1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services 
1.3 	budget; modifying provisions governing health care, MinnesotaCare, MNsure, 
1.4 	continuing care, nursing facility payments and workforce development, public 
1.5 	health and health care delivery, children and family services, chemical and 
1.6 	mental health, direct care and treatment, withdrawal management programs, 
1.7 	and health-related licensing boards; establishing uniform requirements for 
1.8 	public assistance programs related to income calculation, reporting income, 
1.9 	and correcting overpayments and underpayments; making changes to medical 
1.10 	assistance, home and community-based services, Northstar Care for Children, 
1.11 	child protection, group residential housing, child support, and civil commitment; 
1.12 	making changes to and eliminating MinnesotaCare; establishing a federally 
1.13 	facilitated marketplace; providing for certain provider rate and grant increases; 
1.14 	establishing the Minnesota ABLE plan and accounts; modifying requirements 
1.15 	for administrative expenses and audits of certain public health care programs; 
1.16 	providing for protection of born alive infants; establishing standards for 
1.17 	withdrawal management programs; requiring reports and studies; authorizing 
1.18 	rulemaking; making technical changes; modifying certain fees for health-related 
1.19 	licensing boards; making human services forecast adjustments; appropriating 
1.20 	money; amending Minnesota Statutes 2014, sections 13.46, subdivisions 2, 7; 
1.21 	13.461, by adding a subdivision; 15A.0815, subdivision 3; 43A.241; 62A.02, 
1.22 	subdivision 2; 62A.045; 62Q.55, subdivision 3; 62V.02, by adding a subdivision; 
1.23 	62V.03, subdivision 2; 62V.04, subdivisions 1, 2, 4; 62V.05, subdivisions 1, 
1.24 	5, 6, by adding subdivisions; 62V.11, subdivision 2, by adding a subdivision; 
1.25 	103I.205, subdivision 4; 119B.011, subdivision 15; 119B.025, subdivision 1; 
1.26 	119B.035, subdivision 4; 119B.09, subdivision 4; 144.293, subdivision 5; 
1.27 	144A.071, subdivision 4a; 144A.75, subdivision 13; 144E.001, by adding a 
1.28 	subdivision; 144E.275, subdivision 1, by adding a subdivision; 145.4131, 
1.29 	subdivision 1; 145.423; 145.56, subdivisions 2, 4; 145.928, subdivision 13; 
1.30 	146B.01, subdivision 28; 146B.03, subdivisions 4, 6, by adding a subdivision; 
1.31 	146B.07, subdivisions 1, 2; 147.091, subdivision 1; 148.271; 148.52; 148.54; 
1.32 	148.57, subdivisions 1, 2, by adding a subdivision; 148.574; 148.575, subdivision 
1.33 	2; 148.577; 148.59; 148.603; 148E.075; 148E.080, subdivisions 1, 2; 148E.180, 
1.34 	subdivisions 2, 5; 150A.06, subdivision 1b; 150A.091, subdivisions 4, 5, 
1.35 	11, by adding subdivisions; 150A.31; 151.01, subdivisions 15a, 27; 151.02; 
1.36 	151.065, subdivisions 1, 2, 3, 4; 151.102; 151.58, subdivisions 2, 5; 152.34; 
1.37 	157.15, subdivision 8; 214.077; 214.10, subdivisions 2, 2a; 214.32, subdivision 
1.38 	6; 245.467, subdivision 6; 245.4876, subdivision 7; 245A.06, by adding a 
1.39 	subdivision; 245A.155, subdivisions 1, 2; 245A.65, subdivision 2; 245C.03, by 
2.1 	adding a subdivision; 245C.10, by adding a subdivision; 245D.02, by adding a 
2.2 	subdivision; 245D.05, subdivisions 1, 2; 245D.06, subdivisions 1, 2, 7; 245D.07, 
2.3 	subdivision 2; 245D.071, subdivision 5; 245D.09, subdivisions 3, 5; 245D.22, 
2.4 	subdivision 4; 245D.31, subdivisions 3, 4, 5; 252.27, subdivision 2a; 253B.18, 
2.5 	subdivisions 4c, 5; 256.01, by adding subdivisions; 256.017, subdivision 1; 
2.6 	256.478; 256.741, subdivisions 1, 2; 256.962, by adding a subdivision; 256.969, 
2.7 	subdivisions 2b, 9; 256.975, subdivision 2, by adding a subdivision; 256.98, 
2.8 	subdivision 1; 256B.021, subdivision 4; 256B.056, subdivision 5c; 256B.057, 
2.9 	subdivision 9; 256B.0625, subdivisions 3b, 13, 13e, 13h, 17, 28a, 31, 58, 
2.10 	by adding subdivisions; 256B.0631; 256B.0644; 256B.0913, subdivision 4; 
2.11 	256B.0915, subdivisions 3a, 3e, 3h; 256B.0916, subdivisions 2, 11, by adding 
2.12 	a subdivision; 256B.097, subdivisions 3, 4; 256B.431, subdivisions 2b, 36; 
2.13 	256B.434, subdivision 4, by adding a subdivision; 256B.441, subdivisions 
2.14 	1, 5, 6, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 48, 50, 51, 51a, 53, 54, 
2.15 	55a, 56, 63, by adding subdivisions; 256B.49, subdivision 26, by adding a 
2.16 	subdivision; 256B.4913, subdivisions 4a, 5; 256B.4914, subdivisions 2, 6, 
2.17 	8, 10, 14, 15; 256B.492; 256B.50, subdivision 1; 256B.5012, by adding a 
2.18 	subdivision; 256B.69, subdivisions 5a, 5i, 9c, 9d, by adding a subdivision; 
2.19 	256B.75; 256B.76, subdivisions 1, 2; 256B.762; 256B.766; 256B.767; 256D.01, 
2.20 	subdivision 1a; 256D.02, subdivision 8, by adding subdivisions; 256D.06, 
2.21 	subdivision 1; 256D.405, subdivision 3; 256E.35, subdivision 2, by adding a 
2.22 	subdivision; 256I.03, subdivisions 3, 7, by adding subdivisions; 256I.04; 256I.05, 
2.23 	subdivisions 1c, 1g, 2; 256I.06, subdivisions 2, 6, 7, 8; 256J.08, subdivisions 
2.24 	26, 86; 256J.30, subdivisions 1, 9; 256J.35; 256J.40; 256J.95, subdivision 19; 
2.25 	256K.45, subdivision 1a; 256L.01, subdivisions 3a, 5; 256L.03, subdivision 5; 
2.26 	256L.04, subdivisions 1c, 7b, 10; 256L.05, subdivisions 3, 3a, 4, by adding 
2.27 	a subdivision; 256L.06, subdivision 3; 256L.121, subdivision 1; 256N.22, 
2.28 	subdivisions 9, 10; 256N.24, subdivision 4; 256N.25, subdivision 1; 256N.27, 
2.29 	subdivision 2; 256P.001; 256P.01, subdivision 3, by adding subdivisions; 
2.30 	256P.02, by adding a subdivision; 256P.03, subdivision 1; 256P.04, subdivisions 
2.31 	1, 4; 256P.05, subdivision 1; 257.75, subdivisions 3, 5; 259A.75; 260C.007, 
2.32 	subdivisions 27, 32; 260C.203; 260C.212, subdivision 1, by adding subdivisions; 
2.33 	260C.331, subdivision 1; 260C.451, subdivisions 2, 6; 260C.515, subdivision 
2.34 	5; 260C.521, subdivisions 1, 2; 260C.607, subdivision 4; 270A.03, subdivision 
2.35 	5; 270B.14, subdivision 1; 518A.26, subdivision 14; 518A.32, subdivision 2; 
2.36 	518A.39, subdivision 1, by adding a subdivision; 518A.41, subdivisions 1, 3, 4, 
2.37 	14, 15; 518A.43, by adding a subdivision; 518A.46, subdivision 3, by adding a 
2.38 	subdivision; 518A.51; 518A.53, subdivision 4; 518C.802; 626.556, subdivisions 
2.39 	1, as amended, 2, 3, 6a, 7, as amended, 10, 10e, 11c, by adding subdivisions; 
2.40 	Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 2012, chapter 
2.41 	247, article 4, section 47, as amended; Laws 2014, chapter 189, sections 5; 10; 
2.42 	11; 16; 17; 18; 19; 23; 24; 27; 28; 29; 31; 43; 50; 51; 73; proposing coding 
2.43 	for new law in Minnesota Statutes, chapters 62A; 62V; 144; 145; 148; 245; 
2.44 	245A; 256B; 256E; 256M; 256P; 518A; proposing coding for new law as 
2.45 	Minnesota Statutes, chapters 245F; 256Q; repealing Minnesota Statutes 2014, 
2.46 	sections 13.461, subdivision 26; 13D.08, subdivision 5a; 16A.724, subdivision 
2.47 	3; 62A.046, subdivision 5; 62V.01; 62V.02; 62V.03; 62V.04; 62V.05; 62V.06; 
2.48 	62V.07; 62V.08; 62V.09; 62V.10; 62V.11; 148.57, subdivisions 3, 4; 148.571; 
2.49 	148.572; 148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, 6; 148.576; 
2.50 	148E.060, subdivision 12; 148E.075, subdivisions 4, 5, 6, 7; 214.105; 256.01, 
2.51 	subdivision 35; 256B.434, subdivision 19b; 256B.441, subdivisions 14a, 19, 50a, 
2.52 	52, 55, 58, 62; 256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6; 
2.53 	256D.49; 256J.38; 256L.01, subdivisions 1, 1a, 1b, 2, 3, 3a, 5, 6, 7; 256L.02, 
2.54 	subdivisions 1, 2, 3, 5, 6; 256L.03, subdivisions 1, 1a, 1b, 2, 3, 3a, 3b, 4, 4a, 5, 
2.55 	6; 256L.04, subdivisions 1, 1a, 1c, 2, 2a, 7, 7a, 7b, 8, 10, 12, 13, 14; 256L.05, 
2.56 	subdivisions 1, 1a, 1b, 1c, 2, 3, 3a, 3c, 4, 5, 6; 256L.06, subdivision 3; 256L.07, 
2.57 	subdivisions 1, 2, 3, 4; 256L.09, subdivisions 1, 2, 4, 5, 6, 7; 256L.10; 256L.11, 
2.58 	subdivisions 1, 2, 2a, 3, 4, 7; 256L.12; 256L.121; 256L.15, subdivisions 1, 1a, 
3.1 	1b, 2; 256L.18; 256L.22; 256L.24; 256L.26; 256L.28; Minnesota Rules, part 
3.2 	3400.0170, subparts 5, 6, 12, 13.
3.3 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.4 	ARTICLE 1
3.5 	HEALTH CARE

3.6 	Section 1. Minnesota Statutes 2014, section 62A.045, is amended to read:
3.7 	62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 
3.8 	HEALTH PROGRAMS.
3.9 	(a) As a condition of doing business in Minnesota or providing coverage to 
3.10 	residents of Minnesota covered by this section, each health insurer shall comply with the 
3.11 	requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171, including 
3.12 	any federal regulations adopted under that act, to the extent that it imposes a requirement 
3.13 	that applies in this state and that is not also required by the laws of this state. This section 
3.14 	does not require compliance with any provision of the federal act prior to the effective date 
3.15 	provided for that provision in the federal act. The commissioner shall enforce this section.
3.16 	For the purpose of this section, "health insurer" includes self-insured plans, group 
3.17 	health plans (as defined in section 607(1) of the Employee Retirement Income Security 
3.18 	Act of 1974), service benefit plans, managed care organizations, pharmacy benefit 
3.19 	managers, or other parties that are by contract legally responsible to pay a claim for a 
3.20 	health-care item or service for an individual receiving benefits under paragraph (b).
3.21 	(b) No plan offered by a health insurer issued or renewed to provide coverage to 
3.22 	a Minnesota resident shall contain any provision denying or reducing benefits because 
3.23 	services are rendered to a person who is eligible for or receiving medical benefits pursuant 
3.24 	to title XIX of the Social Security Act (Medicaid) in this or any other state; chapter 256; 
3.25 	256B; or 256D or services pursuant to section 252.27; 256L.01 to 256L.10; 260B.331, 
3.26 	subdivision 2; 260C.331, subdivision 2; or 393.07, subdivision 1 or 2. No health insurer 
3.27 	providing benefits under plans covered by this section shall use eligibility for medical 
3.28 	programs named in this section as an underwriting guideline or reason for nonacceptance 
3.29 	of the risk.
3.30 	(c) If payment for covered expenses has been made under state medical programs for 
3.31 	health care items or services provided to an individual, and a third party has a legal liability 
3.32 	to make payments, the rights of payment and appeal of an adverse coverage decision for the 
3.33 	individual, or in the case of a child their responsible relative or caretaker, will be subrogated 
3.34 	to the state agency. The state agency may assert its rights under this section within three 
3.35 	years of the date the service was rendered. For purposes of this section, "state agency" 
4.1 	includes prepaid health plans under contract with the commissioner according to sections 
4.2 	256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; children's mental health 
4.3 	collaboratives under section 245.493; demonstration projects for persons with disabilities 
4.4 	under section 256B.77; nursing homes under the alternative payment demonstration project 
4.5 	under section 256B.434; and county-based purchasing entities under section 256B.692.
4.6 	(d) Notwithstanding any law to the contrary, when a person covered by a plan 
4.7 	offered by a health insurer receives medical benefits according to any statute listed in this 
4.8 	section, payment for covered services or notice of denial for services billed by the provider 
4.9 	must be issued directly to the provider. If a person was receiving medical benefits through 
4.10 	the Department of Human Services at the time a service was provided, the provider must 
4.11 	indicate this benefit coverage on any claim forms submitted by the provider to the health 
4.12 	insurer for those services. If the commissioner of human services notifies the health 
4.13 	insurer that the commissioner has made payments to the provider, payment for benefits or 
4.14 	notices of denials issued by the health insurer must be issued directly to the commissioner. 
4.15 	Submission by the department to the health insurer of the claim on a Department of 
4.16 	Human Services claim form is proper notice and shall be considered proof of payment of 
4.17 	the claim to the provider and supersedes any contract requirements of the health insurer 
4.18 	relating to the form of submission. Liability to the insured for coverage is satisfied to the 
4.19 	extent that payments for those benefits are made by the health insurer to the provider or 
4.20 	the commissioner as required by this section.
4.21 	(e) When a state agency has acquired the rights of an individual eligible for medical 
4.22 	programs named in this section and has health benefits coverage through a health insurer, 
4.23 	the health insurer shall not impose requirements that are different from requirements 
4.24 	applicable to an agent or assignee of any other individual covered. 
4.25 	(f) A health insurer must process a claim made by a state agency for covered 
4.26 	expenses paid under state medical programs within 90 business days of the claim's 
4.27 	submission. If the health insurer needs additional information to process the claim, 
4.28 	the health insurer may be granted an additional 30 business days to process the claim, 
4.29 	provided the health insurer submits the request for additional information to the state 
4.30 	agency within 30 business days after the health insurer received the claim.
4.31 	(g) A health insurer may request a refund of a claim paid in error to the Department 
4.32 	of Human Services within two years of the date the payment was made to the department. 
4.33 	A request for a refund shall not be honored by the department if the health insurer makes 
4.34 	the request after the time period has lapsed.

4.35 	Sec. 2. Minnesota Statutes 2014, section 150A.06, subdivision 1b, is amended to read:
5.1 		Subd. 1b.Resident dentists. A person who is a graduate of a dental school and 
5.2 	is an enrolled graduate student or student of an accredited advanced dental education 
5.3 	program and who is not licensed to practice dentistry in the state shall obtain from the 
5.4 	board a license to practice dentistry as a resident dentist. The license must be designated 
5.5 	"resident dentist license" and authorizes the licensee to practice dentistry only under the 
5.6 	supervision of a licensed dentist. A University of Minnesota School of Dentistry dental 
5.7 	resident holding a resident dentist license is eligible for enrollment in medical assistance, 
5.8 	as provided under section 256B.0625, subdivision 9b. A resident dentist license must be 
5.9 	renewed annually pursuant to the board's rules. An applicant for a resident dentist license 
5.10 	shall pay a nonrefundable fee set by the board for issuing and renewing the license. The 
5.11 	requirements of sections 150A.01 to 150A.21 apply to resident dentists except as specified 
5.12 	in rules adopted by the board. A resident dentist license does not qualify a person for 
5.13 	licensure under subdivision 1.

5.14 	Sec. 3. Minnesota Statutes 2014, section 151.58, subdivision 2, is amended to read:
5.15 		Subd. 2.Definitions. For purposes of this section only, the terms defined in this 
5.16 	subdivision have the meanings given.
5.17 	(a) "Automated drug distribution system" or "system" means a mechanical system 
5.18 	approved by the board that performs operations or activities, other than compounding or 
5.19 	administration, related to the storage, packaging, or dispensing of drugs, and collects, 
5.20 	controls, and maintains all required transaction information and records.
5.21 	(b) "Health care facility" means a nursing home licensed under section 144A.02; 
5.22 	a housing with services establishment registered under section 144D.01, subdivision 4, 
5.23 	in which a home provider licensed under chapter 144A is providing centralized storage 
5.24 	of medications; a boarding care home licensed under sections 144.50 to 144.58 that is 
5.25 	providing centralized storage of medications; or a Minnesota sex offender program facility 
5.26 	operated by the Department of Human Services.
5.27 	(c) "Managing pharmacy" means a pharmacy licensed by the board that controls and 
5.28 	is responsible for the operation of an automated drug distribution system.

5.29 	Sec. 4. Minnesota Statutes 2014, section 151.58, subdivision 5, is amended to read:
5.30 		Subd. 5.Operation of automated drug distribution systems. (a) The managing 
5.31 	pharmacy and the pharmacist in charge are responsible for the operation of an automated 
5.32 	drug distribution system.
5.33 	(b) Access to an automated drug distribution system must be limited to pharmacy 
5.34 	and nonpharmacy personnel authorized to procure drugs from the system, except that field 
6.1 	service technicians may access a system located in a health care facility for the purposes of 
6.2 	servicing and maintaining it while being monitored either by the managing pharmacy, or a 
6.3 	licensed nurse within the health care facility. In the case of an automated drug distribution 
6.4 	system that is not physically located within a licensed pharmacy, access for the purpose 
6.5 	of procuring drugs shall be limited to licensed nurses. Each person authorized to access 
6.6 	the system must be assigned an individual specific access code. Alternatively, access to 
6.7 	the system may be controlled through the use of biometric identification procedures. A 
6.8 	policy specifying time access parameters, including time-outs, logoffs, and lockouts, 
6.9 	must be in place.
6.10 	(c) For the purposes of this section only, the requirements of section 151.215 are met 
6.11 	if the following clauses are met:
6.12 	(1) a pharmacist employed by and working at the managing pharmacy, or at a 
6.13 	pharmacy that is acting as a central services pharmacy for the managing pharmacy, 
6.14 	pursuant to Minnesota Rules, part 6800.4075, must review, interpret, and approve all 
6.15 	prescription drug orders before any drug is distributed from the system to be administered 
6.16 	to a patient. A pharmacy technician may perform data entry of prescription drug orders 
6.17 	provided that a pharmacist certifies the accuracy of the data entry before the drug can 
6.18 	be released from the automated drug distribution system. A pharmacist employed by 
6.19 	and working at the managing pharmacy must certify the accuracy of the filling of any 
6.20 	cassettes, canisters, or other containers that contain drugs that will be loaded into the 
6.21 	automated drug distribution system, unless the filled cassettes, canisters, or containers 
6.22 	have been provided by a repackager registered with the United States Food and Drug 
6.23 	Administration and licensed by the board as a manufacturer; and
6.24 	(2) when the automated drug dispensing system is located and used within the 
6.25 	managing pharmacy, a pharmacist must personally supervise and take responsibility for all 
6.26 	packaging and labeling associated with the use of an automated drug distribution system.
6.27 	(d) Access to drugs when a pharmacist has not reviewed and approved the 
6.28 	prescription drug order is permitted only when a formal and written decision to allow such 
6.29 	access is issued by the pharmacy and the therapeutics committee or its equivalent. The 
6.30 	committee must specify the patient care circumstances in which such access is allowed, 
6.31 	the drugs that can be accessed, and the staff that are allowed to access the drugs.
6.32 	(e) In the case of an automated drug distribution system that does not utilize bar 
6.33 	coding in the loading process, the loading of a system located in a health care facility may 
6.34 	be performed by a pharmacy technician, so long as the activity is continuously supervised, 
6.35 	through a two-way audiovisual system by a pharmacist on duty within the managing 
6.36 	pharmacy. In the case of an automated drug distribution system that utilizes bar coding 
7.1 	in the loading process, the loading of a system located in a health care facility may be 
7.2 	performed by a pharmacy technician or a licensed nurse, provided that the managing 
7.3 	pharmacy retains an electronic record of loading activities.
7.4 	(f) The automated drug distribution system must be under the supervision of a 
7.5 	pharmacist. The pharmacist is not required to be physically present at the site of the 
7.6 	automated drug distribution system if the system is continuously monitored electronically 
7.7 	by the managing pharmacy. A pharmacist on duty within a pharmacy licensed by the 
7.8 	board must be continuously available to address any problems detected by the monitoring 
7.9 	or to answer questions from the staff of the health care facility. The licensed pharmacy 
7.10 	may be the managing pharmacy or a pharmacy which is acting as a central services 
7.11 	pharmacy, pursuant to Minnesota Rules, part 6800.4075, for the managing pharmacy.

7.12 	Sec. 5. Minnesota Statutes 2014, section 256.969, subdivision 2b, is amended to read:
7.13 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after 
7.14 	November 1, 2014, hospital inpatient services for hospitals located in Minnesota shall be 
7.15 	paid according to the following:
7.16 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
7.17 	methodology;
7.18 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem 
7.19 	methodology under subdivision 25;
7.20 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
7.21 	distinct parts as defined by Medicare shall be paid according to the methodology under 
7.22 	subdivision 12; and
7.23 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
7.24 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall 
7.25 	not be rebased, except that a Minnesota long-term hospital shall be rebased effective 
7.26 	January 1, 2011, based on its most recent Medicare cost report ending on or before 
7.27 	September 1, 2008, with the provisions under subdivisions 9 and 23, based on the rates 
7.28 	in effect on December 31, 2010. For rate setting periods after November 1, 2014, in 
7.29 	which the base years are updated, a Minnesota long-term hospital's base year shall remain 
7.30 	within the same period as other hospitals.
7.31 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
7.32 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
7.33 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
7.34 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
7.35 	manner similar to Medicare. The base year for the rates effective November 1, 2014, shall 
8.1 	be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring 
8.2 	that the total aggregate payments under the rebased system are equal to the total aggregate 
8.3 	payments that were made for the same number and types of services in the base year. 
8.4 	Separate budget neutrality calculations shall be determined for payments made to critical 
8.5 	access hospitals and payments made to hospitals paid under the DRG system. Only the rate 
8.6 	increases or decreases under subdivision 3a or 3c that applied to the hospitals being rebased 
8.7 	during the entire base period shall be incorporated into the budget neutrality calculation.
8.8 	(d) For discharges occurring on or after November 1, 2014, through June 30, 2016, 
8.9 	the rebased rates under paragraph (c) shall include adjustments to the projected rates that 
8.10 	result in no greater than a five percent increase or decrease from the base year payments 
8.11 	for any hospital. Any adjustments to the rates made by the commissioner under this 
8.12 	paragraph and paragraph (e) shall maintain budget neutrality as described in paragraph (c).
8.13 	(e) For discharges occurring on or after November 1, 2014, through June 30, 2016, 
8.14 	the commissioner may make additional adjustments to the rebased rates, and when 
8.15 	evaluating whether additional adjustments should be made, the commissioner shall 
8.16 	consider the impact of the rates on the following:
8.17 	(1) pediatric services;
8.18 	(2) behavioral health services;
8.19 	(3) trauma services as defined by the National Uniform Billing Committee;
8.20 	(4) transplant services;
8.21 	(5) obstetric services, newborn services, and behavioral health services provided 
8.22 	by hospitals outside the seven-county metropolitan area;
8.23 	(6) outlier admissions;
8.24 	(7) low-volume providers; and
8.25 	(8) services provided by small rural hospitals that are not critical access hospitals.
8.26 	(f) Hospital payment rates established under paragraph (c) must incorporate the 
8.27 	following:
8.28 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
8.29 	admission is standardized by the applicable Medicare wage index and adjusted by the 
8.30 	hospital's disproportionate population adjustment;
8.31 	(2) for critical access hospitals, interim per diem payment rates shall be based on the 
8.32 	ratio of cost and charges reported on the base year Medicare cost report or reports and 
8.33 	applied to medical assistance utilization data. Final settlement payments for a state fiscal 
8.34 	year must be determined based on a review of the medical assistance cost report required 
8.35 	under subdivision 4b for the applicable state fiscal year;
9.1 	(3) the cost and charge data used to establish hospital payment rates must only 
9.2 	reflect inpatient services covered by medical assistance; and
9.3 	(4) in determining hospital payment rates for discharges occurring on or after the 
9.4 	rate year beginning January 1, 2011, through December 31, 2012, the hospital payment 
9.5 	rate per discharge shall be based on the cost-finding methods and allowable costs of the 
9.6 	Medicare program in effect during the base year or years.
9.7 	(g) The commissioner shall validate the rates effective November 1, 2014, by 
9.8 	applying the rates established under paragraph (c), and any adjustments made to the rates 
9.9 	under paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine 
9.10 	whether the total aggregate payments for the same number and types of services under the 
9.11 	rebased rates are equal to the total aggregate payments made during calendar year 2013.
9.12 	(h) Effective for discharges occurring on or after July 1, 2017, and every two 
9.13 	years thereafter, payment rates under this section shall be rebased to reflect only those 
9.14 	changes in hospital costs between the existing base year and the next base year. The 
9.15 	commissioner shall establish the base year for each rebasing period considering the most 
9.16 	recent year for which filed Medicare cost reports are available. The estimated change in 
9.17 	the average payment per hospital discharge resulting from a scheduled rebasing must be 
9.18 	calculated and made available to the legislature by January 15 of each year in which 
9.19 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
9.20 	rates compared to the individual hospital's costs.
9.21 	(i) Effective for discharges occurring on or after July 1, 2015, payment rates for 
9.22 	critical access hospitals located in Minnesota or the local trade area shall be determined 
9.23 	using a new cost-based methodology. The commissioner shall establish within the 
9.24 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
9.25 	Annual payments to hospitals under this paragraph shall equal the total cost for critical 
9.26 	access hospitals as reflected in base year cost reports. The new cost-based rate shall be 
9.27 	the final rate and shall not be settled to actual incurred costs. The factors used to develop 
9.28 	the new methodology may include but are not limited to:
9.29 	(1) the ratio between the hospital's costs for treating medical assistance patients and 
9.30 	the hospital's charges to the medical assistance program;
9.31 	(2) the ratio between the hospital's costs for treating medical assistance patients and 
9.32 	the hospital's payments received from the medical assistance program for the care of 
9.33 	medical assistance patients;
9.34 	(3) the ratio between the hospital's charges to the medical assistance program and 
9.35 	the hospital's payments received from the medical assistance program for the care of 
9.36 	medical assistance patients;
10.1 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
10.2 	(5) the proportion of that hospital's costs that are administrative and trends in 
10.3 	administrative costs; and
10.4 	(6) geographic location.

10.5 	Sec. 6. Minnesota Statutes 2014, section 256.969, subdivision 9, is amended to read:
10.6 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For 
10.7 	admissions occurring on or after July 1, 1993, the medical assistance disproportionate 
10.8 	population adjustment shall comply with federal law and shall be paid to a hospital, 
10.9 	excluding regional treatment centers and facilities of the federal Indian Health Service, 
10.10 	with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The 
10.11 	adjustment must be determined as follows:
10.12 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
10.13 	arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 
10.14 	federal Indian Health Service but less than or equal to one standard deviation above the 
10.15 	mean, the adjustment must be determined by multiplying the total of the operating and 
10.16 	property payment rates by the difference between the hospital's actual medical assistance 
10.17 	inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 
10.18 	treatment centers and facilities of the federal Indian Health Service; and
10.19 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
10.20 	standard deviation above the mean, the adjustment must be determined by multiplying 
10.21 	the adjustment that would be determined under clause (1) for that hospital by 1.1. 
10.22 	The commissioner may establish a separate disproportionate population payment rate 
10.23 	adjustment for critical access hospitals. The commissioner shall report annually on the 
10.24 	number of hospitals likely to receive the adjustment authorized by this paragraph. The 
10.25 	commissioner shall specifically report on the adjustments received by public hospitals and 
10.26 	public hospital corporations located in cities of the first class.
10.27 	(b) Certified public expenditures made by Hennepin County Medical Center shall 
10.28 	be considered Medicaid disproportionate share hospital payments. Hennepin County 
10.29 	and Hennepin County Medical Center shall report by June 15, 2007, on payments made 
10.30 	beginning July 1, 2005, or another date specified by the commissioner, that may qualify 
10.31 	for reimbursement under federal law. Based on these reports, the commissioner shall 
10.32 	apply for federal matching funds.
10.33 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is 
10.34 	effective retroactively from July 1, 2005, or the earliest effective date approved by the 
10.35 	Centers for Medicare and Medicaid Services.
11.1 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall 
11.2 	be paid in accordance with a new methodology. Annual DSH payments made under 
11.3 	this paragraph shall equal the total amount of DSH payments made for 2012. The new 
11.4 	methodology shall take into account a variety of factors, including but not limited to:
11.5 	(1) the medical assistance utilization rate of the hospitals that receive payments 
11.6 	under this subdivision;
11.7 	(2) whether the hospital is located within Minnesota;
11.8 	(3) the difference between a hospital's costs for treating medical assistance patients 
11.9 	and the total amount of payments received from medical assistance;
11.10 	(4) the percentage of uninsured patient days at each qualifying hospital in relation 
11.11 	to the total number of uninsured patient days statewide;
11.12 	(5) the hospital's status as a hospital authorized to make presumptive eligibility 
11.13 	determinations for medical assistance in accordance with section 256B.057, subdivision 12;
11.14 	(6) the hospital's status as a safety net, critical access, children's, rehabilitation, or 
11.15 	long-term hospital;
11.16 	(7) whether the hospital's administrative cost of compiling the necessary DSH 
11.17 	reports exceeds the anticipated value of any calculated DSH payment; and
11.18 	(8) whether the hospital provides specific services designated by the commissioner 
11.19 	to be of particular importance to the medical assistance program.
11.20 	(e) Any payments or portion of payments made to a hospital under this subdivision 
11.21 	that are subsequently returned to the commissioner because the payments are found to 
11.22 	exceed the hospital-specific DSH limit for that hospital shall be redistributed to other 
11.23 	DSH-eligible hospitals in a manner established by the commissioner.

11.24 	Sec. 7. Minnesota Statutes 2014, section 256B.056, subdivision 5c, is amended to read:
11.25 		Subd. 5c.Excess income standard. (a) The excess income standard for parents 
11.26 	and caretaker relatives, pregnant women, infants, and children ages two through 20 is the 
11.27 	standard specified in subdivision 4, paragraph (b).
11.28 	(b) The excess income standard for a person whose eligibility is based on blindness, 
11.29 	disability, or age of 65 or more years shall equal 75 80 percent of the federal poverty 
11.30 	guidelines.

11.31 	EFFECTIVE DATE. This section is effective July 1, 2016.

11.32 	Sec. 8. Minnesota Statutes 2014, section 256B.0625, is amended by adding a 
11.33 	subdivision to read:
12.1 		Subd. 9b.Dental services provided by faculty members and resident dentists 
12.2 	at a dental school. (a) A dentist who is not enrolled as a medical assistance provider, 
12.3 	is a faculty or adjunct member at the University of Minnesota or a resident dentist 
12.4 	licensed under section 150A.06, subdivision 1b, and is providing dental services at a 
12.5 	dental clinic owned or operated by the University of Minnesota, may be enrolled as a 
12.6 	medical assistance provider if the provider completes and submits to the commissioner an 
12.7 	agreement form developed by the commissioner. The agreement must specify that the 
12.8 	faculty or adjunct member or resident dentist:
12.9 	(1) will not receive payment for the services provided to medical assistance or 
12.10 	MinnesotaCare enrollees performed at the dental clinics owned or operated by the 
12.11 	University of Minnesota;
12.12 	(2) will not be listed in the medical assistance or MinnesotaCare provider directory; 
12.13 	and
12.14 	(3) is not required to serve medical assistance and MinnesotaCare enrollees when 
12.15 	providing nonvolunteer services in a private practice.
12.16 	(b) A dentist or resident dentist enrolled under this subdivision as a fee-for-service 
12.17 	provider shall not otherwise be enrolled in or receive payments from medical assistance or 
12.18 	MinnesotaCare as a fee-for-service provider.

12.19 	Sec. 9. Minnesota Statutes 2014, section 256B.0625, subdivision 13, is amended to read:
12.20 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs 
12.21 	when specifically used to enhance fertility, if prescribed by a licensed practitioner and 
12.22 	dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance 
12.23 	program as a dispensing physician, or by a physician, physician assistant, or a nurse 
12.24 	practitioner employed by or under contract with a community health board as defined in 
12.25 	section 145A.02, subdivision 5, for the purposes of communicable disease control.
12.26 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
12.27 	unless authorized by the commissioner.
12.28 	(c) For the purpose of this subdivision and subdivision 13d, an "active 
12.29 	pharmaceutical ingredient" is defined as a substance that is represented for use in a drug 
12.30 	and when used in the manufacturing, processing, or packaging of a drug becomes an 
12.31 	active ingredient of the drug product. An "excipient" is defined as an inert substance 
12.32 	used as a diluent or vehicle for a drug. The commissioner shall establish a list of active 
12.33 	pharmaceutical ingredients and excipients which are included in the medical assistance 
12.34 	formulary. Medical assistance covers selected active pharmaceutical ingredients and 
13.1 	excipients used in compounded prescriptions when the compounded combination is 
13.2 	specifically approved by the commissioner or when a commercially available product:
13.3 	(1) is not a therapeutic option for the patient;
13.4 	(2) does not exist in the same combination of active ingredients in the same strengths 
13.5 	as the compounded prescription; and
13.6 	(3) cannot be used in place of the active pharmaceutical ingredient in the 
13.7 	compounded prescription.
13.8 	(d) Medical assistance covers the following over-the-counter drugs when prescribed 
13.9 	by a licensed practitioner or by a licensed pharmacist who meets standards established by 
13.10 	the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, 
13.11 	family planning products, aspirin, insulin, products for the treatment of lice, vitamins for 
13.12 	adults with documented vitamin deficiencies, vitamins for children under the age of seven 
13.13 	and pregnant or nursing women, and any other over-the-counter drug identified by the 
13.14 	commissioner, in consultation with the formulary committee, as necessary, appropriate, 
13.15 	and cost-effective for the treatment of certain specified chronic diseases, conditions, 
13.16 	or disorders, and this determination shall not be subject to the requirements of chapter 
13.17 	14. A pharmacist may prescribe over-the-counter medications as provided under this 
13.18 	paragraph for purposes of receiving reimbursement under Medicaid. When prescribing 
13.19 	over-the-counter drugs under this paragraph, licensed pharmacists must consult with the 
13.20 	recipient to determine necessity, provide drug counseling, review drug therapy for potential 
13.21 	adverse interactions, and make referrals as needed to other health care professionals. 
13.22 	Over-the-counter medications must be dispensed in a quantity that is the lower lowest of: 
13.23 	(1) the number of dosage units contained in the manufacturer's original package; and
13.24 	(2) the number of dosage units required to complete the patient's course of therapy; or
13.25 	(3) if applicable, the number of dosage units dispensed from a system using 
13.26 	retrospective billing, as provided under subdivision 13e, paragraph (b).
13.27 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that 
13.28 	are coverable under Medicare Part D as defined in the Medicare Prescription Drug, 
13.29 	Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), 
13.30 	for individuals eligible for drug coverage as defined in the Medicare Prescription 
13.31 	Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 
13.32 	1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the 
13.33 	drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this 
13.34 	subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, 
13.35 	title 42, section 1396r-8(d)(2)(E), shall not be covered.
14.1 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
14.2 	Program and dispensed by 340B covered entities and ambulatory pharmacies under 
14.3 	common ownership of the 340B covered entity. Medical assistance does not cover drugs 
14.4 	acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract 
14.5 	pharmacies.

14.6 	EFFECTIVE DATE. This section is effective January 1, 2016, or upon federal 
14.7 	approval, whichever is later.

14.8 	Sec. 10. Minnesota Statutes 2014, section 256B.0625, subdivision 13e, is amended to 
14.9 	read:
14.10 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
14.11 	shall be the lower of the actual acquisition costs of the drugs or the maximum allowable 
14.12 	cost by the commissioner plus the fixed dispensing fee; or the usual and customary price 
14.13 	charged to the public. The amount of payment basis must be reduced to reflect all discount 
14.14 	amounts applied to the charge by any provider/insurer agreement or contract for submitted 
14.15 	charges to medical assistance programs. The net submitted charge may not be greater 
14.16 	than the patient liability for the service. The pharmacy dispensing fee shall be $3.65 
14.17 	for legend prescription drugs, except that the dispensing fee for intravenous solutions 
14.18 	which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer 
14.19 	chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed 
14.20 	in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in 
14.21 	quantities greater than one liter. The pharmacy dispensing fee for over-the-counter drugs 
14.22 	shall be $3.65, except that the fee shall be $1.31 for retrospectively billing pharmacies 
14.23 	when billing for quantities less than the number of units contained in the manufacturer's 
14.24 	original package. Actual acquisition cost includes quantity and other special discounts 
14.25 	except time and cash discounts. The actual acquisition cost of a drug shall be estimated 
14.26 	by the commissioner at wholesale acquisition cost plus four percent for independently 
14.27 	owned pharmacies located in a designated rural area within Minnesota, and at wholesale 
14.28 	acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently 
14.29 	owned" if it is one of four or fewer pharmacies under the same ownership nationally. A 
14.30 	"designated rural area" means an area defined as a small rural area or isolated rural area 
14.31 	according to the four-category classification of the Rural Urban Commuting Area system 
14.32 	developed for the United States Health Resources and Services Administration. Effective 
14.33 	January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B 
14.34 	Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition 
14.35 	cost minus 40 percent. Wholesale acquisition cost is defined as the manufacturer's list 
15.1 	price for a drug or biological to wholesalers or direct purchasers in the United States, not 
15.2 	including prompt pay or other discounts, rebates, or reductions in price, for the most 
15.3 	recent month for which information is available, as reported in wholesale price guides or 
15.4 	other publications of drug or biological pricing data. The maximum allowable cost of a 
15.5 	multisource drug may be set by the commissioner and it shall be comparable to, but no 
15.6 	higher than, the maximum amount paid by other third-party payors in this state who have 
15.7 	maximum allowable cost programs. Establishment of the amount of payment for drugs 
15.8 	shall not be subject to the requirements of the Administrative Procedure Act.
15.9 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities 
15.10 	using an automated drug distribution system meeting the requirements of section 151.58, 
15.11 	or a packaging system meeting the packaging standards set forth in Minnesota Rules, part 
15.12 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
15.13 	retrospective billing for prescriptions dispensed to long-term care facility residents. A 
15.14 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
15.15 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
15.16 	pharmacy must use a billing period of not less than one calendar month or 30 days.
15.17 	(c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to 
15.18 	pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities 
15.19 	when a unit dose blister card system, approved by the department, is used. Under this type 
15.20 	of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National 
15.21 	Drug Code (NDC) from the drug container used to fill the blister card must be identified on 
15.22 	the claim to the department. The unit dose blister card containing the drug must meet the 
15.23 	packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return 
15.24 	of unused drugs to the pharmacy for reuse. The A pharmacy provider using packaging 
15.25 	that meets the standards set forth in Minnesota Rules, part 6800.2700, subpart 2, will be 
15.26 	required to credit the department for the actual acquisition cost of all unused drugs that are 
15.27 	eligible for reuse, unless the pharmacy is using retrospective billing. The commissioner 
15.28 	may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply.
15.29 	(c) (d) Whenever a maximum allowable cost has been set for a multisource drug, 
15.30 	payment shall be the lower of the usual and customary price charged to the public or the 
15.31 	maximum allowable cost established by the commissioner unless prior authorization 
15.32 	for the brand name product has been granted according to the criteria established by 
15.33 	the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the 
15.34 	prescriber has indicated "dispense as written" on the prescription in a manner consistent 
15.35 	with section 151.21, subdivision 2.
16.1 	(d) (e) The basis for determining the amount of payment for drugs administered in 
16.2 	an outpatient setting shall be the lower of the usual and customary cost submitted by 
16.3 	the provider, 106 percent of the average sales price as determined by the United States 
16.4 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
16.5 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
16.6 	set by the commissioner. If average sales price is unavailable, the amount of payment 
16.7 	must be lower of the usual and customary cost submitted by the provider, the wholesale 
16.8 	acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the 
16.9 	commissioner. Effective January 1, 2014, the commissioner shall discount the payment 
16.10 	rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The 
16.11 	payment for drugs administered in an outpatient setting shall be made to the administering 
16.12 	facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration 
16.13 	in an outpatient setting is not eligible for direct reimbursement.
16.14 	(e) (f) The commissioner may negotiate lower reimbursement rates for specialty 
16.15 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
16.16 	require individuals enrolled in the health care programs administered by the department 
16.17 	to obtain specialty pharmacy products from providers with whom the commissioner has 
16.18 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
16.19 	used by a small number of recipients or recipients with complex and chronic diseases 
16.20 	that require expensive and challenging drug regimens. Examples of these conditions 
16.21 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
16.22 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
16.23 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
16.24 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
16.25 	that require complex care. The commissioner shall consult with the formulary committee 
16.26 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
16.27 	with the formulary committee in developing this list, the commissioner shall take into 
16.28 	consideration the population served by specialty pharmacy products, the current delivery 
16.29 	system and standard of care in the state, and access to care issues. The commissioner shall 
16.30 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
16.31 	(f) (g) Home infusion therapy services provided by home infusion therapy 
16.32 	pharmacies must be paid at rates according to subdivision 8d.

16.33 	EFFECTIVE DATE. This section is effective January 1, 2016, or upon federal 
16.34 	approval, whichever is later.

17.1 	Sec. 11. Minnesota Statutes 2014, section 256B.0625, subdivision 13h, is amended to 
17.2 	read:
17.3 		Subd. 13h.Medication therapy management services. (a) Medical assistance and 
17.4 	general assistance medical care cover covers medication therapy management services 
17.5 	for a recipient taking three or more prescriptions to treat or prevent one or more chronic 
17.6 	medical conditions; a recipient with a drug therapy problem that is identified by the 
17.7 	commissioner or identified by a pharmacist and approved by the commissioner; or prior 
17.8 	authorized by the commissioner that has resulted or is likely to result in significant 
17.9 	nondrug program costs. The commissioner may cover medical therapy management 
17.10 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
17.11 	purposes of this subdivision, "medication therapy management" means the provision 
17.12 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
17.13 	therapeutic outcomes of the patient's medications:
17.14 	(1) performing or obtaining necessary assessments of the patient's health status;
17.15 	(2) formulating a medication treatment plan;
17.16 	(3) monitoring and evaluating the patient's response to therapy, including safety 
17.17 	and effectiveness;
17.18 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
17.19 	medication-related problems, including adverse drug events;
17.20 	(5) documenting the care delivered and communicating essential information to 
17.21 	the patient's other primary care providers;
17.22 	(6) providing verbal education and training designed to enhance patient 
17.23 	understanding and appropriate use of the patient's medications;
17.24 	(7) providing information, support services, and resources designed to enhance 
17.25 	patient adherence with the patient's therapeutic regimens; and
17.26 	(8) coordinating and integrating medication therapy management services within the 
17.27 	broader health care management services being provided to the patient.
17.28 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
17.29 	the pharmacist as defined in section 151.01, subdivision 27.
17.30 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
17.31 	must meet the following requirements:
17.32 	(1) have a valid license issued by the Board of Pharmacy of the state in which the 
17.33 	medication therapy management service is being performed;
17.34 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
17.35 	completed a structured and comprehensive education program approved by the Board of 
17.36 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
18.1 	documentation of pharmaceutical care management services that has both clinical and 
18.2 	didactic elements;
18.3 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
18.4 	have developed a structured patient care process that is offered in a private or semiprivate 
18.5 	patient care area that is separate from the commercial business that also occurs in the 
18.6 	setting, or in home settings, including long-term care settings, group homes, and facilities 
18.7 	providing assisted living services, but excluding skilled nursing facilities; and
18.8 	(4) make use of an electronic patient record system that meets state standards.
18.9 	(c) For purposes of reimbursement for medication therapy management services, 
18.10 	the commissioner may enroll individual pharmacists as medical assistance and general 
18.11 	assistance medical care providers. The commissioner may also establish contact 
18.12 	requirements between the pharmacist and recipient, including limiting the number of 
18.13 	reimbursable consultations per recipient.
18.14 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
18.15 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
18.16 	requirements may provide the services via two-way interactive video. Reimbursement 
18.17 	shall be at the same rates and under the same conditions that would otherwise apply to 
18.18 	the services provided. To qualify for reimbursement under this paragraph, the pharmacist 
18.19 	providing the services must meet the requirements of paragraph (b), and must be 
18.20 	located within an ambulatory care setting approved by the commissioner that meets the 
18.21 	requirements of paragraph (b), clause (3). The patient must also be located within an 
18.22 	ambulatory care setting approved by the commissioner that meets the requirements of 
18.23 	paragraph (b), clause (3). Services provided under this paragraph may not be transmitted 
18.24 	into the patient's residence.
18.25 	(e) The commissioner shall establish a pilot project for an intensive medication 
18.26 	therapy management program for patients identified by the commissioner with multiple 
18.27 	chronic conditions and a high number of medications who are at high risk of preventable 
18.28 	hospitalizations, emergency room use, medication complications, and suboptimal 
18.29 	treatment outcomes due to medication-related problems. For purposes of the pilot 
18.30 	project, medication therapy management services may be provided in a patient's home 
18.31 	or community setting, in addition to other authorized settings. The commissioner may 
18.32 	waive existing payment policies and establish special payment rates for the pilot project. 
18.33 	The pilot project must be designed to produce a net savings to the state compared to the 
18.34 	estimated costs that would otherwise be incurred for similar patients without the program. 
18.35 	The pilot project must begin by January 1, 2010, and end June 30, 2012.
19.1 	(e) Medication therapy management services may be delivered into a patient's 
19.2 	residence via secure interactive video if the medication therapy management services 
19.3 	are performed electronically during a covered home care visit by an enrolled provider. 
19.4 	Reimbursement shall be at the same rates and under the same conditions that would 
19.5 	otherwise apply to the services provided. To qualify for reimbursement under this 
19.6 	paragraph, the pharmacist providing the services must meet the requirements of paragraph 
19.7 	(b) and must be located within an ambulatory care setting that meets the requirements of 
19.8 	paragraph (b), clause (3).

19.9 	Sec. 12. Minnesota Statutes 2014, section 256B.0625, subdivision 17, is amended to 
19.10 	read:
19.11 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation 
19.12 	service" means motor vehicle transportation provided by a public or private person 
19.13 	that serves Minnesota health care program beneficiaries who do not require emergency 
19.14 	ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered 
19.15 	medical services. Nonemergency medical transportation service includes, but is not 
19.16 	limited to, special transportation service, defined in section 174.29, subdivision 1.
19.17 	(b) Medical assistance covers medical transportation costs incurred solely for 
19.18 	obtaining emergency medical care or transportation costs incurred by eligible persons in 
19.19 	obtaining emergency or nonemergency medical care when paid directly to an ambulance 
19.20 	company, common carrier, or other recognized providers of transportation services. 
19.21 	Medical transportation must be provided by:
19.22 	(1) nonemergency medical transportation providers who meet the requirements 
19.23 	of this subdivision;
19.24 	(2) ambulances, as defined in section 144E.001, subdivision 2;
19.25 	(3) taxicabs and public transit, as defined in section 174.22, subdivision 7; or
19.26 	(4) not-for-hire vehicles, including volunteer drivers.
19.27 	(c) Medical assistance covers nonemergency medical transportation provided by 
19.28 	nonemergency medical transportation providers enrolled in the Minnesota health care 
19.29 	programs. All nonemergency medical transportation providers must comply with the 
19.30 	operating standards for special transportation service as defined in sections 174.29 to 
19.31 	174.30 and Minnesota Rules, chapter 8840, and in consultation with the Minnesota 
19.32 	Department of Transportation. All nonemergency medical transportation providers shall 
19.33 	bill for nonemergency medical transportation services in accordance with Minnesota 
19.34 	health care programs criteria. Publicly operated transit systems, volunteers, and 
19.35 	not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
20.1 	(d) The administrative agency of nonemergency medical transportation must:
20.2 	(1) adhere to the policies defined by the commissioner in consultation with the 
20.3 	Nonemergency Medical Transportation Advisory Committee;
20.4 	(2) pay nonemergency medical transportation providers for services provided to 
20.5 	Minnesota health care programs beneficiaries to obtain covered medical services;
20.6 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, 
20.7 	canceled trips, and number of trips by mode; and
20.8 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single 
20.9 	administrative structure assessment tool that meets the technical requirements established 
20.10 	by the commissioner, reconciles trip information with claims being submitted by 
20.11 	providers, and ensures prompt payment for nonemergency medical transportation services.
20.12 	(e) Until the commissioner implements the single administrative structure and 
20.13 	delivery system under subdivision 18e, clients shall obtain their level-of-service certificate 
20.14 	from the commissioner or an entity approved by the commissioner that does not dispatch 
20.15 	rides for clients using modes under paragraph (h), clauses (4), (5), (6), and (7).
20.16 	(f) The commissioner may use an order by the recipient's attending physician or a 
20.17 	medical or mental health professional to certify that the recipient requires nonemergency 
20.18 	medical transportation services. Nonemergency medical transportation providers shall 
20.19 	perform driver-assisted services for eligible individuals, when appropriate. Driver-assisted 
20.20 	service includes passenger pickup at and return to the individual's residence or place of 
20.21 	business, assistance with admittance of the individual to the medical facility, and assistance 
20.22 	in passenger securement or in securing of wheelchairs or stretchers in the vehicle. 
20.23 	Nonemergency medical transportation providers must have trip logs, which include pickup 
20.24 	and drop-off times, signed by the medical provider or client attesting mileage traveled to 
20.25 	obtain covered medical services, whichever is deemed most appropriate. Nonemergency 
20.26 	medical transportation providers may not bill for separate base rates for the continuation 
20.27 	of a trip beyond the original destination. Nonemergency medical transportation providers 
20.28 	must take clients to the health care provider, using the most direct route, and must not 
20.29 	exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty 
20.30 	care provider, unless the client receives authorization from the local agency. The minimum 
20.31 	medical assistance reimbursement rates for special transportation services are:
20.32 	(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to 
20.33 	eligible persons who need a wheelchair-accessible van;
20.34 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
20.35 	eligible persons who do not need a wheelchair-accessible van; and
21.1 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, 
21.2 	for special transportation services to eligible persons who need a stretcher-accessible 
21.3 	vehicle; and
21.4 	(2) clients requesting client mileage reimbursement must sign the trip log attesting 
21.5 	mileage traveled to obtain covered medical services.
21.6 	(g) The covered modes of nonemergency medical transportation include 
21.7 	transportation provided directly by clients or family members of clients with their own 
21.8 	transportation, volunteers using their own vehicles, taxicabs, and public transit, or 
21.9 	provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle, 
21.10 	or a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport ten 
21.11 	or fewer persons. Upon implementation of a new rate structure, a new covered mode of 
21.12 	nonemergency medical transportation shall include transportation provided to a client who 
21.13 	needs a protected vehicle that is not an ambulance or police car and has safety locks, a 
21.14 	video recorder, and a transparent thermoplastic partition between the passenger and the 
21.15 	vehicle driver.
21.16 	(h) The administrative agency shall use the level of service process established by the 
21.17 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
21.18 	Committee to determine the client's most appropriate mode of transportation. If public 
21.19 	transit or a certified transportation provider is not available to provide the appropriate 
21.20 	service mode for the client, the client may receive a onetime service upgrade. The new 
21.21 	modes of transportation, which may not be implemented without a new rate structure, are:
21.22 	(1) client reimbursement, which includes client mileage reimbursement provided 
21.23 	to clients who have their own transportation or family who provides transportation to 
21.24 	the client;
21.25 	(2) volunteer transport, which includes transportation by volunteers using their 
21.26 	own vehicle;
21.27 	(3) unassisted transport, which includes transportation provided to a client by a 
21.28 	taxicab or public transit. If a taxicab or publicly operated transit system is not available, 
21.29 	the client can receive transportation from another nonemergency medical transportation 
21.30 	provider;
21.31 	(4) assisted transport, which includes transport provided to clients who require 
21.32 	assistance by a nonemergency medical transportation provider;
21.33 	(5) lift-equipped/ramp transport, which includes transport provided to a client who 
21.34 	is dependent on a device and requires a nonemergency medical transportation provider 
21.35 	with a vehicle containing a lift or ramp;
22.1 	(6) protected transport, which includes transport to a client who has received a 
22.2 	prescreening that has deemed other forms of transportation inappropriate and who requires 
22.3 	a provider certified as a protected transport provider; and
22.4 	(7) stretcher transport, which includes transport for a client in a prone or supine 
22.5 	position and requires a nonemergency medical transportation provider with a vehicle that 
22.6 	can transport a client in a prone or supine position.
22.7 	(i) In accordance with subdivision 18e, by July 1, 2016, The local agency shall be 
22.8 	the single administrative agency and shall administer and reimburse for modes defined in 
22.9 	paragraph (h) according to a new rate structure, once this is adopted when the commissioner 
22.10 	has developed, made available, and funded the Web-based single administrative structure, 
22.11 	assessment tool, and level of need assessment under subdivision 18e. The local agency's 
22.12 	financial obligation is limited to funds provided by the state or the federal government.
22.13 	(j) The commissioner shall:
22.14 	(1) in consultation with the Nonemergency Medical Transportation Advisory 
22.15 	Committee, verify that the mode and use of nonemergency medical transportation is 
22.16 	appropriate;
22.17 	(2) verify that the client is going to an approved medical appointment; and
22.18 	(3) investigate all complaints and appeals.
22.19 	(k) The administrative agency shall pay for the services provided in this subdivision 
22.20 	and seek reimbursement from the commissioner, if appropriate. As vendors of medical 
22.21 	care, local agencies are subject to the provisions in section 256B.041, the sanctions and 
22.22 	monetary recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 
22.23 	to 9505.2245.
22.24 	(l) The base rates for special transportation services in areas defined under RUCA to 
22.25 	be super rural shall be equal to the reimbursement rate established in paragraph (f), clause 
22.26 	(1), plus 11.3 percent, and for special transportation services in areas defined under RUCA 
22.27 	to be rural or super rural areas:
22.28 	(1) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
22.29 	percent of the respective mileage rate in paragraph (f), clause (1); and
22.30 	(2) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
22.31 	112.5 percent of the respective mileage rate in paragraph (f), clause (1).
22.32 	(m) For purposes of reimbursement rates for special transportation services under 
22.33 	paragraph (c), the zip code of the recipient's place of residence shall determine whether 
22.34 	the urban, rural, or super rural reimbursement rate applies.
23.1 	(n) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
23.2 	means a census-tract based classification system under which a geographical area is 
23.3 	determined to be urban, rural, or super rural.
23.4 	(o) Effective for services provided on or after September 1, 2011, nonemergency 
23.5 	transportation rates, including special transportation, taxi, and other commercial carriers, 
23.6 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
23.7 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
23.8 	to reflect this reduction.

23.9 	Sec. 13. Minnesota Statutes 2014, section 256B.0625, subdivision 28a, is amended to 
23.10 	read:
23.11 		Subd. 28a.Licensed physician assistant services. (a) Medical assistance covers 
23.12 	services performed by a licensed physician assistant if the service is otherwise covered 
23.13 	under this chapter as a physician service and if the service is within the scope of practice 
23.14 	of a licensed physician assistant as defined in section 147A.09.
23.15 	(b) Licensed physician assistants, who are supervised by a physician certified by 
23.16 	the American Board of Psychiatry and Neurology or eligible for board certification in 
23.17 	psychiatry, may bill for medication management and evaluation and management services 
23.18 	provided to medical assistance enrollees in inpatient hospital settings, and in outpatient 
23.19 	settings after the licensed physician assistant completes 2,000 hours of clinical experience 
23.20 	in the evaluation and treatment of mental health, consistent with their authorized scope of 
23.21 	practice, as defined in section 147A.09, with the exception of performing psychotherapy 
23.22 	or diagnostic assessments or providing clinical supervision.

23.23 	Sec. 14. Minnesota Statutes 2014, section 256B.0625, subdivision 31, is amended to 
23.24 	read:
23.25 		Subd. 31.Medical supplies and equipment. (a) Medical assistance covers medical 
23.26 	supplies and equipment. Separate payment outside of the facility's payment rate shall 
23.27 	be made for wheelchairs and wheelchair accessories for recipients who are residents 
23.28 	of intermediate care facilities for the developmentally disabled. Reimbursement for 
23.29 	wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same 
23.30 	conditions and limitations as coverage for recipients who do not reside in institutions. A 
23.31 	wheelchair purchased outside of the facility's payment rate is the property of the recipient. 
23.32 	The commissioner may set reimbursement rates for specified categories of medical 
23.33 	supplies at levels below the Medicare payment rate.
24.1 	(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies 
24.2 	must enroll as a Medicare provider.
24.3 	(c) When necessary to ensure access to durable medical equipment, prosthetics, 
24.4 	orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare 
24.5 	enrollment requirement if:
24.6 	(1) the vendor supplies only one type of durable medical equipment, prosthetic, 
24.7 	orthotic, or medical supply;
24.8 	(2) the vendor serves ten or fewer medical assistance recipients per year;
24.9 	(3) the commissioner finds that other vendors are not available to provide same or 
24.10 	similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
24.11 	(4) the vendor complies with all screening requirements in this chapter and Code of 
24.12 	Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from 
24.13 	the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare 
24.14 	and Medicaid Services approved national accreditation organization as complying with 
24.15 	the Medicare program's supplier and quality standards and the vendor serves primarily 
24.16 	pediatric patients.
24.17 	(d) Durable medical equipment means a device or equipment that:
24.18 	(1) can withstand repeated use;
24.19 	(2) is generally not useful in the absence of an illness, injury, or disability; and
24.20 	(3) is provided to correct or accommodate a physiological disorder or physical 
24.21 	condition or is generally used primarily for a medical purpose.
24.22 	(e) Electronic tablets may be considered durable medical equipment if the electronic 
24.23 	tablet will be used as an augmentative and alternative communication system as defined 
24.24 	under subdivision 31a, paragraph (a). To be covered by medical assistance, the device 
24.25 	must be locked in order to prevent use not related to communication.

24.26 	Sec. 15. Minnesota Statutes 2014, section 256B.0625, subdivision 58, is amended to 
24.27 	read:
24.28 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 24.29 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
24.30 	(EPSDT). The payment amount for a complete EPSDT screening shall not include charges 
24.31 	for vaccines health care services and products that are available at no cost to the provider 
24.32 	and shall not exceed the rate established per Minnesota Rules, part 9505.0445, item M, 
24.33 	effective October 1, 2010.

25.1 	Sec. 16. Minnesota Statutes 2014, section 256B.0631, is amended to read:
25.2 	256B.0631 MEDICAL ASSISTANCE CO-PAYMENTS.
25.3 		Subdivision 1.Cost-sharing. (a) Except as provided in subdivision 2, the medical 
25.4 	assistance benefit plan shall include the following cost-sharing for all recipients, effective 
25.5 	for services provided on or after September 1, 2011:
25.6 	(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 
25.7 	of this subdivision, a visit means an episode of service which is required because of 
25.8 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
25.9 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
25.10 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
25.11 	(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that 
25.12 	this co-payment shall be increased to $20 upon federal approval;
25.13 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
25.14 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
25.15 	shall apply to antipsychotic drugs when used for the treatment of mental illness;
25.16 	(4) effective January 1, 2012, a family deductible equal to the maximum amount 
25.17 	allowed under Code of Federal Regulations, title 42, part 447.54 $2.75 per month per 
25.18 	family and adjusted annually by the percentage increase in the medical care component 
25.19 	of the CPI-U for the period of September to September of the preceding calendar year, 
25.20 	rounded to the next higher five-cent increment; and
25.21 	(5) for individuals identified by the commissioner with income at or below 100 
25.22 	percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five 
25.23 	percent of family income. For purposes of this paragraph, family income is the total 
25.24 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
25.25 	enrolled in medical assistance and also subject to the five percent limit on cost-sharing. 
25.26 	This paragraph does not apply to premiums charged to individuals described under section 
25.27 	256B.057, subdivision 9.
25.28 	(b) Recipients of medical assistance are responsible for all co-payments and 
25.29 	deductibles in this subdivision.
25.30 	(c) Notwithstanding paragraph (b), the commissioner, through the contracting 
25.31 	process under sections 256B.69 and 256B.692, may allow managed care plans and 
25.32 	county-based purchasing plans to waive the family deductible under paragraph (a), 
25.33 	clause (4). The value of the family deductible shall not be included in the capitation 
25.34 	payment to managed care plans and county-based purchasing plans. Managed care plans 
25.35 	and county-based purchasing plans shall certify annually to the commissioner the dollar 
25.36 	value of the family deductible.
26.1 	(d) Notwithstanding paragraph (b), the commissioner may waive the collection of 
26.2 	the family deductible described under paragraph (a), clause (4), from individuals and 
26.3 	allow long-term care and waivered service providers to assume responsibility for payment.
26.4 	(e) Notwithstanding paragraph (b), the commissioner, through the contracting 
26.5 	process under section 256B.0756 shall allow the pilot program in Hennepin County to 
26.6 	waive co-payments. The value of the co-payments shall not be included in the capitation 
26.7 	payment amount to the integrated health care delivery networks under the pilot program.
26.8 		Subd. 2.Exceptions. Co-payments and deductibles shall be subject to the following 
26.9 	exceptions:
26.10 	(1) children under the age of 21;
26.11 	(2) pregnant women for services that relate to the pregnancy or any other medical 
26.12 	condition that may complicate the pregnancy;
26.13 	(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 
26.14 	intermediate care facility for the developmentally disabled;
26.15 	(4) recipients receiving hospice care;
26.16 	(5) 100 percent federally funded services provided by an Indian health service;
26.17 	(6) emergency services;
26.18 	(7) family planning services;
26.19 	(8) services that are paid by Medicare, resulting in the medical assistance program 
26.20 	paying for the coinsurance and deductible;
26.21 	(9) co-payments that exceed one per day per provider for nonpreventive visits, 
26.22 	eyeglasses, and nonemergency visits to a hospital-based emergency room; and
26.23 	(10) services, fee-for-service payments subject to volume purchase through 
26.24 	competitive bidding.;
26.25 	(11) American Indians who meet the requirements in Code of Federal Regulations, 
26.26 	title 42, section 447.51;
26.27 	(12) persons needing treatment for breast or cervical cancer as described under 
26.28 	section 256B.057, subdivision 10; and
26.29 	(13) services that currently have a rating of A or B from the United States Preventive 
26.30 	Services Task Force (USPSTF), immunizations recommended by the Advisory Committee 
26.31 	on Immunization Practices of the Centers for Disease Control and Prevention, and 
26.32 	preventive services and screenings provided to women as described in Code of Federal 
26.33 	Regulations, title 45, section 147.130.
26.34 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider shall 
26.35 	be reduced by the amount of the co-payment or deductible, except that reimbursements 
26.36 	shall not be reduced:
27.1 	(1) once a recipient has reached the $12 per month maximum for prescription drug 
27.2 	co-payments; or
27.3 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
27.4 	poverty guidelines who has met their monthly five percent cost-sharing limit.
27.5 	(b) The provider collects the co-payment or deductible from the recipient. Providers 
27.6 	may not deny services to recipients who are unable to pay the co-payment or deductible.
27.7 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
27.8 	managed care plans shall not be increased as a result of the removal of co-payments or 
27.9 	deductibles effective on or after January 1, 2009.

27.10 	EFFECTIVE DATE. The amendment to subdivision 1, paragraph (a), clause (4), is 
27.11 	effective retroactively from January 1, 2014.

27.12 	Sec. 17. Minnesota Statutes 2014, section 256B.0644, is amended to read:
27.13 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
27.14 	PROGRAMS.
27.15 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 
27.16 	health maintenance organization, as defined in chapter 62D, must participate as a provider 
27.17 	or contractor in the medical assistance program and MinnesotaCare as a condition of 
27.18 	participating as a provider in health insurance plans and programs or contractor for state 
27.19 	employees established under section 43A.18, the public employees insurance program 
27.20 	under section 43A.316, for health insurance plans offered to local statutory or home 
27.21 	rule charter city, county, and school district employees, the workers' compensation 
27.22 	system under section 176.135, and insurance plans provided through the Minnesota 
27.23 	Comprehensive Health Association under sections 62E.01 to 62E.19. The limitations 
27.24 	on insurance plans offered to local government employees shall not be applicable in 
27.25 	geographic areas where provider participation is limited by managed care contracts 
27.26 	with the Department of Human Services. This section does not apply to dental service 
27.27 	providers providing dental services outside the seven-county metropolitan area.
27.28 	(b) For providers other than health maintenance organizations, participation in the 
27.29 	medical assistance program means that:
27.30 	(1) the provider accepts new medical assistance and MinnesotaCare patients;
27.31 	(2) for providers other than dental service providers, at least 20 percent of the 
27.32 	provider's patients are covered by medical assistance and MinnesotaCare as their primary 
27.33 	source of coverage; or
28.1 	(3) for dental service providers providing dental services in the seven-county 
28.2 	metropolitan area, at least ten percent of the provider's patients are covered by medical 
28.3 	assistance and MinnesotaCare as their primary source of coverage, or the provider accepts 
28.4 	new medical assistance and MinnesotaCare patients who are children with special health 
28.5 	care needs. For purposes of this section, "children with special health care needs" means 
28.6 	children up to age 18 who: (i) require health and related services beyond that required 
28.7 	by children generally; and (ii) have or are at risk for a chronic physical, developmental, 
28.8 	behavioral, or emotional condition, including: bleeding and coagulation disorders; 
28.9 	immunodeficiency disorders; cancer; endocrinopathy; developmental disabilities; 
28.10 	epilepsy, cerebral palsy, and other neurological diseases; visual impairment or deafness; 
28.11 	Down syndrome and other genetic disorders; autism; fetal alcohol syndrome; and other 
28.12 	conditions designated by the commissioner after consultation with representatives of 
28.13 	pediatric dental providers and consumers.
28.14 	(c) Patients seen on a volunteer basis by the provider at a location other than 
28.15 	the provider's usual place of practice may be considered in meeting the participation 
28.16 	requirement in this section. The commissioner shall establish participation requirements 
28.17 	for health maintenance organizations. The commissioner shall provide lists of participating 
28.18 	medical assistance providers on a quarterly basis to the commissioner of management and 
28.19 	budget, the commissioner of labor and industry, and the commissioner of commerce. Each 
28.20 	of the commissioners shall develop and implement procedures to exclude as participating 
28.21 	providers in the program or programs under their jurisdiction those providers who do 
28.22 	not participate in the medical assistance program. The commissioner of management 
28.23 	and budget shall implement this section through contracts with participating health and 
28.24 	dental carriers.
28.25 	(d) A volunteer dentist who has signed a volunteer agreement under section 
28.26 	256B.0625, subdivision 9a, shall not be considered to be participating in medical 
28.27 	assistance or MinnesotaCare for the purpose of this section.

28.28 	EFFECTIVE DATE. This section is effective upon receipt of any necessary federal 
28.29 	waiver or approval. The commissioner of human services shall notify the revisor of 
28.30 	statutes if a federal waiver or approval is sought and, if sought, when a federal waiver 
28.31 	or approval is obtained.

28.32 	Sec. 18. [256B.0758] HEALTH CARE DELIVERY PILOT PROGRAM.
28.33 	(a) The commissioner may establish a health care delivery pilot program to test 
28.34 	alternative and innovative integrated health care delivery networks, including accountable 
28.35 	care organizations or a community-based collaborative care network created by or 
29.1 	including North Memorial Health Care. If required, the commissioner shall seek federal 
29.2 	approval of a new waiver request or amend an existing demonstration pilot project waiver.
29.3 	(b) Individuals eligible for the pilot program shall be individuals who are eligible for 
29.4 	medical assistance under section 256B.055. The commissioner may identify individuals 
29.5 	to be enrolled in the pilot program based on zip code or whether the individuals would 
29.6 	benefit from an integrated health care delivery network.
29.7 	(c) In developing a payment system for the pilot programs, the commissioner shall 
29.8 	establish a total cost of care for the individuals enrolled in the pilot program that equals 
29.9 	the cost of care that would otherwise be spent for these enrollees in the prepaid medical 
29.10 	assistance program.

29.11 	Sec. 19. Minnesota Statutes 2014, section 256B.69, subdivision 5a, is amended to read:
29.12 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
29.13 	and section 256L.12 shall be entered into or renewed on a calendar year basis. The 
29.14 	commissioner may issue separate contracts with requirements specific to services to 
29.15 	medical assistance recipients age 65 and older.
29.16 	(b) A prepaid health plan providing covered health services for eligible persons 
29.17 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
29.18 	contract with the commissioner. Requirements applicable to managed care programs 
29.19 	under chapters 256B and 256L established after the effective date of a contract with the 
29.20 	commissioner take effect when the contract is next issued or renewed.
29.21 	(c) The commissioner shall withhold five percent of managed care plan payments 
29.22 	under this section and county-based purchasing plan payments under section 256B.692 
29.23 	for the prepaid medical assistance program pending completion of performance targets. 
29.24 	Each performance target must be quantifiable, objective, measurable, and reasonably 
29.25 	attainable, except in the case of a performance target based on a federal or state law 
29.26 	or rule. Criteria for assessment of each performance target must be outlined in writing 
29.27 	prior to the contract effective date. Clinical or utilization performance targets and their 
29.28 	related criteria must consider evidence-based research and reasonable interventions when 
29.29 	available or applicable to the populations served, and must be developed with input from 
29.30 	external clinical experts and stakeholders, including managed care plans, county-based 
29.31 	purchasing plans, and providers. The managed care or county-based purchasing plan 
29.32 	must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
29.33 	attainment of the performance target is accurate. The commissioner shall periodically 
29.34 	change the administrative measures used as performance targets in order to improve plan 
29.35 	performance across a broader range of administrative services. The performance targets 
30.1 	must include measurement of plan efforts to contain spending on health care services and 
30.2 	administrative activities. The commissioner may adopt plan-specific performance targets 
30.3 	that take into account factors affecting only one plan, including characteristics of the 
30.4 	plan's enrollee population. The withheld funds must be returned no sooner than July of the 
30.5 	following year if performance targets in the contract are achieved. The commissioner may 
30.6 	exclude special demonstration projects under subdivision 23.
30.7 	(d) The commissioner shall require that managed care plans use the assessment and 
30.8 	authorization processes, forms, timelines, standards, documentation, and data reporting 
30.9 	requirements, protocols, billing processes, and policies consistent with medical assistance 
30.10 	fee-for-service or the Department of Human Services contract requirements consistent 
30.11 	with medical assistance fee-for-service or the Department of Human Services contract 
30.12 	requirements for all personal care assistance services under section 256B.0659.
30.13 	(e) Effective for services rendered on or after January 1, 2012, the commissioner 
30.14 	shall include as part of the performance targets described in paragraph (c) a reduction 
30.15 	in the health plan's emergency department utilization rate for medical assistance and 
30.16 	MinnesotaCare enrollees, as determined by the commissioner. For 2012, the reduction 
30.17 	shall be based on the health plan's utilization in 2009. To earn the return of the withhold 
30.18 	each subsequent year, the managed care plan or county-based purchasing plan must 
30.19 	achieve a qualifying reduction of no less than ten percent of the plan's emergency 
30.20 	department utilization rate for medical assistance and MinnesotaCare enrollees, excluding 
30.21 	enrollees in programs described in subdivisions 23 and 28, compared to the previous 
30.22 	measurement year until the final performance target is reached. When measuring 
30.23 	performance, the commissioner must consider the difference in health risk in a managed 
30.24 	care or county-based purchasing plan's membership in the baseline year compared to the 
30.25 	measurement year, and work with the managed care or county-based purchasing plan to 
30.26 	account for differences that they agree are significant.
30.27 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
30.28 	of the following calendar year if the managed care plan or county-based purchasing plan 
30.29 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
30.30 	was achieved. The commissioner shall structure the withhold so that the commissioner 
30.31 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
30.32 	in utilization less than the targeted amount.
30.33 	The withhold described in this paragraph shall continue for each consecutive contract 
30.34 	period until the plan's emergency room utilization rate for state health care program 
30.35 	enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical 
30.36 	assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate 
31.1 	with the health plans in meeting this performance target and shall accept payment 
31.2 	withholds that may be returned to the hospitals if the performance target is achieved.
31.3 	(f) Effective for services rendered on or after January 1, 2012, the commissioner 
31.4 	shall include as part of the performance targets described in paragraph (c) a reduction 
31.5 	in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 
31.6 	enrollees, as determined by the commissioner. To earn the return of the withhold each 
31.7 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
31.8 	reduction of no less than five percent of the plan's hospital admission rate for medical 
31.9 	assistance and MinnesotaCare enrollees, excluding enrollees in programs described in 
31.10 	subdivisions 23 and 28, compared to the previous calendar year until the final performance 
31.11 	target is reached. When measuring performance, the commissioner must consider the 
31.12 	difference in health risk in a managed care or county-based purchasing plan's membership 
31.13 	in the baseline year compared to the measurement year, and work with the managed care 
31.14 	or county-based purchasing plan to account for differences that they agree are significant.
31.15 	The withheld funds must be returned no sooner than July 1 and no later than July 
31.16 	31 of the following calendar year if the managed care plan or county-based purchasing 
31.17 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
31.18 	hospitalization rate was achieved. The commissioner shall structure the withhold so that 
31.19 	the commissioner returns a portion of the withheld funds in amounts commensurate with 
31.20 	achieved reductions in utilization less than the targeted amount.
31.21 	The withhold described in this paragraph shall continue until there is a 25 percent 
31.22 	reduction in the hospital admission rate compared to the hospital admission rates in 
31.23 	calendar year 2011, as determined by the commissioner. The hospital admissions in this 
31.24 	performance target do not include the admissions applicable to the subsequent hospital 
31.25 	admission performance target under paragraph (g). Hospitals shall cooperate with the 
31.26 	plans in meeting this performance target and shall accept payment withholds that may be 
31.27 	returned to the hospitals if the performance target is achieved.
31.28 	(g) Effective for services rendered on or after January 1, 2012, the commissioner 
31.29 	shall include as part of the performance targets described in paragraph (c) a reduction in 
31.30 	the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of 
31.31 	a previous hospitalization of a patient regardless of the reason, for medical assistance and 
31.32 	MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 
31.33 	withhold each year, the managed care plan or county-based purchasing plan must achieve 
31.34 	a qualifying reduction of the subsequent hospitalization rate for medical assistance and 
31.35 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 
32.1 	and 28, of no less than five percent compared to the previous calendar year until the 
32.2 	final performance target is reached.
32.3 	The withheld funds must be returned no sooner than July 1 and no later than July 
32.4 	31 of the following calendar year if the managed care plan or county-based purchasing 
32.5 	plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in 
32.6 	the subsequent hospitalization rate was achieved. The commissioner shall structure the 
32.7 	withhold so that the commissioner returns a portion of the withheld funds in amounts 
32.8 	commensurate with achieved reductions in utilization less than the targeted amount.
32.9 	The withhold described in this paragraph must continue for each consecutive 
32.10 	contract period until the plan's subsequent hospitalization rate for medical assistance and 
32.11 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 
32.12 	and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar 
32.13 	year 2011. Hospitals shall cooperate with the plans in meeting this performance target and 
32.14 	shall accept payment withholds that must be returned to the hospitals if the performance 
32.15 	target is achieved.
32.16 	(h) Effective for services rendered on or after January 1, 2013, through December 
32.17 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
32.18 	under this section and county-based purchasing plan payments under section 256B.692 
32.19 	for the prepaid medical assistance program. The withheld funds must be returned no 
32.20 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
32.21 	exclude special demonstration projects under subdivision 23.
32.22 	(i) Effective for services rendered on or after January 1, 2014, the commissioner 
32.23 	shall withhold three percent of managed care plan payments under this section and 
32.24 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
32.25 	assistance program. The withheld funds must be returned no sooner than July 1 and 
32.26 	no later than July 31 of the following year. The commissioner may exclude special 
32.27 	demonstration projects under subdivision 23.
32.28 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 
32.29 	may include as admitted assets under section 62D.044 any amount withheld under this 
32.30 	section that is reasonably expected to be returned.
32.31 	(k) Contracts between the commissioner and a prepaid health plan are exempt from 
32.32 	the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
32.33 	(a), and 7.
32.34 	(l) The return of the withhold under paragraphs (h) and (i) is not subject to the 
32.35 	requirements of paragraph (c).
33.1 	(m) Managed care plans and county-based purchasing plans shall maintain current 
33.2 	and fully executed agreements for all subcontractors, including bargaining groups, for 
33.3 	administrative services that are expensed to the state's public programs. Subcontractor 
33.4 	agreements of over $200,000 in annual payments must be in the form of a written 
33.5 	instrument or electronic document containing the elements of offer, acceptance, and 
33.6 	consideration, and must clearly indicate how the agreements relate to state public 
33.7 	programs. Upon request, the commissioner shall have access to all subcontractor 
33.8 	documentation under this paragraph. Nothing in this paragraph shall allow release of 
33.9 	information that is nonpublic data pursuant to section 13.02.

33.10 	Sec. 20. Minnesota Statutes 2014, section 256B.69, subdivision 5i, is amended to read:
33.11 		Subd. 5i.Administrative expenses. (a) Managed care plan and county-based 
33.12 	purchasing plan Administrative costs for a prepaid health plan provided paid to managed 
33.13 	care plans and county-based purchasing plans under this section or, section 256B.692, and 
33.14 	section 256L.12 must not exceed by more than five 6.6 percent that prepaid health plan's or 
33.15 	county-based purchasing plan's actual calculated administrative spending for the previous 
33.16 	calendar year as a percentage of total revenue of total payments expected to be made to 
33.17 	all managed care plans and county-based purchasing plans in aggregate across all state 
33.18 	public programs at the beginning of each calendar year. The penalty for exceeding this 
33.19 	limit must be the amount of administrative spending in excess of 105 percent of the actual 
33.20 	calculated amount. The commissioner may waive this penalty if the excess administrative 
33.21 	spending is the result of unexpected shifts in enrollment or member needs or new program 
33.22 	requirements. The commissioner may reduce or eliminate administrative requirements to 
33.23 	meet the administrative cost limit. For purposes of this paragraph, administrative costs do 
33.24 	not include any state or federal taxes, surcharges, or assessments.
33.25 	(b) The following expenses are not allowable administrative expenses for rate-setting 
33.26 	purposes under this section:
33.27 	(1) charitable contributions made by the managed care plan or the county-based 
33.28 	purchasing plan;
33.29 	(2) any portion of an individual's compensation in excess of $200,000 paid by the 
33.30 	managed care plan or county-based purchasing plan compensation of individuals within 
33.31 	the organization, other than the medical director, in excess of $200,000 such that the 
33.32 	allocation of compensation for an individual across all state public programs in total 
33.33 	cannot exceed $200,000;
33.34 	(3) any penalties or fines assessed against the managed care plan or county-based 
33.35 	purchasing plan; and
34.1 	(4) any indirect marketing or advertising expenses of the managed care plan or 
34.2 	county-based purchasing plan. for marketing that does not specifically target state public 
34.3 	programs beneficiaries and that has not been approved by the commissioner;
34.4 	(5) any lobbying and political activities, events, or contributions;
34.5 	(6) administrative expenses related to the provision of services not covered under 
34.6 	the state plan or waiver;
34.7 	(7) alcoholic beverages and related costs;
34.8 	(8) membership in any social, dining, or country club or organization; and
34.9 	(9) entertainment, including amusement, diversion, and social activities, and any 
34.10 	costs directly associated with these costs, including but not limited to tickets to shows or 
34.11 	sporting events, meals, lodging, rentals, transportation, and gratuities.
34.12 	For the purposes of this subdivision, compensation includes salaries, bonuses and 
34.13 	incentives, other reportable compensation on an IRS 990 form, retirement and other 
34.14 	deferred compensation, and nontaxable benefits. Contributions include payments for 
34.15 	or to any organization or entity selected by the health maintenance organization that 
34.16 	is operated for charitable, educational, political, religious, or scientific purposes and 
34.17 	not related to the provision of medical and administrative services covered under the 
34.18 	state public programs, except to the extent that they improve access to or the quality of 
34.19 	covered services for state public programs beneficiaries, or improve the health status of 
34.20 	state public programs beneficiaries.
34.21 	(c) Administrative expenses must be reported using the formats designated by the 
34.22 	commissioner as part of the rate-setting process and must include, at a minimum, the 
34.23 	following categories:
34.24 	(1) employee benefit expenses;
34.25 	(2) sales expenses;
34.26 	(3) general business and office expenses;
34.27 	(4) taxes and assessments;
34.28 	(5) consulting and professional fees; and
34.29 	(6) outsourced services.
34.30 	Definitions of items to be included in each category shall be provided by the commissioner 
34.31 	with quarterly financial filing requirements and shall be aligned with definitions used 
34.32 	by the Departments of Commerce and Health in financial reporting for commercial 
34.33 	carriers. Where reasonably possible, expenses for an administrative item shall be directly 
34.34 	allocated so as to assign costs for an item to an individual state public program when the 
34.35 	cost can be specifically identified with and benefits the individual state public program. 
34.36 	For administrative services expensed to the state's public programs, managed care plans 
35.1 	and county-based purchasing plans must clearly identify and separately record expense 
35.2 	items listed under paragraph (b) in their accounting systems in a manner that allows for 
35.3 	independent verification of unallowable expenses for purposes of determining payment 
35.4 	rates for state public programs.
35.5 	(d) The administrative expenses requirement of this subdivision also apply to 
35.6 	demonstration providers under section 256B.0755.

35.7 	Sec. 21. Minnesota Statutes 2014, section 256B.69, subdivision 9c, is amended to read:
35.8 		Subd. 9c.Managed care financial reporting. (a) The commissioner shall collect 
35.9 	detailed data regarding financials, provider payments, provider rate methodologies, and 
35.10 	other data as determined by the commissioner. The commissioner, in consultation with the 
35.11 	commissioners of health and commerce, and in consultation with managed care plans and 
35.12 	county-based purchasing plans, shall set uniform criteria, definitions, and standards for the 
35.13 	data to be submitted, and shall require managed care and county-based purchasing plans 
35.14 	to comply with these criteria, definitions, and standards when submitting data under this 
35.15 	section. In carrying out the responsibilities of this subdivision, the commissioner shall 
35.16 	ensure that the data collection is implemented in an integrated and coordinated manner 
35.17 	that avoids unnecessary duplication of effort. To the extent possible, the commissioner 
35.18 	shall use existing data sources and streamline data collection in order to reduce public 
35.19 	and private sector administrative costs. Nothing in this subdivision shall allow release of 
35.20 	information that is nonpublic data pursuant to section 13.02.
35.21 	(b) Effective January 1, 2014, each managed care and county-based purchasing plan 
35.22 	must quarterly provide to the commissioner the following information on state public 
35.23 	programs, in the form and manner specified by the commissioner, according to guidelines 
35.24 	developed by the commissioner in consultation with managed care plans and county-based 
35.25 	purchasing plans under contract:
35.26 	(1) an income statement by program;
35.27 	(2) financial statement footnotes;
35.28 	(3) quarterly profitability by program and population group;
35.29 	(4) a medical liability summary by program and population group;
35.30 	(5) received but unpaid claims report by program;
35.31 	(6) services versus payment lags by program for hospital services, outpatient 
35.32 	services, physician services, other medical services, and pharmaceutical benefits;
35.33 	(7) utilization reports that summarize utilization and unit cost information by 
35.34 	program for hospitalization services, outpatient services, physician services, and other 
35.35 	medical services;
36.1 	(8) pharmaceutical statistics by program and population group for measures of price 
36.2 	and utilization of pharmaceutical services;
36.3 	(9) subcapitation expenses by population group;
36.4 	(10) third-party payments by program;
36.5 	(11) all new, active, and closed subrogation cases by program;
36.6 	(12) all new, active, and closed fraud and abuse cases by program;
36.7 	(13) medical loss ratios by program;
36.8 	(14) administrative expenses by category and subcategory by program that reconcile 
36.9 	to other state and federal regulatory agencies;
36.10 	(15) revenues by program, including investment income;
36.11 	(16) nonadministrative service payments, provider payments, and reimbursement 
36.12 	rates by provider type or service category, by program, paid by the managed care plan 
36.13 	under this section or the county-based purchasing plan under section 256B.692 to 
36.14 	providers and vendors for administrative services under contract with the plan, including 
36.15 	but not limited to:
36.16 	(i) individual-level provider payment and reimbursement rate data;
36.17 	(ii) provider reimbursement rate methodologies by provider type, by program, 
36.18 	including a description of alternative payment arrangements and payments outside the 
36.19 	claims process;
36.20 	(iii) data on implementation of legislatively mandated provider rate changes; and
36.21 	(iv) individual-level provider payment and reimbursement rate data and plan-specific 
36.22 	provider reimbursement rate methodologies by provider type, by program, including 
36.23 	alternative payment arrangements and payments outside the claims process, provided to 
36.24 	the commissioner under this subdivision are nonpublic data as defined in section 13.02;
36.25 	(17) data on the amount of reinsurance or transfer of risk by program; and
36.26 	(18) contribution to reserve, by program.
36.27 	(c) In the event a report is published or released based on data provided under 
36.28 	this subdivision, the commissioner shall provide the report to managed care plans and 
36.29 	county-based purchasing plans 15 days prior to the publication or release of the report. 
36.30 	Managed care plans and county-based purchasing plans shall have 15 days to review the 
36.31 	report and provide comment to the commissioner.
36.32 	The quarterly reports shall be submitted to the commissioner no later than 60 days after the 
36.33 	end of the previous quarter, except the fourth-quarter report, which shall be submitted by 
36.34 	April 1 of each year. The fourth-quarter report shall include audited financial statements, 
36.35 	parent company audited financial statements, an income statement reconciliation report, 
37.1 	and any other documentation necessary to reconcile the detailed reports to the audited 
37.2 	financial statements.
37.3 	(d) Managed care plans and county-based purchasing plans shall certify to the 
37.4 	commissioner, for the purpose of managed care financial reporting for state public 
37.5 	health care programs under this subdivision, that costs related to state public health care 
37.6 	programs include only services covered under the state plan and waivers, and related 
37.7 	allowable administrative expenses. Managed care plans and county-based purchasing 
37.8 	plans shall certify and report to the commissioner the dollar value of any unallowable and 
37.9 	nonstate plan services, including both medical and administrative expenditures, for the 
37.10 	purposes of managed care financial reporting under this subdivision.
37.11 	(e) The financial reporting requirements of this subdivision also apply to 
37.12 	demonstration providers under section 256B.0755.

37.13 	Sec. 22. Minnesota Statutes 2014, section 256B.69, subdivision 9d, is amended to read:
37.14 		Subd. 9d.Financial audit and quality assurance audits. (a) The legislative 
37.15 	auditor shall contract with an audit firm to conduct a biennial independent third-party 
37.16 	financial audit of the information required to be provided by managed care plans and 
37.17 	county-based purchasing plans under subdivision 9c, paragraph (b). The audit shall be 
37.18 	conducted in accordance with generally accepted government auditing standards issued 
37.19 	by the United States Government Accountability Office. The contract with the audit 
37.20 	firm shall be designed and administered so as to render the independent third-party audit 
37.21 	eligible for a federal subsidy, if available. The contract shall require the audit to include 
37.22 	a determination of compliance with the federal Medicaid rate certification process. The 
37.23 	contract shall require the audit to determine if the administrative expenses and investment 
37.24 	income reported by the managed care plans and county-based purchasing plans are 
37.25 	compliant with state and federal law.
37.26 	(b) For purposes of this subdivision, "independent third party" means an audit firm 
37.27 	that is independent in accordance with government auditing standards issued by the United 
37.28 	States Government Accountability Office and licensed in accordance with chapter 326A. 
37.29 	An audit firm under contract to provide services in accordance with this subdivision must 
37.30 	not have provided services to a managed care plan or county-based purchasing plan during 
37.31 	the period for which the audit is being conducted.
37.32 	(c)(a) The commissioner shall require, in the request for bids and resulting contracts 
37.33 	with managed care plans and county-based purchasing plans under this section and 
37.34 	section 256B.692, that each managed care plan and county-based purchasing plan submit 
37.35 	to and fully cooperate with the independent third-party financial audit audits by the 
38.1 	legislative auditor under subdivision 9e of the information required under subdivision 9c, 
38.2 	paragraph (b). Each contract with a managed care plan or county-based purchasing plan 
38.3 	under this section or section 256B.692 must provide the commissioner and the audit firm 
38.4 	vendors contracting with the legislative auditor access to all data required to complete 
38.5 	the audit. For purposes of this subdivision, the contracting audit firm shall have the same 
38.6 	investigative power as the legislative auditor under section 3.978, subdivision 2 audits 
38.7 	under subdivision 9e.
38.8 	(d)(b) Each managed care plan and county-based purchasing plan providing services 
38.9 	under this section shall provide to the commissioner biweekly encounter data and claims 
38.10 	data for state public health care programs and shall participate in a quality assurance 
38.11 	program that verifies the timeliness, completeness, accuracy, and consistency of the data 
38.12 	provided. The commissioner shall develop written protocols for the quality assurance 
38.13 	program and shall make the protocols publicly available. The commissioner shall contract 
38.14 	for an independent third-party audit to evaluate the quality assurance protocols as to 
38.15 	the capacity of the protocols to ensure complete and accurate data and to evaluate the 
38.16 	commissioner's implementation of the protocols. The audit firm under contract to provide 
38.17 	this evaluation must meet the requirements in paragraph (b).
38.18 	(e) Upon completion of the audit under paragraph (a) and receipt by the legislative 
38.19 	auditor, the legislative auditor shall provide copies of the audit report to the commissioner, 
38.20 	the state auditor, the attorney general, and the chairs and ranking minority members of the 
38.21 	health and human services finance committees of the legislature. (c) Upon completion 
38.22 	of the evaluation under paragraph (d) (b), the commissioner shall provide copies of the 
38.23 	report to the legislative auditor and the chairs and ranking minority members of the health 
38.24 	finance committees of the legislature legislative committees with jurisdiction over health 
38.25 	care policy and financing.
38.26 	(f)(d) Any actuary under contract with the commissioner to provide actuarial 
38.27 	services must meet the independence requirements under the professional code for fellows 
38.28 	in the Society of Actuaries and must not have provided actuarial services to a managed 
38.29 	care plan or county-based purchasing plan that is under contract with the commissioner 
38.30 	pursuant to this section and section 256B.692 during the period in which the actuarial 
38.31 	services are being provided. An actuary or actuarial firm meeting the requirements 
38.32 	of this paragraph must certify and attest to the rates paid to the managed care plans 
38.33 	and county-based purchasing plans under this section and section 256B.692, and the 
38.34 	certification and attestation must be auditable.
38.35 	(e) The commissioner may conduct ad hoc audits of the state public programs 
38.36 	administrative and medical expenses of managed care organizations and county-based 
39.1 	purchasing plans. This includes: financial and encounter data reported to the commissioner 
39.2 	under subdivision 9c, including payments to providers and subcontractors; supporting 
39.3 	documentation for expenditures; categorization of administrative and medical expenses; 
39.4 	and allocation methods used to attribute administrative expenses to state public programs. 
39.5 	These audits also must monitor compliance with data and financial certifications provided 
39.6 	to the commissioner for the purposes of managed care capitation payment rate-setting. 
39.7 	The managed care plans and county-based purchasing plans shall fully cooperate with the 
39.8 	audits in this subdivision.
39.9 	(g)(f) Nothing in this subdivision shall allow the release of information that is 
39.10 	nonpublic data pursuant to section 13.02.
39.11 	(g) The audit requirements of this subdivision also apply to demonstration providers 
39.12 	under section 256B.0755.

