirection of a person in the event of an 
100.10 	emergency and the person is at imminent risk of harm.; or
100.11 	Any use of manual restraint as allowed in this paragraph must comply with the restrictions 
100.12 	identified in section 245D.061, subdivision 3; or
100.13 	(3) position a person with physical disabilities in a manner specified in the person's 
100.14 	coordinated service and support plan addendum.
100.15 	Any use of manual restraint as allowed in this paragraph must comply with the restrictions 
100.16 	identified in subdivision 6, paragraph (b).
100.17 	(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment 
100.18 	ordered by a licensed health professional to treat a diagnosed medical condition do not in 
100.19 	and of themselves constitute the use of mechanical restraint.
100.20 	(e) Use of an auxiliary device to ensure a person does not unfasten a seat belt when 
100.21 	being transported in a vehicle in accordance with seat belt use requirements in section 
100.22 	169.686 does not constitute the use of mechanical restraint.

100.23 	Sec. 29. Minnesota Statutes 2013 Supplement, section 245D.06, subdivision 8, is 
100.24 	amended to read:
100.25 		Subd. 8.Positive support transition plan. (a) License holders must develop 
100.26 	a positive support transition plan on the forms and in the manner prescribed by the 
100.27 	commissioner for a person who requires intervention in order to maintain safety when 
100.28 	it is known that the person's behavior poses an immediate risk of physical harm to self 
100.29 	or others. The positive support transition plan forms and instructions will supersede the 
100.30 	requirements in Minnesota Rules, parts 9525.2750; 9525.2760; and 9525.2780. The 
100.31 	positive support transition plan must phase out any existing plans for the emergency or 
100.32 	programmatic use of aversive or deprivation procedures prohibited under this chapter 
100.33 	within the following timelines:
101.1 	(1) for persons receiving services from the license holder before January 1, 2014, 
101.2 	the plan must be developed and implemented by February 1, 2014, and phased out no 
101.3 	later than December 31, 2014; and
101.4 	(2) for persons admitted to the program on or after January 1, 2014, the plan must be 
101.5 	developed and implemented within 30 calendar days of service initiation and phased out 
101.6 	no later than 11 months from the date of plan implementation.
101.7 	(b) The commissioner has limited authority to grant approval for the emergency use 
101.8 	of procedures identified in subdivision 6 that had been part of an approved positive support 
101.9 	transition plan when a person is at imminent risk of serious injury as defined in section 
101.10 	245.91, subdivision 6, due to self-injurious behavior and the following conditions are met:
101.11 	(1) the person's expanded support team approves the emergency use of the 
101.12 	procedures; and
101.13 	(2) the interim review panel established in section 245.8251, subdivision 4, 
101.14 	recommends commissioner approval of the emergency use of the procedures.
101.15 	(c) Written requests for the emergency use of the procedures must be developed 
101.16 	and submitted to the commissioner by the designated coordinator with input from the 
101.17 	person's expanded support team in accordance with the requirements set by the interim 
101.18 	review panel, in addition to the following:
101.19 	(1) a copy of the person's current positive support transition plan and copies of 
101.20 	each positive support transition plan review containing data on the progress of the plan 
101.21 	from the previous year;
101.22 	(2) documentation of a good faith effort to eliminate the use of the procedures that 
101.23 	had been part of an approved positive support transition plan;
101.24 	(3) justification for the continued use of the procedures that identifies the imminent 
101.25 	risk of serious injury due to the person's self-injurious behavior if the procedures were 
101.26 	eliminated;
101.27 	(4) documentation of the clinicians consulted in creating and maintaining the 
101.28 	positive support transition plan; and
101.29 	(5) documentation of the expanded support team's approval and the recommendation 
101.30 	from the interim panel required under paragraph (b).
101.31 	(d) A copy of the written request, supporting documentation, and the commissioner's 
101.32 	final determination on the request must be maintained in the person's service recipient 
101.33 	record.

101.34 	Sec. 30. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 3, 
101.35 	is amended to read:
102.1 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service 
102.2 	initiation the license holder must complete a preliminary coordinated service and support 
102.3 	plan addendum based on the coordinated service and support plan.
102.4 	(b) Within 45 days of service initiation the license holder must meet with the person, 
102.5 	the person's legal representative, the case manager, and other members of the support team 
102.6 	or expanded support team to assess and determine the following based on the person's 
102.7 	coordinated service and support plan and the requirements in subdivision 4 and section 
102.8 	245D.07, subdivision 1a:
102.9 	(1) the scope of the services to be provided to support the person's daily needs 
102.10 	and activities;
102.11 	(2) the person's desired outcomes and the supports necessary to accomplish the 
102.12 	person's desired outcomes;
102.13 	(3) the person's preferences for how services and supports are provided;
102.14 	(4) whether the current service setting is the most integrated setting available and 
102.15 	appropriate for the person; and
102.16 	(5) how services must be coordinated across other providers licensed under this 
102.17 	chapter serving the same person to ensure continuity of care for the person.
102.18 	(c) Within the scope of services, the license holder must, at a minimum, assess 
102.19 	the following areas:
102.20 	(1) the person's ability to self-manage health and medical needs to maintain or 
102.21 	improve physical, mental, and emotional well-being, including, when applicable, allergies, 
102.22 	seizures, choking, special dietary needs, chronic medical conditions, self-administration 
102.23 	of medication or treatment orders, preventative screening, and medical and dental 
102.24 	appointments;
102.25 	(2) the person's ability to self-manage personal safety to avoid injury or accident in 
102.26 	the service setting, including, when applicable, risk of falling, mobility, regulating water 
102.27 	temperature, community survival skills, water safety skills, and sensory disabilities; and
102.28 	(3) the person's ability to self-manage symptoms or behavior that may otherwise 
102.29 	result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to 
102.30 	(7), suspension or termination of services by the license holder, or other symptoms 
102.31 	or behaviors that may jeopardize the health and safety of the person or others. The 
102.32 	assessments must produce information about the person that is descriptive of the person's 
102.33 	overall strengths, functional skills and abilities, and behaviors or symptoms.
102.34 	(b) Within the scope of services, the license holder must, at a minimum, complete 
102.35 	assessments in the following areas before the 45-day planning meeting:
103.1 	(1) the person's ability to self-manage health and medical needs to maintain or 
103.2 	improve physical, mental, and emotional well-being, including, when applicable, allergies, 
103.3 	seizures, choking, special dietary needs, chronic medical conditions, self-administration 
103.4 	of medication or treatment orders, preventative screening, and medical and dental 
103.5 	appointments;
103.6 	(2) the person's ability to self-manage personal safety to avoid injury or accident in 
103.7 	the service setting, including, when applicable, risk of falling, mobility, regulating water 
103.8 	temperature, community survival skills, water safety skills, and sensory disabilities; and
103.9 	(3) the person's ability to self-manage symptoms or behavior that may otherwise 
103.10 	result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), 
103.11 	suspension or termination of services by the license holder, or other symptoms or 
103.12 	behaviors that may jeopardize the health and safety of the person or others.
103.13 	Assessments must produce information about the person that describes the person's overall 
103.14 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must 
103.15 	be based on the person's status within the last 12 months at the time of service initiation. 
103.16 	Assessments based on older information must be documented and justified. Assessments 
103.17 	must be conducted annually at a minimum or within 30 days of a written request from the 
103.18 	person or the person's legal representative or case manager. The results must be reviewed 
103.19 	by the support team or expanded support team as part of a service plan review.
103.20 	(c) Within 45 days of service initiation, the license holder must meet with the 
103.21 	person, the person's legal representative, the case manager, and other members of the 
103.22 	support team or expanded support team to determine the following based on information 
103.23 	obtained from the assessments identified in paragraph (b), the person's identified needs 
103.24 	in the coordinated service and support plan, and the requirements in subdivision 4 and 
103.25 	section 245D.07, subdivision 1a:
103.26 	(1) the scope of the services to be provided to support the person's daily needs 
103.27 	and activities;
103.28 	(2) the person's desired outcomes and the supports necessary to accomplish the 
103.29 	person's desired outcomes;
103.30 	(3) the person's preferences for how services and supports are provided;
103.31 	(4) whether the current service setting is the most integrated setting available and 
103.32 	appropriate for the person; and
103.33 	(5) how services must be coordinated across other providers licensed under this 
103.34 	chapter serving the person and members of the support team or expanded support team to 
103.35 	ensure continuity of care and coordination of services for the person.