39.13 	Sec. 23. Minnesota Statutes 2014, section 256B.69, is amended by adding a 
39.14 	subdivision to read:
39.15 		Subd. 9e.Financial audits. (a) The legislative auditor shall contract with vendors 
39.16 	to conduct  independent third-party financial audits of the Department of Human Services' 
39.17 	use of the information required to be provided by managed care plans and county-based 
39.18 	purchasing plans under subdivision 9c, paragraph (b). The audits by the vendors shall 
39.19 	be conducted as vendor resources permit and in accordance with generally accepted 
39.20 	government auditing standards issued by the United States Government Accountability 
39.21 	Office. The contract with the vendors shall be designed and administered so as to render 
39.22 	the independent third-party audits eligible for a federal subsidy, if available. The contract 
39.23 	shall require the audits to include a determination of compliance by the Department of 
39.24 	Human Services with the federal Medicaid rate certification process.
39.25 	(b) For purposes of this subdivision, "independent third-party" means a vendor that 
39.26 	is independent in accordance with government auditing standards issued by the United 
39.27 	States Government Accountability Office.

39.28 	Sec. 24. Minnesota Statutes 2014, section 256B.75, is amended to read:
39.29 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
39.30 	(a) For outpatient hospital facility fee payments for services rendered on or after 
39.31 	October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 
39.32 	charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 
39.33 	services for which there is a federal maximum allowable payment. Effective for services 
39.34 	rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 
40.1 	facility fees and emergency room facility fees shall be increased by eight percent over the 
40.2 	rates in effect on December 31, 1999, except for those services for which there is a federal 
40.3 	maximum allowable payment. Services for which there is a federal maximum allowable 
40.4 	payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 
40.5 	allowable payment. Total aggregate payment for outpatient hospital facility fee services 
40.6 	shall not exceed the Medicare upper limit. If it is determined that a provision of this 
40.7 	section conflicts with existing or future requirements of the United States government with 
40.8 	respect to federal financial participation in medical assistance, the federal requirements 
40.9 	prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 
40.10 	avoid reduced federal financial participation resulting from rates that are in excess of 
40.11 	the Medicare upper limitations.
40.12 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 
40.13 	ambulatory surgery hospital facility fee services for critical access hospitals designated 
40.14 	under section 144.1483, clause (9), shall be paid on a cost-based payment system that is 
40.15 	based on the cost-finding methods and allowable costs of the Medicare program.
40.16 	(c) Effective for services provided on or after July 1, 2003, rates that are based 
40.17 	on the Medicare outpatient prospective payment system shall be replaced by a budget 
40.18 	neutral prospective payment system that is derived using medical assistance data. The 
40.19 	commissioner shall provide a proposal to the 2003 legislature to define and implement 
40.20 	this provision.
40.21 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
40.22 	before third-party liability and spenddown, made to hospitals for outpatient hospital 
40.23 	facility services is reduced by .5 percent from the current statutory rate.
40.24 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
40.25 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital 
40.26 	facility services before third-party liability and spenddown, is reduced five percent from 
40.27 	the current statutory rates. Facilities defined under section 256.969, subdivision 16, are 
40.28 	excluded from this paragraph.
40.29 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
40.30 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
40.31 	hospital facility services before third-party liability and spenddown, is reduced three 
40.32 	percent from the current statutory rates. Mental health services and facilities defined under 
40.33 	section 256.969, subdivision 16, are excluded from this paragraph.
40.34 	(g) Effective for services provided on or after July 1, 2015, rates established for 
40.35 	critical access hospitals under paragraph (b) for the applicable payment year shall be the 
40.36 	final payment and shall not be settled to actual costs.

41.1 	Sec. 25. Minnesota Statutes 2014, section 256B.76, subdivision 1, is amended to read:
41.2 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
41.3 	or after October 1, 1992, the commissioner shall make payments for physician services 
41.4 	as follows:
41.5 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
41.6 	procedural coding system codes titled "office and other outpatient services," "preventive 
41.7 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
41.8 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
41.9 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
41.10 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
41.11 	30, 1992. If the rate on any procedure code within these categories is different than the 
41.12 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
41.13 	then the larger rate shall be paid;
41.14 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
41.15 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
41.16 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
41.17 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
41.18 	except that payment rates for home health agency services shall be the rates in effect 
41.19 	on September 30, 1992.
41.20 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
41.21 	physician and professional services shall be increased by three percent over the rates 
41.22 	in effect on December 31, 1999, except for home health agency and family planning 
41.23 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
41.24 	for managed care.
41.25 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
41.26 	physician and professional services shall be reduced by five percent, except that for the 
41.27 	period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent 
41.28 	for the medical assistance and general assistance medical care programs, over the rates in 
41.29 	effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply 
41.30 	to office or other outpatient visits, preventive medicine visits and family planning visits 
41.31 	billed by physicians, advanced practice nurses, or physician assistants in a family planning 
41.32 	agency or in one of the following primary care practices: general practice, general internal 
41.33 	medicine, general pediatrics, general geriatrics, and family medicine. This reduction 
41.34 	and the reductions in paragraph (d) do not apply to federally qualified health centers, 
41.35 	rural health centers, and Indian health services. Effective October 1, 2009, payments 
42.1 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
42.2 	256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
42.3 	(d) Effective for services rendered on or after July 1, 2010, payment rates for 
42.4 	physician and professional services shall be reduced an additional seven percent over 
42.5 	the five percent reduction in rates described in paragraph (c). This additional reduction 
42.6 	does not apply to physical therapy services, occupational therapy services, and speech 
42.7 	pathology and related services provided on or after July 1, 2010. This additional reduction 
42.8 	does not apply to physician services billed by a psychiatrist or an advanced practice nurse 
42.9 	with a specialty in mental health. Effective October 1, 2010, payments made to managed 
42.10 	care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 
42.11 	256L.12 shall reflect the payment reduction described in this paragraph.
42.12 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 
42.13 	2013, payment rates for physician and professional services shall be reduced three percent 
42.14 	from the rates in effect on August 31, 2011. This reduction does not apply to physical 
42.15 	therapy services, occupational therapy services, and speech pathology and related services.
42.16 	(f) Effective for services rendered on or after September 1, 2014, payment rates for 
42.17 	physician and professional services, including physical therapy, occupational therapy, 
42.18 	speech pathology, and mental health services shall be increased by five percent from the 
42.19 	rates in effect on August 31, 2014. In calculating this rate increase, the commissioner 
42.20 	shall not include in the base rate for August 31, 2014, the rate increase provided under 
42.21 	section 256B.76, subdivision 7. This increase does not apply to federally qualified health 
42.22 	centers, rural health centers, and Indian health services. Payments made to managed 
42.23 	care plans and county-based purchasing plans shall not be adjusted to reflect payments 
42.24 	under this paragraph.
42.25 	(g) Effective for services rendered on or after July 1, 2015, payment rates for 
42.26 	physical therapy, occupational therapy, and speech pathology and related services provided 
42.27 	by a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph 
42.28 	(a), clause (4), shall be increased by 90 percent from the rates in effect on June 30, 2015. 
42.29 	Payments made to managed care plans and county-based purchasing plans shall not be 
42.30 	adjusted to reflect payments under this paragraph.

42.31 	Sec. 26. Minnesota Statutes 2014, section 256B.76, subdivision 2, is amended to read:
42.32 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after 
42.33 	October 1, 1992, the commissioner shall make payments for dental services as follows:
42.34 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
42.35 	percent above the rate in effect on June 30, 1992; and
43.1 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
43.2 	percentile of 1989, less the percent in aggregate necessary to equal the above increases.
43.3 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
43.4 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
43.5 	(c) Effective for services rendered on or after January 1, 2000, payment rates for 
43.6 	dental services shall be increased by three percent over the rates in effect on December 
43.7 	31, 1999.
43.8 	(d) Effective for services provided on or after January 1, 2002, payment for 
43.9 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
43.10 	lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
43.11 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 
43.12 	2000, for managed care.
43.13 	(f) Effective for dental services rendered on or after October 1, 2010, by a 
43.14 	state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 
43.15 	on the Medicare principles of reimbursement. This payment shall be effective for services 
43.16 	rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 
43.17 	county-based purchasing plans.
43.18 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 
43.19 	in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 
43.20 	year, a supplemental state payment equal to the difference between the total payments 
43.21 	in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 
43.22 	services for the operation of the dental clinics.
43.23 	(h) If the cost-based payment system for state-operated dental clinics described in 
43.24 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
43.25 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
43.26 	receive the critical access dental reimbursement rate as described under subdivision 4, 
43.27 	paragraph (a).
43.28 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 
43.29 	2013, payment rates for dental services shall be reduced by three percent. This reduction 
43.30 	does not apply to state-operated dental clinics in paragraph (f).
43.31 	(j) Effective for services rendered on or after January 1, 2014, payment rates for 
43.32 	dental services shall be increased by five percent from the rates in effect on December 
43.33 	31, 2013. This increase does not apply to state-operated dental clinics in paragraph (f), 
43.34 	federally qualified health centers, rural health centers, and Indian health services. Effective 
43.35 	January 1, 2014, payments made to managed care plans and county-based purchasing 
44.1 	plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase 
44.2 	described in this paragraph.
44.3 	(k) Effective for services rendered on or after July 1, 2015, payment rates for dental 
44.4 	services shall be increased by five percent from the rates in effect on June 30, 2015. This 
44.5 	increase does not apply to state-operated dental clinics in paragraph (f), federally qualified 
44.6 	health centers, rural health centers, and Indian health services. Effective January 1, 2016, 
44.7 	payments to managed care plans and county-based purchasing plans under sections 
44.8 	256B.69 and 256B.692 shall reflect the payment increase described in this paragraph.

44.9 	Sec. 27. Minnesota Statutes 2014, section 256B.762, is amended to read:
44.10 	256B.762 REIMBURSEMENT FOR HEALTH CARE SERVICES.
44.11 	(a) Effective for services provided on or after October 1, 2005, payment rates 
44.12 	for the following services shall be increased by five percent over the rates in effect on 
44.13 	September 30, 2005, when these services are provided as home health services under 
44.14 	section 256B.0625, subdivision 6a:
44.15 	(1) skilled nursing visit;
44.16 	(2) physical therapy visit;
44.17 	(3) occupational therapy visit;
44.18 	(4) speech therapy visit; and
44.19 	(5) home health aide visit.
44.20 	(b) Effective for services provided on or after July 1, 2015, payment rates for 
44.21 	managed care and fee-for-service visits for the following services shall be increased by 
44.22 	ten percent over the rates in effect on June 30, 2015, when these services are provided as 
44.23 	home health services under section 256B.0625, subdivision 6a:
44.24 	(1) physical therapy;
44.25 	(2) occupational therapy; and
44.26 	(3) speech therapy.
44.27 	The commissioner shall adjust managed care and county-based purchasing plan capitation 
44.28 	rates to reflect the payment rates under this paragraph.

44.29 	Sec. 28. Minnesota Statutes 2014, section 256B.766, is amended to read:
44.30 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
44.31 	(a) Effective for services provided on or after July 1, 2009, total payments for basic 
44.32 	care services, shall be reduced by three percent, except that for the period July 1, 2009, 
44.33 	through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical 
45.1 	assistance and general assistance medical care programs, prior to third-party liability and 
45.2 	spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical 
45.3 	therapy services, occupational therapy services, and speech-language pathology and 
45.4 	related services as basic care services. The reduction in this paragraph shall apply to 
45.5 	physical therapy services, occupational therapy services, and speech-language pathology 
45.6 	and related services provided on or after July 1, 2010.
45.7 	(b) Payments made to managed care plans and county-based purchasing plans shall 
45.8 	be reduced for services provided on or after October 1, 2009, to reflect the reduction 
45.9 	effective July 1, 2009, and payments made to the plans shall be reduced effective October 
45.10 	1, 2010, to reflect the reduction effective July 1, 2010.
45.11 	(c) Effective for services provided on or after September 1, 2011, through June 30, 
45.12 	2013, total payments for outpatient hospital facility fees shall be reduced by five percent 
45.13 	from the rates in effect on August 31, 2011.
45.14 	(d) Effective for services provided on or after September 1, 2011, through June 
45.15 	30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies 
45.16 	and durable medical equipment not subject to a volume purchase contract, prosthetics 
45.17 	and orthotics, renal dialysis services, laboratory services, public health nursing services, 
45.18 	physical therapy services, occupational therapy services, speech therapy services, 
45.19 	eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume 
45.20 	purchase contract, and anesthesia services shall be reduced by three percent from the 
45.21 	rates in effect on August 31, 2011.
45.22 	(e) Effective for services provided on or after September 1, 2014, payments 
45.23 	for ambulatory surgery centers facility fees, hospice services, renal dialysis services, 
45.24 	laboratory services, public health nursing services, eyeglasses not subject to a volume 
45.25 	purchase contract, and hearing aids not subject to a volume purchase contract shall be 
45.26 	increased by three percent and payments for outpatient hospital facility fees shall be 
45.27 	increased by three percent. Payments made to managed care plans and county-based 
45.28 	purchasing plans shall not be adjusted to reflect payments under this paragraph.
45.29 	(f) Payments for medical supplies and durable medical equipment not subject to a 
45.30 	volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, 
45.31 	through June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies 
45.32 	and durable medical equipment not subject to a volume purchase contract, and prosthetics 
45.33 	and orthotics, provided on or after July 1, 2015, shall be increased by three percent from 
45.34 	the rates in effect on June 30, 2014 as determined under paragraph (i).
45.35 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
45.36 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
46.1 	volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital 
46.2 	meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), 
46.3 	shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made 
46.4 	to managed care plans and county-based purchasing plans shall not be adjusted to reflect 
46.5 	payments under this paragraph.
46.6 	(h) This section does not apply to physician and professional services, inpatient 
46.7 	hospital services, family planning services, mental health services, dental services, 
46.8 	prescription drugs, medical transportation, federally qualified health centers, rural health 
46.9 	centers, Indian health services, and Medicare cost-sharing.
46.10 	(i) Effective July 1, 2015, the medical assistance payment rate for durable medical 
46.11 	equipment, prosthetics, orthotics, or supplies shall be restored to the January 1, 2008, 
46.12 	medical assistance fee schedule, updated to include subsequent rate increases in the 
46.13 	Medicare and medical assistance fee schedules, and including individually priced 
46.14 	items for the following categories: enteral nutrition and supplies, customized and other 
46.15 	specialized tracheostomy tubes and supplies, electric patient lifts, and durable medical 
46.16 	equipment repair and service. This paragraph does not apply to medical supplies and 
46.17 	durable medical equipment subject to a volume purchase contract, products subject to the 
46.18 	preferred diabetic testing supply program, and items provided to dually eligible recipients 
46.19 	when Medicare is the primary payer for the item.

46.20 	Sec. 29. Minnesota Statutes 2014, section 256B.767, is amended to read:
46.21 	256B.767 MEDICARE PAYMENT LIMIT.
46.22 	(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment 
46.23 	rates for physician and professional services under section 256B.76, subdivision 1, and 
46.24 	basic care services subject to the rate reduction specified in section 256B.766, shall not 
46.25 	exceed the Medicare payment rate for the applicable service, as adjusted for any changes 
46.26 	in Medicare payment rates after July 1, 2010. The commissioner shall implement this 
46.27 	section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates 
46.28 	under this section by first reducing or eliminating provider rate add-ons.
46.29 	(b) This section does not apply to services provided by advanced practice certified 
46.30 	nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter 
46.31 	147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates 
46.32 	for advanced practice certified nurse midwives and licensed traditional midwives shall 
46.33 	equal and shall not exceed the medical assistance payment rate to physicians for the 
46.34 	applicable service.
47.1 	(c) This section does not apply to mental health services or physician services billed 
47.2 	by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
47.3 	(d) Effective for durable medical equipment, prosthetics, orthotics, or supplies 
47.4 	provided on or after July 1, 2013, through June 30, 2015, the payment rate for items 
47.5 	that are subject to the rates established under Medicare's National Competitive Bidding 
47.6 	Program shall be equal to the rate that applies to the same item when not subject to the 
47.7 	rate established under Medicare's National Competitive Bidding Program. This paragraph 
47.8 	does not apply to mail-order diabetic supplies and does not apply to items provided to 
47.9 	dually eligible recipients when Medicare is the primary payer of the item.
47.10 	(d) Effective July 1, 2015, this section shall not apply to durable medical equipment, 
47.11 	prosthetics, orthotics, or supplies.
47.12 	(e) This section does not apply to physical therapy, occupational therapy, speech 
47.13 	pathology and related services, and basic care services provided by a hospital meeting the 
47.14 	criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4).

47.15 	Sec. 30. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to read:

47.16	Subd. 5.Basic Health Care Grants

47.17	(a) MinnesotaCare Grants

47.18	Health Care Access
		-0-
		(770,000)
	
47.19 	Incentive Program and Outreach Grants.
47.20 	Of the appropriation for the Minnesota health 
47.21 	care outreach program in Laws 2007, chapter 
47.22 	147, article 19, section 3, subdivision 7, 
47.23 	paragraph (b):
47.24 	(1) $400,000 in fiscal year 2009 from the 
47.25 	general fund and $200,000 in fiscal year 2009 
47.26 	from the health care access fund are for the 
47.27 	incentive program under Minnesota Statutes, 
47.28 	section 256.962, subdivision 5. For the 
47.29 	biennium beginning July 1, 2009, base level 
47.30 	funding for this activity shall be $360,000 
47.31 	from the general fund and $160,000 from the 
47.32 	health care access fund; and
48.1 	(2) $100,000 in fiscal year 2009 from the 
48.2 	general fund and $50,000 in fiscal year 2009 
48.3 	from the health care access fund are for the 
48.4 	outreach grants under Minnesota Statutes, 
48.5 	section 256.962, subdivision 2. For the 
48.6 	biennium beginning July 1, 2009, base level 
48.7 	funding for this activity shall be $90,000 
48.8 	from the general fund and $40,000 from the 
48.9 	health care access fund.

48.10
48.11	(b) MA Basic Health Care Grants - Families 
and Children
		-0-
		(17,280,000)
	
48.12 	Third-Party Liability. (a) During 
48.13 	fiscal year 2009, the commissioner shall 
48.14 	employ a contractor paid on a percentage 
48.15 	basis to improve third-party collections. 
48.16 	Improvement initiatives may include, but not 
48.17 	be limited to, efforts to improve postpayment 
48.18 	collection from nonresponsive claims and 
48.19 	efforts to uncover third-party payers the 
48.20 	commissioner has been unable to identify.
48.21 	(b) In fiscal year 2009, the first $1,098,000 
48.22 	of recoveries, after contract payments and 
48.23 	federal repayments, is appropriated to 
48.24 	the commissioner for technology-related 
48.25 	expenses.
48.26 	Administrative Costs. (a) For contracts 
48.27 	effective on or after January 1, 2009, 
48.28 	the commissioner shall limit aggregate 
48.29 	administrative costs paid to managed care 
48.30 	plans under Minnesota Statutes, section 
48.31 	256B.69, and to county-based purchasing 
48.32 	plans under Minnesota Statutes, section 
48.33 	256B.692, to an overall average of 6.6 percent 
48.34 	of total contract payments under Minnesota 
48.35 	Statutes, sections 256B.69 and 256B.692, 
48.36 	for each calendar year. For purposes of 
49.1 	this paragraph, administrative costs do not 
49.2 	include premium taxes paid under Minnesota 
49.3 	Statutes, section 297I.05, subdivision 5, and 
49.4 	provider surcharges paid under Minnesota 
49.5 	Statutes, section 256.9657, subdivision 3.
49.6 	(b) Notwithstanding any law to the contrary, 
49.7 	the commissioner may reduce or eliminate 
49.8 	administrative requirements to meet the 
49.9 	administrative target under paragraph (a). 
49.10 	(c) Notwithstanding any contrary provision 
49.11 	of this article, this rider shall not expire.
49.12 	Hospital Payment Delay. Notwithstanding 
49.13 	Laws 2005, First Special Session chapter 4, 
49.14 	article 9, section 2, subdivision 6, payments 
49.15 	from the Medicaid Management Information 
49.16 	System that would otherwise have been made 
49.17 	for inpatient hospital services for medical 
49.18 	assistance enrollees are delayed as follows: 
49.19 	(1) for fiscal year 2008, June payments must 
49.20 	be included in the first payments in fiscal 
49.21 	year 2009; and (2) for fiscal year 2009, 
49.22 	June payments must be included in the first 
49.23 	payment of fiscal year 2010. The provisions 
49.24 	of Minnesota Statutes, section 16A.124, 
49.25 	do not apply to these delayed payments. 
49.26 	Notwithstanding any contrary provision in 
49.27 	this article, this paragraph expires on June 
49.28 	30, 2010.

49.29
49.30	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		(14,028,000)
		(9,368,000)
	
49.31 	Minnesota Disability Health Options Rate 
49.32 	Setting Methodology. The commissioner 
49.33 	shall develop and implement a methodology 
49.34 	for risk adjusting payments for community 
49.35 	alternatives for disabled individuals (CADI) 
50.1 	and traumatic brain injury (TBI) home 
50.2 	and community-based waiver services 
50.3 	delivered under the Minnesota disability 
50.4 	health options program (MnDHO) effective 
50.5 	January 1, 2009. The commissioner shall 
50.6 	take into account the weighting system used 
50.7 	to determine county waiver allocations in 
50.8 	developing the new payment methodology. 
50.9 	Growth in the number of enrollees receiving 
50.10 	CADI or TBI waiver payments through 
50.11 	MnDHO is limited to an increase of 200 
50.12 	enrollees in each calendar year from January 
50.13 	2009 through December 2011. If those limits 
50.14 	are reached, additional members may be 
50.15 	enrolled in MnDHO for basic care services 
50.16 	only as defined under Minnesota Statutes, 
50.17 	section 256B.69, subdivision 28, and the 
50.18 	commissioner may establish a waiting list for 
50.19 	future access of MnDHO members to those 
50.20 	waiver services.
50.21 	MA Basic Elderly and Disabled 
50.22 	Adjustments. For the fiscal year ending June 
50.23 	30, 2009, the commissioner may adjust the 
50.24 	rates for each service affected by rate changes 
50.25 	under this section in such a manner across 
50.26 	the fiscal year to achieve the necessary cost 
50.27 	savings and minimize disruption to service 
50.28 	providers, notwithstanding the requirements 
50.29 	of Laws 2007, chapter 147, article 7, section 
50.30 	71.

50.31	(d) General Assistance Medical Care Grants
		-0-
		(6,971,000)

50.32	(e) Other Health Care Grants
		-0-
		(17,000)
	
50.33 	MinnesotaCare Outreach Grants Special 
50.34 	Revenue Account. The balance in the 
50.35 	MinnesotaCare outreach grants special 
51.1 	revenue account on July 1, 2009, estimated 
51.2 	to be $900,000, must be transferred to the 
51.3 	general fund.
51.4 	Grants Reduction. Effective July 1, 2008, 
51.5 	base level funding for nonforecast, general 
51.6 	fund health care grants issued under this 
51.7 	paragraph shall be reduced by 1.8 percent at 
51.8 	the allotment level.

51.9 	Sec. 31. REDUCTION IN ADMINISTRATIVE COSTS.
51.10 	The commissioner of human services, when contracting with managed care and 
51.11 	county-based purchasing plans for the provision of services under Minnesota Statutes, 
51.12 	sections 256B.69 and 256B.692, for calendar years 2016 and 2017, shall negotiate 
51.13 	reductions in managed care and county-based purchasing plan administrative costs, 
51.14 	sufficient to achieve a state medical assistance savings of $100,000,000 for the biennium 
51.15 	ending June 30, 2017.

51.16 	Sec. 32. ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
 51.17 		Subdivision 1.Duties. The commissioner of health shall reconvene the Advisory 
51.18 	Group on Administrative Expenses, established under Laws 2010, First Special Session 
51.19 	chapter 1, article 20, section 3, to develop detailed standards and procedures for examining 
51.20 	the reasonableness of administrative expenses by individual state public programs. 
51.21 	The advisory group shall develop consistent guidelines, definitions, and reporting 
51.22 	requirements, including a common standardized public reporting template for health 
51.23 	maintenance organizations and county-based purchasing plans that participate in state 
51.24 	public programs. The advisory group shall take into consideration relevant reporting 
51.25 	standards of the National Association of Insurance Commissioners and the Centers for 
51.26 	Medicare and Medicaid Services. The advisory group shall expire on January 1, 2016.
51.27 		Subd. 2.Membership. The advisory group shall be composed of the following 
51.28 	members, who serve at the pleasure of their appointing authority:
51.29 	(1) the commissioner of health or the commissioner's designee;
51.30 	(2) the commissioner of human services or the commissioner's designee;
51.31 	(3) the commissioner of commerce or the commissioner's designee; and
51.32 	(4) representatives of health maintenance organizations and county-based purchasing 
51.33 	plans appointed by the commissioner of health.

52.1 	Sec. 33. CAPITATION PAYMENT DELAY.
 52.2 	(a) The commissioner of human services shall delay $135,000,000 of the medical 
52.3 	assistance capitation payment to managed care plans and county-based purchasing plans 
52.4 	due in May 2017 and the payment due in April 2017 for special needs basic care until 
52.5 	July 1, 2017. The payment shall be made no earlier than July 1, 2017, and no later than 
52.6 	July 31, 2017.
52.7 	(b) The commissioner of human services shall delay $135,000,000 of the medical 
52.8 	assistance capitation payment to managed care plans and county-based purchasing plans 
52.9 	due in the second quarter of calendar year 2019 and the April 2019 payment for special 
52.10 	needs basic care until July 1, 2019. The payment shall be made no earlier than July 1, 
52.11 	2019, and no later than July 31, 2019.

52.12 	Sec. 34. HEALTH AND ECONOMIC ASSISTANCE PROGRAM ELIGIBILITY 
52.13 	VERIFICATION AUDIT SERVICES.
 52.14 		Subdivision 1.Request for proposals. By October 1, 2015, the commissioner of 
52.15 	human services shall issue a request for proposals for a contract to provide eligibility 
52.16 	verification audit services for benefits provided through health and economic assistance 
52.17 	programs. The request for proposals must require that the vendor:
52.18 	(1) conduct an eligibility verification audit of all health and economic assistance 
52.19 	program recipients that includes, but is not limited to, appropriate data matching against 
52.20 	relevant state and federal databases;
52.21 	(2) identify any ineligible recipients in these programs and report those findings 
52.22 	to the commissioner; and
52.23 	(3) identify a process for ongoing eligibility verification of health and economic 
52.24 	assistance program recipients and applicants, following the conclusion of the eligibility 
52.25 	verification audit required by this section.
52.26 		Subd. 2.Additional vendor criteria. The request for proposals must require the 
52.27 	vendor to provide the following minimum capabilities and experience in performing the 
52.28 	services described in subdivision 1:
52.29 	(1) a rules-based process for making objective eligibility determinations; 
52.30 	(2) assigned eligibility advocates to assist recipients through the verification process; 
52.31 	(3) a formal claims and appeals process; and 
52.32 	(4) experience in the performance of eligibility verification audits.
52.33 		Subd. 3.Contract required. (a) By January 1, 2016, the commissioner must enter 
52.34 	into a contract for the services specified in subdivision 1. The contract must:
53.1 	(1) incorporate performance-based vendor financing that compensates the vendor 
53.2 	based on the amount of savings generated by the work performed under the contract;
53.3 	(2) require the vendor to reimburse the commissioner and county agencies for all 
53.4 	reasonable costs incurred in implementing this section, out of savings generated by the 
53.5 	work performed under the contract;
53.6 	(3) require the vendor to comply with enrollee data privacy requirements and to use 
53.7 	encryption to safeguard enrollee identity; and
53.8 	(4) provide penalties for vendor noncompliance.
53.9 	(b) The commissioner may renew the contract for up to three additional one-year 
53.10 	periods.  The commissioner may require additional eligibility verification audits, if 
53.11 	the commissioner or the legislative auditor determines that the MNsure information 
53.12 	technology system and agency eligibility determination systems cannot effectively verify 
53.13 	the eligibility of health and economic assistance program recipients.
53.14 		Subd. 4.Health and economic assistance program. For purposes of this section, 
53.15 	"health and economic assistance program" means the medical assistance program under 
53.16 	Minnesota Statutes, chapter 256B, Minnesota family investment and diversionary 
53.17 	work programs under Minnesota Statutes, chapter 256J, child care assistance programs 
53.18 	under Minnesota Statutes, chapter 119B, general assistance under Minnesota Statutes, 
53.19 	sections 256D.01 to 256D.23, alternative care program under Minnesota Statutes, section 
53.20 	256B.0913, and chemical dependency programs funded under Minnesota Statutes, chapter 
53.21 	254B.

53.22 	Sec. 35. REQUEST FOR PROPOSALS.
 53.23 	(a) The commissioner of human services shall issue a request for proposals 
53.24 	for a contract to use technologically advanced software and services to improve the 
53.25 	identification and rejection or elimination of:
53.26 	(1) improper Medicaid payments before payment is made to the provider; and
53.27 	(2) improper provision of benefits by a health and economic assistance program 
53.28 	to ineligible individuals.
53.29 	(b) The request for proposals must ensure that a system recommended and 
53.30 	implemented by the contractor will:
53.31 	(1) implement a more comprehensive, robust, and technologically advanced 
53.32 	improper payments and benefits identification program;
53.33 	(2) utilize state of the art fraud detection methods and technologies such as predictive 
53.34 	modeling, link analysis, and anomaly and outlier detection;
53.35 	(3) have the ability to identify and report  improper claims before the claims are paid;
54.1 	(4) have the ability to identify and report the improper provision of benefits under a 
54.2 	health and economic assistance program;
54.3 	(5) include a mechanism so that the system improves its detection capabilities over 
54.4 	time;
54.5 	(6) leverage technology to make the Medicaid claims evaluation process more 
54.6 	transparent and cost-efficient; and
54.7 	(7) result in increased state savings by reducing or eliminating payouts of wrongful 
54.8 	Medicaid claims and the improper provision of health and economic assistance program 
54.9 	benefits.
54.10 	(c) Based on responses to the request for proposals, the commissioner must enter 
54.11 	into a contract for the services specified in paragraphs (a) and (b) by October 1, 2015. The 
54.12 	contract shall incorporate a performance-based vendor financing option whereby the 
54.13 	vendor shares in the risk of the project's success.
54.14 	(d) For purposes of this section, "health and economic assistance program" means 
54.15 	the medical assistance program under Minnesota Statutes, chapter 256B, Minnesota family 
54.16 	investment and diversionary work programs under Minnesota Statutes, chapter 256J, child 
54.17 	care assistance programs under Minnesota Statutes, chapter 119B, general assistance 
54.18 	under Minnesota Statutes, sections 256D.01 to 256D.23, alternative care program under 
54.19 	Minnesota Statutes, section 256B.0913, and chemical dependency programs funded under 
54.20 	Minnesota Statutes, chapter 254B.

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

54.22 	Sec. 36. FEDERAL WAIVER OR APPROVAL.
 54.23 	The commissioner of human services shall seek any federal waiver or approval 
54.24 	necessary to implement the amendments to Minnesota Statutes, section 256B.0644.

54.25 	ARTICLE 2
54.26 	MINNESOTACARE

54.27 	Section 1. Minnesota Statutes 2014, section 256.98, subdivision 1, is amended to read:
54.28 		Subdivision 1.Wrongfully obtaining assistance. A person who commits any of 
54.29 	the following acts or omissions with intent to defeat the purposes of sections 145.891
54.30 	to 145.897, the MFIP program formerly codified in sections 256.031 to 256.0361, the 
54.31 	AFDC program formerly codified in sections 256.72 to 256.871, chapters 256B, 256D, 
54.32 	256J, 256K, or 256L, and child care assistance programs, is guilty of theft and shall be 
54.33 	sentenced under section 609.52, subdivision 3, clauses (1) to (5):
55.1 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of 
55.2 	a willfully false statement or representation, by intentional concealment of any material 
55.3 	fact, or by impersonation or other fraudulent device, assistance or the continued receipt of 
55.4 	assistance, to include child care assistance or vouchers produced according to sections 
55.5 	145.891 to 145.897 and MinnesotaCare services according to sections premium assistance 
55.6 	under section256.9365, 256.94, and 256L.01 to 256L.15, to which the person is not 
55.7 	entitled or assistance greater than that to which the person is entitled;
55.8 	(2) knowingly aids or abets in buying or in any way disposing of the property of a 
55.9 	recipient or applicant of assistance without the consent of the county agency; or
55.10 	(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of 
55.11 	payments to which the individual is not entitled as a provider of subsidized child care, or 
55.12 	by furnishing or concurring in a willfully false claim for child care assistance.
55.13 	The continued receipt of assistance to which the person is not entitled or greater 
55.14 	than that to which the person is entitled as a result of any of the acts, failure to act, or 
55.15 	concealment described in this subdivision shall be deemed to be continuing offenses from 
55.16 	the date that the first act or failure to act occurred.

55.17 	EFFECTIVE DATE. This section is effective January 1, 2016.

55.18 	Sec. 2. Minnesota Statutes 2014, section 256B.021, subdivision 4, is amended to read:
55.19 		Subd. 4.Projects. The commissioner shall request permission and funding to 
55.20 	further the following initiatives.
55.21 	(a) Health care delivery demonstration projects. This project involves testing 
55.22 	alternative payment and service delivery models in accordance with sections 256B.0755
55.23 	and 256B.0756. These demonstrations will allow the Minnesota Department of Human 
55.24 	Services to engage in alternative payment arrangements with provider organizations that 
55.25 	provide services to a specified patient population for an agreed upon total cost of care or 
55.26 	risk/gain sharing payment arrangement, but are not limited to these models of care delivery 
55.27 	or payment. Quality of care and patient experience will be measured and incorporated into 
55.28 	payment models alongside the cost of care. Demonstration sites should include Minnesota 
55.29 	health care programs fee-for-services recipients and managed care enrollees and support a 
55.30 	robust primary care model and improved care coordination for recipients.
55.31 	(b) Promote personal responsibility and encourage and reward healthy outcomes. 
55.32 	This project provides Medicaid funding to provide individual and group incentives to 
55.33 	encourage healthy behavior, prevent the onset of chronic disease, and reward healthy 
55.34 	outcomes. Focus areas may include diabetes prevention and management, tobacco 
55.35 	cessation, reducing weight, lowering cholesterol, and lowering blood pressure.
56.1 	(c) Encourage utilization of high quality, cost-effective care. This project creates 
56.2 	incentives through Medicaid and MinnesotaCare enrollee cost-sharing and other means to 
56.3 	encourage the utilization of high-quality, low-cost, high-value providers, as determined by 
56.4 	the state's provider peer grouping initiative under section 62U.04.
56.5 	(d) Adults without children. This proposal includes requesting federal authority to 
56.6 	impose a limit on assets for adults without children in medical assistance, as defined in 
56.7 	section 256B.055, subdivision 15, who have a household income equal to or less than 
56.8 	75 percent of the federal poverty limit, and to impose a 180-day durational residency 
56.9 	requirement in MinnesotaCare, consistent with section 256L.09, subdivision 4, for adults 
56.10 	without children, regardless of income.
56.11 	(e) Empower and encourage work, housing, and independence. This project provides 
56.12 	services and supports for individuals who have an identified health or disabling condition 
56.13 	but are not yet certified as disabled, in order to delay or prevent permanent disability, 
56.14 	reduce the need for intensive health care and long-term care services and supports, and to 
56.15 	help maintain or obtain employment or assist in return to work. Benefits may include:
56.16 	(1) coordination with health care homes or health care coordinators;
56.17 	(2) assessment for wellness, housing needs, employment, planning, and goal setting;
56.18 	(3) training services;
56.19 	(4) job placement services;
56.20 	(5) career counseling;
56.21 	(6) benefit counseling;
56.22 	(7) worker supports and coaching;
56.23 	(8) assessment of workplace accommodations;
56.24 	(9) transitional housing services; and
56.25 	(10) assistance in maintaining housing.
56.26 	(f) Redesign home and community-based services. This project realigns existing 
56.27 	funding, services, and supports for people with disabilities and older Minnesotans to 
56.28 	ensure community integration and a more sustainable service system. This may involve 
56.29 	changes that promote a range of services to flexibly respond to the following needs:
56.30 	(1) provide people less expensive alternatives to medical assistance services;
56.31 	(2) offer more flexible and updated community support services under the Medicaid 
56.32 	state plan;
56.33 	(3) provide an individual budget and increased opportunity for self-direction;
56.34 	(4) strengthen family and caregiver support services;
56.35 	(5) allow persons to pool resources or save funds beyond a fiscal year to cover 
56.36 	unexpected needs or foster development of needed services;
57.1 	(6) use of home and community-based waiver programs for people whose needs 
57.2 	cannot be met with the expanded Medicaid state plan community support service options;
57.3 	(7) target access to residential care for those with higher needs;
57.4 	(8) develop capacity within the community for crisis intervention and prevention;
57.5 	(9) redesign case management;
57.6 	(10) offer life planning services for families to plan for the future of their child 
57.7 	with a disability;
57.8 	(11) enhance self-advocacy and life planning for people with disabilities;
57.9 	(12) improve information and assistance to inform long-term care decisions; and
57.10 	(13) increase quality assurance, performance measurement, and outcome-based 
57.11 	reimbursement.
57.12 	This project may include different levels of long-term supports that allow seniors to 
57.13 	remain in their homes and communities, and expand care transitions from acute care to 
57.14 	community care to prevent hospitalizations and nursing home placement. The levels 
57.15 	of support for seniors may range from basic community services for those with lower 
57.16 	needs, access to residential services if a person has higher needs, and targets access to 
57.17 	nursing home care to those with rehabilitation or high medical needs. This may involve 
57.18 	the establishment of medical need thresholds to accommodate the level of support 
57.19 	needed; provision of a long-term care consultation to persons seeking residential services, 
57.20 	regardless of payer source; adjustment of incentives to providers and care coordination 
57.21 	organizations to achieve desired outcomes; and a required coordination with medical 
57.22 	assistance basic care benefit and Medicare/Medigap benefit. This proposal will improve 
57.23 	access to housing and improve capacity to maintain individuals in their existing home; 
57.24 	adjust screening and assessment tools, as needed; improve transition and relocation 
57.25 	efforts; seek federal financial participation for alternative care and essential community 
57.26 	supports; and provide Medigap coverage for people having lower needs.
57.27 	(g) Coordinate and streamline services for people with complex needs, including 
57.28 	those with multiple diagnoses of physical, mental, and developmental conditions. This 
57.29 	project will coordinate and streamline medical assistance benefits for people with complex 
57.30 	needs and multiple diagnoses. It would include changes that:
57.31 	(1) develop community-based service provider capacity to serve the needs of this 
57.32 	group;
57.33 	(2) build assessment and care coordination expertise specific to people with multiple 
57.34 	diagnoses;
57.35 	(3) adopt service delivery models that allow coordinated access to a range of services 
57.36 	for people with complex needs;
58.1 	(4) reduce administrative complexity;
58.2 	(5) measure the improvements in the state's ability to respond to the needs of this 
58.3 	population; and
58.4 	(6) increase the cost-effectiveness for the state budget.
58.5 	(h) Implement nursing home level of care criteria. This project involves obtaining 
58.6 	any necessary federal approval in order to implement the changes to the level of care 
58.7 	criteria in section 144.0724, subdivision 11, and implement further changes necessary to 
58.8 	achieve reform of the home and community-based service system.
58.9 	(i) Improve integration of Medicare and Medicaid. This project involves reducing 
58.10 	fragmentation in the health care delivery system to improve care for people eligible for 
58.11 	both Medicare and Medicaid, and to align fiscal incentives between primary, acute, and 
58.12 	long-term care. The proposal may include:
58.13 	(1) requesting an exception to the new Medicare methodology for payment 
58.14 	adjustment for fully integrated special needs plans for dual eligible individuals;
58.15 	(2) testing risk adjustment models that may be more favorable to capturing the 
58.16 	needs of frail dually eligible individuals;
58.17 	(3) requesting an exemption from the Medicare bidding process for fully integrated 
58.18 	special needs plans for the dually eligible;
58.19 	(4) modifying the Medicare bid process to recognize additional costs of health 
58.20 	home services; and
58.21 	(5) requesting permission for risk-sharing and gain-sharing.
58.22 	(j) Intensive residential treatment services. This project would involve providing 
58.23 	intensive residential treatment services for individuals who have serious mental illness 
58.24 	and who have other complex needs. This proposal would allow such individuals to remain 
58.25 	in these settings after mental health symptoms have stabilized, in order to maintain their 
58.26 	mental health and avoid more costly or unnecessary hospital or other residential care due 
58.27 	to their other complex conditions. The commissioner may pursue a specialized rate for 
58.28 	projects created under this section.
58.29 	(k) Seek federal Medicaid matching funds for Anoka Metro Regional Treatment 
58.30 	Center (AMRTC). This project involves seeking Medicaid reimbursement for medical 
58.31 	services provided to patients to AMRTC, including requesting a waiver of United States 
58.32 	Code, title 42, section 1396d, which prohibits Medicaid reimbursement for expenditures 
58.33 	for services provided by hospitals with more than 16 beds that are primarily focused on 
58.34 	the treatment of mental illness. This waiver would allow AMRTC to serve as a statewide 
58.35 	resource to provide diagnostics and treatment for people with the most complex conditions.
59.1 	(l) Waivers to allow Medicaid eligibility for children under age 21 receiving care 
59.2 	in residential facilities. This proposal would seek Medicaid reimbursement for any 
59.3 	Medicaid-covered service for children who are placed in residential settings that are 
59.4 	determined to be "institutions for mental diseases," under United States Code, title 42, 
59.5 	section 1396d.

59.6 	EFFECTIVE DATE. This section is effective January 1, 2016.

59.7 	Sec. 3. Minnesota Statutes 2014, section 256L.01, subdivision 3a, is amended to read:
59.8 		Subd. 3a.Family. (a) Except as provided in paragraphs (c) and (d), "family" has 
59.9 	the meaning given for family and family size as defined in Code of Federal Regulations, 
59.10 	title 26, section 1.36B-1.
59.11 	(b) The term includes children who are temporarily absent from the household in 
59.12 	settings such as schools, camps, or parenting time with noncustodial parents.
59.13 	(c) For an individual who does not expect to file a federal tax return and does not 
59.14 	expect to be claimed as a dependent for the applicable tax year, "family" has the meaning 
59.15 	given in Code of Federal Regulations, title 42, section 435.603(f)(3).
59.16 	(d) For a married couple, "family" has the meaning given in Code of Federal 
59.17 	Regulations, title 42, section 435.603(f)(4).

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

59.19 	Sec. 4. Minnesota Statutes 2014, section 256L.01, subdivision 5, is amended to read:
59.20 		Subd. 5.Income.  "Income" has the meaning given for modified adjusted gross 
59.21 	income, as defined in Code of Federal Regulations, title 26, section 1.36B-1., and means a 
59.22 	household's projected annual income for the applicable tax year.

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

59.24 	Sec. 5. Minnesota Statutes 2014, section 256L.03, subdivision 5, is amended to read:
59.25 		Subd. 5.Cost-sharing. (a) Except as otherwise provided in this subdivision, the 
59.26 	MinnesotaCare benefit plan shall include the following cost-sharing requirements for all 
59.27 	enrollees:
59.28 	(1) $3 per prescription for adult enrollees;
59.29 	(2) $25 for eyeglasses for adult enrollees;
59.30 	(3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
59.31 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
59.32 	established illness, and which is delivered in an ambulatory setting by a physician or 
60.1 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
60.2 	audiologist, optician, or optometrist;
60.3 	(4) $6 for nonemergency visits to a hospital-based emergency room for services 
60.4 	provided through December 31, 2010, and $3.50 effective January 1, 2011; and
60.5 	(5) a family deductible equal to the maximum amount allowed under Code of 
60.6 	Federal Regulations, title 42, part 447.54. $2.75 per month per family and adjusted 
60.7 	annually by the percentage increase in the medical care component of the CPI-U for 
60.8 	the period of September to September of the preceding calendar year, rounded to the 
60.9 	next-higher five-cent increment.
60.10 	(b) Paragraph (a) does not apply to children under the age of 21 and to American 
60.11 	Indians as defined in Code of Federal Regulations, title 42, section 447.51.
60.12 	(c) Paragraph (a), clause (3), does not apply to mental health services.
60.13 	(d) MinnesotaCare reimbursements to fee-for-service providers and payments to 
60.14 	managed care plans or county-based purchasing plans shall not be increased as a result of 
60.15 	the reduction of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
60.16 	(e) The commissioner, through the contracting process under section 256L.12, 
60.17 	may allow managed care plans and county-based purchasing plans to waive the family 
60.18 	deductible under paragraph (a), clause (5). The value of the family deductible shall not be 
60.19 	included in the capitation payment to managed care plans and county-based purchasing 
60.20 	plans. Managed care plans and county-based purchasing plans shall certify annually to the 
60.21 	commissioner the dollar value of the family deductible.

60.22 	EFFECTIVE DATE. The amendment to paragraph (a), clause (5), is effective 
60.23 	retroactively from January 1, 2014. The amendment to paragraph (b) is effective the 
60.24 	day following final enactment.

60.25 	Sec. 6. Minnesota Statutes 2014, section 256L.04, subdivision 1c, is amended to read:
60.26 		Subd. 1c.General requirements. To be eligible for coverage under MinnesotaCare, 
60.27 	a person must meet the eligibility requirements of this section. A person eligible for 
60.28 	MinnesotaCare shall not be considered a qualified individual under section 1312 of the 
60.29 	Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered 
60.30 	through MNsure under chapter 62V.

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

60.32 	Sec. 7. Minnesota Statutes 2014, section 256L.04, subdivision 7b, is amended to read:
61.1 		Subd. 7b.Annual income limits adjustment. The commissioner shall adjust the 
61.2 	income limits under this section each July 1 by the annual update of the federal poverty 
61.3 	guidelines following publication by the United States Department of Health and Human 
61.4 	Services except that the income standards shall not go below those in effect on July 1, 
61.5 	2009 annually on January 1 as provided in Code of Federal Regulations, title 26, section 
61.6 	1.36B-1(h).

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

61.8 	Sec. 8. Minnesota Statutes 2014, section 256L.04, subdivision 10, is amended to read:
61.9 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is limited 
61.10 	to citizens or nationals of the United States and lawfully present noncitizens as defined 
61.11 	in Code of Federal Regulations, title 8 45, section 103.12 152.2. Undocumented 
61.12 	noncitizens are ineligible for MinnesotaCare. For purposes of this subdivision, an 
61.13 	undocumented noncitizen is an individual who resides in the United States without the 
61.14 	approval or acquiescence of the United States Citizenship and Immigration Services. 
61.15 	Families with children who are citizens or nationals of the United States must cooperate in 
61.16 	obtaining satisfactory documentary evidence of citizenship or nationality according to the 
61.17 	requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
61.18 	(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and 
61.19 	individuals who are lawfully present and ineligible for medical assistance by reason of 
61.20 	immigration status and who have incomes equal to or less than 200 percent of federal 
61.21 	poverty guidelines.

61.22 	Sec. 9. Minnesota Statutes 2014, section 256L.05, is amended by adding a subdivision 
61.23 	to read:
61.24 		Subd. 2a.Eligibility and coverage. For purposes of this chapter, an individual 
61.25 	is eligible for MinnesotaCare following a determination by the commissioner that the 
61.26 	individual meets the eligibility criteria for the applicable period of eligibility. For an 
61.27 	individual required to pay a premium, coverage is only available in each month of the 
61.28 	applicable period of eligibility for which a premium is paid.

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

61.30 	Sec. 10. Minnesota Statutes 2014, section 256L.05, subdivision 3, is amended to read:
61.31 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the first 
61.32 	day of the month following the month in which eligibility is approved and the first premium 
62.1 	payment has been received. The effective date of coverage for new members added to the 
62.2 	family is the first day of the month following the month in which the change is reported. All 
62.3 	eligibility criteria must be met by the family at the time the new family member is added. 
62.4 	The income of the new family member is included with the family's modified adjusted gross 
62.5 	income and the adjusted premium begins in the month the new family member is added.
62.6 	(b) The initial premium must be received by the last working day of the month for 
62.7 	coverage to begin the first day of the following month.
62.8 	(c) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 
62.9 	256L.18 are secondary to a plan of insurance or benefit program under which an eligible 
62.10 	person may have coverage and the commissioner shall use cost avoidance techniques to 
62.11 	ensure coordination of any other health coverage for eligible persons. The commissioner 
62.12 	shall identify eligible persons who may have coverage or benefits under other plans of 
62.13 	insurance or who become eligible for medical assistance.
62.14 	(d) The effective date of coverage for individuals or families who are exempt from 
62.15 	paying premiums under section 256L.15, subdivision 1, paragraph (c), is the first day of 
62.16 	the month following the month in which verification of American Indian status is received 
62.17 	or eligibility is approved, whichever is later.

62.18 	Sec. 11. Minnesota Statutes 2014, section 256L.05, subdivision 3a, is amended to read:
62.19 		Subd. 3a.Renewal Redetermination of eligibility. (a) Beginning July 1, 2007, An 
62.20 	enrollee's eligibility must be renewed every 12 months redetermined on an annual basis. 
62.21 	The 12-month period begins in the month after the month the application is approved. The 
62.22 	period of eligibility is the entire calendar year following the year in which eligibility is 
62.23 	redetermined. Beginning in calendar year 2015, eligibility redeterminations shall occur 
62.24 	during the open enrollment period for qualified health plans as specified in Code of 
62.25 	Federal Regulations, title 45, section 155.410.
62.26 	(b) Each new period of eligibility must take into account any changes in 
62.27 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
62.28 	the information needed to redetermine eligibility by the first day of the month that ends 
62.29 	the eligibility period. The premium for the new period of eligibility must be received 
62.30 	Coverage begins as provided in section 256L.06in order for eligibility to continue.
62.31 	(c) For children enrolled in MinnesotaCare, the first period of renewal begins the 
62.32 	month the enrollee turns 21 years of age.

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

62.34 	Sec. 12. Minnesota Statutes 2014, section 256L.05, subdivision 4, is amended to read:
63.1 		Subd. 4.Application processing. The commissioner of human services shall 
63.2 	determine an applicant's eligibility for MinnesotaCare no more than 30 45 days from the 
63.3 	date that the application is received by the Department of Human Services as set forth in 
63.4 	Code of Federal Regulations, title 42, section 435.911. Beginning January 1, 2000, this 
63.5 	requirement also applies to local county human services agencies that determine eligibility 
63.6 	for MinnesotaCare.

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

63.8 	Sec. 13. Minnesota Statutes 2014, section 256L.06, subdivision 3, is amended to read:
63.9 		Subd. 3.Commissioner's duties and payment. (a) Premiums are dedicated to the 
63.10 	commissioner for MinnesotaCare.
63.11 	(b) The commissioner shall develop and implement procedures to: (1) require 
63.12 	enrollees to report changes in income; (2) adjust sliding scale premium payments, based 
63.13 	upon both increases and decreases in enrollee income, at the time the change in income 
63.14 	is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required 
63.15 	premiums. Failure to pay includes payment with a dishonored check, a returned automatic 
63.16 	bank withdrawal, or a refused credit card or debit card payment. The commissioner may 
63.17 	demand a guaranteed form of payment, including a cashier's check or a money order, as 
63.18 	the only means to replace a dishonored, returned, or refused payment.
63.19 	(c) Premiums are calculated on a calendar month basis and may be paid on a 
63.20 	monthly, quarterly, or semiannual basis, with the first payment due upon notice from the 
63.21 	commissioner of the premium amount required. The commissioner shall inform applicants 
63.22 	and enrollees of these premium payment options. Premium payment is required before 
63.23 	enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments 
63.24 	received before noon are credited the same day. Premium payments received after noon 
63.25 	are credited on the next working day.
63.26 	(d) Nonpayment of the premium will result in disenrollment from the plan 
63.27 	effective for the calendar month following the month for which the premium was due. 
63.28 	Persons disenrolled for nonpayment who pay all past due premiums as well as current 
63.29 	premiums due, including premiums due for the period of disenrollment, within 20 days of 
63.30 	disenrollment, shall be reenrolled retroactively to the first day of disenrollment may not 
63.31 	reenroll prior to the first day of the month following the payment of an amount equal to 
63.32 	two months' premiums.

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

64.1 	Sec. 14. Minnesota Statutes 2014, section 256L.121, subdivision 1, is amended to read:
64.2 		Subdivision 1.Competitive process. The commissioner of human services shall 
64.3 	establish a competitive process for entering into contracts with participating entities for 
64.4 	the offering of standard health plans through MinnesotaCare. Coverage through standard 
64.5 	health plans must be available to enrollees beginning January 1, 2015. Each standard 
64.6 	health plan must cover the health services listed in and meet the requirements of section 
64.7 	256L.03. The competitive process must meet the requirements of section 1331 of the 
64.8 	Affordable Care Act and be designed to ensure enrollee access to high-quality health care 
64.9 	coverage options. The commissioner, to the extent feasible, shall seek to ensure that 
64.10 	enrollees have a choice of coverage from more than one participating entity within a 
64.11 	geographic area. In counties that were part of a county-based purchasing plan on January 
64.12 	1, 2013, the commissioner shall use the medical assistance competitive procurement 
64.13 	process under section 256B.69, subdivisions 1 to 32, under which selection of entities is 
64.14 	based on criteria related to provider network access, coordination of health care with other 
64.15 	local services, alignment with local public health goals, and other factors.

64.16 	Sec. 15. Minnesota Statutes 2014, section 270A.03, subdivision 5, is amended to read:
64.17 		Subd. 5.Debt. (a) "Debt" means a legal obligation of a natural person to pay a fixed 
64.18 	and certain amount of money, which equals or exceeds $25 and which is due and payable 
64.19 	to a claimant agency. The term includes criminal fines imposed under section 609.10 or 
64.20 	609.125, fines imposed for petty misdemeanors as defined in section 609.02, subdivision 
64.21 	4a, and restitution. A debt may arise under a contractual or statutory obligation, a court 
64.22 	order, or other legal obligation, but need not have been reduced to judgment.
64.23 	A debt includes any legal obligation of a current recipient of assistance which is 
64.24 	based on overpayment of an assistance grant where that payment is based on a client 
64.25 	waiver or an administrative or judicial finding of an intentional program violation; 
64.26 	or where the debt is owed to a program wherein the debtor is not a client at the time 
64.27 	notification is provided to initiate recovery under this chapter and the debtor is not a 
64.28 	current recipient of food support, transitional child care, or transitional medical assistance.
64.29 	(b) A debt does not include any legal obligation to pay a claimant agency for medical 
64.30 	care, including hospitalization if the income of the debtor at the time when the medical 
64.31 	care was rendered does not exceed the following amount:
64.32 	(1) for an unmarried debtor, an income of $8,800 or less;
64.33 	(2) for a debtor with one dependent, an income of $11,270 or less;
64.34 	(3) for a debtor with two dependents, an income of $13,330 or less;
64.35 	(4) for a debtor with three dependents, an income of $15,120 or less;
65.1 	(5) for a debtor with four dependents, an income of $15,950 or less; and
65.2 	(6) for a debtor with five or more dependents, an income of $16,630 or less.
65.3 	(c) The commissioner shall adjust the income amounts in paragraph (b) by the 
65.4 	percentage determined pursuant to the provisions of section 1(f) of the Internal Revenue 
65.5 	Code, except that in section 1(f)(3)(B) the word "1999" shall be substituted for the word 
65.6 	"1992." For 2001, the commissioner shall then determine the percent change from the 12 
65.7 	months ending on August 31, 1999, to the 12 months ending on August 31, 2000, and in 
65.8 	each subsequent year, from the 12 months ending on August 31, 1999, to the 12 months 
65.9 	ending on August 31 of the year preceding the taxable year. The determination of the 
65.10 	commissioner pursuant to this subdivision shall not be considered a "rule" and shall not 
65.11 	be subject to the Administrative Procedure Act contained in chapter 14. The income 
65.12 	amount as adjusted must be rounded to the nearest $10 amount. If the amount ends in 
65.13 	$5, the amount is rounded up to the nearest $10 amount.
65.14 	(d) Debt also includes an agreement to pay a MinnesotaCare premium, regardless 
65.15 	of the dollar amount of the premium authorized under Minnesota Statutes 2014, section 
65.16 	256L.15, subdivision 1a.

65.17 	EFFECTIVE DATE. This section is effective January 1, 2016.

65.18 	Sec. 16. Minnesota Statutes 2014, section 270B.14, subdivision 1, is amended to read:
65.19 		Subdivision 1.Disclosure to commissioner of human services. (a) On the request 
65.20 	of the commissioner of human services, the commissioner shall disclose return information 
65.21 	regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to 
65.22 	the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).
65.23 	(b) Data that may be disclosed are limited to data relating to the identity, 
65.24 	whereabouts, employment, income, and property of a person owing or alleged to be owing 
65.25 	an obligation of child support.
65.26 	(c) The commissioner of human services may request data only for the purposes of 
65.27 	carrying out the child support enforcement program and to assist in the location of parents 
65.28 	who have, or appear to have, deserted their children. Data received may be used only 
65.29 	as set forth in section 256.978.
65.30 	(d) The commissioner shall provide the records and information necessary to 
65.31 	administer the supplemental housing allowance to the commissioner of human services.
65.32 	(e) At the request of the commissioner of human services, the commissioner of 
65.33 	revenue shall electronically match the Social Security numbers and names of participants 
65.34 	in the telephone assistance plan operated under sections 237.69 to 237.71, with those of 
66.1 	property tax refund filers, and determine whether each participant's household income is 
66.2 	within the eligibility standards for the telephone assistance plan.
66.3 	(f) The commissioner may provide records and information collected under sections 
66.4 	295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid 
66.5 	Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law 
66.6 	102-234. Upon the written agreement by the United States Department of Health and 
66.7 	Human Services to maintain the confidentiality of the data, the commissioner may provide 
66.8 	records and information collected under sections 295.50 to 295.59 to the Centers for 
66.9 	Medicare and Medicaid Services section of the United States Department of Health and 
66.10 	Human Services for purposes of meeting federal reporting requirements.
66.11 	(g) The commissioner may provide records and information to the commissioner of 
66.12 	human services as necessary to administer the early refund of refundable tax credits.
66.13 	(h) The commissioner may disclose information to the commissioner of human 
66.14 	services necessary to verify income for eligibility and premium payment under the 
66.15 	MinnesotaCare program, under section 256L.05, subdivision 2.
66.16 	(i) (h) The commissioner may disclose information to the commissioner of human 
66.17 	services necessary to verify whether applicants or recipients for the Minnesota family 
66.18 	investment program, general assistance, food support, Minnesota supplemental aid 
66.19 	program, and child care assistance have claimed refundable tax credits under chapter 290 
66.20 	and the property tax refund under chapter 290A, and the amounts of the credits.
66.21 	(j) (i) The commissioner may disclose information to the commissioner of human 
66.22 	services necessary to verify income for purposes of calculating parental contribution 
66.23 	amounts under section 252.27, subdivision 2a.

66.24 	EFFECTIVE DATE. This section is effective January 1, 2016.

66.25 	Sec. 17. REVISOR INSTRUCTION.
 66.26 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall strike 
66.27 	references to Minnesota Statutes, chapter 256L, and to statutory sections within that 
66.28 	chapter, and shall make all necessary grammatical and conforming changes.

66.29 	EFFECTIVE DATE. This section is effective January 1, 2016.

66.30 	Sec. 18.  REPEALER.
 66.31 		Subdivision 1.MinnesotaCare program.  Minnesota Statutes 2014, sections 
66.32 	256L.01, subdivisions 1, 1a, 1b, 2, 3, 3a, 5, 6, and 7; 256L.02, subdivisions 1, 2, 3, 5, and 
66.33 	6; 256L.03, subdivisions 1, 1a, 1b, 2, 3, 3a, 3b, 4, 4a, 5, and 6; 256L.04, subdivisions 1, 
67.1 	1a, 1c, 2, 2a, 7, 7a, 7b, 8, 10, 12, 13, and 14; 256L.05, subdivisions 1, 1a, 1b, 1c, 2, 3, 3a, 
67.2 	3c, 4, 5, and 6; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3, and 4; 256L.09, 
67.3 	subdivisions 1, 2, 4, 5, 6, and 7; 256L.10; 256L.11, subdivisions 1, 2, 2a, 3, 4, and 7; 
67.4 	256L.12; 256L.121; 256L.15, subdivisions 1, 1a, 1b, and 2; 256L.18; 256L.22; 256L.24; 
67.5 	256L.26; and 256L.28, are repealed.
67.6 		Subd. 2.Conforming repealers. Minnesota Statutes 2014, sections 13.461, 
67.7 	subdivision 26; 16A.724, subdivision 3; 62A.046, subdivision 5; and 256.01, subdivision 
67.8 	35, are repealed.

67.9 	EFFECTIVE DATE. This section is effective January 1, 2016.

67.10 	ARTICLE 3
67.11 	MNSURE

67.12 	Section 1. EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND 
67.13 	SUBSIDIES.
 67.14 	The commissioner of commerce, in consultation with the Board of Directors of 
67.15 	MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal to 
67.16 	allow individuals to purchase qualified health plans outside of MNsure directly from 
67.17 	health plan companies and to allow eligible individuals to receive advanced premium tax 
67.18 	credits and cost-sharing reductions when purchasing these health plans. The commissioner 
67.19 	shall seek all federal waivers and approvals necessary to implement this proposal. 
67.20 	The commissioner shall submit a draft proposal to the MNsure board and the MNsure 
67.21 	Legislative Oversight Committee at least 30 days before submitting a final proposal to the 
67.22 	federal government and shall notify the board and legislative oversight committee of any 
67.23 	federal decision or action related to the proposal.

67.24 	Sec. 2. Minnesota Statutes 2014, section 15A.0815, subdivision 3, is amended to read:
67.25 		Subd. 3.Group II salary limits. The salary for a position listed in this subdivision 
67.26 	shall not exceed 120 percent of the salary of the governor. This limit must be adjusted 
67.27 	annually on January 1. The new limit must equal the limit for the prior year increased 
67.28 	by the percentage increase, if any, in the Consumer Price Index for all urban consumers 
67.29 	from October of the second prior year to October of the immediately prior year. The 
67.30 	commissioner of management and budget must publish the limit on the department's Web 
67.31 	site. This subdivision applies to the following positions:
67.32 	Executive director of Gambling Control Board;
67.33 	Commissioner, Iron Range Resources and Rehabilitation Board;
68.1 	Commissioner, Bureau of Mediation Services;
68.2 	Ombudsman for Mental Health and Developmental Disabilities;
68.3 	Chair, Metropolitan Council;
68.4 	Executive Director, MNsure;
68.5 	School trust lands director;
68.6 	Executive director of pari-mutuel racing; and
68.7 	Commissioner, Public Utilities Commission.

68.8 	Sec. 3. Minnesota Statutes 2014, section 62A.02, subdivision 2, is amended to read:
68.9 		Subd. 2.Approval. (a) The health plan form shall not be issued, nor shall any 
68.10 	application, rider, endorsement, or rate be used in connection with it, until the expiration 
68.11 	of 60 days after it has been filed unless the commissioner approves it before that time.
68.12 	(b) Notwithstanding paragraph (a), a rate filed with respect to a policy of accident and 
68.13 	sickness insurance as defined in section 62A.01 by an insurer licensed under chapter 60A, 
68.14 	may be used on or after the date of filing with the commissioner. Rates that are not approved 
68.15 	or disapproved within the 60-day time period are deemed approved. This paragraph does 
68.16 	not apply to Medicare-related coverage as defined in section 62A.3099, subdivision 17.
68.17 	(c) For coverage to begin on or after January 1, 2016, and each January 1 thereafter, 
68.18 	health plans in the individual and small group markets that are not grandfathered plans to 
68.19 	be offered outside MNsure and qualified health plans to be offered inside MNsure must 
68.20 	receive rate approval from the commissioner no later than 30 days prior to the beginning 
68.21 	of the annual open enrollment period for MNsure. Premium rates for all carriers in the 
68.22 	applicable market for the next calendar year must be made available to the public by the 
68.23 	commissioner only after all rates for the applicable market are final and approved. Final 
68.24 	and approved rates must be publicly released at a uniform time for all individual and small 
68.25 	group health plans that are not grandfathered plans to be offered outside MNsure and 
68.26 	qualified health plans to be offered inside MNsure, and no later than 30 days prior to the 
68.27 	beginning of the annual open enrollment period for MNsure.

68.28 	Sec. 4. Minnesota Statutes 2014, section 62V.02, is amended by adding a subdivision 
68.29 	to read:
68.30 		Subd. 2a.Consumer assistance partner. "Consumer assistance partner" means 
68.31 	individuals and entities certified by MNsure to serve as a navigator, in-person assister, or 
68.32 	certified application counselor.

68.33 	Sec. 5. Minnesota Statutes 2014, section 62V.03, subdivision 2, is amended to read:
69.1 		Subd. 2.Application of other law. (a) MNsure must be reviewed by the legislative 
69.2 	auditor under section 3.971. The legislative auditor shall audit the books, accounts, and 
69.3 	affairs of MNsure once each year or less frequently as the legislative auditor's funds and 
69.4 	personnel permit. Upon the audit of the financial accounts and affairs of MNsure, MNsure 
69.5 	is liable to the state for the total cost and expenses of the audit, including the salaries paid 
69.6 	to the examiners while actually engaged in making the examination. The legislative 
69.7 	auditor may bill MNsure either monthly or at the completion of the audit. All collections 
69.8 	received for the audits must be deposited in the general fund and are appropriated to 
69.9 	the legislative auditor. Pursuant to section 3.97, subdivision 3a, the Legislative Audit 
69.10 	Commission is requested to direct the legislative auditor to report by March 1, 2014, to 
69.11 	the legislature on any duplication of services that occurs within state government as a 
69.12 	result of the creation of MNsure. The legislative auditor may make recommendations on 
69.13 	consolidating or eliminating any services deemed duplicative. The board shall reimburse 
69.14 	the legislative auditor for any costs incurred in the creation of this report.
69.15 	(b) Board members of MNsure are subject to sections 10A.07 and 10A.09. Board 
69.16 	members and the personnel of MNsure are subject to section 10A.071.
69.17 	(c) All meetings of the board shall comply with the open meeting law in chapter 
69.18 	13D, except that:.
69.19 	(1) meetings, or portions of meetings, regarding compensation negotiations with the 
69.20 	director or managerial staff may be closed in the same manner and according to the same 
69.21 	procedures identified in section 13D.03;
69.22 	(2) meetings regarding contract negotiation strategy may be closed in the same 
69.23 	manner and according to the same procedures identified in section 13D.05, subdivision 3, 
69.24 	paragraph (c); and
69.25 	(3) meetings, or portions of meetings, regarding not public data described in section 
69.26 	62V.06, subdivision 3, and regarding trade secret information as defined in section 13.37, 
69.27 	subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with 
69.28 	the procedures identified in chapter 13D.
69.29 	(d) MNsure and provisions specified under this chapter are exempt from:
69.30 	(1) chapter 14, including section 14.386, except as specified in section 62V.05; and.
69.31 	(2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision 2, 
69.32 	paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and (3), 
69.33 	paragraph (b), and paragraph (c); and section 16C.16. However, MNsure, in consultation 
69.34 	with the commissioner of administration, shall implement policies and procedures to 
69.35 	establish an open and competitive procurement process for MNsure that, to the extent 
69.36 	practicable, conforms to the principles and procedures contained in chapters 16B and 16C. 
70.1 	In addition, MNsure may enter into an agreement with the commissioner of administration 
70.2 	for other services.
70.3 	(e) The board and the Web site are exempt from chapter 60K. Any employee of 
70.4 	MNsure who sells, solicits, or negotiates insurance to individuals or small employers must 
70.5 	be licensed as an insurance producer under chapter 60K.
70.6 	(f) Section 3.3005 applies to any federal funds received by MNsure.
70.7 	(g) MNsure is exempt from the following sections in chapter 16E: 16E.01, 
70.8 	subdivision 3, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1, 
70.9 	subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055; 
70.10 	16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.
70.11 	(h) (g) A MNsure decision that requires a vote of the board, other than a decision 
70.12 	that applies only to hiring of employees or other internal management of MNsure, is an 
70.13 	"administrative action" under section 10A.01, subdivision 2.

70.14 	Sec. 6. Minnesota Statutes 2014, section 62V.04, subdivision 1, is amended to read:
70.15 		Subdivision 1.Board. MNsure is governed by a board of directors with seven 11 
70.16 	members.

70.17 	Sec. 7. Minnesota Statutes 2014, section 62V.04, subdivision 2, is amended to read:
70.18 		Subd. 2.Appointment. (a) Board membership of MNsure consists of the following:
70.19 	(1) three six members appointed by the governor with the advice and consent of 
70.20 	both the senate and the house of representatives acting separately in accordance with 
70.21 	paragraph (d), with one member representing the interests of individual consumers eligible 
70.22 	for individual market coverage, one member representing individual consumers eligible 
70.23 	for public health care program coverage, and one member representing small employers, 
70.24 	one member who is an insurance producer, and two members who are county employees 
70.25 	involved in the administration of public health care programs. Members are appointed to 
70.26 	serve four-year terms following the initial staggered-term lot determination;
70.27 	(2) three members appointed by the governor with the advice and consent of both the 
70.28 	senate and the house of representatives acting separately in accordance with paragraph (d) 
70.29 	who have demonstrated expertise, leadership, and innovation in the following areas: one 
70.30 	member representing the areas of health administration, health care finance, health plan 
70.31 	purchasing, and health care delivery systems; one member representing the areas of public 
70.32 	health, health disparities, public health care programs, and the uninsured; and one member 
70.33 	representing health policy issues related to the small group and individual markets. 
71.1 	Members are appointed to serve four-year terms following the initial staggered-term lot 
71.2 	determination; and
71.3 	(3) the commissioner of human services or a designee; and
71.4 	(4) the chief information officer of MN.IT Services or a designee.
71.5 	(b) Section 15.0597 shall apply to all appointments, except for the commissioner.
71.6 	(c) The governor shall make appointments to the board that are consistent with 
71.7 	federal law and regulations regarding its composition and structure. All board members 
71.8 	appointed by the governor must be legal residents of Minnesota.
71.9 	(d) Upon appointment by the governor, a board member shall exercise duties of 
71.10 	office immediately. If both the house of representatives and the senate vote not to confirm 
71.11 	an appointment, the appointment terminates on the day following the vote not to confirm 
71.12 	in the second body to vote.
71.13 	(e)Initial appointments shall be made by April 30, 2013.
71.14 	(f)(d) One of the six nine members appointed under paragraph (a), clause (1) or (2), 
71.15 	must have experience in representing the needs of vulnerable populations and persons 
71.16 	with disabilities.
71.17 	(g) (e) Membership on the board must include representation from outside the 
71.18 	seven-county metropolitan area, as defined in section 473.121, subdivision 2.

71.19 	Sec. 8. Minnesota Statutes 2014, section 62V.04, subdivision 4, is amended to read:
71.20 		Subd. 4.Conflicts of interest. (a) Within one year prior to or at any time during 
71.21 	their appointed term, board members appointed under subdivision 2, paragraph (a), 
71.22 	clauses (1) and (2), shall not be employed by, be a member of the board of directors of, or 
71.23 	otherwise be a representative of a health carrier, institutional health care provider or other 
71.24 	entity providing health care, navigator, insurance producer, or other entity in the business 
71.25 	of selling items or services of significant value to or through MNsure. For purposes of this 
71.26 	paragraph, "health care provider or entity" does not include an academic institution.
71.27 	(b) Board members must recuse themselves from discussion of and voting on 
71.28 	an official matter if the board member has a conflict of interest. For board members 
71.29 	other than an insurance producer or a county employee, a conflict of interest means an 
71.30 	association including a financial or personal association that has the potential to bias or 
71.31 	have the appearance of biasing a board member's decisions in matters related to MNsure 
71.32 	or the conduct of activities under this chapter. The board member who is an insurance 
71.33 	producer and the board members who are county employees are subject to section 10A.07.
71.34 	(c) No board member shall have a spouse who is an executive of a health carrier.
72.1 	(d) No member of the board may currently serve as a lobbyist, as defined under 
72.2 	section 10A.01, subdivision 21.

72.3 	Sec. 9. [62V.045] EXECUTIVE DIRECTOR.
72.4 	The governor shall appoint the executive director of MNsure. The executive director 
72.5 	serves in the unclassified service at the pleasure of the governor.

72.6 	Sec. 10. Minnesota Statutes 2014, section 62V.05, subdivision 1, is amended to read:
72.7 		Subdivision 1.General. (a) The board shall operate MNsure according to this 
72.8 	chapter and applicable state and federal law.
72.9 	(b) The board has the power to:
72.10 	(1) employ personnel, subject to the power of the governor to appoint the executive 
72.11 	director, and delegate administrative, operational, and other responsibilities to the director 
72.12 	and other personnel as deemed appropriate by the board. This authority is subject to 
72.13 	chapters 43A and 179A. The director and managerial staff of MNsure shall serve in the 
72.14 	unclassified service and shall be governed by a compensation plan prepared by the board, 
72.15 	submitted to the commissioner of management and budget for review and comment within 
72.16 	14 days of its receipt, and approved by the Legislative Coordinating Commission and the 
72.17 	legislature under section 3.855, except that section 15A.0815, subdivision 5, paragraph 
72.18 	(e), shall not apply. The director of MNsure shall not receive a salary increase on or 
72.19 	after July 1, 2015, unless the increase is approved under the process specified in section 
72.20 	15A.0815, subdivision 5;
72.21 	(2) establish the budget of MNsure;
72.22 	(3) seek and accept money, grants, loans, donations, materials, services, or 
72.23 	advertising revenue from government agencies, philanthropic organizations, and public 
72.24 	and private sources to fund the operation of MNsure. No health carrier or insurance 
72.25 	producer shall advertise on MNsure;
72.26 	(4) contract for the receipt and provision of goods and services;
72.27 	(5) enter into information-sharing agreements with federal and state agencies and 
72.28 	other entities, provided the agreements include adequate protections with respect to 
72.29 	the confidentiality and integrity of the information to be shared, and comply with all 
72.30 	applicable state and federal laws, regulations, and rules, including the requirements of 
72.31 	section 62V.06; and
72.32 	(6) exercise all powers reasonably necessary to implement and administer the 
72.33 	requirements of this chapter and the Affordable Care Act, Public Law 111-148.
73.1 	(c) The board shall establish policies and procedures to gather public comment and 
73.2 	provide public notice in the State Register.
73.3 	(d) Within 180 days of enactment, the board shall establish bylaws, policies, and 
73.4 	procedures governing the operations of MNsure in accordance with this chapter.

73.5 	Sec. 11. Minnesota Statutes 2014, section 62V.05, subdivision 5, is amended to read:
73.6 		Subd. 5.Health carrier and health plan requirements; MNsure participation.
 73.7 	(a) Beginning January 1, 2015, the board may establish certification requirements 
73.8 	for health carriers and health plans to be offered through MNsure that satisfy federal 
73.9 	requirements under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148.
73.10 	(b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory 
73.11 	requirements that:
73.12 	(1) apply uniformly to all health carriers and health plans in the individual market;
73.13 	(2) apply uniformly to all health carriers and health plans in the small group market; 
73.14 	and
73.15 	(3) satisfy minimum federal certification requirements under section 1311(c)(1) of 
73.16 	the Affordable Care Act, Public Law 111-148.
73.17 	(c) In accordance with section 1311(e) of the Affordable Care Act, Public Law 
73.18 	111-148, the board shall establish policies and procedures for certification and selection 
73.19 	of health plans to be offered as qualified health plans through MNsure. The board shall 
73.20 	certify and select a health plan as a qualified health plan to be offered through MNsure, if:
73.21 	(1) the health plan meets the minimum certification requirements established in 
73.22 	paragraph (a) or the market regulatory requirements in paragraph (b);
73.23 	(2) the board determines that making the health plan available through MNsure is in 
73.24 	the interest of qualified individuals and qualified employers;
73.25 	(3) the health carrier applying to offer the health plan through MNsure also applies 
73.26 	to offer health plans at each actuarial value level and service area that the health carrier 
73.27 	currently offers in the individual and small group markets; and
73.28 	(4) the health carrier does not apply to offer health plans in the individual and 
73.29 	small group markets through MNsure under a separate license of a parent organization 
73.30 	or holding company under section 60D.15, that is different from what the health carrier 
73.31 	offers in the individual and small group markets outside MNsure.
73.32 	(d) In determining the interests of qualified individuals and employers under 
73.33 	paragraph (c), clause (2), the board may not exclude a health plan for any reason specified 
73.34 	under section 1311(e)(1)(B) of the Affordable Care Act, Public Law 111-148. The board 
73.35 	may consider:
74.1 	(1) affordability;
74.2 	(2) quality and value of health plans;
74.3 	(3) promotion of prevention and wellness;
74.4 	(4) promotion of initiatives to reduce health disparities;
74.5 	(5) market stability and adverse selection;
74.6 	(6) meaningful choices and access;
74.7 	(7) alignment and coordination with state agency and private sector purchasing 
74.8 	strategies and payment reform efforts; and
74.9 	(8) other criteria that the board determines appropriate.
74.10 	(e) For qualified health plans offered through MNsure on or after January 1, 2015, 
74.11 	the board shall establish policies and procedures under paragraphs (c) and (d) for selection 
74.12 	of health plans to be offered as qualified health plans through MNsure by February 1 
74.13 	of each year, beginning February 1, 2014. The board shall consistently and uniformly 
74.14 	apply all policies and procedures and any requirements, standards, or criteria to all health 
74.15 	carriers and health plans. For any policies, procedures, requirements, standards, or criteria 
74.16 	that are defined as rules under section 14.02, subdivision 4, the board may use the process 
74.17 	described in subdivision 9.
74.18 	(f) For 2014, the board shall not have the power to select health carriers and health 
74.19 	plans for participation in MNsure. The board shall permit all health plans that meet the 
74.20 	certification requirements under section 1311(c)(1) of the Affordable Care Act, Public 
74.21 	Law 111-148, to be offered through MNsure.
74.22 	(a) The board shall permit all health plans that meet the applicable certification 
74.23 	requirements to be offered through MNsure.
74.24 	(g) (b) Under this subdivision, the board shall have the power to verify that health 
74.25 	carriers and health plans are properly certified to be eligible for participation in MNsure.
74.26 	(h) (c) The board has the authority to decertify health carriers and health plans that 
74.27 	fail to maintain compliance with section 1311(c)(1) of the Affordable Care Act, Public 
74.28 	Law 111-148.
74.29 	(i) (d) For qualified health plans offered through MNsure beginning January 1, 
74.30 	2015, health carriers must use the most current addendum for Indian health care providers 
74.31 	approved by the Centers for Medicare and Medicaid Services and the tribes as part of their 
74.32 	contracts with Indian health care providers. MNsure shall comply with all future changes 
74.33 	in federal law with regard to health coverage for the tribes.

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

74.35 	Sec. 12. Minnesota Statutes 2014, section 62V.05, subdivision 6, is amended to read:
75.1 		Subd. 6.Appeals. (a) The board may conduct hearings, appoint hearing officers, 
75.2 	and recommend final orders related to appeals of any MNsure determinations, except for 
75.3 	those determinations identified in paragraph (d). An appeal by a health carrier regarding 
75.4 	a specific certification or selection determination made by MNsure under subdivision 5 
75.5 	must be conducted as a contested case proceeding under chapter 14, with the report or 
75.6 	order of the administrative law judge constituting the final decision in the case, subject to 
75.7 	judicial review under sections 14.63 to 14.69. For other appeals, the board shall establish 
75.8 	hearing processes which provide for a reasonable opportunity to be heard and timely 
75.9 	resolution of the appeal and which are consistent with the requirements of federal law and 
75.10 	guidance. An appealing party may be represented by legal counsel at these hearings, but 
75.11 	this is not a requirement.
75.12 	(b) MNsure may establish service-level agreements with state agencies to conduct 
75.13 	hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is 
75.14 	authorized to enter into service-level agreements for this purpose with MNsure.
75.15 	(c) For proceedings under this subdivision, MNsure may be represented by an 
75.16 	attorney who is an employee of MNsure.
75.17 	(d) This subdivision does not apply to appeals of determinations where a state 
75.18 	agency hearing is available under section 256.045.

75.19 	Sec. 13. Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision 
75.20 	to read:
75.21 		Subd. 11.Health carrier notification. MNsure shall provide a health carrier with 
75.22 	enrollment information for MNsure enrollees who have selected a qualified health plan 
75.23 	that is offered by that health carrier and who have been determined by MNsure to be 
75.24 	eligible for qualified health plan coverage. The enrollment information must be sufficient 
75.25 	for the health carrier to issue coverage and must be provided within 48 hours of the 
75.26 	determination of eligibility by MNsure.

75.27 	Sec. 14. Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision 
75.28 	to read:
75.29 		Subd. 12.Purchase of individual health coverage. For coverage taking effect on 
75.30 	or after January 1, 2016, the MNsure board shall provide members of a household with the 
75.31 	option of purchasing individual health coverage through MNsure and shall apportion any 
75.32 	advanced premium tax credit available to a household choosing this option between the 
75.33 	separate health plans providing coverage to the household members.

76.1 	Sec. 15. Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision 
76.2 	to read:
76.3 		Subd. 13.Prohibition on other product lines. MNsure is prohibited from 
76.4 	certifying, selecting, or offering products and policies of coverage that do not meet the 
76.5 	definition of health plan or dental plan as provided in section 62V.02.

76.6 	Sec. 16. Minnesota Statutes 2014, section 62V.11, subdivision 2, is amended to read:
76.7 		Subd. 2.Membership; meetings; compensation. (a) The Legislative Oversight 
76.8 	Committee shall consist of five members of the senate, three members appointed by 
76.9 	the majority leader of the senate, and two members appointed by the minority leader of 
76.10 	the senate; and five members of the house of representatives, three members appointed 
76.11 	by the speaker of the house, and two members appointed by the minority leader of the 
76.12 	house of representatives.
76.13 	(b) Appointed legislative members serve at the pleasure of the appointing authority 
76.14 	and shall continue to serve until their successors are appointed.
76.15 	(c) The first meeting of the committee shall be convened by the chair of the 
76.16 	Legislative Coordinating Commission. Members shall elect a chair at the first meeting. 
76.17 	The chair must convene at least one meeting annually each quarter of the year, and may 
76.18 	convene other meetings as deemed necessary.

76.19 	Sec. 17. Minnesota Statutes 2014, section 62V.11, is amended by adding a subdivision 
76.20 	to read:
76.21 		Subd. 5.Reports to the committee. (a) The board shall submit an enrollment report 
76.22 	to the Legislative Oversight Committee on a monthly basis. The report must include:
76.23 	(1) total enrollment numbers;
76.24 	(2) the number of commercial plans selected;
76.25 	(3) the percentage of the commercial plans for which the first month's premium 
76.26 	has been paid; and
76.27 	(4) the average number of days between a consumer's submission of an application 
76.28 	and transmittal to the health carrier chosen.
76.29 	(b) At each of the committee's quarterly meetings, the board shall present the 
76.30 	following information:
76.31 	(1) at the first quarterly meeting, a progress report on the most recent MNsure 
76.32 	open enrollment period and a progress report on technology upgrades and any proposed 
76.33 	schedule for future technology upgrades;
77.1 	(2) at the second quarterly meeting, the annual budget for MNsure, as required by 
77.2 	subdivision 4;
77.3 	(3) at the third quarterly meeting, a hearing in conjunction with the Department of 
77.4 	Human Services regarding any backlog created by qualifying life events for enrollees in 
77.5 	public or private health plans through MNsure; and
77.6 	(4) at the fourth quarterly meeting, a hearing in conjunction with the Department of 
77.7 	Commerce on the release of premium rates and in conjunction with the Department of 
77.8 	Human Services on reimbursement of MNsure for public program enrollment.

77.9 	Sec. 18. Minnesota Statutes 2014, section 245C.03, is amended by adding a 
77.10 	subdivision to read:
77.11 		Subd. 10.MNsure consumer assistance partners. Effective January 1, 2016, the 
77.12 	commissioner shall conduct background studies on any individual required under section 
77.13 	256.962, subdivision 9, to have a background study completed under this chapter.

77.14 	Sec. 19. Minnesota Statutes 2014, section 245C.10, is amended by adding a 
77.15 	subdivision to read:
77.16 		Subd. 11.MNsure consumer assistance partners. The commissioner shall recover 
77.17 	the cost of background studies required under section 256.962, subdivision 9, through 
77.18 	a fee of no more than $20 per study. The fees collected under this subdivision are 
77.19 	appropriated to the commissioner for the purpose of conducting background studies.

77.20 	Sec. 20. Minnesota Statutes 2014, section 256.962, is amended by adding a subdivision 
77.21 	to read:
77.22 		Subd. 9.Background studies for consumer assistance partners. Effective January 
77.23 	1, 2016, all consumer assistance partners, as defined in section 62V.02, subdivision 2a, are 
77.24 	required to undergo a background study according to the requirements of chapter 245C.

77.25 	Sec. 21. TRANSITION.
 77.26 	(a) The commissioner of management and budget must assign the positions of 
77.27 	managerial employees of MNsure, other than the director, to salary ranges and salaries in 
77.28 	the managerial plan, effective the first payroll period beginning on or after July 1, 2015.
77.29 	(b) Of the four additional members of the board appointed under the amendments 
77.30 	to Minnesota Statutes, section 62V.04, one shall have an initial term of two years, two 
77.31 	shall have an initial term of three years, and one shall have an initial term of four years, 
77.32 	determined by lot by the secretary of state.
78.1 	(c) Board members must be appointed by the governor within 30 days of final 
78.2 	enactment of these sections.

78.3 	Sec. 22. EXPANDED ACCESS TO THE SMALL BUSINESS HEALTH CARE 
78.4 	TAX CREDIT.
 78.5 	(a) The commissioner of human services, in consultation with the Board of Directors 
78.6 	of MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal 
78.7 	to allow small employers the ability to receive the small business health care tax credit 
78.8 	when the small employer pays the premiums on behalf of employees enrolled in either a 
78.9 	qualified health plan offered through a small business health options program (SHOP) 
78.10 	marketplace or a small group health plan offered outside of the SHOP marketplace within 
78.11 	MNsure. To be eligible for the tax credit, the small employer must meet the requirements 
78.12 	under the Affordable Care Act, except that employees may be enrolled in a small group 
78.13 	health plan product offered outside of MNsure.
78.14 	(b) The commissioner shall seek all federal waivers and approvals necessary to 
78.15 	implement the proposal in paragraph (a). The commissioner shall submit a draft proposal 
78.16 	to the MNsure board and the MNsure Legislative Oversight Committee at least 30 days 
78.17 	before submitting a final proposal to the federal government, and shall notify the board 
78.18 	and Legislative Oversight Committee of any federal decision or action received regarding 
78.19 	the proposal and submitted waiver.

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

78.21 	Sec. 23. CONFIRMATION DEADLINE.
 78.22 	Members of the MNsure Board on the effective date of this section and new 
78.23 	members appointed as required by the amendments to Minnesota Statutes, section 62V.04, 
78.24 	are subject to confirmation by the senate. If any of these members is not confirmed by the 
78.25 	senate before adjournment sine die of the 2016 regular session, the appointment of that 
78.26 	member to the board terminates on the day following adjournment sine die.

78.27 	Sec. 24. ESTABLISHMENT OF FEDERALLY FACILITATED 
78.28 	MARKETPLACE.
78.29 		Subdivision 1.Establishment. The commissioner of commerce, in cooperation 
78.30 	with the secretary of Health and Human Services, shall establish a federally facilitated 
78.31 	marketplace for Minnesota, for coverage beginning January 1, 2017. The federally 
78.32 	facilitated marketplace shall take the place of MNsure, established under Minnesota 
79.1 	Statutes, chapter 62V. In working with the secretary of Health and Human Services to 
79.2 	develop the federally facilitated marketplace, the commissioner of commerce shall:
79.3 	(1) seek to incorporate, where appropriate and cost-effective, elements of the 
79.4 	MNsure eligibility determination system;
79.5 	(2) regularly consult with stakeholder groups, including but not limited to 
79.6 	representatives of state agencies, health care providers, health plan companies, brokers, 
79.7 	and consumers; and
79.8 	(3) seek all available federal grants and funds for state planning and development 
79.9 	costs.
79.10 		Subd. 2.Implementation plan; draft legislation. The commissioner of commerce, 
79.11 	in consultation with the commissioner of human services, the chief information officer 
79.12 	of MN.IT, and the MNsure Board, shall develop and present to the 2016 legislature an 
79.13 	implementation plan for conversion to a federally facilitated marketplace. The plan must 
79.14 	include draft legislation for any changes in state law necessary to implement a federally 
79.15 	facilitated marketplace, including but not limited to necessary changes to Laws 2013, 
79.16 	chapter 84, and technical and conforming changes related to the repeal of Minnesota 
79.17 	Statutes, chapter 62V.
79.18 		Subd. 3.Vendor contract. The commissioner of commerce, in consultation with 
79.19 	the commissioner of human services, the chief information officer of MN.IT, and the 
79.20 	MNsure Board, shall contract with a vendor to provide technical assistance in developing 
79.21 	and implementing the plan for conversion to a federally facilitated marketplace.
79.22 		Subd. 4.Contingent implementation. The commissioner shall not implement 
79.23 	this section if the United States Supreme Court rules in King v. Burwell (No. 14-114) 
79.24 	that persons obtaining qualified health plan coverage through a federally facilitated 
79.25 	marketplace are not eligible for advanced premium tax credits.