104.1 	Sec. 31. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 4, 
104.2 	is amended to read:
104.3 		Subd. 4.Service outcomes and supports. (a) Within ten working days of the 
104.4 	45-day planning meeting, the license holder must develop and document a service plan that 
104.5 	documents the service outcomes and supports based on the assessments completed under 
104.6 	subdivision 3 and the requirements in section 245D.07, subdivision 1a. The outcomes and 
104.7 	supports must be included in the coordinated service and support plan addendum.
104.8 	(b) The license holder must document the supports and methods to be implemented 
104.9 	to support the accomplishment of person and accomplish outcomes related to acquiring, 
104.10 	retaining, or improving skills and physical, mental, and emotional health and well-being. 
104.11 	The documentation must include:
104.12 	(1) the methods or actions that will be used to support the person and to accomplish 
104.13 	the service outcomes, including information about:
104.14 	(i) any changes or modifications to the physical and social environments necessary 
104.15 	when the service supports are provided;
104.16 	(ii) any equipment and materials required; and
104.17 	(iii) techniques that are consistent with the person's communication mode and 
104.18 	learning style;
104.19 	(2) the measurable and observable criteria for identifying when the desired outcome 
104.20 	has been achieved and how data will be collected;
104.21 	(3) the projected starting date for implementing the supports and methods and 
104.22 	the date by which progress towards accomplishing the outcomes will be reviewed and 
104.23 	evaluated; and
104.24 	(4) the names of the staff or position responsible for implementing the supports 
104.25 	and methods.
104.26 	(c) Within 20 working days of the 45-day meeting, the license holder must obtain 
104.27 	dated signatures from the person or the person's legal representative and case manager 
104.28 	to document completion and approval of the assessment and coordinated service and 
104.29 	support plan addendum.

104.30 	Sec. 32. Minnesota Statutes 2013 Supplement, section 245D.071, subdivision 5, 
104.31 	is amended to read:
104.32 		Subd. 5.Progress reviews Service plan review and evaluation. (a) The license 
104.33 	holder must give the person or the person's legal representative and case manager an 
104.34 	opportunity to participate in the ongoing review and development of the service plan 
104.35 	and the methods used to support the person and accomplish outcomes identified in 
105.1 	subdivisions 3 and 4. The license holder, in coordination with the person's support team 
105.2 	or expanded support team, must meet with the person, the person's legal representative, 
105.3 	and the case manager, and participate in progress service plan review meetings following 
105.4 	stated timelines established in the person's coordinated service and support plan or 
105.5 	coordinated service and support plan addendum or within 30 days of a written request 
105.6 	by the person, the person's legal representative, or the case manager, at a minimum of 
105.7 	once per year. The purpose of the service plan review is to determine whether changes 
105.8 	are needed to the service plan based on the assessment information, the license holder's 
105.9 	evaluation of progress towards accomplishing outcomes, or other information provided by 
105.10 	the support team or expanded support team.
105.11 	(b) The license holder must summarize the person's status and progress toward 
105.12 	achieving the identified outcomes and make recommendations and identify the rationale 
105.13 	for changing, continuing, or discontinuing implementation of supports and methods 
105.14 	identified in subdivision 4 in a written report sent to the person or the person's legal 
105.15 	representative and case manager five working days prior to the review meeting, unless 
105.16 	the person, the person's legal representative, or the case manager requests to receive the 
105.17 	report at the time of the meeting.
105.18 	(c) Within ten working days of the progress review meeting, the license holder 
105.19 	must obtain dated signatures from the person or the person's legal representative and 
105.20 	the case manager to document approval of any changes to the coordinated service and 
105.21 	support plan addendum.

105.22 	Sec. 33. Minnesota Statutes 2013 Supplement, section 245D.081, subdivision 2, 
105.23 	is amended to read:
105.24 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
105.25 	and evaluation of services provided by the license holder must be coordinated by a 
105.26 	designated staff person. The designated coordinator must provide supervision, support, 
105.27 	and evaluation of activities that include:
105.28 	(1) oversight of the license holder's responsibilities assigned in the person's 
105.29 	coordinated service and support plan and the coordinated service and support plan 
105.30 	addendum;
105.31 	(2) taking the action necessary to facilitate the accomplishment of the outcomes 
105.32 	according to the requirements in section 245D.07;
105.33 	(3) instruction and assistance to direct support staff implementing the coordinated 
105.34 	service and support plan and the service outcomes, including direct observation of service 
105.35 	delivery sufficient to assess staff competency; and
106.1 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
106.2 	the person's outcomes based on the measurable and observable criteria for identifying when 
106.3 	the desired outcome has been achieved according to the requirements in section 245D.07.
106.4 	(b) The license holder must ensure that the designated coordinator is competent to 
106.5 	perform the required duties identified in paragraph (a) through education and, training 
106.6 	in human services and disability-related fields, and work experience in providing direct 
106.7 	care services and supports to persons with disabilities relevant to the needs of the general 
106.8 	population of persons served by the license holder and the individual persons for whom 
106.9 	the designated coordinator is responsible. The designated coordinator must have the 
106.10 	skills and ability necessary to develop effective plans and to design and use data systems 
106.11 	to measure effectiveness of services and supports. The license holder must verify and 
106.12 	document competence according to the requirements in section 245D.09, subdivision 3. 
106.13 	The designated coordinator must minimally have:
106.14 	(1) a baccalaureate degree in a field related to human services, and one year of 
106.15 	full-time work experience providing direct care services to persons with disabilities or 
106.16 	persons age 65 and older;
106.17 	(2) an associate degree in a field related to human services, and two years of 
106.18 	full-time work experience providing direct care services to persons with disabilities or 
106.19 	persons age 65 and older;
106.20 	(3) a diploma in a field related to human services from an accredited postsecondary 
106.21 	institution and three years of full-time work experience providing direct care services to 
106.22 	persons with disabilities or persons age 65 and older; or
106.23 	(4) a minimum of 50 hours of education and training related to human services 
106.24 	and disabilities; and
106.25 	(5) four years of full-time work experience providing direct care services to persons 
106.26 	with disabilities or persons age 65 and older under the supervision of a staff person who 
106.27 	meets the qualifications identified in clauses (1) to (3).

106.28 	Sec. 34. Minnesota Statutes 2013 Supplement, section 245D.09, subdivision 3, is 
106.29 	amended to read:
106.30 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff providing 
106.31 	direct support, or staff who have responsibilities related to supervising or managing the 
106.32 	provision of direct support service, are competent as demonstrated through skills and 
106.33 	knowledge training, experience, and education to meet the person's needs and additional 
106.34 	requirements as written in the coordinated service and support plan or coordinated 
106.35 	service and support plan addendum, or when otherwise required by the case manager or 
107.1 	the federal waiver plan. The license holder must verify and maintain evidence of staff 
107.2 	competency, including documentation of:
107.3 	(1) education and experience qualifications relevant to the job responsibilities 
107.4 	assigned to the staff and to the needs of the general population of persons served by the 
107.5 	program, including a valid degree and transcript, or a current license, registration, or 
107.6 	certification, when a degree or licensure, registration, or certification is required by this 
107.7 	chapter or in the coordinated service and support plan or coordinated service and support 
107.8 	plan addendum;
107.9 	(2) demonstrated competency in the orientation and training areas required under 
107.10 	this chapter, and when applicable, completion of continuing education required to 
107.11 	maintain professional licensure, registration, or certification requirements. Competency in 
107.12 	these areas is determined by the license holder through knowledge testing and or observed 
107.13 	skill assessment conducted by the trainer or instructor; and
107.14 	(3) except for a license holder who is the sole direct support staff, periodic 
107.15 	performance evaluations completed by the license holder of the direct support staff 
107.16 	person's ability to perform the job functions based on direct observation.
107.17 	(b) Staff under 18 years of age may not perform overnight duties or administer 
107.18 	medication.

107.19 	Sec. 35. Minnesota Statutes 2013 Supplement, section 245D.09, subdivision 4a, 
107.20 	is amended to read:
107.21 		Subd. 4a.Orientation to individual service recipient needs. (a) Before having 
107.22 	unsupervised direct contact with a person served by the program, or for whom the staff 
107.23 	person has not previously provided direct support, or any time the plans or procedures 
107.24 	identified in paragraphs (b) to (f) (g) are revised, the staff person must review and receive 
107.25 	instruction on the requirements in paragraphs (b) to (f) (g) as they relate to the staff 
107.26 	person's job functions for that person.
107.27 	(b) Training and competency evaluations must include the following:
107.28 	(1) appropriate and safe techniques in personal hygiene and grooming, including 
107.29 	hair care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of 
107.30 	daily living (ADLs) as defined under section 256B.0659, subdivision 1;
107.31 	(2) an understanding of what constitutes a healthy diet according to data from the 
107.32 	Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
107.33 	(3) skills necessary to provide appropriate support in instrumental activities of daily 
107.34 	living (IADLs) as defined under section 256B.0659, subdivision 1; and
107.35 	(4) demonstrated competence in providing first aid.
108.1 	(c) The staff person must review and receive instruction on the person's coordinated 
108.2 	service and support plan or coordinated service and support plan addendum as it relates 
108.3 	to the responsibilities assigned to the license holder, and when applicable, the person's 
108.4 	individual abuse prevention plan, to achieve and demonstrate an understanding of the 
108.5 	person as a unique individual, and how to implement those plans.
108.6 	(d) The staff person must review and receive instruction on medication setup, 
108.7 	assistance, or administration procedures established for the person when medication 
108.8 	administration is assigned to the license holder according to section 245D.05, subdivision 
108.9 	1, paragraph (b). Unlicensed staff may administer medications perform medication setup 
108.10 	or medication administration only after successful completion of a medication setup or 
108.11 	medication administration training, from a training curriculum developed by a registered 
108.12 	nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse 
108.13 	practitioner, physician's assistant, or physician or appropriate licensed health professional. 
108.14 	The training curriculum must incorporate an observed skill assessment conducted by the 
108.15 	trainer to ensure unlicensed staff demonstrate the ability to safely and correctly follow 
108.16 	medication procedures.
108.17 	Medication administration must be taught by a registered nurse, clinical nurse 
108.18 	specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of 
108.19 	service initiation or any time thereafter, the person has or develops a health care condition 
108.20 	that affects the service options available to the person because the condition requires:
108.21 	(1) specialized or intensive medical or nursing supervision; and
108.22 	(2) nonmedical service providers to adapt their services to accommodate the health 
108.23 	and safety needs of the person.
108.24 	(e) The staff person must review and receive instruction on the safe and correct 
108.25 	operation of medical equipment used by the person to sustain life, including but not 
108.26 	limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided 
108.27 	by a licensed health care professional or a manufacturer's representative and incorporate 
108.28 	an observed skill assessment to ensure staff demonstrate the ability to safely and correctly 
108.29 	operate the equipment according to the treatment orders and the manufacturer's instructions.
108.30 	(f) The staff person must review and receive instruction on what constitutes use of 
108.31 	restraints, time out, and seclusion, including chemical restraint, and staff responsibilities 
108.32 	related to the prohibitions of their use according to the requirements in section 245D.06, 
108.33 	subdivision 5, why such procedures are not effective for reducing or eliminating symptoms 
108.34 	or undesired behavior and why they are not safe, and the safe and correct use of manual 
108.35 	restraint on an emergency basis according to the requirements in section 245D.061.
109.1 	(g) The staff person must review and receive instruction on mental health crisis 
109.2 	response, de-escalation techniques, and suicide intervention when providing direct support 
109.3 	to a person with a serious mental illness.
109.4 	(g)(h) In the event of an emergency service initiation, the license holder must ensure 
109.5 	the training required in this subdivision occurs within 72 hours of the direct support staff 
109.6 	person first having unsupervised contact with the person receiving services. The license 
109.7 	holder must document the reason for the unplanned or emergency service initiation and 
109.8 	maintain the documentation in the person's service recipient record.
109.9 	(h)(i) License holders who provide direct support services themselves must 
109.10 	complete the orientation required in subdivision 4, clauses (3) to (7).

109.11 	Sec. 36. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 2, 
109.12 	is amended to read:
109.13 		Subd. 2.Behavior professional qualifications. A behavior professional providing 
109.14 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c), 
109.15 	clause (1), item (i), as defined in the brain injury and community alternatives for disabled 
109.16 	individuals waiver plans or successor plans, must have competencies in the following 
109.17 	areas related to as required under the brain injury and community alternatives for disabled 
109.18 	individuals waiver plans or successor plans:
109.19 	(1) ethical considerations;
109.20 	(2) functional assessment;
109.21 	(3) functional analysis;
109.22 	(4) measurement of behavior and interpretation of data;
109.23 	(5) selecting intervention outcomes and strategies;
109.24 	(6) behavior reduction and elimination strategies that promote least restrictive 
109.25 	approved alternatives;
109.26 	(7) data collection;
109.27 	(8) staff and caregiver training;
109.28 	(9) support plan monitoring;
109.29 	(10) co-occurring mental disorders or neurocognitive disorder;
109.30 	(11) demonstrated expertise with populations being served; and
109.31 	(12) must be a:
109.32 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the 
109.33 	Board of Psychology competencies in the above identified areas;
109.34 	(ii) clinical social worker licensed as an independent clinical social worker under 
109.35 	chapter 148D, or a person with a master's degree in social work from an accredited college 
110.1 	or university, with at least 4,000 hours of post-master's supervised experience in the 
110.2 	delivery of clinical services in the areas identified in clauses (1) to (11);
110.3 	(iii) physician licensed under chapter 147 and certified by the American Board 
110.4 	of Psychiatry and Neurology or eligible for board certification in psychiatry with 
110.5 	competencies in the areas identified in clauses (1) to (11);
110.6 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 
110.7 	148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery 
110.8 	of clinical services who has demonstrated competencies in the areas identified in clauses 
110.9 	(1) to (11);
110.10 	(v) person with a master's degree from an accredited college or university in one 
110.11 	of the behavioral sciences or related fields, with at least 4,000 hours of post-master's 
110.12 	supervised experience in the delivery of clinical services with demonstrated competencies 
110.13 	in the areas identified in clauses (1) to (11); or
110.14 	(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
110.15 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
110.16 	mental health nursing by a national nurse certification organization, or who has a master's 
110.17 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
110.18 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
110.19 	experience in the delivery of clinical services.

110.20 	Sec. 37. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 3, 
110.21 	is amended to read:
110.22 		Subd. 3.Behavior analyst qualifications. (a) A behavior analyst providing 
110.23 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph 
110.24 	(c), clause (1), item (i), as defined in the brain injury and community alternatives for 
110.25 	disabled individuals waiver plans or successor plans, must have competencies in the 
110.26 	following areas as required under the brain injury and community alternatives for disabled 
110.27 	individuals waiver plans or successor plans:
110.28 	(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services 
110.29 	discipline; or
110.30 	(2) meet the qualifications of a mental health practitioner as defined in section 
110.31 	245.462, subdivision 17.
110.32 	(b) In addition, a behavior analyst must:
110.33 	(1) have four years of supervised experience working with individuals who exhibit 
110.34 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder;
111.1 	(2) have received ten hours of instruction in functional assessment and functional 
111.2 	analysis;
111.3 	(3) have received 20 hours of instruction in the understanding of the function of 
111.4 	behavior;
111.5 	(4) have received ten hours of instruction on design of positive practices behavior 
111.6 	support strategies;
111.7 	(5) have received 20 hours of instruction on the use of behavior reduction approved 
111.8 	strategies used only in combination with behavior positive practices strategies;
111.9 	(6) be determined by a behavior professional to have the training and prerequisite 
111.10 	skills required to provide positive practice strategies as well as behavior reduction 
111.11 	approved and permitted intervention to the person who receives behavioral support; and
111.12 	(7) be under the direct supervision of a behavior professional.

111.13 	Sec. 38. Minnesota Statutes 2013 Supplement, section 245D.091, subdivision 4, 
111.14 	is amended to read:
111.15 		Subd. 4.Behavior specialist qualifications. (a) A behavior specialist providing 
111.16 	behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c), 
111.17 	clause (1), item (i), as defined in the brain injury and community alternatives for disabled 
111.18 	individuals waiver plans or successor plans, must meet the following qualifications have 
111.19 	competencies in the following areas as required under the brain injury and community 
111.20 	alternatives for disabled individuals waiver plans or successor plans:
111.21 	(1) have an associate's degree in a social services discipline; or
111.22 	(2) have two years of supervised experience working with individuals who exhibit 
111.23 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
111.24 	(b) In addition, a behavior specialist must:
111.25 	(1) have received a minimum of four hours of training in functional assessment;
111.26 	(2) have received 20 hours of instruction in the understanding of the function of 
111.27 	behavior;
111.28 	(3) have received ten hours of instruction on design of positive practices behavioral 
111.29 	support strategies;
111.30 	(4) be determined by a behavior professional to have the training and prerequisite 
111.31 	skills required to provide positive practices strategies as well as behavior reduction 
111.32 	approved intervention to the person who receives behavioral support; and
111.33 	(5) be under the direct supervision of a behavior professional.