79.26 	Sec. 25. REQUIREMENTS FOR STATE MATCH FOR FEDERAL GRANTS.
 79.27 	(a) The legislature shall not appropriate or authorize the use of state funds, and the 
79.28 	MNsure Board and the commissioner of human services shall not allocate, authorize the 
79.29 	use of, or expend board or agency funds, as a state match to obtain federal grant funding 
79.30 	for MNsure, including, but not limited to, grants to support the development and operation 
79.31 	of the MNsure eligibility determination system, unless the following conditions are met:
79.32 	(1) 20 percent of the state match and 20 percent of federal grant funds received are 
79.33 	deposited into a premium reimbursement account established by the MNsure Board, for 
79.34 	use as provided in paragraph (b);
80.1 	(2) the commissioner of human services and the legislative auditor have verified 
80.2 	that all persons currently enrolled in medical assistance and MinnesotaCare, who were 
80.3 	enrolled in medical assistance or MinnesotaCare as of September 30, 2013, have had their 
80.4 	eligibility for the program redetermined at least once since September 30, 2013;
80.5 	(3) the administrative costs of MNsure are less than five percent of MNsure's total 
80.6 	operating budget in each year; and
80.7 	(4) verification from the Office of the Legislative Auditor that:
80.8 	(i) all life events or changes in circumstances are being processed in a timely manner 
80.9 	by MNsure and the Department of Human Services; and
80.10 	(ii) MNsure is transmitting electronic enrollment files in a format that conforms with 
80.11 	standards under the federal Health Insurance Portability and Accountability Act of 1996.
80.12 	(b) Funds deposited into the premium reimbursement account shall be used only to 
80.13 	reimburse the first month's premium for health coverage for any individual who submitted 
80.14 	a complete application for qualified health plan coverage through MNsure, but did not 
80.15 	receive their policy card or other appropriate verification of coverage within 20 days of 
80.16 	submittal of the completed application to MNsure. The MNsure Board shall provide this 
80.17 	reimbursement on a first-come, first-served basis, subject to the limits of available funding.

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

80.19 	Sec. 26. REPEALER.
 80.20 	(a) Minnesota Statutes 2014, sections 62V.01; 62V.02; 62V.03; 62V.04; 62V.05; 
80.21 	62V.06; 62V.07; 62V.08; 62V.09; 62V.10; and 62V.11, are repealed, effective January 1, 
80.22 	2017. This repealer shall not take effect if the United States Supreme Court rules in King 
80.23 	v. Burwell (No. 14-114) that persons obtaining qualified health plan coverage through a 
80.24 	federally facilitated marketplace are not eligible for advanced premium tax credits.
80.25 	(b) Minnesota Statutes 2014, section 13D.08, subdivision 5a, is repealed.

80.26 	ARTICLE 4
80.27 	CONTINUING CARE

80.28 	Section 1. Minnesota Statutes 2014, section 13.461, is amended by adding a 
80.29 	subdivision to read:
80.30 		Subd. 32.ABLE accounts and designated beneficiaries. Data on ABLE accounts 
80.31 	and designated beneficiaries of ABLE accounts are classified under section 256Q.05, 
80.32 	subdivision 7.

81.1 	Sec. 2. Minnesota Statutes 2014, section 245A.06, is amended by adding a subdivision 
81.2 	to read:
81.3 		Subd. 1a.Correction orders and conditional licenses for programs licensed as 
81.4 	home and community-based services. (a) For programs licensed under both this chapter 
81.5 	and chapter 245D, if the license holder operates more than one service site under a single 
81.6 	license governed by chapter 245D, the order issued under this section shall be specific to 
81.7 	the service site or sites at which the violations of applicable law or rules occurred. The 
81.8 	order shall not apply to other service sites governed by chapter 245D and operated by the 
81.9 	same license holder unless the commissioner has included in the order the articulable basis 
81.10 	for applying the order to another service site.
81.11 	(b) If the commissioner has issued more than one license to the license holder under 
81.12 	this chapter, the conditions imposed under this section shall be specific to the license for 
81.13 	the program at which the violations of applicable law or rules occurred and shall not apply 
81.14 	to other licenses held by the same license holder if those programs are being operated in 
81.15 	substantial compliance with applicable law and rules.

81.16 	Sec. 3. [245A.081] SETTLEMENT AGREEMENT.
81.17 	(a) A license holder who has made a timely appeal pursuant to section 245A.06, 
81.18 	subdivision 4, or 245A.07, subdivision 3, or the commissioner may initiate a discussion 
81.19 	about a possible settlement agreement related to the licensing sanction. For the purposes 
81.20 	of this section, the following conditions apply to a settlement agreement reached by the 
81.21 	parties:
81.22 	(1) if the parties enter into a settlement agreement, the effect of the agreement shall 
81.23 	be that the appeal is withdrawn and the agreement shall constitute the full agreement 
81.24 	between the commissioner and the party who filed the appeal; and
81.25 	(2) the settlement agreement must identify the agreed upon actions the license holder 
81.26 	has taken and will take in order to achieve and maintain compliance with the licensing 
81.27 	requirements that the commissioner determined the license holder had violated.
81.28 	(b) Neither the license holder nor the commissioner is required to initiate a 
81.29 	settlement discussion under this section.
81.30 	(c) If a settlement discussion is initiated by the license holder, the commissioner 
81.31 	shall respond to the license holder within 14 calendar days of receipt of the license 
81.32 	holder's submission.
81.33 	(d) If the commissioner agrees to engage in settlement discussions, the commissioner 
81.34 	may decide at any time not to continue settlement discussions with a license holder.

82.1 	Sec. 4. Minnesota Statutes 2014, section 245A.155, subdivision 1, is amended to read:
82.2 		Subdivision 1.Licensed foster care and respite care. This section applies to 
82.3 	foster care agencies and licensed foster care providers who place, supervise, or care for 
82.4 	individuals who rely on medical monitoring equipment to sustain life or monitor a medical 
82.5 	condition that could become life-threatening without proper use of the medical equipment 
82.6 	in respite care or foster care.

82.7 	Sec. 5. Minnesota Statutes 2014, section 245A.155, subdivision 2, is amended to read:
82.8 		Subd. 2.Foster care agency requirements. In order for an agency to place an 
82.9 	individual who relies on medical equipment to sustain life or monitor a medical condition 
82.10 	that could become life-threatening without proper use of the medical equipment with a 
82.11 	foster care provider, the agency must ensure that the foster care provider has received the 
82.12 	training to operate such equipment as observed and confirmed by a qualified source, 
82.13 	and that the provider:
82.14 	(1) is currently caring for an individual who is using the same equipment in the 
82.15 	foster home; or
82.16 	(2) has written documentation that the foster care provider has cared for an 
82.17 	individual who relied on such equipment within the past six months; or
82.18 	(3) has successfully completed training with the individual being placed with the 
82.19 	provider.

82.20 	Sec. 6. Minnesota Statutes 2014, section 245A.65, subdivision 2, is amended to read:
82.21 		Subd. 2.Abuse prevention plans. All license holders shall establish and enforce 
82.22 	ongoing written program abuse prevention plans and individual abuse prevention plans as 
82.23 	required under section 626.557, subdivision 14.
82.24 	(a) The scope of the program abuse prevention plan is limited to the population, 
82.25 	physical plant, and environment within the control of the license holder and the location 
82.26 	where licensed services are provided. In addition to the requirements in section 626.557, 
82.27 	subdivision 14, the program abuse prevention plan shall meet the requirements in clauses 
82.28 	(1) to (5).
82.29 	(1) The assessment of the population shall include an evaluation of the following 
82.30 	factors: age, gender, mental functioning, physical and emotional health or behavior of the 
82.31 	client; the need for specialized programs of care for clients; the need for training of staff to 
82.32 	meet identified individual needs; and the knowledge a license holder may have regarding 
82.33 	previous abuse that is relevant to minimizing risk of abuse for clients.
83.1 	(2) The assessment of the physical plant where the licensed services are provided 
83.2 	shall include an evaluation of the following factors: the condition and design of the 
83.3 	building as it relates to the safety of the clients; and the existence of areas in the building 
83.4 	which are difficult to supervise.
83.5 	(3) The assessment of the environment for each facility and for each site when living 
83.6 	arrangements are provided by the agency shall include an evaluation of the following 
83.7 	factors: the location of the program in a particular neighborhood or community; the type 
83.8 	of grounds and terrain surrounding the building; the type of internal programming; and 
83.9 	the program's staffing patterns.
83.10 	(4) The license holder shall provide an orientation to the program abuse prevention 
83.11 	plan for clients receiving services. If applicable, the client's legal representative must be 
83.12 	notified of the orientation. The license holder shall provide this orientation for each new 
83.13 	person within 24 hours of admission, or for persons who would benefit more from a later 
83.14 	orientation, the orientation may take place within 72 hours.
83.15 	(5) The license holder's governing body or the governing body's delegated 
83.16 	representative shall review the plan at least annually using the assessment factors in the 
83.17 	plan and any substantiated maltreatment findings that occurred since the last review. The 
83.18 	governing body or the governing body's delegated representative shall revise the plan, 
83.19 	if necessary, to reflect the review results.
83.20 	(6) A copy of the program abuse prevention plan shall be posted in a prominent 
83.21 	location in the program and be available upon request to mandated reporters, persons 
83.22 	receiving services, and legal representatives.
83.23 	(b) In addition to the requirements in section 626.557, subdivision 14, the individual 
83.24 	abuse prevention plan shall meet the requirements in clauses (1) and (2).
83.25 	(1) The plan shall include a statement of measures that will be taken to minimize the 
83.26 	risk of abuse to the vulnerable adult when the individual assessment required in section 
83.27 	626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the 
83.28 	specific measures identified in the program abuse prevention plan. The measures shall 
83.29 	include the specific actions the program will take to minimize the risk of abuse within 
83.30 	the scope of the licensed services, and will identify referrals made when the vulnerable 
83.31 	adult is susceptible to abuse outside the scope or control of the licensed services. When 
83.32 	the assessment indicates that the vulnerable adult does not need specific risk reduction 
83.33 	measures in addition to those identified in the program abuse prevention plan, the 
83.34 	individual abuse prevention plan shall document this determination.
83.35 	(2) An individual abuse prevention plan shall be developed for each new person as 
83.36 	part of the initial individual program plan or service plan required under the applicable 
84.1 	licensing rule. The review and evaluation of the individual abuse prevention plan shall 
84.2 	be done as part of the review of the program plan or service plan. The person receiving 
84.3 	services shall participate in the development of the individual abuse prevention plan to the 
84.4 	full extent of the person's abilities. If applicable, the person's legal representative shall be 
84.5 	given the opportunity to participate with or for the person in the development of the plan. 
84.6 	The interdisciplinary team shall document the review of all abuse prevention plans at least 
84.7 	annually, using the individual assessment and any reports of abuse relating to the person. 
84.8 	The plan shall be revised to reflect the results of this review.

84.9 	Sec. 7. Minnesota Statutes 2014, section 245D.02, is amended by adding a subdivision 
84.10 	to read:
84.11 		Subd. 37.Working day. "Working day" means Monday, Tuesday, Wednesday, 
84.12 	Thursday, or Friday, excluding any legal holiday.

84.13 	Sec. 8. Minnesota Statutes 2014, section 245D.05, subdivision 1, is amended to read:
84.14 		Subdivision 1.Health needs. (a) The license holder is responsible for meeting 
84.15 	health service needs assigned in the coordinated service and support plan or the 
84.16 	coordinated service and support plan addendum, consistent with the person's health needs. 
84.17 	Unless directed otherwise in the coordinated service and support plan or the coordinated 
84.18 	service and support plan addendum, the license holder is responsible for promptly 
84.19 	notifying the person's legal representative, if any, and the case manager of changes in a 
84.20 	person's physical and mental health needs affecting health service needs assigned to the 
84.21 	license holder in the coordinated service and support plan or the coordinated service 
84.22 	and support plan addendum, when discovered by the license holder, unless the license 
84.23 	holder has reason to know the change has already been reported. The license holder 
84.24 	must document when the notice is provided.
84.25 	(b) If responsibility for meeting the person's health service needs has been assigned 
84.26 	to the license holder in the coordinated service and support plan or the coordinated service 
84.27 	and support plan addendum, the license holder must maintain documentation on how the 
84.28 	person's health needs will be met, including a description of the procedures the license 
84.29 	holder will follow in order to:
84.30 	(1) provide medication setup, assistance, or administration according to this chapter. 
84.31 	Unlicensed staff responsible for medication setup or medication administration under this 
84.32 	section must complete training according to section 245D.09, subdivision 4a, paragraph (d);
84.33 	(2) monitor health conditions according to written instructions from a licensed 
84.34 	health professional;
85.1 	(3) assist with or coordinate medical, dental, and other health service appointments; or
85.2 	(4) use medical equipment, devices, or adaptive aides or technology safely and 
85.3 	correctly according to written instructions from a licensed health professional.

85.4 	Sec. 9. Minnesota Statutes 2014, section 245D.05, subdivision 2, is amended to read:
85.5 		Subd. 2.Medication administration. (a) For purposes of this subdivision, 
85.6 	"medication administration" means:
85.7 	(1) checking the person's medication record;
85.8 	(2) preparing the medication as necessary;
85.9 	(3) administering the medication or treatment to the person;
85.10 	(4) documenting the administration of the medication or treatment or the reason for 
85.11 	not administering the medication or treatment; and
85.12 	(5) reporting to the prescriber or a nurse any concerns about the medication or 
85.13 	treatment, including side effects, effectiveness, or a pattern of the person refusing to 
85.14 	take the medication or treatment as prescribed. Adverse reactions must be immediately 
85.15 	reported to the prescriber or a nurse.
85.16 	(b)(1) If responsibility for medication administration is assigned to the license holder 
85.17 	in the coordinated service and support plan or the coordinated service and support plan 
85.18 	addendum, the license holder must implement medication administration procedures to 
85.19 	ensure a person takes medications and treatments as prescribed. The license holder must 
85.20 	ensure that the requirements in clauses (2) and (3) have been met before administering 
85.21 	medication or treatment.
85.22 	(2) The license holder must obtain written authorization from the person or the 
85.23 	person's legal representative to administer medication or treatment and must obtain 
85.24 	reauthorization annually as needed. This authorization shall remain in effect unless it is 
85.25 	withdrawn in writing and may be withdrawn at any time. If the person or the person's 
85.26 	legal representative refuses to authorize the license holder to administer medication, the 
85.27 	medication must not be administered. The refusal to authorize medication administration 
85.28 	must be reported to the prescriber as expediently as possible.
85.29 	(3) For a license holder providing intensive support services, the medication or 
85.30 	treatment must be administered according to the license holder's medication administration 
85.31 	policy and procedures as required under section 245D.11, subdivision 2, clause (3).
85.32 	(c) The license holder must ensure the following information is documented in the 
85.33 	person's medication administration record:
85.34 	(1) the information on the current prescription label or the prescriber's current 
85.35 	written or electronically recorded order or prescription that includes the person's name, 
86.1 	description of the medication or treatment to be provided, and the frequency and other 
86.2 	information needed to safely and correctly administer the medication or treatment to 
86.3 	ensure effectiveness;
86.4 	(2) information on any risks or other side effects that are reasonable to expect, and 
86.5 	any contraindications to its use. This information must be readily available to all staff 
86.6 	administering the medication;
86.7 	(3) the possible consequences if the medication or treatment is not taken or 
86.8 	administered as directed;
86.9 	(4) instruction on when and to whom to report the following:
86.10 	(i) if a dose of medication is not administered or treatment is not performed as 
86.11 	prescribed, whether by error by the staff or the person or by refusal by the person; and
86.12 	(ii) the occurrence of possible adverse reactions to the medication or treatment;
86.13 	(5) notation of any occurrence of a dose of medication not being administered or 
86.14 	treatment not performed as prescribed, whether by error by the staff or the person or by 
86.15 	refusal by the person, or of adverse reactions, and when and to whom the report was 
86.16 	made; and
86.17 	(6) notation of when a medication or treatment is started, administered, changed, or 
86.18 	discontinued.

86.19 	Sec. 10. Minnesota Statutes 2014, section 245D.06, subdivision 1, is amended to read:
86.20 		Subdivision 1.Incident response and reporting.  (a) The license holder must 
86.21 	respond to incidents under section 245D.02, subdivision 11, that occur while providing 
86.22 	services to protect the health and safety of and minimize risk of harm to the person.
86.23 	(b) The license holder must maintain information about and report incidents to the 
86.24 	person's legal representative or designated emergency contact and case manager within 
86.25 	24 hours of an incident occurring while services are being provided, within 24 hours of 
86.26 	discovery or receipt of information that an incident occurred, unless the license holder 
86.27 	has reason to know that the incident has already been reported, or as otherwise directed 
86.28 	in a person's coordinated service and support plan or coordinated service and support 
86.29 	plan addendum. An incident of suspected or alleged maltreatment must be reported as 
86.30 	required under paragraph (d), and an incident of serious injury or death must be reported 
86.31 	as required under paragraph (e).
86.32 	(c) When the incident involves more than one person, the license holder must not 
86.33 	disclose personally identifiable information about any other person when making the report 
86.34 	to each person and case manager unless the license holder has the consent of the person.
87.1 	(d) Within 24 hours of reporting maltreatment as required under section 626.556 
87.2 	or 626.557, the license holder must inform the case manager of the report unless there is 
87.3 	reason to believe that the case manager is involved in the suspected maltreatment. The 
87.4 	license holder must disclose the nature of the activity or occurrence reported and the 
87.5 	agency that received the report.
87.6 	(e) The license holder must report the death or serious injury of the person as 
87.7 	required in paragraph (b) and to the Department of Human Services Licensing Division, 
87.8 	and the Office of Ombudsman for Mental Health and Developmental Disabilities as 
87.9 	required under section 245.94, subdivision 2a, within 24 hours of the death or serious 
87.10 	injury, or receipt of information that the death or serious injury occurred, unless the license 
87.11 	holder has reason to know that the death or serious injury has already been reported.
87.12 	(f) When a death or serious injury occurs in a facility certified as an intermediate 
87.13 	care facility for persons with developmental disabilities, the death or serious injury must 
87.14 	be reported to the Department of Health, Office of Health Facility Complaints, and the 
87.15 	Office of Ombudsman for Mental Health and Developmental Disabilities, as required 
87.16 	under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to 
87.17 	know that the death or serious injury has already been reported.
87.18 	(g) The license holder must conduct an internal review of incident reports of deaths 
87.19 	and serious injuries that occurred while services were being provided and that were not 
87.20 	reported by the program as alleged or suspected maltreatment, for identification of incident 
87.21 	patterns, and implementation of corrective action as necessary to reduce occurrences. 
87.22 	The review must include an evaluation of whether related policies and procedures were 
87.23 	followed, whether the policies and procedures were adequate, whether there is a need for 
87.24 	additional staff training, whether the reported event is similar to past events with the 
87.25 	persons or the services involved, and whether there is a need for corrective action by the 
87.26 	license holder to protect the health and safety of persons receiving services. Based on 
87.27 	the results of this review, the license holder must develop, document, and implement a 
87.28 	corrective action plan designed to correct current lapses and prevent future lapses in 
87.29 	performance by staff or the license holder, if any.
87.30 	(h) The license holder must verbally report the emergency use of manual restraint 
87.31 	of a person as required in paragraph (b) within 24 hours of the occurrence. The license 
87.32 	holder must ensure the written report and internal review of all incident reports of the 
87.33 	emergency use of manual restraints are completed according to the requirements in section 
87.34 	245D.061 or successor provisions.

87.35 	Sec. 11. Minnesota Statutes 2014, section 245D.06, subdivision 2, is amended to read:
88.1 		Subd. 2.Environment and safety. The license holder must:
88.2 	(1) ensure the following when the license holder is the owner, lessor, or tenant 
88.3 	of the service site:
88.4 	(i) the service site is a safe and hazard-free environment;
88.5 	(ii) that toxic substances or dangerous items are inaccessible to persons served by 
88.6 	the program only to protect the safety of a person receiving services when a known safety 
88.7 	threat exists and not as a substitute for staff supervision or interactions with a person who 
88.8 	is receiving services. If toxic substances or dangerous items are made inaccessible, the 
88.9 	license holder must document an assessment of the physical plant, its environment, and its 
88.10 	population identifying the risk factors which require toxic substances or dangerous items 
88.11 	to be inaccessible and a statement of specific measures to be taken to minimize the safety 
88.12 	risk to persons receiving services and to restore accessibility to all persons receiving 
88.13 	services at the service site;
88.14 	(iii) doors are locked from the inside to prevent a person from exiting only when 
88.15 	necessary to protect the safety of a person receiving services and not as a substitute for 
88.16 	staff supervision or interactions with the person. If doors are locked from the inside, the 
88.17 	license holder must document an assessment of the physical plant, the environment and 
88.18 	the population served, identifying the risk factors which require the use of locked doors, 
88.19 	and a statement of specific measures to be taken to minimize the safety risk to persons 
88.20 	receiving services at the service site; and
88.21 	(iv) a staff person is available at the service site who is trained in basic first aid and, 
88.22 	when required in a person's coordinated service and support plan or coordinated service 
88.23 	and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are 
88.24 	present and staff are required to be at the site to provide direct support service. The CPR 
88.25 	training must include in-person instruction, hands-on practice, and an observed skills 
88.26 	assessment under the direct supervision of a CPR instructor;
88.27 	(2) maintain equipment, vehicles, supplies, and materials owned or leased by the 
88.28 	license holder in good condition when used to provide services;
88.29 	(3) follow procedures to ensure safe transportation, handling, and transfers of the 
88.30 	person and any equipment used by the person, when the license holder is responsible for 
88.31 	transportation of a person or a person's equipment;
88.32 	(4) be prepared for emergencies and follow emergency response procedures to 
88.33 	ensure the person's safety in an emergency; and
88.34 	(5) follow universal precautions and sanitary practices, including hand washing, for 
88.35 	infection prevention and control, and to prevent communicable diseases.

89.1 	Sec. 12. Minnesota Statutes 2014, section 245D.06, subdivision 7, is amended to read:
89.2 		Subd. 7.Permitted actions and procedures. (a) Use of the instructional techniques 
89.3 	and intervention procedures as identified in paragraphs (b) and (c) is permitted when used 
89.4 	on an intermittent or continuous basis. When used on a continuous basis, it must be 
89.5 	addressed in a person's coordinated service and support plan addendum as identified in 
89.6 	sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this 
89.7 	subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
89.8 	(b) Physical contact or instructional techniques must use the least restrictive 
89.9 	alternative possible to meet the needs of the person and may be used:
89.10 	(1) to calm or comfort a person by holding that person with no resistance from 
89.11 	that person;
89.12 	(2) to protect a person known to be at risk of injury due to frequent falls as a result 
89.13 	of a medical condition;
89.14 	(3) to facilitate the person's completion of a task or response when the person does 
89.15 	not resist or the person's resistance is minimal in intensity and duration;
89.16 	(4) to block or redirect a person's limbs or body without holding the person or 
89.17 	limiting the person's movement to interrupt the person's behavior that may result in injury 
89.18 	to self or others with less than 60 seconds of physical contact by staff; or
89.19 	(5) to redirect a person's behavior when the behavior does not pose a serious threat 
89.20 	to the person or others and the behavior is effectively redirected with less than 60 seconds 
89.21 	of physical contact by staff.
89.22 	(c) Restraint may be used as an intervention procedure to:
89.23 	(1) allow a licensed health care professional to safely conduct a medical examination 
89.24 	or to provide medical treatment ordered by a licensed health care professional to a person 
89.25 	necessary to promote healing or recovery from an acute, meaning short-term, medical 
89.26 	condition;
89.27 	(2) assist in the safe evacuation or redirection of a person in the event of an 
89.28 	emergency and the person is at imminent risk of harm; or
89.29 	(3) position a person with physical disabilities in a manner specified in the person's 
89.30 	coordinated service and support plan addendum.
89.31 	Any use of manual restraint as allowed in this paragraph must comply with the restrictions 
89.32 	identified in subdivision 6, paragraph (b).
89.33 	(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment 
89.34 	ordered by a licensed health professional to treat a diagnosed medical condition do not in 
89.35 	and of themselves constitute the use of mechanical restraint.

90.1 	Sec. 13. Minnesota Statutes 2014, section 245D.07, subdivision 2, is amended to read:
90.2 		Subd. 2.Service planning requirements for basic support services. (a) License 
90.3 	holders providing basic support services must meet the requirements of this subdivision.
90.4 	(b) Within 15 calendar days of service initiation the license holder must complete 
90.5 	a preliminary coordinated service and support plan addendum based on the coordinated 
90.6 	service and support plan.
90.7 	(c) Within 60 calendar days of service initiation the license holder must review 
90.8 	and revise as needed the preliminary coordinated service and support plan addendum to 
90.9 	document the services that will be provided including how, when, and by whom services 
90.10 	will be provided, and the person responsible for overseeing the delivery and coordination 
90.11 	of services.
90.12 	(d) The license holder must participate in service planning and support team 
90.13 	meetings for the person following stated timelines established in the person's coordinated 
90.14 	service and support plan or as requested by the person or the person's legal representative, 
90.15 	the support team or the expanded support team.

90.16 	Sec. 14. Minnesota Statutes 2014, section 245D.071, subdivision 5, is amended to read:
90.17 		Subd. 5.Service plan review and evaluation. (a) The license holder must give the 
90.18 	person or the person's legal representative and case manager an opportunity to participate 
90.19 	in the ongoing review and development of the service plan and the methods used to support 
90.20 	the person and accomplish outcomes identified in subdivisions 3 and 4. The license holder, 
90.21 	in coordination with the person's support team or expanded support team, must meet 
90.22 	with the person, the person's legal representative, and the case manager, and participate 
90.23 	in service plan review meetings following stated timelines established in the person's 
90.24 	coordinated service and support plan or coordinated service and support plan addendum or 
90.25 	within 30 days of a written request by the person, the person's legal representative, or the 
90.26 	case manager, at a minimum of once per year. The purpose of the service plan review 
90.27 	is to determine whether changes are needed to the service plan based on the assessment 
90.28 	information, the license holder's evaluation of progress towards accomplishing outcomes, 
90.29 	or other information provided by the support team or expanded support team.
90.30 	(b) The license holder must summarize the person's status and progress toward 
90.31 	achieving the identified outcomes and make recommendations and identify the rationale 
90.32 	for changing, continuing, or discontinuing implementation of supports and methods 
90.33 	identified in subdivision 4 in a written report sent to the person or the person's legal 
90.34 	representative and case manager five working days prior to the review meeting, unless the 
90.35 	person, the person's legal representative, or the case manager requests to receive the report 
91.1 	available at the time of the progress review meeting. The report must be sent at least 
91.2 	five working days prior to the progress review meeting if requested by the team in the 
91.3 	coordinated service and support plan or coordinated service and support plan addendum.
91.4 	(c) The license holder must send the coordinated service and support plan addendum 
91.5 	to the person, the person's legal representative, and the case manager by mail within ten 
91.6 	working days of the progress review meeting. Within ten working days of the progress 
91.7 	review meetingmailing of the coordinated service and support plan addendum, the license 
91.8 	holder must obtain dated signatures from the person or the person's legal representative 
91.9 	and the case manager to document approval of any changes to the coordinated service and 
91.10 	support plan addendum.
91.11 	(d) If, within ten working days of submitting changes to the coordinated service 
91.12 	and support plan and coordinated service and support plan addendum, the person or the 
91.13 	person's legal representative or case manager has not signed and returned to the license 
91.14 	holder the coordinated service and support plan or coordinated service and support plan 
91.15 	addendum or has not proposed written modifications to the license holder's submission, the 
91.16 	submission is deemed approved and the coordinated service and support plan addendum 
91.17 	becomes effective and remains in effect until the legal representative or case manager 
91.18 	submits a written request to revise the coordinated service and support plan addendum.

91.19 	Sec. 15. Minnesota Statutes 2014, section 245D.09, subdivision 3, is amended to read:
91.20 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff providing 
91.21 	direct support, or staff who have responsibilities related to supervising or managing the 
91.22 	provision of direct support service, are competent as demonstrated through skills and 
91.23 	knowledge training, experience, and education relevant to the primary disability of the 
91.24 	person and to meet the person's needs and additional requirements as written in the 
91.25 	coordinated service and support plan or coordinated service and support plan addendum, 
91.26 	or when otherwise required by the case manager or the federal waiver plan. The license 
91.27 	holder must verify and maintain evidence of staff competency, including documentation of:
91.28 	(1) education and experience qualifications relevant to the job responsibilities 
91.29 	assigned to the staff and to the primary disability of persons served by the program, 
91.30 	including a valid degree and transcript, or a current license, registration, or certification, 
91.31 	when a degree or licensure, registration, or certification is required by this chapter or in the 
91.32 	coordinated service and support plan or coordinated service and support plan addendum;
91.33 	(2) demonstrated competency in the orientation and training areas required under 
91.34 	this chapter, and when applicable, completion of continuing education required to 
91.35 	maintain professional licensure, registration, or certification requirements. Competency in 
92.1 	these areas is determined by the license holder through knowledge testing or observed 
92.2 	skill assessment conducted by the trainer or instructor or by an individual who has been 
92.3 	previously deemed competent by the trainer or instructor in the area being assessed; and
92.4 	(3) except for a license holder who is the sole direct support staff, periodic 
92.5 	performance evaluations completed by the license holder of the direct support staff 
92.6 	person's ability to perform the job functions based on direct observation.
92.7 	(b) Staff under 18 years of age may not perform overnight duties or administer 
92.8 	medication.

92.9 	Sec. 16. Minnesota Statutes 2014, section 245D.09, subdivision 5, is amended to read:
92.10 		Subd. 5.Annual training.  A license holder must provide annual training to direct 
92.11 	support staff on the topics identified in subdivision 4, clauses (3) to (10). If the direct 
92.12 	support staff has a first aid certification, annual training under subdivision 4, clause (9), is 
92.13 	not required as long as the certification remains current. A license holder must provide a 
92.14 	minimum of 24 hours of annual training to direct service staff providing intensive services 
92.15 	and having fewer than five years of documented experience and 12 hours of annual 
92.16 	training to direct service staff providing intensive services and having five or more years 
92.17 	of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) to 
92.18 	(f). Training on relevant topics received from sources other than the license holder may 
92.19 	count toward training requirements. A license holder must provide a minimum of 12 hours 
92.20 	of annual training to direct service staff providing basic services and having fewer than 
92.21 	five years of documented experience and six hours of annual training to direct service staff 
92.22 	providing basic services and having five or more years of documented experience.

92.23 	Sec. 17. Minnesota Statutes 2014, section 245D.22, subdivision 4, is amended to read:
92.24 		Subd. 4.First aid must be available on site. (a) A staff person trained in first 
92.25 	aid must be available on site and, when required in a person's coordinated service and 
92.26 	support plan or coordinated service and support plan addendum, be able to provide 
92.27 	cardiopulmonary resuscitation, whenever persons are present and staff are required to be 
92.28 	at the site to provide direct service. The CPR training must include in-person instruction, 
92.29 	hands-on practice, and an observed skills assessment under the direct supervision of a 
92.30 	CPR instructor.
92.31 	(b) A facility must have first aid kits readily available for use by, and that meet 
92.32 	the needs of, persons receiving services and staff. At a minimum, the first aid kit must 
92.33 	be equipped with accessible first aid supplies including bandages, sterile compresses, 
93.1 	scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, 
93.2 	adhesive tape, and first aid manual.

93.3 	Sec. 18. Minnesota Statutes 2014, section 245D.31, subdivision 3, is amended to read:
93.4 		Subd. 3.Staff ratio requirement for each person receiving services. The case 
93.5 	manager, in consultation with the interdisciplinary team, must determine at least once each 
93.6 	year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving 
93.7 	services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio 
93.8 	assigned each person and the documentation of how the ratio was arrived at must be kept 
93.9 	in each person's individual service plan. Documentation must include an assessment of the 
93.10 	person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard 
93.11 	assessment form required by the commissioner.

93.12 	Sec. 19. Minnesota Statutes 2014, section 245D.31, subdivision 4, is amended to read:
93.13 		Subd. 4.Person requiring staff ratio of one to four. A person must be assigned a 
93.14 	staff ratio requirement of one to four if:
93.15 	(1) on a daily basis the person requires total care and monitoring or constant 
93.16 	hand-over-hand physical guidance to successfully complete at least three of the following 
93.17 	activities: toileting, communicating basic needs, eating, or ambulating; or is not capable 
93.18 	of taking appropriate action for self-preservation under emergency conditions; or
93.19 	(2) the person engages in conduct that poses an imminent risk of physical harm to 
93.20 	self or others at a documented level of frequency, intensity, or duration requiring frequent 
93.21 	daily ongoing intervention and monitoring as established in the person's coordinated 
93.22 	service and support plan or coordinated service and support plan addendum.

93.23 	Sec. 20. Minnesota Statutes 2014, section 245D.31, subdivision 5, is amended to read:
93.24 		Subd. 5.Person requiring staff ratio of one to eight. A person must be assigned a 
93.25 	staff ratio requirement of one to eight if:
93.26 	(1) the person does not meet the requirements in subdivision 4; and
93.27 	(2) on a daily basis the person requires verbal prompts or spot checks and minimal 
93.28 	or no physical assistance to successfully complete at least four three of the following 
93.29 	activities: toileting, communicating basic needs, eating, or ambulating, or taking 
93.30 	appropriate action for self-preservation under emergency conditions.

93.31 	Sec. 21. Minnesota Statutes 2014, section 252.27, subdivision 2a, is amended to read:
94.1 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
94.2 	child, including a child determined eligible for medical assistance without consideration of 
94.3 	parental income, must contribute to the cost of services used by making monthly payments 
94.4 	on a sliding scale based on income, unless the child is married or has been married, parental 
94.5 	rights have been terminated, or the child's adoption is subsidized according to chapter 
94.6 	259A or through title IV-E of the Social Security Act. The parental contribution is a partial 
94.7 	or full payment for medical services provided for diagnostic, therapeutic, curing, treating, 
94.8 	mitigating, rehabilitation, maintenance, and personal care services as defined in United 
94.9 	States Code, title 26, section 213, needed by the child with a chronic illness or disability.
94.10 	(b) For households with adjusted gross income equal to or greater than 275 percent 
94.11 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
94.12 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
94.13 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal 
94.14 	poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 
94.15 	the parental contribution shall be determined using a sliding fee scale established by the 
94.16 	commissioner of human services which begins at 2.48 2.23percent of adjusted gross 
94.17 	income at 275 percent of federal poverty guidelines and increases to 6.75 6.08percent of 
94.18 	adjusted gross income for those with adjusted gross income up to 545 percent of federal 
94.19 	poverty guidelines;
94.20 	(2) if the adjusted gross income is greater than 545 percent of federal poverty 
94.21 	guidelines and less than 675 percent of federal poverty guidelines, the parental 
94.22 	contribution shall be 6.75 6.08percent of adjusted gross income;
94.23 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal 
94.24 	poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 
94.25 	contribution shall be determined using a sliding fee scale established by the commissioner 
94.26 	of human services which begins at 6.75 6.08percent of adjusted gross income at 675 percent 
94.27 	of federal poverty guidelines and increases to nine 8.1 percent of adjusted gross income 
94.28 	for those with adjusted gross income up to 975 percent of federal poverty guidelines; and
94.29 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal 
94.30 	poverty guidelines, the parental contribution shall be 11.25 10.13percent of adjusted 
94.31 	gross income.
94.32 	If the child lives with the parent, the annual adjusted gross income is reduced by 
94.33 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
94.34 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
94.35 	specified under that section in addition to the parental contribution determined under this 
95.1 	section. The parental contribution is reduced by any amount required to be paid directly to 
95.2 	the child pursuant to a court order, but only if actually paid.
95.3 	(c) The household size to be used in determining the amount of contribution under 
95.4 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
95.5 	child receiving services. Adjustments in the contribution amount due to annual changes 
95.6 	in the federal poverty guidelines shall be implemented on the first day of July following 
95.7 	publication of the changes.
95.8 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
95.9 	natural or adoptive parents determined according to the previous year's federal tax form, 
95.10 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
95.11 	have been used to purchase a home shall not be counted as income.
95.12 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
95.13 	for services is being determined. The contribution shall be made on a monthly basis 
95.14 	effective with the first month in which the child receives services. Annually upon 
95.15 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
95.16 	services provided, the local agency or the state shall reimburse that excess amount to 
95.17 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
95.18 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
95.19 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
95.20 	taxable income if the parent paid for the parent's fees through an employer's health care 
95.21 	flexible spending account under the Internal Revenue Code, section 125, and that the 
95.22 	parent is responsible for paying the taxes owed on the amount reimbursed.
95.23 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
95.24 	when there is a change in household size; and when there is a loss of or gain in income 
95.25 	from one month to another in excess of ten percent. The local agency shall mail a written 
95.26 	notice 30 days in advance of the effective date of a change in the contribution amount. 
95.27 	A decrease in the contribution amount is effective in the month that the parent verifies a 
95.28 	reduction in income or change in household size.
95.29 	(g) Parents of a minor child who do not live with each other shall each pay the 
95.30 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
95.31 	child support payment actually paid on behalf of the child receiving services shall be 
95.32 	deducted from the adjusted gross income of the parent making the payment prior to 
95.33 	calculating the parental contribution under paragraph (b).
95.34 	(h) The contribution under paragraph (b) shall be increased by an additional five 
95.35 	percent if the local agency determines that insurance coverage is available but not 
95.36 	obtained for the child. For purposes of this section, "available" means the insurance is a 
96.1 	benefit of employment for a family member at an annual cost of no more than five percent 
96.2 	of the family's annual income. For purposes of this section, "insurance" means health 
96.3 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
96.4 	maintenance organization, self-insured plan, or preferred provider organization.
96.5 	Parents who have more than one child receiving services shall not be required 
96.6 	to pay more than the amount for the child with the highest expenditures. There shall 
96.7 	be no resource contribution from the parents. The parent shall not be required to pay 
96.8 	a contribution in excess of the cost of the services provided to the child, not counting 
96.9 	payments made to school districts for education-related services. Notice of an increase in 
96.10 	fee payment must be given at least 30 days before the increased fee is due.
96.11 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
96.12 	in the 12 months prior to July 1:
96.13 	(1) the parent applied for insurance for the child;
96.14 	(2) the insurer denied insurance;
96.15 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
96.16 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
96.17 	commerce, or litigated the complaint or appeal; and
96.18 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
96.19 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
96.20 	A parent who has requested a reduction in the contribution amount under this 
96.21 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
96.22 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
96.23 	letter or complaint of the parents, court documents, and the written response of the insurer 
96.24 	approving insurance. The determinations of the commissioner or county agency under this 
96.25 	paragraph are not rules subject to chapter 14.

96.26 	Sec. 22. Minnesota Statutes 2014, section 256.478, is amended to read:
96.27 	256.478 HOME AND COMMUNITY-BASED SERVICES TRANSITIONS 
96.28 	GRANTS.
96.29 	(a) The commissioner shall make available home and community-based services 
96.30 	transition grants to serve individuals who do not meet eligibility criteria for the medical 
96.31 	assistance program under section 256B.056 or 256B.057, but who otherwise meet the 
96.32 	criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
96.33 	(b) For the purposes of this section, the commissioner has the authority to transfer 
96.34 	funds between the medical assistance account and the home and community-based 
96.35 	services transitions grants account.

97.1 	Sec. 23. Minnesota Statutes 2014, section 256.975, subdivision 2, is amended to read:
97.2 		Subd. 2.Duties. The board Minnesota Board on Aging shall carry out the following 
97.3 	duties:
97.4 	(1) to advise the governor and heads of state departments and agencies regarding 
97.5 	policy, programs, and services affecting the aging;
97.6 	(2) to provide a mechanism for coordinating plans and activities of state departments 
97.7 	and citizens' groups as they pertain to aging;
97.8 	(3) to create public awareness of the special needs and potentialities of older persons;
97.9 	(4) to gather and disseminate information about research and action programs, 
97.10 	and to encourage state departments and other agencies to conduct needed research in 
97.11 	the field of aging;
97.12 	(5) to stimulate, guide, and provide technical assistance in the organization of local 
97.13 	councils on aging;
97.14 	(6) to provide continuous review of ongoing services, programs and proposed 
97.15 	legislation affecting the elderly in Minnesota;
97.16 	(7) to administer and to make policy relating to all aspects of the Older Americans 
97.17 	Act of 1965, as amended, including implementation thereof; and
97.18 	(8) to award grants, enter into contracts, and adopt rules the Minnesota Board on 
97.19 	Aging deems necessary to carry out the purposes of this section.;
97.20 	(9) develop the criteria and procedures to allocate the grants under subdivision 11, 
97.21 	evaluate all applications on a competitive basis and award the grants, and select qualified 
97.22 	providers to offer technical assistance to grant applicants and grantees. The selected 
97.23 	provider shall provide applicants and grantees assistance with project design, evaluation 
97.24 	methods, materials, and training; and
97.25 	(10) submit by January 15, 2017, and on each January 15 thereafter, a progress 
97.26 	report on the dementia grants programs under subdivision 11 to the chairs and ranking 
97.27 	minority members of the senate and house of representatives committees and divisions 
97.28 	with jurisdiction over health finance and policy. The report shall include: 
97.29 	(i) information on each grant recipient; 
97.30 	(ii) a summary of all projects or initiatives undertaken with each grant; 
97.31 	(iii) the measurable outcomes established by each grantee, an explanation of the 
97.32 	evaluation process used to determine whether the outcomes were met, and the results of 
97.33 	the evaluation; 
97.34 	(iv) an accounting of how the grant funds were spent; and 
97.35 	(v) the overall impact of the projects and initiatives that were conducted.

98.1 	Sec. 24. Minnesota Statutes 2014, section 256.975, is amended by adding a subdivision 
98.2 	to read:
98.3 		Subd. 11.Regional and local dementia grants. (a) The Minnesota Board on 
98.4 	Aging shall award competitive grants to eligible applicants for regional and local projects 
98.5 	and initiatives targeted to a designated community, which may consist of a specific 
98.6 	geographic area or population, to increase awareness of Alzheimer's disease and other 
98.7 	dementias, increase the rate of cognitive testing in the population at risk for dementias, 
98.8 	promote the benefits of early diagnosis of dementias, or connect caregivers of persons 
98.9 	with dementia to education and resources.
98.10 	(b) The project areas for grants include:
98.11 	(1) local or community-based initiatives to promote the benefits of physician 
98.12 	consultations for all individuals who suspect a memory or cognitive problem;
98.13 	(2) local or community-based initiatives to promote the benefits of early diagnosis of 
98.14 	Alzheimer's disease and other dementias; and
98.15 	(3) local or community-based initiatives to provide informational materials and 
98.16 	other resources to caregivers of persons with dementia.
98.17 	(c) Eligible applicants for local and regional grants may include, but are not limited 
98.18 	to, community health boards, school districts, colleges and universities, community 
98.19 	clinics, tribal communities, nonprofit organizations, and other health care organizations.
98.20 	(d) Applicants must submit proposals for available grants to the Minnesota Board on 
98.21 	Aging by September 1, 2015, and each September 1 thereafter. The application must:
98.22 	(1) describe the proposed initiative, including the targeted community and how the 
98.23 	initiative meets the requirements of this subdivision; and
98.24 	(2) identify the proposed outcomes of the initiative and the evaluation process to be 
98.25 	used to measure these outcomes.
98.26 	(e) In awarding the regional and local dementia grants, the Minnesota Board on 
98.27 	Aging must give priority to applicants who demonstrate that the proposed project:
98.28 	(1) is supported by and appropriately targeted to the community the applicant serves;
98.29 	(2) is designed to coordinate with other community activities related to other health 
98.30 	initiatives, particularly those initiatives targeted at the elderly;
98.31 	(3) is conducted by an applicant able to demonstrate expertise in the project areas;
98.32 	(4) utilizes and enhances existing activities and resources or involves innovative 
98.33 	approaches to achieve success in the project areas; and 
98.34 	(5) strengthens community relationships and partnerships in order to achieve the 
98.35 	project areas.
99.1 	(f) The board shall divide the state into specific geographic regions and allocate a 
99.2 	percentage of the money available for the local and regional dementia grants to projects or 
99.3 	initiatives aimed at each geographic region.
99.4 	(g) The board shall award any available grants by October 1, 2015, and each 
99.5 	October 1 thereafter.
99.6 	(h) Each grant recipient shall report to the board on the progress of the initiative at 
99.7 	least once during the grant period, and within two months of the end of the grant period 
99.8 	shall submit a final report to the board that includes the outcome results.

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

99.10 	Sec. 25. Minnesota Statutes 2014, section 256B.057, subdivision 9, is amended to read:
99.11 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
99.12 	for a person who is employed and who:
99.13 	(1) but for excess earnings or assets, meets the definition of disabled under the 
99.14 	Supplemental Security Income program;
99.15 	(2) meets the asset limits in paragraph (d); and
99.16 	(3) pays a premium and other obligations under paragraph (e).
99.17 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
99.18 	for medical assistance under this subdivision, a person must have more than $65 of earned 
99.19 	income. Earned income must have Medicare, Social Security, and applicable state and 
99.20 	federal taxes withheld. The person must document earned income tax withholding. Any 
99.21 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
99.22 	determinations.
99.23 	(c) After the month of enrollment, a person enrolled in medical assistance under 
99.24 	this subdivision who:
99.25 	(1) is temporarily unable to work and without receipt of earned income due to a 
99.26 	medical condition, as verified by a physician; or
99.27 	(2) loses employment for reasons not attributable to the enrollee, and is without 
99.28 	receipt of earned income may retain eligibility for up to four consecutive months after the 
99.29 	month of job loss. To receive a four-month extension, enrollees must verify the medical 
99.30 	condition or provide notification of job loss. All other eligibility requirements must be met 
99.31 	and the enrollee must pay all calculated premium costs for continued eligibility.
99.32 	(d) For purposes of determining eligibility under this subdivision, a person's assets 
99.33 	must not exceed $20,000, excluding:
99.34 	(1) all assets excluded under section 256B.056;
100.1 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
100.2 	Keogh plans, and pension plans;
100.3 	(3) medical expense accounts set up through the person's employer; and
100.4 	(4) spousal assets, including spouse's share of jointly held assets.
100.5 	(e) All enrollees must pay a premium to be eligible for medical assistance under this 
100.6 	subdivision, except as provided under clause (5).
100.7 	(1) An enrollee must pay the greater of a $65 $35 premium or the premium calculated 
100.8 	based on the person's gross earned and unearned income and the applicable family size 
100.9 	using a sliding fee scale established by the commissioner, which begins at one percent of 
100.10 	income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of 
100.11 	income for those with incomes at or above 300 percent of the federal poverty guidelines.
100.12 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
100.13 	poverty guidelines shall be effective for premiums due in July of each year.
100.14 	(3) All enrollees who receive unearned income must pay five one-half of one percent 
100.15 	of unearned income in addition to the premium amount, except as provided under clause (5).
100.16 	(4) Increases in benefits under title II of the Social Security Act shall not be counted 
100.17 	as income for purposes of this subdivision until July 1 of each year.
100.18 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
100.19 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
100.20 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
100.21 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
100.22 	(f) A person's eligibility and premium shall be determined by the local county 
100.23 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
100.24 	the commissioner.
100.25 	(g) Any required premium shall be determined at application and redetermined at 
100.26 	the enrollee's six-month income review or when a change in income or household size is 
100.27 	reported. Enrollees must report any change in income or household size within ten days 
100.28 	of when the change occurs. A decreased premium resulting from a reported change in 
100.29 	income or household size shall be effective the first day of the next available billing month 
100.30 	after the change is reported. Except for changes occurring from annual cost-of-living 
100.31 	increases, a change resulting in an increased premium shall not affect the premium amount 
100.32 	until the next six-month review.
100.33 	(h) Premium payment is due upon notification from the commissioner of the 
100.34 	premium amount required. Premiums may be paid in installments at the discretion of 
100.35 	the commissioner.
101.1 	(i) Nonpayment of the premium shall result in denial or termination of medical 
101.2 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
101.3 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
101.4 	D, are met. Except when an installment agreement is accepted by the commissioner, all 
101.5 	persons disenrolled for nonpayment of a premium must pay any past due premiums as well 
101.6 	as current premiums due prior to being reenrolled. Nonpayment shall include payment with 
101.7 	a returned, refused, or dishonored instrument. The commissioner may require a guaranteed 
101.8 	form of payment as the only means to replace a returned, refused, or dishonored instrument.
101.9 	(j) For enrollees whose income does not exceed 200 percent of the federal poverty 
101.10 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 
101.11 	the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 
101.12 	paragraph (a).

101.13 	Sec. 26. Minnesota Statutes 2014, section 256B.0916, subdivision 2, is amended to read:
101.14 		Subd. 2.Distribution of funds; partnerships. (a) Beginning with fiscal year 2000, 
101.15 	the commissioner shall distribute all funding available for home and community-based 
101.16 	waiver services for persons with developmental disabilities to individual counties or to 
101.17 	groups of counties that form partnerships to jointly plan, administer, and authorize funding 
101.18 	for eligible individuals. The commissioner shall encourage counties to form partnerships 
101.19 	that have a sufficient number of recipients and funding to adequately manage the risk 
101.20 	and maximize use of available resources.
101.21 	(b) Counties must submit a request for funds and a plan for administering the 
101.22 	program as required by the commissioner. The plan must identify the number of clients to 
101.23 	be served, their ages, and their priority listing based on:
101.24 	(1) requirements in Minnesota Rules, part 9525.1880; and
101.25 	(2) statewide priorities identified in section 256B.092, subdivision 12.
101.26 	The plan must also identify changes made to improve services to eligible persons and to 
101.27 	improve program management.
101.28 	(c) In allocating resources to counties, priority must be given to groups of counties 
101.29 	that form partnerships to jointly plan, administer, and authorize funding for eligible 
101.30 	individuals and to counties determined by the commissioner to have sufficient waiver 
101.31 	capacity to maximize resource use.
101.32 	(d) Within 30 days after receiving the county request for funds and plans, the 
101.33 	commissioner shall provide a written response to the plan that includes the level of 
101.34 	resources available to serve additional persons.
102.1 	(e) Counties are eligible to receive medical assistance administrative reimbursement 
102.2 	for administrative costs under criteria established by the commissioner.
102.3 	(f) The commissioner shall manage waiver allocations in such a manner as to fully 
102.4 	use available state and federal waiver appropriations.

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

102.6 	Sec. 27. Minnesota Statutes 2014, section 256B.0916, subdivision 11, is amended to 
102.7 	read:
102.8 		Subd. 11.Excess spending. County and tribal agencies are responsible for spending 
102.9 	in excess of the allocation made by the commissioner. In the event a county or tribal agency 
102.10 	spends in excess of the allocation made by the commissioner for a given allocation period, 
102.11 	they must submit a corrective action plan to the commissioner for approval. The plan must 
102.12 	state the actions the agency will take to correct their overspending for the yeartwo years 
102.13 	following the period when the overspending occurred. Failure to correct overspending 
102.14 	shall result in recoupment of spending in excess of the allocation The commissioner 
102.15 	shall recoup spending in excess of the allocation only in cases where statewide spending 
102.16 	exceeds the appropriation designated for the home and community-based services waivers. 
102.17 	Nothing in this subdivision shall be construed as reducing the county's responsibility to 
102.18 	offer and make available feasible home and community-based options to eligible waiver 
102.19 	recipients within the resources allocated to them for that purpose.

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

102.21 	Sec. 28. Minnesota Statutes 2014, section 256B.0916, is amended by adding a 
102.22 	subdivision to read:
102.23 		Subd. 12.Use of waiver allocations. County and tribal agencies are responsible 
102.24 	for spending the annual allocation made by the commissioner. In the event a county or 
102.25 	tribal agency spends less than 97 percent of the allocation, while maintaining a list of 
102.26 	persons waiting for waiver services, the county or tribal agency must submit a corrective 
102.27 	action plan to the commissioner for approval. The commissioner may determine a plan 
102.28 	is unnecessary given the size of the allocation and capacity for new enrollment. The 
102.29 	plan must state the actions the agency will take to assure reasonable and timely access 
102.30 	to home and community-based waiver services for persons waiting for services. If a 
102.31 	county or tribe does not submit a plan when required or implement the changes required, 
102.32 	the commissioner shall assure access to waiver services within the county's or tribe's 
103.1 	available allocation and take other actions needed to assure that all waiver participants in 
103.2 	that county or tribe are receiving appropriate waiver services to meet their needs.

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

103.4 	Sec. 29. Minnesota Statutes 2014, section 256B.097, subdivision 3, is amended to read:
103.5 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
103.6 	Council which must define regional quality councils, and carry out a community-based, 
103.7 	person-directed quality review component, and a comprehensive system for effective 
103.8 	incident reporting, investigation, analysis, and follow-up.
103.9 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
103.10 	members of the initial State Quality Council. Members shall include representatives 
103.11 	from the following groups:
103.12 	(1) disability service recipients and their family members;
103.13 	(2) during the first four years of the State Quality Council, there must be at least 
103.14 	three members from the Region 10 stakeholders. As regional quality councils are formed 
103.15 	under subdivision 4, each regional quality council shall appoint one member;
103.16 	(3) disability service providers;
103.17 	(4) disability advocacy groups; and
103.18 	(5) county human services agencies and staff from the Department of Human 
103.19 	Services and Ombudsman for Mental Health and Developmental Disabilities.
103.20 	(c) Members of the council who do not receive a salary or wages from an employer 
103.21 	for time spent on council duties may receive a per diem payment when performing council 
103.22 	duties and functions.
103.23 	(d) The State Quality Council shall:
103.24 	(1) assist the Department of Human Services in fulfilling federally mandated 
103.25 	obligations by monitoring disability service quality and quality assurance and 
103.26 	improvement practices in Minnesota;
103.27 	(2) establish state quality improvement priorities with methods for achieving results 
103.28 	and provide an annual report to the legislative committees with jurisdiction over policy 
103.29 	and funding of disability services on the outcomes, improvement priorities, and activities 
103.30 	undertaken by the commission during the previous state fiscal year;
103.31 	(3) identify issues pertaining to financial and personal risk that impede Minnesotans 
103.32 	with disabilities from optimizing choice of community-based services; and
103.33 	(4) recommend to the chairs and ranking minority members of the legislative 
103.34 	committees with jurisdiction over human services and civil law by January 15, 2014, 
103.35 	statutory and rule changes related to the findings under clause (3) that promote 
104.1 	individualized service and housing choices balanced with appropriate individualized 
104.2 	protection.
104.3 	(e) The State Quality Council, in partnership with the commissioner, shall:
104.4 	(1) approve and direct implementation of the community-based, person-directed 
104.5 	system established in this section;
104.6 	(2) recommend an appropriate method of funding this system, and determine the 
104.7 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
104.8 	(3) approve measurable outcomes in the areas of health and safety, consumer 
104.9 	evaluation, education and training, providers, and systems;
104.10 	(4) establish variable licensure periods not to exceed three years based on outcomes 
104.11 	achieved; and
104.12 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
104.13 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2015.
104.14 	(f) The State Quality Council shall notify the commissioner of human services that a 
104.15 	facility, program, or service has been reviewed by quality assurance team members under 
104.16 	subdivision 4, paragraph (b) (c), clause (13), and qualifies for a license.
104.17 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
104.18 	an ongoing review process for the system. The review shall take into account the 
104.19 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
104.20 	licensed and unlicensed entities that provide services to persons with disabilities. The 
104.21 	review shall address efficiencies and effectiveness of the system.
104.22 	(h) The State Quality Council may recommend to the commissioner certain 
104.23 	variances from the standards governing licensure of programs for persons with disabilities 
104.24 	in order to improve the quality of services so long as the recommended variances do 
104.25 	not adversely affect the health or safety of persons being served or compromise the 
104.26 	qualifications of staff to provide services.
104.27 	(i) The safety standards, rights, or procedural protections referenced under 
104.28 	subdivision 2 4, paragraph (c) (d), shall not be varied. The State Quality Council may 
104.29 	make recommendations to the commissioner or to the legislature in the report required 
104.30 	under paragraph (c) (d) regarding alternatives or modifications to the safety standards, 
104.31 	rights, or procedural protections referenced under subdivision 2 (4), paragraph (c) (d).
104.32 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
104.33 	subdivision.

104.34 	Sec. 30. Minnesota Statutes 2014, section 256B.097, subdivision 4, is amended to read:
105.1 		Subd. 4.Regional quality councils. (a) By July 1, 2015, the commissioner shall 
105.2 	establish, as selected by the State Quality Council,or continue the operation of three 
105.3 	regional quality councils of key stakeholders, includingas selected by the State Quality 
105.4 	Council. One regional quality council shall be established in the Twin Cities metropolitan 
105.5 	area, one shall be established in greater Minnesota, and one shall be the Quality Assurance 
105.6 	Commission established under section 256B.0951. By July 1, 2016, the commissioner 
105.7 	shall establish three additional regional quality councils, as selected by the State Quality 
105.8 	Council. The regional quality councils established under this paragraph shall include 
105.9 	regional representatives of:
105.10 	(1) disability service recipients and their family members;
105.11 	(2) disability service providers;
105.12 	(3) disability advocacy groups; and
105.13 	(4) county human services agencies and staff from the Department of Human 
105.14 	Services and Ombudsman for Mental Health and Developmental Disabilities.
105.15 	(b) In establishing the regional quality councils, the commissioner shall:
105.16 	(1) appoint the members from the groups identified in paragraph (a) by July 1, 2015;
105.17 	(2) designate a chair for each council or prescribe a process for each council to 
105.18 	select a chair from among its members;
105.19 	(3) set term limits for members of the regional quality councils;
105.20 	(4) set the total number or maximum number of members of each regional council;
105.21 	(5) set the number or proportion of members representing each of the groups 
105.22 	identified in paragraph (a);
105.23 	(6) set deadlines and requirements for annual reports to the chair of the State 
105.24 	Quality Council and to the chairs of the legislative committees in the senate and house of 
105.25 	representatives with primary jurisdiction over human services on the status, outcomes, 
105.26 	improvement priorities, and activities in the regions; and
105.27 	(7) convene a first meeting of each regional quality council by July 1, 2016, or 
105.28 	identify a person responsible for convening the first meeting of each regional quality 
105.29 	council and require that the person convene the first meeting by July 1, 2016.
105.30 	(b) (c) Each regional quality council shall:
105.31 	(1) direct and monitor the community-based, person-directed quality assurance 
105.32 	system in this section;
105.33 	(2) approve a training program for quality assurance team members under clause (13);
105.34 	(3) review summary reports from quality assurance team reviews and make 
105.35 	recommendations to the State Quality Council regarding program licensure;
105.36 	(4) make recommendations to the State Quality Council regarding the system;
106.1 	(5) resolve complaints between the quality assurance teams, counties, providers, 
106.2 	persons receiving services, their families, and legal representatives;
106.3 	(6) analyze and review quality outcomes and critical incident data reporting 
106.4 	incidents of life safety concerns immediately to the Department of Human Services 
106.5 	licensing division;
106.6 	(7) provide information and training programs for persons with disabilities and their 
106.7 	families and legal representatives on service options and quality expectations;
106.8 	(8) disseminate information and resources developed to other regional quality 
106.9 	councils;
106.10 	(9) respond to state-level priorities;
106.11 	(10) establish regional priorities for quality improvement;
106.12 	(11) submit an annual report to the State Quality Council on the status, outcomes, 
106.13 	improvement priorities, and activities in the region;
106.14 	(12) choose a representative to participate on the State Quality Council and assume 
106.15 	other responsibilities consistent with the priorities of the State Quality Council; and
106.16 	(13) recruit, train, and assign duties to members of quality assurance teams, taking 
106.17 	into account the size of the service provider, the number of services to be reviewed, 
106.18 	the skills necessary for the team members to complete the process, and ensure that no 
106.19 	team member has a financial, personal, or family relationship with the facility, program, 
106.20 	or service being reviewed or with anyone served at the facility, program, or service. 
106.21 	Quality assurance teams must be comprised of county staff, persons receiving services 
106.22 	or the person's families, legal representatives, members of advocacy organizations, 
106.23 	providers, and other involved community members. Team members must complete 
106.24 	the training program approved by the regional quality council and must demonstrate 
106.25 	performance-based competency. Team members may be paid a per diem and reimbursed 
106.26 	for expenses related to their participation in the quality assurance process.
106.27 	(c) (d) The commissioner shall monitor the safety standards, rights, and procedural 
106.28 	protections for the monitoring of psychotropic medications and those identified under 
106.29 	sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) 
106.30 	and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause 
106.31 	(7); 626.556; and 626.557.
106.32 	(d) (e) The regional quality councils may hire staff to perform the duties assigned 
106.33 	in this subdivision.
106.34 	(e) (f) The regional quality councils may charge fees for their services.
106.35 	(f) (g) The quality assurance process undertaken by a regional quality council consists 
106.36 	of an evaluation by a quality assurance team of the facility, program, or service. The 
107.1 	process must include an evaluation of a random sample of persons served. The sample must 
107.2 	be representative of each service provided. The sample size must be at least five percent but 
107.3 	not less than two persons served. All persons must be given the opportunity to be included 
107.4 	in the quality assurance process in addition to those chosen for the random sample.
107.5 	(g) (h) A facility, program, or service may contest a licensing decision of the regional 
107.6 	quality council as permitted under chapter 245A.

107.7 	Sec. 31. Minnesota Statutes 2014, section 256B.49, subdivision 26, is amended to read:
107.8 		Subd. 26.Excess allocations. (a) Effective through June 30, 2018, county and 
107.9 	tribal agencies will be responsible for authorizations in excess of the annual allocation 
107.10 	made by the commissioner. In the event a county or tribal agency authorizes in excess 
107.11 	of the allocation made by the commissioner for a given allocation period, the county or 
107.12 	tribal agency must submit a corrective action plan to the commissioner for approval. 
107.13 	The plan must state the actions the agency will take to correct their overspending for 
107.14 	the yeartwo years following the period when the overspending occurred. Failure to 
107.15 	correct overauthorizations shall result in recoupment of authorizations in excess of the 
107.16 	allocation.The commissioner shall recoup funds spent in excess of the allocation only 
107.17 	in cases where statewide spending exceeds the appropriation designated for the home 
107.18 	and community-based services waivers. Nothing in this subdivision shall be construed 
107.19 	as reducing the county's responsibility to offer and make available feasible home and 
107.20 	community-based options to eligible waiver recipients within the resources allocated 
107.21 	to them for that purpose. If a county or tribe does not submit a plan when required or 
107.22 	implement the changes required, the commissioner shall assure access to waiver services 
107.23 	within the county's or tribe's available allocation and take other actions needed to assure 
107.24 	that all waiver participants in that county or tribe are receiving appropriate waiver services 
107.25 	to meet their needs.
107.26 	(b) Effective July 1, 2018, county and tribal agencies will be responsible for 
107.27 	spending in  excess of the annual allocation made by the commissioner. In the event a 
107.28 	county or tribal  agency spends in excess of the allocation made by the commissioner for a 
107.29 	given allocation  period, the county or tribal agency must submit a corrective action plan to 
107.30 	the   commissioner for approval. The plan must state the actions the agency will take to 
107.31 	correct  its overspending for the two years following the period when the overspending 
107.32 	occurred.  The commissioner shall recoup funds spent in excess of the allocation only 
107.33 	in cases when  statewide spending exceeds the appropriation designated for the home 
107.34 	and community-based services waivers. Nothing in this subdivision shall be construed 
107.35 	as reducing the county's responsibility to offer and make available feasible home and 
108.1 	community-based  options to eligible waiver recipients within the resources allocated to it 
108.2 	for that purpose.  If a county or tribe does not submit a plan when required or implement 
108.3 	the changes  required, the commissioner shall assure access to waiver services within 
108.4 	the county's or tribe's available allocation and take other actions needed to assure that 
108.5 	all waiver  participants in that county or tribe are receiving appropriate waiver services 
108.6 	to meet their  needs.

108.7 	Sec. 32. Minnesota Statutes 2014, section 256B.49, is amended by adding a 
108.8 	subdivision to read:
108.9 		Subd. 27.Use of waiver allocations. (a) Effective until June 30, 2018, county 
108.10 	and tribal agencies are responsible for authorizing the annual allocation made by the 
108.11 	commissioner. In the event a county or tribal agency authorizes less than 97 percent of 
108.12 	the allocation, while maintaining a list of persons waiting for waiver services, the county 
108.13 	or tribal agency must submit a corrective action plan to the commissioner for approval. 
108.14 	The commissioner may determine a plan is unnecessary given the size of the allocation 
108.15 	and capacity for new enrollment. The plan must state the actions the agency will take 
108.16 	to assure reasonable and timely access to home and community-based waiver services 
108.17 	for persons waiting for services. 
108.18 	(b) Effective July 1, 2018, county and tribal agencies are responsible for spending 
108.19 	the annual allocation made by the commissioner. In the event a county or tribal agency 
108.20 	spends less than 97 percent of the allocation, while maintaining a list of persons waiting 
108.21 	for waiver services, the county or tribal agency must submit a corrective action plan to the 
108.22 	commissioner for approval. The commissioner may determine a plan is unnecessary given 
108.23 	the size of the allocation and capacity for new enrollment. The plan must state the actions 
108.24 	the agency will take to assure reasonable and timely access to home and community-based 
108.25 	waiver services for persons waiting for services.

108.26 	Sec. 33. Minnesota Statutes 2014, section 256B.4913, subdivision 4a, is amended to 
108.27 	read:
108.28 		Subd. 4a.Rate stabilization adjustment. (a) For purposes of this subdivision, 
108.29 	"implementation period" means the period beginning January 1, 2014, and ending on 
108.30 	the last day of the month in which the rate management system is populated with the 
108.31 	data necessary to calculate rates for substantially all individuals receiving home and 
108.32 	community-based waiver services under sections 256B.092 and 256B.49. "Banding 
108.33 	period" means the time period beginning on January 1, 2014, and ending upon the 
108.34 	expiration of the 12-month period defined in paragraph (c), clause (5).
109.1 	(b) For purposes of this subdivision, the historical rate for all service recipients means 
109.2 	the individual reimbursement rate for a recipient in effect on December 1, 2013, except that:
109.3 	(1) for a day service recipient who was not authorized to receive these waiver 
109.4 	services prior to January 1, 2014; added a new service or services on or after January 1, 
109.5 	2014; or changed providers on or after January 1, 2014, the historical rate must be the 
109.6 	authorized rate for the provider in the county of service, effective December 1, 2013; or
109.7 	(2) for a unit-based service with programming or a unit-based service without 
109.8 	programming recipient who was not authorized to receive these waiver services prior to 
109.9 	January 1, 2014; added a new service or services on or after January 1, 2014; or changed 
109.10 	providers on or after January 1, 2014, the historical rate must be the weighted average 
109.11 	authorized rate for each provider number in the county of service, effective December 1, 
109.12 	2013; or
109.13 	(3) for residential service recipients who change providers on or after January 1, 
109.14 	2014, the historical rate must be set by each lead agency within their county aggregate 
109.15 	budget using their respective methodology for residential services effective December 1, 
109.16 	2013, for determining the provider rate for a similarly situated recipient being served by 
109.17 	that provider.
109.18 	(c) The commissioner shall adjust individual reimbursement rates determined under 
109.19 	this section so that the unit rate is no higher or lower than:
109.20 	(1) 0.5 percent from the historical rate for the implementation period;
109.21 	(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period 
109.22 	immediately following the time period of clause (1);
109.23 	(3) 1.00.5 percent from the rate in effect in clause (2), for the 12-month period 
109.24 	immediately following the time period of clause (2);
109.25 	(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period 
109.26 	immediately following the time period of clause (3); and
109.27 	(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period 
109.28 	immediately following the time period of clause (4); and
109.29 	(6) no adjustment to the rate in effect in clause (5) for the 12-month period 
109.30 	immediately following the time period of clause (5). During this banding rate period, the 
109.31 	commissioner shall not enforce any rate decrease or increase that would otherwise result 
109.32 	from the end of the banding period. The commissioner shall, upon enactment, seek federal 
109.33 	approval for the addition of this banding period.
109.34 	(d) The commissioner shall review all changes to rates that were in effect on 
109.35 	December 1, 2013, to verify that the rates in effect produce the equivalent level of spending 
109.36 	and service unit utilization on an annual basis as those in effect on October 31, 2013.
110.1 	(e) By December 31, 2014, the commissioner shall complete the review in paragraph 
110.2 	(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
110.3 	(f) During the banding period, the Medicaid Management Information System 
110.4 	(MMIS) service agreement rate must be adjusted to account for change in an individual's 
110.5 	need. The commissioner shall adjust the Medicaid Management Information System 
110.6 	(MMIS) service agreement rate by:
110.7 	(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for 
110.8 	the individual with variables reflecting the level of service in effect on December 1, 2013;
110.9 	(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 
110.10 	9, for the individual with variables reflecting the updated level of service at the time 
110.11 	of application; and
110.12 	(3) adding to or subtracting from the Medicaid Management Information System 
110.13 	(MMIS) service agreement rate, the difference between the values in clauses (1) and (2).
110.14 	(g) This subdivision must not apply to rates for recipients served by providers new 
110.15 	to a given county after January 1, 2014. Providers of personal supports services who also 
110.16 	acted as fiscal support entities must be treated as new providers as of January 1, 2014.

110.17 	Sec. 34. Minnesota Statutes 2014, section 256B.4913, subdivision 5, is amended to read:
110.18 		Subd. 5.Stakeholder consultation and county training. (a) The commissioner 
110.19 	shall continue consultation on regular intervals with the existing stakeholder group 
110.20 	established as part of the rate-setting methodology process and others, to gather input, 
110.21 	concerns, and data, to assist in the full implementation of the new rate payment system and 
110.22 	to make pertinent information available to the public through the department's Web site.
110.23 	(b) The commissioner shall offer training at least annually for county personnel 
110.24 	responsible for administering the rate-setting framework in a manner consistent with this 
110.25 	section and section 256B.4914.
110.26 	(c) The commissioner shall maintain an online instruction manual explaining the 
110.27 	rate-setting framework. The manual shall be consistent with this section and section 
110.28 	256B.4914, and shall be accessible to all stakeholders including recipients, representatives 
110.29 	of recipients, county or tribal agencies, and license holders.
110.30 	(d) The commissioner shall not defer to the county or tribal agency on matters of 
110.31 	technical application of the rate-setting framework, and a county or tribal agency shall not 
110.32 	set rates in a manner that conflicts with this section or section 256B.4914.

110.33 	Sec. 35. Minnesota Statutes 2014, section 256B.4914, subdivision 2, is amended to read:
111.1 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
111.2 	meanings given them, unless the context clearly indicates otherwise.
111.3 	(b) "Commissioner" means the commissioner of human services.
111.4 	(c) "Component value" means underlying factors that are part of the cost of providing 
111.5 	services that are built into the waiver rates methodology to calculate service rates.
111.6 	(d) "Customized living tool" means a methodology for setting service rates that 
111.7 	delineates and documents the amount of each component service included in a recipient's 
111.8 	customized living service plan.
111.9 	(e) "Disability waiver rates system" means a statewide system that establishes rates 
111.10 	that are based on uniform processes and captures the individualized nature of waiver 
111.11 	services and recipient needs.
111.12 	(f) "Individual staffing" means the time spent as a one-to-one interaction specific to 
111.13 	an individual recipient by staff brought in solely to provide direct support and assistance 
111.14 	with activities of daily living, instrumental activities of daily living, and training to 
111.15 	participants, and is based on the requirements in each individual's coordinated service and 
111.16 	support plan under section 245D.02, subdivision 4b; any coordinated service and support 
111.17 	plan addendum under section 245D.02, subdivision 4c;  and an assessment tool; and. 
111.18 	Provider observation of an individual's needs must also be considered.
111.19 	(g) "Lead agency" means a county, partnership of counties, or tribal agency charged 
111.20 	with administering waivered services under sections 256B.092 and 256B.49.
111.21 	(h) "Median" means the amount that divides distribution into two equal groups, 
111.22 	one-half above the median and one-half below the median.
111.23 	(i) "Payment or rate" means reimbursement to an eligible provider for services 
111.24 	provided to a qualified individual based on an approved service authorization.
111.25 	(j) "Rates management system" means a Web-based software application that uses 
111.26 	a framework and component values, as determined by the commissioner, to establish 
111.27 	service rates.
111.28 	(k) "Recipient" means a person receiving home and community-based services 
111.29 	funded under any of the disability waivers.
111.30 	(l) "Shared staffing" means time spent by employees, not defined under paragraph 
111.31 	(f), providing or available to provide more than one individual with direct support and 
111.32 	assistance with activities of daily living as defined under section 256B.0659, subdivision 1, 
111.33 	paragraph (b); instrumental activities of daily living as defined under section 256B.0659, 
111.34 	subdivision 1, paragraph (i); ancillary activities needed to support individual services; and 
111.35 	training to participants, and is based on the requirements in each individual's coordinated 
111.36 	service and support plan under section 245D.02, subdivision 4b; any coordinated service 
112.1 	and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and 
112.2 	provider observation of an individual's service need. Total shared staffing hours are divided 
112.3 	proportionally by the number of individuals who receive the shared service provisions.
112.4 	(m) "Staffing ratio" means the number of recipients a service provider employee 
112.5 	supports during a unit of service based on a uniform assessment tool, provider observation, 
112.6 	case history, and the recipient's services of choice, and not based on the staffing ratios 
112.7 	under section 245D.31.
112.8 	(n) "Unit of service" means the following:
112.9 	(1) for residential support services under subdivision 6, a unit of service is a day. 
112.10 	Any portion of any calendar day, within allowable Medicaid rules, where an individual 
112.11 	spends time in a residential setting is billable as a day;
112.12 	(2) for day services under subdivision 7:
112.13 	(i) for day training and habilitation services, a unit of service is either:
112.14 	(A) a day unit of service is defined as six or more hours of time spent providing 
112.15 	direct services and transportation; or
112.16 	(B) a partial day unit of service is defined as fewer than six hours of time spent 
112.17 	providing direct services and transportation; and
112.18 	(C) for new day service recipients after January 1, 2014, 15 minute units of 
112.19 	service must be used for fewer than six hours of time spent providing direct services 
112.20 	and transportation;
112.21 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. 
112.22 	A day unit of service is six or more hours of time spent providing direct services;
112.23 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of 
112.24 	service is six or more hours of time spent providing direct service;
112.25 	(3) for unit-based services with programming under subdivision 8:
112.26 	(i) for supported living services, a unit of service is a day or 15 minutes. When a 
112.27 	day rate is authorized, any portion of a calendar day where an individual receives services 
112.28 	is billable as a day; and
112.29 	(ii) for all other services, a unit of service is 15 minutes; and
112.30 	(4) for unit-based services without programming under subdivision 9:
112.31 	(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is 
112.32 	authorized, any portion of a calendar day when an individual receives services is billable 
112.33 	as a day; and
112.34 	(ii) for all other services, a unit of service is 15 minutes.

112.35 	Sec. 36. Minnesota Statutes 2014, section 256B.4914, subdivision 6, is amended to read:
113.1 		Subd. 6.Payments for residential support services. (a) Payments for residential 
113.2 	support services, as defined in sections 256B.092, subdivision 11, and 256B.49, 
113.3 	subdivision 22, must be calculated as follows:
113.4 	(1) determine the number of shared staffing and individual direct staff hours to meet 
113.5 	a recipient's needs provided on site or through monitoring technology;
113.6 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
113.7 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
113.8 	5. This is defined as the direct-care rate;
113.9 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
113.10 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
113.11 	to the result of clause (2). This is defined as the customized direct-care rate;
113.12 	(4) multiply the number of shared and individual direct staff hours provided on site 
113.13 	or through monitoring technology and nursing hours by the appropriate staff wages in 
113.14 	subdivision 5, paragraph (a), or the customized direct-care rate;
113.15 	(5) multiply the number of shared and individual direct staff hours provided on site 
113.16 	or through monitoring technology and nursing hours by the product of the supervision 
113.17 	span of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate 
113.18 	supervision wage in subdivision 5, paragraph (a), clause (16);
113.19 	(6) combine the results of clauses (4) and (5), excluding any shared and individual 
113.20 	direct staff hours provided through monitoring technology, and multiply the result by one 
113.21 	plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph 
113.22 	(b), clause (2). This is defined as the direct staffing cost;
113.23 	(7) for employee-related expenses, multiply the direct staffing cost, excluding any 
113.24 	shared and individual direct staff hours provided through monitoring technology, by one 
113.25 	plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
113.26 	(8) for client programming and supports, the commissioner shall add $2,179; and
113.27 	(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
113.28 	customized for adapted transport, based on the resident with the highest assessed need.
113.29 	(b) The total rate must be calculated using the following steps:
113.30 	(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any 
113.31 	shared and individual direct staff hours provided through monitoring technology that 
113.32 	was excluded in clause (7);
113.33 	(2) sum the standard general and administrative rate, the program-related expense 
113.34 	ratio, and the absence and utilization ratio;
113.35 	(3) divide the result of clause (1) by one minus the result of clause (2). This is 
113.36 	the total payment amount; and
114.1 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner 
114.2 	to adjust for regional differences in the cost of providing services.
114.3 	(c) The payment methodology for customized living, 24-hour customized living, and 
114.4 	residential care services must be the customized living tool. Revisions to the customized 
114.5 	living tool must be made to reflect the services and activities unique to disability-related 
114.6 	recipient needs.
114.7 	(d) The commissioner shall establish a Monitoring Technology Review Panel to 
114.8 	annually review and approve the plans, safeguards, and rates that include residential 
114.9 	direct care provided remotely through monitoring technology. Lead agencies shall submit 
114.10 	individual service plans that include supervision using monitoring technology to the 
114.11 	Monitoring Technology Review Panel for approval. Individual service plans that include 
114.12 	supervision using monitoring technology as of December 31, 2013, shall be submitted to 
114.13 	the Monitoring Technology Review Panel, but the plans are not subject to approval.
114.14 	(e) (d) For individuals enrolled prior to January 1, 2014, the days of service 
114.15 	authorized must meet or exceed the days of service used to convert service agreements 
114.16 	in effect on December 1, 2013, and must not result in a reduction in spending or service 
114.17 	utilization due to conversion during the implementation period under section 256B.4913, 
114.18 	subdivision 4a. If during the implementation period, an individual's historical rate, 
114.19 	including adjustments required under section 256B.4913, subdivision 4a, paragraph (c), 
114.20 	is equal to or greater than the rate determined in this subdivision, the number of days 
114.21 	authorized for the individual is 365.
114.22 	(f) (e) The number of days authorized for all individuals enrolling after January 1, 
114.23 	2014, in residential services must include every day that services start and end.

114.24 	Sec. 37. Minnesota Statutes 2014, section 256B.4914, subdivision 8, is amended to read:
114.25 		Subd. 8.Payments for unit-based services with programming. Payments for 
114.26 	unit-based with program services with programming, including behavior programming, 
114.27 	housing access coordination, in-home family support, independent living skills training, 
114.28 	hourly supported living services, and supported employment provided to an individual 
114.29 	outside of any day or residential service plan must be calculated as follows, unless the 
114.30 	services are authorized separately under subdivision 6 or 7:
114.31 	(1) determine the number of units of service to meet a recipient's needs;
114.32 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
114.33 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
115.1 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
115.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
115.3 	to the result of clause (2). This is defined as the customized direct-care rate;
115.4 	(4) multiply the number of direct staff hours by the appropriate staff wage in 
115.5 	subdivision 5, paragraph (a), or the customized direct-care rate;
115.6 	(5) multiply the number of direct staff hours by the product of the supervision span 
115.7 	of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision 
115.8 	wage in subdivision 5, paragraph (a), clause (16);
115.9 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus 
115.10 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), 
115.11 	clause (2). This is defined as the direct staffing rate;
115.12 	(7) for program plan support, multiply the result of clause (6) by one plus the 
115.13 	program plan supports ratio in subdivision 5, paragraph (e), clause (4);
115.14 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
115.15 	employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
115.16 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
115.17 	the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
115.18 	(10) this is the subtotal rate;
115.19 	(11) sum the standard general and administrative rate, the program-related expense 
115.20 	ratio, and the absence and utilization factor ratio;
115.21 	(12) divide the result of clause (10) by one minus the result of clause (11). This is 
115.22 	the total payment amount;
115.23 	(13) for supported employment provided in a shared manner, divide the total 
115.24 	payment amount in clause (12) by the number of service recipients, not to exceed three. 
115.25 	For independent living skills training provided in a shared manner, divide the total 
115.26 	payment amount in clause (12) by the number of service recipients, not to exceed two; and
115.27 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
115.28 	to adjust for regional differences in the cost of providing services.

115.29 	Sec. 38. Minnesota Statutes 2014, section 256B.4914, subdivision 10, is amended to 
115.30 	read:
115.31 		Subd. 10.Updating payment values and additional information. (a) From 
115.32 	January 1, 2014, through December 31, 2017, the commissioner shall develop and 
115.33 	implement uniform procedures to refine terms and adjust values used to calculate payment 
115.34 	rates in this section.
116.1 	(b) No later than July 1, 2014, the commissioner shall, within available resources, 
116.2 	begin to conduct research and gather data and information from existing state systems or 
116.3 	other outside sources on the following items:
116.4 	(1) differences in the underlying cost to provide services and care across the state; and
116.5 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, 
116.6 	and units of transportation for all day services, which must be collected from providers 
116.7 	using the rate management worksheet and entered into the rates management system; and
116.8 	(3) the distinct underlying costs for services provided by a license holder under 
116.9 	sections 245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services 
116.10 	provided by a license holder certified under section 245D.33.
116.11 	(c) Using a statistically valid set of rates management system data, the commissioner, 
116.12 	in consultation with stakeholders, shall analyze for each service the average difference 
116.13 	in the rate on December 31, 2013, and the framework rate at the individual, provider, 
116.14 	lead agency, and state levels. The commissioner shall issue semiannual reports to the 
116.15 	stakeholders on the difference in rates by service and by county during the banding period 
116.16 	under section 256B.4913, subdivision 4a. The commissioner shall issue the first report 
116.17 	by October 1, 2014.
116.18 	(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, 
116.19 	shall begin the review and evaluation of the following values already in subdivisions 6 to 
116.20 	9, or issues that impact all services, including, but not limited to:
116.21 	(1) values for transportation rates for day services;
116.22 	(2) values for transportation rates in residential services;
116.23 	(3) values for services where monitoring technology replaces staff time;
116.24 	(4) values for indirect services;
116.25 	(5) values for nursing;
116.26 	(6) component values for independent living skills;
116.27 	(7) component values for family foster care that reflect licensing requirements;
116.28 	(8) adjustments to other components to replace the budget neutrality factor;
116.29 	(9) remote monitoring technology for nonresidential services;
116.30 	(10) values for basic and intensive services in residential services;
116.31 	(11) values for the facility use rate in day services the weightings used in the day 
116.32 	service ratios and adjustments to those weightings;
116.33 	(12) values for workers' compensation as part of employee-related expenses;
116.34 	(13) values for unemployment insurance as part of employee-related expenses;
117.1 	(14) a component value to reflect costs for individuals with rates previously adjusted 
117.2 	for the inclusion of group residential housing rate 3 costs, only for any individual enrolled 
117.3 	as of December 31, 2013; and
117.4 	(15) any changes in state or federal law with an impact on the underlying cost of 
117.5 	providing home and community-based services.
117.6 	(e) The commissioner shall report to the chairs and the ranking minority members of 
117.7 	the legislative committees and divisions with jurisdiction over health and human services 
117.8 	policy and finance with the information and data gathered under paragraphs (b) to (d) 
117.9 	on the following dates:
117.10 	(1) January 15, 2015, with preliminary results and data;
117.11 	(2) January 15, 2016, with a status implementation update, and additional data 
117.12 	and summary information;
117.13 	(3) January 15, 2017, with the full report; and
117.14 	(4) January 15, 2019, with another full report, and a full report once every four 
117.15 	years thereafter.
117.16 	(f) Based on the commissioner's evaluation of the information and data collected in 
117.17 	paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by 
117.18 	January 15, 2015, to address any issues identified during the first year of implementation. 
117.19 	After January 15, 2015, the commissioner may make recommendations to the legislature 
117.20 	to address potential issues.
117.21 	(g) The commissioner shall implement a regional adjustment factor to all rate 
117.22 	calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to 
117.23 	implementation, the commissioner shall consult with stakeholders on the methodology to 
117.24 	calculate the adjustment.
117.25 	(h) The commissioner shall provide a public notice via LISTSERV in October of 
117.26 	each year beginning October 1, 2014, containing information detailing legislatively 
117.27 	approved changes in:
117.28 	(1) calculation values including derived wage rates and related employee and 
117.29 	administrative factors;
117.30 	(2) service utilization;
117.31 	(3) county and tribal allocation changes; and
117.32 	(4) information on adjustments made to calculation values and the timing of those 
117.33 	adjustments.
117.34 	The information in this notice must be effective January 1 of the following year.
117.35 	(i) No later than July 1, 2016, the commissioner shall develop and implement, in 
117.36 	consultation with stakeholders, a methodology sufficient to determine the shared staffing 
118.1 	levels necessary to meet, at a minimum, health and welfare needs of individuals who 
118.2 	will be living together in shared residential settings, and the required shared staffing 
118.3 	activities described in subdivision 2, paragraph (1). This determination methodology must 
118.4 	ensure staffing levels are adaptable to meet the needs and desired outcomes for current and 
118.5 	prospective residents in shared residential settings.
118.6 	(j)  When the available shared staffing hours in a residential setting are insufficient to 
118.7 	meet the needs of an individual who enrolled in residential services after January 1, 2014, 
118.8 	or insufficient to meet the needs of an individual with a service agreement adjustment 
118.9 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing 
118.10 	hours shall be used.

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

118.12 	Sec. 39. Minnesota Statutes 2014, section 256B.4914, subdivision 14, is amended to 
118.13 	read:
118.14 		Subd. 14.Exceptions. (a) In a format prescribed by the commissioner, lead 
118.15 	agencies must identify individuals with exceptional needs that cannot be met under the 
118.16 	disability waiver rate system. The commissioner shall use that information to evaluate 
118.17 	and, if necessary, approve an alternative payment rate for those individuals. Whether 
118.18 	granted, denied, or modified, the commissioner shall respond to all exception requests in 
118.19 	writing. The commissioner shall include in the written response the basis for the action 
118.20 	and provide notification of the right to appeal under paragraph (h).
118.21 	(b) Lead agencies must act on an exception request within 30 days and notify the 
118.22 	initiator of the request of their recommendation in writing. A lead agency shall submit all 
118.23 	exception requests along with its recommendation to the state commissioner.
118.24 	(c) An application for a rate exception may be submitted for the following criteria:
118.25 	(1) an individual has service needs that cannot be met through additional units 
118.26 	of service; or
118.27 	(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 resultsis so 
118.28 	insufficient that it has resulted in an individual being discharged receiving a notice of 
118.29 	discharge from the individual's provider; or
118.30 	(3) an individual's service needs, including behavioral changes, require a level of 
118.31 	service which necessitates a change in provider or which requires the current provider to 
118.32 	propose service changes beyond those currently authorized.
118.33 	(d) Exception requests must include the following information:
118.34 	(1) the service needs required by each individual that are not accounted for in 
118.35 	subdivisions 6, 7, 8, and 9;
119.1 	(2) the service rate requested and the difference from the rate determined in 
119.2 	subdivisions 6, 7, 8, and 9;
119.3 	(3) a basis for the underlying costs used for the rate exception and any accompanying 
119.4 	documentation; and
119.5 	(4) the duration of the rate exception; and
119.6 	(5) any contingencies for approval.
119.7 	(e) Approved rate exceptions shall be managed within lead agency allocations under 
119.8 	sections 256B.092 and 256B.49.
119.9 	(f) Individual disability waiver recipients, an interested party, or the license holder 
119.10 	that would receive the rate exception increase may request that a lead agency submit an 
119.11 	exception request. A lead agency that denies such a request shall notify the individual 
119.12 	waiver recipient, interested party, or license holder  of its decision and the reasons for 
119.13 	denying the request in writing no later than 30 days after the individual's request has been 
119.14 	made and shall submit its denial to the commissioner in accordance with paragraph (b). 
119.15 	The reasons for the denial must be based on the failure to meet the criteria in paragraph (c).
119.16 	(g) The commissioner shall determine whether to approve or deny an exception 
119.17 	request no more than 30 days after receiving the request. If the commissioner denies the 
119.18 	request, the commissioner shall notify the lead agency and the individual disability waiver 
119.19 	recipient, the interested party, and the license holder in writing of the reasons for the denial.
119.20 	(h) The individual disability waiver recipient may appeal any denial of an exception 
119.21 	request by either the lead agency or the commissioner, pursuant to sections 256.045 and 
119.22 	256.0451. When the denial of an exception request results in the proposed demission of a 
119.23 	waiver recipient from a residential or day habilitation program, the commissioner shall 
119.24 	issue a temporary stay of demission, when requested by the disability waiver recipient, 
119.25 	consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). 
119.26 	The temporary stay shall remain in effect until the lead agency can provide an informed 
119.27 	choice of appropriate, alternative services to the disability waiver.
119.28 	(i) Providers may petition lead agencies to update values that were entered 
119.29 	incorrectly or erroneously into the rate management system, based on past service level 
119.30 	discussions and determination in subdivision 4, without applying for a rate exception.
119.31 	(j) The starting date for the rate exception will be the later of the date of the 
119.32 	recipient's change in support or the date of the request to the lead agency for an exception.
119.33 	(k) The commissioner shall track all exception requests received and their 
119.34 	dispositions. The commissioner shall issue quarterly public exceptions statistical reports, 
119.35 	including the number of exception requests received and the numbers granted, denied, 
120.1 	withdrawn, and pending. The report shall include the average amount of time required to 
120.2 	process exceptions.
120.3 	(l) No later than January 15, 2016, the commissioner shall provide research 
120.4 	findings on the estimated fiscal impact, the primary cost drivers, and common population 
120.5 	characteristics of recipients with needs that cannot be met by the framework rates.
120.6 	(m) No later than July 1, 2016, the commissioner shall develop and implement, 
120.7 	in consultation with stakeholders, a process to determine eligibility for rate exceptions 
120.8 	for individuals with rates determined under the methodology in section 256B.4913, 
120.9 	subdivision 4a. Determination of the eligibility for an exception will occur as annual 
120.10 	service renewals are completed.
120.11 	(n) Approved rate exceptions will be implemented at such time that the individual's 
120.12 	rate is no longer banded and remain in effect in all cases until an individual's needs change 
120.13 	as defined in paragraph (c).