112.1 	Sec. 39. Minnesota Statutes 2013 Supplement, section 245D.10, subdivision 3, is 
112.2 	amended to read:
112.3 		Subd. 3.Service suspension and service termination. (a) The license holder must 
112.4 	establish policies and procedures for temporary service suspension and service termination 
112.5 	that promote continuity of care and service coordination with the person and the case 
112.6 	manager and with other licensed caregivers, if any, who also provide support to the person.
112.7 	(b) The policy must include the following requirements:
112.8 	(1) the license holder must notify the person or the person's legal representative and 
112.9 	case manager in writing of the intended termination or temporary service suspension, and 
112.10 	the person's right to seek a temporary order staying the termination of service according to 
112.11 	the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
112.12 	(2) notice of the proposed termination of services, including those situations that 
112.13 	began with a temporary service suspension, must be given at least 60 days before the 
112.14 	proposed termination is to become effective when a license holder is providing intensive 
112.15 	supports and services identified in section 245D.03, subdivision 1, paragraph (c), and 30 
112.16 	days prior to termination for all other services licensed under this chapter. This notice 
112.17 	may be given in conjunction with a notice of temporary service suspension;
112.18 	(3) notice of temporary service suspension must be given on the first day of the 
112.19 	service suspension;
112.20 	(3) (4) the license holder must provide information requested by the person or case 
112.21 	manager when services are temporarily suspended or upon notice of termination;
112.22 	(4) (5) prior to giving notice of service termination or temporary service suspension, 
112.23 	the license holder must document actions taken to minimize or eliminate the need for 
112.24 	service suspension or termination;
112.25 	(5) (6) during the temporary service suspension or service termination notice period, 
112.26 	the license holder will must work with the appropriate county agency support team or 
112.27 	expanded support team to develop reasonable alternatives to protect the person and others;
112.28 	(6) (7) the license holder must maintain information about the service suspension or 
112.29 	termination, including the written termination notice, in the service recipient record; and
112.30 	(7) (8) the license holder must restrict temporary service suspension to situations in 
112.31 	which the person's conduct poses an imminent risk of physical harm to self or others and 
112.32 	less restrictive or positive support strategies would not achieve and maintain safety.

112.33 	Sec. 40. Minnesota Statutes 2013 Supplement, section 245D.11, subdivision 2, is 
112.34 	amended to read:
113.1 		Subd. 2.Health and safety. The license holder must establish policies and 
113.2 	procedures that promote health and safety by ensuring:
113.3 	(1) use of universal precautions and sanitary practices in compliance with section 
113.4 	245D.06, subdivision 2, clause (5);
113.5 	(2) if the license holder operates a residential program, health service coordination 
113.6 	and care according to the requirements in section 245D.05, subdivision 1;
113.7 	(3) safe medication assistance and administration according to the requirements 
113.8 	in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in 
113.9 	consultation with a registered nurse, nurse practitioner, physician's assistant, or medical 
113.10 	doctor and require completion of medication administration training according to the 
113.11 	requirements in section 245D.09, subdivision 4a, paragraph (d). Medication assistance 
113.12 	and administration includes, but is not limited to:
113.13 	(i) providing medication-related services for a person;
113.14 	(ii) medication setup;
113.15 	(iii) medication administration;
113.16 	(iv) medication storage and security;
113.17 	(v) medication documentation and charting;
113.18 	(vi) verification and monitoring of effectiveness of systems to ensure safe medication 
113.19 	handling and administration;
113.20 	(vii) coordination of medication refills;
113.21 	(viii) handling changes to prescriptions and implementation of those changes;
113.22 	(ix) communicating with the pharmacy; and
113.23 	(x) coordination and communication with prescriber;
113.24 	(4) safe transportation, when the license holder is responsible for transportation of 
113.25 	persons, with provisions for handling emergency situations according to the requirements 
113.26 	in section 245D.06, subdivision 2, clauses (2) to (4);
113.27 	(5) a plan for ensuring the safety of persons served by the program in emergencies as 
113.28 	defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies 
113.29 	to the license holder. A license holder with a community residential setting or a day service 
113.30 	facility license must ensure the policy and procedures comply with the requirements in 
113.31 	section 245D.22, subdivision 4;
113.32 	(6) a plan for responding to all incidents as defined in section 245D.02, subdivision 
113.33 	11; and reporting all incidents required to be reported according to section 245D.06, 
113.34 	subdivision 1. The plan must:
113.35 	(i) provide the contact information of a source of emergency medical care and 
113.36 	transportation; and
114.1 	(ii) require staff to first call 911 when the staff believes a medical emergency may 
114.2 	be life threatening, or to call the mental health crisis intervention team or similar mental 
114.3 	health response team or service when such a team is available and appropriate when the 
114.4 	person is experiencing a mental health crisis; and
114.5 	(7) a procedure for the review of incidents and emergencies to identify trends or 
114.6 	patterns, and corrective action if needed. The license holder must establish and maintain 
114.7 	a record-keeping system for the incident and emergency reports. Each incident and 
114.8 	emergency report file must contain a written summary of the incident. The license holder 
114.9 	must conduct a review of incident reports for identification of incident patterns, and 
114.10 	implementation of corrective action as necessary to reduce occurrences. Each incident 
114.11 	report must include:
114.12 	(i) the name of the person or persons involved in the incident. It is not necessary 
114.13 	to identify all persons affected by or involved in an emergency unless the emergency 
114.14 	resulted in an incident;
114.15 	(ii) the date, time, and location of the incident or emergency;
114.16 	(iii) a description of the incident or emergency;
114.17 	(iv) a description of the response to the incident or emergency and whether a person's 
114.18 	coordinated service and support plan addendum or program policies and procedures were 
114.19 	implemented as applicable;
114.20 	(v) the name of the staff person or persons who responded to the incident or 
114.21 	emergency; and
114.22 	(vi) the determination of whether corrective action is necessary based on the results 
114.23 	of the review.

114.24 	Sec. 41. Minnesota Statutes 2012, section 252.451, subdivision 2, is amended to read:
114.25 		Subd. 2.Vendor participation and reimbursement. Notwithstanding requirements 
114.26 	in chapter chapters 245A and 245D, and sections 252.28, 252.40 to 252.46, and 256B.501, 
114.27 	vendors of day training and habilitation services may enter into written agreements with 
114.28 	qualified businesses to provide additional training and supervision needed by individuals 
114.29 	to maintain their employment.

114.30 	Sec. 42. Minnesota Statutes 2013 Supplement, section 256B.439, subdivision 1, 
114.31 	is amended to read:
114.32 		Subdivision 1.Development and implementation of quality profiles. (a) The 
114.33 	commissioner of human services, in cooperation with the commissioner of health, shall 
114.34 	develop and implement quality profiles for nursing facilities and, beginning not later than 
115.1 	July 1, 2014, for home and community-based services providers, except when the quality 
115.2 	profile system would duplicate requirements under section 256B.5011, 256B.5012, or 
115.3 	256B.5013. For purposes of this section, home and community-based services providers 
115.4 	are defined as providers of home and community-based services under sections 256B.0625, 
115.5 	subdivisions 6a, 7, and 19a; 256B.0913,;256B.0915,;256B.092, and;256B.49,; and 
115.6 	256B.85, and intermediate care facilities for persons with developmental disabilities 
115.7 	providers under section 256B.5013. To the extent possible, quality profiles must be 
115.8 	developed for providers of services to older adults and people with disabilities, regardless 
115.9 	of payor source, for the purposes of providing information to consumers. The quality 
115.10 	profiles must be developed using existing data sets maintained by the commissioners of 
115.11 	health and human services to the extent possible. The profiles must incorporate or be 
115.12 	coordinated with information on quality maintained by area agencies on aging, long-term 
115.13 	care trade associations, the ombudsman offices, counties, tribes, health plans, and other 
115.14 	entities and the long-term care database maintained under section 256.975, subdivision 7. 
115.15 	The profiles must be designed to provide information on quality to:
115.16 	(1) consumers and their families to facilitate informed choices of service providers;
115.17 	(2) providers to enable them to measure the results of their quality improvement 
115.18 	efforts and compare quality achievements with other service providers; and
115.19 	(3) public and private purchasers of long-term care services to enable them to 
115.20 	purchase high-quality care.
115.21 	(b) The profiles must be developed in consultation with the long-term care task 
115.22 	force, area agencies on aging, and representatives of consumers, providers, and labor 
115.23 	unions. Within the limits of available appropriations, the commissioners may employ 
115.24 	consultants to assist with this project.

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

115.26 	Sec. 43. Minnesota Statutes 2013 Supplement, section 256B.439, subdivision 7, 
115.27 	is amended to read:
115.28 		Subd. 7.Calculation of home and community-based services quality add-on. 
 115.29 	Effective On July 1, 2015, the commissioner shall determine the quality add-on rate 
115.30 	change and adjust payment rates for participating all home and community-based services 
115.31 	providers for services rendered on or after that date. The adjustment to a provider payment 
115.32 	rate determined under this subdivision shall become part of the ongoing rate paid to that 
115.33 	provider. The payment rate for the quality add-on shall be a variable amount based on 
115.34 	each provider's quality score as determined in subdivisions 1 and 2a. All home and 
115.35 	community-based services providers shall receive a minimum rate increase under this 
116.1 	subdivision. In addition to a minimum rate increase, a home and community-based 
116.2 	services provider shall receive a quality add-on payment. The commissioner shall limit 
116.3 	the types of home and community-based services providers that may receive the quality 
116.4 	add-on and based on availability of quality measures and outcome data. The commissioner 
116.5 	shall limit the amount of the minimum rate increase and quality add-on payments to 
116.6 	operate the quality add-on within funds appropriated for this purpose and based on the 
116.7 	availability of the quality measures the equivalent of a one percent rate increase for all 
116.8 	home and community-based services providers.

116.9 	Sec. 44. Minnesota Statutes 2013 Supplement, section 256B.4912, subdivision 1, 
116.10 	is amended to read:
116.11 		Subdivision 1.Provider qualifications. (a) For the home and community-based 
116.12 	waivers providing services to seniors and individuals with disabilities under sections 
116.13 	256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
116.14 	(1) agreements with enrolled waiver service providers to ensure providers meet 
116.15 	Minnesota health care program requirements;
116.16 	(2) regular reviews of provider qualifications, and including requests of proof of 
116.17 	documentation; and
116.18 	(3) processes to gather the necessary information to determine provider qualifications.
116.19 	(b) Beginning July 1, 2012, staff that provide direct contact, as defined in section 
116.20 	245C.02, subdivision 11, for services specified in the federally approved waiver plans 
116.21 	must meet the requirements of chapter 245C prior to providing waiver services and as 
116.22 	part of ongoing enrollment. Upon federal approval, this requirement must also apply to 
116.23 	consumer-directed community supports.
116.24 	(c) Beginning January 1, 2014, service owners and managerial officials overseeing 
116.25 	the management or policies of services that provide direct contact as specified in the 
116.26 	federally approved waiver plans must meet the requirements of chapter 245C prior to 
116.27 	reenrollment or revalidation or, for new providers, prior to initial enrollment if they have 
116.28 	not already done so as a part of service licensure requirements.

116.29 	Sec. 45. Minnesota Statutes 2012, section 256B.5012, is amended by adding a 
116.30 	subdivision to read:
116.31 		Subd. 16.ICF/DD rate increases effective July 1, 2014. (a) For each facility 
116.32 	reimbursed under this section, for the rate period beginning July 1, 2014, the commissioner 
116.33 	shall increase operating payments equal to four percent of the operating payment rates in 
116.34 	effect on July 1, 2014. For each facility, the commissioner shall apply the rate increase 
117.1 	based on occupied beds, using the percentage specified in this subdivision multiplied by 
117.2 	the total payment rate, including the variable rate but excluding the property-related 
117.3 	payment rate in effect on the preceding date.
117.4 	(b) To receive the rate increase under paragraph (a), each facility reimbursed under 
117.5 	this section must submit to the commissioner documentation that identifies a quality 
117.6 	improvement project the facility will implement by June 30, 2015. Documentation must 
117.7 	be provided in a format specified by the commissioner. Projects must:
117.8 	(1) improve the quality of life of intermediate care facility residents in a meaningful 
117.9 	way;
117.10 	(2) improve the quality of services in a measurable way; or
117.11 	(3) deliver good quality service more efficiently.
117.12 	(c) For a facility that fails to submit the documentation described in paragraph (b) 
117.13 	by a date or in a format specified by the commissioner, the commissioner shall reduce 
117.14 	the facility's rate by one percent effective January 1, 2015.
117.15 	(d) Facilities that receive a rate increase under this subdivision shall use 75 percent 
117.16 	of the rate increase to increase compensation-related costs for employees directly 
117.17 	employed by the facility on or after the effective date of the rate adjustments, except:
117.18 	(1) persons employed in the central office of a corporation or entity that has an 
117.19 	ownership interest in the facility or exercises control over the facility; and
117.20 	(2) persons paid by the facility under a management contract.
117.21 	This requirement is subject to audit by the commissioner.
117.22 	(e) Compensation-related costs include:
117.23 	(1) wages and salaries;
117.24 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
117.25 	unemployment taxes, workers' compensation, and mileage reimbursement;
117.26 	(3) the employer's share of health and dental insurance, life insurance, disability 
117.27 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
117.28 	employee retirement accounts; and
117.29 	(4) other benefits provided and workforce needs, including the recruiting and 
117.30 	training of employees as specified in the distribution plan required under paragraph (f).
117.31 	(f) A facility that receives a rate adjustment under paragraph (a) that is subject to 
117.32 	paragraphs (d) and (e) shall prepare and produce for the commissioner, upon request, a 
117.33 	plan that specifies the amount of money the provider expects to receive that is subject to 
117.34 	the requirements of paragraphs (d) and (e), as well as how that money will be distributed 
117.35 	to increase compensation for employees. The commissioner may recover funds from a 
117.36 	facility that fails to comply with this requirement.
118.1 	(g) Within six months after the effective date of the rate adjustment, the facility shall 
118.2 	post the distribution plan required under paragraph (f) for a period of at least six weeks in 
118.3 	an area of the facility's operation to which all eligible employees have access, and shall 
118.4 	provide instructions for employees who believe they have not received the wage and other 
118.5 	compensation-related increases specified in the distribution plan. These instructions must 
118.6 	include a mailing address, e-mail address, and telephone number that an employee may 
118.7 	use to contact the commissioner or the commissioner's representative. Facilities shall 
118.8 	make assurances to the commissioner of compliance with this subdivision using forms 
118.9 	prescribed by the commissioner.
118.10 	(h) For public employees, the increase for wages and benefits for certain staff is 
118.11 	available and pay rates must be increased only to the extent that the increases comply with 
118.12 	laws governing public employees' collective bargaining. Money received by a provider for 
118.13 	pay increases for public employees under this subdivision may be used only for increases 
118.14 	implemented within one month of the effective date of the rate increase and must not be 
118.15 	used for increases implemented prior to that date.

118.16 	Sec. 46. Laws 2013, chapter 108, article 14, section 2, subdivision 6, is amended to read:

118.17	Subd. 6.Grant Programs
 					
118.18 	The amounts that may be spent from this 
118.19 	appropriation for each purpose are as follows:

118.20	(a) Support Services Grants

118.21	Appropriations by Fund
	
118.22	General
	8,915,000
	13,333,000
	
118.23	Federal TANF
	94,611,000
	94,611,000
	
118.24 	Paid Work Experience. $2,168,000 
118.25 	each year in fiscal years 2015 and 2016 
118.26 	is from the general fund for paid work 
118.27 	experience for long-term MFIP recipients. 
118.28 	Paid work includes full and partial wage 
118.29 	subsidies and other related services such as 
118.30 	job development, marketing, preworksite 
118.31 	training, job coaching, and postplacement 
118.32 	services. These are onetime appropriations. 
118.33 	Unexpended funds for fiscal year 2015 do not 
119.1 	cancel, but are available to the commissioner 
119.2 	for this purpose in fiscal year 2016.
119.3 	Work Study Funding for MFIP 
119.4 	Participants. $250,000 each year in fiscal 
119.5 	years 2015 and 2016 is from the general fund 
119.6 	to pilot work study jobs for MFIP recipients 
119.7 	in approved postsecondary education 
119.8 	programs. This is a onetime appropriation. 
119.9 	Unexpended funds for fiscal year 2015 do 
119.10 	not cancel, but are available for this purpose 
119.11 	in fiscal year 2016.
119.12 	Local Strategies to Reduce Disparities.
119.13 	$2,000,000 each year in fiscal years 2015 
119.14 	and 2016 is from the general fund for 
119.15 	local projects that focus on services for 
119.16 	subgroups within the MFIP caseload 
119.17 	who are experiencing poor employment 
119.18 	outcomes. These are onetime appropriations. 
119.19 	Unexpended funds for fiscal year 2015 do not 
119.20 	cancel, but are available to the commissioner 
119.21 	for this purpose in fiscal year 2016.
119.22 	Home Visiting Collaborations for MFIP 
119.23 	Teen Parents. $200,000 per year in fiscal 
119.24 	years 2014 and 2015 is from the general fund 
119.25 	and $200,000 in fiscal year 2016 is from the 
119.26 	federal TANF fund for technical assistance 
119.27 	and training to support local collaborations 
119.28 	that provide home visiting services for 
119.29 	MFIP teen parents. The general fund 
119.30 	appropriation is onetime. The federal TANF 
119.31 	fund appropriation is added to the base.
119.32 	Performance Bonus Funds for Counties.
119.33 	The TANF fund base is increased by 
119.34 	$1,500,000 each year in fiscal years 2016 
119.35 	and 2017. The commissioner must allocate 
120.1 	this amount each year to counties that exceed 
120.2 	their expected range of performance on the 
120.3 	annualized three-year self-support index 
120.4 	as defined in Minnesota Statutes, section 
120.5 	256J.751, subdivision 2, clause (6). This is a 
120.6 	permanent base adjustment. Notwithstanding 
120.7 	any contrary provisions in this article, this 
120.8 	provision expires June 30, 2016.
120.9 	Base Adjustment. The general fund base is 
120.10 	decreased by $200,000 in fiscal year 2016 
120.11 	and $4,618,000 in fiscal year 2017. The 
120.12 	TANF fund base is increased by $1,700,000 
120.13 	in fiscal years 2016 and 2017.