120.14 	Sec. 40. Minnesota Statutes 2014, section 256B.4914, subdivision 15, is amended to 
120.15 	read:
120.16 		Subd. 15.County or tribal allocations. (a) Upon implementation of the disability 
120.17 	waiver rates management system on January 1, 2014, the commissioner shall establish 
120.18 	a method of tracking and reporting the fiscal impact of the disability waiver rates 
120.19 	management system on individual lead agencies.
120.20 	(b) Beginning January 1, 2014, the commissioner shall make annual adjustments to 
120.21 	lead agencies' home and community-based waivered service budget allocations to adjust 
120.22 	for rate differences and the resulting impact on county allocations upon implementation of 
120.23 	the disability waiver rates system.
120.24 	(c) During the first two years of implementation under section 256B.4913, 
120.25 	Lead agencies exceeding their allocations shall be subject to the provisions under 
120.26 	sections 256B.092 and 256B.49shall only be held liable for spending in excess of their 
120.27 	allocations after a reallocation of resources by the commissioner under paragraph (b). The 
120.28 	commissioner shall reallocate resources under sections 256B.092, subdivision 12, and 
120.29 	256B.49, subdivision 11a. The commissioner shall notify lead agencies of this process by 
120.30 	July 1, 2014.

120.31 	Sec. 41. [256B.4915] DISABILITY WAIVER REIMBURSEMENT RATE 
120.32 	ADJUSTMENTS.
120.33 		Subdivision 1.Historical rate. The commissioner of human services shall adjust 
120.34 	the historical rates calculated in section 256B.4913, subdivision 4a, paragraph (b), in 
121.1 	effect during the banding period under section 256B.4913, subdivision 4a, paragraph (a), 
121.2 	for each reimbursement rate increase effective on or after July 1, 2015.
121.3 		Subd. 2.Residential support services. The commissioner of human services shall 
121.4 	adjust the rates calculated in section 256B.4914, subdivision 6, paragraphs (b) and (c), for 
121.5 	each reimbursement rate increase effective on or after July 1, 2015.
121.6 		Subd. 3.Day programs. The commissioner of human services shall adjust the rates 
121.7 	calculated in section 256B.4914, subdivision 7, for each reimbursement rate increase 
121.8 	effective on or after July 1, 2015.
121.9 		Subd. 4.Unit-based services with programming. The commissioner of human 
121.10 	services shall adjust the rate calculated in section 256B.4914, subdivision 8, for each 
121.11 	reimbursement rate increase effective on or after July 1, 2015.
121.12 		Subd. 5.Unit-based services without programming. The commissioner of human 
121.13 	services shall adjust the rate calculated in section 256B.4914, subdivision 9, for each 
121.14 	reimbursement rate increase effective on or after July 1, 2015.

121.15 	Sec. 42. Minnesota Statutes 2014, section 256B.492, is amended to read:
121.16 	256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE 
121.17 	WITH DISABILITIES.
121.18 	(a) Individuals receiving services under a home and community-based waiver under 
121.19 	section 256B.092 or 256B.49 may receive services in the following settings:
121.20 	(1) an individual's own home or family home and community-based settings that 
121.21 	comply with all requirements identified by the federal Centers for Medicare and Medicaid 
121.22 	Services in the Code of Federal Regulations, title 42, section 441.301(c), and with the 
121.23 	requirements of the federally approved transition plan and waiver plans for each home 
121.24 	and community-based services waiver; and
121.25 	(2) a licensed adult foster care or child foster care setting of up to five people or 
121.26 	community residential setting of up to five people; and settings required by the Housing 
121.27 	Opportunities for Persons with AIDS Program.
121.28 	(3) community living settings as defined in section 256B.49, subdivision 23, where 
121.29 	individuals with disabilities may reside in all of the units in a building of four or fewer units, 
121.30 	and who receive services under a home and community-based waiver occupy no more 
121.31 	than the greater of four or 25 percent of the units in a multifamily building of more than 
121.32 	four units, unless required by the Housing Opportunities for Persons with AIDS Program.
121.33 	(b) The settings in paragraph (a) must not:
121.34 	(1) be located in a building that is a publicly or privately operated facility that 
121.35 	provides institutional treatment or custodial care;
122.1 	(2) be located in a building on the grounds of or adjacent to a public or private 
122.2 	institution;
122.3 	(3) be a housing complex designed expressly around an individual's diagnosis or 
122.4 	disability, unless required by the Housing Opportunities for Persons with AIDS Program;
122.5 	(4) be segregated based on a disability, either physically or because of setting 
122.6 	characteristics, from the larger community; and
122.7 	(5) have the qualities of an institution which include, but are not limited to: 
122.8 	regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions 
122.9 	agreed to and documented in the person's individual service plan shall not result in a 
122.10 	residence having the qualities of an institution as long as the restrictions for the person are 
122.11 	not imposed upon others in the same residence and are the least restrictive alternative, 
122.12 	imposed for the shortest possible time to meet the person's needs.
122.13 	(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which 
122.14 	individuals receive services under a home and community-based waiver as of July 1, 
122.15 	2012, and the setting does not meet the criteria of this section.
122.16 	(d) Notwithstanding paragraph (c), a program in Hennepin County established as 
122.17 	part of a Hennepin County demonstration project is qualified for the exception allowed 
122.18 	under paragraph (c).
122.19 	(e) Notwithstanding paragraphs (a) and (b), a program in Hennepin County, located 
122.20 	in the city of Golden Valley, within the city of Golden Valley's Highway 55 West 
122.21 	redevelopment area, that is not a provider-owned or controlled home and community-based 
122.22 	setting, and is scheduled to open by July 1, 2016, is exempt from the restrictions in 
122.23 	paragraphs (a) and (b). If the program fails to comply with the Centers for Medicare and 
122.24 	Medicaid Services rules for home and community-based settings, the exemption is void.
122.25 	(f) The commissioner shall submit an amendment to the waiver plan no later than 
122.26 	December 31, 2012.

122.27 	EFFECTIVE DATE. This section is effective July 1, 2016.

122.28 	Sec. 43. Minnesota Statutes 2014, section 256B.5012, is amended by adding a 
122.29 	subdivision to read:
122.30 		Subd. 17.ICF/DD rate increase effective July 1, 2016. (a) For the rate period from 
122.31 	July 1, 2016, to June 30, 2017, the commissioner shall increase operating payments for 
122.32 	each facility reimbursed under this section equal to five percent of the operating payment 
122.33 	rates in effect on June 30, 2016.
122.34 	(b) For each facility, the commissioner shall apply the rate increase based on 
122.35 	occupied beds, using the percentage specified in this subdivision multiplied by the total 
123.1 	payment rate, including the variable rate but excluding the property-related payment 
123.2 	rate in effect on the preceding date. The total rate increase shall include the adjustment 
123.3 	provided in section 256B.501, subdivision 12.
123.4 	(c) Facilities that receive a rate increase under this subdivision shall use 90 percent 
123.5 	of the additional revenue to increase compensation-related costs for employees directly 
123.6 	employed by the facility on or after the effective date of the rate adjustment in paragraph 
123.7 	(a), except:
123.8 	(1) persons employed in the central office of a corporation or entity that has an 
123.9 	ownership interest in the facility or exercises control over the facility; and
123.10 	(2) persons paid by the facility under a management contract.
123.11 	(d) Compensation-related costs include:
123.12 	(1) wages and salaries;
123.13 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
123.14 	unemployment taxes, workers' compensation, and mileage reimbursement;
123.15 	(3) the employer's share of health and dental insurance, life insurance, disability 
123.16 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
123.17 	employee retirement accounts; and
123.18 	(4) other benefits provided and workforce needs, including the recruiting and 
123.19 	training of employees as specified in the distribution plan required under paragraph (h).
123.20 	(e) For public employees under a collective bargaining agreement, the increases for 
123.21 	wages and benefits for certain staff are available and pay rates must be increased only to 
123.22 	the extent that the increases comply with laws governing public employees' collective 
123.23 	bargaining. A provider that receives additional revenue for compensation-related cost 
123.24 	increases under paragraph (c), that is a public employer, and whose fiscal year ends on 
123.25 	June 30 of each year, must use the portion of the rate increase specified in paragraph (c) 
123.26 	only for compensation-related cost increases implemented between July 1, 2016, and 
123.27 	August 1, 2016. A provider that receives additional revenue for compensation-related cost 
123.28 	increases under paragraph (c), that is a public employer, and whose fiscal year ends on 
123.29 	December 31 of each year, must use the portion of the compensation-related cost increases 
123.30 	specified in paragraph (c) only for compensation-related cost increases implemented 
123.31 	during the contract period.
123.32 	(f) For a facility that has employees that are represented by an exclusive bargaining 
123.33 	representative, the provider shall obtain a letter of acceptance of the distribution plan 
123.34 	required under paragraph (h), in regard to the members of the bargaining unit, signed by 
123.35 	the exclusive bargaining agent. Upon receipt of the letter of acceptance, the facility shall 
123.36 	be deemed to have met all the requirements of this subdivision in regard to the members 
124.1 	of the bargaining unit. Upon request, the facility shall produce the letter of acceptance for 
124.2 	the commissioner.
124.3 	(g) The commissioner shall amend state grant contracts that include direct 
124.4 	personnel-related grant expenditures to include the allocation for the portion of the 
124.5 	contract related to employee compensation. Grant contracts for compensation-related 
124.6 	services must be amended to pass through the adjustment within 60 days of the effective 
124.7 	date of the increase and must be retroactive to the effective date of the rate adjustment.
124.8 	(h) A facility that receives a rate adjustment under paragraph (a) that is subject to 
124.9 	paragraphs (c) and (d) shall prepare and, upon request, submit to the commissioner a 
124.10 	distribution plan that specifies the amount of money the facility expects to receive that is 
124.11 	subject to the requirements of paragraphs (c) and (d), including how that money will be 
124.12 	distributed to increase compensation for employees.
124.13 	(i) Within six months of the effective date of the rate adjustment, the facility shall 
124.14 	post the distribution plan required under paragraph (h) for a period of at least six weeks in 
124.15 	an area of the facility's operation to which all eligible employees have access and shall 
124.16 	provide instructions for employees who do not believe they have received the wage and 
124.17 	other compensation-related increases specified in the distribution plan. The instructions 
124.18 	must include a mailing address, e-mail address, and telephone number that an employee 
124.19 	may use to contact the commissioner or the commissioner's representative.

124.20 	Sec. 44. [256Q.01] PLAN ESTABLISHED.
124.21 	A savings plan known as the Minnesota ABLE plan is established. In establishing 
124.22 	this plan, the legislature seeks to encourage and assist individuals and families in saving 
124.23 	private funds for the purpose of supporting individuals with disabilities to maintain health, 
124.24 	independence, and quality of life, and to provide secure funding for disability-related 
124.25 	expenses on behalf of designated beneficiaries with disabilities that will supplement, but 
124.26 	not supplant, benefits provided through private insurance, the Medicaid program under 
124.27 	title XIX of the Social Security Act, the Supplemental Security Income program under 
124.28 	title XVI of the Social Security Act, the beneficiary's employment, and other sources.

124.29 	Sec. 45. [256Q.02] CITATION.
124.30 	This chapter may be cited as the "Minnesota Achieving a Better Life Experience 
124.31 	Act" or "Minnesota ABLE Act."

124.32 	Sec. 46. [256Q.03] DEFINITIONS.
125.1 		Subdivision 1.Scope. For the purposes of this chapter, the terms defined in this 
125.2 	section have the meanings given them.
125.3 		Subd. 2.ABLE account. "ABLE account" has the meaning given in section 
125.4 	529A(e)(6) of the Internal Revenue Code.
125.5 		Subd. 3.ABLE account plan or plan. "ABLE account plan" or "plan" means the 
125.6 	qualified ABLE program, as defined in section 529A(b) of the Internal Revenue Code, 
125.7 	provided for in this chapter.
125.8 		Subd. 4.Account. "Account" means the formal record of transactions relating to an 
125.9 	ABLE plan beneficiary.
125.10 		Subd. 5.Account owner. "Account owner" means the designated beneficiary 
125.11 	of the account.
125.12 		Subd. 6.Annual contribution limit. "Annual contribution limit" has the meaning 
125.13 	given in section 529A(b)(2) of the Internal Revenue Code.
125.14 		Subd. 7.Application. "Application" means the form executed by a prospective 
125.15 	account owner to enter into a participation agreement and open an account in the plan. 
125.16 	The application incorporates by reference the participation agreement.
125.17 		Subd. 8.Board. "Board" mans the State Board of Investment.
125.18 		Subd. 9.Commissioner. "Commissioner" means the commissioner of human 
125.19 	services.
125.20 		Subd. 10.Contribution. "Contribution" means a payment directly allocated to 
125.21 	an account for the benefit of a beneficiary.
125.22 		Subd. 11.Department. "Department" means the Department of Human Services.
125.23 		Subd. 12.Designated beneficiary or beneficiary. "Designated beneficiary" or 
125.24 	"beneficiary" has the meaning given in section 529A(e)(3) of the Internal Revenue Code 
125.25 	and further defined through regulations issued under that section.
125.26 		Subd. 13.Earnings. "Earnings" means the total account balance minus the 
125.27 	investment in the account.
125.28 		Subd. 14.Eligible individual. "Eligible individual" has the meaning given in 
125.29 	section 529A(e)(1) of the Internal Revenue Code and further defined through regulations 
125.30 	issued under that section.
125.31 		Subd. 15.Executive director. "Executive director" means the executive director of 
125.32 	the State Board of Investment.
125.33 		Subd. 16.Internal Revenue Code. "Internal Revenue Code" means the Internal 
125.34 	Revenue Code of 1986, as amended.
125.35 		Subd. 17.Investment in the account. "Investment in the account" means the sum 
125.36 	of all contributions made to an account by a particular date minus the aggregate amount 
126.1 	of contributions included in distributions or rollover distributions, if any, made from the 
126.2 	account as of that date.
126.3 		Subd. 18.Member of the family. "Member of the family" has the meaning given in 
126.4 	section 529A(e)(4) of the Internal Revenue Code.
126.5 		Subd. 19.Participation agreement. "Participation agreement" means an agreement 
126.6 	to participate in the Minnesota ABLE plan between an account owner and the state 
126.7 	through its agencies, the commissioner, and the board.
126.8 		Subd. 20.Person. "Person" means an individual, trust, estate, partnership, 
126.9 	association, company, corporation, or the state.
126.10 		Subd. 21.Plan administrator. "Plan administrator" means the person selected by 
126.11 	the commissioner and the board to administer the daily operations of the ABLE account  
126.12 	plan and provide record keeping, investment management, and other services for the plan.
126.13 		Subd. 22.Qualified disability expense. "Qualified disability expense" has the 
126.14 	meaning given in section 529A(e)(5) of the Internal Revenue Code and further defined 
126.15 	through regulations issued under that section.
126.16 		Subd. 23.Qualified distribution. "Qualified distribution" means a withdrawal from 
126.17 	an ABLE account to pay the qualified disability expenses of the beneficiary of the account. 
126.18 	A qualified withdrawal may be made by the beneficiary, by an agent of the beneficiary 
126.19 	who has the power of attorney, or by the beneficiary's legal guardian.
126.20 		Subd. 24.Rollover distribution. "Rollover distribution" means a transfer of funds  
126.21 	made:
126.22 	(1) from one account in another state's qualified ABLE program to an account for 
126.23 	the benefit of the same designated beneficiary or an eligible individual who is a family  
126.24 	member of the former designated beneficiary; or
126.25 	(2) from one account to another account for the benefit of an eligible individual who 
126.26 	is a family member of the former designated beneficiary.
126.27 		Subd. 25.Total account balance. "Total account balance" means the amount in an 
126.28 	account on a particular date or the fair market value of an account on a particular date.

126.29 	Sec. 47. [256Q.04] ABLE PLAN REQUIREMENTS.
126.30 		Subdivision 1.State residency requirement. The designated beneficiary of an 
126.31 	ABLE account must be a resident of Minnesota, or the resident of a state that has entered 
126.32 	into a contract with Minnesota to provide its residents access to the Minnesota ABLE plan.
126.33 		Subd. 2.Single account requirement. No more than one ABLE account shall be 
126.34 	established per beneficiary, except as permitted under section 529A(c)(4) of the Internal 
126.35 	Revenue Code.
127.1 		Subd. 3.Accounts-type plan. The plan must be operated as an accounts-type 
127.2 	plan. A separate account must be maintained for each designated beneficiary for whom  
127.3 	contributions are made.
127.4 		Subd. 4.Contribution and account requirements. Contributions to an ABLE 
127.5 	account are subject to the requirements of section 529A(b)(2) of the Internal Revenue 
127.6 	Code prohibiting noncash contributions and contributions in excess of the annual 
127.7 	contribution limit. The total account balance may not exceed the maximum account  
127.8 	balance limit imposed under section 136G.09, subdivision 8.
127.9 		Subd. 5.Limited investment direction. Designated beneficiaries may not direct 
127.10 	the investment of assets in their accounts more than twice in any calendar year.
127.11 		Subd. 6.Security for loans. An interest in an account must not be used as security 
127.12 	for a loan.

127.13 	Sec. 48. [256Q.05] ABLE PLAN ADMINISTRATION.
127.14 		Subdivision 1.Plan to comply with federal law. The commissioner shall ensure 
127.15 	that the plan meets the requirements for an ABLE account under section 529A of the 
127.16 	Internal Revenue Code, including any regulations released after the effective date of this 
127.17 	section. The commissioner may request a private letter ruling or rulings from the Internal 
127.18 	Revenue Service or secretary of health and human services and must take any necessary 
127.19 	steps to ensure that the plan qualifies under relevant provisions of federal law.
127.20 		Subd. 2.Plan rules and procedures. (a) The commissioner shall establish the 
127.21 	rules, terms, and conditions for the plan, subject to the requirements of this chapter and 
127.22 	section 529A of the Internal Revenue Code.
127.23 	(b) The commissioner shall prescribe the application forms, procedures, and other 
127.24 	requirements that apply to the plan.
127.25 		Subd. 3.Consultation with other state agencies; annual fee.  In designing and 
127.26 	establishing the plan's requirements and in negotiating or entering into contracts with third 
127.27 	parties under subdivision 4, the commissioner shall consult with the executive director of 
127.28 	the board and the commissioner of the Office of Higher Education. The commissioner and 
127.29 	the executive director shall establish an annual fee, equal to a percentage of the average 
127.30 	daily net assets of the plan, to be imposed on account owners to recover the costs of 
127.31 	administration, record keeping, and investment management as provided in subdivision 5.
127.32 		Subd. 4.Administration. The commissioner shall administer the plan, including 
127.33 	accepting and processing applications, verifying state residency, verifying eligibility, 
127.34 	maintaining account records, making payments, and undertaking any other necessary 
127.35 	tasks to administer the plan. Notwithstanding other requirements of this chapter, the 
128.1 	commissioner shall adopt rules for purposes of implementing and administering the plan. 
128.2 	The commissioner may contract with one or more third parties to carry out some or all of 
128.3 	these administrative duties, including providing incentives. The commissioner and the 
128.4 	board may jointly contract with third-party providers if the commissioner and board 
128.5 	determine that it is desirable to contract with the same entity or entities for administration 
128.6 	and investment management.
128.7 		Subd. 5.Authority to impose fees. The commissioner, or the commissioner's 
128.8 	designee, may impose annual fees, as provided in subdivision 3, on account owners to 
128.9 	recover the costs of administration. The commissioner must keep the fees as low as 
128.10 	possible, consistent with efficient administration, so that the returns on savings invested in 
128.11 	the plan are as high as possible.
128.12 		Subd. 6.Federally mandated reporting. (a) As required under section 529A(d) of 
128.13 	the Internal Revenue Code, the commissioner or the commissioner's designee shall submit 
128.14 	a notice to the secretary of the treasury upon the establishment of each ABLE account. 
128.15 	The notice must contain the name and state of residence of the designated beneficiary and  
128.16 	other information as the secretary may require.
128.17 	(b) As required under section 529A(d) of the Internal Revenue Code, the  
128.18 	commissioner or the commissioner's designee shall submit electronically on a monthly 
128.19 	basis to the commissioner of Social Security, in a manner specified by the commissioner 
128.20 	of Social Security, statements on relevant distributions and account balances from all 
128.21 	ABLE accounts.
128.22 		Subd. 7.Data. (a) Data on ABLE accounts and designated beneficiaries of ABLE 
128.23 	accounts are private data on individuals or nonpublic data as defined in section 13.02.
128.24 	(b) The commissioner may share or disseminate data classified as private or 
128.25 	nonpublic in this subdivision as follows:
128.26 	(1) with other state or federal agencies, only to the extent necessary to verify the 
128.27 	identity of, determine the eligibility of, or process applications for an eligible individual 
128.28 	participating in the Minnesota ABLE plan; and
128.29 	(2) with a nongovernmental person, only to the extent necessary to carry out the 
128.30 	functions of the Minnesota ABLE plan, provided the commissioner has entered into 
128.31 	a data-sharing agreement with the person, as provided in section 13.05, subdivision 6, 
128.32 	prior to sharing data under this clause or a contract with that person that complies with 
128.33 	section 13.05, subdivision 11, as applicable.

128.34 	Sec. 49. [256Q.06] PLAN ACCOUNTS.
129.1 		Subdivision 1.Contributions to an account. Any person may make contributions 
129.2 	to an ABLE account on behalf of a designated beneficiary. Contributions to an account 
129.3 	made by persons other than the account owner become the property of the account owner. 
129.4 	A person does not acquire an interest in an ABLE account by making contributions to 
129.5 	an account. Contributions to an account must be made in cash, by check, or by other 
129.6 	commercially acceptable means, as permitted by the Internal Revenue Service and 
129.7 	approved by the plan administrator in cooperation with the commissioner and the board.
129.8 		Subd. 2.Contribution and account limitations. Contributions to an ABLE 
129.9 	account are subject to the requirements of section 529A(b) of the Internal Revenue Code. 
129.10 	The total account balance of an ABLE account may not exceed the maximum account 
129.11 	balance limit imposed under section 136G.09, subdivision 8. The plan administrator must 
129.12 	reject any portion of a contribution to an account that exceeds the annual contribution limit 
129.13 	or that would cause the total account balance to exceed the maximum account balance 
129.14 	limit imposed under section 136G.09, subdivision 8.
129.15 		Subd. 3.Authority of account owner. An account owner is the only person 
129.16 	entitled to:
129.17 	(1) request distributions;
129.18 	(2) request rollover distributions; or
129.19 	(3) change the beneficiary of an ABLE account to a member of the family of the 
129.20 	current beneficiary, but only if the beneficiary to whom the ABLE account is transferred 
129.21 	is an eligible individual.
129.22 		Subd. 4.Effect of plan changes on participation agreement. Amendments to 
129.23 	this chapter automatically amend the participation agreement. Any amendments to the 
129.24 	operating procedures and policies of the plan automatically amend the participation 
129.25 	agreement after adoption by the commissioner or the board.
129.26 		Subd. 5.Special account to hold plan assets in trust. All assets of the plan, 
129.27 	including contributions to accounts, are held in trust for the exclusive benefit of account 
129.28 	owners. Assets must be held in a separate account in the state treasury to be known as 
129.29 	the Minnesota ABLE plan account or in accounts with the third-party provider selected 
129.30 	pursuant to section 256Q.05, subdivision 4. Plan assets are not subject to claims by creditors 
129.31 	of the state, are not part of the general fund, and are not subject to appropriation by the 
129.32 	state. Payments from the Minnesota ABLE plan account shall be made under this chapter.

129.33 	Sec. 50. [256Q.07] INVESTMENT OF ABLE ACCOUNTS.
129.34 		Subdivision 1.State Board of Investment to invest. The State Board of Investment 
129.35 	shall invest the money deposited in accounts in the plan.
130.1 		Subd. 2.Permitted investments. The board may invest the accounts in any 
130.2 	permitted investment under section 11A.24, except that the accounts may be invested  
130.3 	without limit in investment options from open-ended investment companies registered 
130.4 	under the federal Investment Company Act of 1940, United States Code, title 15, sections 
130.5 	80a-1 to 80a-64.
130.6 		Subd. 3.Contracting authority. The board may contract with one or more third 
130.7 	parties for investment management, record keeping, or other services in connection with  
130.8 	investing the accounts. The board and commissioner may jointly contract with third-party 
130.9 	providers if the commissioner and board determine that it is desirable to contract with the 
130.10 	same entity or entities for administration and investment management.

130.11 	Sec. 51. [256Q.08] ACCOUNT DISTRIBUTIONS.
130.12 		Subdivision 1.Qualified distribution methods. (a) Qualified distributions may 
130.13 	be made:
130.14 	(1) directly to participating providers of goods and services that are qualified 
130.15 	disability expenses, if purchased for a beneficiary;
130.16 	(2) in the form of a check payable to both the beneficiary and provider of goods or 
130.17 	services that are qualified disability expenses; or
130.18 	(3) directly to the beneficiary, if the beneficiary has already paid qualified disability 
130.19 	expenses.
130.20 	(b) Qualified distributions must be withdrawn proportionally from contributions and 
130.21 	earnings in an account owner's account on the date of distribution as provided in section 
130.22 	529A of the Internal Revenue Code.
130.23 		Subd. 2.Distributions upon death of beneficiary. Upon the death of a beneficiary, 
130.24 	the amount remaining in the beneficiary's account must be distributed pursuant to section 
130.25 	529A(f) of the Internal Revenue Code.
130.26 		Subd. 3.Nonqualified distribution. An account owner may request a nonqualified 
130.27 	distribution from an account at any time. Nonqualified distributions are based on the total 
130.28 	account balances in an account owner's account and must be withdrawn proportionally 
130.29 	from contributions and earnings as provided in section 529A of the Internal Revenue 
130.30 	Code. The earnings portion of a nonqualified distribution is subject to a federal additional 
130.31 	tax pursuant to section 529A of the Internal Revenue Code. For purposes of this 
130.32 	subdivision, "earnings portion" means the ratio of the earnings in the account to the total 
130.33 	account balance, immediately prior to the distribution, multiplied by the distribution.

131.1 	Sec. 52. Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, 
131.2 	chapter 312, article 27, section 72, is amended to read:
131.3 	Sec. 47. COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION 
131.4 	TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 
131.5 	METHODOLOGY.
 131.6 	By July 1, 2014, if necessary, The commissioner shall request an amendment to 
131.7 	the home and community-based services waivers authorized under Minnesota Statutes, 
131.8 	sections 256B.092 and 256B.49, to establish an exception to the consumer-directed 
131.9 	community supports budget methodology for the home and community-based services 
131.10 	waivers under Minnesota Statutes, sections 256B.092 and 256B.49, to provide up to 
131.11 	20 percent more funds for those:
131.12 	(1) consumer-directed community supports participants who have their 21st birthday 
131.13 	and graduate graduated from high school between 2013 to 2015 and are authorized for to 
131.14 	receive more services under consumer-directed community supports prior to graduation 
131.15 	than the amount they are eligible to receive under the current consumer-directed 
131.16 	community supports budget methodology; and
131.17 	(2) those who are currently using licensed services for employment supports or 
131.18 	services during the day which cost more annually than the person would spend under a 
131.19 	consumer-directed community supports plan for individualized employment supports 
131.20 	or services during the day. The exception is limited to those who can demonstrate 
131.21 	either that they will have to leave consumer-directed community supports and use other 
131.22 	waiver services because their need for day or employment supports cannot be met 
131.23 	within the consumer-directed community supports budget limits or they will move to 
131.24 	consumer-directed community supports and their services will cost less than services 
131.25 	currently being used. The commissioner shall consult with the stakeholder group 
131.26 	authorized under Minnesota Statutes, section 256B.0657, subdivision 11, to implement 
131.27 	this provision. The exception process shall be effective upon federal approval for persons 
131.28 	eligible through June 30, 2017 2019.

131.29 	Sec. 53.  PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY 
131.30 	1, 2016.
 131.31 	(a) The commissioner of human services shall increase reimbursement rates, grants, 
131.32 	allocations, individual limits, and rate limits, as applicable, by five percent for the rate 
131.33 	period from July 1, 2016, to June 30, 2017, for services rendered on or after those dates. 
131.34 	County or tribal contracts for services specified in this section must be amended to pass 
131.35 	through the rate increase within 60 days of the effective date of the increase.
132.1 	(b) The rate changes described in this section must be provided to:
132.2 	(1) home and community-based waivered services for persons with developmental 
132.3 	disabilities, including consumer-directed community supports, under Minnesota Statutes, 
132.4 	section 256B.092;
132.5 	(2) waivered services under community alternatives for disabled individuals, 
132.6 	including consumer-directed community supports, under Minnesota Statutes, section 
132.7 	256B.49;
132.8 	(3) community alternative care waivered services, including consumer-directed 
132.9 	community supports, under Minnesota Statutes, section 256B.49;
132.10 	(4) brain injury waivered services, including consumer-directed community 
132.11 	supports, under Minnesota Statutes, section 256B.49;
132.12 	(5) home and community-based waivered services for the elderly under Minnesota 
132.13 	Statutes, section 256B.0915;
132.14 	(6) nursing services and home health services under Minnesota Statutes, section 
132.15 	256B.0625, subdivision 6a;
132.16 	(7) personal care services and qualified professional supervision of personal care 
132.17 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
132.18 	(8) home care nursing services under Minnesota Statutes, section 256B.0625, 
132.19 	subdivision 7;
132.20 	(9) community first services and supports under Minnesota Statutes, section 256B.85;
132.21 	(10) essential community supports under Minnesota Statutes, section 256B.0922;
132.22 	(11) day training and habilitation services for adults with developmental disabilities 
132.23 	under Minnesota Statutes, sections 252.41 to 252.46, including the additional cost to 
132.24 	counties of the rate adjustments on day training and habilitation services provided as a 
132.25 	social service;
132.26 	(12) alternative care services under Minnesota Statutes, section 256B.0913;
132.27 	(13) living skills training programs for persons with intractable epilepsy who need 
132.28 	assistance in the transition to independent living under Laws 1988, chapter 689;
132.29 	(14) semi-independent living services (SILS) under Minnesota Statutes, section 
132.30 	252.275;
132.31 	(15) consumer support grants under Minnesota Statutes, section 256.476;
132.32 	(16) family support grants under Minnesota Statutes, section 252.32;
132.33 	(17) housing access grants under Minnesota Statutes, section 256B.0658;
132.34 	(18) self-advocacy grants under Laws 2009, chapter 101;
132.35 	(19) technology grants under Laws 2009, chapter 79;
133.1 	(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977 and 
133.2 	256B.0917;
133.3 	(21) deaf and hard-of-hearing grants, including community support services for deaf 
133.4 	and hard-of-hearing adults with mental illness who use or wish to use sign language as their 
133.5 	primary means of communication under Minnesota Statutes, section 256.01, subdivision 2;
133.6 	(22) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233, 
133.7 	256C.25, and 256C.261;
133.8 	(23) Disability Linkage Line grants under Minnesota Statutes, section 256.01, 
133.9 	subdivision 24;
133.10 	(24) transition initiative grants under Minnesota Statutes, section 256.478;
133.11 	(25) employment support grants under Minnesota Statutes, section 256B.021, 
133.12 	subdivision 6; and
133.13 	(26) grants provided to people who are eligible for the Housing Opportunities for 
133.14 	Persons with AIDS program under Minnesota Statutes, section 256B.492.
133.15 	(c) A managed care plan or county-based purchasing plan receiving state payments 
133.16 	for the services, grants, and programs in paragraph (b) must include the increase in their 
133.17 	payments to providers. For the purposes of this subdivision, entities that provide care 
133.18 	coordination are providers. To implement the rate increase in paragraph (a), capitation rates 
133.19 	paid by the commissioner to managed care plans and county-based purchasing plans under 
133.20 	Minnesota Statutes, section 256B.69, shall reflect a five percent increase for the services, 
133.21 	grants, and programs specified in paragraph (b) for the period beginning July 1, 2016.
133.22 	(d) Counties shall increase the budget for each recipient of consumer-directed 
133.23 	community supports by the amounts in paragraph (a) on the effective date in paragraph (a).
133.24 	(e) Providers that receive a rate increase under paragraph (a) shall use 90 percent 
133.25 	of the additional revenue to increase compensation-related costs for employees directly 
133.26 	employed by the program on or after the effective date of the rate adjustment in paragraph 
133.27 	(a), except:
133.28 	(1) persons employed in the central office of a corporation or entity that has an 
133.29 	ownership interest in the provider or exercises control over the provider; and
133.30 	(2) persons paid by the provider under a management contract.
133.31 	(f) Compensation-related costs include:
133.32 	(1) wages and salaries;
133.33 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal 
133.34 	unemployment taxes, workers' compensation, and mileage reimbursement;
134.1 	(3) the employer's share of health and dental insurance, life insurance, disability 
134.2 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
134.3 	employee retirement accounts; and
134.4 	(4) other benefits provided and workforce needs, including the recruiting and 
134.5 	training of employees as specified in the distribution plan required under paragraph (k).
134.6 	(g) For public employees under a collective bargaining agreement, the increases for 
134.7 	wages and benefits are available and pay rates must be increased only to the extent that the 
134.8 	increases comply with laws governing public employees' collective bargaining. A provider 
134.9 	that receives additional revenue for compensation-related cost increases under paragraph 
134.10 	(e), that is a public employer, and whose fiscal year ends on June 30 of each year, must use 
134.11 	the portion of the rate increase specified in paragraph (e) only for compensation-related 
134.12 	cost increases implemented between July 1, 2016, and August 1, 2016. A provider that 
134.13 	receives additional revenue for compensation-related cost increases under paragraph (e), 
134.14 	that is a public employer, and whose fiscal year ends on December 31 of each year, must 
134.15 	use the portion of the compensation-related cost increases specified in paragraph (e) only 
134.16 	for compensation-related cost increases implemented during the contract period. 
134.17 	(h) For a provider that has employees who are represented by an exclusive bargaining 
134.18 	representative, the provider shall obtain a letter of acceptance of the distribution plan 
134.19 	required under paragraph (k), in regard to the members of the bargaining unit, signed by 
134.20 	the exclusive bargaining agent. Upon receipt of the letter of acceptance, the provider shall 
134.21 	be deemed to have met all the requirements of this section in regard to the members of 
134.22 	the bargaining unit. Upon request, the provider shall produce the letter of acceptance for 
134.23 	the commissioner.
134.24 	(i) The commissioner shall amend state grant contracts that include direct 
134.25 	personnel-related grant expenditures to include the allocation for the portion of the 
134.26 	contract related to employee compensation. Grant contracts for compensation-related 
134.27 	services must be amended to pass through these adjustments within 60 days of the 
134.28 	effective date of the increase under paragraph (a) and must be retroactive to the effective 
134.29 	date of the rate adjustment.
134.30 	(j) The Board on Aging and its area agencies on aging shall amend their grants that 
134.31 	include direct personnel-related grant expenditures to include the rate adjustment for the 
134.32 	portion of the grant related to employee compensation. Grants for compensation-related 
134.33 	services must be amended to pass through these adjustments within 60 days of the 
134.34 	effective date of the increase under paragraph (a) and must be retroactive to the effective 
134.35 	date of the rate adjustment.
135.1 	(k) A provider that receives a rate adjustment under paragraph (a) that is subject to 
135.2 	paragraph (e) shall prepare and, upon request, submit to the commissioner a distribution 
135.3 	plan that specifies the amount of money the provider expects to receive that is subject 
135.4 	to the requirements of paragraph (e), including how that money will be distributed to 
135.5 	increase compensation for employees.
135.6 	(l) Within six months of the effective date of the rate adjustment, the provider shall 
135.7 	post the distribution plan required under paragraph (k) for a period of at least six weeks in 
135.8 	an area of the provider's operation to which all eligible employees have access and shall 
135.9 	provide instructions for employees who do not believe they have received the wage and 
135.10 	other compensation-related increases specified in the distribution plan. The instructions 
135.11 	must include a mailing address, e-mail address, and telephone number that the employee 
135.12 	may use to contact the commissioner or the commissioner's representative.

135.13 	Sec. 54. DIRECTION TO COMMISSIONER; PEDIATRIC HOME CARE 
135.14 	STUDY.
 135.15 	The commissioner of human services shall review the status of delayed discharges of 
135.16 	pediatric patients and determine if an increase in the medical assistance payment rate for 
135.17 	intensive pediatric home care would reduce the number of delayed discharges of pediatric 
135.18 	patients. The commissioner shall report the results of the review to the chairs and ranking 
135.19 	minority members of the house of representatives and senate committees and divisions 
135.20 	with jurisdiction over health and human services policy and finance by January 15, 2016.

135.21 	Sec. 55. DIRECTION TO COMMISSIONER; REPORTS REQUIRED.
 135.22 	The commissioner of human services shall develop and submit reports to the chairs 
135.23 	and ranking minority members of the house of representatives and senate committees and 
135.24 	divisions with jurisdiction over health and human services policy and finance on the 
135.25 	implementation of Minnesota Statutes, sections 256B.0916, subdivisions 2, 11, and 12, 
135.26 	and 256B.49, subdivisions 26 and 27. The commissioner shall submit two reports, one by 
135.27 	February 15, 2018, and the second by February 15, 2019.

135.28 	Sec. 56. DIRECTION TO COMMISSIONER; DAY TRAINING AND 
135.29 	HABILITATION.
 135.30 	For service agreements renewed or entered into on or after January 1, 2016, the 
135.31 	commissioner of human services shall calculate the transportation portion of the payment 
135.32 	for day training and habilitation programs using payments factors found in Minnesota 
135.33 	Statutes, section 256B.4914, subdivision 7, clauses (16) and (17).

136.1 	Sec. 57. HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.
 136.2 	The commissioner of human services shall develop an initiative to provide 
136.3 	incentives for innovation in achieving integrated competitive employment, living in 
136.4 	the most integrated setting, and other outcomes determined by the commissioner. The 
136.5 	commissioner shall seek requests for proposals and shall contract with one or more entities 
136.6 	to provide incentive payments for meeting identified outcomes. The initial requests for 
136.7 	proposals must be issued by October 1, 2015.

136.8 	ARTICLE 5
136.9 	NURSING FACILITY PAYMENT REFORM AND WORKFORCE 
136.10 	DEVELOPMENT

136.11 	Section 1. [144.1503] HOME AND COMMUNITY-BASED SERVICES 
136.12 	EMPLOYEE SCHOLARSHIP PROGRAM.
136.13 		Subdivision 1.Creation. The home and community-based services employee 
136.14 	scholarship grant program is established for the purpose of assisting qualified provider 
136.15 	applicants to fund employee scholarships for education in nursing and other health care 
136.16 	fields.
136.17 		Subd. 2.Provision of grants. The commissioner shall make grants available 
136.18 	to qualified providers of older adult services. Grants must be used by home and 
136.19 	community-based service providers to recruit and train staff through the establishment of 
136.20 	an employee scholarship fund.
136.21 		Subd. 3.Eligibility. (a) Eligible providers must primarily provide services to 
136.22 	individuals who are 65 years of age and older in home and community-based settings, 
136.23 	including housing with services establishments as defined in section 144D.01, subdivision 
136.24 	4; adult day care as defined in section 245A.02, subdivision 2a; and home care services as 
136.25 	defined in section 144A.43, subdivision 3.
136.26 	(b) Qualifying providers must establish a home and community-based services 
136.27 	employee scholarship program, as specified in subdivision 4. Providers that receive 
136.28 	funding under this section must use the funds to award scholarships to employees who 
136.29 	work an average of at least 16 hours per week for the provider.
136.30 		Subd. 4.Home and community-based services employee scholarship program.
 136.31 	Each qualifying provider under this section must propose a home and community-based 
136.32 	services employee scholarship program. Providers must establish criteria by which 
136.33 	funds are to be distributed among employees. At a minimum, the scholarship program 
136.34 	must cover employee costs related to a course of study that is expected to lead to career 
137.1 	advancement with the provider or in the field of long-term care, including home care, 
137.2 	care of persons with disabilities, or nursing.
137.3 		Subd. 5.Participating providers. The commissioner shall publish a request for 
137.4 	proposals in the State Register, specifying provider eligibility requirements, criteria for 
137.5 	a qualifying employee scholarship program, provider selection criteria, documentation 
137.6 	required for program participation, maximum award amount, and methods of evaluation. 
137.7 	The commissioner must publish additional requests for proposals each year in which 
137.8 	funding is available for this purpose.
137.9 		Subd. 6.Application requirements. Eligible providers seeking a grant shall submit 
137.10 	an application to the commissioner.  Applications must contain a complete description of 
137.11 	the employee scholarship program being proposed by the applicant, including the need for 
137.12 	the organization to enhance the education of its workforce, the process for determining 
137.13 	which employees will be eligible for scholarships, any other sources of funding for 
137.14 	scholarships, the expected degrees or credentials eligible for scholarships, the amount of 
137.15 	funding sought for the scholarship program, a proposed budget detailing how funds will 
137.16 	be spent, and plans for retaining eligible employees after completion of their scholarship.
137.17 		Subd. 7.Selection process. The commissioner shall determine a maximum 
137.18 	award for grants and make grant selections based on the information provided in the 
137.19 	grant application, including the demonstrated need for an applicant provider to enhance 
137.20 	the education of its workforce, the proposed employee scholarship selection process, 
137.21 	the applicant's proposed budget, and other criteria as determined by the commissioner.  
137.22 	Notwithstanding any law or rule to the contrary, funds awarded to grantees in a grant 
137.23 	agreement do not lapse until the grant agreement expires.
137.24 		Subd. 8.Reporting requirements. Participating providers shall submit an invoice 
137.25 	for reimbursement and a report to the commissioner on a schedule determined by the 
137.26 	commissioner and on a form supplied by the commissioner. The report shall include 
137.27 	the amount spent on scholarships; the number of employees who received scholarships; 
137.28 	and, for each scholarship recipient, the name of the recipient, the current position of 
137.29 	the recipient, the amount awarded, the educational institution attended, the nature of 
137.30 	the educational program, and the expected or actual program completion date. During 
137.31 	the grant period, the commissioner may require and collect from grant recipients other 
137.32 	information necessary to evaluate the program.

137.33 	Sec. 2. Minnesota Statutes 2014, section 144A.071, subdivision 4a, is amended to read:
137.34 		Subd. 4a.Exceptions for replacement beds.  It is in the best interest of the state 
137.35 	to ensure that nursing homes and boarding care homes continue to meet the physical 
138.1 	plant licensing and certification requirements by permitting certain construction projects. 
138.2 	Facilities should be maintained in condition to satisfy the physical and emotional needs 
138.3 	of residents while allowing the state to maintain control over nursing home expenditure 
138.4 	growth.
138.5 	The commissioner of health in coordination with the commissioner of human 
138.6 	services, may approve the renovation, replacement, upgrading, or relocation of a nursing 
138.7 	home or boarding care home, under the following conditions:
138.8 	(a) to license or certify beds in a new facility constructed to replace a facility or to 
138.9 	make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by 
138.10 	fire, lightning, or other hazard provided:
138.11 	(i) destruction was not caused by the intentional act of or at the direction of a 
138.12 	controlling person of the facility;
138.13 	(ii) at the time the facility was destroyed or damaged the controlling persons of the 
138.14 	facility maintained insurance coverage for the type of hazard that occurred in an amount 
138.15 	that a reasonable person would conclude was adequate;
138.16 	(iii) the net proceeds from an insurance settlement for the damages caused by the 
138.17 	hazard are applied to the cost of the new facility or repairs;
138.18 	(iv) the number of licensed and certified beds in the new facility does not exceed the 
138.19 	number of licensed and certified beds in the destroyed facility; and
138.20 	(v) the commissioner determines that the replacement beds are needed to prevent an 
138.21 	inadequate supply of beds.
138.22 	Project construction costs incurred for repairs authorized under this clause shall not be 
138.23 	considered in the dollar threshold amount defined in subdivision 2;
138.24 	(b) to license or certify beds that are moved from one location to another within a 
138.25 	nursing home facility, provided the total costs of remodeling performed in conjunction 
138.26 	with the relocation of beds does not exceed $1,000,000;
138.27 	(c) to license or certify beds in a project recommended for approval under section 
138.28 	144A.073;
138.29 	(d) to license or certify beds that are moved from an existing state nursing home to 
138.30 	a different state facility, provided there is no net increase in the number of state nursing 
138.31 	home beds;
138.32 	(e) to certify and license as nursing home beds boarding care beds in a certified 
138.33 	boarding care facility if the beds meet the standards for nursing home licensure, or in a 
138.34 	facility that was granted an exception to the moratorium under section 144A.073, and if 
138.35 	the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care 
138.36 	beds are licensed as nursing home beds, the number of boarding care beds in the facility 
139.1 	must not increase beyond the number remaining at the time of the upgrade in licensure. 
139.2 	The provisions contained in section 144A.073 regarding the upgrading of the facilities 
139.3 	do not apply to facilities that satisfy these requirements;
139.4 	(f) to license and certify up to 40 beds transferred from an existing facility owned and 
139.5 	operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the 
139.6 	same location as the existing facility that will serve persons with Alzheimer's disease and 
139.7 	other related disorders. The transfer of beds may occur gradually or in stages, provided 
139.8 	the total number of beds transferred does not exceed 40. At the time of licensure and 
139.9 	certification of a bed or beds in the new unit, the commissioner of health shall delicense 
139.10 	and decertify the same number of beds in the existing facility. As a condition of receiving 
139.11 	a license or certification under this clause, the facility must make a written commitment 
139.12 	to the commissioner of human services that it will not seek to receive an increase in its 
139.13 	property-related payment rate as a result of the transfers allowed under this paragraph;
139.14 	(g) to license and certify nursing home beds to replace currently licensed and certified 
139.15 	boarding care beds which may be located either in a remodeled or renovated boarding care 
139.16 	or nursing home facility or in a remodeled, renovated, newly constructed, or replacement 
139.17 	nursing home facility within the identifiable complex of health care facilities in which the 
139.18 	currently licensed boarding care beds are presently located, provided that the number of 
139.19 	boarding care beds in the facility or complex are decreased by the number to be licensed 
139.20 	as nursing home beds and further provided that, if the total costs of new construction, 
139.21 	replacement, remodeling, or renovation exceed ten percent of the appraised value of 
139.22 	the facility or $200,000, whichever is less, the facility makes a written commitment to 
139.23 	the commissioner of human services that it will not seek to receive an increase in its 
139.24 	property-related payment rate by reason of the new construction, replacement, remodeling, 
139.25 	or renovation. The provisions contained in section 144A.073 regarding the upgrading of 
139.26 	facilities do not apply to facilities that satisfy these requirements;
139.27 	(h) to license as a nursing home and certify as a nursing facility a facility that is 
139.28 	licensed as a boarding care facility but not certified under the medical assistance program, 
139.29 	but only if the commissioner of human services certifies to the commissioner of health that 
139.30 	licensing the facility as a nursing home and certifying the facility as a nursing facility will 
139.31 	result in a net annual savings to the state general fund of $200,000 or more;
139.32 	(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing 
139.33 	home beds in a facility that was licensed and in operation prior to January 1, 1992;
139.34 	(j) to license and certify new nursing home beds to replace beds in a facility acquired 
139.35 	by the Minneapolis Community Development Agency as part of redevelopment activities 
139.36 	in a city of the first class, provided the new facility is located within three miles of the site 
140.1 	of the old facility. Operating and property costs for the new facility must be determined 
140.2 	and allowed under section 256B.431 or 256B.434;
140.3 	(k) to license and certify up to 20 new nursing home beds in a community-operated 
140.4 	hospital and attached convalescent and nursing care facility with 40 beds on April 21, 
140.5 	1991, that suspended operation of the hospital in April 1986. The commissioner of human 
140.6 	services shall provide the facility with the same per diem property-related payment rate 
140.7 	for each additional licensed and certified bed as it will receive for its existing 40 beds;
140.8 	(l) to license or certify beds in renovation, replacement, or upgrading projects as 
140.9 	defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the 
140.10 	facility's remodeling projects do not exceed $1,000,000;
140.11 	(m) to license and certify beds that are moved from one location to another for the 
140.12 	purposes of converting up to five four-bed wards to single or double occupancy rooms 
140.13 	in a nursing home that, as of January 1, 1993, was county-owned and had a licensed 
140.14 	capacity of 115 beds;
140.15 	(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified 
140.16 	nursing facility located in Minneapolis to layaway all of its licensed and certified nursing 
140.17 	home beds. These beds may be relicensed and recertified in a newly constructed teaching 
140.18 	nursing home facility affiliated with a teaching hospital upon approval by the legislature. 
140.19 	The proposal must be developed in consultation with the interagency committee on 
140.20 	long-term care planning. The beds on layaway status shall have the same status as 
140.21 	voluntarily delicensed and decertified beds, except that beds on layaway status remain 
140.22 	subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;
140.23 	(o) to allow a project which will be completed in conjunction with an approved 
140.24 	moratorium exception project for a nursing home in southern Cass County and which is 
140.25 	directly related to that portion of the facility that must be repaired, renovated, or replaced, 
140.26 	to correct an emergency plumbing problem for which a state correction order has been 
140.27 	issued and which must be corrected by August 31, 1993;
140.28 	(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified 
140.29 	nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to 
140.30 	the commissioner, up to 30 of the facility's licensed and certified beds by converting 
140.31 	three-bed wards to single or double occupancy. Beds on layaway status shall have the 
140.32 	same status as voluntarily delicensed and decertified beds except that beds on layaway 
140.33 	status remain subject to the surcharge in section 256.9657, remain subject to the license 
140.34 	application and renewal fees under section 144A.07 and shall be subject to a $100 per bed 
140.35 	reactivation fee. In addition, at any time within three years of the effective date of the 
140.36 	layaway, the beds on layaway status may be:
141.1 	(1) relicensed and recertified upon relocation and reactivation of some or all of 
141.2 	the beds to an existing licensed and certified facility or facilities located in Pine River, 
141.3 	Brainerd, or International Falls; provided that the total project construction costs related to 
141.4 	the relocation of beds from layaway status for any facility receiving relocated beds may 
141.5 	not exceed the dollar threshold provided in subdivision 2 unless the construction project 
141.6 	has been approved through the moratorium exception process under section 144A.073;
141.7 	(2) relicensed and recertified, upon reactivation of some or all of the beds within the 
141.8 	facility which placed the beds in layaway status, if the commissioner has determined a 
141.9 	need for the reactivation of the beds on layaway status.
141.10 	The property-related payment rate of a facility placing beds on layaway status 
141.11 	must be adjusted by the incremental change in its rental per diem after recalculating the 
141.12 	rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The 
141.13 	property-related payment rate for a facility relicensing and recertifying beds from layaway 
141.14 	status must be adjusted by the incremental change in its rental per diem after recalculating 
141.15 	its rental per diem using the number of beds after the relicensing to establish the facility's 
141.16 	capacity day divisor, which shall be effective the first day of the month following the 
141.17 	month in which the relicensing and recertification became effective. Any beds remaining 
141.18 	on layaway status more than three years after the date the layaway status became effective 
141.19 	must be removed from layaway status and immediately delicensed and decertified;
141.20 	(q) to license and certify beds in a renovation and remodeling project to convert 12 
141.21 	four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing 
141.22 	home that, as of January 1, 1994, met the following conditions: the nursing home was 
141.23 	located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked 
141.24 	among the top 15 applicants by the 1993 moratorium exceptions advisory review panel. 
141.25 	The total project construction cost estimate for this project must not exceed the cost 
141.26 	estimate submitted in connection with the 1993 moratorium exception process;
141.27 	(r) to license and certify up to 117 beds that are relocated from a licensed and certified 
141.28 	138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds 
141.29 	located in South St. Paul, provided that the nursing facility and hospital are owned by the 
141.30 	same or a related organization and that prior to the date the relocation is completed the 
141.31 	hospital ceases operation of its inpatient hospital services at that hospital. After relocation, 
141.32 	the nursing facility's status shall be the same as it was prior to relocation. The nursing 
141.33 	facility's property-related payment rate resulting from the project authorized in this 
141.34 	paragraph shall become effective no earlier than April 1, 1996. For purposes of calculating 
141.35 	the incremental change in the facility's rental per diem resulting from this project, the 
142.1 	allowable appraised value of the nursing facility portion of the existing health care facility 
142.2 	physical plant prior to the renovation and relocation may not exceed $2,490,000;
142.3 	(s) to license and certify two beds in a facility to replace beds that were voluntarily 
142.4 	delicensed and decertified on June 28, 1991;
142.5 	(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed 
142.6 	nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding 
142.7 	the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed 
142.8 	nursing home facility after completion of a construction project approved in 1993 under 
142.9 	section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner. 
142.10 	Beds on layaway status shall have the same status as voluntarily delicensed or decertified 
142.11 	beds except that they shall remain subject to the surcharge in section 256.9657. The 
142.12 	16 beds on layaway status may be relicensed as nursing home beds and recertified at 
142.13 	any time within five years of the effective date of the layaway upon relocation of some 
142.14 	or all of the beds to a licensed and certified facility located in Watertown, provided that 
142.15 	the total project construction costs related to the relocation of beds from layaway status 
142.16 	for the Watertown facility may not exceed the dollar threshold provided in subdivision 
142.17 	2 unless the construction project has been approved through the moratorium exception 
142.18 	process under section 144A.073.
142.19 	The property-related payment rate of the facility placing beds on layaway status must 
142.20 	be adjusted by the incremental change in its rental per diem after recalculating the rental per 
142.21 	diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
142.22 	payment rate for the facility relicensing and recertifying beds from layaway status must be 
142.23 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
142.24 	diem using the number of beds after the relicensing to establish the facility's capacity day 
142.25 	divisor, which shall be effective the first day of the month following the month in which 
142.26 	the relicensing and recertification became effective. Any beds remaining on layaway 
142.27 	status more than five years after the date the layaway status became effective must be 
142.28 	removed from layaway status and immediately delicensed and decertified;
142.29 	(u) to license and certify beds that are moved within an existing area of a facility or 
142.30 	to a newly constructed addition which is built for the purpose of eliminating three- and 
142.31 	four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary 
142.32 	service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had 
142.33 	a licensed capacity of 129 beds;
142.34 	(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County 
142.35 	to a 160-bed facility in Crow Wing County, provided all the affected beds are under 
142.36 	common ownership;
143.1 	(w) to license and certify a total replacement project of up to 49 beds located in 
143.2 	Norman County that are relocated from a nursing home destroyed by flood and whose 
143.3 	residents were relocated to other nursing homes. The operating cost payment rates for 
143.4 	the new nursing facility shall be determined based on the interim and settle-up payment 
143.5 	provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of 
143.6 	section 256B.431. Property-related reimbursement rates shall be determined under section 
143.7 	256B.431, taking into account any federal or state flood-related loans or grants provided 
143.8 	to the facility;
143.9 	(x) to license and certify a total to the licensee of a nursing home in Polk County 
143.10 	that was destroyed by flood in 1997 replacement project projects with a total of up to 129 
143.11 	beds, with at least 25 beds to be located in Polk County that are relocated from a nursing 
143.12 	home destroyed by flood and whose residents were relocated to other nursing homes.and 
143.13 	up to 104 beds distributed among up to three other counties. These beds may only be 
143.14 	distributed to counties with fewer than the median number of age intensity adjusted beds 
143.15 	per thousand, as most recently published by the commissioner of human services. If the 
143.16 	licensee chooses to distribute beds outside of Polk County under this paragraph, prior to 
143.17 	distributing the beds, the commissioner of health must approve the location in which the 
143.18 	licensee plans to distribute the beds. The commissioner of health shall consult with the 
143.19 	commissioner of human services prior to approving the location of the proposed beds. 
143.20 	The licensee may combine these beds with beds relocated from other nursing facilities 
143.21 	as provided in section 144A.073, subdivision 3c. The operating cost payment rates for 
143.22 	the new nursing facility facilities shall be determined based on the interim and settle-up 
143.23 	payment provisions of section 256B.431, 256B.434, or 256B.441 or Minnesota Rules, part 
143.24 	9549.0057, and the reimbursement provisions of section 256B.431, except that subdivision 
143.25 	26, paragraphs (a) and (b), shall not apply until the second rate year after the settle-up cost 
143.26 	report is filed. Property-related reimbursement rates shall be determined under section 
143.27 	256B.431, taking into account any federal or state flood-related loans or grants provided to 
143.28 	the facility; parts 9549.0010 to 9549.0080. Property-related reimbursement rates shall 
143.29 	be determined under section 256B.431, 256B.434, or 256B.441. If the replacement beds 
143.30 	permitted under this paragraph are combined with beds from other nursing facilities, the 
143.31 	rates shall be calculated as the weighted average of rates determined as provided in this 
143.32 	paragraph and section 256B.441, subdivision 60;
143.33 	(y) to license and certify beds in a renovation and remodeling project to convert 13 
143.34 	three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and 
143.35 	add improvements in a nursing home that, as of January 1, 1994, met the following 
143.36 	conditions: the nursing home was located in Ramsey County, was not owned by a hospital 
144.1 	corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15 
144.2 	applicants by the 1993 moratorium exceptions advisory review panel. The total project 
144.3 	construction cost estimate for this project must not exceed the cost estimate submitted in 
144.4 	connection with the 1993 moratorium exception process;
144.5 	(z) to license and certify up to 150 nursing home beds to replace an existing 285 
144.6 	bed nursing facility located in St. Paul. The replacement project shall include both the 
144.7 	renovation of existing buildings and the construction of new facilities at the existing 
144.8 	site. The reduction in the licensed capacity of the existing facility shall occur during the 
144.9 	construction project as beds are taken out of service due to the construction process. Prior 
144.10 	to the start of the construction process, the facility shall provide written information to the 
144.11 	commissioner of health describing the process for bed reduction, plans for the relocation 
144.12 	of residents, and the estimated construction schedule. The relocation of residents shall be 
144.13 	in accordance with the provisions of law and rule;
144.14 	(aa) to allow the commissioner of human services to license an additional 36 beds 
144.15 	to provide residential services for the physically disabled under Minnesota Rules, parts 
144.16 	9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that 
144.17 	the total number of licensed and certified beds at the facility does not increase;
144.18 	(bb) to license and certify a new facility in St. Louis County with 44 beds 
144.19 	constructed to replace an existing facility in St. Louis County with 31 beds, which has 
144.20 	resident rooms on two separate floors and an antiquated elevator that creates safety 
144.21 	concerns for residents and prevents nonambulatory residents from residing on the second 
144.22 	floor. The project shall include the elimination of three- and four-bed rooms;
144.23 	(cc) to license and certify four beds in a 16-bed certified boarding care home in 
144.24 	Minneapolis to replace beds that were voluntarily delicensed and decertified on or 
144.25 	before March 31, 1992. The licensure and certification is conditional upon the facility 
144.26 	periodically assessing and adjusting its resident mix and other factors which may 
144.27 	contribute to a potential institution for mental disease declaration. The commissioner of 
144.28 	human services shall retain the authority to audit the facility at any time and shall require 
144.29 	the facility to comply with any requirements necessary to prevent an institution for mental 
144.30 	disease declaration, including delicensure and decertification of beds, if necessary;
144.31 	(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 
144.32 	80 beds as part of a renovation project. The renovation must include construction of 
144.33 	an addition to accommodate ten residents with beginning and midstage dementia in a 
144.34 	self-contained living unit; creation of three resident households where dining, activities, 
144.35 	and support spaces are located near resident living quarters; designation of four beds 
145.1 	for rehabilitation in a self-contained area; designation of 30 private rooms; and other 
145.2 	improvements;
145.3 	(ee) to license and certify beds in a facility that has undergone replacement or 
145.4 	remodeling as part of a planned closure under section 256B.437;
145.5 	(ff) to license and certify a total replacement project of up to 124 beds located 
145.6 	in Wilkin County that are in need of relocation from a nursing home significantly 
145.7 	damaged by flood. The operating cost payment rates for the new nursing facility shall be 
145.8 	determined based on the interim and settle-up payment provisions of Minnesota Rules, 
145.9 	part 9549.0057, and the reimbursement provisions of section 256B.431. Property-related 
145.10 	reimbursement rates shall be determined under section 256B.431, taking into account any 
145.11 	federal or state flood-related loans or grants provided to the facility;
145.12 	(gg) to allow the commissioner of human services to license an additional nine beds 
145.13 	to provide residential services for the physically disabled under Minnesota Rules, parts 
145.14 	9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the 
145.15 	total number of licensed and certified beds at the facility does not increase;
145.16 	(hh) to license and certify up to 120 new nursing facility beds to replace beds in a 
145.17 	facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the 
145.18 	new facility is located within four miles of the existing facility and is in Anoka County. 
145.19 	Operating and property rates shall be determined and allowed under section 256B.431 and 
145.20 	Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.441; or
145.21 	(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County 
145.22 	that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit 
145.23 	nursing facility located in the city of Columbia Heights or its affiliate. The transfer is 
145.24 	effective when the receiving facility notifies the commissioner in writing of the number of 
145.25 	beds accepted. The commissioner shall place all transferred beds on layaway status held in 
145.26 	the name of the receiving facility. The layaway adjustment provisions of section 256B.431, 
145.27 	subdivision 30, do not apply to this layaway. The receiving facility may only remove the 
145.28 	beds from layaway for recertification and relicensure at the receiving facility's current 
145.29 	site, or at a newly constructed facility located in Anoka County. The receiving facility 
145.30 	must receive statutory authorization before removing these beds from layaway status, or 
145.31 	may remove these beds from layaway status if removal from layaway status is part of a 
145.32 	moratorium exception project approved by the commissioner under section 144A.073.

145.33 	Sec. 3. Minnesota Statutes 2014, section 256B.0913, subdivision 4, is amended to read:
146.1 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 146.2 	(a) Funding for services under the alternative care program is available to persons who 
146.3 	meet the following criteria:
146.4 	(1) the person has been determined by a community assessment under section 
146.5 	256B.0911 to be a person who would require the level of care provided in a nursing 
146.6 	facility, as determined under section 256B.0911, subdivision 4e, but for the provision of 
146.7 	services under the alternative care program;
146.8 	(2) the person is age 65 or older;
146.9 	(3) the person would be eligible for medical assistance within 135 days of admission 
146.10 	to a nursing facility;
146.11 	(4) the person is not ineligible for the payment of long-term care services by the 
146.12 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
146.13 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
146.14 	(5) the person needs long-term care services that are not funded through other 
146.15 	state or federal funding, or other health insurance or other third-party insurance such as 
146.16 	long-term care insurance;
146.17 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
146.18 	care services funded by the program for this person does not exceed 75 percent of the 
146.19 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
146.20 	does not prohibit the alternative care client from payment for additional services, but in no 
146.21 	case may the cost of additional services purchased under this section exceed the difference 
146.22 	between the client's monthly service limit defined under section 256B.0915, subdivision 
146.23 	3, and the alternative care program monthly service limit defined in this paragraph. If 
146.24 	care-related supplies and equipment or environmental modifications and adaptations are or 
146.25 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
146.26 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
146.27 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
146.28 	limit established in this paragraph, the annual cost of the alternative care services shall be 
146.29 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
146.30 	times the monthly limit described in this paragraph;
146.31 	(7) for individuals assigned a case mix classification A as described under section 
146.32 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
146.33 	living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating 
146.34 	when the dependency score in eating is three or greater as determined by an assessment 
146.35 	performed under section 256B.0911, the monthly cost of alternative care services funded 
146.36 	by the program cannot exceed $593 per month for all new participants enrolled in 
147.1 	the program on or after July 1, 2011. This monthly limit shall be applied to all other 
147.2 	participants who meet this criteria at reassessment. This monthly limit shall be increased 
147.3 	annually as described in section 256B.0915, subdivision 3a, paragraph paragraphs (a) and 
147.4 	(e). This monthly limit does not prohibit the alternative care client from payment for 
147.5 	additional services, but in no case may the cost of additional services purchased exceed the 
147.6 	difference between the client's monthly service limit defined in this clause and the limit 
147.7 	described in clause (6) for case mix classification A; and
147.8 	(8) the person is making timely payments of the assessed monthly fee.
147.9 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
147.10 	agrees to:
147.11 	(i) the appointment of a representative payee;
147.12 	(ii) automatic payment from a financial account;
147.13 	(iii) the establishment of greater family involvement in the financial management of 
147.14 	payments; or
147.15 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
147.16 	The lead agency may extend the client's eligibility as necessary while making 
147.17 	arrangements to facilitate payment of past-due amounts and future premium payments. 
147.18 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
147.19 	reinstated for a period of 30 days.
147.20 	(b) Alternative care funding under this subdivision is not available for a person who 
147.21 	is a medical assistance recipient or who would be eligible for medical assistance without a 
147.22 	spenddown or waiver obligation. A person whose initial application for medical assistance 
147.23 	and the elderly waiver program is being processed may be served under the alternative care 
147.24 	program for a period up to 60 days. If the individual is found to be eligible for medical 
147.25 	assistance, medical assistance must be billed for services payable under the federally 
147.26 	approved elderly waiver plan and delivered from the date the individual was found eligible 
147.27 	for the federally approved elderly waiver plan. Notwithstanding this provision, alternative 
147.28 	care funds may not be used to pay for any service the cost of which: (i) is payable by 
147.29 	medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to 
147.30 	pay a medical assistance income spenddown for a person who is eligible to participate in the 
147.31 	federally approved elderly waiver program under the special income standard provision.
147.32 	(c) Alternative care funding is not available for a person who resides in a licensed 
147.33 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
147.34 	for case management services which are provided in support of the discharge planning 
147.35 	process for a nursing home resident or certified boarding care home resident to assist with 
147.36 	a relocation process to a community-based setting.
148.1 	(d) Alternative care funding is not available for a person whose income is greater 
148.2 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
148.3 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
148.4 	year for which alternative care eligibility is determined, who would be eligible for the 
148.5 	elderly waiver with a waiver obligation.

148.6 	Sec. 4. Minnesota Statutes 2014, section 256B.0915, subdivision 3a, is amended to read:
148.7 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
148.8 	waivered services to an individual elderly waiver client except for individuals described 
148.9 	in paragraphs (b) and (d) shall be the weighted average monthly nursing facility rate of 
148.10 	the case mix resident class to which the elderly waiver client would be assigned under 
148.11 	Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs 
148.12 	allowance as described in subdivision 1d, paragraph (a), until the first day of the state 
148.13 	fiscal year in which the resident assessment system as described in section 256B.438 for 
148.14 	nursing home rate determination is implemented. Effective on the first day of the state 
148.15 	fiscal year in which the resident assessment system as described in section 256B.438 for 
148.16 	nursing home rate determination is implemented and the first day of each subsequent state 
148.17 	fiscal year, the monthly limit for the cost of waivered services to an individual elderly 
148.18 	waiver client shall be the rate monthly limit of the case mix resident class to which the 
148.19 	waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in 
148.20 	effect on the last day of the previous state fiscal year, adjusted by any legislatively adopted 
148.21 	home and community-based services percentage rate adjustment.
148.22 	(b) The monthly limit for the cost of waivered services under paragraph (a) to an 
148.23 	individual elderly waiver client assigned to a case mix classification A under paragraph 
148.24 	(a) with:
148.25 	(1) no dependencies in activities of daily living; or
148.26 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating 
148.27 	when the dependency score in eating is three or greater as determined by an assessment 
148.28 	performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, 
148.29 	for all new participants enrolled in the program on or after July 1, 2011. This monthly 
148.30 	limit shall be applied to all other participants who meet this criteria at reassessment. This 
148.31 	monthly limit shall be increased annually as described in paragraph paragraphs (a) and (e).
148.32 	(c) If extended medical supplies and equipment or environmental modifications are 
148.33 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
148.34 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
148.35 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or, 
149.1 	(b), (d), or (e), the annual cost of all waivered services shall be determined. In this event, 
149.2 	the annual cost of all waivered services shall not exceed 12 times the monthly limit of 
149.3 	waivered services as described in paragraph (a) or,  (b), (d), or (e).
149.4 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including 
149.5 	any necessary home care services described in section 256B.0651, subdivision 2, for 
149.6 	individuals who meet the criteria as ventilator-dependent given in section 256B.0651, 
149.7 	subdivision 1, paragraph (g), shall be the average of the monthly medical assistance 
149.8 	amount established for home care services as described in section 256B.0652, subdivision 
149.9 	7, and the annual average contracted amount established by the commissioner for nursing 
149.10 	facility services for ventilator-dependent individuals. This monthly limit shall be increased 
149.11 	annually as described in paragraph paragraphs (a) and (e).
149.12 	(e) Effective July 1, 2016, and each July 1 thereafter, the monthly cost limits for 
149.13 	elderly waiver services in effect on the previous June 30 shall be adjusted by the greater of 
149.14 	the difference between any legislatively adopted home and community-based provider 
149.15 	rate increase effective on July 1 and the average statewide percentage increase in nursing 
149.16 	facility operating payment rates under sections 256B.431, 256B.434, and 256B.441, 
149.17 	effective the previous January 1.

149.18 	EFFECTIVE DATE. This section is effective July 1, 2016.

149.19 	Sec. 5. Minnesota Statutes 2014, section 256B.0915, subdivision 3e, is amended to read:
149.20 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
149.21 	services shall be a monthly rate authorized by the lead agency within the parameters 
149.22 	established by the commissioner. The payment agreement must delineate the amount of 
149.23 	each component service included in the recipient's customized living service plan. The 
149.24 	lead agency, with input from the provider of customized living services, shall ensure that 
149.25 	there is a documented need within the parameters established by the commissioner for all 
149.26 	component customized living services authorized.
149.27 	(b) The payment rate must be based on the amount of component services to be 
149.28 	provided utilizing component rates established by the commissioner. Counties and tribes 
149.29 	shall use tools issued by the commissioner to develop and document customized living 
149.30 	service plans and rates.
149.31 	(c) Component service rates must not exceed payment rates for comparable elderly 
149.32 	waiver or medical assistance services and must reflect economies of scale. Customized 
149.33 	living services must not include rent or raw food costs.
149.34 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
149.35 	individualized monthly authorized payment for the customized living service plan shall not 
150.1 	exceed 50 percent of the greater of either the statewide or any of the geographic groups' 
150.2 	weighted average monthly nursing facility rate of the case mix resident class to which the 
150.3 	elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 
150.4 	9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph 
150.5 	(a), until the July 1 of the state fiscal year in which the resident assessment system as 
150.6 	described in section 256B.438 for nursing home rate determination is implemented. 
150.7 	Effective on July 1 of the state fiscal year in which the resident assessment system as 
150.8 	described in section 256B.438 for nursing home rate determination is implemented and 
150.9 	July 1 of each subsequent state fiscal year, the individualized monthly authorized payment 
150.10 	for the services described in this clause shall not exceed the limit which was in effect on 
150.11 	June 30 of the previous state fiscal year updated annually based on legislatively adopted 
150.12 	changes to all service rate maximums for home and community-based service providers.
150.13 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
150.14 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
150.15 	monthly authorized payment limit for customized living for individuals classified as case 
150.16 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
150.17 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
150.18 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
150.19 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
150.20 	(f) Customized living services are delivered by a provider licensed by the 
150.21 	Department of Health as a class A or class F home care provider and provided in a 
150.22 	building that is registered as a housing with services establishment under chapter 144D. 
150.23 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
150.24 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
150.25 	family for additional units of any allowable component service beyond those available 
150.26 	under the service rate limits described in paragraph (d), nor for additional units of any 
150.27 	allowable component service beyond those approved in the service plan by the lead agency.
150.28 	(h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate 
150.29 	limits for customized living services under this subdivision shall be adjusted by the greater 
150.30 	of the difference between any legislatively adopted home and community-based provider 
150.31 	rate increase effective on July 1 and the average statewide percentage increase in nursing 
150.32 	facility operating payment rates under sections 256B.431, 256B.434, and 256B.441, 
150.33 	effective the previous January 1.

150.34 	EFFECTIVE DATE. This section is effective July 1, 2016.

150.35 	Sec. 6. Minnesota Statutes 2014, section 256B.0915, subdivision 3h, is amended to read:
151.1 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
151.2 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
151.3 	lead agency within the parameters established by the commissioner of human services. 
151.4 	The payment agreement must delineate the amount of each component service included 
151.5 	in each recipient's customized living service plan. The lead agency, with input from 
151.6 	the provider of customized living services, shall ensure that there is a documented need 
151.7 	within the parameters established by the commissioner for all component customized 
151.8 	living services authorized. The lead agency shall not authorize 24-hour customized living 
151.9 	services unless there is a documented need for 24-hour supervision.
151.10 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
151.11 	requires assistance due to needs related to one or more of the following:
151.12 	(1) intermittent assistance with toileting, positioning, or transferring;
151.13 	(2) cognitive or behavioral issues;
151.14 	(3) a medical condition that requires clinical monitoring; or
151.15 	(4) for all new participants enrolled in the program on or after July 1, 2011, and 
151.16 	all other participants at their first reassessment after July 1, 2011, dependency in at 
151.17 	least three of the following activities of daily living as determined by assessment under 
151.18 	section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency 
151.19 	score in eating is three or greater; and needs medication management and at least 50 
151.20 	hours of service per month. The lead agency shall ensure that the frequency and mode 
151.21 	of supervision of the recipient and the qualifications of staff providing supervision are 
151.22 	described and meet the needs of the recipient.
151.23 	(c) The payment rate for 24-hour customized living services must be based on the 
151.24 	amount of component services to be provided utilizing component rates established by the 
151.25 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
151.26 	and document customized living plans and authorize rates.
151.27 	(d) Component service rates must not exceed payment rates for comparable elderly 
151.28 	waiver or medical assistance services and must reflect economies of scale.
151.29 	(e) The individually authorized 24-hour customized living payments, in combination 
151.30 	with the payment for other elderly waiver services, including case management, must not 
151.31 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
151.32 	living services must not include rent or raw food costs.
151.33 	(f) The individually authorized 24-hour customized living payment rates shall not 
151.34 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
151.35 	living services in effect and in the Medicaid management information systems on March 
151.36 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
152.1 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
152.2 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
152.3 	shall multiply the calculated service payment rate maximum for the A classification by 
152.4 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
152.5 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
152.6 	maximums shall be updated annually based on legislatively adopted changes to all service 
152.7 	rates for home and community-based service providers.
152.8 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
152.9 	may establish alternative payment rate systems for 24-hour customized living services in 
152.10 	housing with services establishments which are freestanding buildings with a capacity of 
152.11 	16 or fewer, by applying a single hourly rate for covered component services provided 
152.12 	in either:
152.13 	(1) licensed corporate adult foster homes; or
152.14 	(2) specialized dementia care units which meet the requirements of section 144D.065 
152.15 	and in which:
152.16 	(i) each resident is offered the option of having their own apartment; or
152.17 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
152.18 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
152.19 	subparts 1, 2, 3, and 4, item A.
152.20 	(h) Twenty-four-hour customized living services are delivered by a provider licensed 
152.21 	by the Department of Health as a class A or class F home care provider and provided in a 
152.22 	building that is registered as a housing with services establishment under chapter 144D. 
152.23 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
152.24 	(i) A provider may not bill or otherwise charge an elderly waiver participant or their 
152.25 	family for additional units of any allowable component service beyond those available 
152.26 	under the service rate limits described in paragraph (e), nor for additional units of any 
152.27 	allowable component service beyond those approved in the service plan by the lead agency.
152.28 	(j) Effective July 1, 2016, and each July 1 thereafter, individualized service rate 
152.29 	limits for 24-hour customized living services under this subdivision shall be adjusted by 
152.30 	the greater of the difference between any legislatively adopted home and community-based 
152.31 	provider rate increase effective on July 1 and the average statewide percentage increase 
152.32 	in nursing facility operating payment rates under sections 256B.431, 256B.434, and 
152.33 	256B.441, effective the previous January 1.

152.34 	EFFECTIVE DATE. This section is effective July 1, 2016.

152.35 	Sec. 7. Minnesota Statutes 2014, section 256B.431, subdivision 2b, is amended to read:
153.1 		Subd. 2b.Operating costs after July 1, 1985. (a) For rate years beginning on or 
153.2 	after July 1, 1985, the commissioner shall establish procedures for determining per diem 
153.3 	reimbursement for operating costs.
153.4 	(b) The commissioner shall contract with an econometric firm with recognized 
153.5 	expertise in and access to national economic change indices that can be applied to the 
153.6 	appropriate cost categories when determining the operating cost payment rate.
153.7 	(c) The commissioner shall analyze and evaluate each nursing facility's cost report 
153.8 	of allowable operating costs incurred by the nursing facility during the reporting year 
153.9 	immediately preceding the rate year for which the payment rate becomes effective.
153.10 	(d) The commissioner shall establish limits on actual allowable historical operating 
153.11 	cost per diems based on cost reports of allowable operating costs for the reporting year 
153.12 	that begins October 1, 1983, taking into consideration relevant factors including resident 
153.13 	needs, geographic location, and size of the nursing facility. In developing the geographic 
153.14 	groups for purposes of reimbursement under this section, the commissioner shall ensure 
153.15 	that nursing facilities in any county contiguous to the Minneapolis-St. Paul seven-county 
153.16 	metropolitan area are included in the same geographic group. The limits established by 
153.17 	the commissioner shall not be less, in the aggregate, than the 60th percentile of total 
153.18 	actual allowable historical operating cost per diems for each group of nursing facilities 
153.19 	established under subdivision 1 based on cost reports of allowable operating costs in the 
153.20 	previous reporting year. For rate years beginning on or after July 1, 1989, facilities located 
153.21 	in geographic group I as described in Minnesota Rules, part 9549.0052, on January 1, 
153.22 	1989, may choose to have the commissioner apply either the care related limits or the 
153.23 	other operating cost limits calculated for facilities located in geographic group II, or 
153.24 	both, if either of the limits calculated for the group II facilities is higher. The efficiency 
153.25 	incentive for geographic group I nursing facilities must be calculated based on geographic 
153.26 	group I limits. The phase-in must be established utilizing the chosen limits. For purposes 
153.27 	of these exceptions to the geographic grouping requirements, the definitions in Minnesota 
153.28 	Rules, parts 9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080, apply. 
153.29 	The limits established under this paragraph remain in effect until the commissioner 
153.30 	establishes a new base period. Until the new base period is established, the commissioner 
153.31 	shall adjust the limits annually using the appropriate economic change indices established 
153.32 	in paragraph (e). In determining allowable historical operating cost per diems for purposes 
153.33 	of setting limits and nursing facility payment rates, the commissioner shall divide the 
153.34 	allowable historical operating costs by the actual number of resident days, except that 
153.35 	where a nursing facility is occupied at less than 90 percent of licensed capacity days, the 
153.36 	commissioner may establish procedures to adjust the computation of the per diem to 
154.1 	an imputed occupancy level at or below 90 percent. The commissioner shall establish 
154.2 	efficiency incentives as appropriate. The commissioner may establish efficiency incentives 
154.3 	for different operating cost categories. The commissioner shall consider establishing 
154.4 	efficiency incentives in care related cost categories. The commissioner may combine one 
154.5 	or more operating cost categories and may use different methods for calculating payment 
154.6 	rates for each operating cost category or combination of operating cost categories. For the 
154.7 	rate year beginning on July 1, 1985, the commissioner shall:
154.8 	(1) allow nursing facilities that have an average length of stay of 180 days or less in 
154.9 	their skilled nursing level of care, 125 percent of the care related limit and 105 percent 
154.10 	of the other operating cost limit established by rule; and
154.11 	(2) exempt nursing facilities licensed on July 1, 1983, by the commissioner to 
154.12 	provide residential services for the physically disabled under Minnesota Rules, parts 
154.13 	9570.2000 to 9570.3600, from the care related limits and allow 105 percent of the other 
154.14 	operating cost limit established by rule.
154.15 	For the purpose of calculating the other operating cost efficiency incentive for 
154.16 	nursing facilities referred to in clause (1) or (2), the commissioner shall use the other 
154.17 	operating cost limit established by rule before application of the 105 percent.
154.18 	(e) The commissioner shall establish a composite index or indices by determining 
154.19 	the appropriate economic change indicators to be applied to specific operating cost 
154.20 	categories or combination of operating cost categories.
154.21 	(f) Each nursing facility shall receive an operating cost payment rate equal to the sum 
154.22 	of the nursing facility's operating cost payment rates for each operating cost category. The 
154.23 	operating cost payment rate for an operating cost category shall be the lesser of the nursing 
154.24 	facility's historical operating cost in the category increased by the appropriate index 
154.25 	established in paragraph (e) for the operating cost category plus an efficiency incentive 
154.26 	established pursuant to paragraph (d) or the limit for the operating cost category increased 
154.27 	by the same index. If a nursing facility's actual historic operating costs are greater than the 
154.28 	prospective payment rate for that rate year, there shall be no retroactive cost settle up. In 
154.29 	establishing payment rates for one or more operating cost categories, the commissioner may 
154.30 	establish separate rates for different classes of residents based on their relative care needs.
154.31 	(g) The commissioner shall include the reported actual real estate tax liability or 
154.32 	payments in lieu of real estate tax of each nursing facility as an operating cost of that 
154.33 	nursing facility. Allowable costs under this subdivision for payments made by a nonprofit 
154.34 	nursing facility that are in lieu of real estate taxes shall not exceed the amount which the 
154.35 	nursing facility would have paid to a city or township and county for fire, police, sanitation 
154.36 	services, and road maintenance costs had real estate taxes been levied on that property 
155.1 	for those purposes. For rate years beginning on or after July 1, 1987, the reported actual 
155.2 	real estate tax liability or payments in lieu of real estate tax of nursing facilities shall be 
155.3 	adjusted to include an amount equal to one-half of the dollar change in real estate taxes 
155.4 	from the prior year. The commissioner shall include a reported actual special assessment, 
155.5 	and reported actual license fees required by the Minnesota Department of Health, for each 
155.6 	nursing facility as an operating cost of that nursing facility. For rate years beginning 
155.7 	on or after July 1, 1989, the commissioner shall include a nursing facility's reported 
155.8 	Public Employee Retirement Act contribution for the reporting year as apportioned to the 
155.9 	care-related operating cost categories and other operating cost categories multiplied by 
155.10 	the appropriate composite index or indices established pursuant to paragraph (e) as costs 
155.11 	under this paragraph. Total adjusted real estate tax liability, payments in lieu of real 
155.12 	estate tax, actual special assessments paid, the indexed Public Employee Retirement Act 
155.13 	contribution, and license fees paid as required by the Minnesota Department of Health, 
155.14 	for each nursing facility (1) shall be divided by actual resident days in order to compute 
155.15 	the operating cost payment rate for this operating cost category, (2) shall not be used to 
155.16 	compute the care-related operating cost limits or other operating cost limits established 
155.17 	by the commissioner, and (3) shall not be increased by the composite index or indices 
155.18 	established pursuant to paragraph (e), unless otherwise indicated in this paragraph.
155.19 	(h) For rate years beginning on or after July 1, 1987, the commissioner shall adjust 
155.20 	the rates of a nursing facility that meets the criteria for the special dietary needs of its 
155.21 	residents and the requirements in section 31.651. The adjustment for raw food cost shall 
155.22 	be the difference between the nursing facility's allowable historical raw food cost per 
155.23 	diem and 115 percent of the median historical allowable raw food cost per diem of the 
155.24 	corresponding geographic group.
155.25 	The rate adjustment shall be reduced by the applicable phase-in percentage as 
155.26 	provided under subdivision 2h.

155.27 	Sec. 8. Minnesota Statutes 2014, section 256B.431, subdivision 36, is amended to read:
155.28 		Subd. 36.Employee scholarship costs and training in English as a second 
155.29 	language. (a) For the period between July 1, 2001, and June 30, 2003, the commissioner 
155.30 	shall provide to each nursing facility reimbursed under this section, section 256B.434, or 
155.31 	any other section, a scholarship per diem of 25 cents to the total operating payment rate. 
155.32 	For the two rate years beginning on or after October 1, 2015, through September 30, 2017, 
155.33 	the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing 
155.34 	facility with no scholarship per diem that is requesting a scholarship per diem to be added 
155.35 	to the external fixed payment rate to be used:
156.1 	(1) for employee scholarships that satisfy the following requirements:
156.2 	(i) scholarships are available to all employees who work an average of at least 20  
156.3 	ten hours per week at the facility except the administrator, department supervisors, and 
156.4 	registered nurses and to reimburse student loan expenses for newly hired and recently 
156.5 	graduated registered nurses and licensed practical nurses, and training expenses for 
156.6 	nursing assistants as defined in section 144A.61, subdivision 2, who are newly hired and 
156.7 	have graduated within the last 12 months; and
156.8 	(ii) the course of study is expected to lead to career advancement with the facility or 
156.9 	in long-term care, including medical care interpreter services and social work; and
156.10 	(2) to provide job-related training in English as a second language.
156.11 	(b) A facility receiving All facilities may annually request a rate adjustment under 
156.12 	this subdivision may submit by submitting information to the commissioner on a schedule 
156.13 	determined by the commissioner and on in a form supplied by the commissioner a 
156.14 	calculation of the scholarship per diem, including: the amount received from this rate 
156.15 	adjustment; the amount used for training in English as a second language; the number of 
156.16 	persons receiving the training; the name of the person or entity providing the training; 
156.17 	and for each scholarship recipient, the name of the recipient, the amount awarded, the 
156.18 	educational institution attended, the nature of the educational program, the program 
156.19 	completion date, and a determination of the per diem amount of these costs based on 
156.20 	actual resident days. The commissioner shall allow a scholarship payment rate equal to 
156.21 	the reported and allowable costs divided by resident days.
156.22 	(c) On July 1, 2003, the commissioner shall remove the 25 cent scholarship per diem 
156.23 	from the total operating payment rate of each facility.
156.24 	(d) For rate years beginning after June 30, 2003, the commissioner shall provide to 
156.25 	each facility the scholarship per diem determined in paragraph (b). In calculating the per 
156.26 	diem under paragraph (b), the commissioner shall allow only costs related to tuition and, 
156.27 	direct educational expenses, and reasonable costs as defined by the commissioner for child 
156.28 	care costs and transportation expenses related to direct educational expenses.
156.29 	(d) The rate increase under this subdivision is an optional rate add-on that the facility 
156.30 	must request from the commissioner in a manner prescribed by the commissioner. The 
156.31 	rate increase must be used for scholarships as specified in this subdivision.
156.32 	(e) Nursing facilities that close beds during a rate year may request to have their 
156.33 	scholarship adjustment under paragraph (b) recalculated by the commissioner for the 
156.34 	remainder of the rate year to reflect the reduction in resident days compared to the cost 
156.35 	report year.

157.1 	Sec. 9. Minnesota Statutes 2014, section 256B.434, subdivision 4, is amended to read:
157.2 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
157.3 	have their payment rates determined under this section rather than section 256B.431, the 
157.4 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
157.5 	into a written contract with the commissioner.
157.6 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
157.7 	contract under this section is the payment rate the facility would have received under 
157.8 	section 256B.431.
157.9 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
157.10 	of a facility's contract under this section are the previous rate year's contract payment rates 
157.11 	plus an inflation adjustment and, for facilities reimbursed under this section or section 
157.12 	256B.431, an adjustment to include the cost of any increase in Health Department licensing 
157.13 	fees for the facility taking effect on or after July 1, 2001. The index for the inflation 
157.14 	adjustment must be based on the change in the Consumer Price Index-All Items (United 
157.15 	States City average) (CPI-U) forecasted by the commissioner of management and budget's 
157.16 	national economic consultant, as forecasted in the fourth quarter of the calendar year 
157.17 	preceding the rate year. The inflation adjustment must be based on the 12-month period 
157.18 	from the midpoint of the previous rate year to the midpoint of the rate year for which the 
157.19 	rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 
157.20 	1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, 
157.21 	July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the 
157.22 	property-related payment rate. For the rate years beginning on October 1, 2011, October 1, 
157.23 	2012, October 1, 2013, October 1, 2014, October 1, 2015, and October January 1, 2016, and 
157.24 	January 1, 2017, the rate adjustment under this paragraph shall be suspended. Beginning 
157.25 	in 2005, adjustment to the property payment rate under this section and section 256B.431 
157.26 	shall be effective on October 1. In determining the amount of the property-related payment 
157.27 	rate adjustment under this paragraph, the commissioner shall determine the proportion of 
157.28 	the facility's rates that are property-related based on the facility's most recent cost report.
157.29 	(d) The commissioner shall develop additional incentive-based payments of up to 
157.30 	five percent above a facility's operating payment rate for achieving outcomes specified 
157.31 	in a contract. The commissioner may solicit contract amendments and implement those 
157.32 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
157.33 	shall limit the amount of any incentive payment and the number of contract amendments 
157.34 	under this paragraph to operate the incentive payments within funds appropriated for this 
157.35 	purpose. The contract amendments may specify various levels of payment for various 
157.36 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
158.1 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
158.2 	the specified outcomes and related criteria, the commissioner shall consider the following 
158.3 	state policy objectives:
158.4 	(1) successful diversion or discharge of residents to the residents' prior home or other 
158.5 	community-based alternatives;
158.6 	(2) adoption of new technology to improve quality or efficiency;
158.7 	(3) improved quality as measured in the Nursing Home Report Card;
158.8 	(4) reduced acute care costs; and
158.9 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
158.10 	finds desirable.
158.11 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
158.12 	take action to come into compliance with existing or pending requirements of the life 
158.13 	safety code provisions or federal regulations governing sprinkler systems must receive 
158.14 	reimbursement for the costs associated with compliance if all of the following conditions 
158.15 	are met:
158.16 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
158.17 	and before December 31, 2008;
158.18 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
158.19 	144A.071 or 144A.073; and
158.20 	(3) the total allowable costs reported under this paragraph are less than the minimum 
158.21 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
158.22 	subdivision 16.
158.23 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
158.24 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
158.25 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
158.26 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
158.27 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
158.28 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
158.29 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
158.30 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
158.31 	costs of the project divided by the resident days reported for the report year ending 
158.32 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
158.33 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the 
158.34 	qualifying facilities by reducing the rate adjustment determined for each facility by an 
158.35 	equal percentage. Facilities that used estimated costs when requesting the rate adjustment 
158.36 	shall report to the commissioner by January 31, 2009, on the use of this money on a 
159.1 	form provided by the commissioner. If the nursing facility fails to provide the report, the 
159.2 	commissioner shall recoup the money paid to the facility for this purpose. If the facility 
159.3 	reports expenditures allowable under this subdivision that are less than the amount received 
159.4 	in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

159.5 	Sec. 10. Minnesota Statutes 2014, section 256B.434, is amended by adding a 
159.6 	subdivision to read:
159.7 		Subd. 4i.Construction project rate adjustments for certain nursing facilities.
 159.8 	(a) This subdivision applies to nursing facilities with at least 120 active beds as of January 
159.9 	1, 2015, that have projects approved in 2015 under the nursing facility moratorium 
159.10 	exception process in section 144A.073. When each facility's moratorium exception 
159.11 	construction project is completed, the facility must receive the rate adjustment allowed 
159.12 	under subdivision 4f. In addition to that rate adjustment, facilities with at least 120 
159.13 	active beds, but not more than 149 active beds, as of January 1, 2015, must have their 
159.14 	construction project rate adjustment increased by an additional $4; and facilities with at 
159.15 	least 150 active beds, but not more than 160 active beds, as of January 1, 2015, must have 
159.16 	their construction project rate adjustment increased by an additional $12.50.
159.17 	(b) Notwithstanding any other law to the contrary, money available under section 
159.18 	144A.073, subdivision 11, after the completion of the moratorium exception approval 
159.19 	process in 2015 under section 144A.073, subdivision 3, shall be used to reduce the fiscal 
159.20 	impact to the medical assistance budget for the increases allowed in this subdivision.

159.21 	Sec. 11. Minnesota Statutes 2014, section 256B.441, subdivision 1, is amended to read:
159.22 		Subdivision 1.Rebasing Calculation of nursing facility operating payment 
159.23 	rates. (a) The commissioner shall rebase nursing facility operating payment rates to align 
159.24 	payments to facilities with the cost of providing care. The rebased calculate operating 
159.25 	payment rates shall be calculated using the statistical and cost report filed by each nursing 
159.26 	facility for the report period ending one year prior to the rate year.
159.27 	(b) The new operating payment rates based on this section shall take effect beginning 
159.28 	with the rate year beginning October 1, 2008, and shall be phased in over eight rate years 
159.29 	through October 1, 2015. For each year of the phase-in, the operating payment rates shall 
159.30 	be calculated using the statistical and cost report filed by each nursing facility for the 
159.31 	report period ending one year prior to the rate year January 1, 2016.
159.32 	(c) Operating payment rates shall be rebased on October 1, 2016, and every two 
159.33 	years after that date.
160.1 	(d) (c) Each cost reporting year shall begin on October 1 and end on the following 
160.2 	September 30. Beginning in 2014, A statistical and cost report shall be filed by each 
160.3 	nursing facility by February 1 in a form and manner specified by the commissioner. 
160.4 	Notice of rates shall be distributed by August November 15 and the rates shall go into 
160.5 	effect on October January 1 for one year.
160.6 	(e) Effective October 1, 2014, property rates shall be rebased in accordance with 
160.7 	section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine 
160.8 	what the property payment rate for a nursing facility would be had the facility not had its 
160.9 	property rate determined under section 256B.434. The commissioner shall allow nursing 
160.10 	facilities to provide information affecting this rate determination that would have been 
160.11 	filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report 
160.12 	information necessary to determine allowable debt. The commissioner shall use this 
160.13 	information to determine the property payment rate.

160.14 	Sec. 12. Minnesota Statutes 2014, section 256B.441, subdivision 5, is amended to read:
160.15 		Subd. 5.Administrative costs. "Administrative costs" means the direct costs for 
160.16 	administering the overall activities of the nursing home. These costs include salaries and 
160.17 	wages of the administrator, assistant administrator, business office employees, security 
160.18 	guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 
160.19 	related to business office functions, licenses, and permits except as provided in the 
160.20 	external fixed costs category, employee recognition, travel including meals and lodging, 
160.21 	all training except as specified in subdivision 11, voice and data communication or 
160.22 	transmission, office supplies, property and liability insurance and other forms of insurance 
160.23 	not designated to other areas, personnel recruitment, legal services, accounting services, 
160.24 	management or business consultants, data processing, information technology, Web 
160.25 	site, central or home office costs, business meetings and seminars, postage, fees for 
160.26 	professional organizations, subscriptions, security services, advertising, board of director's 
160.27 	fees, working capital interest expense, and bad debts and bad debt collection fees.

160.28 	Sec. 13. Minnesota Statutes 2014, section 256B.441, subdivision 6, is amended to read:
160.29 		Subd. 6.Allowed costs. (a) "Allowed costs" means the amounts reported by the 
160.30 	facility which are necessary for the operation of the facility and the care of residents 
160.31 	and which are reviewed by the department for accuracy; reasonableness, in accordance 
160.32 	with the requirements set forth in title XVIII of the federal Social Security Act and the 
160.33 	interpretations in the provider reimbursement manual; and compliance with this section 
161.1 	and generally accepted accounting principles. All references to costs in this section shall 
161.2 	be assumed to refer to allowed costs.
161.3 	(b) For facilities where employees are represented by collective bargaining agents, 
161.4 	costs related to the salaries and wages, payroll taxes, and employer's share of fringe benefit 
161.5 	costs, except employer health insurance costs, for facility employees who are members of 
161.6 	the bargaining unit are allowed costs only if:
161.7 	(1) these costs are incurred pursuant to a collective bargaining agreement. The 
161.8 	commissioner shall allow until March 1 following the date on which the cost report was 
161.9 	required to be submitted for a collective bargaining agent to notify the commissioner if 
161.10 	a collective bargaining agreement, effective on the last day of the cost reporting year, 
161.11 	was in effect; or
161.12 	(2) the collective bargaining agent notifies the commissioner by October 1 following 
161.13 	the date on which the cost report was required to be submitted that these costs are 
161.14 	incurred pursuant to an agreement or understanding between the facility and the collective 
161.15 	bargaining agent.
161.16 	(c) In any year when a portion of a facility's reported costs are not allowed costs 
161.17 	under paragraph (b), when calculating the operating payment rate for the facility, the 
161.18 	commissioner shall use the facility's allowed costs from the facility's second most recent 
161.19 	cost report in place of the nonallowed costs. For the purpose of setting the price for other 
161.20 	operating costs under subdivision 51, the price shall be reduced by the difference between 
161.21 	the nonallowed costs and the allowed costs from the facility's second most recent cost 
161.22 	report.

161.23 	Sec. 14. Minnesota Statutes 2014, section 256B.441, is amended by adding a 
161.24 	subdivision to read:
161.25 		Subd. 11a.Employer health insurance costs. "Employer health insurance costs" 
161.26 	means premium expenses for group coverage and reinsurance, actual expenses incurred 
161.27 	for self-insured plans, and employer contributions to employee health reimbursement and 
161.28 	health savings accounts. Premium and expense costs and contributions are allowable for 
161.29 	employees who meet the definition of full-time employees and their families under the 
161.30 	federal Affordable Care Act, Public Law 111-148, and part-time employees.

161.31 	Sec. 15. Minnesota Statutes 2014, section 256B.441, subdivision 13, is amended to read:
161.32 		Subd. 13.External fixed costs. "External fixed costs" means costs related to the 
161.33 	nursing home surcharge under section 256.9657, subdivision 1; licensure fees under 
161.34 	section 144.122; until September 30, 2013, long-term care consultation fees under 
162.1 	section 256B.0911, subdivision 6; family advisory council fee under section 144A.33; 
162.2 	scholarships under section 256B.431, subdivision 36; planned closure rate adjustments 
162.3 	under section 256B.437; or single bed room incentives under section 256B.431, 
162.4 	subdivision 42; property taxes and property insurance, assessments, and payments in 
162.5 	lieu of taxes; employer health insurance costs; quality improvement incentive payment 
162.6 	rate adjustments under subdivision 46c; performance-based incentive payments under 
162.7 	subdivision 46d; special dietary needs under subdivision 51b; and PERA.

162.8 	Sec. 16. Minnesota Statutes 2014, section 256B.441, subdivision 14, is amended to read:
162.9 		Subd. 14.Facility average case mix index. "Facility average case mix index" 
162.10 	or "CMI" means a numerical value score that describes the relative resource use for 
162.11 	all residents within the groups under the resource utilization group (RUG-III) (RUG) 
162.12 	classification system prescribed by the commissioner based on an assessment of each 
162.13 	resident. The facility average CMI shall be computed as the standardized days divided by 
162.14 	total days for all residents in the facility. The RUG's weights used in this section shall be 
162.15 	as follows for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 
162.16 	1.259; RAB 1.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1 
162.17 	1.200; CB2 1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; 
162.18 	IA1 0.676; BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 
162.19 	1.023; PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; 
162.20 	BC1 0.651; and DDF 1.000 shall be based on the system prescribed in section 256B.438.

162.21 	Sec. 17. Minnesota Statutes 2014, section 256B.441, subdivision 17, is amended to read:
162.22 		Subd. 17.Fringe benefit costs. "Fringe benefit costs" means the costs for group life, 
162.23 	health, dental, workers' compensation, and other employee insurances and pension, except 
162.24 	for the Public Employees Retirement Association and employer health insurance costs; 
162.25 	profit sharing,; and retirement plans for which the employer pays all or a portion of the costs.

162.26 	Sec. 18. Minnesota Statutes 2014, section 256B.441, subdivision 30, is amended to read:
162.27 		Subd. 30.Peer groups Median total care-related cost per diem and other 
162.28 	operating per diem determined. Facilities shall be classified into three groups by county. 
162.29 	The groups shall consist of:
162.30 	(1) group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, 
162.31 	Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, 
162.32 	Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
163.1 	(2) group two: facilities in Aitkin, Beltrami, Blue Earth, Brown, Cass, Clay, 
163.2 	Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, Itasca, Kanabec, 
163.3 	Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, Meeker, Mower, 
163.4 	Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin 
163.5 	County; and
163.6 	(3) group three: facilities in all other counties (a) The commissioner shall determine 
163.7 	the median total care-related per diem to be used in subdivision 50 and the median other 
163.8 	operating per diem to be used in subdivision 51 using the cost reports from nursing 
163.9 	facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties.
163.10 	(b) The median total care-related per diem shall be equal to the median direct care 
163.11 	cost for a RUG's weight of 1.00 for facilities located in the counties listed in paragraph (a).
163.12 	(c) The median other operating per diem shall be equal to the median other 
163.13 	operating per diem for facilities located in the counties listed in paragraph (a). The other 
163.14 	operating per diem shall be the sum of each facility's administrative costs, dietary costs, 
163.15 	housekeeping costs, laundry costs, and maintenance and plant operations costs divided 
163.16 	by each facility's resident days.

163.17 	Sec. 19. Minnesota Statutes 2014, section 256B.441, subdivision 31, is amended to read:
163.18 		Subd. 31.Prior system operating cost payment rate. "Prior system operating 
163.19 	cost payment rate" means the operating cost payment rate in effect on September 30, 
163.20 	2008 December 31, 2015, under Minnesota Rules and Minnesota Statutes, not including 
163.21 	planned closure rate adjustments under section 256B.437 or single bed room incentives 
163.22 	under section 256B.431, subdivision 42.

163.23 	Sec. 20. Minnesota Statutes 2014, section 256B.441, subdivision 33, is amended to read:
163.24 		Subd. 33.Rate year. "Rate year" means the 12-month period beginning on October 
163.25 	January 1 following the second most recent reporting year.

163.26 	Sec. 21. Minnesota Statutes 2014, section 256B.441, subdivision 35, is amended to read:
163.27 		Subd. 35.Reporting period. "Reporting period" means the one-year period 
163.28 	beginning on October 1 and ending on the following September 30 during which incurred 
163.29 	costs are accumulated and then reported on the statistical and cost report. If a facility is 
163.30 	reporting for an interim or settle-up period, the reporting period beginning date may be a 
163.31 	date other than October 1. An interim or settle-up report must cover at least five months, 
163.32 	but no more than 17 months, and must always end on September 30.

164.1 	Sec. 22. Minnesota Statutes 2014, section 256B.441, subdivision 40, is amended to read:
164.2 		Subd. 40.Standardized days. "Standardized days" means the sum of resident days 
164.3 	by case mix category multiplied by the RUG index for each category. When a facility has 
164.4 	resident days at a penalty classification, these days shall be reported as resident days at the 
164.5 	RUG class established immediately after the penalty period, if available, and otherwise, at 
164.6 	the RUG class in effect before the penalty began.

164.7 	Sec. 23. Minnesota Statutes 2014, section 256B.441, subdivision 44, is amended to read:
164.8 		Subd. 44.Calculation of a quality score. (a) The commissioner shall determine 
164.9 	a quality score for each nursing facility using quality measures established in section 
164.10 	256B.439, according to methods determined by the commissioner in consultation with 
164.11 	stakeholders and experts, and using data as provided in the Minnesota Nursing Home 
164.12 	Report Card. These methods shall be exempt from the rulemaking requirements under 
164.13 	chapter 14.
164.14 	(b) For each quality measure, a score shall be determined with a maximum the  number 
164.15 	of points available and number of points assigned as determined by the commissioner 
164.16 	using the methodology established according to this subdivision. The scores determined 
164.17 	for all quality measures shall be totaled. The determination of the quality measures to be 
164.18 	used and the methods of calculating scores may be revised annually by the commissioner.
164.19 	(c) For the initial rate year under the new payment system, the quality measures 
164.20 	shall include:
164.21 	(1) staff turnover;
164.22 	(2) staff retention;
164.23 	(3) use of pool staff;
164.24 	(4) quality indicators from the minimum data set; and
164.25 	(5) survey deficiencies.
164.26 	(d) Beginning July 1, 2013 January 1, 2016, the quality score shall be a value 
164.27 	between zero and 100, using data as provided in the Minnesota nursing home report 
164.28 	card, with include up to  50 percent derived from points related to  the Minnesota quality 
164.29 	indicators score,  up to 40 percent derived from points related to  the resident quality of life 
164.30 	score, and up to  ten percent derived from points related to  the state inspection results score.
164.31 	(e) (d)  The commissioner, in cooperation with the commissioner of health, may 
164.32 	adjust the formula in paragraph (d) (c), or the methodology for computing the total quality 
164.33 	score, effective July 1 of any year beginning in 2014 2017, with five months advance 
164.34 	public notice. In changing the formula, the commissioner shall consider quality measure 
164.35 	priorities registered by report card users, advice of stakeholders, and available research.

165.1 	Sec. 24. Minnesota Statutes 2014, section 256B.441, subdivision 46c, is amended to 
165.2 	read:
165.3 		Subd. 46c.Quality improvement incentive system beginning October 1, 2015.
 165.4 	The commissioner shall develop a quality improvement incentive program in consultation 
165.5 	with stakeholders. The annual funding pool available for quality improvement incentive 
165.6 	payments shall be equal to 0.8 percent of all operating payments, not including any rate 
165.7 	components resulting from equitable cost-sharing for publicly owned nursing facility 
165.8 	program participation under subdivision 55a, critical access nursing facility program 
165.9 	participation under subdivision 63, or performance-based incentive payment program 
165.10 	participation under section 256B.434, subdivision 4, paragraph (d). For the period from 
165.11 	October 1, 2015, to December 31, 2016, rate adjustments provided under this subdivision 
165.12 	shall be effective for 15 months. Beginning October 1, 2015 January 1, 2017, annual 
165.13 	rate adjustments provided under this subdivision shall be effective for one year, starting 
165.14 	October January  1 and ending the following September 30 December 31. The increase in 
165.15 	this subdivision shall be included in the external fixed payment rate under subdivisions 
165.16 	13 and 53.

165.17 	Sec. 25. Minnesota Statutes 2014, section 256B.441, is amended by adding a 
165.18 	subdivision to read:
165.19 		Subd. 46d.Performance-based incentive payments. The commissioner shall 
165.20 	develop additional incentive-based payments of up to five percent above a facility's 
165.21 	operating payment rate for achieving outcomes specified in a contract. The commissioner 
165.22 	may solicit proposals and select those which, on a competitive basis, best meet the state's 
165.23 	policy objectives. The commissioner shall limit the amount of any incentive payment 
165.24 	and the number of contract amendments under this subdivision to operate the incentive 
165.25 	payments within funds appropriated for this purpose. The commissioner shall approve 
165.26 	proposals through a memorandum of understanding which shall specify various levels of 
165.27 	payment for various levels of performance. Incentive payments to facilities under this 
165.28 	subdivision shall be in the form of time-limited rate adjustments which shall be included 
165.29 	in the external fixed payment rate under subdivisions 13 and 53. In establishing the 
165.30 	specified outcomes and related criteria, the commissioner shall consider the following 
165.31 	state policy objectives:
165.32 	(1) successful diversion or discharge of residents to the residents' prior home or other 
165.33 	community-based alternatives;
165.34 	(2) adoption of new technology to improve quality or efficiency;
165.35 	(3) improved quality as measured in the Minnesota Nursing Home Report Card;
166.1 	(4) reduced acute care costs; and
166.2 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
166.3 	finds desirable.

166.4 	Sec. 26. Minnesota Statutes 2014, section 256B.441, subdivision 48, is amended to read:
166.5 		Subd. 48.Calculation of operating care-related per diems. The direct care per 
166.6 	diem for each facility shall be the facility's direct care costs divided by its standardized 
166.7 	days. The other care-related per diem shall be the sum of the facility's activities costs, 
166.8 	other direct care costs, raw food costs, therapy costs, and social services costs, divided by 
166.9 	the facility's resident days. The other operating per diem shall be the sum of the facility's 
166.10 	administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 
166.11 	and plant operations costs divided by the facility's resident days.

166.12 	Sec. 27. Minnesota Statutes 2014, section 256B.441, subdivision 50, is amended to read:
166.13 		Subd. 50.Determination of total care-related limit. (a) The limit on the median 
166.14 	total care-related per diem shall be determined for each peer group and facility type group 
166.15 	combination. A facility's total care-related per diems shall be limited to 120 percent of the 
166.16 	median for the facility's peer and facility type group. The facility-specific direct care costs 
166.17 	used in making this comparison and in the calculation of the median shall be based on a 
166.18 	RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per 
166.19 	diem reduced to the limit. If a reduction of the total care-related per diem is necessary 
166.20 	because of this limit, the reduction shall be made proportionally to both the direct care per 
166.21 	diem and the other care-related per diem according to subdivision 30.
166.22 	(b) Beginning with rates determined for October 1, 2016, the A facility's total 
166.23 	care-related limit shall be a variable amount based on each facility's quality score, as 
166.24 	determined under subdivision 44, in accordance with clauses (1) to (4) (3):
166.25 	(1) for each facility, the commissioner shall determine the quality score, subtract 40, 
166.26 	divide by 40, and convert to a percentage the quality score shall be multiplied by 0.5625;
166.27 	(2) if the value determined in clause (1) is less than zero, the total care-related limit 
166.28 	shall be 105 percent of the median for the facility's peer and facility type group add 89.375 
166.29 	to the amount determined in clause (1), and divide the total by 100; and
166.30 	(3) if the value determined in clause (1) is greater than 100 percent, the total 
166.31 	care-related limit shall be 125 percent of the median for the facility's peer and facility type 
166.32 	group; and multiply the amount determined in clause (2) by the median total care-related 
166.33 	per diem determined in subdivision 30, paragraph (b).
167.1 	(4) if the value determined in clause (1) is greater than zero and less than 100 
167.2 	percent, the total care-related limit shall be 105 percent of the median for the facility's peer 
167.3 	and facility type group plus one-fifth of the percentage determined in clause (1).
167.4 	(c) A RUG's weight of 1.00 shall be used in the calculation of the median total 
167.5 	care-related per diem, and in comparisons of facility-specific direct care costs to the median.
167.6 	(d) A facility that is above its total care-related limit as determined according to 
167.7 	paragraph (b) shall have its total care-related per diem reduced to its limit. If a reduction 
167.8 	of the total care-related per diem is necessary due to this limit, the reduction shall be made 
167.9 	proportionally to both the direct care per diem and the other care-related per diem.

167.10 	Sec. 28. Minnesota Statutes 2014, section 256B.441, subdivision 51, is amended to read:
167.11 		Subd. 51.Determination of other operating limit price. The limit on the A price 
167.12 	for other operating per diem costs shall be determined for each peer group. A facility's 
167.13 	other operating per diem shall be limited to The price shall be calculated as 105 percent 
167.14 	of the median for its peer group other operating per diem described in subdivision 30, 
167.15 	paragraph (c). A facility that is above that limit shall have its other operating per diem 
167.16 	reduced to the limit.

167.17 	Sec. 29. Minnesota Statutes 2014, section 256B.441, subdivision 51a, is amended to 
167.18 	read:
167.19 		Subd. 51a.Exception allowing contracting for specialized care facilities. (a) 
167.20 	For rate years beginning on or after October January 1, 2016, the commissioner may 
167.21 	negotiate increases to the care-related limit for nursing facilities that provide specialized 
167.22 	care, at a cost to the general fund not to exceed $600,000 per year. The commissioner 
167.23 	shall publish a request for proposals annually, and may negotiate increases to the limits 
167.24 	that shall apply for either one or two years before the increase shall be subject to a new 
167.25 	proposal and negotiation. the care-related limit may for specialized care facilities shall 
167.26 	be increased by up to 50 percent.
167.27 	(b) In selecting facilities with which to negotiate, the commissioner shall consider: 
167.28 	"Specialized care facilities" are defined as a facility having a program licensed under 
167.29 	chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1, 
167.30 	2015, located in Robbinsdale that specializes in the treatment of Huntington's Disease.
167.31 	(1) the diagnoses or other circumstances of residents in the specialized program that 
167.32 	require care that costs substantially more than the RUG's rates associated with those 
167.33 	residents;
168.1 	(2) the nature of the specialized program or programs offered to meet the needs 
168.2 	of these individuals; and
168.3 	(3) outcomes achieved by the specialized program.

168.4 	Sec. 30. Minnesota Statutes 2014, section 256B.441, is amended by adding a 
168.5 	subdivision to read:
168.6 		Subd. 51b.Special dietary needs. The commissioner shall adjust the rates of a 
168.7 	nursing facility that meets the criteria for the special dietary needs of its residents and the 
168.8 	requirements in section 31.651. The adjustment for raw food cost shall be the difference 
168.9 	between the nursing facility's most recently reported allowable raw food cost per diem and 
168.10 	115 percent of the median allowable raw food cost per diem. For rate years beginning 
168.11 	on or after January 1, 2016, this amount shall be removed from allowable raw food per 
168.12 	diem costs under operating costs and included in the external fixed per diem rate under 
168.13 	subdivisions 13 and 53.

168.14 	Sec. 31. Minnesota Statutes 2014, section 256B.441, subdivision 53, is amended to read:
168.15 		Subd. 53.Calculation of payment rate for external fixed costs. The commissioner 
168.16 	shall calculate a payment rate for external fixed costs.
168.17 	(a) For a facility licensed as a nursing home, the portion related to section 256.9657 
168.18 	shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 
168.19 	home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 
168.20 	result of its number of nursing home beds divided by its total number of licensed beds.
168.21 	(b) The portion related to the licensure fee under section 144.122, paragraph (d), 
168.22 	shall be the amount of the fee divided by actual resident days.
168.23 	(c) The portion related to development and education of resident and family advisory 
168.24 	councils under section 144A.33 shall be $5 divided by 365.
168.25 	(d) The portion related to scholarships shall be determined under section 256B.431, 
168.26 	subdivision 36.
168.27 	(d) Until September 30, 2013, the portion related to long-term care consultation shall 
168.28 	be determined according to section 256B.0911, subdivision 6.
168.29 	(e) The portion related to development and education of resident and family advisory 
168.30 	councils under section 144A.33 shall be $5 divided by 365.
168.31 	(f) (e) The portion related to planned closure rate adjustments shall be as determined 
168.32 	under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436. 
168.33 	Planned closure rate adjustments that take effect before October 1, 2014, shall no longer 
168.34 	be included in the payment rate for external fixed costs beginning October 1, 2016. 
169.1 	Planned closure rate adjustments that take effect on or after October 1, 2014, shall no 
169.2 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
169.3 	the first year not less than two years after their effective date.
169.4 	(f) The single bed room incentives shall be as determined under section 256B.431, 
169.5 	subdivision 42.
169.6 	(g) The portions related to property insurance, real estate taxes, special assessments, 
169.7 	and payments made in lieu of real estate taxes directly identified or allocated to the nursing 
169.8 	facility shall be the actual amounts divided by actual resident days.
169.9 	(h) The portion related to employer health insurance costs shall be the allowable 
169.10 	costs divided by resident days.
169.11 	(i) The portion related to the Public Employees Retirement Association shall be 
169.12 	actual costs divided by resident days.
169.13 	(i) The single bed room incentives shall be as determined under section 256B.431, 
169.14 	subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall 
169.15 	no longer be included in the payment rate for external fixed costs beginning October 1, 
169.16 	2016. Single bed room incentives that take effect on or after October 1, 2014, shall no 
169.17 	longer be included in the payment rate for external fixed costs beginning on October 1 of 
169.18 	the first year not less than two years after their effective date.
169.19 	(j) The portion related to quality improvement incentive payment rate adjustments 
169.20 	shall be as determined under subdivision 46c.
169.21 	(k) The portion related to performance-based incentive payments shall be as 
169.22 	determined under subdivision 46d.
169.23 	(l) The portion related to special dietary needs shall be the per diem amount 
169.24 	determined under subdivision 51b.
169.25 	(j) (m) The payment rate for external fixed costs shall be the sum of the amounts in 
169.26 	paragraphs (a) to (i) (l).

169.27 	Sec. 32. Minnesota Statutes 2014, section 256B.441, subdivision 54, is amended to read:
169.28 		Subd. 54.Determination of total payment rates. In rate years when rates are 
169.29 	rebased, The total care-related per diem, other operating price, and external fixed per 
169.30 	diem for each facility shall be converted to payment rates. The total payment rate for 
169.31 	a RUG's weight of 1.00 shall be the sum of the total care-related payment rate, other 
169.32 	operating payment rate, efficiency incentive, external fixed cost rate, and the property rate 
169.33 	determined under section 256B.434. To determine a total payment rate for each RUG's 
169.34 	level, the total care-related payment rate shall be divided into the direct care payment rate 
170.1 	and the other care-related payment rate, and the direct care payment rate multiplied by the 
170.2 	RUG's weight for each RUG's level using the weights in subdivision 14.

170.3 	Sec. 33. Minnesota Statutes 2014, section 256B.441, subdivision 55a, is amended to 
170.4 	read:
170.5 		Subd. 55a.Alternative to phase-in for publicly owned nursing facilities. (a) For 
170.6 	operating payment rates implemented between October 1, 2011, and the day before the 
170.7 	phase-in under subdivision 55 is complete operating payment rates are determined under 
170.8 	this section, the commissioner shall allow nursing facilities whose physical plant is owned 
170.9 	or whose license is held by a city, county, or hospital district to apply for a higher payment 
170.10 	rate under this section if the local governmental entity agrees to pay a specified portion 
170.11 	of the nonfederal share of medical assistance costs. Nursing facilities that apply shall be 
170.12 	eligible to select an operating payment rate, with a weight of 1.00, up to the rate calculated 
170.13 	in subdivision 54, without application of the phase-in under subdivision 55. The rates for 
170.14 	the other RUGs shall be computed as provided under subdivision 54.
170.15 	(b) For operating payment rates implemented beginning the day when the phase-in 
170.16 	under subdivision 55 is complete operating payment rates are determined under this 
170.17 	section, the commissioner shall allow nursing facilities whose physical plant is owned or 
170.18 	whose license is held by a city, county, or hospital district to apply for a higher payment 
170.19 	rate under this section if the local governmental entity agrees to pay a specified portion of 
170.20 	the nonfederal share of medical assistance costs. Nursing facilities that apply are eligible 
170.21 	to select an operating payment rate with a weight of 1.00, up to an amount determined by 
170.22 	the commissioner to be allowable under the Medicare upper payment limit test. The rates 
170.23 	for the other RUGs shall be computed under subdivision 54. The rate increase allowed in 
170.24 	this paragraph shall take effect only upon federal approval.
170.25 	(c) Rates determined under this subdivision shall take effect beginning October 1, 
170.26 	2011, based on cost reports for the reporting year ending September 30, 2010, and in 
170.27 	future rate years, rates determined for nursing facilities participating under this subdivision 
170.28 	shall take effect on October 1 of each year, based on the most recent available cost report.
170.29 	(d) Eligible nursing facilities that wish to participate under this subdivision shall 
170.30 	make an application to the commissioner by August 31, 2011, or by June 30 of any 
170.31 	subsequent year.
170.32 	(e) For each participating nursing facility, the public entity that owns the physical 
170.33 	plant or is the license holder of the nursing facility shall pay to the state the entire 
170.34 	nonfederal share of medical assistance payments received as a result of the difference 
170.35 	between the nursing facility's payment rate under paragraph (a) or (b), and the rates that 
171.1 	the nursing facility would otherwise be paid without application of this subdivision under 
171.2 	subdivision 54 or 55 as determined by the commissioner.
171.3 	(f) The commissioner may, at any time, reduce the payments under this subdivision 
171.4 	based on the commissioner's determination that the payments shall cause nursing facility 
171.5 	rates to exceed the state's Medicare upper payment limit or any other federal limitation. If 
171.6 	the commissioner determines a reduction is necessary, the commissioner shall reduce all 
171.7 	payment rates for participating nursing facilities by a percentage applied to the amount of 
171.8 	increase they would otherwise receive under this subdivision and shall notify participating 
171.9 	facilities of the reductions. If payments to a nursing facility are reduced, payments under 
171.10 	section 256B.19, subdivision 1e, shall be reduced accordingly.

171.11 	Sec. 34. Minnesota Statutes 2014, section 256B.441, subdivision 56, is amended to read:
171.12 		Subd. 56.Hold harmless. (a) For the rate years beginning October 1, 2008, 
171.13 	to October on or after January 1, 2016, no nursing facility shall receive an operating 
171.14 	cost payment rate less than its prior system operating cost payment rate under section 
171.15 	256B.434. For rate years beginning between October 1, 2009, and October 1, 2015, no 
171.16 	nursing facility shall receive an operating payment rate less than its operating payment 
171.17 	rate in effect on September 30, 2009. The comparison of operating payment rates under 
171.18 	this section shall be made for a RUG's rate with a weight of 1.00.
171.19 	(b) For rate years beginning on or after January 1, 2016, no facility shall be subject 
171.20 	to a care-related payment rate limit reduction greater than five percent of the median 
171.21 	determined in subdivision 30.

171.22 	Sec. 35. Minnesota Statutes 2014, section 256B.441, subdivision 63, is amended to read:
171.23 		Subd. 63.Critical access nursing facilities. (a) The commissioner, in consultation 
171.24 	with the commissioner of health, may designate certain nursing facilities as critical access 
171.25 	nursing facilities. The designation shall be granted on a competitive basis, within the 
171.26 	limits of funds appropriated for this purpose.
171.27 	(b) The commissioner shall request proposals from nursing facilities every 
171.28 	two years. Proposals must be submitted in the form and according to the timelines 
171.29 	established by the commissioner. In selecting applicants to designate, the commissioner, 
171.30 	in consultation with the commissioner of health, and with input from stakeholders, shall 
171.31 	develop criteria designed to preserve access to nursing facility services in isolated areas, 
171.32 	rebalance long-term care, and improve quality. Beginning in fiscal year 2015, to the 
171.33 	extent practicable, the commissioner shall ensure an even distribution of designations 
171.34 	across the state.
172.1 	(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing 
172.2 	facilities designated as critical access nursing facilities:
172.3 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
172.4 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
172.5 	in accordance with subdivision 54 and at least 40 percent, with the sum of the two portions 
172.6 	being equal to 100 percent, of the operating payment rate that would have been allowed 
172.7 	had the facility not been designated. The commissioner may adjust these percentages by 
172.8 	up to 20 percent and may approve a request for less than the amount allowed;
172.9 	(2) enhanced payments for leave days. Notwithstanding section 256B.431, 
172.10 	subdivision 2r, upon designation as a critical access nursing facility, the commissioner 
172.11 	shall limit payment for leave days to 60 percent of that nursing facility's total payment rate 
172.12 	for the involved resident, and shall allow this payment only when the occupancy of the 
172.13 	nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
172.14 	(3) two designated critical access nursing facilities, with up to 100 beds in active 
172.15 	service, may jointly apply to the commissioner of health for a waiver of Minnesota 
172.16 	Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The 
172.17 	commissioner of health will consider each waiver request independently based on the 
172.18 	criteria under Minnesota Rules, part 4658.0040;
172.19 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), 
172.20 	shall be 40 percent of the amount that would otherwise apply; and
172.21 	(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based 
172.22 	rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
172.23 	(d) Designation of a critical access nursing facility shall be for a period of two 
172.24 	years, after which the benefits allowed under paragraph (c) shall be removed. Designated 
172.25 	facilities may apply for continued designation.
172.26 	(e) This subdivision is suspended and no state or federal funding shall be 
172.27 	appropriated or allocated for the purposes of this subdivision from January 1, 2016, to 
172.28 	December 31, 2017.

172.29 	Sec. 36. Minnesota Statutes 2014, section 256B.441, is amended by adding a 
172.30 	subdivision to read:
172.31 		Subd. 65.Nursing facility in Golden Valley. Effective for the rate year beginning 
172.32 	January 1, 2016, and all subsequent rate years, the operating payment rate for a facility 
172.33 	located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed 
172.34 	rehabilitation beds as of January 7, 2015, must be calculated without the application of 
172.35 	subdivisions 50 and 51.

173.1 	Sec. 37. Minnesota Statutes 2014, section 256B.441, is amended by adding a 
173.2 	subdivision to read:
173.3 		Subd. 66.Nursing facilities in border cities. Effective for the rate year beginning 
173.4 	January 1, 2016, and annually thereafter, operating payment rates of a nonprofit nursing 
173.5 	facility that exists on January 1, 2015, is located anywhere within the boundaries of the 
173.6 	city of Breckenridge, and is reimbursed under this section, section 256B.431, or section 
173.7 	256B.434, shall be adjusted to be equal to the median RUG's rates, including comparable 
173.8 	rate components as determined by the commissioner, for the equivalent RUG's weight of 
173.9 	the nonprofit nursing facility or facilities located in an adjacent city in another state and 
173.10 	in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate 
173.11 	with a weight of 1.0 shall be computed by dividing the adjacent city's nursing facilities 
173.12 	median operating payment rate with a weight of 1.02 by 1.02. If the adjustments under 
173.13 	this subdivision result in a rate that exceeds the limits in subdivisions 50 and 51 in a given 
173.14 	rate year, the facility's rate shall not be subject to those limits for that rate year. This 
173.15 	subdivision shall apply only if it results in a rate increase.

173.16 	Sec. 38. Minnesota Statutes 2014, section 256B.50, subdivision 1, is amended to read:
173.17 		Subdivision 1.Scope. A provider may appeal from a determination of a payment 
173.18 	rate established pursuant to this chapter or allowed costs under section 256B.441 and 
173.19 	reimbursement rules of the commissioner if the appeal, if successful, would result in 
173.20 	a change to the provider's payment rate or to the calculation of maximum charges to 
173.21 	therapy vendors as provided by section 256B.433, subdivision 3. Appeals must be filed 
173.22 	in accordance with procedures in this section. This section does not apply to a request 
173.23 	from a resident or long-term care facility for reconsideration of the classification of a 
173.24 	resident under section 144.0722.

173.25 	EFFECTIVE DATE. This section is effective July 1, 2015, and applies to appeals 
173.26 	filed on or after that date.

173.27 	Sec. 39. Minnesota Statutes 2014, section 256I.05, subdivision 2, is amended to read:
173.28 		Subd. 2.Monthly rates; exemptions. This subdivision applies to a residence 
173.29 	that on August 1, 1984, was licensed by the commissioner of health only as a boarding 
173.30 	care home, certified by the commissioner of health as an intermediate care facility, and 
173.31 	licensed by the commissioner of human services under Minnesota Rules, parts 9520.0500 
173.32 	to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to a 
173.33 	facility reimbursed under this subdivision shall be determined under section 256B.431, 
173.34 	or under section256B.434, or 256B.441, if the facility is accepted by the commissioner 
174.1 	for participation in the alternative payment demonstration project. The rate paid to this 
174.2 	facility shall also include adjustments to the group residential housing rate according to 
174.3 	subdivision 1, and any adjustments applicable to supplemental service rates statewide.

174.4 	Sec. 40. DIRECTION TO COMMISSIONER; NURSING FACILITY PAYMENT 
174.5 	REFORM REPORT.
 174.6 	By January 1, 2017, the commissioner of human services shall evaluate and report to 
174.7 	the house of representatives and senate committees and divisions with jurisdiction over 
174.8 	nursing facility payment rates on:
174.9 	(1) the impact of using cost report data to set rates without accounting for cost 
174.10 	report to rate year inflation;
174.11 	(2) the impact of the quality adjusted care limits;
174.12 	(3) the ability of nursing facilities to attract and retain employees, including how rate 
174.13 	increases are being passed through to employees, under the new payment system;
174.14 	(4) the efficacy of the critical access nursing facility program under Minnesota 
174.15 	Statutes, section 256B.441, subdivision 63, given the new nursing facility payment system;
174.16 	(5) creating a process for the commissioner to designate certain facilities as 
174.17 	specialized care facilities for difficult-to-serve populations; and
174.18 	(6) limiting the hold harmless in Minnesota Statutes, section 256B.441, subdivision 
174.19 	56.

174.20 	Sec. 41. PROPERTY RATE SETTING.
 174.21 	The commissioner shall conduct a study, in consultation with stakeholders and 
174.22 	experts, of property rate setting, based on a rental value approach for Minnesota nursing 
174.23 	facilities, and shall report the findings to the house of representatives and senate 
174.24 	committees and divisions with jurisdiction over nursing facility payment rates by March 1, 
174.25 	2016, for a system implementation date of January 1, 2017. The commissioner shall:
174.26 	(1) contract with at least two firms to conduct appraisals of all nursing facilities in 
174.27 	the medical assistance program. Each firm shall conduct appraisals of approximately 
174.28 	equal portions of all nursing facilities assigned to them at random. The appraisals shall 
174.29 	determine the value of the land, building, and equipment of each nursing facility, taking 
174.30 	into account the quality of construction and current condition of the building;
174.31 	(2) use the information from the appraisals to complete the design of a fair rental 
174.32 	value system and calculate a replacement value and an effective age for each nursing 
174.33 	facility. Nursing facilities may request an appraisal by a second firm which shall be 
174.34 	assigned randomly by the commissioner. The commissioner shall use the findings of 
175.1 	the second appraisal. If the second firm increases the appraisal value by more than five 
175.2 	percent, the state shall pay for the second appraisal. Otherwise, the nursing facility shall 
175.3 	pay the cost of the appraisal. Results of appraisals are not otherwise subject to appeal 
175.4 	under section 256B.50; and
175.5 	(3) include in the report required under this section the following items:
175.6 	(i) a description of the proposed rental value system;
175.7 	(ii) options for adjusting the system parameters that vary the cost of implementing 
175.8 	the new property rate system and an analysis of individual nursing facilities under the 
175.9 	current property payment rate and the rates under various approaches to calculating rates 
175.10 	under the rental value system;
175.11 	(iii) recommended steps for transition to the rental value system;
175.12 	(iv) an analysis of the expected long-term incentives of the rental value system for 
175.13 	nursing facilities to maintain and replace buildings, including how the current exceptions to 
175.14 	the moratorium process under Minnesota Statutes, section 144A.073, may be adapted; and
175.15 	(v) bill language for implementation of the rental value system.

175.16 	Sec. 42. REVISOR'S INSTRUCTION.
 175.17 	The revisor of statutes, in consultation with the House Research Department, Office 
175.18 	of Senate Counsel, Research, and Fiscal Analysis, Department of Human Services, and 
175.19 	stakeholders, shall prepare legislation for the 2016 legislative session to recodify laws 
175.20 	governing nursing home payments and rates in Minnesota Statutes, chapter 256B, and in 
175.21 	Minnesota Rules, chapter 9549.

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

175.23 	Sec. 43.  REPEALER.
 175.24 	Minnesota Statutes 2014, sections 256B.434, subdivision 19b; and 256B.441, 
175.25 	subdivisions 14a, 19, 50a, 52, 55, 58, and 62, are repealed.

175.26 	ARTICLE 6
175.27 	PUBLIC HEALTH AND HEALTH CARE DELIVERY

175.28 	Section 1. [62A.67] SHORT TITLE.
175.29 	Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."

175.30 	EFFECTIVE DATE. This section is effective January 1, 2017, and applies to 
175.31 	coverage offered, sold, issued, or renewed on or after that date.

176.1 	Sec. 2. [62A.671] DEFINITIONS.
176.2 		Subdivision 1.Applicability. For purposes of sections 62A.67 to 62A.672, the 
176.3 	terms defined in this section have the meanings given.
176.4 		Subd. 2.Distant site. "Distant site" means a site at which a licensed health care 
176.5 	provider is located while providing health care services or consultations by means of 
176.6 	telemedicine.
176.7 		Subd. 3.Health care provider. "Health care provider" has the meaning provided 
176.8 	in section 62A.63, subdivision 2.
176.9 		Subd. 4.Heath carrier. "Health carrier" has the meaning provided in section 
176.10 	62A.011, subdivision 2.
176.11 		Subd. 5.Health plan. "Health plan" means a health plan as defined in section 
176.12 	62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 
176.13 	3, but does not include dental plans that provide indemnity-based benefits, regardless of 
176.14 	expenses incurred and are designed to pay benefits directly to the policyholder.
176.15 		Subd. 6.Licensed health care provider. "Licensed health care provider" means a 
176.16 	health care provider who is:
176.17 	(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a 
176.18 	mental health professional as defined under section 245.462, subdivision 18, or 245.4871, 
176.19 	subdivision 27; or a vendor of medical care as defined in section 256B.02, subdivision 
176.20 	7; and
176.21 	(2) authorized within their respective scope of practice to provide the particular 
176.22 	service with no supervision or under general supervision.
176.23 		Subd. 7.Originating site. "Originating site" means a site including, but not limited 
176.24 	to, a health care facility at which a patient is located at the time health care services are 
176.25 	provided to the patient by means of telemedicine.
176.26 		Subd. 8.Store-and-forward technology. "Store-and-forward technology" means 
176.27 	the transmission of a patient's medical information from an originating site to a health care 
176.28 	provider at a distant site without the patient being present, or the delivery of telemedicine 
176.29 	that does not occur in real time via synchronous transmissions.
176.30 		Subd. 9.Telemedicine. "Telemedicine" means the delivery of health care services 
176.31 	or consultations while the patient is at an originating site and the licensed health care 
176.32 	provider is at a distant site. A communication between licensed health care providers 
176.33 	that consists solely of a telephone conversation, e-mail, or facsimile transmissions does 
176.34 	not constitute telemedicine consultations or services. Telemedicine may be provided by 
176.35 	means of real-time two-way, interactive audio and visual communications, including the 
176.36 	application of secure video conferencing or store-and-forward technology to provide or 
177.1 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
177.2 	treatment, education, and care management of a patient's health care.

177.3 	EFFECTIVE DATE. This section is effective January 1, 2017, and applies to 
177.4 	coverage offered, sold, issued, or renewed on or after that date.

177.5 	Sec. 3. [62A.672] COVERAGE OF TELEMEDICINE SERVICES.
177.6 		Subdivision 1.Coverage of telemedicine. (a) A health plan sold, issued, or renewed 
177.7 	by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall 
177.8 	include coverage for telemedicine benefits in the same manner as any other benefits covered 
177.9 	under the policy, plan, or contract, and shall comply with the regulations of this section.
177.10 	(b) Nothing in this section shall be construed to:
177.11 	(1) require a health carrier to provide coverage for services that are not medically 
177.12 	necessary;
177.13 	(2) prohibit a health carrier from establishing criteria that a health care provider 
177.14 	must meet to demonstrate the safety or efficacy of delivering a particular service via 
177.15 	telemedicine for which the health carrier does not already reimburse other health 
177.16 	care providers for delivering via telemedicine, so long as the criteria are not unduly 
177.17 	burdensome or unreasonable for the particular service; or
177.18 	(3) prevent a health carrier from requiring a health care provider to agree to certain 
177.19 	documentation or billing practices designed to protect the health carrier or patients from 
177.20 	fraudulent claims so long as the practices are not unduly burdensome or unreasonable 
177.21 	for the particular service.
177.22 		Subd. 2.Parity between telemedicine and in-person services. A health carrier 
177.23 	shall not exclude a service for coverage solely because the service is provided via 
177.24 	telemedicine and is not provided through in-person consultation or contact between a 
177.25 	licensed health care provider and a patient.
177.26 		Subd. 3.Reimbursement for telemedicine services. (a) A health carrier shall 
177.27 	reimburse the distant site licensed health care provider for covered services delivered 
177.28 	via telemedicine commensurate with the cost of delivering health care services through 
177.29 	telemedicine. The distant site provider is responsible for reimbursing any fees to the 
177.30 	originating site.
177.31 	(b) It is not a violation of this subdivision for a health carrier to include a 
177.32 	deductible, co-payment, or coinsurance requirement for a health care service provided via 
177.33 	telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition 
177.34 	to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same 
177.35 	services were provided through in-person contact.

178.1 	EFFECTIVE DATE. This section is effective January 1, 2017, and applies to 
178.2 	coverage offered, sold, issued, or renewed on or after that date.

178.3 	Sec. 4. Minnesota Statutes 2014, section 103I.205, subdivision 4, is amended to read:
178.4 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
178.5 	section 103I.401, subdivision 2, or section 103I.601, subdivision 2, a person may not 
178.6 	drill, construct, repair, or seal a well or boring unless the person has a well contractor's 
178.7 	license in possession.
178.8 	(b) A person may construct, repair, and seal a monitoring well if the person:
178.9 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the 
178.10 	branches of civil or geological engineering;
178.11 	(2) is a hydrologist or hydrogeologist certified by the American Institute of 
178.12 	Hydrology;
178.13 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
178.14 	(4) is a geologist certified by the American Institute of Professional Geologists; or
178.15 	(5) meets the qualifications established by the commissioner in rule.
178.16 	A person must register with the commissioner as a monitoring well contractor on 
178.17 	forms provided by the commissioner.
178.18 	(c) A person may do the following work with a limited well/boring contractor's 
178.19 	license in possession. A separate license is required for each of the six activities:
178.20 	(1) installing or repairing well screens or pitless units or pitless adaptors and well 
178.21 	casings from the pitless adaptor or pitless unit to the upper termination of the well casing;
178.22 	(2) constructing, repairing, and sealing drive point wells or dug wells;
178.23 	(3) installing well pumps or pumping equipment;
178.24 	(4) sealing wells;
178.25 	(5) constructing, repairing, or sealing dewatering wells; or
178.26 	(6) constructing, repairing, or sealing bored geothermal heat exchangers.
178.27 	(d) A person may construct, repair, and seal an elevator boring with an elevator 
178.28 	boring contractor's license.
178.29 	(e) Notwithstanding other provisions of this chapter requiring a license or 
178.30 	registration, a license or registration is not required for a person who complies with the 
178.31 	other provisions of this chapter if the person is:
178.32 	(1) an individual who constructs a well on land that is owned or leased by the 
178.33 	individual and is used by the individual for farming or agricultural purposes or as the 
178.34 	individual's place of abode;
179.1 	(2) an individual who performs labor or services for a contractor licensed or 
179.2 	registered under the provisions of this chapter in connection with the construction, sealing, 
179.3 	or repair of a well or boring at the direction and under the personal supervision of a 
179.4 	contractor licensed or registered under the provisions of this chapter; or
179.5 	(3) a licensed plumber who is repairing submersible pumps or water pipes associated 
179.6 	with well water systems if:
179.7 	(i) the repair location is within an area where there is no licensed or registered 
179.8 	well contractor within 25 50 miles; and
179.9 	(ii) the licensed plumber complies with all of the requirements of this chapter and 
179.10 	all relevant sections of the plumbing code.

179.11 	Sec. 5. [144.1506] PRIMARY CARE RESIDENCY EXPANSION GRANT 
179.12 	PROGRAM.
179.13 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
179.14 	apply:
179.15 	(1) "eligible primary care residency program" means a program that meets the 
179.16 	following criteria:
179.17 	(i) is located in Minnesota;
179.18 	(ii) trains medical residents in the specialties of family medicine, general internal 
179.19 	medicine, general pediatrics, psychiatry, geriatrics, or general surgery; and
179.20 	(iii) is accredited by the Accreditation Council for Graduate Medical Education or 
179.21 	presents a credible plan to obtain accreditation;
179.22 	(2) "eligible project" means a project to establish a new eligible primary care 
179.23 	residency program or create at least one new residency slot in an existing eligible primary 
179.24 	care residency program; and
179.25 	(3) "new residency slot" means the creation of a new residency position and the 
179.26 	execution of a contract with a new resident in a residency program.
179.27 		Subd. 2.Expansion grant program. (a) The commissioner of health shall award 
179.28 	primary care residency expansion grants to eligible primary care residency programs to 
179.29 	plan and implement new residency slots. A planning grant shall not exceed $75,000, and a 
179.30 	training grant shall not exceed $150,000 per new residency slot for the first year, $100,000 
179.31 	for the second year, and $50,000 for the third year of the new residency slot.
179.32 	(b) Funds may be spent to cover the costs of:
179.33 	(1) planning related to establishing an accredited primary care residency program;
179.34 	(2) obtaining accreditation by the Accreditation Council for Graduate Medical 
179.35 	Education or another national body that accredits residency programs;
180.1 	(3) establishing new residency programs or new resident training slots;
180.2 	(4) recruitment, training, and retention of new residents and faculty;
180.3 	(5) travel and lodging for new residents;
180.4 	(6) faculty, new resident, and preceptor salaries related to new residency slots;
180.5 	(7) training site improvements, fees, equipment, and supplies required for new 
180.6 	family medicine resident training slots; and
180.7 	(8) supporting clinical education in which trainees are part of a primary care team 
180.8 	model.
180.9 		Subd. 3.Applications for expansion grants. Eligible primary care residency 
180.10 	programs seeking a grant shall apply to the commissioner. Applications must include the 
180.11 	number of new family medicine residency slots planned or under contract; attestation that 
180.12 	funding will be used to support an increase in the number of available residency slots; 
180.13 	a description of the training to be received by the new residents, including the location 
180.14 	of training; a description of the project, including all costs associated with the project; 
180.15 	all sources of funds for the project; detailed uses of all funds for the project; the results 
180.16 	expected; and a plan to maintain the new residency slot after the grant period. The 
180.17 	applicant must describe achievable objectives, a timetable, and roles and capabilities of 
180.18 	responsible individuals in the organization.
180.19 		Subd. 4.Consideration of expansion grant applications. The commissioner shall 
180.20 	review each application to determine whether or not the residency program application 
180.21 	is complete and whether the proposed new residency program and any new residency 
180.22 	slots are eligible for a grant.  The commissioner shall award grants to support up to six 
180.23 	family medicine, general internal medicine, or general pediatrics residents; four psychiatry 
180.24 	residents; two geriatrics residents; and two general surgery residents.  If insufficient 
180.25 	applications are received from any eligible specialty, funds may be redistributed to 
180.26 	applications from other eligible specialties. 
180.27 		Subd. 5.Program oversight. During the grant period, the commissioner may 
180.28 	require and collect from grantees any information necessary to evaluate the program. 
180.29 	Appropriations made to the program do not cancel and are available until expended.

180.30 	Sec. 6. Minnesota Statutes 2014, section 144.293, subdivision 5, is amended to read:
180.31 		Subd. 5.Exceptions to consent requirement. (a) This section does not prohibit the 
180.32 	release of health records:
180.33 	(1) for a medical emergency when the provider is unable to obtain the patient's 
180.34 	consent due to the patient's condition or the nature of the medical emergency;
181.1 	(2) to other providers within related health care entities when necessary for the 
181.2 	current treatment of the patient; or
181.3 	(3) to a health care facility licensed by this chapter, chapter 144A, or to the same 
181.4 	types of health care facilities licensed by this chapter and chapter 144A that are licensed 
181.5 	in another state when a patient:
181.6 	(i) is returning to the health care facility and unable to provide consent; or
181.7 	(ii) who resides in the health care facility, has services provided by an outside 
181.8 	resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable 
181.9 	to provide consent.
181.10 	(b) A provider may release a deceased patient's health care records to another provider 
181.11 	for the purposes of diagnosing or treating the deceased patient's surviving adult child.

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

181.13 	Sec. 7. [144.586] REQUIREMENTS FOR CERTAIN NOTICES AND 
181.14 	DISCHARGE PLANNING.
181.15 		Subdivision 1.Observation stay notice. (a) Each hospital, as defined under 
181.16 	section 144.50, subdivision 2, shall provide oral and written notice to each patient that 
181.17 	the hospital places in observation status of such placement not later than 24 hours after 
181.18 	such placement. The oral and written notices must include:
181.19 	(1) a statement that the patient is not admitted to the hospital but is under observation 
181.20 	status;
181.21 	(2) a statement that observation status may affect the patient's Medicare coverage for:
181.22 	(i) hospital services, including medications and pharmaceutical supplies; or
181.23 	(ii) home or community-based care or care at a skilled nursing facility upon the 
181.24 	patient's discharge; and
181.25 	(3) a recommendation that the patient contact the patient's health insurance provider 
181.26 	or the Office of the Ombudsman for Long-Term Care or Office of the Ombudsman for 
181.27 	State Managed Health Care Programs or the Beneficiary and Family Centered Care 
181.28 	Quality Improvement Organization to better understand the implications of placement in 
181.29 	observation status.
181.30 	(b) The hospital shall document the date in the patient's record that the notice 
181.31 	required in paragraph (a) was provided to the patient, the patient's designated 
181.32 	representative such as the patient's health care agent, legal guardian, conservator, or 
181.33 	another person acting as the patient's representative.
182.1 		Subd. 2.Postacute care discharge planning. Each hospital, including hospitals 
182.2 	designated as critical access hospitals, must comply with the federal hospital requirements 
182.3 	for discharge planning which include:
182.4 	(1) conducting a discharge planning evaluation that includes an evaluation of:
182.5 	(i) the likelihood of the patient needing posthospital services and of the availability 
182.6 	of those services; and
182.7 	(ii) the patient's capacity for self-care or the possibility of the patient being cared for 
182.8 	in the environment from which the patient entered the hospital;
182.9 	(2) timely completion of the discharge planning evaluation under clause (1) by 
182.10 	hospital personnel so that appropriate arrangements for posthospital care are made before 
182.11 	discharge, and to avoid unnecessary delays in discharge;
182.12 	(3) including the discharge planning evaluation under clause (1) in the patient's 
182.13 	medical record for use in establishing an appropriate discharge plan. The hospital must 
182.14 	discuss the results of the evaluation with the patient or individual acting on behalf of the 
182.15 	patient. The hospital must reassess the patient's discharge plan if the hospital determines 
182.16 	that there are factors that may affect continuing care needs or the appropriateness of 
182.17 	the discharge plan; and
182.18 	(4) providing counseling, as needed, for the patient and family members or interested 
182.19 	persons to prepare them for posthospital care. The hospital must provide a list of available 
182.20 	Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's 
182.21 	geographic area, or other area requested by the patient if such care or placement is 
182.22 	indicated and appropriate. Once the patient has designated their preferred providers, the 
182.23 	hospital will assist the patient in securing care covered by their health plan or within the 
182.24 	care network. The hospital must not specify or otherwise limit the qualified providers that 
182.25 	are available to the patient. The hospital must document in the patient's record that the list 
182.26 	was presented to the patient or to the individual acting on the patient's behalf.

182.27 	Sec. 8. [144.999] LIFE-SAVING ALLERGY MEDICATION.
182.28 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
182.29 	have the meanings given.
182.30 	(b) "Administer" means the direct application of an epinephrine auto-injector to 
182.31 	the body of an individual.
182.32 	(c) "Authorized entity" means entities that fall in the categories of recreation camps, 
182.33 	colleges and universities, preschools and day cares, and any other category of entities or 
182.34 	organizations that the commissioner authorizes to obtain and administer epinephrine 
183.1 	auto-injectors pursuant to this section. This definition does not include a school covered 
183.2 	under section 121A.2207.
183.3 	(d) "Commissioner" means the commissioner of health.
183.4 	(e) "Epinephrine auto-injector" means a single-use device used for the automatic 
183.5 	injection of a premeasured dose of epinephrine into the human body.
183.6 	(f) "Provide" means to supply one or more epinephrine auto-injectors to an 
183.7 	individual or the individual's parent, legal guardian, or caretaker.
183.8 		Subd. 2.Commissioner duties. The commissioner may identify additional 
183.9 	categories of entities or organizations to be authorized entities if the commissioner 
183.10 	determines that individuals may come in contact with allergens capable of causing 
183.11 	anaphylaxis. Beginning July 1, 2016, the commissioner may annually review the 
183.12 	categories of authorized entities and may authorize additional categories of authorized 
183.13 	entities as the commissioner deems appropriate. The commissioner may contract with a 
183.14 	vendor to perform the review and identification of authorized entities.
183.15 		Subd. 3.Obtaining and storing epinephrine auto-injectors. (a) Notwithstanding 
183.16 	section 151.37, an authorized entity may obtain and possess epinephrine auto-injectors to 
183.17 	be provided or administered to an individual if, in good faith, an employee or agent of 
183.18 	an authorized entity believes that the individual is experiencing anaphylaxis regardless 
183.19 	of whether the individual has a prescription for an epinephrine auto-injector. The 
183.20 	administration of an epinephrine auto-injector in accordance with this section is not the 
183.21 	practice of medicine.
183.22 	(b) An authorized entity may obtain epinephrine auto-injectors from pharmacies 
183.23 	licensed as wholesale drug distributors pursuant to section 151.47. Prior to obtaining an 
183.24 	epinephrine auto-injector, an owner, manager, or authorized agent of the entity must 
183.25 	present to the pharmacy a valid certificate of training obtained pursuant to subdivision 5.
183.26 	(c) An authorized entity shall store epinephrine auto-injectors in a location readily 
183.27 	accessible in an emergency and in accordance with the epinephrine auto-injector's 
183.28 	instructions for use and any additional requirements that may be established by the 
183.29 	commissioner. An authorized entity shall designate employees or agents who have 
183.30 	completed the training program required under subdivision 5 to be responsible for the 
183.31 	storage, maintenance, and control of epinephrine auto-injectors obtained and possessed 
183.32 	by the authorized entity.
183.33 		Subd. 4.Use of epinephrine auto-injectors. (a) An owner, manager, employee, or 
183.34 	agent of an authorized entity who has completed the training required under subdivision 5 
183.35 	may:
184.1 	(1) provide an epinephrine auto-injector for immediate administration to an 
184.2 	individual or the individual's parent, legal guardian, or caregiver if the employee or agent 
184.3 	believes, in good faith, the individual is experiencing anaphylaxis, regardless of whether 
184.4 	the individual has a prescription for an epinephrine auto-injector or has previously been 
184.5 	diagnosed with an allergy; or
184.6 	(2) administer an epinephrine auto-injector to an individual who the employee 
184.7 	or agent believes, in good faith, is experiencing anaphylaxis, regardless of whether the 
184.8 	individual has a prescription for an epinephrine auto-injector or has previously been 
184.9 	diagnosed with an allergy.
184.10 	(b) Nothing in this section shall be construed to require any authorized entity to 
184.11 	maintain a stock of epinephrine auto-injectors.
184.12 		Subd. 5.Training. (a) In order to use an epinephrine auto-injector as authorized 
184.13 	under subdivision 4, an individual must complete, every two years, an anaphylaxis training 
184.14 	program conducted by a nationally recognized organization experienced in training 
184.15 	laypersons in emergency health treatment, a statewide organization with experience 
184.16 	providing training on allergies and anaphylaxis under the supervision of board-certified 
184.17 	allergy medical advisors, or an entity or individual approved by the commissioner to 
184.18 	provide an anaphylaxis training program. The commissioner may approve specific entities 
184.19 	or individuals to conduct the training program or may approve categories of entities or 
184.20 	individuals to conduct the training program. Training may be conducted online or in 
184.21 	person and, at a minimum, must cover:
184.22 	(1) how to recognize signs and symptoms of severe allergic reactions, including 
184.23 	anaphylaxis;
184.24 	(2) standards and procedures for the storage and administration of an epinephrine 
184.25 	auto-injector; and
184.26 	(3) emergency follow-up procedures.
184.27 	(b) The entity or individual conducting the training shall issue a certificate to each 
184.28 	person who successfully completes the anaphylaxis training program. The commissioner 
184.29 	may develop, approve, and disseminate a standard certificate of completion. The 
184.30 	certificate of completion shall be valid for two years from the date issued.
184.31 		Subd. 6.Good samaritan protections. Any act or omission taken pursuant to 
184.32 	this section by an authorized entity that possesses and makes available epinephrine 
184.33 	auto-injectors and its employees or agents, a pharmacy or manufacturer that dispenses 
184.34 	epinephrine auto-injectors to an authorized entity, or an individual or entity that conducts 
184.35 	the training described in subdivision 5 is considered "emergency care, advice, or 
184.36 	assistance" under section 604A.01.

185.1 	Sec. 9. Minnesota Statutes 2014, section 144A.75, subdivision 13, is amended to read:
185.2 		Subd. 13.Residential hospice facility. (a) "Residential hospice facility" means 
185.3 	a facility that resembles a single-family home located in a residential area that directly 
185.4 	provides 24-hour residential and support services in a home-like setting for hospice patients 
185.5 	as an integral part of the continuum of home care provided by a hospice and that houses:
185.6 	(1) no more than eight hospice patients; or
185.7 	(2) at least nine and no more than 12 hospice patients with the approval of the local 
185.8 	governing authority, notwithstanding section 462.357, subdivision 8.
185.9 	(b) Residential hospice facility also means a facility that directly provides 24-hour 
185.10 	residential and support services for hospice patients and that:
185.11 	(1) houses no more than 21 hospice patients;
185.12 	(2) meets hospice certification regulations adopted pursuant to title XVIII of the 
185.13 	federal Social Security Act, United States Code, title 42, section 1395, et seq.; and
185.14 	(3) is located on St. Anthony Avenue in St. Paul, Minnesota, and was licensed as a 
185.15 	40-bed non-Medicare certified nursing home as of January 1, 2015.

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

185.17 	Sec. 10. Minnesota Statutes 2014, section 144E.001, is amended by adding a 
185.18 	subdivision to read:
185.19 		Subd. 5h.Community medical response emergency medical technician.
 185.20 	"Community medical response emergency medical technician" or "CEMT" means 
185.21 	a person who is certified as an emergency medical technician, who is a member of a 
185.22 	registered medical response unit under this chapter, and who meets the requirements for 
185.23 	additional certification as a CEMT as specified in section 144E.275, subdivision 7.

185.24 	Sec. 11. Minnesota Statutes 2014, section 144E.275, subdivision 1, is amended to read:
185.25 		Subdivision 1.Definition. For purposes of this section, the following definitions 
185.26 	apply:
185.27 	(a) "Medical response unit" means an organized service recognized by a local political 
185.28 	subdivision whose primary responsibility is to respond to medical emergencies to provide 
185.29 	initial medical care before the arrival of a licensed ambulance service. Medical response 
185.30 	units may, subject to requirements specified elsewhere in this chapter and only when 
185.31 	requested by the patient's primary physician, advanced practice registered nurse, physician 
185.32 	assistant, or care team, provide, at the direction of a medical director, episodic population 
185.33 	health support, episodic individual patient education, and prevention education programs.
186.1 	(b) "Specialized medical response unit" means an organized service recognized by a 
186.2 	board-approved authority other than a local political subdivision that responds to medical 
186.3 	emergencies as needed or as required by local procedure or protocol.

186.4 	Sec. 12. Minnesota Statutes 2014, section 144E.275, is amended by adding a 
186.5 	subdivision to read:
186.6 		Subd. 7.Community medical response emergency medical technician. (a) To be 
186.7 	eligible for certification by the board as a CEMT, an individual shall:
186.8 	(1) be currently certified as an EMT or AEMT;
186.9 	(2) have two years of service as an EMT or AEMT;
186.10 	(3) be a member of a registered medical response unit as defined in this chapter;
186.11 	(4) successfully complete a CEMT training program from a college or university that 
186.12 	has been approved by the board or accredited by a board-approved national accrediting 
186.13 	organization. The training must include clinical experience under the supervision of the 
186.14 	medical response unit medical director, an advanced practice registered nurse, a physician 
186.15 	assistant, or a public health nurse operating under the direct authority of a local unit 
186.16 	of government; and
186.17 	(5) complete a board-approved application form.
186.18 	(b) A CEMT must practice in accordance with protocols and supervisory standards 
186.19 	established by the medical response unit medical director in accordance with section 
186.20 	144E.265.
186.21 	(c) A CEMT may provide services as approved by the medical response unit medical 
186.22 	director.
186.23 	(d) A CEMT may provide episodic individual patient education and prevention 
186.24 	education only as directed by a patient care plan developed by the patient's primary 
186.25 	physician, an advanced practice registered nurse, or a physician assistant, in conjunction 
186.26 	with the medical response unit medical director and relevant local health care providers. 
186.27 	The care plan must ensure that the services provided by the CEMT are consistent with 
186.28 	services offered by the patient's health care home, if one exists, that the patient receives 
186.29 	the necessary services, and that there is no duplication of services to the patient.
186.30 	(e) A CEMT is subject to all certification, disciplinary, complaint, and other 
186.31 	regulatory requirements that apply to EMTs under this chapter.
186.32 	(f) A CEMT may not provide services defined in section 144A.471, subdivisions 6 
186.33 	and 7, except a CEMT may provide verbal or visual reminders to the patient to:
186.34 	(1) take a regularly scheduled medication, but not to provide or bring the patient 
186.35 	medication; and
187.1 	(2) follow regularly scheduled treatment or exercise plans.

187.2 	Sec. 13. Minnesota Statutes 2014, section 145.4131, subdivision 1, is amended to read:
187.3 		Subdivision 1.Forms. (a) Within 90 days of July 1, 1998, the commissioner shall 
187.4 	prepare a reporting form for use by physicians or facilities performing abortions. A copy 
187.5 	of this section shall be attached to the form. A physician or facility performing an abortion 
187.6 	shall obtain a form from the commissioner.
187.7 	(b) The form shall require the following information:
187.8 	(1) the number of abortions performed by the physician in the previous calendar 
187.9 	year, reported by month;
187.10 	(2) the method used for each abortion;
187.11 	(3) the approximate gestational age expressed in one of the following increments:
187.12 	(i) less than nine weeks;
187.13 	(ii) nine to ten weeks;
187.14 	(iii) 11 to 12 weeks;
187.15 	(iv) 13 to 15 weeks;
187.16 	(v) 16 to 20 weeks;
187.17 	(vi) 21 to 24 weeks;
187.18 	(vii) 25 to 30 weeks;
187.19 	(viii) 31 to 36 weeks; or
187.20 	(ix) 37 weeks to term;
187.21 	(4) the age of the woman at the time the abortion was performed;
187.22 	(5) the specific reason for the abortion, including, but not limited to, the following:
187.23 	(i) the pregnancy was a result of rape;
187.24 	(ii) the pregnancy was a result of incest;
187.25 	(iii) economic reasons;
187.26 	(iv) the woman does not want children at this time;
187.27 	(v) the woman's emotional health is at stake;
187.28 	(vi) the woman's physical health is at stake;
187.29 	(vii) the woman will suffer substantial and irreversible impairment of a major bodily 
187.30 	function if the pregnancy continues;
187.31 	(viii) the pregnancy resulted in fetal anomalies; or
187.32 	(ix) unknown or the woman refused to answer;
187.33 	(6) the number of prior induced abortions;
187.34 	(7) the number of prior spontaneous abortions;
187.35 	(8) whether the abortion was paid for by:
188.1 	(i) private coverage;
188.2 	(ii) public assistance health coverage; or
188.3 	(iii) self-pay;
188.4 	(9) whether coverage was under:
188.5 	(i) a fee-for-service plan;
188.6 	(ii) a capitated private plan; or
188.7 	(iii) other;
188.8 	(10) complications, if any, for each abortion and for the aftermath of each abortion. 
188.9 	Space for a description of any complications shall be available on the form; and
188.10 	(11) the medical specialty of the physician performing the abortion;
188.11 	(12) whether the abortion resulted in a born alive infant, as defined in section 
188.12 	145.423, subdivision 4, and:
188.13 	(i) any medical actions taken to preserve the life of the born alive infant;
188.14 	(ii) whether the born alive infant survived; and
188.15 	(iii) the status of the born alive infant, should the infant survive, if known.

188.16 	Sec. 14. Minnesota Statutes 2014, section 145.423, is amended to read:
188.17 	145.423 ABORTION; LIVE BIRTHS.
188.18 		Subdivision 1.Recognition; medical care. A live child born born alive infant as a 
188.19 	result of an abortion shall be fully recognized as a human person, and accorded immediate 
188.20 	protection under the law. All reasonable measures consistent with good medical practice, 
188.21 	including the compilation of appropriate medical records, shall be taken by the responsible 
188.22 	medical personnel to preserve the life and health of the child born alive infant.
188.23 		Subd. 2.Physician required. When an abortion is performed after the twentieth 
188.24 	week of pregnancy, a physician, other than the physician performing the abortion, shall 
188.25 	be immediately accessible to take all reasonable measures consistent with good medical 
188.26 	practice, including the compilation of appropriate medical records, to preserve the life and 
188.27 	health of any live birth born alive infant that is the result of the abortion.
188.28 		Subd. 3.Death. If a child born alive infant described in subdivision 1 dies after 
188.29 	birth, the body shall be disposed of in accordance with the provisions of section 145.1621.
188.30 		Subd. 4.Definition of born alive infant. (a) In determining the meaning of 
188.31 	any Minnesota statute, or of any ruling, regulation, or interpretation of the various 
188.32 	administrative bureaus and agencies of Minnesota, the words "person," "human being," 
188.33 	"child," and "individual" shall include every infant member of the species Homo sapiens 
188.34 	who is born alive at any stage of development.
189.1 	(b) As used in this section, the term "born alive," with respect to a member of the 
189.2 	species Homo sapiens, means the complete expulsion or extraction from his or her mother 
189.3 	of that member, at any stage of development, who, after such expulsion or extraction, 
189.4 	breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of 
189.5 	voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless 
189.6 	of whether the expulsion or extraction occurs as a result of a natural or induced labor, 
189.7 	cesarean section, or induced abortion.
189.8 	(c) Nothing in this section shall be construed to affirm, deny, expand, or contract any 
189.9 	legal status or legal right applicable to any member of the species Homo sapiens at any 
189.10 	point prior to being born alive, as defined in this section.
189.11 		Subd. 5.Civil and disciplinary actions. (a) Any person upon whom an abortion 
189.12 	has been performed, or the parent or guardian of the mother if the mother is a minor, 
189.13 	and the abortion results in the infant having been born alive, may maintain an action for 
189.14 	death of or injury to the born alive infant against the person who performed the abortion 
189.15 	if the death or injury was a result of simple negligence, gross negligence, wantonness, 
189.16 	willfulness, intentional conduct, or another violation of the legal standard of care.
189.17 	(b) Any responsible medical personnel that does not take all reasonable measures 
189.18 	consistent with good medical practice to preserve the life and health of the born alive 
189.19 	infant, as required by subdivision 1, may be subject to the suspension or revocation of that 
189.20 	person's professional license by the professional board with authority over that person. 
189.21 	Any person who has performed an abortion and against whom judgment has been rendered 
189.22 	pursuant to paragraph (a) shall be subject to an automatic suspension of the person's 
189.23 	professional license for at least one year and said license shall be reinstated only after the 
189.24 	person's professional board requires compliance with this section by all board licensees.
189.25 	(c) Nothing in this subdivision shall be construed to hold the mother of the born alive 
189.26 	infant criminally or civilly liable for the actions of a physician, nurse, or other licensed 
189.27 	health care provider in violation of this section to which the mother did not give her consent.
189.28 		Subd. 6.Protection of privacy in court proceedings. In every civil action 
189.29 	brought under this section, the court shall rule whether the anonymity of any female 
189.30 	upon whom an abortion has been performed or attempted shall be preserved from public 
189.31 	disclosure if she does not give her consent to such disclosure. The court, upon motion or 
189.32 	sua sponte, shall make such a ruling and, upon determining that her anonymity should 
189.33 	be preserved, shall issue orders to the parties, witnesses, and counsel and shall direct the 
189.34 	sealing of the record and exclusion of individuals from courtrooms or hearing rooms to 
189.35 	the extent necessary to safeguard her identity from public disclosure. Each order must be 
189.36 	accompanied by specific written findings explaining why the anonymity of the female 
190.1 	should be preserved from public disclosure, why the order is essential to that end, how the 
190.2 	order is narrowly tailored to serve that interest, and why no reasonable, less restrictive 
190.3 	alternative exists. This section may not be construed to conceal the identity of the plaintiff 
190.4 	or of witnesses from the defendant.
190.5 		Subd. 7.Status of born alive infant. Unless the abortion is performed to save the 
190.6 	life of the woman or fetus, or, unless one or both of the parents of the born alive infant 
190.7 	agree within 30 days of the birth to accept the parental rights and responsibilities for the 
190.8 	child, the child shall be an abandoned ward of the state and the parents shall have no 
190.9 	parental rights or obligations as if the parental rights had been terminated pursuant to 
190.10 	section 260C.301. The child shall be provided for pursuant to chapter 256J.
190.11 		Subd. 8.Severability. If any one or more provision, section, subdivision, sentence, 
190.12 	clause, phrase, or word of this section or the application of it to any person or circumstance 
190.13 	is found to be unconstitutional, it is declared to be severable and the balance of this section 
190.14 	shall remain effective notwithstanding such unconstitutionality. The legislature intends 
190.15 	that it would have passed this section, and each provision, section, subdivision, sentence, 
190.16 	clause, phrase, or word, regardless of the fact that any one provision, section, subdivision, 
190.17 	sentence, clause, phrase, or word is declared unconstitutional.
190.18 		Subd. 9.Short title. This act may be cited as the "Born Alive Infants Protection Act."

190.19 	Sec. 15. [145.471] PRENATAL TRISOMY DIAGNOSIS AWARENESS ACT.
190.20 		Subdivision 1.Short title. This section shall be known and may be cited as the 
190.21 	"Prenatal Trisomy Diagnosis Awareness Act."
190.22 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
190.23 	meanings given them:
190.24 	(1) "commissioner" means the commissioner of health;
190.25 	(2) "deliver" means providing information to an expectant parent and, if appropriate, 
190.26 	other family members, in a written format;
190.27 	(3) "health care practitioner" means a medical professional that provides prenatal or 
190.28 	postnatal care and administers or requests administration of a diagnostic or screening test 
190.29 	to a pregnant woman that detects for trisomy conditions; and
190.30 	(4) "trisomy conditions" means trisomy 13, otherwise known as Patau syndrome; 
190.31 	trisomy 18, otherwise known as Edwards syndrome; and trisomy 21, otherwise known 
190.32 	as Down syndrome.
190.33 		Subd. 3.Health care practitioner duty. A health care practitioner who orders tests 
190.34 	for a pregnant woman to screen for trisomy conditions shall provide the information in 
191.1 	subdivision 4 to the pregnant woman if the test reveals a positive result for any of the 
191.2 	trisomy conditions.
191.3 		Subd. 4.Commissioner duties. (a) The commissioner shall make the following 
191.4 	information available to health care practitioners:
191.5 	(1) up-to-date and evidence-based information about the trisomy conditions that has 
191.6 	been reviewed by medical experts and national trisomy organizations. The information 
191.7 	must be provided in a written or an alternative format and must include the following:
191.8 	(i) expected physical, developmental, educational, and psychosocial outcomes;
191.9 	(ii) life expectancy;
191.10 	(iii) the clinical course description;
191.11 	(iv) expected intellectual and functional development; and
191.12 	(v) treatment options available for the particular syndrome for which the test was 
191.13 	positive; and
191.14 	(2) contact information for nonprofit organizations that provide information and 
191.15 	support services for trisomy conditions.
191.16 	(b) The commissioner shall post the information in paragraph (a) on the Department 
191.17 	of Health Web site.
191.18 	(c) The commissioner shall follow existing department practice to ensure that the 
191.19 	information is culturally and linguistically appropriate for all recipients.
191.20 	(d) Any local or national organization that provides education or services related 
191.21 	to trisomy conditions may request that the commissioner include the organization's 
191.22 	informational material and contact information on the Department of Health Web site. 
191.23 	Once a request is made, the commissioner may add the information to the Web site.

191.24 	EFFECTIVE DATE. This section is effective August 1, 2015.

191.25 	Sec. 16. Minnesota Statutes 2014, section 145.928, subdivision 13, is amended to read:
191.26 		Subd. 13.Report Reports. (a) The commissioner shall submit a biennial report 
191.27 	to the legislature on the local community projects, tribal government, and community 
191.28 	health board prevention activities funded under this section. These reports must include 
191.29 	information on grant recipients, activities that were conducted using grant funds, 
191.30 	evaluation data, and outcome measures, if available. These reports are due by January 15 
191.31 	of every other year, beginning in the year 2003.
191.32 	(b) The commissioner shall submit an annual report to the chairs and ranking 
191.33 	minority members of the house of representatives and senate committees with jurisdiction 
191.34 	over public health on grants made under subdivision 7 to decrease racial and ethnic 
191.35 	disparities in infant mortality rates. The report must provide specific information on the 
192.1 	amount of each grant awarded to each agency or organization, the population served 
192.2 	by each agency or organization, outcomes of the programs funded by each grant, and 
192.3 	the amount of the appropriation retained by the commissioner for administrative and 
192.4 	associated expenses. The commissioner shall issue a report each January 15 for the 
192.5 	previous fiscal year beginning January 15, 2016.

192.6 	Sec. 17. [145.9299] SMILE HEALTHY MINNESOTA 2016 GRANT PROGRAM.
192.7 	(a) The commissioner of health shall establish the Smile Healthy Minnesota 2016 
192.8 	grant program to provide access to dental care for at-risk children, adolescents, adults, 
192.9 	and seniors in rural areas of Minnesota. The grant is available to nonprofit agencies that 
192.10 	provide mobile dental care through the use of portable dental equipment. To be eligible 
192.11 	for a grant, a provider agency must:
192.12 	(1) encourage early screening and preventative care by providing dental exams for 
192.13 	children one year of age;
192.14 	(2) provide dental services to at-risk children, adolescents, adults, and seniors in 
192.15 	a health professional shortage area as defined under Code of Federal Regulations, title 
192.16 	42, part 5, and United States Code, title 42, section 254E, that is located outside the 
192.17 	seven-county metropolitan area; and
192.18 	(3) provide preventative dental care including fluoride monitoring, screenings, and 
192.19 	minor dental treatment; and general dental care, education, and information.
192.20 	(b) Grantees must report their dental health outcomes to the commissioner by 
192.21 	December 31, 2018.
192.22 	(c) Grant recipients must be organized as a nonprofit entity in Minnesota.
192.23 	(d) A grantee is prohibited from billing for preventative screenings until the 
192.24 	comprehensive oral health services are completed.

192.25 	Sec. 18. Minnesota Statutes 2014, section 152.34, is amended to read:
192.26 	152.34 NURSING HEALTH CARE FACILITIES.
192.27 	Nursing Health care facilities licensed under chapter 144A, boarding care homes 
192.28 	licensed under section 144.50, and assisted living facilities, and facilities owned, 
192.29 	controlled, managed, or under common control with hospitals licensed under chapter 144 
192.30 	may adopt reasonable restrictions on the use of medical cannabis by a patient enrolled in 
192.31 	the registry program who resides at or is actively receiving treatment or care at the facility. 
192.32 	The restrictions may include a provision that the facility will not store or maintain the 
192.33 	patient's supply of medical cannabis, that the facility is not responsible for providing the 
192.34 	medical cannabis for patients, and that medical cannabis be used only in a place specified 
193.1 	by the facility. Nothing contained in this section shall require the facilities to adopt such 
193.2 	restrictions and no facility shall unreasonably limit a patient's access to or use of medical 
193.3 	cannabis to the extent that use is authorized by the patient under sections 152.22 to 152.37.

193.4 	Sec. 19. Minnesota Statutes 2014, section 157.15, subdivision 8, is amended to read:
193.5 		Subd. 8.Lodging establishment. "Lodging establishment" means: (1) a building, 
193.6 	structure, enclosure, or any part thereof used as, maintained as, advertised as, or held out to 
193.7 	be a place where sleeping accommodations are furnished to the public as regular roomers, 
193.8 	for periods of one week or more, and having five or more beds to let to the public.; or (2) a 
193.9 	building, structure, or enclosure or any part thereof located within ten miles distance from 
193.10 	a hospital or medical center and maintained as, advertised as, or held out to be a place 
193.11 	where sleeping accommodations are furnished exclusively to patients, their families, and 
193.12 	caregivers while the patient is receiving or waiting to receive health care treatments or 
193.13 	procedures for periods of one week or more, and where no supportive services, as defined 
193.14 	under section 157.17, subdivision 1, paragraph (a), or health supervision services, as 
193.15 	defined under section 157.17, subdivision 1, paragraph (b), or home care services, as 
193.16 	defined under section 144A.471, subdivisions 6 and 7, are provided.

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

193.18 	Sec. 20. Minnesota Statutes 2014, section 256B.0625, subdivision 3b, is amended to 
193.19 	read:
193.20 		Subd. 3b.Telemedicine consultations services. (a) Medical assistance covers 
193.21 	medically necessary services and consultations delivered by a licensed health care provider 
193.22 	via telemedicine consultations. Telemedicine consultations must be made via two-way, 
193.23 	interactive video or store-and-forward technology. Store-and-forward technology includes 
193.24 	telemedicine consultations that do not occur in real time via synchronous transmissions, 
193.25 	and that do not require a face-to-face encounter with the patient for all or any part of any 
193.26 	such telemedicine consultation. The patient record must include a written opinion from the 
193.27 	consulting physician providing the telemedicine consultation. A communication between 
193.28 	two physicians that consists solely of a telephone conversation is not a telemedicine 
193.29 	consultation in the same manner as if the service or consultation was delivered in person. 
193.30 	Coverage is limited to three telemedicine consultationsservices per recipient enrollee per 
193.31 	calendar week. Telemedicine consultations services shall be paid at the full allowable rate.
193.32 	(b) The commissioner shall establish criteria that a health care provider must attest 
193.33 	to in order to demonstrate the safety or efficacy of delivering a particular service via 
193.34 	telemedicine. The attestation may include that the health care provider:
194.1 	(1) has identified the categories or types of services the health care provider will 
194.2 	provide via telemedicine;
194.3 	(2) has written policies and procedures specific to telemedicine services that are 
194.4 	regularly reviewed and updated;
194.5 	(3) has policies and procedures that adequately address patient safety before, during, 
194.6 	and after the telemedicine service is rendered;
194.7 	(4) has established protocols addressing how and when to discontinue telemedicine 
194.8 	services; and
194.9 	(5) has an established quality assurance process related to telemedicine services.
194.10 	(c) As a condition of payment, a licensed health care provider must document 
194.11 	each occurrence of a health service provided by telemedicine to a medical assistance 
194.12 	enrollee. Health care service records for services provided by telemedicine must meet 
194.13 	the requirements set forth in Minnesota Rules, chapter 9505.2175, subparts 1 and 2, 
194.14 	and must document:
194.15 	(1) the type of service provided by telemedicine;
194.16 	(2) the time the service began and the time the service ended, including an a.m. and 
194.17 	p.m. designation;
194.18 	(3) documentation of the licensed health care provider's basis for determining that 
194.19 	telemedicine is an appropriate and effective means for delivering the service to the enrollee; 
194.20 	(4) the mode of transmission of the telemedicine service and records evidencing that 
194.21 	a particular mode of transmission was utilized;
194.22 	(5) the location of the originating site and the distant site;
194.23 	(6) if the claim for payment is based on a physician's telemedicine consultation 
194.24 	with another physician, the written opinion from the consulting physician providing the 
194.25 	telemedicine consultation; and
194.26 	(7) documentation of compliance with the criteria attested to by the health care 
194.27 	provider in accordance with paragraph (b).
194.28 	(d) If a health care provider provides the facility used as the originating site for the 
194.29 	delivery of telemedicine to a patient, the commissioner shall make a facility fee payment 
194.30 	to the originating site health care provider in an amount equivalent to the originated site 
194.31 	fee paid by Medicare. No facility fee shall be paid to a health care provider that is being 
194.32 	paid under a cost-based methodology or if Medicare has already paid the facility fee for an 
194.33 	enrollee who is dually eligible for Medicare and medical assistance.
194.34 	(e) For purposes of this subdivision, "telemedicine" is defined under section 
194.35 	62A.671, subdivision 9; "licensed health care provider" is defined under section 62A.671, 
195.1 	subdivision 6; "health care provider" is defined under section 62A.671, subdivision 3; and 
195.2 	"originating site" is defined under section 62A.671, subdivision 7.
195.3 	(f) The criteria described in section 256B.0625, subdivision 3b, paragraph (b), shall 
195.4 	not apply to managed care organizations and county-based purchasing plans, which may 
195.5 	establish criteria as described in section 62A.672, subdivision 1, paragraph (b), clause (2), 
195.6 	for the coverage of telemedicine services.

195.7 	EFFECTIVE DATE. This section is effective January 1, 2017, and applies to 
195.8 	coverage offered, sold, issued, or renewed on or after that date.

195.9 	Sec. 21. COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL 
195.10 	TECHNICIAN SERVICES COVERED UNDER THE MEDICAL ASSISTANCE 
195.11 	PROGRAM.
 195.12 	(a) The commissioner of human services, in consultation with representatives of 
195.13 	emergency medical service providers, public health nurses, community health workers, 
195.14 	the Minnesota State Fire Chiefs Association, the Minnesota Professional Firefighters 
195.15 	Association, the Minnesota State Firefighters Department Association, Minnesota 
195.16 	Academy of Family Physicians, Minnesota Licensed Practical Nurses Association, 
195.17 	Minnesota Nurses Association, and local public health agencies, shall determine specified 
195.18 	services and payment rates for these services to be performed by community medical 
195.19 	response emergency medical technicians certified under Minnesota Statutes, section 
195.20 	144E.275, subdivision 7, and covered by medical assistance under Minnesota Statutes, 
195.21 	section 256B.0625. Services may include interventions intended to prevent avoidable 
195.22 	ambulance transportation or hospital emergency department use, care coordination, 
195.23 	diagnosis-related patient education, and population-based preventive education.
195.24 	(b) In order to be eligible for payment, services provided by a community medical 
195.25 	response emergency medical technician must be:
195.26 	(1) ordered by a medical response unit medical director;
195.27 	(2) part of a patient care plan that has been developed in coordination with the 
195.28 	patient's primary physician, advanced practice registered nurse, and relevant local health 
195.29 	care providers; and
195.30 	(3) billed by an eligible medical assistance-enrolled provider that employs or 
195.31 	contracts with the community medical response emergency medical technician.
195.32 	In determining the community medical response emergency medical technician services 
195.33 	to include under medical assistance coverage, the commissioner of human services shall 
196.1 	consider the potential of hospital admittance and emergency room utilization reductions as 
196.2 	well as increased access to quality care in rural communities.
196.3 	(c) The commissioner of human services shall submit the list of services to be 
196.4 	covered by medical assistance to the chairs and ranking minority members of the 
196.5 	legislative committees with jurisdiction over health and human services policy and finance 
196.6 	by February 15, 2016. These services shall not be covered by medical assistance until 
196.7 	legislation providing coverage for the services is enacted in law.

196.8 	Sec. 22. EVALUATION OF COMMUNITY ADVANCED EMERGENCY 
196.9 	MEDICAL TECHNICIAN SERVICES.
 196.10 	If legislation is enacted to cover community advanced emergency medical technician 
196.11 	services with medical assistance, the commissioner of human services shall evaluate 
196.12 	the effect of medical assistance and MinnesotaCare coverage for those services on the 
196.13 	cost and quality of care under those programs and the coordination of those services 
196.14 	with the health care home services. The commissioner shall present findings to the 
196.15 	chairs and ranking minority members of the legislative committees with jurisdiction over 
196.16 	health and human services policy and finance by December 1, 2017. The commissioner 
196.17 	shall require medical assistance- and MinnesotaCare-enrolled providers that employ or 
196.18 	contract with community medical response emergency medical technicians to provide to 
196.19 	the commissioner, in the form and manner specified by the commissioner, the utilization, 
196.20 	cost, and quality data necessary to conduct this evaluation.

196.21 	ARTICLE 7
196.22 	CHILDREN AND FAMILY SERVICES

196.23 	Section 1. Minnesota Statutes 2014, section 245C.03, is amended by adding a 
196.24 	subdivision to read:
196.25 		Subd. 10.Providers of group residential housing or supplementary services.
 196.26 	The commissioner shall conduct background studies on any individual required under 
196.27 	section 256I.04 to have a background study completed under this chapter.

196.28 	EFFECTIVE DATE. This section is effective July 1, 2016.

196.29 	Sec. 2. Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision 
196.30 	to read:
196.31 		Subd. 11.Providers of group residential housing or supplementary services.
 196.32 	The commissioner shall recover the cost of background studies initiated by providers of 
197.1 	group residential housing or supplementary services under section 256I.04 through a fee 
197.2 	of no more than $20 per study. The fees collected under this subdivision are appropriated 
197.3 	to the commissioner for the purpose of conducting background studies.

197.4 	EFFECTIVE DATE. This section is effective July 1, 2016.

197.5 	Sec. 3. Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision 
197.6 	to read:
197.7 		Subd. 12a.Department of Human Services child fatality and near fatality 
197.8 	review team. The commissioner shall establish a Department of Human Services child 
197.9 	fatality and near fatality review team to review child fatalities and near fatalities due to 
197.10 	child maltreatment and child fatalities and near fatalities that occur in licensed facilities 
197.11 	and are not due to natural causes. The review team shall assess the entire child protection 
197.12 	services process from the point of a mandated reporter reporting the alleged maltreatment 
197.13 	through the ongoing case management process. Department staff shall lead and conduct 
197.14 	on-site local reviews and utilize supervisors from local county and tribal child welfare 
197.15 	agencies as peer reviewers. The review process must focus on critical elements of the case 
197.16 	and on the involvement of the child and family with the county or tribal child welfare 
197.17 	agency. The review team shall identify necessary program improvement planning to 
197.18 	address any practice issues identified and training and technical assistance needs of 
197.19 	the local agency. Summary reports of each review shall be provided to the state child 
197.20 	mortality review panel when completed.