120.14
120.15	(b) Basic Sliding Fee Child Care Assistance 
Grants
		36,836,000
		42,318,000
	
120.16 	Base Adjustment. The general fund base is 
120.17 	increased by $3,778,000 in fiscal year 2016 
120.18 	and by $3,849,000 in fiscal year 2017.

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

120.20	(d) Child Support Enforcement Grants
		50,000
		50,000
	
120.21 	Federal Child Support Demonstration 
120.22 	Grants. Federal administrative 
120.23 	reimbursement resulting from the federal 
120.24 	child support grant expenditures authorized 
120.25 	under United States Code, title 42, section 
120.26 	1315, is appropriated to the commissioner 
120.27 	for this activity.

120.28	(e) Children's Services Grants

120.29	Appropriations by Fund
	
120.30	General
	49,760,000
	52,961,000
	
120.31	Federal TANF
	140,000
	140,000
	
120.32 	Adoption Assistance and Relative Custody 
120.33 	Assistance. $37,453,000 in fiscal year 2014 
120.34 	and $37,453,000 in fiscal year 2015 is for 
121.1 	the adoption assistance and relative custody 
121.2 	assistance programs. The commissioner 
121.3 	shall determine with the commissioner of 
121.4 	Minnesota Management and Budget the 
121.5 	appropriation for Northstar Care for Children 
121.6 	effective January 1, 2015. The commissioner 
121.7 	may transfer appropriations for adoption 
121.8 	assistance, relative custody assistance, and 
121.9 	Northstar Care for Children between fiscal 
121.10 	years and among programs to adjust for 
121.11 	transfers across the programs.
121.12 	Title IV-E Adoption Assistance. Additional 
121.13 	federal reimbursements to the state as a result 
121.14 	of the Fostering Connections to Success 
121.15 	and Increasing Adoptions Act's expanded 
121.16 	eligibility for Title IV-E adoption assistance 
121.17 	are appropriated for postadoption services, 
121.18 	including a parent-to-parent support network.
121.19 	Privatized Adoption Grants. Federal 
121.20 	reimbursement for privatized adoption grant 
121.21 	and foster care recruitment grant expenditures 
121.22 	is appropriated to the commissioner for 
121.23 	adoption grants and foster care and adoption 
121.24 	administrative purposes.
121.25 	Adoption Assistance Incentive Grants.
121.26 	Federal funds available during fiscal years 
121.27 	2014 and 2015 for adoption incentive grants 
121.28 	are appropriated for postadoption services, 
121.29 	including a parent-to-parent support network.
121.30 	Base Adjustment. The general fund base is 
121.31 	increased by $5,913,000 in fiscal year 2016 
121.32 	and by $10,297,000 in fiscal year 2017.

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

121.34	(g) Child and Economic Support Grants
		21,047,000
		20,848,000
	
122.1 	Minnesota Food Assistance Program. 
122.2 	Unexpended funds for the Minnesota food 
122.3 	assistance program for fiscal year 2014 do 
122.4 	not cancel but are available for this purpose 
122.5 	in fiscal year 2015.
122.6 	Transitional Housing. $250,000 each year 
122.7 	is for the transitional housing programs under 
122.8 	Minnesota Statutes, section 256E.33.
122.9 	Emergency Services. $250,000 each year 
122.10 	is for emergency services grants under 
122.11 	Minnesota Statutes, section 256E.36.
122.12 	Family Assets for Independence. $250,000 
122.13 	each year is for the Family Assets for 
122.14 	Independence Minnesota program. This 
122.15 	appropriation is available in either year of the 
122.16 	biennium and may be transferred between 
122.17 	fiscal years.
122.18 	Food Shelf Programs. $375,000 in fiscal 
122.19 	year 2014 and $375,000 in fiscal year 
122.20 	2015 are for food shelf programs under 
122.21 	Minnesota Statutes, section 256E.34. If the 
122.22 	appropriation for either year is insufficient, 
122.23 	the appropriation for the other year is 
122.24 	available for it. Notwithstanding Minnesota 
122.25 	Statutes, section 256E.34, subdivision 4, no 
122.26 	portion of this appropriation may be used 
122.27 	by Hunger Solutions for its administrative 
122.28 	expenses, including but not limited to rent 
122.29 	and salaries.
122.30 	Homeless Youth Act. $2,000,000 in fiscal 
122.31 	year 2014 and $2,000,000 in fiscal year 2015 
122.32 	is for purposes of Minnesota Statutes, section 
122.33 	256K.45.
122.34 	Safe Harbor Shelter and Housing. 
122.35 	$500,000 in fiscal year 2014 and $500,000 in 
123.1 	fiscal year 2015 is for a safe harbor shelter 
123.2 	and housing fund for housing and supportive 
123.3 	services for youth who are sexually exploited. 

123.4	(h) Health Care Grants

123.5	Appropriations by Fund
	
123.6	General
	190,000
	190,000
	
123.7	Health Care Access
	190,000
	190,000
	
123.8 	Emergency Medical Assistance Referral 
123.9 	and Assistance Grants. (a) The 
123.10 	commissioner of human services shall 
123.11 	award grants to nonprofit programs that 
123.12 	provide immigration legal services based 
123.13 	on indigency to provide legal services for 
123.14 	immigration assistance to individuals with 
123.15 	emergency medical conditions or complex 
123.16 	and chronic health conditions who are not 
123.17 	currently eligible for medical assistance 
123.18 	or other public health care programs, but 
123.19 	who may meet eligibility requirements with 
123.20 	immigration assistance.
123.21 	(b) The grantees, in collaboration with 
123.22 	hospitals and safety net providers, shall 
123.23 	provide referral assistance to connect 
123.24 	individuals identified in paragraph (a) with 
123.25 	alternative resources and services to assist in 
123.26 	meeting their health care needs. $100,000 
123.27 	is appropriated in fiscal year 2014 and 
123.28 	$100,000 in fiscal year 2015. This is a 
123.29 	onetime appropriation.
123.30 	Base Adjustment. The general fund is 
123.31 	decreased by $100,000 in fiscal year 2016 
123.32 	and $100,000 in fiscal year 2017.

123.33
123.34	(i) Aging and Adult Services Grants
		14,827,000
14,812,000
		15,010,000
14,936,000
	
124.1 	Base Adjustment. The general fund base 
124.2 	is increased by $1,150,000 $1,077,000 in 
124.3 	fiscal year 2016 and $1,151,000 $1,077,000
124.4 	 in fiscal year 2017.
124.5 	Community Service Development 
124.6 	Grants and Community Services Grants.
124.7 	Community service development grants and 
124.8 	community services grants are reduced by 
124.9 	$1,150,000 each year. This is a onetime 
124.10 	reduction.

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

124.12	(k) Disabilities Grants
		18,605,000
		18,823,000
	
124.13 	Advocating Change Together. $310,000 in 
124.14 	fiscal year 2014 is for a grant to Advocating 
124.15 	Change Together (ACT) to maintain and 
124.16 	promote services for persons with intellectual 
124.17 	and developmental disabilities throughout 
124.18 	the state. This appropriation is onetime. Of 
124.19 	this appropriation:
124.20 	(1) $120,000 is for direct costs associated 
124.21 	with the delivery and evaluation of 
124.22 	peer-to-peer training programs administered 
124.23 	throughout the state, focusing on education, 
124.24 	employment, housing, transportation, and 
124.25 	voting;
124.26 	(2) $100,000 is for delivery of statewide 
124.27 	conferences focusing on leadership and 
124.28 	skill development within the disability 
124.29 	community; and
124.30 	(3) $90,000 is for administrative and general 
124.31 	operating costs associated with managing 
124.32 	or maintaining facilities, program delivery, 
124.33 	staff, and technology.
125.1 	Base Adjustment. The general fund base 
125.2 	is increased by $535,000 in fiscal year 2016 
125.3 	and by $709,000 in fiscal year 2017.