197.21 	Sec. 4. Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision 
197.22 	to read:
197.23 		Subd. 14c.Early intervention support and services for at-risk American Indian 
197.24 	families. (a) The commissioner shall authorize grants to tribal child welfare agencies and 
197.25 	urban Indian organizations for the purpose of providing early intervention support and 
197.26 	services to prevent child maltreatment for at-risk American Indian families.
197.27 	(b) The commissioner is authorized to develop program eligibility criteria, early 
197.28 	intervention service delivery procedures, and reporting requirements for agencies and 
197.29 	organizations receiving grants.

197.30 	Sec. 5. Minnesota Statutes 2014, section 256.017, subdivision 1, is amended to read:
197.31 		Subdivision 1.Authority and purpose. The commissioner shall administer a 
197.32 	compliance system for the Minnesota family investment program, the food stamp or food 
197.33 	support program, emergency assistance, general assistance, medical assistance, emergency 
198.1 	general assistance, Minnesota supplemental assistance, group residential housing, 
198.2 	preadmission screening, alternative care grants, the child care assistance program, and 
198.3 	all other programs administered by the commissioner or on behalf of the commissioner 
198.4 	under the powers and authorities named in section 256.01, subdivision 2. The purpose of 
198.5 	the compliance system is to permit the commissioner to supervise the administration of 
198.6 	public assistance programs and to enforce timely and accurate distribution of benefits, 
198.7 	completeness of service and efficient and effective program management and operations, 
198.8 	to increase uniformity and consistency in the administration and delivery of public 
198.9 	assistance programs throughout the state, and to reduce the possibility of sanctions and 
198.10 	fiscal disallowances for noncompliance with federal regulations and state statutes. The 
198.11 	commissioner, or the commissioner's representative, may issue administrative subpoenas 
198.12 	as needed in administering the compliance system.
198.13 	The commissioner shall utilize training, technical assistance, and monitoring 
198.14 	activities, as specified in section 256.01, subdivision 2, to encourage county agency 
198.15 	compliance with written policies and procedures.

198.16 	Sec. 6. Minnesota Statutes 2014, section 256.741, subdivision 1, is amended to read:
198.17 		Subdivision 1.Definitions. (a) The term "direct support" as used in this chapter and 
198.18 	chapters 257, 518, 518A, and 518C refers to an assigned support payment from an obligor 
198.19 	which is paid directly to a recipient of public assistance.
198.20 	(b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A, 
198.21 	and 518C, includes any form of assistance provided under the AFDC program formerly 
198.22 	codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter 
198.23 	256, MFIP under chapter 256J, work first program formerly codified under chapter 256K; 
198.24 	child care assistance provided through the child care fund under chapter 119B; any form 
198.25 	of medical assistance under chapter 256B; MinnesotaCare under chapter 256L; and 
198.26 	foster care as provided under title IV-E of the Social Security Act. MinnesotaCare and 
198.27 	plans supplemented by tax credits are not considered public assistance for purposes of 
198.28 	a child support referral.
198.29 	(c) The term "child support agency" as used in this section refers to the public 
198.30 	authority responsible for child support enforcement.
198.31 	(d) The term "public assistance agency" as used in this section refers to a public 
198.32 	authority providing public assistance to an individual.
198.33 	(e) The terms "child support" and "arrears" as used in this section have the meanings 
198.34 	provided in section 518A.26.
199.1 	(f) The term "maintenance" as used in this section has the meaning provided in 
199.2 	section 518.003.

199.3 	Sec. 7. Minnesota Statutes 2014, section 256.741, subdivision 2, is amended to read:
199.4 		Subd. 2.Assignment of support and maintenance rights. (a) An individual 
199.5 	receiving public assistance in the form of assistance under any of the following programs: 
199.6 	the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter 
199.7 	256J, MFIP-R and MFIP formerly codified under chapter 256, or work first program 
199.8 	formerly codified under chapter 256K is considered to have assigned to the state at the 
199.9 	time of application all rights to child support and maintenance from any other person the 
199.10 	applicant or recipient may have in the individual's own behalf or in the behalf of any other 
199.11 	family member for whom application for public assistance is made. An assistance unit is 
199.12 	ineligible for the Minnesota family investment program unless the caregiver assigns all 
199.13 	rights to child support and maintenance benefits according to this section.
199.14 	(1) The assignment is effective as to any current child support and current 
199.15 	maintenance.
199.16 	(2) Any child support or maintenance arrears that accrue while an individual is 
199.17 	receiving public assistance in the form of assistance under any of the programs listed in 
199.18 	this paragraph are permanently assigned to the state.
199.19 	(3) The assignment of current child support and current maintenance ends on the 
199.20 	date the individual ceases to receive or is no longer eligible to receive public assistance 
199.21 	under any of the programs listed in this paragraph.
199.22 	(b) An individual receiving public assistance in the form of medical assistance, 
199.23 	including MinnesotaCare, is considered to have assigned to the state at the time of 
199.24 	application all rights to medical support from any other person the individual may have 
199.25 	in the individual's own behalf or in the behalf of any other family member for whom 
199.26 	medical assistance is provided.
199.27 	(1) An assignment made after September 30, 1997, is effective as to any medical 
199.28 	support accruing after the date of medical assistance or MinnesotaCare eligibility.
199.29 	(2) Any medical support arrears that accrue while an individual is receiving public 
199.30 	assistance in the form of medical assistance, including MinnesotaCare, are permanently 
199.31 	assigned to the state.
199.32 	(3) The assignment of current medical support ends on the date the individual ceases 
199.33 	to receive or is no longer eligible to receive public assistance in the form of medical 
199.34 	assistance or MinnesotaCare.
200.1 	(c) An individual receiving public assistance in the form of child care assistance 
200.2 	under the child care fund pursuant to chapter 119B is considered to have assigned to the 
200.3 	state at the time of application all rights to child care support from any other person the 
200.4 	individual may have in the individual's own behalf or in the behalf of any other family 
200.5 	member for whom child care assistance is provided.
200.6 	(1) The assignment is effective as to any current child care support.
200.7 	(2) Any child care support arrears that accrue while an individual is receiving public 
200.8 	assistance in the form of child care assistance under the child care fund in chapter 119B 
200.9 	are permanently assigned to the state.
200.10 	(3) The assignment of current child care support ends on the date the individual 
200.11 	ceases to receive or is no longer eligible to receive public assistance in the form of child 
200.12 	care assistance under the child care fund under chapter 119B.

200.13 	Sec. 8. [256E.28] CHILD PROTECTION GRANTS TO ADDRESS CHILD 
200.14 	WELFARE DISPARITIES.
200.15 		Subdivision 1.Child welfare disparities grant program established.  The 
200.16 	commissioner may award grants to eligible entities for the development, implementation, 
200.17 	and evaluation of activities to address racial disparities and disproportionality in the child 
200.18 	welfare system by: 
200.19 	(1) identifying and addressing structural factors that contribute to inequities in 
200.20 	outcomes;
200.21 	(2) identifying and implementing strategies to reduce racial disparities in treatment 
200.22 	and outcomes;
200.23 	(3) using cultural values, beliefs, and practices of families, communities, and tribes 
200.24 	for case planning, service design, and decision-making processes;
200.25 	(4) using placement and reunification strategies to maintain and support relationships 
200.26 	and connections between parents, siblings, children, kin, significant others, and tribes; and
200.27 	(5) supporting families in the context of their communities and tribes to safely divert 
200.28 	them from the child welfare system, whenever possible.
200.29 		Subd. 2.State-community partnerships; plan. The commissioner, in partnership 
200.30 	with the culturally based community organizations; the Indian Affairs Council under 
200.31 	section 3.922; the Council on Affairs of Chicano/Latino People under section 3.9223; 
200.32 	the Council on Black Minnesotans under section 3.9225; the Council on Asian-Pacific 
200.33 	Minnesotans under section 3.9226; the American Indian Child Welfare Advisory Council 
200.34 	under section 260.835; counties; and tribal governments, shall develop and implement a 
200.35 	comprehensive, coordinated plan to award funds under this section for the priority areas 
201.1 	identified in subdivision 1. In developing and implementing this plan, the commissioner 
201.2 	shall consult with the legislative task force on child protection.
201.3 		Subd. 3.Measurable outcomes. The commissioner, in consultation with the 
201.4 	community partners listed in subdivision 2 and the legislative task force on child protection, 
201.5 	shall establish measurable outcomes to achieve the goals specified in subdivision 1 and to 
201.6 	determine the effectiveness of the grants and other activities funded under this section in 
201.7 	reducing disparities identified in subdivision 1. The development of measurable outcomes 
201.8 	must be completed before any funds are distributed under this section.
201.9 		Subd. 4.Process. (a) The commissioner, in consultation with the community 
201.10 	partners listed in subdivision 2 and the legislative task force on child protection, shall 
201.11 	develop the criteria and procedures to allocate competitive grants under this section. In 
201.12 	developing the criteria, the commissioner shall establish an administrative cost limit for 
201.13 	grant recipients. A county awarded a grant shall not spend more than three percent of the 
201.14 	grant on administrative costs. When a grant is awarded, the commissioner must provide a 
201.15 	grant recipient with information on the outcomes established according to subdivision 3.
201.16 	(b) A grant recipient must coordinate its activities with other entities receiving funds 
201.17 	under this section that are in the grant recipient's service area.
201.18 	(c) Grant funds must not be used to supplant any state or federal funds received 
201.19 	for child welfare services.
201.20 		Subd. 5.Grant program criteria. (a) The commissioner, in consultation with 
201.21 	the legislative task force on child protection, shall award competitive grants to eligible 
201.22 	applicants for local or regional projects and initiatives directed at reducing disparities in 
201.23 	the child welfare system.
201.24 	(b) The commissioner may award up to 20 percent of the funds available as planning 
201.25 	grants. Planning grants must be used to address such areas as community assessment, 
201.26 	coordination activities, and development of community supported strategies. 
201.27 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
201.28 	social service organizations, community nonprofit organizations, counties, and tribal 
201.29 	governments. Applicants must submit proposals to the commissioner. A proposal must 
201.30 	specify the strategies to be implemented to address one or more of the priority areas in 
201.31 	subdivision 1 and must be targeted to achieve the outcomes established according to 
201.32 	subdivision 3.
201.33 	(d) The commissioner shall give priority to applicants who demonstrate that their 
201.34 	proposed project or initiative:
201.35 	(1) is supported by the community the applicant will serve;
201.36 	(2) is evidence-based;
202.1 	(3) is designed to complement other related community activities;
202.2 	(4) utilizes strategies that positively impact priority areas;
202.3 	(5) reflects culturally appropriate approaches; or
202.4 	(6) will be implemented through or with community-based organizations that reflect 
202.5 	the culture of the population to be reached.
202.6 		Subd. 6.Evaluation. (a) Using the outcomes established according to subdivision 
202.7 	3, the commissioner shall conduct a biennial evaluation of the grant program funded under 
202.8 	this section. Grant recipients shall cooperate with the commissioner in the evaluation and 
202.9 	shall provide the commissioner with the information needed to conduct the evaluation.
202.10 	(b) The commissioner shall consult with the legislative task force on child protection 
202.11 	during the evaluation process and shall submit a biennial evaluation report to the task 
202.12 	force and to the chairs and ranking minority members of the house of representatives and 
202.13 	senate committees with jurisdiction over child protection funding. 
202.14 		Subd. 7.American Indian child welfare projects. Of the amount appropriated for 
202.15 	purposes of this section, the commissioner shall award $75,000 to each tribe authorized to 
202.16 	provide tribal delivery of child welfare services under section 256.01, subdivision 14b. To 
202.17 	receive funds under this subdivision, a participating tribe is not required to apply to the 
202.18 	commissioner for grant funds. Participating tribes are also eligible for competitive grant 
202.19 	funds under this section.

202.20 	Sec. 9. Minnesota Statutes 2014, section 256E.35, subdivision 2, is amended to read:
202.21 		Subd. 2.Definitions. (a) The definitions in this subdivision apply to this section.
202.22 	(b) "Eligible educational institution" means the following:
202.23 	(1) an institution of higher education described in section 101 or 102 of the Higher 
202.24 	Education Act of 1965; or
202.25 	(2) an area vocational education school, as defined in subparagraph (C) or (D) of 
202.26 	United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational 
202.27 	and Applied Technology Education Act), which is located within any state, as defined in 
202.28 	United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only 
202.29 	to the extent section 2302 is in effect on August 1, 2008.
202.30 	(b) (c) "Family asset account" means a savings account opened by a household 
202.31 	participating in the Minnesota family assets for independence initiative.
202.32 	(c) (d) "Fiduciary organization" means:
202.33 	(1) a community action agency that has obtained recognition under section 256E.31;
202.34 	(2) a federal community development credit union serving the seven-county 
202.35 	metropolitan area; or
203.1 	(3) a women-oriented economic development agency serving the seven-county 
203.2 	metropolitan area.
203.3 	(e) "Financial coach" means a person who:
203.4 	(1) has completed an intensive financial literacy training workshop that includes 
203.5 	curriculum on budgeting to increase savings, debt reduction and asset building, building a 
203.6 	good credit rating, and consumer protection;
203.7 	(2) participates in ongoing statewide family assets for independence in Minnesota 
203.8 	(FAIM) network training meetings under FAIM program supervision; and
203.9 	(3) provides financial coaching to program participants under subdivision 4a.
203.10 	(d) (f) "Financial institution" means a bank, bank and trust, savings bank, savings 
203.11 	association, or credit union, the deposits of which are insured by the Federal Deposit 
203.12 	Insurance Corporation or the National Credit Union Administration.
203.13 	(g) "Household" means all individuals who share use of a dwelling unit as primary 
203.14 	quarters for living and eating separate from other individuals.
203.15 	(e) (h) "Permissible use" means:
203.16 	(1) postsecondary educational expenses at an eligible educational institution as 
203.17 	defined in paragraph (g) (b), including books, supplies, and equipment required for 
203.18 	courses of instruction;
203.19 	(2) acquisition costs of acquiring, constructing, or reconstructing a residence, 
203.20 	including any usual or reasonable settlement, financing, or other closing costs;
203.21 	(3) business capitalization expenses for expenditures on capital, plant, equipment, 
203.22 	working capital, and inventory expenses of a legitimate business pursuant to a business 
203.23 	plan approved by the fiduciary organization; and
203.24 	(4) acquisition costs of a principal residence within the meaning of section 1034 of 
203.25 	the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area 
203.26 	purchase price applicable to the residence determined according to section 143(e)(2) and 
203.27 	(3) of the Internal Revenue Code of 1986.
203.28 	(f) "Household" means all individuals who share use of a dwelling unit as primary 
203.29 	quarters for living and eating separate from other individuals.
203.30 	(g) "Eligible educational institution" means the following:
203.31 	(1) an institution of higher education described in section 101 or 102 of the Higher 
203.32 	Education Act of 1965; or
203.33 	(2) an area vocational education school, as defined in subparagraph (C) or (D) of 
203.34 	United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational 
203.35 	and Applied Technology Education Act), which is located within any state, as defined in 
204.1 	United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only 
204.2 	to the extent section 2302 is in effect on August 1, 2008.

204.3 	Sec. 10. Minnesota Statutes 2014, section 256E.35, is amended by adding a subdivision 
204.4 	to read:
204.5 		Subd. 4a.Financial coaching. Within available appropriations, a financial coach 
204.6 	shall provide the following to program participants:
204.7 	(1) financial education relating to budgeting, debt reduction, asset-specific training, 
204.8 	and financial stability activities;
204.9 	(2) asset-specific training related to buying a home, acquiring postsecondary 
204.10 	education, or starting or expanding a small business; and
204.11 	(3) financial stability education and training to improve and sustain financial security.

204.12 	Sec. 11. Minnesota Statutes 2014, section 256I.03, subdivision 3, is amended to read:
204.13 		Subd. 3.Group residential housing. "Group residential housing" means a group 
204.14 	living situation that provides at a minimum room and board to unrelated persons who 
204.15 	meet the eligibility requirements of section 256I.04. This definition includes foster care 
204.16 	settings or community residential settings for a single adult. To receive payment for a 
204.17 	group residence rate, the residence must meet the requirements under section 256I.04, 
204.18 	subdivision subdivisions 2a to 2f.

204.19 	Sec. 12. Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
204.20 		Subd. 7.Countable income. "Countable income" means all income received by 
204.21 	an applicant or recipient less any applicable exclusions or disregards. For a recipient of 
204.22 	any cash benefit from the SSI program, countable income means the SSI benefit limit in 
204.23 	effect at the time the person is in a GRH a recipient of group residential housing, less the 
204.24 	medical assistance personal needs allowance under section 256B.35. If the SSI limit 
204.25 	has been or benefit is reduced for a person due to events occurring prior to the persons 
204.26 	entering the GRH setting other than receipt of additional income, countable income means 
204.27 	actual income less any applicable exclusions and disregards.

204.28 	Sec. 13. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
204.29 	to read:
204.30 		Subd. 9.Direct contact. "Direct contact" means providing face-to-face care, 
204.31 	training, supervision, counseling, consultation, or medication assistance to recipients of 
204.32 	group residential housing.

205.1 	Sec. 14. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
205.2 	to read:
205.3 		Subd. 10.Habitability inspection. "Habitability inspection" means an inspection to 
205.4 	determine whether the housing occupied by an individual meets the habitability standards 
205.5 	specified by the commissioner. The standards must be provided to the applicant in writing 
205.6 	and posted on the Department of Human Services Web site.

205.7 	Sec. 15. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
205.8 	to read:
205.9 		Subd. 11.Long-term homelessness. "Long-term homelessness" means lacking a 
205.10 	permanent place to live:
205.11 	(1) continuously for one year or more; or
205.12 	(2) at least four times in the past three years.

205.13 	Sec. 16. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
205.14 	to read:
205.15 		Subd. 12.Professional certification. "Professional certification" means a statement 
205.16 	about an individual's illness, injury, or incapacity that is signed by a qualified professional. 
205.17 	The statement must specify that the individual has an illness or incapacity which limits the 
205.18 	individual's ability to work and provide self-support. The statement must also specify that 
205.19 	the individual needs assistance to access or maintain housing, as evidenced by the need 
205.20 	for two or more of the following services:
205.21 	(1) tenancy supports to assist an individual with finding the individual's own 
205.22 	home, landlord negotiation, securing furniture and household supplies, understanding 
205.23 	and maintaining tenant responsibilities, conflict negotiation, and budgeting and financial 
205.24 	education;
205.25 	(2) supportive services to assist with basic living and social skills, household 
205.26 	management, monitoring of overall well-being, and problem solving;
205.27 	(3) employment supports to assist with maintaining or increasing employment, 
205.28 	increasing earnings, understanding and utilizing appropriate benefits and services, 
205.29 	improving physical or mental health, moving toward self-sufficiency, and achieving 
205.30 	personal goals; or
205.31 	(4) health supervision services to assist in the preparation and administration of 
205.32 	medications other than injectables, the provision of therapeutic diets, taking vital signs, or 
205.33 	providing assistance in dressing, grooming, bathing, or with walking devices.

206.1 	Sec. 17. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
206.2 	to read:
206.3 		Subd. 13.Prospective budgeting. "Prospective budgeting" means estimating the 
206.4 	amount of monthly income a person will have in the payment month.

206.5 	Sec. 18. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
206.6 	to read:
206.7 		Subd. 14.Qualified professional. "Qualified professional" means an individual as 
206.8 	defined in section 256J.08, subdivision 73a, or Minnesota Rules, part 9530.6450, subpart 
206.9 	3, 4, or 5; or an individual approved by the director of human services or a designee 
206.10 	of the director.

206.11 	Sec. 19. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
206.12 	to read:
206.13 		Subd. 15.Supportive housing. "Supportive housing" means housing with support 
206.14 	services according to the continuum of care coordinated assessment system established 
206.15 	under Code of Federal Regulations, title 24, section 578.3.

206.16 	Sec. 20. Minnesota Statutes 2014, section 256I.04, is amended to read:
206.17 	256I.04 ELIGIBILITY FOR GROUP RESIDENTIAL HOUSING PAYMENT.
206.18 		Subdivision 1.Individual eligibility requirements. An individual is eligible for 
206.19 	and entitled to a group residential housing payment to be made on the individual's behalf 
206.20 	if the agency has approved the individual's residence in a group residential housing setting 
206.21 	and the individual meets the requirements in paragraph (a) or (b).
206.22 	(a) The individual is aged, blind, or is over 18 years of age and disabled as 
206.23 	determined under the criteria used by the title II program of the Social Security Act, and 
206.24 	meets the resource restrictions and standards of section 256P.02, and the individual's 
206.25 	countable income after deducting the (1) exclusions and disregards of the SSI program, 
206.26 	(2) the medical assistance personal needs allowance under section 256B.35, and (3) an 
206.27 	amount equal to the income actually made available to a community spouse by an elderly 
206.28 	waiver participant under the provisions of sections 256B.0575, paragraph (a), clause 
206.29 	(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's 
206.30 	agreement with the provider of group residential housing in which the individual resides.
206.31 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 
206.32 	1, paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and 
206.33 	the individual's resources are less than the standards specified by section 256P.02, and 
207.1 	the individual's countable income as determined under sections 256D.01 to 256D.21, less 
207.2 	the medical assistance personal needs allowance under section 256B.35 is less than the 
207.3 	monthly rate specified in the agency's agreement with the provider of group residential 
207.4 	housing in which the individual resides.
207.5 		Subd. 1a.County approval. (a) A county agency may not approve a group 
207.6 	residential housing payment for an individual in any setting with a rate in excess of the 
207.7 	MSA equivalent rate for more than 30 days in a calendar year unless the county agency 
207.8 	has developed or approved individual has a plan for the individual which specifies that:
207.9 	(1) the individual has an illness or incapacity which prevents the person from living 
207.10 	independently in the community; and
207.11 	(2) the individual's illness or incapacity requires the services which are available in 
207.12 	the group residence.
207.13 	The plan must be signed or countersigned by any of the following employees of the 
207.14 	county of financial responsibility: the director of human services or a designee of the 
207.15 	director; a social worker; or a case aide professional certification under section 256I.03, 
207.16 	subdivision 12.
207.17 	(b) If a county agency determines that an applicant is ineligible due to not meeting 
207.18 	eligibility requirements under this section, a county agency may accept a signed personal 
207.19 	statement from the applicant in lieu of documentation verifying ineligibility.
207.20 	(c) Effective July 1, 2016, to be eligible for supplementary service payments, 
207.21 	providers must enroll in the provider enrollment system identified by the commissioner.
207.22 		Subd. 1b.Optional state supplements to SSI. Group residential housing payments 
207.23 	made on behalf of persons eligible under subdivision 1, paragraph (a), are optional state 
207.24 	supplements to the SSI program.
207.25 		Subd. 1c.Interim assistance. Group residential housing payments made on behalf 
207.26 	of persons eligible under subdivision 1, paragraph (b), are considered interim assistance 
207.27 	payments to applicants for the federal SSI program.
207.28 		Subd. 2.Date of eligibility. An individual who has met the eligibility requirements 
207.29 	of subdivision 1, shall have a group residential housing payment made on the individual's 
207.30 	behalf from the first day of the month in which a signed application form is received by 
207.31 	a county agency, or the first day of the month in which all eligibility factors have been 
207.32 	met, whichever is later.
207.33 		Subd. 2a.License required; staffing qualifications. A county (a) Except 
207.34 	as provided in paragraph (b), an agency may not enter into an agreement with an 
207.35 	establishment to provide group residential housing unless:
208.1 	(1) the establishment is licensed by the Department of Health as a hotel and 
208.2 	restaurant; a board and lodging establishment; a residential care home; a boarding care 
208.3 	home before March 1, 1985; or a supervised living facility, and the service provider 
208.4 	for residents of the facility is licensed under chapter 245A. However, an establishment 
208.5 	licensed by the Department of Health to provide lodging need not also be licensed to 
208.6 	provide board if meals are being supplied to residents under a contract with a food vendor 
208.7 	who is licensed by the Department of Health;
208.8 	(2) the residence is: (i) licensed by the commissioner of human services under 
208.9 	Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services 
208.10 	agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 
208.11 	to 9555.6265; (iii) a residence licensed by the commissioner under Minnesota Rules, parts 
208.12 	2960.0010 to 2960.0120, with a variance under section 245A.04, subdivision 9; or (iv) 
208.13 	licensed under section 245D.02, subdivision 4a, as a community residential setting by 
208.14 	the commissioner of human services; or
208.15 	(3) the establishment is registered under chapter 144D and provides three meals a 
208.16 	day, or is an establishment voluntarily registered under section 144D.025 as a supportive 
208.17 	housing establishment; or.
208.18 	(4) an establishment voluntarily registered under section 144D.025, other than 
208.19 	a supportive housing establishment under clause (3), is not eligible to provide group 
208.20 	residential housing.
208.21 	(b) The requirements under clauses (1) to (4) paragraph (a) do not apply to 
208.22 	establishments exempt from state licensure because they are:
208.23 	(1) located on Indian reservations and subject to tribal health and safety 
208.24 	requirements.; or
208.25 	(2) a supportive housing establishment that has an approved habitability inspection 
208.26 	and an individual lease agreement and that serves people who have experienced long-term 
208.27 	homelessness and were referred through a coordinated assessment in section 256I.03, 
208.28 	subdivision 15.
208.29 	(c) Supportive housing establishments and emergency shelters must participate in 
208.30 	the homeless management information system.
208.31 	(d) Effective July 1, 2016, an agency shall not have an agreement with a provider 
208.32 	of group residential housing or supplementary services unless all staff members who 
208.33 	have direct contact with recipients:
208.34 	(1) have skills and knowledge acquired through one or more of the following:
208.35 	(i) a course of study in a health- or human services-related field leading to a bachelor 
208.36 	of arts, bachelor of science, or associate's degree;
209.1 	(ii) one year of experience with the target population served;
209.2 	(iii) experience as a certified peer specialist according to section 256B.0615; or
209.3 	(iv) meeting the requirements for unlicensed personnel under sections 144A.43 
209.4 	to 144A.483;
209.5 	(2) hold a current Minnesota driver's license appropriate to the vehicle driven 
209.6 	if transporting recipients;
209.7 	(3) complete training on vulnerable adults mandated reporting and child 
209.8 	maltreatment mandated reporting, where applicable; and
209.9 	(4) complete group residential housing orientation training offered by the 
209.10 	commissioner.
209.11 		Subd. 2b.Group residential housing agreements. (a) Agreements between 
209.12 	county agencies and providers of group residential housing must be in writing on a 
209.13 	form developed and approved by the commissioner and must specify the name and 
209.14 	address under which the establishment subject to the agreement does business and under 
209.15 	which the establishment, or service provider, if different from the group residential 
209.16 	housing establishment, is licensed by the Department of Health or the Department of 
209.17 	Human Services; the specific license or registration from the Department of Health or the 
209.18 	Department of Human Services held by the provider and the number of beds subject to 
209.19 	that license; the address of the location or locations at which group residential housing is 
209.20 	provided under this agreement; the per diem and monthly rates that are to be paid from 
209.21 	group residential housing funds for each eligible resident at each location; the number 
209.22 	of beds at each location which are subject to the group residential housing agreement; 
209.23 	whether the license holder is a not-for-profit corporation under section 501(c)(3) of the 
209.24 	Internal Revenue Code; and a statement that the agreement is subject to the provisions of 
209.25 	sections 256I.01 to 256I.06 and subject to any changes to those sections.
209.26 	(b) Providers are required to verify the following minimum requirements in the 
209.27 	agreement:
209.28 	(1) current license or registration, including authorization if managing or monitoring 
209.29 	medications;
209.30 	(2) all staff who have direct contact with recipients meet the staff qualifications;
209.31 	(3) the provision of group residential housing;
209.32 	(4) the provision of supplementary services, if applicable;
209.33 	(5) reports of adverse events, including recipient death or serious injury; and
209.34 	(6) submission of residency requirements that could result in recipient eviction. 
210.1 	Group residential housing (c) Agreements may be terminated with or without cause by 
210.2 	either the county commissioner, the agency, or the provider with two calendar months prior 
210.3 	notice. The commissioner may immediately terminate an agreement under subdivision 2d.
210.4 		Subd. 2c.Crisis shelters Background study requirements. Secure crisis shelters 
210.5 	for battered women and their children designated by the Minnesota Department of 
210.6 	Corrections are not group residences under this chapter. (a) Effective July 1, 2016, a 
210.7 	provider of group residential housing or supplementary services must initiate background 
210.8 	studies in accordance with chapter 245C of the following individuals:
210.9 	(1) controlling individuals as defined in section 245A.02;
210.10 	(2) managerial officials as defined in section 245A.02; and
210.11 	(3) all employees and volunteers of the establishment who have direct contact 
210.12 	with recipients, or who have unsupervised access to recipients, their personal property, 
210.13 	or their private data.
210.14 	(b) The provider of group residential housing or supplementary services must  
210.15 	maintain compliance with all requirements established for entities initiating background  
210.16 	studies under chapter 245C.
210.17 	(c)  Effective July 1, 2017, a provider of group residential housing or supplementary 
210.18 	services must demonstrate that all individuals required to have a background study 
210.19 	according to paragraph (a) have a notice stating either that:
210.20 	(1) the individual is not disqualified under section 245C.14; or
210.21 	(2)  the individual is disqualified, but the individual has been issued a set-aside of  
210.22 	the disqualification for that setting under section 245C.22.
210.23 		Subd. 2d.Conditions of payment; commissioner's right to suspend or terminate 
210.24 	agreement. (a) Group residential housing or supplementary services must be provided  
210.25 	to the satisfaction of the commissioner, as determined at the sole discretion of the 
210.26 	commissioner's authorized representative, and in accordance with all applicable federal, 
210.27 	state, and local laws, ordinances, rules, and regulations, including business registration 
210.28 	requirements of the Office of the Secretary of State. A provider shall not receive payment 
210.29 	for services or housing found by the commissioner to be performed or provided in 
210.30 	violation of federal, state, or local law, ordinance, rule, or regulation.
210.31 	(b) The commissioner has the right to suspend or terminate the agreement  
210.32 	immediately when the commissioner determines the health or welfare of the housing or 
210.33 	service recipients is endangered, or when the commissioner has reasonable cause to believe 
210.34 	that the provider has breached a material term of the agreement under subdivision 2b.
210.35 	(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material  
210.36 	breach of the agreement by the provider, the commissioner shall provide the provider 
211.1 	with a written notice of the breach and allow ten days to cure the breach. If the provider 
211.2 	does not cure the breach within the time allowed, the provider shall be in default of the 
211.3 	agreement and the commissioner may terminate the agreement immediately thereafter. If 
211.4 	the provider has breached a material term of the agreement and cure is not possible, the 
211.5 	commissioner may immediately terminate the agreement.
211.6 		Subd. 2e.Providers holding health or human services licenses. (a) Except 
211.7 	for facilities with only a board and lodging license, when group residential housing or 
211.8 	supplementary service staff are also operating under a license issued by the Department of 
211.9 	Health or the Department of Human Services, the minimum staff qualification requirements 
211.10 	for the setting shall be the qualifications listed under the related licensing standards.
211.11 	(b) A background study completed for the licensed service must also satisfy the 
211.12 	background study requirements under this section, if the provider has established the  
211.13 	background study contact person according to chapter 245C and as directed by the 
211.14 	Department of Human Services.
211.15 		Subd. 2f.Required services. In licensed and registered settings under subdivision 
211.16 	2a, providers shall ensure that participants have at a minimum:
211.17 	(1) food preparation and service for three nutritional meals a day on site;
211.18 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or 
211.19 	service;
211.20 	(3) housekeeping, including cleaning and lavatory supplies or service; and
211.21 	(4) maintenance and operation of the building and grounds, including heat, water, 
211.22 	garbage removal, electricity, telephone for the site, cooling, supplies, and parts and tools 
211.23 	to repair and maintain equipment and facilities.
211.24 		Subd. 2g.Crisis shelters. Secure crisis shelters for battered women and their 
211.25 	children designated by the Minnesota Department of Corrections are not group residences 
211.26 	under this chapter.
211.27 		Subd. 3.Moratorium on development of group residential housing beds. (a) 
211.28 	County Agencies shall not enter into agreements for new group residential housing beds 
211.29 	with total rates in excess of the MSA equivalent rate except:
211.30 	(1) for group residential housing establishments licensed under Minnesota Rules, 
211.31 	parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction 
211.32 	targets for persons with developmental disabilities at regional treatment centers;
211.33 	(2) up to 80 beds in a single, specialized facility located in Hennepin County that will 
211.34 	provide housing for chronic inebriates who are repetitive users of detoxification centers 
211.35 	and are refused placement in emergency shelters because of their state of intoxication, 
211.36 	and planning for the specialized facility must have been initiated before July 1, 1991, 
212.1 	in anticipation of receiving a grant from the Housing Finance Agency under section 
212.2 	462A.05, subdivision 20a, paragraph (b);
212.3 	(3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive 
212.4 	housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a 
212.5 	mental illness, a history of substance abuse, or human immunodeficiency virus or acquired 
212.6 	immunodeficiency syndrome. For purposes of this section, "homeless adult" means a 
212.7 	person who is living on the street or in a shelter or discharged from a regional treatment 
212.8 	center, community hospital, or residential treatment program and has no appropriate 
212.9 	housing available and lacks the resources and support necessary to access appropriate 
212.10 	housing. At least 70 percent of the supportive housing units must serve homeless adults 
212.11 	with mental illness, substance abuse problems, or human immunodeficiency virus or 
212.12 	acquired immunodeficiency syndrome who are about to be or, within the previous six 
212.13 	months, has been discharged from a regional treatment center, or a state-contracted 
212.14 	psychiatric bed in a community hospital, or a residential mental health or chemical 
212.15 	dependency treatment program. If a person meets the requirements of subdivision 1, 
212.16 	paragraph (a), and receives a federal or state housing subsidy, the group residential housing 
212.17 	rate for that person is limited to the supplementary rate under section 256I.05, subdivision 
212.18 	1a, and is determined by subtracting the amount of the person's countable income that 
212.19 	exceeds the MSA equivalent rate from the group residential housing supplementary rate. 
212.20 	A resident in a demonstration project site who no longer participates in the demonstration 
212.21 	program shall retain eligibility for a group residential housing payment in an amount 
212.22 	determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service 
212.23 	funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching 
212.24 	funds are available and the services can be provided through a managed care entity. If 
212.25 	federal matching funds are not available, then service funding will continue under section 
212.26 	256I.05, subdivision 1a;
212.27 	(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in 
212.28 	Hennepin County providing services for recovering and chemically dependent men that 
212.29 	has had a group residential housing contract with the county and has been licensed as a 
212.30 	board and lodge facility with special services since 1980;
212.31 	(5) for a group residential housing provider located in the city of St. Cloud, or a county 
212.32 	contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing 
212.33 	through the Minnesota Housing Finance Agency Ending Long-Term Homelessness 
212.34 	Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
213.1 	(6) for a new 65-bed facility in Crow Wing County that will serve chemically 
213.2 	dependent persons, operated by a group residential housing provider that currently 
213.3 	operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
213.4 	(7) for a group residential housing provider that operates two ten-bed facilities, one 
213.5 	located in Hennepin County and one located in Ramsey County, that provide community 
213.6 	support and 24-hour-a-day supervision to serve the mental health needs of individuals 
213.7 	who have chronically lived unsheltered; and
213.8 	(8) for a group residential facility in Hennepin County with a capacity of up to 48 
213.9 	beds that has been licensed since 1978 as a board and lodging facility and that until August 
213.10 	1, 2007, operated as a licensed chemical dependency treatment program.
213.11 	(b) A county An agency may enter into a group residential housing agreement for 
213.12 	beds with rates in excess of the MSA equivalent rate in addition to those currently covered 
213.13 	under a group residential housing agreement if the additional beds are only a replacement 
213.14 	of beds with rates in excess of the MSA equivalent rate which have been made available 
213.15 	due to closure of a setting, a change of licensure or certification which removes the beds 
213.16 	from group residential housing payment, or as a result of the downsizing of a group 
213.17 	residential housing setting. The transfer of available beds from one county agency to 
213.18 	another can only occur by the agreement of both counties agencies.
213.19 		Subd. 4.Rental assistance. For participants in the Minnesota supportive housing 
213.20 	demonstration program under subdivision 3, paragraph (a), clause (5), notwithstanding 
213.21 	the provisions of section 256I.06, subdivision 8, the amount of the group residential 
213.22 	housing payment for room and board must be calculated by subtracting 30 percent of the 
213.23 	recipient's adjusted income as defined by the United States Department of Housing and 
213.24 	Urban Development for the Section 8 program from the fair market rent established for the 
213.25 	recipient's living unit by the federal Department of Housing and Urban Development. This 
213.26 	payment shall be regarded as a state housing subsidy for the purposes of subdivision 3. 
213.27 	Notwithstanding the provisions of section 256I.06, subdivision 6, the recipient's countable 
213.28 	income will only be adjusted when a change of greater than $100 in a month occurs or 
213.29 	upon annual redetermination of eligibility, whichever is sooner. The commissioner is 
213.30 	directed to study the feasibility of developing a rental assistance program to serve persons 
213.31 	traditionally served in group residential housing settings and report to the legislature by 
213.32 	February 15, 1999.

213.33 	EFFECTIVE DATE. Subdivision 1, paragraph (b), is effective September 1, 2015.

213.34 	Sec. 21. Minnesota Statutes 2014, section 256I.05, subdivision 1c, is amended to read:
214.1 		Subd. 1c.Rate increases. A county An agency may not increase the rates 
214.2 	negotiated for group residential housing above those in effect on June 30, 1993, except as 
214.3 	provided in paragraphs (a) to (f).
214.4 	(a) A county An agency may increase the rates for group residential housing settings 
214.5 	to the MSA equivalent rate for those settings whose current rate is below the MSA 
214.6 	equivalent rate.
214.7 	(b) A county An agency may increase the rates for residents in adult foster care 
214.8 	whose difficulty of care has increased. The total group residential housing rate for these 
214.9 	residents must not exceed the maximum rate specified in subdivisions 1 and 1a. County 
214.10 	Agencies must not include nor increase group residential housing difficulty of care rates 
214.11 	for adults in foster care whose difficulty of care is eligible for funding by home and 
214.12 	community-based waiver programs under title XIX of the Social Security Act.
214.13 	(c) The room and board rates will be increased each year when the MSA equivalent 
214.14 	rate is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, 
214.15 	less the amount of the increase in the medical assistance personal needs allowance under 
214.16 	section 256B.35.
214.17 	(d) When a group residential housing rate is used to pay for an individual's room 
214.18 	and board, or other costs necessary to provide room and board, the rate payable to 
214.19 	the residence must continue for up to 18 calendar days per incident that the person is 
214.20 	temporarily absent from the residence, not to exceed 60 days in a calendar year, if the 
214.21 	absence or absences have received the prior approval of the county agency's social service 
214.22 	staff. Prior approval is not required for emergency absences due to crisis, illness, or injury.
214.23 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
214.24 	change criteria exists if the group residential housing establishment experiences a 25 
214.25 	percent increase or decrease in the total number of its beds, if the net cost of capital 
214.26 	additions or improvements is in excess of 15 percent of the current market value of the 
214.27 	residence, or if the residence physically moves, or changes its licensure, and incurs a 
214.28 	resulting increase in operation and property costs.
214.29 	(f) Until June 30, 1994, a county an agency may increase by up to five percent the 
214.30 	total rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33
214.31 	to 256D.54 who reside in residences that are licensed by the commissioner of health as 
214.32 	a boarding care home, but are not certified for the purposes of the medical assistance 
214.33 	program. However, an increase under this clause must not exceed an amount equivalent to 
214.34 	65 percent of the 1991 medical assistance reimbursement rate for nursing home resident 
214.35 	class A, in the geographic grouping in which the facility is located, as established under 
214.36 	Minnesota Rules, parts 9549.0050 to 9549.0058.

215.1 	Sec. 22. Minnesota Statutes 2014, section 256I.05, subdivision 1g, is amended to read:
215.2 		Subd. 1g.Supplementary service rate for certain facilities. On or after July 1, 
215.3 	2005, a county An agency may negotiate a supplementary service rate for recipients of 
215.4 	assistance under section 256I.04, subdivision 1, paragraph (a) or (b), who relocate from a 
215.5 	homeless shelter licensed and registered prior to December 31, 1996, by the Minnesota 
215.6 	Department of Health under section 157.17, to have experienced long-term homelessness 
215.7 	and who live in a supportive housing establishment developed and funded in whole or in 
215.8 	part with funds provided specifically as part of the plan to end long-term homelessness 
215.9 	required under Laws 2003, chapter 128, article 15, section 9, not to exceed $456.75 under 
215.10 	section 256I.04, subdivision 2a, paragraph (b), clause (2).

215.11 	Sec. 23. Minnesota Statutes 2014, section 256I.06, subdivision 2, is amended to read:
215.12 		Subd. 2.Time of payment. A county agency may make payments to a group 
215.13 	residence in advance for an individual whose stay in the group residence is expected 
215.14 	to last beyond the calendar month for which the payment is made and who does not 
215.15 	expect to receive countable earned income during the month for which the payment is 
215.16 	made. Group residential housing payments made by a county agency on behalf of an 
215.17 	individual who is not expected to remain in the group residence beyond the month for 
215.18 	which payment is made must be made subsequent to the individual's departure from the 
215.19 	group residence. Group residential housing payments made by a county agency on behalf 
215.20 	of an individual with countable earned income must be made subsequent to receipt of a 
215.21 	monthly household report form.

215.22 	EFFECTIVE DATE. This section is effective April 1, 2016.

215.23 	Sec. 24. Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
215.24 		Subd. 6.Reports. Recipients must report changes in circumstances that affect 
215.25 	eligibility or group residential housing payment amounts, other than changes in earned 
215.26 	income, within ten days of the change. Recipients with countable earned income must 
215.27 	complete a monthly household report form at least once every six months. If the report 
215.28 	form is not received before the end of the month in which it is due, the county agency 
215.29 	must terminate eligibility for group residential housing payments. The termination shall 
215.30 	be effective on the first day of the month following the month in which the report was due. 
215.31 	If a complete report is received within the month eligibility was terminated, the individual 
215.32 	is considered to have continued an application for group residential housing payment 
215.33 	effective the first day of the month the eligibility was terminated.

216.1 	EFFECTIVE DATE. This section is effective April 1, 2016.

216.2 	Sec. 25. Minnesota Statutes 2014, section 256I.06, subdivision 7, is amended to read:
216.3 		Subd. 7.Determination of rates. The agency in the county in which a group 
216.4 	residence is located will shall determine the amount of group residential housing rate to 
216.5 	be paid on behalf of an individual in the group residence regardless of the individual's 
216.6 	county agency of financial responsibility.

216.7 	Sec. 26. Minnesota Statutes 2014, section 256I.06, subdivision 8, is amended to read:
216.8 		Subd. 8.Amount of group residential housing payment. (a) The amount of 
216.9 	a group residential housing payment to be made on behalf of an eligible individual is 
216.10 	determined by subtracting the individual's countable income under section 256I.04, 
216.11 	subdivision 1, for a whole calendar month from the group residential housing charge for 
216.12 	that same month. The group residential housing charge is determined by multiplying the 
216.13 	group residential housing rate times the period of time the individual was a resident or 
216.14 	temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
216.15 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
216.16 	must be used to determine the amount of the individual's payment for the following 
216.17 	six-month period. An increase in income shall not affect an individual's eligibility or 
216.18 	payment amount until the month following the reporting month. A decrease in income shall 
216.19 	be effective the first day of the month after the month in which the decrease is reported.

216.20 	EFFECTIVE DATE. Paragraph (b) is effective April 1, 2016.

216.21 	Sec. 27. Minnesota Statutes 2014, section 256K.45, subdivision 1a, is amended to read:
216.22 		Subd. 1a.Definitions. (a) The definitions in this subdivision apply to this section.
216.23 	(b) "Commissioner" means the commissioner of human services.
216.24 	(c) "Homeless youth" means a person 21 24 years of age or younger who is 
216.25 	unaccompanied by a parent or guardian and is without shelter where appropriate care and 
216.26 	supervision are available, whose parent or legal guardian is unable or unwilling to provide 
216.27 	shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The 
216.28 	following are not fixed, regular, or adequate nighttime residences:
216.29 	(1) a supervised publicly or privately operated shelter designed to provide temporary 
216.30 	living accommodations;
216.31 	(2) an institution or a publicly or privately operated shelter designed to provide 
216.32 	temporary living accommodations;
216.33 	(3) transitional housing;
217.1 	(4) a temporary placement with a peer, friend, or family member that has not offered 
217.2 	permanent residence, a residential lease, or temporary lodging for more than 30 days; or
217.3 	(5) a public or private place not designed for, nor ordinarily used as, a regular 
217.4 	sleeping accommodation for human beings.
217.5 	Homeless youth does not include persons incarcerated or otherwise detained under 
217.6 	federal or state law.
217.7 	(d) "Youth at risk of homelessness" means a person 2124 years of age or younger 
217.8 	whose status or circumstances indicate a significant danger of experiencing homelessness 
217.9 	in the near future. Status or circumstances that indicate a significant danger may include: 
217.10 	(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3) 
217.11 	youth whose parents or primary caregivers are or were previously homeless; (4) youth 
217.12 	who are exposed to abuse and neglect in their homes; (5) youth who experience conflict 
217.13 	with parents due to chemical or alcohol dependency, mental health disabilities, or other 
217.14 	disabilities; and (6) runaways.
217.15 	(e) "Runaway" means an unmarried child under the age of 18 years who is absent 
217.16 	from the home of a parent or guardian or other lawful placement without the consent of 
217.17 	the parent, guardian, or lawful custodian.

217.18 	Sec. 28. [256M.41] CHILD PROTECTION GRANT ALLOCATION.
217.19 		Subdivision 1.Formula for county staffing funds. The commissioner shall allocate 
217.20 	state funds appropriated under this section to each county board on a calendar year basis 
217.21 	in an amount determined according to the following formula:
217.22 	(1) 25 percent must be distributed on the basis of the number of screened-out 
217.23 	reports of child maltreatment under sections 626.556 and 626.5561, and in the county as 
217.24 	determined by the most recent data of the commissioner;
217.25 	(2) 25 percent must be distributed on the basis of the number of screened-in 
217.26 	reports of child maltreatment under sections 626.556 and 626.5561, and in the county as 
217.27 	determined by the most recent data of the commissioner; and
217.28 	(3) 50 percent must be distributed on the basis of the number of open child 
217.29 	protection case management cases in the county as determined by the most recent data of 
217.30 	the commissioner.
217.31 		Subd. 2.Prohibition on supplanting existing funds. Funds received under this 
217.32 	section must be used to address staffing for child protection or expand child protection 
217.33 	services. Funds must not be used to supplant current county expenditures for these 
217.34 	purposes.
218.1 		Subd. 3.Payments based on performance. (a) The commissioner shall make 
218.2 	payments under this section to each county board on a calendar year basis in an amount 
218.3 	determined under paragraph (b).
218.4 	(b) Calendar year allocations under subdivision 1 shall be paid to counties in the 
218.5 	following manner:
218.6 	(1) 80 percent of the allocation as determined in subdivision 1 must be paid to 
218.7 	counties on or before July 10 of each year;
218.8 	(2) ten percent of the allocation shall be withheld until the commissioner determines 
218.9 	if the county has met the performance outcome threshold of 90 percent based on 
218.10 	face-to-face contact with alleged child victims. In order to receive the performance 
218.11 	allocation, the county child protection workers must have a timely face-to-face contact 
218.12 	with at least 90 percent of all alleged child victims of screened-in maltreatment reports. 
218.13 	The standard requires that each initial face-to-face contact occur consistent with timelines 
218.14 	defined in section 626.556, subdivision 10, paragraph (i). The commissioner shall make 
218.15 	threshold determinations in January of each year and payments to counties meeting the 
218.16 	performance outcome threshold shall occur in February of each year. Any withheld funds 
218.17 	from this appropriation for counties that do not meet this requirement shall be reallocated 
218.18 	by the commissioner to those counties meeting the requirement; and
218.19 	(3) ten percent of the allocation shall be withheld until the commissioner determines 
218.20 	that the county has met the performance outcome threshold of 90 percent based on 
218.21 	face-to-face visits by the case manager. In order to receive the performance allocation, the 
218.22 	total number of visits made by caseworkers on a monthly basis to children in foster care 
218.23 	and children receiving child protection services while residing in their home must be at 
218.24 	least 90 percent of the total number of such visits that would occur if every child were 
218.25 	visited once per month. The commissioner shall make such determinations in January 
218.26 	of each year and payments to counties meeting the performance outcome threshold 
218.27 	shall occur in February of each year. Any withheld funds from this appropriation for 
218.28 	counties that do not meet this requirement shall be reallocated by the commissioner to 
218.29 	those counties meeting the requirement.
218.30 	(c) The commissioner shall work with stakeholders and the Human Services 
218.31 	Performance Council under section 402A.16 to develop recommendations for specific 
218.32 	outcome measures that counties should meet in order to receive funds withheld under 
218.33 	paragraph (b), and include in those recommendations a determination as to whether 
218.34 	the performance measures under paragraph (b) should be modified or phased out. The 
218.35 	commissioner shall report the recommendations to the legislative committees having 
218.36 	jurisdiction over child protection issues by January 1, 2018.

219.1 	Sec. 29. Minnesota Statutes 2014, section 256N.22, subdivision 9, is amended to read:
219.2 		Subd. 9.Death or incapacity of relative custodian or dissolution modification 
219.3 	of custody. The Northstar kinship assistance agreement ends upon death or dissolution 
219.4 	incapacity of the relative custodian or modification  of the order for permanent legal and 
219.5 	physical custody of both relative custodians in the case of assignment of custody to two 
219.6 	individuals, or the sole relative custodian in the case of assignment of custody to one 
219.7 	individual in which legal or physical custody is removed from the relative custodian. 
219.8 	In the case of a relative custodian's death or incapacity, Northstar kinship assistance 
219.9 	eligibility may be continued according to subdivision 10.

219.10 	Sec. 30. Minnesota Statutes 2014, section 256N.22, subdivision 10, is amended to read:
219.11 		Subd. 10.Assigning a successor relative custodian for a child's Northstar 
219.12 	kinship assistance to a court-appointed guardian or custodian. (a) Northstar kinship 
219.13 	assistance may be continued with the written consent of the commissioner to In the event 
219.14 	of the death or incapacity of the relative custodian, eligibility for Northstar kinship 
219.15 	assistance and title IV-E assistance, if applicable, is not affected if the relative custodian 
219.16 	is replaced by a successor named in the Northstar kinship assistance benefit agreement. 
219.17 	Northstar kinship assistance shall be paid to a named successor who is not the child's 
219.18 	legal parent, biological parent, or stepparent, or other adult living in the home of the 
219.19 	legal parent, biological parent, or stepparent. 
219.20 	(b) In order to receive Northstar kinship assistance, a named successor must:
219.21 	(1) meet the background study requirements in subdivision 4;
219.22 	(2) renegotiate the agreement consistent with section 256N.25, subdivision 2, 
219.23 	including cooperating with an assessment under section 256N.24;
219.24 	(3) be ordered by the court to be the child's legal relative custodian in a modification 
219.25 	proceeding under section 260C.521, subdivision 2; and
219.26 	(4) satisfy the requirements in this paragraph within one year of the relative 
219.27 	custodian's death or incapacity unless the commissioner certifies that the named successor 
219.28 	made reasonable attempts to satisfy the requirements within one year and failure to satisfy 
219.29 	the requirements was not the responsibility of the named successor.
219.30 	(c) Payment of Northstar kinship assistance to the successor guardian may be 
219.31 	temporarily approved through the policies, procedures, requirements, and deadlines under 
219.32 	section 256N.28, subdivision 2. Ongoing payment shall begin in the month when all the 
219.33 	requirements in paragraph (b) are satisfied.
219.34 	(d) Continued payment of Northstar kinship assistance may occur in the event of the 
219.35 	death or incapacity of the relative custodian when no successor has been named in the 
220.1 	benefit agreement when the commissioner gives written consent to an individual who is a 
220.2 	guardian or custodian appointed by a court for the child upon the death of both relative 
220.3 	custodians in the case of assignment of custody to two individuals, or the sole relative 
220.4 	custodian in the case of assignment of custody to one individual, unless the child is under 
220.5 	the custody of a county, tribal, or child-placing agency.
220.6 	(b) (e) Temporary assignment of Northstar kinship assistance may be approved 
220.7 	for a maximum of six consecutive months from the death or incapacity of the relative 
220.8 	custodian or custodians as provided in paragraph (a) and must adhere to the policies and, 
220.9 	procedures, requirements, and deadlines under section 256N.28, subdivision 2, that are 
220.10 	prescribed by the commissioner. If a court has not appointed a permanent legal guardian 
220.11 	or custodian within six months, the Northstar kinship assistance must terminate and must 
220.12 	not be resumed.
220.13 	(c) (f) Upon assignment of assistance payments under this subdivision paragraphs 
220.14 	(d) and (e), assistance must be provided from funds other than title IV-E.

220.15 	Sec. 31. Minnesota Statutes 2014, section 256N.24, subdivision 4, is amended to read:
220.16 		Subd. 4.Extraordinary levels. (a) The assessment tool established under 
220.17 	subdivision 2 must provide a mechanism through which up to five levels can be added 
220.18 	to the supplemental difficulty of care for a particular child under section 256N.26, 
220.19 	subdivision 4. In establishing the assessment tool, the commissioner must design the tool 
220.20 	so that the levels applicable to the portions of the assessment other than the extraordinary 
220.21 	levels can accommodate the requirements of this subdivision.
220.22 	(b) These extraordinary levels are available when all of the following circumstances 
220.23 	apply:
220.24 	(1) the child has extraordinary needs as determined by the assessment tool provided 
220.25 	for under subdivision 2, and the child meets other requirements established by the 
220.26 	commissioner, such as a minimum score on the assessment tool;
220.27 	(2) the child's extraordinary needs require extraordinary care and intense supervision 
220.28 	that is provided by the child's caregiver as part of the parental duties as described in the 
220.29 	supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary 
220.30 	care provided by the caregiver is required so that the child can be safely cared for in the 
220.31 	home and community, and prevents residential placement;
220.32 	(3) the child is physically living in a foster family setting, as defined in Minnesota 
220.33 	Rules, part 2960.3010, subpart 23, in a foster residence setting, or physically living in the 
220.34 	home with the adoptive parent or relative custodian; and
221.1 	(4) the child is receiving the services for which the child is eligible through medical 
221.2 	assistance programs or other programs that provide necessary services for children with 
221.3 	disabilities or other medical and behavioral conditions to live with the child's family, but 
221.4 	the agency with caregiver's input has identified a specific support gap that cannot be met 
221.5 	through home and community support waivers or other programs that are designed to 
221.6 	provide support for children with special needs.
221.7 	(c) The agency completing an assessment, under subdivision 2, that suggests an 
221.8 	extraordinary level must document as part of the assessment, the following:
221.9 	(1) the assessment tool that determined that the child's needs or disabilities require 
221.10 	extraordinary care and intense supervision;
221.11 	(2) a summary of the extraordinary care and intense supervision that is provided by 
221.12 	the caregiver as part of the parental duties as described in the supplemental difficulty of 
221.13 	care rate, section 256N.02, subdivision 21;
221.14 	(3) confirmation that the child is currently physically residing in the foster family 
221.15 	setting or in the home with the adoptive parent or relative custodian;
221.16 	(4) the efforts of the agency, caregiver, parents, and others to request support services 
221.17 	in the home and community that would ease the degree of parental duties provided by the 
221.18 	caregiver for the care and supervision of the child. This would include documentation of 
221.19 	the services provided for the child's needs or disabilities, and the services that were denied 
221.20 	or not available from the local social service agency, community agency, the local school 
221.21 	district, local public health department, the parent, or child's medical insurance provider;
221.22 	(5) the specific support gap identified that places the child's safety and well-being at 
221.23 	risk in the home or community and is necessary to prevent residential placement; and
221.24 	(6) the extraordinary care and intense supervision provided by the foster, adoptive, 
221.25 	or guardianship caregivers to maintain the child safely in the child's home and prevent 
221.26 	residential placement that cannot be supported by medical assistance or other programs 
221.27 	that provide services, necessary care for children with disabilities, or other medical or 
221.28 	behavioral conditions in the home or community.
221.29 	(d) An agency completing an assessment under subdivision 2 that suggests 
221.30 	an extraordinary level is appropriate must forward the assessment and required 
221.31 	documentation to the commissioner. If the commissioner approves, the extraordinary 
221.32 	levels must be retroactive to the date the assessment was forwarded.

221.33 	Sec. 32. Minnesota Statutes 2014, section 256N.25, subdivision 1, is amended to read:
221.34 		Subdivision 1.Agreement; Northstar kinship assistance; adoption assistance. (a) 
221.35 	In order to receive Northstar kinship assistance or adoption assistance benefits on behalf 
222.1 	of an eligible child, a written, binding agreement between the caregiver or caregivers, 
222.2 	the financially responsible agency, or, if there is no financially responsible agency, the 
222.3 	agency designated by the commissioner, and the commissioner must be established prior 
222.4 	to finalization of the adoption or a transfer of permanent legal and physical custody. The 
222.5 	agreement must be negotiated with the caregiver or caregivers under subdivision 2 and 
222.6 	renegotiated under subdivision 3, if applicable.
222.7 	(b) The agreement must be on a form approved by the commissioner and must 
222.8 	specify the following:
222.9 	(1) duration of the agreement;
222.10 	(2) the nature and amount of any payment, services, and assistance to be provided 
222.11 	under such agreement;
222.12 	(3) the child's eligibility for Medicaid services;
222.13 	(4) the terms of the payment, including any child care portion as specified in section 
222.14 	256N.24, subdivision 3;
222.15 	(5) eligibility for reimbursement of nonrecurring expenses associated with adopting 
222.16 	or obtaining permanent legal and physical custody of the child, to the extent that the 
222.17 	total cost does not exceed $2,000 per child;
222.18 	(6) that the agreement must remain in effect regardless of the state of which the 
222.19 	adoptive parents or relative custodians are residents at any given time;
222.20 	(7) provisions for modification of the terms of the agreement, including renegotiation 
222.21 	of the agreement; and
222.22 	(8) the effective date of the agreement; and
222.23 	(9) the successor relative custodian or custodians for Northstar kinship assistance, 
222.24 	when applicable. The successor relative custodian or custodians may be added or changed 
222.25 	by mutual agreement under subdivision 3.
222.26 	(c) The caregivers, the commissioner, and the financially responsible agency, or, if 
222.27 	there is no financially responsible agency, the agency designated by the commissioner, must 
222.28 	sign the agreement. A copy of the signed agreement must be given to each party. Once 
222.29 	signed by all parties, the commissioner shall maintain the official record of the agreement.
222.30 	(d) The effective date of the Northstar kinship assistance agreement must be the date 
222.31 	of the court order that transfers permanent legal and physical custody to the relative. The 
222.32 	effective date of the adoption assistance agreement is the date of the finalized adoption 
222.33 	decree.
222.34 	(e) Termination or disruption of the preadoptive placement or the foster care 
222.35 	placement prior to assignment of custody makes the agreement with that caregiver void.

223.1 	Sec. 33. Minnesota Statutes 2014, section 256N.27, subdivision 2, is amended to read:
223.2 		Subd. 2.State share. The commissioner shall pay the state share of the maintenance 
223.3 	payments as determined under subdivision 4, and an identical share of the pre-Northstar 
223.4 	Care foster care program under section 260C.4411, subdivision 1, the relative custody 
223.5 	assistance program under section 257.85, and the pre-Northstar Care for Children adoption 
223.6 	assistance program under chapter 259A. The commissioner may transfer funds into the 
223.7 	account if a deficit occurs.

223.8 	Sec. 34. Minnesota Statutes 2014, section 257.75, subdivision 3, is amended to read:
223.9 		Subd. 3.Effect of recognition. (a) Subject to subdivision 2 and section 257.55, 
223.10 	subdivision 1, paragraph (g) or (h), the recognition has the force and effect of a judgment or 
223.11 	order determining the existence of the parent and child relationship under section 257.66. If 
223.12 	the conditions in section 257.55, subdivision 1, paragraph (g) or (h), exist, the recognition 
223.13 	creates only a presumption of paternity for purposes of sections 257.51 to 257.74. Once a 
223.14 	recognition has been properly executed and filed with the state registrar of vital statistics, 
223.15 	if there are no competing presumptions of paternity, a judicial or administrative court may 
223.16 	not allow further action to determine parentage regarding the signator of the recognition. 
223.17 	An action to determine custody and parenting time may be commenced pursuant to 
223.18 	chapter 518 without an adjudication of parentage. Until an a temporary or permanent 
223.19 	order is entered granting custody to another, the mother has sole custody. 
223.20 	(b) Following commencement of an action to determine custody or parenting time 
223.21 	under chapter 518, the court may, pursuant to section 518.131, grant temporary parenting 
223.22 	time rights and temporary custody to either parent. 
223.23 	(c) The recognition is:
223.24 	(1) a basis for bringing an action for the following:
223.25 	(i) to award temporary custody or parenting time pursuant to section 518.131;
223.26 	(ii) to award permanent custody or parenting time to either parent,;
223.27 	(iii) establishing a child support obligation which may include up to the two years 
223.28 	immediately preceding the commencement of the action,;
223.29 	(iv) ordering a contribution by a parent under section 256.87, or;
223.30 	(v) ordering a contribution to the reasonable expenses of the mother's pregnancy and 
223.31 	confinement, as provided under section 257.66, subdivision 3,; or 
223.32 	(vi) ordering reimbursement for the costs of blood or genetic testing, as provided 
223.33 	under section 257.69, subdivision 2;
223.34 	(2) determinative for all other purposes related to the existence of the parent and 
223.35 	child relationship; and
224.1 	(3) entitled to full faith and credit in other jurisdictions.

224.2 	Sec. 35. Minnesota Statutes 2014, section 257.75, subdivision 5, is amended to read:
224.3 		Subd. 5.Recognition form. (a) The commissioner of human services shall prepare 
224.4 	a form for the recognition of parentage under this section. In preparing the form, the 
224.5 	commissioner shall consult with the individuals specified in subdivision 6. The recognition 
224.6 	form must be drafted so that the force and effect of the recognition, the alternatives to 
224.7 	executing a recognition, and the benefits and responsibilities of establishing paternity, and 
224.8 	the limitations of the recognition of parentage for purposes of exercising and enforcing 
224.9 	custody or parenting time are clear and understandable. The form must include a notice 
224.10 	regarding the finality of a recognition and the revocation procedure under subdivision 
224.11 	2. The form must include a provision for each parent to verify that the parent has read 
224.12 	or viewed the educational materials prepared by the commissioner of human services 
224.13 	describing the recognition of paternity. The individual providing the form to the parents 
224.14 	for execution shall provide oral notice of the rights, responsibilities, and alternatives to 
224.15 	executing the recognition. Notice may be provided by audiotape, videotape, or similar 
224.16 	means. Each parent must receive a copy of the recognition.
224.17 	(b) The form must include the following:
224.18 	(1) a notice regarding the finality of a recognition and the revocation procedure 
224.19 	under subdivision 2;
224.20 	(2) a notice, in large print, that the recognition does not establish an enforceable right 
224.21 	to legal custody, physical custody, or parenting time until such rights are awarded pursuant 
224.22 	to a court action to establish custody and parenting time;
224.23 	(3) a notice stating that when a court awards custody and parenting time under 
224.24 	chapter 518, there is no presumption for or against joint physical custody, except when 
224.25 	domestic abuse, as defined in section 518B.01, subdivision 2, paragraph (a), has occurred 
224.26 	between the parties;
224.27 	(4) a notice that the recognition of parentage is a basis for:
224.28 	(i) bringing a court action to award temporary or permanent custody or parenting time;
224.29 	(ii) establishing a child support obligation that may include the two years 
224.30 	immediately preceding the commencement of the action; 
224.31 	(iii) ordering a contribution by a parent under section 256.87;
224.32 	(iv) ordering a contribution to the reasonable expenses of the mother's pregnancy 
224.33 	and confinement, as provided under section 257.66, subdivision 3; and
224.34 	(v) ordering reimbursement for the costs of blood or genetic testing, as provided 
224.35 	under section 257.69, subdivision 2; and
225.1 	(5) a provision for each parent to verify that the parent has read or viewed the 
225.2 	educational materials prepared by the commissioner of human services describing the 
225.3 	recognition of paternity. 
225.4 	(c) The individual providing the form to the parents for execution shall provide oral 
225.5 	notice of the rights, responsibilities, and alternatives to executing the recognition. Notice 
225.6 	may be provided in audio or video format, or by other similar means. Each parent must 
225.7 	receive a copy of the recognition.

225.8 	Sec. 36. Minnesota Statutes 2014, section 259A.75, is amended to read:
225.9 	259A.75 REIMBURSEMENT OF CERTAIN AGENCY COSTS; PURCHASE 
225.10 	OF SERVICE CONTRACTS AND TRIBAL CUSTOMARY ADOPTIONS.
225.11 		Subdivision 1.General information. (a) Subject to the procedures required by 
225.12 	the commissioner and the provisions of this section, a Minnesota county or tribal social 
225.13 	services agency shall receive a reimbursement from the commissioner equal to 100 percent 
225.14 	of the reasonable and appropriate cost for contracted adoption placement services identified 
225.15 	for a specific child that are not reimbursed under other federal or state funding sources.
225.16 	(b) The commissioner may spend up to $16,000 for each purchase of service 
225.17 	contract. Only one contract per child per adoptive placement is permitted. Funds 
225.18 	encumbered and obligated under the contract for the child remain available until the terms 
225.19 	of the contract are fulfilled or the contract is terminated.
225.20 	(c) The commissioner shall set aside an amount not to exceed five percent of the 
225.21 	total amount of the fiscal year appropriation from the state for the adoption assistance 
225.22 	program to reimburse a Minnesota county or tribal social services placing agencies agency 
225.23 	for child-specific adoption placement services. When adoption assistance payments for 
225.24 	children's needs exceed 95 percent of the total amount of the fiscal year appropriation from 
225.25 	the state for the adoption assistance program, the amount of reimbursement available to 
225.26 	placing agencies for adoption services is reduced correspondingly.
225.27 		Subd. 2.Purchase of service contract child eligibility criteria. (a) A child who is 
225.28 	the subject of a purchase of service contract must:
225.29 	(1) have the goal of adoption, which may include an adoption in accordance with 
225.30 	tribal law;
225.31 	(2) be under the guardianship of the commissioner of human services or be a ward of 
225.32 	tribal court pursuant to section 260.755, subdivision 20; and
225.33 	(3) meet all of the special needs criteria according to section 259A.10, subdivision 2.
226.1 	(b) A child under the guardianship of the commissioner must have an identified 
226.2 	adoptive parent and a fully executed adoption placement agreement according to section 
226.3 	260C.613, subdivision 1, paragraph (a).
226.4 		Subd. 3.Agency eligibility criteria. (a) A Minnesota county or tribal social 
226.5 	services agency shall receive reimbursement for child-specific adoption placement 
226.6 	services for an eligible child that it purchases from a private adoption agency licensed in 
226.7 	Minnesota or any other state or tribal social services agency.
226.8 	(b) Reimbursement for adoption services is available only for services provided 
226.9 	prior to the date of the adoption decree.
226.10 		Subd. 4.Application and eligibility determination. (a) A county or tribal social 
226.11 	services agency may request reimbursement of costs for adoption placement services by 
226.12 	submitting a complete purchase of service application, according to the requirements and 
226.13 	procedures and on forms prescribed by the commissioner.
226.14 	(b) The commissioner shall determine eligibility for reimbursement of adoption 
226.15 	placement services. If determined eligible, the commissioner of human services shall 
226.16 	sign the purchase of service agreement, making this a fully executed contract. No 
226.17 	reimbursement under this section shall be made to an agency for services provided prior to 
226.18 	the fully executed contract.
226.19 	(c) Separate purchase of service agreements shall be made, and separate records 
226.20 	maintained, on each child. Only one agreement per child per adoptive placement is 
226.21 	permitted. For siblings who are placed together, services shall be planned and provided to 
226.22 	best maximize efficiency of the contracted hours.
226.23 		Subd. 5.Reimbursement process. (a) The agency providing adoption services is 
226.24 	responsible to track and record all service activity, including billable hours, on a form 
226.25 	prescribed by the commissioner. The agency shall submit this form to the state for 
226.26 	reimbursement after services have been completed.
226.27 	(b) The commissioner shall make the final determination whether or not the 
226.28 	requested reimbursement costs are reasonable and appropriate and if the services have 
226.29 	been completed according to the terms of the purchase of service agreement.
226.30 		Subd. 6.Retention of purchase of service records. Agencies entering into 
226.31 	purchase of service contracts shall keep a copy of the agreements, service records, and all 
226.32 	applicable billing and invoicing according to the department's record retention schedule. 
226.33 	Agency records shall be provided upon request by the commissioner.
226.34 		Subd. 7.Tribal customary adoptions. (a) The commissioner shall enter into 
226.35 	grant contracts with Minnesota tribal social services agencies to provide child-specific 
227.1 	recruitment and adoption placement services for Indian children under the jurisdiction 
227.2 	of tribal court.
227.3 	(b) Children served under these grant contracts must meet the child eligibility 
227.4 	criteria in subdivision 2.

227.5 	Sec. 37. Minnesota Statutes 2014, section 260C.007, subdivision 27, is amended to read:
227.6 		Subd. 27.Relative. "Relative" means a person related to the child by blood, 
227.7 	marriage, or adoption,; the legal parent, guardian, or custodian of the child's siblings; or an 
227.8 	individual who is an important friend with whom the child has resided or had significant 
227.9 	contact. For an Indian child, relative includes members of the extended family as defined 
227.10 	by the law or custom of the Indian child's tribe or, in the absence of law or custom, nieces, 
227.11 	nephews, or first or second cousins, as provided in the Indian Child Welfare Act of 1978, 
227.12 	United States Code, title 25, section 1903.

227.13 	Sec. 38. Minnesota Statutes 2014, section 260C.007, subdivision 32, is amended to read:
227.14 		Subd. 32.Sibling. "Sibling" means one of two or more individuals who have one or 
227.15 	both parents in common through blood, marriage, or adoption, including. This includes 
227.16 	siblings as defined by the child's tribal code or custom. Sibling also includes an individual 
227.17 	who would have been considered a sibling but for a termination of parental rights of one 
227.18 	or both parents, suspension of parental rights under tribal code, or other disruption of 
227.19 	parental rights such as the death of a parent.

227.20 	Sec. 39. Minnesota Statutes 2014, section 260C.203, is amended to read:
227.21 	260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.
227.22 	(a) Unless the court is conducting the reviews required under section 260C.202, 
227.23 	there shall be an administrative review of the out-of-home placement plan of each child 
227.24 	placed in foster care no later than 180 days after the initial placement of the child in foster 
227.25 	care and at least every six months thereafter if the child is not returned to the home of the 
227.26 	parent or parents within that time. The out-of-home placement plan must be monitored and 
227.27 	updated at each administrative review. The administrative review shall be conducted by 
227.28 	the responsible social services agency using a panel of appropriate persons at least one of 
227.29 	whom is not responsible for the case management of, or the delivery of services to, either 
227.30 	the child or the parents who are the subject of the review. The administrative review shall 
227.31 	be open to participation by the parent or guardian of the child and the child, as appropriate.
227.32 	(b) As an alternative to the administrative review required in paragraph (a), the court 
227.33 	may, as part of any hearing required under the Minnesota Rules of Juvenile Protection 
228.1 	Procedure, conduct a hearing to monitor and update the out-of-home placement plan 
228.2 	pursuant to the procedure and standard in section 260C.201, subdivision 6, paragraph 
228.3 	(d). The party requesting review of the out-of-home placement plan shall give parties to 
228.4 	the proceeding notice of the request to review and update the out-of-home placement 
228.5 	plan. A court review conducted pursuant to section 260C.141, subdivision 2; 260C.193; 
228.6 	260C.201, subdivision 1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the 
228.7 	requirement for the review so long as the other requirements of this section are met.
228.8 	(c) As appropriate to the stage of the proceedings and relevant court orders, the 
228.9 	responsible social services agency or the court shall review:
228.10 	(1) the safety, permanency needs, and well-being of the child;
228.11 	(2) the continuing necessity for and appropriateness of the placement;
228.12 	(3) the extent of compliance with the out-of-home placement plan;
228.13 	(4) the extent of progress that has been made toward alleviating or mitigating the 
228.14 	causes necessitating placement in foster care;
228.15 	(5) the projected date by which the child may be returned to and safely maintained in 
228.16 	the home or placed permanently away from the care of the parent or parents or guardian; and
228.17 	(6) the appropriateness of the services provided to the child.
228.18 	(d) When a child is age 16 14 or older, in addition to any administrative review 
228.19 	conducted by the agency, at the in-court review required under section 260C.317, 
228.20 	subdivision 3, clause (3), or 260C.515, subdivision 5 or 6, the court shall review the 
228.21 	independent living plan required under section 260C.212, subdivision 1, paragraph (c), 
228.22 	clause (11) (12), and the provision of services to the child related to the well-being of 
228.23 	the child as the child prepares to leave foster care. The review shall include the actual 
228.24 	plans related to each item in the plan necessary to the child's future safety and well-being 
228.25 	when the child is no longer in foster care.
228.26 	(e) At the court review required under paragraph (d) for a child age 16 14 or older, 
228.27 	the following procedures apply:
228.28 	(1) six months before the child is expected to be discharged from foster care, the 
228.29 	responsible social services agency shall give the written notice required under section 
228.30 	260C.451, subdivision 1, regarding the right to continued access to services for certain 
228.31 	children in foster care past age 18 and of the right to appeal a denial of social services 
228.32 	under section 256.045. The agency shall file a copy of the notice, including the right to 
228.33 	appeal a denial of social services, with the court. If the agency does not file the notice by 
228.34 	the time the child is age 17-1/2, the court shall require the agency to give it;
228.35 	(2) consistent with the requirements of the independent living plan, the court shall 
228.36 	review progress toward or accomplishment of the following goals:
229.1 	(i) the child has obtained a high school diploma or its equivalent;
229.2 	(ii) the child has completed a driver's education course or has demonstrated the 
229.3 	ability to use public transportation in the child's community;
229.4 	(iii) the child is employed or enrolled in postsecondary education;
229.5 	(iv) the child has applied for and obtained postsecondary education financial aid for 
229.6 	which the child is eligible;
229.7 	(v) the child has health care coverage and health care providers to meet the child's 
229.8 	physical and mental health needs;
229.9 	(vi) the child has applied for and obtained disability income assistance for which 
229.10 	the child is eligible;
229.11 	(vii) the child has obtained affordable housing with necessary supports, which does 
229.12 	not include a homeless shelter;
229.13 	(viii) the child has saved sufficient funds to pay for the first month's rent and a 
229.14 	damage deposit;
229.15 	(ix) the child has an alternative affordable housing plan, which does not include a 
229.16 	homeless shelter, if the original housing plan is unworkable;
229.17 	(x) the child, if male, has registered for the Selective Service; and
229.18 	(xi) the child has a permanent connection to a caring adult; and
229.19 	(3) the court shall ensure that the responsible agency in conjunction with the 
229.20 	placement provider assists the child in obtaining the following documents prior to the 
229.21 	child's leaving foster care: a Social Security card; the child's birth certificate; a state 
229.22 	identification card or driver's license, tribal enrollment identification card, green card, or 
229.23 	school visa; the child's school, medical, and dental records; a contact list of the child's 
229.24 	medical, dental, and mental health providers; and contact information for the child's 
229.25 	siblings, if the siblings are in foster care.
229.26 	(f) For a child who will be discharged from foster care at age 18 or older, the 
229.27 	responsible social services agency is required to develop a personalized transition plan as 
229.28 	directed by the youth. The transition plan must be developed during the 90-day period 
229.29 	immediately prior to the expected date of discharge. The transition plan must be as 
229.30 	detailed as the child may elect and include specific options on housing, health insurance, 
229.31 	education, local opportunities for mentors and continuing support services, and work force 
229.32 	supports and employment services. The agency shall ensure that the youth receives, at 
229.33 	no cost to the youth, a copy of the youth's consumer credit report as defined in section 
229.34 	13C.001 and assistance in interpreting and resolving any inaccuracies in the report. The 
229.35 	plan must include information on the importance of designating another individual to 
229.36 	make health care treatment decisions on behalf of the child if the child becomes unable 
230.1 	to participate in these decisions and the child does not have, or does not want, a relative 
230.2 	who would otherwise be authorized to make these decisions. The plan must provide the 
230.3 	child with the option to execute a health care directive as provided under chapter 145C. 
230.4 	The agency shall also provide the youth with appropriate contact information if the youth 
230.5 	needs more information or needs help dealing with a crisis situation through age 21.

230.6 	Sec. 40. Minnesota Statutes 2014, section 260C.212, subdivision 1, is amended to read:
230.7 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan 
230.8 	shall be prepared within 30 days after any child is placed in foster care by court order or a 
230.9 	voluntary placement agreement between the responsible social services agency and the 
230.10 	child's parent pursuant to section 260C.227 or chapter 260D.
230.11 	(b) An out-of-home placement plan means a written document which is prepared 
230.12 	by the responsible social services agency jointly with the parent or parents or guardian 
230.13 	of the child and in consultation with the child's guardian ad litem, the child's tribe, if the 
230.14 	child is an Indian child, the child's foster parent or representative of the foster care facility, 
230.15 	and, where appropriate, the child. When a child is age 14 or older, the child may include 
230.16 	two other individuals on the team preparing the child's out-of-home placement plan. For 
230.17 	a child in voluntary foster care for treatment under chapter 260D, preparation of the 
230.18 	out-of-home placement plan shall additionally include the child's mental health treatment 
230.19 	provider. As appropriate, the plan shall be:
230.20 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
230.21 	(2) ordered by the court, either as presented or modified after hearing, under section 
230.22 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
230.23 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad 
230.24 	litem, a representative of the child's tribe, the responsible social services agency, and, if 
230.25 	possible, the child.
230.26 	(c) The out-of-home placement plan shall be explained to all persons involved in its 
230.27 	implementation, including the child who has signed the plan, and shall set forth:
230.28 	(1) a description of the foster care home or facility selected, including how the 
230.29 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
230.30 	least restrictive, most family-like, setting available which is in close proximity to the home 
230.31 	of the parent or parents or guardian of the child when the case plan goal is reunification, 
230.32 	and how the placement is consistent with the best interests and special needs of the child 
230.33 	according to the factors under subdivision 2, paragraph (b);
230.34 	(2) the specific reasons for the placement of the child in foster care, and when 
230.35 	reunification is the plan, a description of the problems or conditions in the home of the 
231.1 	parent or parents which necessitated removal of the child from home and the changes the 
231.2 	parent or parents must make in order for the child to safely return home;
231.3 	(3) a description of the services offered and provided to prevent removal of the child 
231.4 	from the home and to reunify the family including:
231.5 	(i) the specific actions to be taken by the parent or parents of the child to eliminate 
231.6 	or correct the problems or conditions identified in clause (2), and the time period during 
231.7 	which the actions are to be taken; and
231.8 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 
231.9 	to achieve a safe and stable home for the child including social and other supportive 
231.10 	services to be provided or offered to the parent or parents or guardian of the child, the 
231.11 	child, and the residential facility during the period the child is in the residential facility;
231.12 	(4) a description of any services or resources that were requested by the child or the 
231.13 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
231.14 	in the residential facility, and whether those services or resources were provided and if 
231.15 	not, the basis for the denial of the services or resources;
231.16 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined 
231.17 	in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed 
231.18 	together in foster care, and whether visitation is consistent with the best interest of the 
231.19 	child, during the period the child is in foster care;
231.20 	(6) when a child cannot return to or be in the care of either parent, documentation 
231.21 	of steps to finalize adoption as the permanency plan for the child, including: (i) through 
231.22 	reasonable efforts to place the child for adoption. At a minimum, the documentation must 
231.23 	include consideration of whether adoption is in the best interests of the child, child-specific 
231.24 	recruitment efforts such as relative search and the use of state, regional, and national 
231.25 	adoption exchanges to facilitate orderly and timely placements in and outside of the state. 
231.26 	A copy of this documentation shall be provided to the court in the review required under 
231.27 	section 260C.317, subdivision 3, paragraph (b); and
231.28 	(ii) documentation necessary to support the requirements of the kinship placement 
231.29 	agreement under section 256N.22 when adoption is determined not to be in the child's 
231.30 	best interests; (7) when a child cannot return to or be in the care of either parent, 
231.31 	documentation of steps to finalize the transfer of permanent legal and physical custody 
231.32 	to a relative as the permanency plan for the child. This documentation must support the 
231.33 	requirements of the kinship placement agreement under section 256N.22 and must include 
231.34 	the reasonable efforts used to determine that it is not appropriate for the child to return 
231.35 	home or be adopted, and reasons why permanent placement with a relative through a 
231.36 	Northstar kinship assistance arrangement is in the child's best interest; how the child meets 
232.1 	the eligibility requirements for Northstar kinship assistance payments; agency efforts to 
232.2 	discuss adoption with the child's relative foster parent and reasons why the relative foster 
232.3 	parent chose not to pursue adoption, if applicable; and agency efforts to discuss with the 
232.4 	child's parent or parents the permanent transfer of permanent legal and physical custody or 
232.5 	the reasons why these efforts were not made;
232.6 	(7) (8) efforts to ensure the child's educational stability while in foster care, including:
232.7 	(i) efforts to ensure that the child remains in the same school in which the child was 
232.8 	enrolled prior to placement or upon the child's move from one placement to another, 
232.9 	including efforts to work with the local education authorities to ensure the child's 
232.10 	educational stability; or
232.11 	(ii) if it is not in the child's best interest to remain in the same school that the child 
232.12 	was enrolled in prior to placement or move from one placement to another, efforts to 
232.13 	ensure immediate and appropriate enrollment for the child in a new school;
232.14 	(8) (9) the educational records of the child including the most recent information 
232.15 	available regarding:
232.16 	(i) the names and addresses of the child's educational providers;
232.17 	(ii) the child's grade level performance;
232.18 	(iii) the child's school record;
232.19 	(iv) a statement about how the child's placement in foster care takes into account 
232.20 	proximity to the school in which the child is enrolled at the time of placement; and
232.21 	(v) any other relevant educational information;
232.22 	(9) (10) the efforts by the local agency to ensure the oversight and continuity of 
232.23 	health care services for the foster child, including:
232.24 	(i) the plan to schedule the child's initial health screens;
232.25 	(ii) how the child's known medical problems and identified needs from the screens, 
232.26 	including any known communicable diseases, as defined in section 144.4172, subdivision 
232.27 	2, will be monitored and treated while the child is in foster care;
232.28 	(iii) how the child's medical information will be updated and shared, including 
232.29 	the child's immunizations;
232.30 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
232.31 	including the role of the parent, the agency, and the foster parent;
232.32 	(v) who is responsible for oversight of the child's prescription medications;
232.33 	(vi) how physicians or other appropriate medical and nonmedical professionals 
232.34 	will be consulted and involved in assessing the health and well-being of the child and 
232.35 	determine the appropriate medical treatment for the child; and
233.1 	(vii) the responsibility to ensure that the child has access to medical care through 
233.2 	either medical insurance or medical assistance;
233.3 	(10) (11) the health records of the child including information available regarding:
233.4 	(i) the names and addresses of the child's health care and dental care providers;
233.5 	(ii) a record of the child's immunizations;
233.6 	(iii) the child's known medical problems, including any known communicable 
233.7 	diseases as defined in section 144.4172, subdivision 2;
233.8 	(iv) the child's medications; and
233.9 	(v) any other relevant health care information such as the child's eligibility for 
233.10 	medical insurance or medical assistance;
233.11 	(11) (12) an independent living plan for a child age 16 14 or older. The plan should 
233.12 	include, but not be limited to, the following objectives:
233.13 	(i) educational, vocational, or employment planning;
233.14 	(ii) health care planning and medical coverage;
233.15 	(iii) transportation including, where appropriate, assisting the child in obtaining a 
233.16 	driver's license;
233.17 	(iv) money management, including the responsibility of the agency to ensure that 
233.18 	the youth annually receives, at no cost to the youth, a consumer report as defined under 
233.19 	section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;
233.20 	(v) planning for housing;
233.21 	(vi) social and recreational skills; and
233.22 	(vii) establishing and maintaining connections with the child's family and 
233.23 	community; and
233.24 	(viii) regular opportunities to engage in age-appropriate or developmentally 
233.25 	appropriate activities typical for the child's age group, taking into consideration the 
233.26 	capacities of the individual child; and
233.27 	(12) (13) for a child in voluntary foster care for treatment under chapter 260D, 
233.28 	diagnostic and assessment information, specific services relating to meeting the mental 
233.29 	health care needs of the child, and treatment outcomes.
233.30 	(d) The parent or parents or guardian and the child each shall have the right to legal 
233.31 	counsel in the preparation of the case plan and shall be informed of the right at the time 
233.32 	of placement of the child. The child shall also have the right to a guardian ad litem. 
233.33 	If unable to employ counsel from their own resources, the court shall appoint counsel 
233.34 	upon the request of the parent or parents or the child or the child's legal guardian. The 
233.35 	parent or parents may also receive assistance from any person or social services agency 
233.36 	in preparation of the case plan.
234.1 	After the plan has been agreed upon by the parties involved or approved or ordered 
234.2 	by the court, the foster parents shall be fully informed of the provisions of the case plan 
234.3 	and shall be provided a copy of the plan.
234.4 	Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 
234.5 	physical custodian, as appropriate, and the child, if appropriate, must be provided with 
234.6 	a current copy of the child's health and education record.

234.7 	Sec. 41. Minnesota Statutes 2014, section 260C.212, is amended by adding a 
234.8 	subdivision to read:
234.9 		Subd. 13.Protecting missing and runaway children and youth at risk of sex 
234.10 	trafficking. (a) The local social services agency shall expeditiously locate any child 
234.11 	missing from foster care.
234.12 	(b) The local social services agency shall report immediately, but no later than 
234.13 	24 hours, after receiving information on a missing or abducted child to the local law 
234.14 	enforcement agency for entry into the National Crime Information Center (NCIC) 
234.15 	database of the Federal Bureau of Investigation, and to the National Center for Missing 
234.16 	and Exploited Children.
234.17 	(c) The local social services agency shall not discharge a child from foster care or 
234.18 	close the social services case until diligent efforts have been exhausted to locate the child 
234.19 	and the court terminates the agency's jurisdiction.
234.20 	(d) The local social services agency shall determine the primary factors that 
234.21 	contributed to the child's running away or otherwise being absent from care and, to 
234.22 	the extent possible and appropriate, respond to those factors in current and subsequent 
234.23 	placements.
234.24 	(e) The local social services agency shall determine what the child experienced 
234.25 	while absent from care, including screening the child to determine if the child is a possible 
234.26 	sex trafficking victim as defined in section 609.321, subdivision 7b.
234.27 	(f) The local social services agency shall report immediately, but no later than 24 
234.28 	hours, to the local law enforcement agency any reasonable cause to believe a child is, or is 
234.29 	at risk of being, a sex trafficking victim.
234.30 	(g) The local social services agency shall determine appropriate services as described 
234.31 	in section 145.4717 with respect to any child for whom the local social services agency has 
234.32 	responsibility for placement, care, or supervision when the local social services agency 
234.33 	has reasonable cause to believe the child is, or is at risk of being, a sex trafficking victim.

235.1 	Sec. 42. Minnesota Statutes 2014, section 260C.212, is amended by adding a 
235.2 	subdivision to read:
235.3 		Subd. 14.Support normalcy for foster children. Responsible social services 
235.4 	agencies and child-placing agencies shall support a foster child's emotional and 
235.5 	developmental growth by permitting the child to participate in activities or events that 
235.6 	are generally accepted as suitable for children of the same chronological age or are 
235.7 	developmentally appropriate for the child. Foster parents and residential facility staff 
235.8 	are permitted to allow foster children to participate in extracurricular, social, or cultural 
235.9 	activities that are typical for the child's age by applying reasonable and prudent parenting 
235.10 	standards. Reasonable and prudent parenting standards are characterized by careful and 
235.11 	sensible parenting decisions that maintain the child's health and safety, and are made in 
235.12 	the child's best interest.

235.13 	Sec. 43. Minnesota Statutes 2014, section 260C.331, subdivision 1, is amended to read:
235.14 		Subdivision 1.Care, examination, or treatment. (a) Except where parental rights 
235.15 	are terminated,
235.16 	(1) whenever legal custody of a child is transferred by the court to a responsible 
235.17 	social services agency,
235.18 	(2) whenever legal custody is transferred to a person other than the responsible social 
235.19 	services agency, but under the supervision of the responsible social services agency, or
235.20 	(3) whenever a child is given physical or mental examinations or treatment under 
235.21 	order of the court, and no provision is otherwise made by law for payment for the care, 
235.22 	examination, or treatment of the child, these costs are a charge upon the welfare funds of 
235.23 	the county in which proceedings are held upon certification of the judge of juvenile court.
235.24 	(b) The court shall order, and the responsible social services agency shall require, 
235.25 	the parents or custodian of a child, while the child is under the age of 18, to use the 
235.26 	total income and resources attributable to the child for the period of care, examination, 
235.27 	or treatment, except for clothing and personal needs allowance as provided in section 
235.28 	256B.35, to reimburse the county for the cost of care, examination, or treatment. Income 
235.29 	and resources attributable to the child include, but are not limited to, Social Security 
235.30 	benefits, Supplemental Security Income (SSI), veterans benefits, railroad retirement 
235.31 	benefits and child support. When the child is over the age of 18, and continues to receive 
235.32 	care, examination, or treatment, the court shall order, and the responsible social services 
235.33 	agency shall require, reimbursement from the child for the cost of care, examination, or 
235.34 	treatment from the income and resources attributable to the child less the clothing and 
235.35 	personal needs allowance. Income does not include earnings from a child over the age of 
236.1 	18 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), 
236.2 	clause (11) (12), to transition from foster care, or the income and resources from sources 
236.3 	other than Supplemental Security Income and child support that are needed to complete 
236.4 	the requirements listed in section 260C.203.
236.5 	(c) If the income and resources attributable to the child are not enough to reimburse 
236.6 	the county for the full cost of the care, examination, or treatment, the court shall inquire 
236.7 	into the ability of the parents to support the child and, after giving the parents a reasonable 
236.8 	opportunity to be heard, the court shall order, and the responsible social services agency 
236.9 	shall require, the parents to contribute to the cost of care, examination, or treatment of 
236.10 	the child. When determining the amount to be contributed by the parents, the court shall 
236.11 	use a fee schedule based upon ability to pay that is established by the responsible social 
236.12 	services agency and approved by the commissioner of human services. The income of 
236.13 	a stepparent who has not adopted a child shall be excluded in calculating the parental 
236.14 	contribution under this section.
236.15 	(d) The court shall order the amount of reimbursement attributable to the parents 
236.16 	or custodian, or attributable to the child, or attributable to both sources, withheld under 
236.17 	chapter 518A from the income of the parents or the custodian of the child. A parent or 
236.18 	custodian who fails to pay without good reason may be proceeded against for contempt, or 
236.19 	the court may inform the county attorney, who shall proceed to collect the unpaid sums, 
236.20 	or both procedures may be used.
236.21 	(e) If the court orders a physical or mental examination for a child, the examination 
236.22 	is a medically necessary service for purposes of determining whether the service is 
236.23 	covered by a health insurance policy, health maintenance contract, or other health 
236.24 	coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan 
236.25 	requirements for medical necessity. Nothing in this paragraph changes or eliminates 
236.26 	benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, 
236.27 	or other requirements in the policy, contract, or plan that relate to coverage of other 
236.28 	medically necessary services.
236.29 	(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the 
236.30 	child is not required to use income and resources attributable to the child to reimburse 
236.31 	the county for costs of care and is not required to contribute to the cost of care of the 
236.32 	child during any period of time when the child is returned to the home of that parent, 
236.33 	custodian, or guardian pursuant to a trial home visit under section 260C.201, subdivision 
236.34 	1, paragraph (a).

236.35 	Sec. 44. Minnesota Statutes 2014, section 260C.451, subdivision 2, is amended to read:
237.1 		Subd. 2.Independent living plan. Upon the request of any child in foster care 
237.2 	immediately prior to the child's 18th birthday and who is in foster care at the time 
237.3 	of the request, the responsible social services agency shall, in conjunction with the 
237.4 	child and other appropriate parties, update the independent living plan required under 
237.5 	section 260C.212, subdivision 1, paragraph (c), clause (11) (12), related to the child's 
237.6 	employment, vocational, educational, social, or maturational needs. The agency shall 
237.7 	provide continued services and foster care for the child including those services that are 
237.8 	necessary to implement the independent living plan.

237.9 	Sec. 45. Minnesota Statutes 2014, section 260C.451, subdivision 6, is amended to read:
237.10 		Subd. 6.Reentering foster care and accessing services after age 18. (a) 
237.11 	Upon request of an individual between the ages of 18 and 21 who had been under the 
237.12 	guardianship of the commissioner and who has left foster care without being adopted, the 
237.13 	responsible social services agency which had been the commissioner's agent for purposes 
237.14 	of the guardianship shall develop with the individual a plan to increase the individual's 
237.15 	ability to live safely and independently using the plan requirements of section 260C.212, 
237.16 	subdivision 1, paragraph (b) (c), clause (11) (12), and to assist the individual to meet 
237.17 	one or more of the eligibility criteria in subdivision 4 if the individual wants to reenter 
237.18 	foster care. The agency shall provide foster care as required to implement the plan. The 
237.19 	agency shall enter into a voluntary placement agreement under section 260C.229 with the 
237.20 	individual if the plan includes foster care.
237.21 	(b) Individuals who had not been under the guardianship of the commissioner of 
237.22 	human services prior to age 18 and are between the ages of 18 and 21 may ask to reenter 
237.23 	foster care after age 18 and, to the extent funds are available, the responsible social 
237.24 	services agency that had responsibility for planning for the individual before discharge 
237.25 	from foster care may provide foster care or other services to the individual for the purpose 
237.26 	of increasing the individual's ability to live safely and independently and to meet the 
237.27 	eligibility criteria in subdivision 3a, if the individual:
237.28 	(1) was in foster care for the six consecutive months prior to the person's 18th 
237.29 	birthday and was not discharged home, adopted, or received into a relative's home under a 
237.30 	transfer of permanent legal and physical custody under section 260C.515, subdivision 4; or
237.31 	(2) was discharged from foster care while on runaway status after age 15.
237.32 	(c) In conjunction with a qualifying and eligible individual under paragraph (b) and 
237.33 	other appropriate persons, the responsible social services agency shall develop a specific 
237.34 	plan related to that individual's vocational, educational, social, or maturational needs 
237.35 	and, to the extent funds are available, provide foster care as required to implement the 
238.1 	plan. The agency shall enter into a voluntary placement agreement with the individual 
238.2 	if the plan includes foster care.
238.3 	(d) Youth who left foster care while under guardianship of the commissioner of 
238.4 	human services retain eligibility for foster care for placement at any time between the 
238.5 	ages of 18 and 21.

238.6 	Sec. 46. Minnesota Statutes 2014, section 260C.515, subdivision 5, is amended to read:
238.7 		Subd. 5.Permanent custody to agency. The court may order permanent custody to 
238.8 	the responsible social services agency for continued placement of the child in foster care 
238.9 	but only if it approves the responsible social services agency's compelling reasons that no 
238.10 	other permanency disposition order is in the child's best interests and:
238.11 	(1) the child has reached age 12 16 and has been asked about the child's desired 
238.12 	permanency outcome;
238.13 	(2) the child is a sibling of a child described in clause (1) and the siblings have a 
238.14 	significant positive relationship and are ordered into the same foster home;
238.15 	(3) the responsible social services agency has made reasonable efforts to locate and 
238.16 	place the child with an adoptive family or a fit and willing relative who would either agree 
238.17 	to adopt the child or to a transfer of permanent legal and physical custody of the child, but 
238.18 	these efforts have not proven successful; and
238.19 	(4) the parent will continue to have visitation or contact with the child and will 
238.20 	remain involved in planning for the child.

238.21 	Sec. 47. Minnesota Statutes 2014, section 260C.521, subdivision 1, is amended to read:
238.22 		Subdivision 1.Child in permanent custody of responsible social services agency.
 238.23 	(a) Court reviews of an order for permanent custody to the responsible social services 
238.24 	agency for placement of the child in foster care must be conducted at least yearly at an 
238.25 	in-court appearance hearing.
238.26 	(b) The purpose of the review hearing is to ensure:
238.27 	(1) the order for permanent custody to the responsible social services agency for 
238.28 	placement of the child in foster care continues to be in the best interests of the child and 
238.29 	that no other permanency disposition order is in the best interests of the child;
238.30 	(2) that the agency is assisting the child to build connections to the child's family 
238.31 	and community; and
238.32 	(3) that the agency is appropriately planning with the child for development of 
238.33 	independent living skills for the child and, as appropriate, for the orderly and successful 
239.1 	transition to independent living that may occur if the child continues in foster care without 
239.2 	another permanency disposition order.
239.3 	(c) The court must review the child's out-of-home placement plan and the reasonable 
239.4 	efforts of the agency to finalize an alternative permanent plan for the child including the 
239.5 	agency's efforts to:
239.6 	(1) ensure that permanent custody to the agency with placement of the child in 
239.7 	foster care continues to be the most appropriate legal arrangement for meeting the child's 
239.8 	need for permanency and stability or, if not, to identify and attempt to finalize another 
239.9 	permanency disposition order under this chapter that would better serve the child's needs 
239.10 	and best interests;
239.11 	(2) identify a specific foster home for the child, if one has not already been identified;
239.12 	(3) support continued placement of the child in the identified home, if one has been 
239.13 	identified;
239.14 	(4) ensure appropriate services are provided to address the physical health, mental 
239.15 	health, and educational needs of the child during the period of foster care and also ensure 
239.16 	appropriate services or assistance to maintain relationships with appropriate family 
239.17 	members and the child's community; and
239.18 	(5) plan for the child's independence upon the child's leaving foster care living as 
239.19 	required under section 260C.212, subdivision 1.
239.20 	(d) The court may find that the agency has made reasonable efforts to finalize the 
239.21 	permanent plan for the child when:
239.22 	(1) the agency has made reasonable efforts to identify a more legally permanent 
239.23 	home for the child than is provided by an order for permanent custody to the agency 
239.24 	for placement in foster care; and
239.25 	(2) the child has been asked about the child's desired permanency outcome; and
239.26 	(2) (3) the agency's engagement of the child in planning for independent living is 
239.27 	reasonable and appropriate.

239.28 	Sec. 48. Minnesota Statutes 2014, section 260C.521, subdivision 2, is amended to read:
239.29 		Subd. 2.Modifying order for permanent legal and physical custody to a 
239.30 	relative. (a) An order for a relative to have permanent legal and physical custody of a 
239.31 	child may be modified using standards under sections 518.18 and 518.185.
239.32 	(b) If a relative named as permanent legal and physical custodian in an order made 
239.33 	under this chapter becomes incapacitated or dies, a successor custodian named in the 
239.34 	kinship placement agreement under section 256N.22, subdivision 2, may file a request 
239.35 	to modify the order for permanent legal and physical custody to name the successor 
240.1 	custodian as the permanent legal and physical custodian of the child. The court shall 
240.2 	modify the order to name the successor custodian as the permanent legal and physical 
240.3 	custodian upon reviewing the background study required under section 245C.33 if the 
240.4 	court finds the modification is in the child's best interests.
240.5 	(c) The social services agency is a party to the proceeding and must receive notice.

240.6 	Sec. 49. Minnesota Statutes 2014, section 260C.607, subdivision 4, is amended to read:
240.7 		Subd. 4.Content of review. (a) The court shall review:
240.8 	(1) the agency's reasonable efforts under section 260C.605 to finalize an adoption 
240.9 	for the child as appropriate to the stage of the case; and
240.10 	(2) the child's current out-of-home placement plan required under section 260C.212, 
240.11 	subdivision 1, to ensure the child is receiving all services and supports required to meet 
240.12 	the child's needs as they relate to the child's:
240.13 	(i) placement;
240.14 	(ii) visitation and contact with siblings;
240.15 	(iii) visitation and contact with relatives;
240.16 	(iv) medical, mental, and dental health; and
240.17 	(v) education.
240.18 	(b) When the child is age 16 14 and older, and as long as the child continues in foster 
240.19 	care, the court shall also review the agency's planning for the child's independent living 
240.20 	after leaving foster care including how the agency is meeting the requirements of section 
240.21 	260C.212, subdivision 1, paragraph (c), clause (11) (12). The court shall use the review 
240.22 	requirements of section 260C.203 in any review conducted under this paragraph.

240.23 	Sec. 50. Minnesota Statutes 2014, section 518A.26, subdivision 14, is amended to read:
240.24 		Subd. 14.Obligor. "Obligor" means a person obligated to pay maintenance or 
240.25 	support. A person who has primary physical custody of a child is presumed not to be 
240.26 	an obligor for purposes of a child support order under section 518A.34, unless section 
240.27 	518A.36, subdivision 3, applies or the court makes specific written findings to overcome 
240.28 	this presumption. For purposes of ordering medical support under section 518A.41, a 
240.29 	parent who has primary physical custody of a child may be an obligor subject to a payment 
240.30 	agreement under section 518A.69.

240.31 	Sec. 51. Minnesota Statutes 2014, section 518A.32, subdivision 2, is amended to read:
240.32 		Subd. 2.Methods. Determination of potential income must be made according 
240.33 	to one of three methods, as appropriate:
241.1 	(1) the parent's probable earnings level based on employment potential, recent 
241.2 	work history, and occupational qualifications in light of prevailing job opportunities and 
241.3 	earnings levels in the community;
241.4 	(2) if a parent is receiving unemployment compensation or workers' compensation, 
241.5 	that parent's income may be calculated using the actual amount of the unemployment 
241.6 	compensation or workers' compensation benefit received; or
241.7 	(3) the amount of income a parent could earn working full time 30 hours per week at 
241.8 	150 100 percent of the current federal or state minimum wage, whichever is higher.

241.9 	Sec. 52. Minnesota Statutes 2014, section 518A.39, subdivision 1, is amended to read:
241.10 		Subdivision 1.Authority. After an order under this chapter or chapter 518 for 
241.11 	maintenance or support money, temporary or permanent, or for the appointment of trustees 
241.12 	to receive property awarded as maintenance or support money, the court may from time to 
241.13 	time, on motion of either of the parties, a copy of which is served on the public authority 
241.14 	responsible for child support enforcement if payments are made through it, or on motion 
241.15 	of the public authority responsible for support enforcement, modify the order respecting 
241.16 	the amount of maintenance or support money or medical support, and the payment of it, 
241.17 	and also respecting the appropriation and payment of the principal and income of property 
241.18 	held in trust, and may make an order respecting these matters which it might have made 
241.19 	in the original proceeding, except as herein otherwise provided. A party or the public 
241.20 	authority also may bring a motion for contempt of court if the obligor is in arrears in 
241.21 	support or maintenance payments.

241.22 	Sec. 53. Minnesota Statutes 2014, section 518A.39, is amended by adding a 
241.23 	subdivision to read:
241.24 		Subd. 8.Medical support-only modification. (a) The medical support terms of 
241.25 	a support order and determination of the child dependency tax credit may be modified 
241.26 	without modification of the full order for support or maintenance, if the order has been 
241.27 	established or modified in its entirety within three years from the date of the motion, and 
241.28 	upon a showing of one or more of the following:
241.29 	(1) a change in the availability of appropriate health care coverage or a substantial 
241.30 	increase or decrease in health care coverage costs;
241.31 	(2) a change in the eligibility for medical assistance under chapter 256B;
241.32 	(3) a party's failure to carry court-ordered coverage, or to provide other medical 
241.33 	support as ordered;
242.1 	(4) the federal child dependency tax credit is not ordered for the same parent who is 
242.2 	ordered to carry health care coverage; or
242.3 	(5) the federal child dependency tax credit is not addressed in the order and the 
242.4 	noncustodial parent is ordered to carry health care coverage.
242.5 	(b) For a motion brought under this subdivision, a modification of the medical 
242.6 	support terms of an order may be made retroactive only with respect to any period during 
242.7 	which the petitioning party has pending a motion for modification, but only from the date 
242.8 	of service of notice of the motion on the responding party and on the public authority if 
242.9 	public assistance is being furnished or the county attorney is the attorney of record.
242.10 	(c) The court need not hold an evidentiary hearing on a motion brought under this 
242.11 	subdivision for modification of medical support only.
242.12 	(d) Sections 518.14 and 518A.735 shall govern the award of attorney fees for 
242.13 	motions brought under this subdivision.
242.14 	(e) The PICS originally stated in the order being modified shall be used to determine 
242.15 	the modified medical support order under section 518A.41 for motions brought under 
242.16 	this subdivision.

242.17 	Sec. 54. Minnesota Statutes 2014, section 518A.41, subdivision 1, is amended to read:
242.18 		Subdivision 1.Definitions. The definitions in this subdivision apply to this chapter 
242.19 	and chapter 518.
242.20 	(a) "Health care coverage" means medical, dental, or other health care benefits that 
242.21 	are provided by one or more health plans. Health care coverage does not include any 
242.22 	form of public coverage.
242.23 	(b) "Health carrier" means a carrier as defined in sections 62A.011, subdivision 
242.24 	2, and 62L.02, subdivision 16.
242.25 	(c) "Health plan" means a plan, other than any form of public coverage, that provides 
242.26 	medical, dental, or other health care benefits and is:
242.27 	(1) provided on an individual or group basis;
242.28 	(2) provided by an employer or union;
242.29 	(3) purchased in the private market; or
242.30 	(4) available to a person eligible to carry insurance for the joint child, including a 
242.31 	party's spouse or parent.
242.32 	Health plan includes, but is not limited to, a plan meeting the definition under section 
242.33 	62A.011, subdivision 3, except that the exclusion of coverage designed solely to provide 
242.34 	dental or vision care under section 62A.011, subdivision 3, clause (6), does not apply to 
242.35 	the definition of health plan under this section; a group health plan governed under the 
243.1 	federal Employee Retirement Income Security Act of 1974 (ERISA); a self-insured plan 
243.2 	under sections 43A.23 to 43A.317 and 471.617; and a policy, contract, or certificate issued 
243.3 	by a community-integrated service network licensed under chapter 62N.
243.4 	(d) "Medical support" means providing health care coverage for a joint child by 
243.5 	carrying health care coverage for the joint child or by contributing to the cost of health 
243.6 	care coverage, public coverage, unreimbursed medical expenses, and uninsured medical 
243.7 	expenses of the joint child.
243.8 	(e) "National medical support notice" means an administrative notice issued by the 
243.9 	public authority to enforce health insurance provisions of a support order in accordance 
243.10 	with Code of Federal Regulations, title 45, section 303.32, in cases where the public 
243.11 	authority provides support enforcement services.
243.12 	(f) "Public coverage" means health care benefits provided by any form of medical 
243.13 	assistance under chapter 256B or MinnesotaCare under chapter 256L. Public coverage 
243.14 	does not include MinnesotaCare or federally tax-subsidized medical plans.
243.15 	(g) "Uninsured medical expenses" means a joint child's reasonable and necessary 
243.16 	health-related expenses if the joint child is not covered by a health plan or public coverage 
243.17 	when the expenses are incurred.
243.18 	(h) "Unreimbursed medical expenses" means a joint child's reasonable and necessary 
243.19 	health-related expenses if a joint child is covered by a health plan or public coverage and 
243.20 	the plan or coverage does not pay for the total cost of the expenses when the expenses 
243.21 	are incurred. Unreimbursed medical expenses do not include the cost of premiums. 
243.22 	Unreimbursed medical expenses include, but are not limited to, deductibles, co-payments, 
243.23 	and expenses for orthodontia, and prescription eyeglasses and contact lenses, but not 
243.24 	over-the-counter medications if coverage is under a health plan.

243.25 	Sec. 55. Minnesota Statutes 2014, section 518A.41, subdivision 3, is amended to read:
243.26 		Subd. 3.Determining appropriate health care coverage.  In determining whether 
243.27 	a parent has appropriate health care coverage for the joint child, the court must consider 
243.28 	the following factors:
243.29 	(1) comprehensiveness of health care coverage providing medical benefits. 
243.30 	Dependent health care coverage providing medical benefits is presumed comprehensive if 
243.31 	it includes medical and hospital coverage and provides for preventive, emergency, acute, 
243.32 	and chronic care; or if it meets the minimum essential coverage definition in United States 
243.33 	Code, title 26, section 5000A(f). If both parents have health care coverage providing 
243.34 	medical benefits that is presumed comprehensive under this paragraph, the court must 
244.1 	determine which parent's coverage is more comprehensive by considering what other 
244.2 	benefits are included in the coverage;
244.3 	(2) accessibility. Dependent health care coverage is accessible if the covered joint 
244.4 	child can obtain services from a health plan provider with reasonable effort by the parent 
244.5 	with whom the joint child resides. Health care coverage is presumed accessible if:
244.6 	(i) primary care is available within 30 minutes or 30 miles of the joint child's residence 
244.7 	and specialty care is available within 60 minutes or 60 miles of the joint child's residence;
244.8 	(ii) the health care coverage is available through an employer and the employee can 
244.9 	be expected to remain employed for a reasonable amount of time; and
244.10 	(iii) no preexisting conditions exist to unduly delay enrollment in health care 
244.11 	coverage;
244.12 	(3) the joint child's special medical needs, if any; and
244.13 	(4) affordability. Dependent health care coverage is affordable if it is reasonable 
244.14 	in cost. If both parents have health care coverage available for a joint child that is 
244.15 	comparable with regard to comprehensiveness of medical benefits, accessibility, and the 
244.16 	joint child's special needs, the least costly health care coverage is presumed to be the most 
244.17 	appropriate health care coverage for the joint child.

244.18 	Sec. 56. Minnesota Statutes 2014, section 518A.41, subdivision 4, is amended to read:
244.19 		Subd. 4.Ordering health care coverage. (a) If a joint child is presently enrolled 
244.20 	in health care coverage, the court must order that the parent who currently has the joint 
244.21 	child enrolled continue that enrollment unless the parties agree otherwise or a party 
244.22 	requests a change in coverage and the court determines that other health care coverage is 
244.23 	more appropriate.
244.24 	(b) If a joint child is not presently enrolled in health care coverage providing medical 
244.25 	benefits, upon motion of a parent or the public authority, the court must determine whether 
244.26 	one or both parents have appropriate health care coverage providing medical benefits 
244.27 	for the joint child.
244.28 	(c) If only one parent has appropriate health care coverage providing medical 
244.29 	benefits available, the court must order that parent to carry the coverage for the joint child.
244.30 	(d) If both parents have appropriate health care coverage providing medical benefits 
244.31 	available, the court must order the parent with whom the joint child resides to carry the 
244.32 	coverage for the joint child, unless:
244.33 	(1) a party expresses a preference for health care coverage providing medical 
244.34 	benefits available through the parent with whom the joint child does not reside;
245.1 	(2) the parent with whom the joint child does not reside is already carrying 
245.2 	dependent health care coverage providing medical benefits for other children and the cost 
245.3 	of contributing to the premiums of the other parent's coverage would cause the parent with 
245.4 	whom the joint child does not reside extreme hardship; or
245.5 	(3) the parties agree as to which parent will carry health care coverage providing 
245.6 	medical benefits and agree on the allocation of costs.
245.7 	(e) If the exception in paragraph (d), clause (1) or (2), applies, the court must 
245.8 	determine which parent has the most appropriate coverage providing medical benefits 
245.9 	available and order that parent to carry coverage for the joint child.
245.10 	(f) If neither parent has appropriate health care coverage available, the court must 
245.11 	order the parents to:
245.12 	(1) contribute toward the actual health care costs of the joint children based on 
245.13 	a pro rata share; or
245.14 	(2) if the joint child is receiving any form of public coverage, the parent with whom 
245.15 	the joint child does not reside shall contribute a monthly amount toward the actual cost of 
245.16 	public coverage. The amount of the noncustodial parent's contribution is determined by 
245.17 	applying the noncustodial parent's PICS to the premium schedule for public coverage scale 
245.18 	for MinnesotaCare under section 256L.15, subdivision 2, paragraph (c). If the noncustodial 
245.19 	parent's PICS meets the eligibility requirements for public coverage MinnesotaCare, the 
245.20 	contribution is the amount the noncustodial parent would pay for the child's premium. If 
245.21 	the noncustodial parent's PICS exceeds the eligibility requirements for public coverage, the 
245.22 	contribution is the amount of the premium for the highest eligible income on the appropriate 
245.23 	premium schedule for public coverage scale for MinnesotaCare under section 256L.15, 
245.24 	subdivision 2, paragraph (c). For purposes of determining the premium amount, the 
245.25 	noncustodial parent's household size is equal to one parent plus the child or children who 
245.26 	are the subject of the child support order. The custodial parent's obligation is determined 
245.27 	under the requirements for public coverage as set forth in chapter 256B or 256L.; or
245.28 	(3) if the noncustodial parent's PICS meet the eligibility requirement for public 
245.29 	coverage under chapter 256B or the noncustodial parent receives public assistance, the 
245.30 	noncustodial parent must not be ordered to contribute toward the cost of public coverage.
245.31 	(g) If neither parent has appropriate health care coverage available, the court may 
245.32 	order the parent with whom the child resides to apply for public coverage for the child.
245.33 	(h) The commissioner of human services must publish a table with the premium 
245.34 	schedule for public coverage and update the chart for changes to the schedule by July 
245.35 	1 of each year.
246.1 	(i) If a joint child is not presently enrolled in health care coverage providing dental 
246.2 	benefits, upon motion of a parent or the public authority, the court must determine whether 
246.3 	one or both parents have appropriate dental health care coverage for the joint child, and the 
246.4 	court may order a parent with appropriate dental health care coverage available to carry 
246.5 	the coverage for the joint child.
246.6 	(j) If a joint child is not presently enrolled in available health care coverage 
246.7 	providing benefits other than medical benefits or dental benefits, upon motion of a parent 
246.8 	or the public authority, the court may determine whether that other health care coverage 
246.9 	for the joint child is appropriate, and the court may order a parent with that appropriate 
246.10 	health care coverage available to carry the coverage for the joint child.

246.11 	Sec. 57. Minnesota Statutes 2014, section 518A.41, subdivision 14, is amended to read:
246.12 		Subd. 14.Child support enforcement services. The public authority must take 
246.13 	necessary steps to establish and enforce, enforce, and modify an order for medical support 
246.14 	if the joint child receives public assistance or a party completes an application for services 
246.15 	from the public authority under section 518A.51.

246.16 	Sec. 58. Minnesota Statutes 2014, section 518A.41, subdivision 15, is amended to read:
246.17 		Subd. 15.Enforcement. (a) Remedies available for collecting and enforcing child 
246.18 	support apply to medical support.
246.19 	(b) For the purpose of enforcement, the following are additional support:
246.20 	(1) the costs of individual or group health or hospitalization coverage;
246.21 	(2) dental coverage;
246.22 	(3) medical costs ordered by the court to be paid by either party, including health 
246.23 	care coverage premiums paid by the obligee because of the obligor's failure to obtain 
246.24 	coverage as ordered; and
246.25 	(4) liabilities established under this subdivision.
246.26 	(c) A party who fails to carry court-ordered dependent health care coverage is liable 
246.27 	for the joint child's uninsured medical expenses unless a court order provides otherwise. 
246.28 	A party's failure to carry court-ordered coverage, or to provide other medical support as 
246.29 	ordered, is a basis for modification of a medical support order under section 518A.39, 
246.30 	subdivision 2 8, unless it meets the presumption in section 518A.39, subdivision 2.
246.31 	(d) Payments by the health carrier or employer for services rendered to the dependents 
246.32 	that are directed to a party not owed reimbursement must be endorsed over to and forwarded 
246.33 	to the vendor or appropriate party or the public authority. A party retaining insurance 
246.34 	reimbursement not owed to the party is liable for the amount of the reimbursement.

247.1 	Sec. 59. Minnesota Statutes 2014, section 518A.43, is amended by adding a 
247.2 	subdivision to read:
247.3 		Subd. 1a.Income disparity between parties.  The court may deviate from the 
247.4 	presumptive child support obligation under section 518A.34 and elect not to order a party 
247.5 	who has between ten and 45 percent parenting time to pay basic support where such a 
247.6 	significant disparity of income exists between the parties that an order directing payment 
247.7 	of basic support would be detrimental to the parties' joint child.

247.8 	Sec. 60. Minnesota Statutes 2014, section 518A.46, subdivision 3, is amended to read:
247.9 		Subd. 3.Contents of pleadings. (a) In cases involving establishment or 
247.10 	modification of a child support order, the initiating party shall include the following 
247.11 	information, if known, in the pleadings:
247.12 	(1) names, addresses, and dates of birth of the parties;
247.13 	(2) Social Security numbers of the parties and the minor children of the parties, 
247.14 	which information shall be considered private information and shall be available only to 
247.15 	the parties, the court, and the public authority;
247.16 	(3) other support obligations of the obligor;
247.17 	(4) names and addresses of the parties' employers;
247.18 	(5) gross income of the parties as calculated in section 518A.29;
247.19 	(6) amounts and sources of any other earnings and income of the parties;
247.20 	(7) health insurance coverage of parties;
247.21 	(8) types and amounts of public assistance received by the parties, including 
247.22 	Minnesota family investment plan, child care assistance, medical assistance, 
247.23 	MinnesotaCare, title IV-E foster care, or other form of assistance as defined in section 
247.24 	256.741, subdivision 1; and
247.25 	(9) any other information relevant to the computation of the child support obligation 
247.26 	under section 518A.34.
247.27 	(b) For all matters scheduled in the expedited process, whether or not initiated by 
247.28 	the public authority, the nonattorney employee of the public authority shall file with the 
247.29 	court and serve on the parties the following information:
247.30 	(1) information pertaining to the income of the parties available to the public 
247.31 	authority from the Department of Employment and Economic Development;
247.32 	(2) a statement of the monthly amount of child support, medical support, child care, 
247.33 	and arrears currently being charged the obligor on Minnesota IV-D cases;
247.34 	(3) a statement of the types and amount of any public assistance, as defined in 
247.35 	section 256.741, subdivision 1, received by the parties; and
248.1 	(4) any other information relevant to the determination of support that is known to 
248.2 	the public authority and that has not been otherwise provided by the parties.
248.3 	The information must be filed with the court or child support magistrate at least 
248.4 	five days before any hearing involving child support, medical support, or child care 
248.5 	reimbursement issues.

248.6 	Sec. 61. Minnesota Statutes 2014, section 518A.46, is amended by adding a 
248.7 	subdivision to read:
248.8 		Subd. 3a.Contents of pleadings for medical support modifications. (a) In cases 
248.9 	involving modification of only the medical support portion of a child support order 
248.10 	under section 518A.39, subdivision 8, the initiating party shall include the following 
248.11 	information, if known, in the pleadings:
248.12 	(1) names, addresses, and dates of birth of the parties;
248.13 	(2) Social Security numbers of the parties and the minor children of the parties, 
248.14 	which shall be considered private information and shall be available only to the parties, 
248.15 	the court, and the public authority;
248.16 	(3) a copy of the full support order being modified;
248.17 	(4) names and addresses of the parties' employers;
248.18 	(5) gross income of the parties as stated in the order being modified;
248.19 	(6) health insurance coverage of the parties; and
248.20 	(7) any other information relevant to the determination of the medical support 
248.21 	obligation under section 518A.41.
248.22 	(b) For all matters scheduled in the expedited process, whether or not initiated by 
248.23 	the public authority, the nonattorney employee of the public authority shall file with the 
248.24 	court and serve on the parties the following information:
248.25 	(1) a statement of the monthly amount of child support, medical support, child care, 
248.26 	and arrears currently being charged the obligor on Minnesota IV-D cases;
248.27 	(2) a statement of the amount of medical assistance received by the parties; and 
248.28 	(3) any other information relevant to the determination of medical support that is 
248.29 	known to the public authority and that has not been otherwise provided by the parties.
248.30 	The information must be filed with the court or child support magistrate at least five 
248.31 	days before the hearing on the motion to modify medical support.

248.32 	Sec. 62. Minnesota Statutes 2014, section 518A.51, is amended to read:
248.33 	518A.51 FEES FOR IV-D SERVICES.
249.1 	(a) When a recipient of IV-D services is no longer receiving assistance under the 
249.2 	state's title IV-A, IV-E foster care, or medical assistance, or MinnesotaCare programs, the 
249.3 	public authority responsible for child support enforcement must notify the recipient, 
249.4 	within five working days of the notification of ineligibility, that IV-D services will be 
249.5 	continued unless the public authority is notified to the contrary by the recipient. The 
249.6 	notice must include the implications of continuing to receive IV-D services, including the 
249.7 	available services and fees, cost recovery fees, and distribution policies relating to fees.
249.8 	(b) An application fee of $25 shall be paid by the person who applies for child 
249.9 	support and maintenance collection services, except persons who are receiving public 
249.10 	assistance as defined in section 256.741 and the diversionary work program under section 
249.11 	256J.95, persons who transfer from public assistance to nonpublic assistance status, and 
249.12 	minor parents and parents enrolled in a public secondary school, area learning center, or 
249.13 	alternative learning program approved by the commissioner of education.
249.14 	(c) (b) In the case of an individual who has never received assistance under a state 
249.15 	program funded under title IV-A of the Social Security Act and for whom the public 
249.16 	authority has collected at least $500 of support, the public authority must impose an 
249.17 	annual federal collections fee of $25 for each case in which services are furnished. This 
249.18 	fee must be retained by the public authority from support collected on behalf of the 
249.19 	individual, but not from the first $500 collected.
249.20 	(d) (c) When the public authority provides full IV-D services to an obligee who 
249.21 	has applied for those services, upon written notice to the obligee, the public authority 
249.22 	must charge a cost recovery fee of two percent of the amount collected. This fee must 
249.23 	be deducted from the amount of the child support and maintenance collected and not 
249.24 	assigned under section 256.741 before disbursement to the obligee. This fee does not 
249.25 	apply to an obligee who:
249.26 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, or 
249.27 	medical assistance, or MinnesotaCare programs; or
249.28 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
249.29 	until the person has not received this assistance for 24 consecutive months.
249.30 	(e) (d) When the public authority provides full IV-D services to an obligor who has 
249.31 	applied for such services, upon written notice to the obligor, the public authority must 
249.32 	charge a cost recovery fee of two percent of the monthly court-ordered child support and 
249.33 	maintenance obligation. The fee may be collected through income withholding, as well 
249.34 	as by any other enforcement remedy available to the public authority responsible for 
249.35 	child support enforcement.
250.1 	(f) (e) Fees assessed by state and federal tax agencies for collection of overdue 
250.2 	support owed to or on behalf of a person not receiving public assistance must be imposed 
250.3 	on the person for whom these services are provided. The public authority upon written 
250.4 	notice to the obligee shall assess a fee of $25 to the person not receiving public assistance 
250.5 	for each successful federal tax interception. The fee must be withheld prior to the release 
250.6 	of the funds received from each interception and deposited in the general fund.
250.7 	(g) (f) Federal collections fees collected under paragraph (c) (b) and cost recovery 
250.8 	fees collected under paragraphs (c) and (d) and (e) retained by the commissioner of human 
250.9 	services shall be considered child support program income according to Code of Federal 
250.10 	Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 
250.11 	account established under paragraph (i) (h). The commissioner of human services must 
250.12 	elect to recover costs based on either actual or standardized costs.
250.13 	(h) (g) The limitations of this section on the assessment of fees shall not apply to 
250.14 	the extent inconsistent with the requirements of federal law for receiving funds for the 
250.15 	programs under title IV-A and title IV-D of the Social Security Act, United States Code, 
250.16 	title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
250.17 	(i) (h) The commissioner of human services is authorized to establish a special 
250.18 	revenue fund account to receive the federal collections fees collected under paragraph (c) 
250.19 	(b) and cost recovery fees collected under paragraphs (c) and (d) and (e).
250.20 	(j) (i) The nonfederal share of the cost recovery fee revenue must be retained by the 
250.21 	commissioner and distributed as follows:
250.22 	(1) one-half of the revenue must be transferred to the child support system special 
250.23 	revenue account to support the state's administration of the child support enforcement 
250.24 	program and its federally mandated automated system;
250.25 	(2) an additional portion of the revenue must be transferred to the child support 
250.26 	system special revenue account for expenditures necessary to administer the fees; and
250.27 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
250.28 	counties in funding their child support enforcement programs.
250.29 	(k) (j) The nonfederal share of the federal collections fees must be distributed to the 
250.30 	counties to aid them in funding their child support enforcement programs.
250.31 	(l) (k) The commissioner of human services shall distribute quarterly any of the 
250.32 	funds dedicated to the counties under paragraphs (i) and (j) and (k) using the methodology 
250.33 	specified in section 256.979, subdivision 11. The funds received by the counties must be 
250.34 	reinvested in the child support enforcement program and the counties must not reduce the 
250.35 	funding of their child support programs by the amount of the funding distributed.

251.1 	Sec. 63. Minnesota Statutes 2014, section 518A.53, subdivision 4, is amended to read:
251.2 		Subd. 4.Collection services. (a) The commissioner of human services shall prepare 
251.3 	and make available to the courts a notice of services that explains child support and 
251.4 	maintenance collection services available through the public authority, including income 
251.5 	withholding, and the fees for such services. Upon receiving a petition for dissolution of 
251.6 	marriage or legal separation, the court administrator shall promptly send the notice of 
251.7 	services to the petitioner and respondent at the addresses stated in the petition.
251.8 	(b) Either the obligee or obligor may at any time apply to the public authority for 
251.9 	either full IV-D services or for income withholding only services.
251.10 	(c) For those persons applying for income withholding only services, a monthly 
251.11 	service fee of $15 must be charged to the obligor. This fee is in addition to the amount of 
251.12 	the support order and shall be withheld through income withholding. The public authority 
251.13 	shall explain the service options in this section to the affected parties and encourage the 
251.14 	application for full child support collection services.
251.15 	(d) If the obligee is not a current recipient of public assistance as defined in section 
251.16 	256.741, the person who applied for services may at any time choose to terminate either 
251.17 	full IV-D services or income withholding only services regardless of whether income 
251.18 	withholding is currently in place. The obligee or obligor may reapply for either full IV-D 
251.19 	services or income withholding only services at any time. Unless the applicant is a 
251.20 	recipient of public assistance as defined in section 256.741, a $25 application fee shall be 
251.21 	charged at the time of each application.
251.22 	(e) When a person terminates IV-D services, if an arrearage for public assistance as 
251.23 	defined in section 256.741 exists, the public authority may continue income withholding, 
251.24 	as well as use any other enforcement remedy for the collection of child support, until all 
251.25 	public assistance arrears are paid in full. Income withholding shall be in an amount equal 
251.26 	to 20 percent of the support order in effect at the time the services terminated.

251.27 	Sec. 64. [518A.685] CONSUMER REPORTING AGENCY; REPORTING 
251.28 	ARREARS.
251.29 	(a) If a public authority determines that an obligor has not paid the current monthly 
251.30 	support obligation plus any required arrearage payment for three months, the public 
251.31 	authority must report this information to a consumer reporting agency.
251.32 	(b) Before reporting that an obligor is in arrears for court-ordered child support, 
251.33 	the public authority must:
251.34 	(1) provide written notice to the obligor that the public authority intends to report the 
251.35 	arrears to a consumer reporting agency; and
252.1 	(2) mail the written notice to the obligor's last known mailing address at least 30 
252.2 	days before the public authority reports the arrears to a consumer reporting agency.
252.3 	(c) The obligor may, within 21 days of receipt of the notice, do the following to 
252.4 	prevent the public authority from reporting the arrears to a consumer reporting agency:
252.5 	(1) pay the arrears in full; or
252.6 	(2) request an administrative review. An administrative review is limited to issues 
252.7 	of mistaken identity, a pending legal action involving the arrears, or an incorrect arrears 
252.8 	balance.
252.9 	(d) If the public authority has reported that an obligor is in arrears for court-ordered 
252.10 	child support and subsequently determines that the obligor has paid the court-ordered 
252.11 	child support arrears in full, or is paying the current monthly support obligation plus any 
252.12 	required arrearage payment, the public authority must report to the consumer reporting 
252.13 	agency that the obligor is currently paying child support as ordered by the court.
252.14 	(e) A public authority that reports arrearage information under this section must 
252.15 	make monthly reports to a consumer reporting agency. The monthly report must be 
252.16 	consistent with credit reporting industry standards for child support.
252.17 	(f) For purposes of this section, "consumer reporting agency" has the meaning given 
252.18 	in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).

252.19 	Sec. 65. Minnesota Statutes 2014, section 518C.802, is amended to read:
252.20 	518C.802 CONDITIONS OF RENDITION.
252.21 	(a) Before making demand that the governor of another state surrender an individual 
252.22 	charged criminally in this state with having failed to provide for the support of an obligee, 
252.23 	the governor of this state may require a prosecutor of this state to demonstrate that at least 
252.24 	60 days previously the obligee had initiated proceedings for support pursuant to this 
252.25 	chapter or that the proceeding would be of no avail.
252.26 	(b) If, under this chapter or a law substantially similar to this chapter, the Uniform 
252.27 	Reciprocal Enforcement of Support Act, or the Revised Uniform Reciprocal Enforcement 
252.28 	of Support Act, the governor of another state makes a demand that the governor of 
252.29 	this state surrender an individual charged criminally in that state with having failed to 
252.30 	provide for the support of a child or other individual to whom a duty of support is owed, 
252.31 	the governor may require a prosecutor to investigate the demand and report whether 
252.32 	a proceeding for support has been initiated or would be effective. If it appears that a 
252.33 	proceeding would be effective but has not been initiated, the governor may delay honoring 
252.34 	the demand for a reasonable time to permit the initiation of a proceeding.
253.1 	(c) If a proceeding for support has been initiated and the individual whose rendition is 
253.2 	demanded prevails, the governor may decline to honor the demand. If the petitioner prevails 
253.3 	and the individual whose rendition is demanded is subject to a support order, the governor 
253.4 	may decline to honor the demand if the individual is complying with the support order.

253.5 	Sec. 66. Minnesota Statutes 2014, section 626.556, subdivision 1, as amended by Laws 
253.6 	2015, chapter 4, section 1, is amended to read:
253.7 		Subdivision 1.Public policy. (a) The legislature hereby declares that the public 
253.8 	policy of this state is to protect children whose health or welfare may be jeopardized 
253.9 	through physical abuse, neglect, or sexual abuse. While it is recognized that most parents 
253.10 	want to keep their children safe, sometimes circumstances or conditions interfere with 
253.11 	their ability to do so. When this occurs, the health and safety of the children shall be of 
253.12 	paramount concern. Intervention and prevention efforts shall address immediate concerns 
253.13 	for child safety and the ongoing risk of abuse or neglect and should engage the protective 
253.14 	capacities of families. In furtherance of this public policy, it is the intent of the legislature 
253.15 	under this section to:
253.16 	(1) protect children and promote child safety;
253.17 	(2) strengthen the family;
253.18 	(3) make the home, school, and community safe for children by promoting 
253.19 	responsible child care in all settings; and 
253.20 	(4) provide, when necessary, a safe temporary or permanent home environment for 
253.21 	physically or sexually abused or neglected children.
253.22 	(b) In addition, it is the policy of this state to:
253.23 	(1) require the reporting of neglect or physical or sexual abuse of children in the 
253.24 	home, school, and community settings; 
253.25 	(2) provide for the voluntary reporting of abuse or neglect of children; to require 
253.26 	a family assessment, when appropriate, as the preferred response to reports not alleging 
253.27 	substantial child endangerment;
253.28 	(3) require an investigation when the report alleges sexual abuse or substantial child 
253.29 	endangerment, as defined in subdivision 2, paragraph (c); 
253.30 	(4) provide a family assessment when there is no alleged substantial child 
253.31 	endangerment; and 
253.32 	(4) (5) provide protective, family support, and family preservation services when 
253.33 	needed in appropriate cases.

253.34 	Sec. 67. Minnesota Statutes 2014, section 626.556, subdivision 2, is amended to read:
254.1 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
254.2 	given them unless the specific content indicates otherwise:
254.3 	(a) "Family assessment" means a comprehensive assessment of child safety, risk 
254.4 	of subsequent child maltreatment, and family strengths and needs that is applied to a 
254.5 	child maltreatment report that does not allege substantial child endangerment. Family 
254.6 	assessment does not include a determination as to whether child maltreatment occurred 
254.7 	but does determine the need for services to address the safety of family members and the 
254.8 	risk of subsequent maltreatment.
254.9 	(b) "Investigation" means fact gathering related to the current safety of a child 
254.10 	and the risk of subsequent maltreatment that determines whether child maltreatment 
254.11 	occurred and whether child protective services are needed. An investigation must be used 
254.12 	when reports involve substantial child endangerment, and for reports of maltreatment in 
254.13 	facilities required to be licensed under chapter 245A or 245D; under sections 144.50 to 
254.14 	144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 
254.15 	13, and 124D.10; or in a nonlicensed personal care provider association as defined in 
254.16 	section 256B.0625, subdivision 19a.
254.17 	(c) "Substantial child endangerment" means a person responsible for a child's care, 
254.18 	and in the case of sexual abuse includes a person who has a significant relationship to the 
254.19 	child as defined in section 609.341, or a person in a position of authority as defined in 
254.20 	section 609.341, who by act or omission commits or attempts to commit an act against a 
254.21 	child under their care that constitutes any of the following:
254.22 	(1) egregious harm as defined in section 260C.007, subdivision 14;
254.23 	(2) sexual abuse as defined in paragraph (d);
254.24 	(3) abandonment under section 260C.301, subdivision 2;
254.25 	(4) neglect as defined in paragraph (f), clause (2), that substantially endangers the 
254.26 	child's physical or mental health, including a growth delay, which may be referred to as 
254.27 	failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
254.28 	(5) murder in the first, second, or third degree under section 609.185, 609.19, or 
254.29 	609.195;
254.30 	(6) manslaughter in the first or second degree under section 609.20 or 609.205;
254.31 	(7) assault in the first, second, or third degree under section 609.221, 609.222, or 
254.32 	609.223;
254.33 	(8) solicitation, inducement, and promotion of prostitution under section 609.322;
254.34 	(9) criminal sexual conduct under sections 609.342 to 609.3451;
254.35 	(10) solicitation of children to engage in sexual conduct under section 609.352;
255.1 	(11) malicious punishment or neglect or endangerment of a child under section 
255.2 	609.377 or 609.378;
255.3 	(12) use of a minor in sexual performance under section 617.246; or
255.4 	(13) parental behavior, status, or condition which mandates that the county attorney 
255.5 	file a termination of parental rights petition under section 260C.503, subdivision 2.
255.6 	(d) "Sexual abuse" means the subjection of a child by a person responsible for the 
255.7 	child's care, by a person who has a significant relationship to the child, as defined in 
255.8 	section 609.341, or by a person in a position of authority, as defined in section 609.341, 
255.9 	subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 
255.10 	conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 
255.11 	609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 
255.12 	in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 
255.13 	abuse also includes any act which involves a minor which constitutes a violation of 
255.14 	prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 
255.15 	threatened sexual abuse which includes the status of a parent or household member 
255.16 	who has committed a violation which requires registration as an offender under section 
255.17 	243.166, subdivision 1b, paragraph (a) or (b), or required registration under section 
255.18 	243.166, subdivision 1b, paragraph (a) or (b).
255.19 	(e) "Person responsible for the child's care" means (1) an individual functioning 
255.20 	within the family unit and having responsibilities for the care of the child such as a 
255.21 	parent, guardian, or other person having similar care responsibilities, or (2) an individual 
255.22 	functioning outside the family unit and having responsibilities for the care of the child 
255.23 	such as a teacher, school administrator, other school employees or agents, or other lawful 
255.24 	custodian of a child having either full-time or short-term care responsibilities including, 
255.25 	but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 
255.26 	and coaching.
255.27 	(f) "Neglect" means the commission or omission of any of the acts specified under 
255.28 	clauses (1) to (9), other than by accidental means:
255.29 	(1) failure by a person responsible for a child's care to supply a child with necessary 
255.30 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
255.31 	mental health when reasonably able to do so;
255.32 	(2) failure to protect a child from conditions or actions that seriously endanger the 
255.33 	child's physical or mental health when reasonably able to do so, including a growth delay, 
255.34 	which may be referred to as a failure to thrive, that has been diagnosed by a physician and 
255.35 	is due to parental neglect;
256.1 	(3) failure to provide for necessary supervision or child care arrangements 
256.2 	appropriate for a child after considering factors as the child's age, mental ability, physical 
256.3 	condition, length of absence, or environment, when the child is unable to care for the 
256.4 	child's own basic needs or safety, or the basic needs or safety of another child in their care;
256.5 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
256.6 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
256.7 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
256.8 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
256.9 	because the child's parent, guardian, or other person responsible for the child's care in 
256.10 	good faith selects and depends upon spiritual means or prayer for treatment or care of 
256.11 	disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 
256.12 	or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 
256.13 	if a lack of medical care may cause serious danger to the child's health. This section does 
256.14 	not impose upon persons, not otherwise legally responsible for providing a child with 
256.15 	necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
256.16 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, 
256.17 	subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 
256.18 	symptoms in the child at birth, results of a toxicology test performed on the mother at 
256.19 	delivery or the child at birth, medical effects or developmental delays during the child's 
256.20 	first year of life that medically indicate prenatal exposure to a controlled substance, or the 
256.21 	presence of a fetal alcohol spectrum disorder;
256.22 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
256.23 	(8) chronic and severe use of alcohol or a controlled substance by a parent or 
256.24 	person responsible for the care of the child that adversely affects the child's basic needs 
256.25 	and safety; or
256.26 	(9) emotional harm from a pattern of behavior which contributes to impaired 
256.27 	emotional functioning of the child which may be demonstrated by a substantial and 
256.28 	observable effect in the child's behavior, emotional response, or cognition that is not 
256.29 	within the normal range for the child's age and stage of development, with due regard to 
256.30 	the child's culture.
256.31 	(g) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
256.32 	inflicted by a person responsible for the child's care on a child other than by accidental 
256.33 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
256.34 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
256.35 	that have not been authorized under section 125A.0942 or 245.825.
257.1 	Abuse does not include reasonable and moderate physical discipline of a child 
257.2 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
257.3 	not include the use of reasonable force by a teacher, principal, or school employee as 
257.4 	allowed by section 121A.582. Actions which are not reasonable and moderate include, 
257.5 	but are not limited to, any of the following that are done in anger or without regard to the 
257.6 	safety of the child:
257.7 	(1) throwing, kicking, burning, biting, or cutting a child;
257.8 	(2) striking a child with a closed fist;
257.9 	(3) shaking a child under age three;
257.10 	(4) striking or other actions which result in any nonaccidental injury to a child 
257.11 	under 18 months of age;
257.12 	(5) unreasonable interference with a child's breathing;
257.13 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
257.14 	(7) striking a child under age one on the face or head;
257.15 	(8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
257.16 	substances which were not prescribed for the child by a practitioner, in order to control or 
257.17 	punish the child; or other substances that substantially affect the child's behavior, motor 
257.18 	coordination, or judgment or that results in sickness or internal injury, or subjects the 
257.19 	child to medical procedures that would be unnecessary if the child were not exposed 
257.20 	to the substances;
257.21 	(9) unreasonable physical confinement or restraint not permitted under section 
257.22 	609.379, including but not limited to tying, caging, or chaining; or
257.23 	(10) in a school facility or school zone, an act by a person responsible for the child's 
257.24 	care that is a violation under section 121A.58.
257.25 	(h) "Report" means any report received by the local welfare agency, police 
257.26 	department, county sheriff, or agency responsible for assessing or investigating 
257.27 	maltreatment pursuant to this section.
257.28 	(i) "Facility" means:
257.29 	(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 
257.30 	sanitarium, or other facility or institution required to be licensed under sections 144.50 to 
257.31 	144.58, 241.021, or 245A.01 to 245A.16, or chapter 245D;
257.32 	(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 
257.33 	124D.10; or
257.34 	(3) a nonlicensed personal care provider organization as defined in section 
257.35 	256B.0625, subdivision 19a.
257.36 	(j) "Operator" means an operator or agency as defined in section 245A.02.
258.1 	(k) "Commissioner" means the commissioner of human services.
258.2 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is 
258.3 	not limited to employee assistance counseling and the provision of guardian ad litem and 
258.4 	parenting time expeditor services.
258.5 	(m) "Mental injury" means an injury to the psychological capacity or emotional 
258.6 	stability of a child as evidenced by an observable or substantial impairment in the child's 
258.7 	ability to function within a normal range of performance and behavior with due regard to 
258.8 	the child's culture.
258.9 	(n) "Threatened injury" means a statement, overt act, condition, or status that 
258.10 	represents a substantial risk of physical or sexual abuse or mental injury. Threatened 
258.11 	injury includes, but is not limited to, exposing a child to a person responsible for the 
258.12 	child's care, as defined in paragraph (e), clause (1), who has:
258.13 	(1) subjected a child to, or failed to protect a child from, an overt act or condition 
258.14 	that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 
258.15 	similar law of another jurisdiction;
258.16 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
258.17 	(b), clause (4), or a similar law of another jurisdiction;
258.18 	(3) committed an act that has resulted in an involuntary termination of parental rights 
258.19 	under section 260C.301, or a similar law of another jurisdiction; or
258.20 	(4) committed an act that has resulted in the involuntary transfer of permanent 
258.21 	legal and physical custody of a child to a relative under Minnesota Statutes 2010, section 
258.22 	260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a 
258.23 	similar law of another jurisdiction.
258.24 	A child is the subject of a report of threatened injury when the responsible social 
258.25 	services agency receives birth match data under paragraph (o) from the Department of 
258.26 	Human Services.
258.27 	(o) Upon receiving data under section 144.225, subdivision 2b, contained in a 
258.28 	birth record or recognition of parentage identifying a child who is subject to threatened 
258.29 	injury under paragraph (n), the Department of Human Services shall send the data to the 
258.30 	responsible social services agency. The data is known as "birth match" data. Unless the 
258.31 	responsible social services agency has already begun an investigation or assessment of the 
258.32 	report due to the birth of the child or execution of the recognition of parentage and the 
258.33 	parent's previous history with child protection, the agency shall accept the birth match 
258.34 	data as a report under this section. The agency may use either a family assessment or 
258.35 	investigation to determine whether the child is safe. All of the provisions of this section 
258.36 	apply. If the child is determined to be safe, the agency shall consult with the county 
259.1 	attorney to determine the appropriateness of filing a petition alleging the child is in need 
259.2 	of protection or services under section 260C.007, subdivision 6, clause (16), in order to 
259.3 	deliver needed services. If the child is determined not to be safe, the agency and the county 
259.4 	attorney shall take appropriate action as required under section 260C.503, subdivision 2.
259.5 	(p) Persons who conduct assessments or investigations under this section shall take 
259.6 	into account accepted child-rearing practices of the culture in which a child participates 
259.7 	and accepted teacher discipline practices, which are not injurious to the child's health, 
259.8 	welfare, and safety.
259.9 	(q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected 
259.10 	occurrence or event which:
259.11 	(1) is not likely to occur and could not have been prevented by exercise of due 
259.12 	care; and
259.13 	(2) if occurring while a child is receiving services from a facility, happens when the 
259.14 	facility and the employee or person providing services in the facility are in compliance 
259.15 	with the laws and rules relevant to the occurrence or event.
259.16 	(r) "Nonmaltreatment mistake" means:
259.17 	(1) at the time of the incident, the individual was performing duties identified in the 
259.18 	center's child care program plan required under Minnesota Rules, part 9503.0045;
259.19 	(2) the individual has not been determined responsible for a similar incident that 
259.20 	resulted in a finding of maltreatment for at least seven years;
259.21 	(3) the individual has not been determined to have committed a similar 
259.22 	nonmaltreatment mistake under this paragraph for at least four years;
259.23 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
259.24 	remedies that are available over the counter, whether ordered by a medical professional or 
259.25 	not; and
259.26 	(5) except for the period when the incident occurred, the facility and the individual 
259.27 	providing services were both in compliance with all licensing requirements relevant to the 
259.28 	incident.
259.29 	This definition only applies to child care centers licensed under Minnesota 
259.30 	Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of 
259.31 	substantiated maltreatment by the individual, the commissioner of human services shall 
259.32 	determine that a nonmaltreatment mistake was made by the individual.

259.33 	Sec. 68. Minnesota Statutes 2014, section 626.556, subdivision 3, is amended to read:
259.34 		Subd. 3.Persons mandated to report. (a) A person who knows or has reason 
259.35 	to believe a child is being neglected or physically or sexually abused, as defined in 
260.1 	subdivision 2, or has been neglected or physically or sexually abused within the preceding 
260.2 	three years, shall immediately report the information to the local welfare agency, agency 
260.3 	responsible for assessing or investigating the report, police department, or the county 
260.4 	sheriff if the person is:
260.5 	(1) a professional or professional's delegate who is engaged in the practice of 
260.6 	the healing arts, social services, hospital administration, psychological or psychiatric 
260.7 	treatment, child care, education, correctional supervision, probation and correctional 
260.8 	services, or law enforcement; or
260.9 	(2) employed as a member of the clergy and received the information while 
260.10 	engaged in ministerial duties, provided that a member of the clergy is not required by 
260.11 	this subdivision to report information that is otherwise privileged under section 595.02, 
260.12 	subdivision 1, paragraph (c).
260.13 	The police department or the county sheriff, upon receiving a report, shall 
260.14 	immediately notify the local welfare agency or agency responsible for assessing or 
260.15 	investigating the report, orally and in writing. The local welfare agency, or agency 
260.16 	responsible for assessing or investigating the report, upon receiving a report, shall 
260.17 	immediately notify the local police department or the county sheriff orally and in writing 
260.18 	when a report is received, including reports that are not accepted for investigation or 
260.19 	assessment. The county sheriff and the head of every local welfare agency, agency 
260.20 	responsible for assessing or investigating reports, and police department shall each 
260.21 	designate a person within their agency, department, or office who is responsible for 
260.22 	ensuring that the notification duties of this paragraph and paragraph (b) are carried out. 
260.23 	Nothing in this subdivision shall be construed to require more than one report from any 
260.24 	institution, facility, school, or agency.
260.25 	(b) Any person may voluntarily report to the local welfare agency, agency 
260.26 	responsible for assessing or investigating the report, police department, or the county 
260.27 	sheriff if the person knows, has reason to believe, or suspects a child is being or has been 
260.28 	neglected or subjected to physical or sexual abuse. The police department or the county 
260.29 	sheriff, upon receiving a report, shall immediately notify the local welfare agency or 
260.30 	agency responsible for assessing or investigating the report, orally and in writing. The 
260.31 	local welfare agency or agency responsible for assessing or investigating the report, upon 
260.32 	receiving a report, shall immediately notify the local police department or the county 
260.33 	sheriff orally and in writing when a report is received, including reports that are not 
260.34 	accepted for investigation or assessment.
260.35 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
260.36 	within a licensed facility shall report the information to the agency responsible for 
261.1 	licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 
261.2 	chapter 245D; or a nonlicensed personal care provider organization as defined in section 
261.3 	256B.0625, subdivision 19. A health or corrections agency receiving a report may request 
261.4 	the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A 
261.5 	board or other entity whose licensees perform work within a school facility, upon receiving 
261.6 	a complaint of alleged maltreatment, shall provide information about the circumstances of 
261.7 	the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4, 
261.8 	applies to data received by the commissioner of education from a licensing entity.
261.9 	(d) Any person mandated to report shall receive a summary of the disposition of 
261.10 	any report made by that reporter, including whether the case has been opened for child 
261.11 	protection or other services, or if a referral has been made to a community organization, 
261.12 	unless release would be detrimental to the best interests of the child. Any person who is 
261.13 	not mandated to report shall, upon request to the local welfare agency, receive a concise 
261.14 	summary of the disposition of any report made by that reporter, unless release would be 
261.15 	detrimental to the best interests of the child.
261.16 	(e) For purposes of this section, "immediately" means as soon as possible but in 
261.17 	no event longer than 24 hours.

261.18 	Sec. 69. Minnesota Statutes 2014, section 626.556, subdivision 6a, is amended to read:
261.19 		Subd. 6a.Failure to notify. If a local welfare agency receives a report under 
261.20 	subdivision 3 10, paragraph (a) or (b), and fails to notify the local police department or 
261.21 	county sheriff as required by subdivision 3 10, paragraph (a) or (b), the person within 
261.22 	the agency who is responsible for ensuring that notification is made shall be subject to 
261.23 	disciplinary action in keeping with the agency's existing policy or collective bargaining 
261.24 	agreement on discipline of employees. If a local police department or a county sheriff 
261.25 	receives a report under subdivision 3, paragraph (a) or (b), and fails to notify the local 
261.26 	welfare agency as required by subdivision 3, paragraph (a) or (b), the person within 
261.27 	the police department or county sheriff's office who is responsible for ensuring that 
261.28 	notification is made shall be subject to disciplinary action in keeping with the agency's 
261.29 	existing policy or collective bargaining agreement on discipline of employees.

261.30 	Sec. 70. Minnesota Statutes 2014, section 626.556, subdivision 7, as amended by Laws 
261.31 	2015, chapter 4, section 2, is amended to read:
261.32 		Subd. 7.Report; information provided to parent. (a) An oral report shall be 
261.33 	made immediately by telephone or otherwise. An oral report made by a person required 
261.34 	under subdivision 3 to report shall be followed within 72 hours, exclusive of weekends 
262.1 	and holidays, by a report in writing to the appropriate police department, the county 
262.2 	sheriff, the agency responsible for assessing or investigating or assessing the report, or 
262.3 	the local welfare agency. 
262.4 	(b) The local welfare agency shall immediately notify local law enforcement when a 
262.5 	report is received, including reports that are not accepted for investigation or assessment.
262.6 	(c) The local welfare agency shall determine if the report is accepted for an 
262.7 	assessment or investigation or assessment as soon as possible but in no event longer 
262.8 	than 24 hours after the report is received.
262.9 	(b) (d) Any report shall be of sufficient content to identify the child, any person 
262.10 	believed to be responsible for the abuse or neglect of the child if the person is known, the 
262.11 	nature and extent of the abuse or neglect and the name and address of the reporter. The 
262.12 	local welfare agency or agency responsible for assessing or investigating the report shall 
262.13 	accept a report made under subdivision 3 notwithstanding refusal by a reporter to provide 
262.14 	the reporter's name or address as long as the report is otherwise sufficient under this 
262.15 	paragraph. Written reports received by a police department or the county sheriff shall be 
262.16 	forwarded immediately to the local welfare agency or the agency responsible for assessing 
262.17 	or investigating the report. The police department or the county sheriff may keep copies of 
262.18 	reports received by them. Copies of written reports received by a local welfare department 
262.19 	or the agency responsible for assessing or investigating the report shall be forwarded 
262.20 	immediately to the local police department or the county sheriff.
262.21 	(c) (e) When requested, the agency responsible for assessing or investigating a 
262.22 	report shall inform the reporter within ten days after the report was made, either orally or 
262.23 	in writing, whether the report was accepted or not. If the responsible agency determines 
262.24 	the report does not constitute a report under this section, the agency shall advise the 
262.25 	reporter the report was screened out. 
262.26 	(f) A local welfare agency or agency responsible for investigating or assessing a 
262.27 	report may use a screened-out report for making an offer of social services to the subjects 
262.28 	of the screened-out report. A local welfare agency or agency responsible for evaluating a 
262.29 	report alleging maltreatment of a child shall consider prior reports, including screened-out 
262.30 	reports, to determine whether an investigation or family assessment must be conducted. A 
262.31 	screened-out report must be maintained in accordance with subdivision 11c, paragraph (a).
262.32 	(d) (g) Notwithstanding paragraph (a), the commissioner of education must inform 
262.33 	the parent, guardian, or legal custodian of the child who is the subject of a report of 
262.34 	alleged maltreatment in a school facility within ten days of receiving the report, either 
262.35 	orally or in writing, whether the commissioner is assessing or investigating the report 
262.36 	of alleged maltreatment.
263.1 	(e) (h) Regardless of whether a report is made under this subdivision, as soon as 
263.2 	practicable after a school receives information regarding an incident that may constitute 
263.3 	maltreatment of a child in a school facility, the school shall inform the parent, legal 
263.4 	guardian, or custodian of the child that an incident has occurred that may constitute 
263.5 	maltreatment of the child, when the incident occurred, and the nature of the conduct 
263.6 	that may constitute maltreatment.
263.7 	(f) (i) A written copy of a report maintained by personnel of agencies, other than 
263.8 	welfare or law enforcement agencies, which are subject to chapter 13 shall be confidential. 
263.9 	An individual subject of the report may obtain access to the original report as provided 
263.10 	by subdivision 11.

263.11 	Sec. 71. Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision 
263.12 	to read:
263.13 		Subd. 7a.Guidance for screening reports. (a) Child protection staff, supervisors, 
263.14 	and others involved in child protection screening shall follow the guidance provided 
263.15 	in the child maltreatment screening guidelines issued by the commissioner of human 
263.16 	services and, when notified by the commissioner, shall immediately implement updated 
263.17 	procedures and protocols.
263.18 	(b) In consultation with the county attorney, the county social service agency may 
263.19 	elect to adopt a standard consistent with state law that permits the county to accept reports 
263.20 	that are not required to be screened in under the child maltreatment screening guidelines.

263.21 	Sec. 72. Minnesota Statutes 2014, section 626.556, subdivision 10, is amended to read:
263.22 		Subd. 10.Duties of local welfare agency and local law enforcement agency upon 
263.23 	receipt of report. (a) Upon receipt of a report, the local welfare agency shall determine 
263.24 	whether to conduct a family assessment or an investigation as appropriate to prevent or 
263.25 	provide a remedy for child maltreatment. The local welfare agency must notify local 
263.26 	law enforcement when a report is received, including reports that are not accepted for 
263.27 	investigation or assessment. The local welfare agency:
263.28 	(1) shall conduct an investigation on reports involving sexual abuse or substantial 
263.29 	child endangerment;
263.30 	(2) shall begin an immediate investigation if, at any time when it is using a family 
263.31 	assessment response, it determines that there is reason to believe that substantial child 
263.32 	endangerment or a serious threat to the child's safety exists;
263.33 	(3) may conduct a family assessment for reports that do not allege substantial child 
263.34 	endangerment. In determining that a family assessment is appropriate, the local welfare 
264.1 	agency may consider issues of child safety, parental cooperation, and the need for an 
264.2 	immediate response; and
264.3 	(4) may conduct a family assessment on a report that was initially screened and 
264.4 	assigned for an investigation. In determining that a complete investigation is not required, 
264.5 	the local welfare agency must document the reason for terminating the investigation and 
264.6 	notify the local law enforcement agency if the local law enforcement agency is conducting 
264.7 	a joint investigation.
264.8 	If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, 
264.9 	or individual functioning within the family unit as a person responsible for the child's 
264.10 	care, or sexual abuse by a person with a significant relationship to the child when that 
264.11 	person resides in the child's household or by a sibling, the local welfare agency shall 
264.12 	immediately conduct a family assessment or investigation as identified in clauses (1) to 
264.13 	(4). In conducting a family assessment or investigation, the local welfare agency shall 
264.14 	gather information on the existence of substance abuse and domestic violence and offer 
264.15 	services for purposes of preventing future child maltreatment, safeguarding and enhancing 
264.16 	the welfare of the abused or neglected minor, and supporting and preserving family 
264.17 	life whenever possible. If the report alleges a violation of a criminal statute involving 
264.18 	sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the 
264.19 	local law enforcement agency and local welfare agency shall coordinate the planning and 
264.20 	execution of their respective investigation and assessment efforts to avoid a duplication of 
264.21 	fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of 
264.22 	the results of its investigation. In cases of alleged child maltreatment resulting in death, 
264.23 	the local agency may rely on the fact-finding efforts of a law enforcement investigation 
264.24 	to make a determination of whether or not maltreatment occurred. When necessary the 
264.25 	local welfare agency shall seek authority to remove the child from the custody of a parent, 
264.26 	guardian, or adult with whom the child is living. In performing any of these duties, the 
264.27 	local welfare agency shall maintain appropriate records.
264.28 	If the family assessment or investigation indicates there is a potential for abuse of 
264.29 	alcohol or other drugs by the parent, guardian, or person responsible for the child's care, 
264.30 	the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota 
264.31 	Rules, part 9530.6615.
264.32 	(b) When a local agency receives a report or otherwise has information indicating 
264.33 	that a child who is a client, as defined in section 245.91, has been the subject of physical 
264.34 	abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 
264.35 	245.91, it shall, in addition to its other duties under this section, immediately inform the 
264.36 	ombudsman established under sections 245.91 to 245.97. The commissioner of education 
265.1 	shall inform the ombudsman established under sections 245.91 to 245.97 of reports 
265.2 	regarding a child defined as a client in section 245.91 that maltreatment occurred at a 
265.3 	school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
265.4 	(c) Authority of the local welfare agency responsible for assessing or investigating 
265.5 	the child abuse or neglect report, the agency responsible for assessing or investigating 
265.6 	the report, and of the local law enforcement agency for investigating the alleged abuse or 
265.7 	neglect includes, but is not limited to, authority to interview, without parental consent, 
265.8 	the alleged victim and any other minors who currently reside with or who have resided 
265.9 	with the alleged offender. The interview may take place at school or at any facility or 
265.10 	other place where the alleged victim or other minors might be found or the child may be 
265.11 	transported to, and the interview conducted at, a place appropriate for the interview of a 
265.12 	child designated by the local welfare agency or law enforcement agency. The interview 
265.13 	may take place outside the presence of the alleged offender or parent, legal custodian, 
265.14 	guardian, or school official. For family assessments, it is the preferred practice to request 
265.15 	a parent or guardian's permission to interview the child prior to conducting the child 
265.16 	interview, unless doing so would compromise the safety assessment. Except as provided in 
265.17 	this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible 
265.18 	local welfare or law enforcement agency no later than the conclusion of the investigation 
265.19 	or assessment that this interview has occurred. Notwithstanding rule 32 of the Minnesota 
265.20 	Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on an ex parte 
265.21 	motion by the local welfare agency, order that, where reasonable cause exists, the agency 
265.22 	withhold notification of this interview from the parent, legal custodian, or guardian. If the 
265.23 	interview took place or is to take place on school property, the order shall specify that 
265.24 	school officials may not disclose to the parent, legal custodian, or guardian the contents 
265.25 	of the notification of intent to interview the child on school property, as provided under 
265.26 	this paragraph, and any other related information regarding the interview that may be a 
265.27 	part of the child's school record. A copy of the order shall be sent by the local welfare or 
265.28 	law enforcement agency to the appropriate school official.
265.29 	(d) When the local welfare, local law enforcement agency, or the agency responsible 
265.30 	for assessing or investigating a report of maltreatment determines that an interview should 
265.31 	take place on school property, written notification of intent to interview the child on school 
265.32 	property must be received by school officials prior to the interview. The notification 
265.33 	shall include the name of the child to be interviewed, the purpose of the interview, and 
265.34 	a reference to the statutory authority to conduct an interview on school property. For 
265.35 	interviews conducted by the local welfare agency, the notification shall be signed by the 
265.36 	chair of the local social services agency or the chair's designee. The notification shall be 
266.1 	private data on individuals subject to the provisions of this paragraph. School officials 
266.2 	may not disclose to the parent, legal custodian, or guardian the contents of the notification 
266.3 	or any other related information regarding the interview until notified in writing by the 
266.4 	local welfare or law enforcement agency that the investigation or assessment has been 
266.5 	concluded, unless a school employee or agent is alleged to have maltreated the child. 
266.6 	Until that time, the local welfare or law enforcement agency or the agency responsible 
266.7 	for assessing or investigating a report of maltreatment shall be solely responsible for any 
266.8 	disclosures regarding the nature of the assessment or investigation.
266.9 	Except where the alleged offender is believed to be a school official or employee, 
266.10 	the time and place, and manner of the interview on school premises shall be within the 
266.11 	discretion of school officials, but the local welfare or law enforcement agency shall have 
266.12 	the exclusive authority to determine who may attend the interview. The conditions as to 
266.13 	time, place, and manner of the interview set by the school officials shall be reasonable and 
266.14 	the interview shall be conducted not more than 24 hours after the receipt of the notification 
266.15 	unless another time is considered necessary by agreement between the school officials and 
266.16 	the local welfare or law enforcement agency. Where the school fails to comply with the 
266.17 	provisions of this paragraph, the juvenile court may order the school to comply. Every 
266.18 	effort must be made to reduce the disruption of the educational program of the child, other 
266.19 	students, or school staff when an interview is conducted on school premises.
266.20 	(e) Where the alleged offender or a person responsible for the care of the alleged 
266.21 	victim or other minor prevents access to the victim or other minor by the local welfare 
266.22 	agency, the juvenile court may order the parents, legal custodian, or guardian to produce 
266.23 	the alleged victim or other minor for questioning by the local welfare agency or the local 
266.24 	law enforcement agency outside the presence of the alleged offender or any person 
266.25 	responsible for the child's care at reasonable places and times as specified by court order.
266.26 	(f) Before making an order under paragraph (e), the court shall issue an order to 
266.27 	show cause, either upon its own motion or upon a verified petition, specifying the basis for 
266.28 	the requested interviews and fixing the time and place of the hearing. The order to show 
266.29 	cause shall be served personally and shall be heard in the same manner as provided in 
266.30 	other cases in the juvenile court. The court shall consider the need for appointment of a 
266.31 	guardian ad litem to protect the best interests of the child. If appointed, the guardian ad 
266.32 	litem shall be present at the hearing on the order to show cause.
266.33 	(g) The commissioner of human services, the ombudsman for mental health and 
266.34 	developmental disabilities, the local welfare agencies responsible for investigating reports, 
266.35 	the commissioner of education, and the local law enforcement agencies have the right to 
266.36 	enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, 
267.1 	including medical records, as part of the investigation. Notwithstanding the provisions of 
267.2 	chapter 13, they also have the right to inform the facility under investigation that they are 
267.3 	conducting an investigation, to disclose to the facility the names of the individuals under 
267.4 	investigation for abusing or neglecting a child, and to provide the facility with a copy of 
267.5 	the report and the investigative findings.
267.6 	(h) The local welfare agency responsible for conducting a family assessment or 
267.7 	investigation shall collect available and relevant information to determine child safety, 
267.8 	risk of subsequent child maltreatment, and family strengths and needs and share not public 
267.9 	information with an Indian's tribal social services agency without violating any law of the 
267.10 	state that may otherwise impose duties of confidentiality on the local welfare agency in 
267.11 	order to implement the tribal state agreement. The local welfare agency or the agency 
267.12 	responsible for investigating the report shall collect available and relevant information 
267.13 	to ascertain whether maltreatment occurred and whether protective services are needed. 
267.14 	Information collected includes, when relevant, information with regard to the person 
267.15 	reporting the alleged maltreatment, including the nature of the reporter's relationship to the 
267.16 	child and to the alleged offender, and the basis of the reporter's knowledge for the report; 
267.17 	the child allegedly being maltreated; the alleged offender; the child's caretaker; and other 
267.18 	collateral sources having relevant information related to the alleged maltreatment. The 
267.19 	local welfare agency or the agency responsible for investigating the report may make a 
267.20 	determination of no maltreatment early in an investigation, and close the case and retain 
267.21 	immunity, if the collected information shows no basis for a full investigation.
267.22 	Information relevant to the assessment or investigation must be asked for, and 
267.23 	may include:
267.24 	(1) the child's sex and age,; prior reports of maltreatment, including any 
267.25 	maltreatment reports that were screened out and not accepted for assessment or 
267.26 	investigation;  information relating to developmental functioning,; credibility of the child's 
267.27 	statement,; and whether the information provided under this clause is consistent with other 
267.28 	information collected during the course of the assessment or investigation;
267.29 	(2) the alleged offender's age, a record check for prior reports of maltreatment, and 
267.30 	criminal charges and convictions. The local welfare agency or the agency responsible for 
267.31 	assessing or investigating the report must provide the alleged offender with an opportunity 
267.32 	to make a statement. The alleged offender may submit supporting documentation relevant 
267.33 	to the assessment or investigation;
267.34 	(3) collateral source information regarding the alleged maltreatment and care of the 
267.35 	child. Collateral information includes, when relevant: (i) a medical examination of the 
267.36 	child; (ii) prior medical records relating to the alleged maltreatment or the care of the 
268.1 	child maintained by any facility, clinic, or health care professional and an interview with 
268.2 	the treating professionals; and (iii) interviews with the child's caretakers, including the 
268.3 	child's parent, guardian, foster parent, child care provider, teachers, counselors, family 
268.4 	members, relatives, and other persons who may have knowledge regarding the alleged 
268.5 	maltreatment and the care of the child; and
268.6 	(4) information on the existence of domestic abuse and violence in the home of 
268.7 	the child, and substance abuse.
268.8 	Nothing in this paragraph precludes the local welfare agency, the local law 
268.9 	enforcement agency, or the agency responsible for assessing or investigating the report 
268.10 	from collecting other relevant information necessary to conduct the assessment or 
268.11 	investigation. Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare 
268.12 	agency has access to medical data and records for purposes of clause (3). Notwithstanding 
268.13 	the data's classification in the possession of any other agency, data acquired by the 
268.14 	local welfare agency or the agency responsible for assessing or investigating the report 
268.15 	during the course of the assessment or investigation are private data on individuals and 
268.16 	must be maintained in accordance with subdivision 11. Data of the commissioner of 
268.17 	education collected or maintained during and for the purpose of an investigation of 
268.18 	alleged maltreatment in a school are governed by this section, notwithstanding the data's 
268.19 	classification as educational, licensing, or personnel data under chapter 13.
268.20 	In conducting an assessment or investigation involving a school facility as defined 
268.21 	in subdivision 2, paragraph (i), the commissioner of education shall collect investigative 
268.22 	reports and data that are relevant to a report of maltreatment and are from local law 
268.23 	enforcement and the school facility.
268.24 	(i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face 
268.25 	contact with the child reported to be maltreated and with the child's primary caregiver 
268.26 	sufficient to complete a safety assessment and ensure the immediate safety of the child. 
268.27 	The face-to-face contact with the child and primary caregiver shall occur immediately 
268.28 	if substantial child endangerment is alleged and within five calendar days for all other 
268.29 	reports. If the alleged offender was not already interviewed as the primary caregiver, the 
268.30 	local welfare agency shall also conduct a face-to-face interview with the alleged offender 
268.31 	in the early stages of the assessment or investigation. At the initial contact, the local child 
268.32 	welfare agency or the agency responsible for assessing or investigating the report must 
268.33 	inform the alleged offender of the complaints or allegations made against the individual in 
268.34 	a manner consistent with laws protecting the rights of the person who made the report. 
268.35 	The interview with the alleged offender may be postponed if it would jeopardize an active 
268.36 	law enforcement investigation.
269.1 	(j) When conducting an investigation, the local welfare agency shall use a question 
269.2 	and answer interviewing format with questioning as nondirective as possible to elicit 
269.3 	spontaneous responses. For investigations only, the following interviewing methods and 
269.4 	procedures must be used whenever possible when collecting information:
269.5 	(1) audio recordings of all interviews with witnesses and collateral sources; and
269.6 	(2) in cases of alleged sexual abuse, audio-video recordings of each interview with 
269.7 	the alleged victim and child witnesses.
269.8 	(k) In conducting an assessment or investigation involving a school facility as 
269.9 	defined in subdivision 2, paragraph (i), the commissioner of education shall collect 
269.10 	available and relevant information and use the procedures in paragraphs (i), (k), and 
269.11 	subdivision 3d, except that the requirement for face-to-face observation of the child 
269.12 	and face-to-face interview of the alleged offender is to occur in the initial stages of the 
269.13 	assessment or investigation provided that the commissioner may also base the assessment 
269.14 	or investigation on investigative reports and data received from the school facility and 
269.15 	local law enforcement, to the extent those investigations satisfy the requirements of 
269.16 	paragraphs (i) and (k), and subdivision 3d.

269.17 	Sec. 73. Minnesota Statutes 2014, section 626.556, subdivision 10e, is amended to read:
269.18 		Subd. 10e.Determinations. (a) The local welfare agency shall conclude the family 
269.19 	assessment or the investigation within 45 days of the receipt of a report. The conclusion of 
269.20 	the assessment or investigation may be extended to permit the completion of a criminal 
269.21 	investigation or the receipt of expert information requested within 45 days of the receipt 
269.22 	of the report.
269.23 	(b) After conducting a family assessment, the local welfare agency shall determine 
269.24 	whether services are needed to address the safety of the child and other family members 
269.25 	and the risk of subsequent maltreatment.
269.26 	(c) After conducting an investigation, the local welfare agency shall make two 
269.27 	determinations: first, whether maltreatment has occurred; and second, whether child 
269.28 	protective services are needed. No determination of maltreatment shall be made when the 
269.29 	alleged perpetrator is a child under the age of ten.
269.30 	(d) If the commissioner of education conducts an assessment or investigation, 
269.31 	the commissioner shall determine whether maltreatment occurred and what corrective 
269.32 	or protective action was taken by the school facility. If a determination is made that 
269.33 	maltreatment has occurred, the commissioner shall report to the employer, the school 
269.34 	board, and any appropriate licensing entity the determination that maltreatment occurred 
269.35 	and what corrective or protective action was taken by the school facility. In all other cases, 
270.1 	the commissioner shall inform the school board or employer that a report was received, 
270.2 	the subject of the report, the date of the initial report, the category of maltreatment alleged 
270.3 	as defined in paragraph (f), the fact that maltreatment was not determined, and a summary 
270.4 	of the specific reasons for the determination.
270.5 	(e) When maltreatment is determined in an investigation involving a facility, 
270.6 	the investigating agency shall also determine whether the facility or individual was 
270.7 	responsible, or whether both the facility and the individual were responsible for the 
270.8 	maltreatment using the mitigating factors in paragraph (i). Determinations under this 
270.9 	subdivision must be made based on a preponderance of the evidence and are private data 
270.10 	on individuals or nonpublic data as maintained by the commissioner of education.
270.11 	(f) For the purposes of this subdivision, "maltreatment" means any of the following 
270.12 	acts or omissions:
270.13 	(1) physical abuse as defined in subdivision 2, paragraph (g);
270.14 	(2) neglect as defined in subdivision 2, paragraph (f);
270.15 	(3) sexual abuse as defined in subdivision 2, paragraph (d);
270.16 	(4) mental injury as defined in subdivision 2, paragraph (m); or
270.17 	(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (i).
270.18 	(g) For the purposes of this subdivision, a determination that child protective 
270.19 	services are needed means that the local welfare agency has documented conditions 
270.20 	during the assessment or investigation sufficient to cause a child protection worker, as 
270.21 	defined in section 626.559, subdivision 1, to conclude that a child is at significant risk of 
270.22 	maltreatment if protective intervention is not provided and that the individuals responsible 
270.23 	for the child's care have not taken or are not likely to take actions to protect the child 
270.24 	from maltreatment or risk of maltreatment.
270.25 	(h) This subdivision does not mean that maltreatment has occurred solely because 
270.26 	the child's parent, guardian, or other person responsible for the child's care in good faith 
270.27 	selects and depends upon spiritual means or prayer for treatment or care of disease 
270.28 	or remedial care of the child, in lieu of medical care. However, if lack of medical care 
270.29 	may result in serious danger to the child's health, the local welfare agency may ensure 
270.30 	that necessary medical services are provided to the child.
270.31 	(i) When determining whether the facility or individual is the responsible party, or 
270.32 	whether both the facility and the individual are responsible for determined maltreatment in 
270.33 	a facility, the investigating agency shall consider at least the following mitigating factors:
270.34 	(1) whether the actions of the facility or the individual caregivers were according to, 
270.35 	and followed the terms of, an erroneous physician order, prescription, individual care plan, 
270.36 	or directive; however, this is not a mitigating factor when the facility or caregiver was 
271.1 	responsible for the issuance of the erroneous order, prescription, individual care plan, or 
271.2 	directive or knew or should have known of the errors and took no reasonable measures to 
271.3 	correct the defect before administering care;
271.4 	(2) comparative responsibility between the facility, other caregivers, and 
271.5 	requirements placed upon an employee, including the facility's compliance with related 
271.6 	regulatory standards and the adequacy of facility policies and procedures, facility training, 
271.7 	an individual's participation in the training, the caregiver's supervision, and facility staffing 
271.8 	levels and the scope of the individual employee's authority and discretion; and
271.9 	(3) whether the facility or individual followed professional standards in exercising 
271.10 	professional judgment.
271.11 	The evaluation of the facility's responsibility under clause (2) must not be based on the 
271.12 	completeness of the risk assessment or risk reduction plan required under section 245A.66, 
271.13 	but must be based on the facility's compliance with the regulatory standards for policies and 
271.14 	procedures, training, and supervision as cited in Minnesota Statutes and Minnesota Rules.
271.15 	(j) Notwithstanding paragraph (i), when maltreatment is determined to have been 
271.16 	committed by an individual who is also the facility license holder, both the individual and 
271.17 	the facility must be determined responsible for the maltreatment, and both the background 
271.18 	study disqualification standards under section 245C.15, subdivision 4, and the licensing 
271.19 	actions under sections 245A.06 or 245A.07 apply.
271.20 	(k) Individual counties may implement more detailed definitions or criteria that 
271.21 	indicate which allegations to investigate, as long as a county's policies are consistent 
271.22 	with the definitions in the statutes and rules and are approved by the county board. Each 
271.23 	local welfare agency shall periodically inform mandated reporters under subdivision 3 
271.24 	who work in the county of the definitions of maltreatment in the statutes and rules and any 
271.25 	additional definitions or criteria that have been approved by the county board.

271.26 	Sec. 74. Minnesota Statutes 2014, section 626.556, subdivision 11c, is amended to read:
271.27 		Subd. 11c.Welfare, court services agency, and school records maintained.
 271.28 	Notwithstanding sections 138.163 and 138.17, records maintained or records derived 
271.29 	from reports of abuse by local welfare agencies, agencies responsible for assessing or 
271.30 	investigating the report, court services agencies, or schools under this section shall be 
271.31 	destroyed as provided in paragraphs (a) to (d) by the responsible authority.
271.32 	(a) For reports alleging child maltreatment that were not accepted for assessment 
271.33 	or investigation, family assessment cases, and cases where an investigation results in no 
271.34 	determination of maltreatment or the need for child protective services, the assessment or 
271.35 	investigation records must be maintained for a period of four five years after the date the 
272.1 	report was not accepted for assessment or investigation or of the final entry in the case 
272.2 	record. Records of reports that were not accepted must contain sufficient information to 
272.3 	identify the subjects of the report, the nature of the alleged maltreatment, and the reasons 
272.4 	as to why the report was not accepted. Records under this paragraph may not be used for 
272.5 	employment, background checks, or purposes other than to assist in future screening 
272.6 	decisions and risk and safety assessments.
272.7 	(b) All records relating to reports which, upon investigation, indicate either 
272.8 	maltreatment or a need for child protective services shall be maintained for ten years after 
272.9 	the date of the final entry in the case record.
272.10 	(c) All records regarding a report of maltreatment, including any notification of intent 
272.11 	to interview which was received by a school under subdivision 10, paragraph (d), shall be 
272.12 	destroyed by the school when ordered to do so by the agency conducting the assessment or 
272.13 	investigation. The agency shall order the destruction of the notification when other records 
272.14 	relating to the report under investigation or assessment are destroyed under this subdivision.
272.15 	(d) Private or confidential data released to a court services agency under subdivision 
272.16 	10h must be destroyed by the court services agency when ordered to do so by the local 
272.17 	welfare agency that released the data. The local welfare agency or agency responsible for 
272.18 	assessing or investigating the report shall order destruction of the data when other records 
272.19 	relating to the assessment or investigation are destroyed under this subdivision.
272.20 	(e) For reports alleging child maltreatment that were not accepted for assessment 
272.21 	or investigation, counties shall maintain sufficient information to identify repeat reports 
272.22 	alleging maltreatment of the same child or children for 365 days from the date the report 
272.23 	was screened out. The commissioner of human services shall specify to the counties the 
272.24 	minimum information needed to accomplish this purpose. Counties shall enter this data 
272.25 	into the state social services information system.

272.26 	Sec. 75. Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision 
272.27 	to read:
272.28 		Subd. 16.Commissioner's duty to provide oversight; quality assurance reviews; 
272.29 	annual summary of reviews. (a) The commissioner shall develop a plan to perform 
272.30 	quality assurance reviews of local welfare agency screening practices and decisions. 
272.31 	The commissioner shall provide oversight and guidance to counties to ensure consistent 
272.32 	application of screening guidelines, thorough and appropriate screening decisions, and 
272.33 	correct documentation and maintenance of reports. Quality assurance reviews must begin 
272.34 	no later than September 30, 2015.
273.1 	(b) The commissioner shall produce an annual report of the summary results of the 
273.2 	reviews. The report must only contain aggregate data and may not include any data that 
273.3 	could be used to personally identify any subject whose data is included in the report. The 
273.4 	report is public information and must be provided to the chairs and ranking minority 
273.5 	members of the legislative committees having jurisdiction over child protection issues.

273.6 	Sec. 76. Laws 2014, chapter 189, section 5, is amended to read:
273.7 	Sec. 5. Minnesota Statutes 2012, section 518C.201, is amended to read:
273.8 	518C.201 BASES FOR JURISDICTION OVER NONRESIDENT.
273.9 	(a) In a proceeding to establish, or enforce, or modify a support order or to determine 
273.10 	parentage of a child, a tribunal of this state may exercise personal jurisdiction over a 
273.11 	nonresident individual or the individual's guardian or conservator if:
273.12 	(1) the individual is personally served with a summons or comparable document 
273.13 	within this state;
273.14 	(2) the individual submits to the jurisdiction of this state by consent, by entering a 
273.15 	general appearance, or by filing a responsive document having the effect of waiving any 
273.16 	contest to personal jurisdiction;
273.17 	(3) the individual resided with the child in this state;
273.18 	(4) the individual resided in this state and provided prenatal expenses or support 
273.19 	for the child;
273.20 	(5) the child resides in this state as a result of the acts or directives of the individual;
273.21 	(6) the individual engaged in sexual intercourse in this state and the child may have 
273.22 	been conceived by that act of intercourse;
273.23 	(7) the individual asserted parentage of a child under sections 257.51 to 257.75; or 
273.24 	(8) there is any other basis consistent with the constitutions of this state and the 
273.25 	United States for the exercise of personal jurisdiction.
273.26 	(b) The bases of personal jurisdiction in paragraph (a) or in any other law of this state 
273.27 	may not be used to acquire personal jurisdiction for a tribunal of this state to modify a child 
273.28 	support order of another state unless the requirements of section 518C.611 are met, or, in 
273.29 	the case of a foreign support order, unless the requirements of section 518C.615 are met.

273.30 	Sec. 77. Laws 2014, chapter 189, section 10, is amended to read:
273.31 	Sec. 10. Minnesota Statutes 2012, section 518C.206, is amended to read:
273.32 	518C.206 ENFORCEMENT AND MODIFICATION OF SUPPORT ORDER 
273.33 	BY TRIBUNAL HAVING CONTINUING JURISDICTION TO ENFORCE CHILD 
273.34 	SUPPORT ORDER.
274.1 	(a) A tribunal of this state that has issued a child support order consistent with the 
274.2 	law of this state may serve as an initiating tribunal to request a tribunal of another state 
274.3 	to enforce:
274.4 	(1) the order if the order is the controlling order and has not been modified by 
274.5 	a tribunal of another state that assumed jurisdiction pursuant to this chapter or a law 
274.6 	substantially similar to this chapter the Uniform Interstate Family Support Act; or
274.7 	(2) a money judgment for arrears of support and interest on the order accrued before 
274.8 	a determination that an order of a tribunal of another state is the controlling order.
274.9 	(b) A tribunal of this state having continuing, exclusive jurisdiction over a support 
274.10 	order may act as a responding tribunal to enforce the order. 