125.4	(l) Adult Mental Health Grants

125.5	Appropriations by Fund
	
125.6	General
	71,199,000
	69,530,000
	
125.7	Health Care Access
	750,000
	750,000
	
125.8	Lottery Prize
	1,733,000
	1,733,000
	
125.9 	Problem Gambling. $225,000 in fiscal year 
125.10 	2014 and $225,000 in fiscal year 2015 is 
125.11 	appropriated from the lottery prize fund for a 
125.12 	grant to the state affiliate recognized by the 
125.13 	National Council on Problem Gambling. The 
125.14 	affiliate must provide services to increase 
125.15 	public awareness of problem gambling, 
125.16 	education and training for individuals and 
125.17 	organizations providing effective treatment 
125.18 	services to problem gamblers and their 
125.19 	families, and research relating to problem 
125.20 	gambling. 
125.21 	Funding Usage. Up to 75 percent of a fiscal 
125.22 	year's appropriations for adult mental health 
125.23 	grants may be used to fund allocations in that 
125.24 	portion of the fiscal year ending December 
125.25 	31.
125.26 	Base Adjustment. The general fund base is 
125.27 	decreased by $4,427,000 in fiscal years 2016 
125.28 	and 2017.
125.29 	Mental Health Pilot Project. $230,000 
125.30 	each year is for a grant to the Zumbro 
125.31 	Valley Mental Health Center. The grant 
125.32 	shall be used to implement a pilot project 
125.33 	to test an integrated behavioral health care 
125.34 	coordination model. The grant recipient must 
125.35 	report measurable outcomes and savings 
126.1 	to the commissioner of human services 
126.2 	by January 15, 2016. This is a onetime 
126.3 	appropriation.
126.4 	High-risk adults. $200,000 in fiscal 
126.5 	year 2014 is for a grant to the nonprofit 
126.6 	organization selected to administer the 
126.7 	demonstration project for high-risk adults 
126.8 	under Laws 2007, chapter 54, article 1, 
126.9 	section 19, in order to complete the project. 
126.10 	This is a onetime appropriation.

126.11	(m) Child Mental Health Grants
		18,246,000
		20,636,000
	
126.12 	Text Message Suicide Prevention 
126.13 	Program. $625,000 in fiscal year 2014 and 
126.14 	$625,000 in fiscal year 2015 is for a grant 
126.15 	to a nonprofit organization to establish and 
126.16 	implement a statewide text message suicide 
126.17 	prevention program. The program shall 
126.18 	implement a suicide prevention counseling 
126.19 	text line designed to use text messaging to 
126.20 	connect with crisis counselors and to obtain 
126.21 	emergency information and referrals to 
126.22 	local resources in the local community. The 
126.23 	program shall include training within schools 
126.24 	and communities to encourage the use of the 
126.25 	program.
126.26 	Mental Health First Aid Training. $22,000 
126.27 	in fiscal year 2014 and $23,000 in fiscal 
126.28 	year 2015 is to train teachers, social service 
126.29 	personnel, law enforcement, and others who 
126.30 	come into contact with children with mental 
126.31 	illnesses, in children and adolescents mental 
126.32 	health first aid training.
126.33 	Funding Usage. Up to 75 percent of a fiscal 
126.34 	year's appropriation for child mental health 
126.35 	grants may be used to fund allocations in that 
127.1 	portion of the fiscal year ending December 
127.2 	31.

127.3	(n) CD Treatment Support Grants
		1,816,000
		1,816,000
	
127.4 	SBIRT Training. (1) $300,000 each year is 
127.5 	for grants to train primary care clinicians to 
127.6 	provide substance abuse brief intervention 
127.7 	and referral to treatment (SBIRT). This is a 
127.8 	onetime appropriation. The commissioner of 
127.9 	human services shall apply to SAMHSA for 
127.10 	an SBIRT professional training grant.
127.11 	(2) If the commissioner of human services 
127.12 	receives a grant under clause (1) funds 
127.13 	appropriated under this clause, equal to 
127.14 	the grant amount, up to the available 
127.15 	appropriation, shall be transferred to the 
127.16 	Minnesota Organization on Fetal Alcohol 
127.17 	Syndrome (MOFAS). MOFAS must use 
127.18 	the funds for grants. Grant recipients must 
127.19 	be selected from communities that are 
127.20 	not currently served by federal Substance 
127.21 	Abuse Prevention and Treatment Block 
127.22 	Grant funds. Grant money must be used to 
127.23 	reduce the rates of fetal alcohol syndrome 
127.24 	and fetal alcohol effects, and the number of 
127.25 	drug-exposed infants. Grant money may be 
127.26 	used for prevention and intervention services 
127.27 	and programs, including, but not limited to, 
127.28 	community grants, professional eduction, 
127.29 	public awareness, and diagnosis.
127.30 	Fetal Alcohol Syndrome Grant. $180,000 
127.31 	each year from the general fund is for a 
127.32 	grant to the Minnesota Organization on Fetal 
127.33 	Alcohol Syndrome (MOFAS) to support 
127.34 	nonprofit Fetal Alcohol Spectrum Disorders 
127.35 	(FASD) outreach prevention programs 
128.1 	in Olmsted County. This is a onetime 
128.2 	appropriation.
128.3 	Base Adjustment. The general fund base is 
128.4 	decreased by $480,000 in fiscal year 2016 
128.5 	and $480,000 in fiscal year 2017.

128.6 	Sec. 47. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY 
128.7 	1, 2014.
 128.8 	(a) The commissioner of human services shall increase reimbursement rates, grants, 
128.9 	allocations, individual limits, and rate limits, as applicable, by four percent for the rate 
128.10 	period beginning July 1, 2014, for services rendered on or after that date. County or tribal 
128.11 	contracts for services specified in this section must be amended to pass through these rate 
128.12 	increases within 60 days of the effective date.
128.13 	(b) The rate changes described in this section must be provided to:
128.14 	(1) home and community-based waiver services for persons with developmental 
128.15 	disabilities, including consumer-directed community supports, under Minnesota Statutes, 
128.16 	section 256B.092;
128.17 	(2) waiver services under community alternatives for disabled individuals, including 
128.18 	consumer-directed community supports, under Minnesota Statutes, section 256B.49;
128.19 	(3) community alternative care waiver services, including consumer-directed 
128.20 	community supports, under Minnesota Statutes, section 256B.49;
128.21 	(4) brain injury waiver services, including consumer-directed community supports, 
128.22 	under Minnesota Statutes, section 256B.49;
128.23 	(5) home and community-based waiver services for the elderly under Minnesota 
128.24 	Statutes, section 256B.0915;
128.25 	(6) nursing services and home health services under Minnesota Statutes, section 
128.26 	256B.0625, subdivision 6a;
128.27 	(7) personal care services and qualified professional supervision of personal care 
128.28 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
128.29 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
128.30 	subdivision 7;
128.31 	(9) community first services and supports under Minnesota Statutes, section 256B.85;
128.32 	(10) essential community supports under Minnesota Statutes, section 256B.0922;
128.33 	(11) day training and habilitation services for adults with developmental disabilities 
128.34 	or related conditions under Minnesota Statutes, sections 252.41 to 252.46, including the 
129.1 	additional cost to counties for rate adjustments to day training and habilitation services 
129.2 	provided as a social service;
129.3 	(12) alternative care services under Minnesota Statutes, section 256B.0913;
129.4 	(13) living skills training programs for persons with intractable epilepsy who need 
129.5 	assistance in the transition to independent living under Laws 1988, chapter 689;
129.6 	(14) consumer support grants under Minnesota Statutes, section 256.476;
129.7 	(15) semi-independent living services under Minnesota Statutes, section 252.275;
129.8 	(16) family support grants under Minnesota Statutes, section 252.32;
129.9 	(17) housing access grants under Minnesota Statutes, section 256B.0658;
129.10 	(18) self-advocacy grants under Laws 2009, chapter 101;
129.11 	(19) technology grants under Laws 2009, chapter 79;
129.12 	(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977 and 
129.13 	256B.0917;
129.14 	(21) deaf and hard-of-hearing grants, including community support services for deaf 
129.15 	and hard-of-hearing adults with mental illness who use or wish to use sign language as their 
129.16 	primary means of communication under Minnesota Statutes, section 256.01, subdivision 2;
129.17 	(22) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233, 
129.18 	256C.25, and 256C.261;
129.19 	(23) Disability Linkage Line grants under Minnesota Statutes, section 256.01, 
129.20 	subdivision 24;
129.21 	(24) transition initiative grants under Minnesota Statutes, section 256.478;
129.22 	(25) employment support grants under Minnesota Statutes, section 256B.021, 
129.23 	subdivision 6; and
129.24 	(26) grants provided to people who are eligible for the Housing Opportunities for 
129.25 	Persons with AIDS program under Minnesota Statutes, section 256B.492.
129.26 	(c) A managed care plan receiving state payments for the services in paragraph (b) 
129.27 	must include the increases in paragraph (a) in payments to providers. To implement the 
129.28 	rate increase in this section, capitation rates paid by the commissioner to managed care 
129.29 	organizations under Minnesota Statutes, section 256B.69, shall reflect a four percent 
129.30 	increase for the specified services for the period beginning July 1, 2014.
129.31 	(d) Counties shall increase the budget for each recipient of consumer-directed 
129.32 	community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).
129.33 	(e) To implement this section, the commissioner shall increase service rates in the 
129.34 	disability waiver payment system authorized in Minnesota Statutes, sections 256B.4913 
129.35 	and 256B.4914.
130.1 	(f) To receive the rate increase described in this section, providers under paragraphs 
130.2 	(a) and (b) must submit to the commissioner documentation that identifies a quality 
130.3 	improvement project that the provider will implement by June 30, 2015. Documentation 
130.4 	must be provided in a format specified by the commissioner. Projects must:
130.5 	(1) improve the quality of life of home and community-based services recipients in 
130.6 	a meaningful way;
130.7 	(2) improve the quality of services in a measurable way; or
130.8 	(3) deliver good quality service more efficiently.
130.9 	Providers listed in paragraph (b), clauses (7), (9), (10), and (13) to (26), are not subject 
130.10 	to this requirement.
130.11 	(g) For a provider that fails to submit documentation described in paragraph (f) by 
130.12 	a date or in a format specified by the commissioner, the commissioner shall reduce the 
130.13 	provider's rate by one percent effective January 1, 2015.
130.14 	(h) Providers that receive a rate increase under this subdivision shall use 75 percent 
130.15 	of the rate increase to increase compensation-related costs for employees directly 
130.16 	employed by the facility on or after the effective date of the rate adjustments, except:
130.17 	(1) persons employed in the central office of a corporation or entity that has an 
130.18 	ownership interest in the facility or exercises control over the facility; and
130.19 	(2) persons paid by the facility under a management contract.
130.20 	This requirement is subject to audit by the commissioner.
130.21 	(i) Compensation-related costs include:
130.22 	(1) wages and salaries;
130.23 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
130.24 	unemployment taxes, workers' compensation, and mileage reimbursement;
130.25 	(3) the employer's share of health and dental insurance, life insurance, disability 
130.26 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
130.27 	employee retirement accounts; and
130.28 	(4) other benefits provided and workforce needs, including the recruiting and 
130.29 	training of employees as specified in the distribution plan required under paragraph (k).
130.30 	(j) For public employees, the increase for wages and benefits for certain staff is 
130.31 	available and pay rates must be increased only to the extent that the increases comply with 
130.32 	laws governing public employees' collective bargaining. Money received by a provider 
130.33 	for pay increases for public employees under this section may be used only for increases 
130.34 	implemented within one month of the effective date of the rate increase and must not be 
130.35 	used for increases implemented prior to that date.
131.1 	(k) A provider that receives a rate adjustment under paragraph (b) that is subject to 
131.2 	paragraphs (h) and (i) shall prepare and produce for the commissioner, upon request, a 
131.3 	plan that specifies the amount of money the provider expects to receive that is subject to 
131.4 	the requirements of paragraphs (h) and (i), as well as how that money will be distributed 
131.5 	to increase compensation for employees. The commissioner may recover funds from a 
131.6 	facility that fails to comply with this requirement.
131.7 	(l) Within six months after the effective date of the rate adjustment, the provider 
131.8 	shall post the distribution plan required under paragraph (k) for a period of at least six 
131.9 	weeks in an area of the provider's operation to which all eligible employees have access, 
131.10 	and shall provide instructions for employees who believe they have not received the 
131.11 	wage and other compensation-related increases specified in the distribution plan. These 
131.12 	instructions must include a mailing address, e-mail address, and telephone number that 
131.13 	an employee may use to contact the commissioner or the commissioner's representative. 
131.14 	Providers shall make assurances to the commissioner of compliance with this section 
131.15 	using forms prescribed by the commissioner.

131.16 	Sec. 48. REVISOR'S INSTRUCTION.
 131.17 	In each section of Minnesota Statutes or part of Minnesota Rules referred to in 
131.18 	column A, the revisor of statutes shall delete the word or phrase in column B and insert 
131.19 	the phrase in column C. The revisor shall also make related grammatical changes and 
131.20 	changes in headnotes.

131.21	Column A
	Column B
	Column C
	
131.22
131.23	section 158.13
	defective persons
	persons with intellectual 
disabilities
	
131.24
131.25	section 158.14
	defective persons
	persons with intellectual 
disabilities
	
131.26
131.27	section 158.17
	defective persons
	persons with intellectual 
disabilities
	
131.28
131.29	section 158.18
	persons not defective
	persons without intellectual 
disabilities
	
131.30
131.31		defective person
	person with intellectual 
disabilities
	
131.32
131.33		defective persons
	persons with intellectual 
disabilities
	
131.34
131.35	section 158.19
	defective
	person with intellectual 
disabilities
	
131.36
131.37	section 256.94
	defective
	children with intellectual 
disabilities and
	
131.38
131.39	section 257.175
	defective
	children with intellectual 
disabilities and
	
131.40	part 2911.1350
	retardation
	developmental disability

132.1 	Sec. 49.  REPEALER.
 132.2 	(a) Minnesota Statutes 2013 Supplement, section 245D.061, subdivision 3, is 
132.3 	repealed.
132.4 	(b) Minnesota Statutes 2012, section 245.825, subdivisions 1 and 1b, are repealed 
132.5 	upon the effective date of rules adopted according to Minnesota Statutes, section 245.8251. 
132.6 	The commissioner of human services shall notify the revisor of statutes when this occurs.
132.7 	(c) Minnesota Statutes 2013 Supplement, sections 245D.02, subdivisions 2b, 2c, 
132.8 	3b, 5a, 8a, 15a, 15b, 23b, 28, 29, and 34a; 245D.06, subdivisions 5, 6, 7, and 8; and 
132.9 	245D.061, subdivisions 1, 2, 4, 5, 6, 7, 8, and 9, are repealed upon the effective date of 
132.10 	rules adopted according to Minnesota Statutes, section 245.8251. The commissioner of 
132.11 	human services shall notify the revisor of statutes when this occurs.
132.12 	(d) Minnesota Rules, parts 9525.2700; and 9525.2810, are repealed upon the 
132.13 	effective date of rules adopted according to Minnesota Statutes, section 245.8251. The 
132.14 	commissioner of human services shall notify the revisor of statutes when this occurs.

132.15 	ARTICLE 6
132.16 	MISCELLANEOUS

132.17 	Section 1. Minnesota Statutes 2012, section 254B.12, is amended to read:
132.18 	254B.12 RATE METHODOLOGY.
132.19 		Subdivision 1.CCDTF rate methodology established. The commissioner shall 
132.20 	establish a new rate methodology for the consolidated chemical dependency treatment 
132.21 	fund. The new methodology must replace county-negotiated rates with a uniform 
132.22 	statewide methodology that must include a graduated reimbursement scale based on the 
132.23 	patients' level of acuity and complexity. At least biennially, the commissioner shall review 
132.24 	the financial information provided by vendors to determine the need for rate adjustments.
132.25 		Subd. 2.Payment methodology for state-operated vendors. (a) Notwithstanding 
132.26 	subdivision 1, the commissioner shall seek federal authority to develop a separate 
132.27 	payment methodology for chemical dependency treatment services provided under the 
132.28 	consolidated chemical dependency treatment fund by a state-operated vendor. This 
132.29 	payment methodology is effective for services provided on or after October 1, 2015, or on 
132.30 	or after the receipt of federal approval, whichever is later.
132.31 	(b) Before implementing an approved payment methodology under paragraph 
132.32 	(a), the commissioner must also receive any necessary legislative approval of required 
132.33 	changes to state law or funding.

133.1 	Sec. 2. Minnesota Statutes 2012, section 256I.05, subdivision 2, is amended to read:
133.2 		Subd. 2.Monthly rates; exemptions. The maximum group residential housing rate 
133.3 	does not apply This subdivision applies to a residence that on August 1, 1984, was licensed 
133.4 	by the commissioner of health only as a boarding care home, certified by the commissioner 
133.5 	of health as an intermediate care facility, and licensed by the commissioner of human 
133.6 	services under Minnesota Rules, parts 9520.0500 to 9520.0690. Notwithstanding the 
133.7 	provisions of subdivision 1c, the rate paid to a facility reimbursed under this subdivision 
133.8 	shall be determined under section 256B.431, or under section 256B.434 if the facility is 
133.9 	accepted by the commissioner for participation in the alternative payment demonstration 
133.10 	project. The rate paid to this facility shall also include adjustments to the group residential 
133.11 	housing rate according to subdivision 1, and any adjustments applicable to supplemental 
133.12 	service rates statewide.