274.11 	Sec. 78. Laws 2014, chapter 189, section 11, is amended to read:
274.12 	Sec. 11. Minnesota Statutes 2012, section 518C.207, is amended to read:
274.13 	518C.207 RECOGNITION DETERMINATION OF CONTROLLING CHILD 
274.14 	SUPPORT ORDER.
274.15 	(a) If a proceeding is brought under this chapter and only one tribunal has issued a 
274.16 	child support order, the order of that tribunal is controlling controls and must be recognized.
274.17 	(b) If a proceeding is brought under this chapter, and two or more child support 
274.18 	orders have been issued by tribunals of this state, another state, or a foreign country with 
274.19 	regard to the same obligor and child, a tribunal of this state having personal jurisdiction 
274.20 	over both the obligor and the individual obligee shall apply the following rules and by 
274.21 	order shall determine which order controls and must be recognized:
274.22 	(1) If only one of the tribunals would have continuing, exclusive jurisdiction under 
274.23 	this chapter, the order of that tribunal is controlling controls.
274.24 	(2) If more than one of the tribunals would have continuing, exclusive jurisdiction 
274.25 	under this chapter:
274.26 	(i) an order issued by a tribunal in the current home state of the child controls; or
274.27 	(ii) if an order has not been issued in the current home state of the child, the order 
274.28 	most recently issued controls.
274.29 	(3) If none of the tribunals would have continuing, exclusive jurisdiction under this 
274.30 	chapter, the tribunal of this state shall issue a child support order, which controls.
274.31 	(c) If two or more child support orders have been issued for the same obligor and 
274.32 	child, upon request of a party who is an individual or that is a support enforcement agency, 
274.33 	a tribunal of this state having personal jurisdiction over both the obligor and the obligee 
274.34 	who is an individual shall determine which order controls under paragraph (b). The 
275.1 	request may be filed with a registration for enforcement or registration for modification 
275.2 	pursuant to sections 518C.601 to 518C.616, or may be filed as a separate proceeding.
275.3 	(d) A request to determine which is the controlling order must be accompanied 
275.4 	by a copy of every child support order in effect and the applicable record of payments. 
275.5 	The requesting party shall give notice of the request to each party whose rights may 
275.6 	be affected by the determination.
275.7 	(e) The tribunal that issued the controlling order under paragraph (a), (b), or (c) has 
275.8 	continuing jurisdiction to the extent provided in section 518C.205, or 518C.206. 
275.9 	(f) A tribunal of this state which determines by order which is the controlling order 
275.10 	under paragraph (b), clause (1) or (2), or paragraph (c), or which issues a new controlling 
275.11 	child support order under paragraph (b), clause (3), shall state in that order:
275.12 	(1) the basis upon which the tribunal made its determination;
275.13 	(2) the amount of prospective support, if any; and
275.14 	(3) the total amount of consolidated arrears and accrued interest, if any, under all of 
275.15 	the orders after all payments made are credited as provided by section 518C.209.
275.16 	(g) Within 30 days after issuance of the order determining which is the controlling 
275.17 	order, the party obtaining that order shall file a certified copy of it with each tribunal that 
275.18 	issued or registered an earlier order of child support. A party or support enforcement 
275.19 	agency obtaining the order that fails to file a certified copy is subject to appropriate 
275.20 	sanctions by a tribunal in which the issue of failure to file arises. The failure to file does 
275.21 	not affect the validity or enforceability of the controlling order.
275.22 	(h) An order that has been determined to be the controlling order, or a judgment for 
275.23 	consolidated arrears of support and interest, if any, made pursuant to this section must be 
275.24 	recognized in proceedings under this chapter.

275.25 	Sec. 79. Laws 2014, chapter 189, section 16, is amended to read:
275.26 	Sec. 16. Minnesota Statutes 2012, section 518C.301, is amended to read:
275.27 	518C.301 PROCEEDINGS UNDER THIS CHAPTER.
275.28 	(a) Except as otherwise provided in this chapter, sections 518C.301 to 518C.319
275.29 	apply to all proceedings under this chapter. 
275.30 	(b) This chapter provides for the following proceedings:
275.31 	(1) establishment of an order for spousal support or child support pursuant to 
275.32 	section 518C.401; 
275.33 	(2) enforcement of a support order and income-withholding order of another state or 
275.34 	a foreign country without registration pursuant to sections 518C.501 and 518C.502; 
276.1 	(3) registration of an order for spousal support or child support of another state or a 
276.2 	foreign country for enforcement pursuant to sections 518C.601 to 518C.612; 
276.3 	(4) modification of an order for child support or spousal support issued by a tribunal 
276.4 	of this state pursuant to sections 518C.203 to 518C.206; 
276.5 	(5) registration of an order for child support of another state or a foreign country for 
276.6 	modification pursuant to sections 518C.601 to 518C.612; 
276.7 	(6) determination of parentage of a child pursuant to section 518C.701; and 
276.8 	(7) assertion of jurisdiction over nonresidents pursuant to sections 518C.201 and 
276.9 	518C.202. 
276.10 	(c) (b) An individual petitioner or a support enforcement agency may commence 
276.11 	a proceeding authorized under this chapter by filing a petition in an initiating tribunal 
276.12 	for forwarding to a responding tribunal or by filing a petition or a comparable pleading 
276.13 	directly in a tribunal of another state or a foreign country which has or can obtain personal 
276.14 	jurisdiction over the respondent.

276.15 	Sec. 80. Laws 2014, chapter 189, section 17, is amended to read:
276.16 	Sec. 17. Minnesota Statutes 2012, section 518C.303, is amended to read:
276.17 	518C.303 APPLICATION OF LAW OF THIS STATE.
276.18 	Except as otherwise provided by this chapter, a responding tribunal of this state shall:
276.19 	(1) apply the procedural and substantive law, including the rules on choice of law, 
276.20 	generally applicable to similar proceedings originating in this state and may exercise all 
276.21 	powers and provide all remedies available in those proceedings; and
276.22 	(2) determine the duty of support and the amount payable in accordance with the 
276.23 	law and support guidelines of this state.

276.24 	Sec. 81. Laws 2014, chapter 189, section 18, is amended to read:
276.25 	Sec. 18. Minnesota Statutes 2012, section 518C.304, is amended to read:
276.26 	518C.304 DUTIES OF INITIATING TRIBUNAL.
276.27 	(a) Upon the filing of a petition authorized by this chapter, an initiating tribunal of 
276.28 	this state shall forward the petition and its accompanying documents:
276.29 	(1) to the responding tribunal or appropriate support enforcement agency in the 
276.30 	responding state; or
276.31 	(2) if the identity of the responding tribunal is unknown, to the state information 
276.32 	agency of the responding state with a request that they be forwarded to the appropriate 
276.33 	tribunal and that receipt be acknowledged.
277.1 	(b) If requested by the responding tribunal, a tribunal of this state shall issue a 
277.2 	certificate or other documents and make findings required by the law of the responding 
277.3 	state. If the responding tribunal is in a foreign country, upon request the tribunal of this 
277.4 	state shall specify the amount of support sought, convert that amount into the equivalent 
277.5 	amount in the foreign currency under applicable official or market exchange rate as 
277.6 	publicly reported, and provide other documents necessary to satisfy the requirements of 
277.7 	the responding foreign tribunal.

277.8 	Sec. 82. Laws 2014, chapter 189, section 19, is amended to read:
277.9 	Sec. 19. Minnesota Statutes 2012, section 518C.305, is amended to read:
277.10 	518C.305 DUTIES AND POWERS OF RESPONDING TRIBUNAL.
277.11 	(a) When a responding tribunal of this state receives a petition or comparable 
277.12 	pleading from an initiating tribunal or directly pursuant to section 518C.301, paragraph (c) 
277.13 	(b), it shall cause the petition or pleading to be filed and notify the petitioner where and 
277.14 	when it was filed. 
277.15 	(b) A responding tribunal of this state, to the extent otherwise authorized by not 
277.16 	prohibited by other law, may do one or more of the following:
277.17 	(1) establish or enforce a support order, modify a child support order, determine the 
277.18 	controlling child support order, or to determine parentage of a child;
277.19 	(2) order an obligor to comply with a support order, specifying the amount and 
277.20 	the manner of compliance;
277.21 	(3) order income withholding;
277.22 	(4) determine the amount of any arrearages, and specify a method of payment;
277.23 	(5) enforce orders by civil or criminal contempt, or both;
277.24 	(6) set aside property for satisfaction of the support order;
277.25 	(7) place liens and order execution on the obligor's property;
277.26 	(8) order an obligor to keep the tribunal informed of the obligor's current residential 
277.27 	address, electronic mail address, telephone number, employer, address of employment, 
277.28 	and telephone number at the place of employment;
277.29 	(9) issue a bench warrant for an obligor who has failed after proper notice to appear 
277.30 	at a hearing ordered by the tribunal and enter the bench warrant in any local and state 
277.31 	computer systems for criminal warrants;
277.32 	(10) order the obligor to seek appropriate employment by specified methods;
277.33 	(11) award reasonable attorney's fees and other fees and costs; and
277.34 	(12) grant any other available remedy.
278.1 	(c) A responding tribunal of this state shall include in a support order issued under 
278.2 	this chapter, or in the documents accompanying the order, the calculations on which 
278.3 	the support order is based.
278.4 	(d) A responding tribunal of this state may not condition the payment of a support 
278.5 	order issued under this chapter upon compliance by a party with provisions for visitation.
278.6 	(e) If a responding tribunal of this state issues an order under this chapter, the 
278.7 	tribunal shall send a copy of the order to the petitioner and the respondent and to the 
278.8 	initiating tribunal, if any.
278.9 	(f) If requested to enforce a support order, arrears, or judgment or modify a support 
278.10 	order stated in a foreign currency, a responding tribunal of this state shall convert the 
278.11 	amount stated in the foreign currency to the equivalent amount in dollars under the 
278.12 	applicable official or market exchange rate as publicly reported.

278.13 	Sec. 83. Laws 2014, chapter 189, section 23, is amended to read:
278.14 	Sec. 23. Minnesota Statutes 2012, section 518C.310, is amended to read:
278.15 	518C.310 DUTIES OF STATE INFORMATION AGENCY.
278.16 	(a) The unit within the Department of Human Services that receives and disseminates 
278.17 	incoming interstate actions under title IV-D of the Social Security Act is the State 
278.18 	Information Agency under this chapter.
278.19 	(b) The State Information Agency shall:
278.20 	(1) compile and maintain a current list, including addresses, of the tribunals in this 
278.21 	state which have jurisdiction under this chapter and any support enforcement agencies in 
278.22 	this state and transmit a copy to the state information agency of every other state;
278.23 	(2) maintain a register of names and addresses of tribunals and support enforcement 
278.24 	agencies received from other states;
278.25 	(3) forward to the appropriate tribunal in the place in this state in which the 
278.26 	individual obligee or the obligor resides, or in which the obligor's property is believed 
278.27 	to be located, all documents concerning a proceeding under this chapter received from 
278.28 	another state or a foreign country; and
278.29 	(4) obtain information concerning the location of the obligor and the obligor's 
278.30 	property within this state not exempt from execution, by such means as postal verification 
278.31 	and federal or state locator services, examination of telephone directories, requests for the 
278.32 	obligor's address from employers, and examination of governmental records, including, to 
278.33 	the extent not prohibited by other law, those relating to real property, vital statistics, law 
278.34 	enforcement, taxation, motor vehicles, driver's licenses, and Social Security.

279.1 	Sec. 84. Laws 2014, chapter 189, section 24, is amended to read:
279.2 	Sec. 24. Minnesota Statutes 2012, section 518C.311, is amended to read:
279.3 	518C.311 PLEADINGS AND ACCOMPANYING DOCUMENTS.
279.4 	(a) A petitioner seeking to establish or modify a support order, determine parentage 
279.5 	of a child, or register and modify a support order of a tribunal of another state or a foreign 
279.6 	country, in a proceeding under this chapter must file a petition. Unless otherwise ordered 
279.7 	under section 518C.312, the petition or accompanying documents must provide, so far 
279.8 	as known, the name, residential address, and Social Security numbers of the obligor and 
279.9 	the obligee or parent and alleged parent, and the name, sex, residential address, Social 
279.10 	Security number, and date of birth of each child for whom support is sought or whose 
279.11 	parenthood parentage is to be determined. Unless filed at the time of registration, the 
279.12 	petition must be accompanied by a certified copy of any support order in effect known 
279.13 	to have been issued by another tribunal. The petition may include any other information 
279.14 	that may assist in locating or identifying the respondent. 
279.15 	(b) The petition must specify the relief sought. The petition and accompanying 
279.16 	documents must conform substantially with the requirements imposed by the forms 
279.17 	mandated by federal law for use in cases filed by a support enforcement agency.

279.18 	Sec. 85. Laws 2014, chapter 189, section 27, is amended to read:
279.19 	Sec. 27. Minnesota Statutes 2012, section 518C.314, is amended to read:
279.20 	518C.314 LIMITED IMMUNITY OF PETITIONER.
279.21 	(a) Participation by a petitioner in a proceeding under this chapter before a 
279.22 	responding tribunal, whether in person, by private attorney, or through services provided 
279.23 	by the support enforcement agency, does not confer personal jurisdiction over the 
279.24 	petitioner in another proceeding.
279.25 	(b) A petitioner is not amenable to service of civil process while physically present 
279.26 	in this state to participate in a proceeding under this chapter.
279.27 	(c) The immunity granted by this section does not extend to civil litigation based on 
279.28 	acts unrelated to a proceeding under this chapter committed by a party while physically 
279.29 	present in this state to participate in the proceeding.

279.30 	Sec. 86. Laws 2014, chapter 189, section 28, is amended to read:
279.31 	Sec. 28. Minnesota Statutes 2012, section 518C.316, is amended to read:
279.32 	518C.316 SPECIAL RULES OF EVIDENCE AND PROCEDURE.
280.1 	(a) The physical presence of the petitioner a nonresident party who is an individual 
280.2 	in a responding tribunal of this state is not required for the establishment, enforcement, 
280.3 	or modification of a support order or the rendition of a judgment determining parentage 
280.4 	of a child.
280.5 	(b) A verified petition, An affidavit, a document substantially complying with 
280.6 	federally mandated forms, and or a document incorporated by reference in any of them, 
280.7 	not excluded under the hearsay rule if given in person, is admissible in evidence if given 
280.8 	under oath penalty of perjury by a party or witness residing outside this state.
280.9 	(c) A copy of the record of child support payments certified as a true copy of the 
280.10 	original by the custodian of the record may be forwarded to a responding tribunal. The copy 
280.11 	is evidence of facts asserted in it, and is admissible to show whether payments were made.
280.12 	(d) Copies of bills for testing for parentage of a child, and for prenatal and postnatal 
280.13 	health care of the mother and child, furnished to the adverse party at least ten days before 
280.14 	trial, are admissible in evidence to prove the amount of the charges billed and that the 
280.15 	charges were reasonable, necessary, and customary.
280.16 	(e) Documentary evidence transmitted from outside this state to a tribunal of this state 
280.17 	by telephone, telecopier, or other electronic means that do not provide an original record 
280.18 	may not be excluded from evidence on an objection based on the means of transmission.
280.19 	(f) In a proceeding under this chapter, a tribunal of this state shall permit a party 
280.20 	or witness residing outside this state to be deposed or to testify under penalty of perjury 
280.21 	by telephone, audiovisual means, or other electronic means at a designated tribunal or 
280.22 	other location. A tribunal of this state shall cooperate with other tribunals in designating 
280.23 	an appropriate location for the deposition or testimony.
280.24 	(g) If a party called to testify at a civil hearing refuses to answer on the ground that 
280.25 	the testimony may be self-incriminating, the trier of fact may draw an adverse inference 
280.26 	from the refusal.
280.27 	(h) A privilege against disclosure of communications between spouses does not 
280.28 	apply in a proceeding under this chapter.
280.29 	(i) The defense of immunity based on the relationship of husband and wife or parent 
280.30 	and child does not apply in a proceeding under this chapter.
280.31 	(j) A voluntary acknowledgment of paternity, certified as a true copy, is admissible 
280.32 	to establish parentage of a child.

280.33 	Sec. 87. Laws 2014, chapter 189, section 29, is amended to read:
280.34 	Sec. 29. Minnesota Statutes 2012, section 518C.317, is amended to read:
280.35 	518C.317 COMMUNICATIONS BETWEEN TRIBUNALS.
281.1 	A tribunal of this state may communicate with a tribunal outside this state in 
281.2 	writing, by e-mail, or a record, or by telephone, electronic mail, or other means, to obtain 
281.3 	information concerning the laws of that state, the legal effect of a judgment, decree, or 
281.4 	order of that tribunal, and the status of a proceeding. A tribunal of this state may furnish 
281.5 	similar information by similar means to a tribunal outside this state.

281.6 	Sec. 88. Laws 2014, chapter 189, section 31, is amended to read:
281.7 	Sec. 31. Minnesota Statutes 2012, section 518C.319, is amended to read:
281.8 	518C.319 RECEIPT AND DISBURSEMENT OF PAYMENTS.
281.9 	(a) A support enforcement agency or tribunal of this state shall disburse promptly 
281.10 	any amounts received pursuant to a support order, as directed by the order. The agency 
281.11 	or tribunal shall furnish to a requesting party or tribunal of another state or a foreign 
281.12 	country a certified statement by the custodian of the record of the amounts and dates 
281.13 	of all payments received.
281.14 	(b) If neither the obligor, not nor the obligee who is an individual, nor the child 
281.15 	resides in this state, upon request from the support enforcement agency of this state or 
281.16 	another state, the support enforcement agency of this state or a tribunal of this state shall:
281.17 	(1) direct that the support payment be made to the support enforcement agency in 
281.18 	the state in which the obligee is receiving services; and
281.19 	(2) issue and send to the obligor's employer a conforming income-withholding order 
281.20 	or an administrative notice of change of payee, reflecting the redirected payments.
281.21 	(c) The support enforcement agency of this state receiving redirected payments from 
281.22 	another state pursuant to a law similar to paragraph (b) shall furnish to a requesting party 
281.23 	or tribunal of the other state a certified statement by the custodian of the record of the 
281.24 	amount and dates of all payments received.

281.25 	Sec. 89. Laws 2014, chapter 189, section 43, is amended to read:
281.26 	Sec. 43. Minnesota Statutes 2012, section 518C.604, is amended to read:
281.27 	518C.604 CHOICE OF LAW.
281.28 	(a) Except as otherwise provided in paragraph (d), the law of the issuing state or 
281.29 	foreign country governs:
281.30 	(1) the nature, extent, amount, and duration of current payments under a registered 
281.31 	support order;
281.32 	(2) the computation and payment of arrearages and accrual of interest on the 
281.33 	arrearages under the support order; and
281.34 	(3) the existence and satisfaction of other obligations under the support order.
282.1 	(b) In a proceeding for arrearages under a registered support order, the statute of 
282.2 	limitation under the laws of this state or of the issuing state or foreign country, whichever 
282.3 	is longer, applies.
282.4 	(c) A responding tribunal of this state shall apply the procedures and remedies of 
282.5 	this state to enforce current support and collect arrears and interest due on a support order 
282.6 	of another state or a foreign country registered in this state.
282.7 	(d) After a tribunal of this state or another state determines which is the controlling 
282.8 	order and issues an order consolidating arrears, if any, a tribunal of this state shall 
282.9 	prospectively apply the law of the state or foreign country issuing the controlling order, 
282.10 	including its law on interest on arrears, on current and future support, and on consolidated 
282.11 	arrears.

282.12 	Sec. 90. Laws 2014, chapter 189, section 50, is amended to read:
282.13 	Sec. 50. Minnesota Statutes 2012, section 518C.611, is amended to read:
282.14 	518C.611 MODIFICATION OF CHILD SUPPORT ORDER OF ANOTHER 
282.15 	STATE.
282.16 	(a) If section 518C.613 does not apply, upon petition a tribunal of this state may 
282.17 	modify a child support order issued in another state that is registered in this state if, after 
282.18 	notice and hearing, it finds that: 
282.19 	(1) the following requirements are met:
282.20 	(i) neither the child, nor the obligee who is an individual, nor the obligor resides 
282.21 	in the issuing state;
282.22 	(ii) a petitioner who is a nonresident of this state seeks modification; and
282.23 	(iii) the respondent is subject to the personal jurisdiction of the tribunal of this state; or
282.24 	(2) this state is the residence of the child, or a party who is an individual is subject to 
282.25 	the personal jurisdiction of the tribunal of this state and all of the parties who are individuals 
282.26 	have filed written consents in a record in the issuing tribunal for a tribunal of this state to 
282.27 	modify the support order and assume continuing, exclusive jurisdiction over the order. 
282.28 	(b) Modification of a registered child support order is subject to the same 
282.29 	requirements, procedures, and defenses that apply to the modification of an order issued 
282.30 	by a tribunal of this state and the order may be enforced and satisfied in the same manner.
282.31 	(c) A tribunal of this state may not modify any aspect of a child support order that 
282.32 	may not be modified under the law of the issuing state, including the duration of the 
282.33 	obligation of support. If two or more tribunals have issued child support orders for the 
282.34 	same obligor and child, the order that controls and must be recognized under section 
282.35 	518C.207 establishes the aspects of the support order which are nonmodifiable. 
283.1 	(d) In a proceeding to modify a child support order, the law of the state that is 
283.2 	determined to have issued the initial controlling order governs the duration of the 
283.3 	obligation of support. The obligor's fulfillment of the duty of support established by that 
283.4 	order precludes imposition of a further obligation of support by a tribunal of this state.
283.5 	(e) On issuance of an order by a tribunal of this state modifying a child support order 
283.6 	issued in another state, a tribunal of this state becomes the tribunal having continuing, 
283.7 	exclusive jurisdiction.
283.8 	(f) Notwithstanding paragraphs (a) to (d) (e) and section 518C.201, paragraph (b), 
283.9 	a tribunal of this state retains jurisdiction to modify an order issued by a tribunal of this 
283.10 	state if:
283.11 	(1) one party resides in another state; and
283.12 	(2) the other party resides outside the United States.

283.13 	Sec. 91. Laws 2014, chapter 189, section 51, is amended to read:
283.14 	Sec. 51. Minnesota Statutes 2012, section 518C.612, is amended to read:
283.15 	518C.612 RECOGNITION OF ORDER MODIFIED IN ANOTHER STATE.
283.16 	If a child support order issued by a tribunal of this state is modified by a tribunal of 
283.17 	another state which assumed jurisdiction according to this chapter or a law substantially 
283.18 	similar to this chapter pursuant to the Uniform Interstate Family Support Act, a tribunal of 
283.19 	this state:
283.20 	(1) may enforce its order that was modified only as to arrears and interest accruing 
283.21 	before the modification;
283.22 	(2) may provide appropriate relief for violations of its order which occurred before 
283.23 	the effective date of the modification; and
283.24 	(3) shall recognize the modifying order of the other state, upon registration, for the 
283.25 	purpose of enforcement.

283.26 	Sec. 92. Laws 2014, chapter 189, section 73, is amended to read:
283.27 	Sec. 73. EFFECTIVE DATE.
 283.28 	This act becomes is effective on the date that the United States deposits the 
283.29 	instrument of ratification for the Hague Convention on the International Recovery of Child 
283.30 	Support and Other Forms of Family Maintenance with the Hague Conference on Private 
283.31 	International Law July 1, 2015.

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

284.1 	Sec. 93. CHILD SUPPORT WORK GROUP.
 284.2 	(a) A child support work group is established to review the parenting expense 
284.3 	adjustment in Minnesota Statutes, section 518A.36, and to identify and recommend 
284.4 	changes to the parenting expense adjustment.
284.5 	(b) Members of the work group shall include:
284.6 	(1) two members of the house of representatives, one appointed by the speaker of the 
284.7 	house and one appointed by the minority leader;
284.8 	(2) two members of the senate, one appointed by the majority leader and one 
284.9 	appointed by the minority leader;
284.10 	(3) the commissioner of human services or a designee;
284.11 	(4) one staff member from the Child Support Division of the Department of Human 
284.12 	Services, appointed by the commissioner;
284.13 	(5) one representative of the Minnesota State Bar Association, Family Law section, 
284.14 	appointed by the section;
284.15 	(6) one representative of the Minnesota County Attorney's Association, appointed 
284.16 	by the association;
284.17 	(7) one representative of the Minnesota Legal Services Coalition, appointed by 
284.18 	the coalition;
284.19 	(8) one representative of the Minnesota Family Support and Recovery Council, 
284.20 	appointed by the council; and
284.21 	(9) two representatives from parent advocacy groups, one representing custodial 
284.22 	parents and one representing noncustodial parents, appointed by the commissioner of 
284.23 	human services.
284.24 	The commissioner, or the commissioner's designee, shall appoint the work group chair.
284.25 	(c) The work group shall be authorized to retain the services of an economist to help 
284.26 	create an equitable parenting expense adjustment formula. The work group may hire an 
284.27 	economist by use of a sole-source contract.
284.28 	(d) The work group shall issue a report to the chairs and ranking minority members 
284.29 	of the legislative committees with jurisdiction over civil law, judiciary, and health and 
284.30 	human services by January 15, 2016. The report must include recommendations for 
284.31 	changes to the computation of child support and recommendations on the composition 
284.32 	of a permanent child support task force.
284.33 	(e) Terms, compensation, and removal of members and the filling of vacancies are 
284.34 	governed by Minnesota Statutes, section 15.059.
284.35 	(f) The work group expires January 16, 2016.

285.1 	Sec. 94. INSTRUCTIONS TO COMMISSIONER; SCREENING GUIDELINES.
 285.2 	(a) No later than August 1, 2015, the commissioner of human services shall 
285.3 	update the child maltreatment screening guidelines to require agencies to consider prior 
285.4 	screened-out reports when determining whether a new report will be screened out or will 
285.5 	be accepted for investigation or assessment. The updated guidelines must emphasize that 
285.6 	intervention and prevention efforts are to focus on child safety and the ongoing risk of child 
285.7 	abuse or neglect and that the health and safety of children are of paramount concern. The 
285.8 	commissioner must consult with county attorneys while developing the updated guidelines.
285.9 	(b) No later than September 30, 2015, the commissioner shall publish and distribute 
285.10 	the updated guidelines and ensure that all agency staff have received training on the 
285.11 	updated guidelines.
285.12 	(c) Agency staff must implement the guidelines on October 1, 2015.

285.13 	Sec. 95. INSTRUCTIONS TO THE COMMISSIONER; CHILD 
285.14 	MALTREATMENT SCREENING GUIDELINES.
 285.15 	(a) No later than August 1, 2015, the commissioner of human services shall update the 
285.16 	child maltreatment screening guidelines to require agencies to consider prior reports that 
285.17 	were not screened in when determining whether a new report will or will not be screened 
285.18 	in. The updated guidelines must emphasize that intervention and prevention efforts are to 
285.19 	focus on child safety and the ongoing risk of child abuse or neglect, and that the health and 
285.20 	safety of children are of paramount concern. The commissioner shall work with a diverse 
285.21 	group of community representatives who are experts on limiting cultural and ethnic bias 
285.22 	when developing the updated guidelines. The guidelines must be developed with special 
285.23 	sensitivity to reducing system bias with regard to screening and assessment tools.
285.24 	(b) No later than September 30, 2015, the commissioner shall publish and distribute 
285.25 	the updated guidelines and ensure that all agency staff have received training on the 
285.26 	updated guidelines.
285.27 	(c) Agency staff must implement the guidelines by October 1, 2015.

285.28 	Sec. 96. COMMISSIONER'S DUTY TO PROVIDE TRAINING TO CHILD 
285.29 	PROTECTION SUPERVISORS.
 285.30 	The commissioner shall establish requirements for competency-based initial 
285.31 	training, support, and continuing education for child protection supervisors. This includes 
285.32 	developing a set of competencies specific to child protection supervisor knowledge, skills, 
285.33 	and attitudes based on the Minnesota Child Welfare Practice Model. Competency-based 
285.34 	training of supervisors must advance continuous emphasis and improvement in skills that 
286.1 	promote the use of the client's culture as a resource and the ability to integrate the client's 
286.2 	traditions, customs, values, and faith into service delivery.

286.3 	Sec. 97. CHILD PROTECTION UPDATED FORMULA.
 286.4 	The commissioner of human services shall evaluate the formulas in Minnesota 
286.5 	Statutes, section 256M.41, and recommend an updated equitable distribution formula 
286.6 	beginning in fiscal year 2018, for funding child protection staffing and expanded services 
286.7 	to counties and tribes, taking into consideration any relief to counties and tribes for child 
286.8 	welfare and foster care costs, additional tribes delivering social services, and any other 
286.9 	relevant information that should be considered in developing a new distribution formula. 
286.10 	The commissioner shall report to the legislative committees having jurisdiction over child 
286.11 	protection issues by December 15, 2016.

286.12 	Sec. 98. LEGISLATIVE TASK FORCE; CHILD PROTECTION.
 286.13 	(a) A legislative task force is created to:
286.14 	(1) review the efforts being made to implement the recommendations of the 
286.15 	Governor's Task Force on the Protection of Children;
286.16 	(2) expand the efforts into related areas of the child welfare system;
286.17 	(3) work with the commissioner and community partners to establish and evaluate 
286.18 	child protection grants to address disparities in child welfare pursuant to Minnesota 
286.19 	Statutes, section 256E.28; and
286.20 	(4) identify additional areas within the child welfare system that need to be addressed 
286.21 	by the legislature.
286.22 	(b) The four legislative members of the governor's task force shall be the members 
286.23 	of the legislative task force. They may appoint up to eight legislators as ex officio 
286.24 	members of the task force.
286.25 	(c) The task force may provide oversight and monitoring of:
286.26 	(1) the efforts by the Department of Human Services, counties, and tribes to 
286.27 	implement laws related to child protection;
286.28 	(2) efforts by the Department of Human Services, counties, and tribes to implement 
286.29 	the recommendations of the Governor's Task Force on the Protection of Children;
286.30 	(3) efforts by agencies, including but not limited to the Minnesota Department 
286.31 	of Education, the Minnesota Housing Finance Agency, the Minnesota Department of 
286.32 	Corrections, and the Minnesota Department of Public Safety, to work with the Department 
286.33 	of Human Services to assure safety and well-being for children at risk of harm or children 
286.34 	in the child welfare system;
287.1 	(4) efforts by the Department of Human Services, other agencies, counties, and 
287.2 	tribes to implement best practices to ensure every child is protected from maltreatment 
287.3 	and neglect and to ensure every child has the opportunity for healthy development.
287.4 	(d) The task force, in cooperation with the commissioner of human services, shall 
287.5 	issue a report to the legislature and governor February 1, 2016, and February 1, 2017. 
287.6 	The report must contain information on the progress toward implementation of changes 
287.7 	to the child protection system; recommendations for additional legislative changes and 
287.8 	procedures affecting child protection and child welfare; and funding needs to implement 
287.9 	recommended changes.
287.10 	(e) The task force shall convene upon enactment of this act and shall continue until 
287.11 	the last day of the 2017 legislative session.

287.12 	ARTICLE 8
287.13 	CHEMICAL AND MENTAL HEALTH

287.14 	Section 1. Minnesota Statutes 2014, section 13.46, subdivision 2, is amended to read:
287.15 		Subd. 2.General. (a) Data on individuals collected, maintained, used, or 
287.16 	disseminated by the welfare system are private data on individuals, and shall not be 
287.17 	disclosed except:
287.18 	(1) according to section 13.05;
287.19 	(2) according to court order;
287.20 	(3) according to a statute specifically authorizing access to the private data;
287.21 	(4) to an agent of the welfare system and an investigator acting on behalf of a county, 
287.22 	the state, or the federal government, including a law enforcement person or attorney in the 
287.23 	investigation or prosecution of a criminal, civil, or administrative proceeding relating to 
287.24 	the administration of a program;
287.25 	(5) to personnel of the welfare system who require the data to verify an individual's 
287.26 	identity; determine eligibility, amount of assistance, and the need to provide services 
287.27 	to an individual or family across programs; coordinate services for an individual or 
287.28 	family; evaluate the effectiveness of programs; assess parental contribution amounts; 
287.29 	and investigate suspected fraud;
287.30 	(6) to administer federal funds or programs;
287.31 	(7) between personnel of the welfare system working in the same program;
287.32 	(8) to the Department of Revenue to assess parental contribution amounts for 
287.33 	purposes of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit 
287.34 	programs and to identify individuals who may benefit from these programs. The following 
287.35 	information may be disclosed under this paragraph: an individual's and their dependent's 
288.1 	names, dates of birth, Social Security numbers, income, addresses, and other data as 
288.2 	required, upon request by the Department of Revenue. Disclosures by the commissioner 
288.3 	of revenue to the commissioner of human services for the purposes described in this clause 
288.4 	are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include, 
288.5 	but are not limited to, the dependent care credit under section 290.067, the Minnesota 
288.6 	working family credit under section 290.0671, the property tax refund and rental credit 
288.7 	under section 290A.04, and the Minnesota education credit under section 290.0674;
288.8 	(9) between the Department of Human Services, the Department of Employment 
288.9 	and Economic Development, and when applicable, the Department of Education, for 
288.10 	the following purposes:
288.11 	(i) to monitor the eligibility of the data subject for unemployment benefits, for any 
288.12 	employment or training program administered, supervised, or certified by that agency;
288.13 	(ii) to administer any rehabilitation program or child care assistance program, 
288.14 	whether alone or in conjunction with the welfare system;
288.15 	(iii) to monitor and evaluate the Minnesota family investment program or the child 
288.16 	care assistance program by exchanging data on recipients and former recipients of food 
288.17 	support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance 
288.18 	under chapter 119B, or medical programs under chapter 256B, 256D, or 256L; and
288.19 	(iv) to analyze public assistance employment services and program utilization, 
288.20 	cost, effectiveness, and outcomes as implemented under the authority established in Title 
288.21 	II, Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 
288.22 	1999. Health records governed by sections 144.291 to 144.298 and "protected health 
288.23 	information" as defined in Code of Federal Regulations, title 45, section 160.103, and 
288.24 	governed by Code of Federal Regulations, title 45, parts 160-164, including health care 
288.25 	claims utilization information, must not be exchanged under this clause;
288.26 	(10) to appropriate parties in connection with an emergency if knowledge of 
288.27 	the information is necessary to protect the health or safety of the individual or other 
288.28 	individuals or persons;
288.29 	(11) data maintained by residential programs as defined in section 245A.02 may 
288.30 	be disclosed to the protection and advocacy system established in this state according 
288.31 	to Part C of Public Law 98-527 to protect the legal and human rights of persons with 
288.32 	developmental disabilities or other related conditions who live in residential facilities for 
288.33 	these persons if the protection and advocacy system receives a complaint by or on behalf 
288.34 	of that person and the person does not have a legal guardian or the state or a designee of 
288.35 	the state is the legal guardian of the person;
289.1 	(12) to the county medical examiner or the county coroner for identifying or locating 
289.2 	relatives or friends of a deceased person;
289.3 	(13) data on a child support obligor who makes payments to the public agency 
289.4 	may be disclosed to the Minnesota Office of Higher Education to the extent necessary to 
289.5 	determine eligibility under section 136A.121, subdivision 2, clause (5);
289.6 	(14) participant Social Security numbers and names collected by the telephone 
289.7 	assistance program may be disclosed to the Department of Revenue to conduct an 
289.8 	electronic data match with the property tax refund database to determine eligibility under 
289.9 	section 237.70, subdivision 4a;
289.10 	(15) the current address of a Minnesota family investment program participant 
289.11 	may be disclosed to law enforcement officers who provide the name of the participant 
289.12 	and notify the agency that:
289.13 	(i) the participant:
289.14 	(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 
289.15 	conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 
289.16 	jurisdiction from which the individual is fleeing; or
289.17 	(B) is violating a condition of probation or parole imposed under state or federal law;
289.18 	(ii) the location or apprehension of the felon is within the law enforcement officer's 
289.19 	official duties; and
289.20 	(iii) the request is made in writing and in the proper exercise of those duties;
289.21 	(16) the current address of a recipient of general assistance or general assistance 
289.22 	medical care may be disclosed to probation officers and corrections agents who are 
289.23 	supervising the recipient and to law enforcement officers who are investigating the 
289.24 	recipient in connection with a felony level offense;
289.25 	(17) information obtained from food support applicant or recipient households may 
289.26 	be disclosed to local, state, or federal law enforcement officials, upon their written request, 
289.27 	for the purpose of investigating an alleged violation of the Food Stamp Act, according 
289.28 	to Code of Federal Regulations, title 7, section 272.1(c);
289.29 	(18) the address, Social Security number, and, if available, photograph of any 
289.30 	member of a household receiving food support shall be made available, on request, to a 
289.31 	local, state, or federal law enforcement officer if the officer furnishes the agency with the 
289.32 	name of the member and notifies the agency that:
289.33 	(i) the member:
289.34 	(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 
289.35 	crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
290.1 	(B) is violating a condition of probation or parole imposed under state or federal 
290.2 	law; or
290.3 	(C) has information that is necessary for the officer to conduct an official duty related 
290.4 	to conduct described in subitem (A) or (B);
290.5 	(ii) locating or apprehending the member is within the officer's official duties; and
290.6 	(iii) the request is made in writing and in the proper exercise of the officer's official 
290.7 	duty;
290.8 	(19) the current address of a recipient of Minnesota family investment program, 
290.9 	general assistance, general assistance medical care, or food support may be disclosed to 
290.10 	law enforcement officers who, in writing, provide the name of the recipient and notify the 
290.11 	agency that the recipient is a person required to register under section 243.166, but is not 
290.12 	residing at the address at which the recipient is registered under section 243.166;
290.13 	(20) certain information regarding child support obligors who are in arrears may be 
290.14 	made public according to section 518A.74;
290.15 	(21) data on child support payments made by a child support obligor and data on 
290.16 	the distribution of those payments excluding identifying information on obligees may be 
290.17 	disclosed to all obligees to whom the obligor owes support, and data on the enforcement 
290.18 	actions undertaken by the public authority, the status of those actions, and data on the 
290.19 	income of the obligor or obligee may be disclosed to the other party;
290.20 	(22) data in the work reporting system may be disclosed under section 256.998, 
290.21 	subdivision 7;
290.22 	(23) to the Department of Education for the purpose of matching Department of 
290.23 	Education student data with public assistance data to determine students eligible for free 
290.24 	and reduced-price meals, meal supplements, and free milk according to United States 
290.25 	Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and 
290.26 	state funds that are distributed based on income of the student's family; and to verify 
290.27 	receipt of energy assistance for the telephone assistance plan;
290.28 	(24) the current address and telephone number of program recipients and emergency 
290.29 	contacts may be released to the commissioner of health or a community health board as 
290.30 	defined in section 145A.02, subdivision 5, when the commissioner or community health 
290.31 	board has reason to believe that a program recipient is a disease case, carrier, suspect case, 
290.32 	or at risk of illness, and the data are necessary to locate the person;
290.33 	(25) to other state agencies, statewide systems, and political subdivisions of this 
290.34 	state, including the attorney general, and agencies of other states, interstate information 
290.35 	networks, federal agencies, and other entities as required by federal regulation or law for 
290.36 	the administration of the child support enforcement program;
291.1 	(26) to personnel of public assistance programs as defined in section 256.741, for 
291.2 	access to the child support system database for the purpose of administration, including 
291.3 	monitoring and evaluation of those public assistance programs;
291.4 	(27) to monitor and evaluate the Minnesota family investment program by 
291.5 	exchanging data between the Departments of Human Services and Education, on 
291.6 	recipients and former recipients of food support, cash assistance under chapter 256, 256D, 
291.7 	256J, or 256K, child care assistance under chapter 119B, or medical programs under 
291.8 	chapter 256B, 256D, or 256L;
291.9 	(28) to evaluate child support program performance and to identify and prevent 
291.10 	fraud in the child support program by exchanging data between the Department of Human 
291.11 	Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) 
291.12 	and (b), without regard to the limitation of use in paragraph (c), Department of Health, 
291.13 	Department of Employment and Economic Development, and other state agencies as is 
291.14 	reasonably necessary to perform these functions;
291.15 	(29) counties operating child care assistance programs under chapter 119B may 
291.16 	disseminate data on program participants, applicants, and providers to the commissioner 
291.17 	of education; or
291.18 	(30) child support data on the child, the parents, and relatives of the child may be 
291.19 	disclosed to agencies administering programs under titles IV-B and IV-E of the Social 
291.20 	Security Act, as authorized by federal law.; or
291.21 	(31) to a health care provider governed by sections 144.291 to 144.298, to the extent 
291.22 	necessary to coordinate services, provided that a health record may be disclosed only as 
291.23 	provided under section 144.293, if the patient has provided annual consent, consistent 
291.24 	with section 144.293, subdivisions 2 and 4.
291.25 	(b) Information on persons who have been treated for drug or alcohol abuse may 
291.26 	only be disclosed according to the requirements of Code of Federal Regulations, title 
291.27 	42, sections 2.1 to 2.67.
291.28 	(c) Data provided to law enforcement agencies under paragraph (a), clause (15), 
291.29 	(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected 
291.30 	nonpublic while the investigation is active. The data are private after the investigation 
291.31 	becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
291.32 	(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are 
291.33 	not subject to the access provisions of subdivision 10, paragraph (b).
291.34 	For the purposes of this subdivision, a request will be deemed to be made in writing 
291.35 	if made through a computer interface system.

292.1 	Sec. 2. Minnesota Statutes 2014, section 13.46, subdivision 7, is amended to read:
292.2 		Subd. 7.Mental health data. (a) Mental health data are private data on individuals 
292.3 	and shall not be disclosed, except:
292.4 	(1) pursuant to section 13.05, as determined by the responsible authority for the 
292.5 	community mental health center, mental health division, or provider;
292.6 	(2) pursuant to court order;
292.7 	(3) pursuant to a statute specifically authorizing access to or disclosure of mental 
292.8 	health data or as otherwise provided by this subdivision; or
292.9 	(4) to personnel of the welfare system working in the same program or providing 
292.10 	services to the same individual or family to the extent necessary to coordinate services, 
292.11 	provided that a health record may be disclosed only as provided under section 144.293, if 
292.12 	the patient has provided annual consent, consistent with section 144.293, subdivisions 
292.13 	2 and 4;
292.14 	(5) to a health care provider governed by sections 144.291 to 144.298, to the extent 
292.15 	necessary to coordinate services, provided that a health record may be disclosed only as 
292.16 	provided under section 144.293, if the patient has provided annual consent, consistent with 
292.17 	section 144.293, subdivisions 2 and 4; or
292.18 	(6) with the consent of the client or patient.
292.19 	(b) An agency of the welfare system may not require an individual to consent to the 
292.20 	release of mental health data as a condition for receiving services or for reimbursing a 
292.21 	community mental health center, mental health division of a county, or provider under 
292.22 	contract to deliver mental health services.
292.23 	(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law 
292.24 	to the contrary, the responsible authority for a community mental health center, mental 
292.25 	health division of a county, or a mental health provider must disclose mental health data to 
292.26 	a law enforcement agency if the law enforcement agency provides the name of a client or 
292.27 	patient and communicates that the:
292.28 	(1) client or patient is currently involved in an emergency interaction with the law 
292.29 	enforcement agency; and
292.30 	(2) data is necessary to protect the health or safety of the client or patient or of 
292.31 	another person.
292.32 	The scope of disclosure under this paragraph is limited to the minimum necessary for 
292.33 	law enforcement to respond to the emergency. Disclosure under this paragraph may include, 
292.34 	but is not limited to, the name and telephone number of the psychiatrist, psychologist, 
292.35 	therapist, mental health professional, practitioner, or case manager of the client or patient. 
292.36 	A law enforcement agency that obtains mental health data under this paragraph shall 
293.1 	maintain a record of the requestor, the provider of the information, and the client or patient 
293.2 	name. Mental health data obtained by a law enforcement agency under this paragraph 
293.3 	are private data on individuals and must not be used by the law enforcement agency for 
293.4 	any other purpose. A law enforcement agency that obtains mental health data under this 
293.5 	paragraph shall inform the subject of the data that mental health data was obtained.
293.6 	(d) In the event of a request under paragraph (a), clause (4), a community mental 
293.7 	health center, county mental health division, or provider must release mental health data to 
293.8 	Criminal Mental Health Court personnel in advance of receiving a copy of a consent if the 
293.9 	Criminal Mental Health Court personnel communicate that the:
293.10 	(1) client or patient is a defendant in a criminal case pending in the district court;
293.11 	(2) data being requested is limited to information that is necessary to assess whether 
293.12 	the defendant is eligible for participation in the Criminal Mental Health Court; and
293.13 	(3) client or patient has consented to the release of the mental health data and a copy 
293.14 	of the consent will be provided to the community mental health center, county mental 
293.15 	health division, or provider within 72 hours of the release of the data.
293.16 	For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty 
293.17 	criminal calendar of the Hennepin County District Court for defendants with mental illness 
293.18 	and brain injury where a primary goal of the calendar is to assess the treatment needs of 
293.19 	the defendants and to incorporate those treatment needs into voluntary case disposition 
293.20 	plans. The data released pursuant to this paragraph may be used for the sole purpose of 
293.21 	determining whether the person is eligible for participation in mental health court. This 
293.22 	paragraph does not in any way limit or otherwise extend the rights of the court to obtain the 
293.23 	release of mental health data pursuant to court order or any other means allowed by law.

293.24 	Sec. 3. Minnesota Statutes 2014, section 62Q.55, subdivision 3, is amended to read:
293.25 		Subd. 3.Emergency services. As used in this section, "emergency services" means, 
293.26 	with respect to an emergency medical condition:
293.27 	(1) a medical screening examination, as required under section 1867 of the Social 
293.28 	Security Act, that is within the capability of the emergency department of a hospital, 
293.29 	including ancillary services routinely available to the emergency department to evaluate 
293.30 	such emergency medical condition; and
293.31 	(2) within the capabilities of the staff and facilities available at the hospital, such 
293.32 	further medical examination and treatment as are required under section 1867 of the Social 
293.33 	Security Act to stabilize the patient; and
293.34 	(3) emergency services as defined in sections 245.462, subdivision 11, and 245.4871, 
293.35 	subdivision 14.

294.1 	Sec. 4. Minnesota Statutes 2014, section 144.293, subdivision 5, is amended to read:
294.2 		Subd. 5.Exceptions to consent requirement. This section does not prohibit the 
294.3 	release of health records:
294.4 	(1) for a medical emergency when the provider is unable to obtain the patient's 
294.5 	consent due to the patient's condition or the nature of the medical emergency;
294.6 	(2) to other providers within related health care entities when necessary for the 
294.7 	current treatment of the patient; or
294.8 	(3) to a health care facility licensed by this chapter, chapter 144A, or to the same 
294.9 	types of health care facilities licensed by this chapter and chapter 144A that are licensed 
294.10 	in another state when a patient:
294.11 	(i) is returning to the health care facility and unable to provide consent; or
294.12 	(ii) who resides in the health care facility, has services provided by an outside 
294.13 	resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable to 
294.14 	provide consent.; or
294.15 	(4) to a program in the welfare system, as defined in section 13.46, upon written 
294.16 	documentation that access to the data is necessary to coordinate services for an individual 
294.17 	who is receiving services from the welfare system.

294.18 	Sec. 5. Minnesota Statutes 2014, section 145.56, subdivision 2, is amended to read:
294.19 		Subd. 2.Community-based programs. To the extent funds are appropriated for the 
294.20 	purposes of this subdivision, the commissioner shall establish a grant program to fund:
294.21 	(1) community-based programs to provide education, outreach, and advocacy 
294.22 	services to populations who may be at risk for suicide;
294.23 	(2) community-based programs that educate community helpers and gatekeepers, 
294.24 	such as family members, spiritual leaders, coaches, and business owners, employers, and 
294.25 	coworkers on how to prevent suicide by encouraging help-seeking behaviors;
294.26 	(3) community-based programs that educate populations at risk for suicide and 
294.27 	community helpers and gatekeepers that must include information on the symptoms 
294.28 	of depression and other psychiatric illnesses, the warning signs of suicide, skills for 
294.29 	preventing suicides, and making or seeking effective referrals to intervention and 
294.30 	community resources; and
294.31 	(4) community-based programs to provide evidence-based suicide prevention and 
294.32 	intervention education to school staff, parents, and students in grades kindergarten through 
294.33 	12, and for students attending Minnesota colleges and universities;
294.34 	(5) community-based programs to provide evidence-based suicide prevention and 
294.35 	intervention to public school nurses, teachers, administrators, coaches, school social 
295.1 	workers, peace officers, firefighters, emergency medical technicians, advanced emergency 
295.2 	medical technicians, paramedics, primary care providers, and others; and
295.3 	(6) community-based, evidence-based postvention training to mental health 
295.4 	professionals and practitioners in order to provide technical assistance to communities 
295.5 	after a suicide and to prevent suicide clusters and contagion.

295.6 	Sec. 6. Minnesota Statutes 2014, section 145.56, subdivision 4, is amended to read:
295.7 		Subd. 4.Collection and reporting suicide data. (a) The commissioner shall 
295.8 	coordinate with federal, regional, local, and other state agencies to collect, analyze, and 
295.9 	annually issue a public report on Minnesota-specific data on suicide and suicidal behaviors.
295.10 	(b) The commissioner, in consultation with stakeholders, shall submit a detailed 
295.11 	plan identifying proposed methods to improve the timeliness, usefulness, and quality of 
295.12 	suicide-related data so that the data can help identify the scope of the suicide problem, 
295.13 	identify high-risk groups, set priority prevention activities, and monitor the effects of 
295.14 	suicide prevention programs. The report shall include how to improve external cause 
295.15 	of injury coding, progress on implementing the Minnesota Violent Death Reporting 
295.16 	System, how to obtain and release data in a timely manner, and how to support the use of 
295.17 	psychological autopsies.
295.18 	(c) The written report must be provided to the chairs and ranking minority members 
295.19 	of the house of representatives and senate finance and policy divisions and committees 
295.20 	with jurisdiction over health and human services by February 1, 2016.

295.21 	Sec. 7. Minnesota Statutes 2014, section 245.467, subdivision 6, is amended to read:
295.22 		Subd. 6.Restricted access to data. The county board shall establish procedures 
295.23 	to ensure that the names and addresses of persons receiving mental health services are 
295.24 	disclosed only to:
295.25 	(1) county employees who are specifically responsible for determining county of 
295.26 	financial responsibility or making payments to providers; and
295.27 	(2) staff who provide treatment services or case management and their clinical 
295.28 	supervisors.; and
295.29 	(3) personnel of the welfare system or health care providers who have access to the 
295.30 	data under section 13.46, subdivision 7.
295.31 	Release of mental health data on individuals submitted under subdivisions 4 and 5, 
295.32 	to persons other than those specified in this subdivision, or use of this data for purposes 
295.33 	other than those stated in subdivisions 4 and 5, results in civil or criminal liability under 
295.34 	the standards in section 13.08 or 13.09.
296.1 	Only persons acting consistent with section 13.05 may enter, update, or access mental 
296.2 	health data on individuals submitted under subdivisions 4 and 5. The ability of authorized 
296.3 	persons to enter, update, or access data must be limited through the use of role-based access 
296.4 	that corresponds to the official duties or training level of the person, and the statutory 
296.5 	authorization that grants access for that purpose. For data submitted under subdivisions 4 
296.6 	and 5 and stored in an information system not operated by a state agency, all queries and 
296.7 	all actions in which records are viewed, accessed, accepted, or exited must be recorded in 
296.8 	a data audit trail. Data contained in the audit trail are public data, to the extent that the 
296.9 	data are not otherwise classified by law. The authorization of any person determined to 
296.10 	have willfully entered, updated, accessed, shared, or disseminated data in violation of this 
296.11 	section, or any other provision of law, must be immediately revoked and investigated. If a 
296.12 	person is determined to have willfully gained access to data without explicit authorization, 
296.13 	the person is subject to civil and criminal liability under sections 13.08 and 13.09.

296.14 	Sec. 8. Minnesota Statutes 2014, section 245.4876, subdivision 7, is amended to read:
296.15 		Subd. 7.Restricted access to data. The county board shall establish procedures 
296.16 	to ensure that the names and addresses of children receiving mental health services and 
296.17 	their families are disclosed only to:
296.18 	(1) county employees who are specifically responsible for determining county of 
296.19 	financial responsibility or making payments to providers; and
296.20 	(2) staff who provide treatment services or case management and their clinical 
296.21 	supervisors.; and
296.22 	(3) personnel of the welfare system or health care providers who have access to the 
296.23 	data under section 13.46, subdivision 7.
296.24 	Release of mental health data on individuals submitted under subdivisions 5 and 6, 
296.25 	to persons other than those specified in this subdivision, or use of this data for purposes 
296.26 	other than those stated in subdivisions 5 and 6, results in civil or criminal liability under 
296.27 	section 13.08 or 13.09.
296.28 	Only persons acting consistent with section 13.05 may enter, update, or access mental 
296.29 	health data on individuals submitted under subdivisions 5 and 6. The ability of authorized 
296.30 	persons to enter, update, or access data must be limited through the use of role-based access 
296.31 	that corresponds to the official duties or training level of the person, and the statutory 
296.32 	authorization that grants access for that purpose. For data submitted under subdivisions 5 
296.33 	and 6 and stored in an information system not operated by a state agency, all queries and 
296.34 	all actions in which records are viewed, accessed, accepted, or exited must be recorded in 
296.35 	a data audit trail. Data contained in the audit trail are public data, to the extent that the 
297.1 	data are not otherwise classified by law. The authorization of any person determined to 
297.2 	have willfully entered, updated, accessed, shared, or disseminated data in violation of this 
297.3 	section, or any other provision of law, must be immediately revoked and investigated. If a 
297.4 	person is determined to have willfully gained access to data without explicit authorization, 
297.5 	the person is subject to civil and criminal liability under sections 13.08 and 13.09.

297.6 	Sec. 9. [245.735] EXCELLENCE IN MENTAL HEALTH DEMONSTRATION 
297.7 	PROJECT.
297.8 		Subdivision 1.Excellence in Mental Health demonstration project. The 
297.9 	commissioner may develop and execute projects to reform the mental health system by 
297.10 	participating in the Excellence in Mental Health demonstration project.
297.11 		Subd. 2.Federal proposal. The commissioner may develop and submit to the 
297.12 	United States Department of Health and Human Services a proposal for the Excellence 
297.13 	in Mental Health demonstration project. The proposal shall include any necessary state 
297.14 	plan amendments, waivers, requests for new funding, realignment of existing funding, and 
297.15 	other authority necessary to implement the projects specified in subdivision 3.
297.16 		Subd. 3.Reform projects. (a) The commissioner may establish standards for 
297.17 	state certification of a clinic as a certified community behavioral health clinic, in 
297.18 	accordance with the criteria published on or before September 1, 2015, by the United 
297.19 	States Department of Health and Human Services. Certification standards established by 
297.20 	the commissioner shall require that:
297.21 	(1) clinic staff have backgrounds in diverse disciplines, include licensed mental 
297.22 	health professionals, and are culturally and linguistically trained to serve the needs of the 
297.23 	clinic's patient population;
297.24 	(2) clinic services are available and accessible and crisis management services 
297.25 	are available 24 hours per day;
297.26 	(3) fees for clinic services are established using a sliding fee scale and services to 
297.27 	patients are not denied or limited due to a patient's inability to pay for services;
297.28 	(4) clinics provide coordination of care across settings and providers to ensure 
297.29 	seamless transitions for patients across the full spectrum of health services, including 
297.30 	acute, chronic, and behavioral needs. Care coordination may be accomplished through 
297.31 	partnerships or formal contracts with federally qualified health centers, inpatient 
297.32 	psychiatric facilities, substance use and detoxification facilities, community-based mental 
297.33 	health providers, and other community services, supports, and providers including 
297.34 	schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health 
297.35 	Services clinics, tribally licensed health care and mental health facilities, urban Indian 
298.1 	health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in 
298.2 	centers, acute care hospitals, and hospital outpatient clinics; and
298.3 	(5) services provided by clinics include crisis mental health services, emergency 
298.4 	crisis intervention services, and stabilization services; screening, assessment, and 
298.5 	diagnosis services, including risk assessments and level of care determinations; 
298.6 	patient-centered treatment planning; outpatient mental health and substance use services; 
298.7 	targeted case management; psychiatric rehabilitation services; peer support and counselor 
298.8 	services and family support services; and intensive community-based mental health 
298.9 	services, including mental health services for members of the armed forces and veterans.
298.10 	(b) The commissioner shall establish standards and methodologies for a prospective 
298.11 	payment system for medical assistance payments for mental health services delivered by 
298.12 	certified community behavioral health clinics, in accordance with guidance issued on or 
298.13 	before September 1, 2015, by the Centers for Medicare and Medicaid Services. During the 
298.14 	operation of the demonstration project, payments shall comply with federal requirements 
298.15 	for a 90 percent enhanced federal medical assistance percentage.
298.16 		Subd. 4.Public participation. In developing the projects under subdivision 3, the 
298.17 	commissioner shall consult with mental health providers, advocacy organizations, licensed 
298.18 	mental health professionals, and Minnesota health care program enrollees who receive 
298.19 	mental health services and their families.
298.20 		Subd. 5.Information systems support. The commissioner and the state chief 
298.21 	information officer shall provide information systems support to the projects as necessary 
298.22 	to comply with federal requirements.

298.23 	Sec. 10. Minnesota Statutes 2014, section 256B.0625, is amended by adding a 
298.24 	subdivision to read:
298.25 		Subd. 45a.Psychiatric residential treatment facility services for persons under 
298.26 	21 years of age. (a) Medical assistance covers psychiatric residential treatment facility 
298.27 	services for persons under 21 years of age. Individuals who reach age 21 at the time they 
298.28 	are receiving services are eligible to continue receiving services until they no longer 
298.29 	require services or until they reach age 22, whichever occurs first.
298.30 	(b) For purposes of this subdivision, "psychiatric residential treatment facility" 
298.31 	means a facility other than a hospital that provides psychiatric services, as described in 
298.32 	Code of Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under 
298.33 	age 21 in an inpatient setting.
299.1 	(c) The commissioner shall develop admissions and discharge procedures and 
299.2 	establish rates consistent with guidelines from the federal Centers for Medicare and 
299.3 	Medicaid Services.
299.4 	(d) The commissioner shall enroll up to 150 certified psychiatric residential 
299.5 	treatment facility services beds at up to six sites. The commissioner shall select psychiatric 
299.6 	residential treatment facility services providers through a request for proposals process. 
299.7 	Providers of state-operated services may respond to the request for proposals.

299.8 	EFFECTIVE DATE. This section is effective July 1, 2016, or upon federal 
299.9 	approval, whichever is later. The commissioner of human services shall notify the revisor 
299.10 	of statutes when federal approval is obtained.

299.11 	Sec. 11. [256B.7631] CHEMICAL DEPENDENCY PROVIDER RATE 
299.12 	INCREASE.
299.13 	For the chemical dependency services listed in section 254B.05, subdivision 5, and 
299.14 	provided on or after July 1, 2015, payment rates shall be increased by 2.5 percent over 
299.15 	the rates in effect on January 1, 2014, for vendors who meet the requirements of section 
299.16 	254B.05.

299.17 	Sec. 12. REPORT TO LEGISLATURE; PERFORMANCE MEASURES FOR 
299.18 	CHEMICAL DEPENDENCY TREATMENT SERVICES.
 299.19 	The commissioner of human services, in consultation with members of the 
299.20 	Minnesota State Substance Abuse Strategy and representatives of counties, tribes, health 
299.21 	plan companies, and chemical dependency treatment providers, shall develop performance 
299.22 	measures to assess the outcomes of chemical dependency treatment services. The 
299.23 	commissioner shall report these performance measures to the members of the health and 
299.24 	human services policy and finance committees in the house of representatives and senate 
299.25 	on or before January 15, 2016.

299.26 	Sec. 13. RATE-SETTING METHODOLOGY FOR COMMUNITY-BASED 
299.27 	MENTAL HEALTH SERVICES.
 299.28 	The commissioner of human services shall conduct a comprehensive analysis of 
299.29 	the current rate-setting methodology for all community-based mental health services 
299.30 	for children and adults. The report shall also include recommendations for establishing 
299.31 	pay-for-performance measures for providers delivering services consistent with 
299.32 	evidence-based practices. In developing the report, the commissioner shall consult with 
299.33 	stakeholders and with outside experts in Medicaid financing. The commissioner shall 
300.1 	provide a report on the analysis to the chairs of the legislative committees with jurisdiction 
300.2 	over health and human services finance by January 1, 2017.

300.3 	Sec. 14. EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT.
 300.4 	By January 15, 2016, the commissioner of human services shall report to the 
300.5 	legislative committees in the house of representatives and senate with jurisdiction over 
300.6 	human services issues on the progress of the Excellence in Mental Health demonstration 
300.7 	project under Minnesota Statutes, section 245.735. The commissioner shall include in 
300.8 	the report any recommendations for legislative changes needed to implement the reform 
300.9 	projects specified in Minnesota Statutes, section 245.735, subdivision 3.

300.10 	Sec. 15. CLUBHOUSE PROGRAM SERVICES.
 300.11 	The commissioner of human services, in consultation with stakeholders, may 
300.12 	develop service standards and a payment methodology for Clubhouse program services 
300.13 	to be covered under medical assistance when provided by a Clubhouse International 
300.14 	accredited provider or a provider meeting equivalent standards. The commissioner may 
300.15 	seek federal approval for the service standards and payment methodology. Upon federal 
300.16 	approval, the commissioner must seek and obtain legislative approval of the services 
300.17 	standards and funding methodology allowing medical assistance coverage of the service.

300.18 	Sec. 16. SPECIAL PROJECTS; INTENSIVE TREATMENT AND SUPPORTS.
 300.19 	(a) The commissioner shall fund special projects to:
300.20 	(1) provide intensive treatment and supports to adolescents and young adults 26 
300.21 	years of age and younger who are experiencing their first psychotic or manic episode; and
300.22 	(2) conduct outreach, training, and guidance, in the project's region, to mental health 
300.23 	and health care professionals, including postsecondary health clinics, on early psychosis 
300.24 	symptoms, screening tools, and best practices.
300.25 	(b) Intensive treatment and supports includes medication management, 
300.26 	psychoeducation for the individual and family, care coordination, employment supports, 
300.27 	education supports, cognitive behavioral approaches, cognitive remediation, social skills 
300.28 	training, peer support, crisis planning, and stress management.

300.29 	Sec. 17. INSTRUCTIONS TO THE COMMISSIONER.
 300.30 	The commissioner of human services shall, in consultation with stakeholders, develop 
300.31 	recommendations on funding for children's mental health crisis residential services that will 
300.32 	allow for timely access without requiring county authorization or child welfare placement.

301.1 	Sec. 18. MENTAL HEALTH CRISIS SERVICES.
 301.2 	The commissioner of human services shall increase access to mental health crisis 
301.3 	services for children and adults. In order to increase access, the commissioner must:
301.4 	(1) develop a central phone number where calls can be routed to the appropriate 
301.5 	crisis services;
301.6 	(2) provide telephone consultation 24 hours a day to mobile crisis teams who are 
301.7 	serving people with traumatic brain injury or intellectual disabilities who are experiencing 
301.8 	a mental health crisis;
301.9 	(3) expand crisis services across the state, including rural areas of the state and 
301.10 	examining access per population;
301.11 	(4) establish and implement state standards for crisis services; and
301.12 	(5) provide grants to adult mental health initiatives, counties, tribes, or community 
301.13 	mental health providers to establish new mental health crisis residential service capacity.
301.14 	Priority will be given to regions that do not have a mental health crisis residential 
301.15 	services program, do not have an inpatient psychiatric unit within the region, do not have 
301.16 	an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the 
301.17 	number of crisis residential or intensive residential treatment beds available to meet the 
301.18 	needs of the residents in the region. At least 50 percent of the funds must be distributed to 
301.19 	programs in rural Minnesota. Grant funds may be used for start-up costs, including but not 
301.20 	limited to renovations, furnishings, and staff training. Grant applications shall provide 
301.21 	details on how the intended service will address identified needs and shall demonstrate 
301.22 	collaboration with crisis teams, other mental health providers, hospitals, and police.

301.23 	Sec. 19. COMPREHENSIVE MENTAL HEALTH CENTER.
 301.24 	(a) To the extent funds are appropriated for the purposes of this section, the 
301.25 	commissioner of human services shall establish a grant for Beltrami County to fund the 
301.26 	planning and development of a comprehensive mental health center for individuals who 
301.27 	are under arrest or subject to arrest, individuals who are experiencing a mental health 
301.28 	crisis, or individuals who are under a transport hold under Minnesota Statutes, section 
301.29 	253B.05, subdivision 2, in Beltrami County and northwestern Minnesota. The program 
301.30 	must be a sustainable, integrated care model for the provision of mental health and 
301.31 	substance use disorder treatment for the population served in collaboration with existing 
301.32 	services. The model may include mobile crisis services, crisis residential services, 
301.33 	outpatient services, and community-based services. The model must be patient-centered, 
301.34 	culturally competent, and based on evidence-based practices.
302.1 	(b) The program shall maintain data on the extent to which the center reduces 
302.2 	incarceration and hospitalization rates for individuals with mental illness or co-occurring 
302.3 	disorders, and the extent to which the center impacts service utilization for these 
302.4 	individuals. In order to have the capacity to be replicated in other areas of the state, the 
302.5 	center must report outcomes to the commissioner, at a time and in a manner determined 
302.6 	by the commissioner. The commissioner shall use the data to evaluate the effect the 
302.7 	program has on incarceration rates and services utilization, and report to the chairs and 
302.8 	ranking minority members of the senate and house of representatives committees having 
302.9 	jurisdiction over health and human services and corrections issues every two years, 
302.10 	beginning February 1, 2017.
302.11 	(c) The commissioner shall encourage the commissioners of the Minnesota Housing 
302.12 	Finance Agency, corrections, and health to provide technical assistance and support to this 
302.13 	program. The commissioner, together with the commissioner of health, shall determine 
302.14 	the most appropriate model for licensure of the proposed services and which agency 
302.15 	will regulate the services of the center. The commissioners of the Minnesota Housing 
302.16 	Finance Agency and human services shall work with the center to provide short-term 
302.17 	and long-term housing for individuals served by the center within the limits of existing 
302.18 	appropriations available for low-income housing or homelessness.

302.19 	Sec. 20. REPORT ON INTENSIVE COMMUNITY REHABILITATION 
302.20 	SERVICES.
 302.21 	(a) The commissioner of human services shall issue a report to the chairs and 
302.22 	ranking minority members of the house and senate committees with jurisdiction over 
302.23 	health and human services programs that contains recommendations on the intensive 
302.24 	community rehabilitation services program, including options for sustainable funding 
302.25 	models. The report shall:
302.26 	(1) analyze how the intensive community rehabilitation services program provides 
302.27 	needed mental health services and supports that are not currently covered by medical 
302.28 	assistance;
302.29 	(2) identify similar program models that are used in other states to fill similar service 
302.30 	gaps and the program funding sources used by those states;
302.31 	(3) analyze how the intensive community rehabilitation services model differs 
302.32 	between rural and metro areas;
302.33 	(4) make recommendations for expanding services; and
302.34 	(5) analyze potential sources for sustainable funding, including inclusion as a 
302.35 	medical assistance benefit.
303.1 	(b) The commissioner shall include stakeholders in developing recommendations 
303.2 	and developing the legislative report. The commissioner shall submit the report no later 
303.3 	than January 15, 2016.

303.4 	Sec. 21. COMMISSIONER'S DUTIES RELATED TO PEER SPECIALIST 
303.5 	TRAINING AND OUTREACH.
 303.6 	The commissioner shall collaborate with the Minnesota State Colleges and 
303.7 	Universities system to identify coursework to fulfill the peer specialist training 
303.8 	requirements. In addition, the commissioner shall provide outreach to community mental 
303.9 	health providers to increase their knowledge on how peer specialists can be utilized, best 
303.10 	practices on hiring peer specialists, how peer specialist activities can be billed, and the 
303.11 	benefits of hiring peer specialists.

303.12 	Sec. 22. INSTRUCTIONS TO THE COMMISSIONER.
 303.13 	The commissioner shall determine the number of individuals who were determined 
303.14 	to be ineligible to receive community first services and supports because they did not 
303.15 	require constant supervision and cuing in order to accomplish activities of daily living. 
303.16 	The commissioner shall issue a report with these findings to the chairs and ranking 
303.17 	minority members of the house and senate committees with jurisdiction over human 
303.18 	services programs.

303.19 	ARTICLE 9
303.20 	DIRECT CARE AND TREATMENT

303.21 	Section 1. Minnesota Statutes 2014, section 43A.241, is amended to read:
303.22 	43A.241 INSURANCE CONTRIBUTIONS; FORMER CORRECTIONS 
303.23 	EMPLOYEES.
303.24 	(a) This section applies to a person who:
303.25 	(1) was employed by the commissioner of the Department of Corrections at a state 
303.26 	institution under control of the commissioner, and in that employment was a member 
303.27 	of the general plan of the Minnesota State Retirement System; or by the Department 
303.28 	of Human Services;
303.29 	(2)  was covered by the correctional employee retirement plan under section 352.91 
303.30 	or the general state employees retirement plan of the Minnesota State Retirement System 
303.31 	as defined in section 352.021;
304.1 	(3) while employed under clause (1), was assaulted by an inmate at a state institution 
304.2 	under control of the commissioner of the Department of Corrections; and:
304.3 	(i) a person under correctional supervision for a criminal offense; or
304.4 	(ii) a client or patient at the Minnesota sex offender program or at a state-operated 
304.5 	forensic services program as defined in section 352.91, subdivision 3j, under the control of 
304.6 	the commissioner of the Department of Human Services; and
304.7 	(3)(4) as a direct result of the assault under clause (3), was determined to be totally 
304.8 	and permanently disabled under laws governing the Minnesota State Retirement System.
304.9 	(b) For a person to whom this section applies, the commissioner of the Department 
304.10 	of Corrections or the commissioner of the Department of Human Services must continue 
304.11 	to make the employer contribution for hospital, medical, and dental benefits under the 
304.12 	State Employee Group Insurance Program after the person terminates state service. If 
304.13 	the person had dependent coverage at the time of terminating state service, employer 
304.14 	contributions for dependent coverage also must continue under this section. The employer 
304.15 	contributions must be in the amount of the employer contribution for active state 
304.16 	employees at the time each payment is made. The employer contributions must continue 
304.17 	until the person reaches age 65, provided the person makes the required employee 
304.18 	contributions, in the amount required of an active state employee, at the time and in 
304.19 	the manner specified by the commissioner.

304.20 	EFFECTIVE DATE. This section is effective the day following final enactment 
304.21 	and applies to a person assaulted by an inmate, client, or patient on or after that date.

304.22 	Sec. 2. Minnesota Statutes 2014, section 253B.18, subdivision 4c, is amended to read:
304.23 		Subd. 4c.Special review board. (a) The commissioner shall establish one or more 
304.24 	panels of a special review board. The board shall consist of three members experienced 
304.25 	in the field of mental illness. One member of each special review board panel shall be a 
304.26 	psychiatrist or a doctoral level psychologist with forensic experience and one member 
304.27 	shall be an attorney. No member shall be affiliated with the Department of Human 
304.28 	Services. The special review board shall meet at least every six months and at the call of 
304.29 	the commissioner. It shall hear and consider all petitions for a reduction in custody or to 
304.30 	appeal a revocation of provisional discharge. A "reduction in custody" means transfer 
304.31 	from a secure treatment facility, discharge, and provisional discharge. Patients may be 
304.32 	transferred by the commissioner between secure treatment facilities without a special 
304.33 	review board hearing. 
304.34 	Members of the special review board shall receive compensation and reimbursement 
304.35 	for expenses as established by the commissioner.
305.1 	(b) The special review board must review each denied petition under subdivision 
305.2 	5 for barriers and obstacles preventing the patient from progressing in treatment. Based 
305.3 	on the cases before the board in the previous year, the special review board shall provide 
305.4 	to the commissioner an annual summation of the barriers to treatment progress, and 
305.5 	recommendations to achieve the common goal of making progress in treatment.
305.6 	(c) A petition filed by a person committed as mentally ill and dangerous to the 
305.7 	public under this section must be heard as provided in subdivision 5 and, as applicable, 
305.8 	subdivision 13. A petition filed by a person committed as a sexual psychopathic personality 
305.9 	or as a sexually dangerous person under chapter 253D, or committed as both mentally ill 
305.10 	and dangerous to the public under this section and as a sexual psychopathic personality or 
305.11 	as a sexually dangerous person must be heard as provided in section 253D.27.

305.12 	Sec. 3. Minnesota Statutes 2014, section 253B.18, subdivision 5, is amended to read:
305.13 		Subd. 5.Petition; notice of hearing; attendance; order. (a) A petition for 
305.14 	a reduction in custody or revocation of provisional discharge shall be filed with the 
305.15 	commissioner and may be filed by the patient or by the head of the treatment facility. A 
305.16 	patient may not petition the special review board for six months following commitment 
305.17 	under subdivision 3 or following the final disposition of any previous petition and 
305.18 	subsequent appeal by the patient.  The head of the treatment facility must schedule a 
305.19 	hearing before the special review board for any patient who has not appeared before the 
305.20 	special review board in the previous three years, and schedule a hearing at least every 
305.21 	three years thereafter. The medical director may petition at any time.
305.22 	(b) Fourteen days prior to the hearing, the committing court, the county attorney of 
305.23 	the county of commitment, the designated agency, interested person, the petitioner, and 
305.24 	the petitioner's counsel shall be given written notice by the commissioner of the time and 
305.25 	place of the hearing before the special review board. Only those entitled to statutory notice 
305.26 	of the hearing or those administratively required to attend may be present at the hearing. 
305.27 	The patient may designate interested persons to receive notice by providing the names 
305.28 	and addresses to the commissioner at least 21 days before the hearing. The board shall 
305.29 	provide the commissioner with written findings of fact and recommendations within 21 
305.30 	days of the hearing. The commissioner shall issue an order no later than 14 days after 
305.31 	receiving the recommendation of the special review board. A copy of the order shall be 
305.32 	mailed to every person entitled to statutory notice of the hearing within five days after it 
305.33 	is signed. No order by the commissioner shall be effective sooner than 30 days after the 
305.34 	order is signed, unless the county attorney, the patient, and the commissioner agree that 
305.35 	it may become effective sooner.
306.1 	(c) The special review board shall hold a hearing on each petition prior to making 
306.2 	its recommendation to the commissioner. The special review board proceedings are not 
306.3 	contested cases as defined in chapter 14. Any person or agency receiving notice that 
306.4 	submits documentary evidence to the special review board prior to the hearing shall also 
306.5 	provide copies to the patient, the patient's counsel, the county attorney of the county of 
306.6 	commitment, the case manager, and the commissioner.
306.7 	(d) Prior to the final decision by the commissioner, the special review board may be 
306.8 	reconvened to consider events or circumstances that occurred subsequent to the hearing.
306.9 	(e) In making their recommendations and order, the special review board and 
306.10 	commissioner must consider any statements received from victims under subdivision 5a.

306.11 	Sec. 4. CLOSURE OF FACILITY PROHIBITED.
 306.12 	The commissioner of human services shall not close, or otherwise terminate services 
306.13 	at, the Community Addiction Recovery Enterprise program located in Fergus Falls earlier 
306.14 	than July 1, 2019.

306.15 	Sec. 5. CLOSURE OF FACILITY PROHIBITED.
 306.16 	The commissioner of human services shall not close, or otherwise terminate services 
306.17 	at, the Child and Adolescent Behavioral Health Services program in Willmar without 
306.18 	legislative approval.

306.19 	ARTICLE 10
306.20 	WITHDRAWAL MANAGEMENT PROGRAMS

306.21 	Section 1. [245F.01] PURPOSE.
306.22 	It is hereby declared to be the public policy of this state that the public interest is best 
306.23 	served by providing efficient and effective withdrawal management services to persons 
306.24 	in need of  appropriate detoxification, assessment, intervention, and referral services. 
306.25 	The services shall vary to address the unique medical needs of each patient and shall be 
306.26 	responsive to the language and cultural needs of each patient. Services shall not be denied 
306.27 	on the basis of a patient's inability to pay.

306.28 	Sec. 2. [245F.02] DEFINITIONS.
306.29 		Subdivision 1.Scope. The terms used in this chapter have the meanings given 
306.30 	them in this section.
307.1 		Subd. 2.Administration of medications. "Administration of medications" means 
307.2 	performing a task to provide medications to a patient, and includes the following tasks 
307.3 	performed in the following order:
307.4 	(1) checking the patient's medication record;
307.5 	(2) preparing the medication for administration;
307.6 	(3) administering the medication to the patient;
307.7 	(4) documenting administration of the medication or the reason for not administering 
307.8 	the medication as prescribed; and
307.9 	(5) reporting information to a licensed practitioner or a registered nurse regarding 
307.10 	problems with the administration of the medication or the patient's refusal to take the 
307.11 	medication.
307.12 		Subd. 3.Alcohol and drug counselor. "Alcohol and drug counselor" means an 
307.13 	individual qualified under Minnesota Rules, part 9530.6450, subpart 5.
307.14 		Subd. 4.Applicant. "Applicant" means an individual, partnership, voluntary 
307.15 	association, corporation, or other public or private organization that submits an application 
307.16 	for licensure under this chapter.
307.17 		Subd. 5.Care coordination. "Care coordination" means activities intended to bring 
307.18 	together health services, patient needs, and streams of information to facilitate the aims 
307.19 	of care. Care coordination includes an ongoing needs assessment, life skills advocacy, 
307.20 	treatment follow-up, disease management, education, and other services as needed.  
307.21 		Subd. 6.Chemical. "Chemical" means alcohol, solvents, controlled substances as 
307.22 	defined in section 152.01, subdivision 4, and other mood-altering substances.
307.23 		Subd. 7.Clinically managed program. "Clinically managed program" means a 
307.24 	residential setting with staff comprised of a medical director and a licensed practical 
307.25 	nurse. A licensed practical nurse must be on site 24 hours a day, seven days a week. 
307.26 	An individual who meets the qualification requirements of a medical director must be 
307.27 	available by telephone or in person for consultation 24 hours a day. Patients admitted to 
307.28 	this level of service receive medical observation, evaluation, and stabilization services 
307.29 	during the detoxification process; access to medications administered by trained, licensed 
307.30 	staff to manage withdrawal; and a comprehensive assessment pursuant to Minnesota 
307.31 	Rules, part 9530.6422.
307.32 		Subd. 8.Commissioner. "Commissioner" means the commissioner of human 
307.33 	services or the commissioner's designated representative.
307.34 		Subd. 9.Department. "Department" means the Department of Human Services.
307.35 		Subd. 10.Direct patient contact. "Direct patient contact" has the meaning given 
307.36 	for "direct contact" in section 245C.02, subdivision 11.
308.1 		Subd. 11.Discharge plan. "Discharge plan" means a written plan that states with 
308.2 	specificity the services the program has arranged for the patient to transition back into 
308.3 	the community.
308.4 		Subd. 12.Licensed practitioner. "Licensed practitioner" means a practitioner as 
308.5 	defined in section 151.01, subdivision 23, who is authorized to prescribe.
308.6 		Subd. 13.Medical director. "Medical director" means an individual licensed in 
308.7 	Minnesota as a doctor of osteopathy or physician, or an individual licensed in Minnesota 
308.8 	as an advanced practice registered nurse by the Board of Nursing and certified to practice 
308.9 	as a clinical nurse specialist or nurse practitioner by a national nurse organization 
308.10 	acceptable to the board. The medical director must be employed by or under contract with 
308.11 	the license holder to direct and supervise health care for patients of a program licensed 
308.12 	under this chapter.
308.13 		Subd. 14.Medically monitored program. "Medically monitored program" means 
308.14 	a residential setting with staff that includes a registered nurse and a medical director. A 
308.15 	registered nurse must be on site 24 hours a day. A medical director must be on site seven 
308.16 	days a week, and patients must have the ability to be seen by a medical director within 24 
308.17 	hours. Patients admitted to this level of service receive medical observation, evaluation, 
308.18 	and stabilization services during the detoxification process; medications administered by 
308.19 	trained, licensed staff to manage withdrawal; and a comprehensive assessment pursuant to 
308.20 	Minnesota Rules, part 9530.6422.
308.21 		Subd. 15.Nurse. "Nurse" means a person licensed and currently registered to 
308.22 	practice practical or professional nursing as defined in section 148.171, subdivisions 
308.23 	14 and 15.
308.24 		Subd. 16.Patient. "Patient" means an individual who presents or is presented for 
308.25 	admission to a withdrawal management program that meets the criteria in section 245F.05.
308.26 		Subd. 17.Peer recovery support services. "Peer recovery support services" 
308.27 	means mentoring and education, advocacy, and nonclinical recovery support provided 
308.28 	by a recovery peer.
308.29 		Subd. 18.Program director. "Program director" means the individual who is 
308.30 	designated by the license holder to be responsible for all operations of a withdrawal 
308.31 	management program and who meets the qualifications specified in section 245F.15, 
308.32 	subdivision 3.
308.33 		Subd. 19.Protective procedure. "Protective procedure" means an action taken by a 
308.34 	staff member of a withdrawal management program to protect a patient from imminent 
308.35 	danger of harming self or others. Protective procedures include the following actions:
309.1 	(1) seclusion, which means the temporary placement of a patient, without the 
309.2 	patient's consent, in an environment to prevent social contact; and
309.3 	(2) physical restraint, which means the restraint of a patient by use of physical holds 
309.4 	intended to limit movement of the body.
309.5 		Subd. 20.Recovery peer. "Recovery peer" means a person who has progressed in 
309.6 	the person's own recovery from substance use disorder and is willing to serve as a peer 
309.7 	to assist others in their recovery.
309.8 		Subd. 21.Responsible staff person. "Responsible staff person" means the program 
309.9 	director, the medical director, or a staff person with current licensure as a nurse in 
309.10 	Minnesota. The responsible staff person must be on the premises and is authorized to 
309.11 	make immediate decisions concerning patient care and safety.
309.12 		Subd. 22.Substance. "Substance" means "chemical" as defined in subdivision 6.
309.13 		Subd. 23.Substance use disorder. "Substance use disorder" means a pattern of 
309.14 	substance use as defined in the current edition of the Diagnostic and Statistical Manual of 
309.15 	Mental Disorders.
309.16 		Subd. 24.Technician. "Technician" means a person who meets the qualifications in 
309.17 	section 245F.15, subdivision 6.
309.18 		Subd. 25.Withdrawal management program. "Withdrawal management 
309.19 	program" means a licensed program that provides short-term medical services on 
309.20 	a 24-hour basis for the purpose of stabilizing intoxicated patients, managing their 
309.21 	withdrawal, and facilitating access to substance use disorder treatment as indicated by a 
309.22 	comprehensive assessment.

309.23 	Sec. 3. [245F.03] APPLICATION.
309.24 	(a) This chapter establishes minimum standards for withdrawal management 
309.25 	programs licensed by the commissioner that serve one or more unrelated persons. 
309.26 	(b) This chapter does not apply to a withdrawal management program licensed as a 
309.27 	hospital under sections 144.50 to 144.581. A withdrawal management program located in 
309.28 	a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this 
309.29 	chapter is deemed to be in compliance with section 245F.13.

309.30 	Sec. 4. [245F.04] PROGRAM LICENSURE.
309.31 		Subdivision 1.General application and license requirements. An applicant 
309.32 	for licensure as a clinically managed withdrawal management program or medically 
309.33 	monitored withdrawal management program must meet the following requirements, 
309.34 	except where otherwise noted. All programs must comply with federal requirements and 
310.1 	the general requirements in chapters 245A and 245C and sections 626.556, 626.557, and 
310.2 	626.5572. A withdrawal management program must be located in a hospital licensed 
310.3 	under sections 144.50 to 144.581, or must be a supervised living facility with a class B 
310.4 	license from the Department of Health under Minnesota Rules, chapter 4665.
310.5 		Subd. 2.Contents of application. Prior to the issuance of a license, an applicant 
310.6 	must submit, on forms provided by the commissioner, documentation demonstrating 
310.7 	the following:
310.8 	(1) compliance with this section;
310.9 	(2) compliance with applicable building, fire, and safety codes; health rules; zoning 
310.10 	ordinances; and other applicable rules and regulations or documentation that a waiver 
310.11 	has been granted. The granting of a waiver does not constitute modification of any 
310.12 	requirement of this section;
310.13 	(3) completion of an assessment of need for a new or expanded program as required 
310.14 	by Minnesota Rules, part 9530.6800; and
310.15 	(4) insurance coverage, including bonding, sufficient to cover all patient funds, 
310.16 	property, and interests.
310.17 		Subd. 3.Changes in license terms. (a) A license holder must notify the 
310.18 	commissioner before one of the following occurs and the commissioner must determine 
310.19 	the need for a new license:
310.20 	(1) a change in the Department of Health's licensure of the program;
310.21 	(2) a change in the medical services provided by the program that affects the 
310.22 	program's capacity to provide services required by the program's license designation as a 
310.23 	clinically managed program or medically monitored program;
310.24 	(3) a change in program capacity; or
310.25 	(4) a change in location.
310.26 	(b) A license holder must notify the commissioner and apply for a new license 
310.27 	when a change in program ownership occurs.
310.28 		Subd. 4.Variances. The commissioner may grant variances to the requirements of 
310.29 	this chapter under section 245A.04, subdivision 9.

310.30 	Sec. 5. [245F.05] ADMISSION AND DISCHARGE POLICIES.
310.31 		Subdivision 1.Admission policy. A license holder must have a written admission 
310.32 	policy containing specific admission criteria. The policy must describe the admission 
310.33 	process and the point at which an individual who is eligible under subdivision 2 is 
310.34 	admitted to the program. A license holder must not admit individuals who do not meet the 
310.35 	admission criteria. The admission policy must be approved and signed by the medical 
311.1 	director of the facility and must designate which staff members are authorized to admit 
311.2 	and discharge patients. The admission policy must be posted in the area of the facility 
311.3 	where patients are admitted and given to all interested individuals upon request.
311.4 		Subd. 2.Admission criteria. For an individual to be admitted to a withdrawal 
311.5 	management program, the program must make a determination that the program services 
311.6 	are appropriate to the needs of the individual.  A program may only admit individuals who 
311.7 	meet the admission criteria and who, at the time of admission:
311.8 	(1) are impaired as the result of intoxication;
311.9 	(2) are experiencing physical, mental, or emotional problems due to intoxication or 
311.10 	withdrawal from alcohol or other drugs;
311.11 	(3) are being held under apprehend and hold orders under section 253B.07, 
311.12 	subdivision 2b;
311.13 	(4) have been committed under chapter 253B and need temporary placement;
311.14 	(5) are held under emergency holds or peace and health officer holds under section 
311.15 	253B.05, subdivision 1 or 2; or
311.16 	(6) need to stay temporarily in a protective environment because of a crisis related 
311.17 	to substance use disorder. Individuals satisfying this clause may be admitted only at the 
311.18 	request of the county of fiscal responsibility, as determined according to section 256G.02, 
311.19 	subdivision 4. Individuals admitted according to this clause must not be restricted to 
311.20 	the facility.
311.21 		Subd. 3.Individuals denied admission by program. (a) A license holder must 
311.22 	have a written policy and procedure for addressing the needs of individuals who are 
311.23 	denied admission to the program. These individuals include:
311.24 	(1) individuals whose pregnancy, in combination with their presenting problem, 
311.25 	requires services not provided by the program; and
311.26 	(2) individuals who are in imminent danger of harming self or others if their 
311.27 	behavior is beyond the behavior management capabilities of the program and staff.
311.28 	(b) Programs must document denied admissions, including the date and time of 
311.29 	the admission request, reason for the denial of admission, and where the individual was 
311.30 	referred. If the individual did not receive a referral, the program must document why a 
311.31 	referral was not made. This information must be documented on a form approved by the 
311.32 	commissioner and made available to the commissioner upon request.
311.33 		Subd. 4.License holder responsibilities; denying admission or terminating 
311.34 	services. (a) If a license holder denies an individual admission to the program or 
311.35 	terminates services to a patient and the denial or termination poses an immediate threat to 
311.36 	the patient's or individual's health or requires immediate medical intervention, the license 
312.1 	holder must refer the patient or individual to a medical facility capable of admitting the 
312.2 	patient or individual.
312.3 	(b) A license holder must report to a law enforcement agency with proper jurisdiction 
312.4 	all denials of admission and terminations of services that involve the commission of a crime 
312.5 	against a staff member of the license holder or on the license holder's property, as provided 
312.6 	in Code of Federal Regulations, title 42, section 2.12(c)(5), and title 45, parts 160 to 164.
312.7 		Subd. 5.Discharge and transfer policies. A license holder must have a written 
312.8 	policy and procedure, approved and signed by the medical director, that specifies 
312.9 	conditions under which patients may be discharged or transferred. The policy must 
312.10 	include the following:
312.11 	(1) guidelines for determining when a patient is medically stable and whether a 
312.12 	patient is able to be discharged or transferred to a lower level of care;
312.13 	(2) guidelines for determining when a patient needs a transfer to a higher level of care. 
312.14 	Clinically managed program guidelines must include guidelines for transfer to a medically 
312.15 	monitored program, hospital, or other acute care facility. Medically monitored program 
312.16 	guidelines must include guidelines for transfer to a hospital or other acute care facility;
312.17 	(3) procedures staff must follow when discharging a patient under each of the 
312.18 	following circumstances:
312.19 	(i) the patient is involved in the commission of a crime against program staff or 
312.20 	against a license holder's property. The procedures for a patient discharged under this 
312.21 	item must specify how reports must be made to law enforcement agencies with proper 
312.22 	jurisdiction as allowed under Code of Federal Regulations, title 42, section 2.12(c)(5), and 
312.23 	title 45, parts 160 to 164;
312.24 	(ii) the patient is in imminent danger of harming self or others and is beyond the 
312.25 	license holder's capacity to ensure safety;
312.26 	(iii) the patient was admitted under chapter 253B; or
312.27 	(iv) the patient is leaving against staff or medical advice; and
312.28 	(4) a requirement that staff must document where the patient was referred after 
312.29 	discharge or transfer, and if a referral was not made, the reason the patient was not 
312.30 	provided a referral.

312.31 	Sec. 6. [245F.06] SCREENING AND COMPREHENSIVE ASSESSMENT.
312.32 		Subdivision 1.Screening for substance use disorder. A nurse or an alcohol 
312.33 	and drug counselor must screen each patient upon admission to determine whether a 
312.34 	comprehensive assessment is indicated. The license holder must screen patients at 
313.1 	each admission, except that if the patient has already been determined to suffer from a 
313.2 	substance use disorder, subdivision 2 applies.
313.3 		Subd. 2.Comprehensive assessment. (a) Prior to a medically stable discharge, 
313.4 	but not later than 72 hours following admission, a license holder must provide a 
313.5 	comprehensive assessment according to section 245.4863, paragraph (a), and Minnesota 
313.6 	Rules, part 9530.6422, for each patient who has a positive screening for a substance use 
313.7 	disorder. If a patient's medical condition prevents a comprehensive assessment from 
313.8 	being completed within 72 hours, the license holder must document why the assessment 
313.9 	was not completed. The comprehensive assessment must include documentation of the 
313.10 	appropriateness of an involuntary referral through the civil commitment process.
313.11 	(b) If available to the program, a patient's previous comprehensive assessment may 
313.12 	be used in the patient record. If a previously completed comprehensive assessment is used, 
313.13 	its contents must be reviewed to ensure the assessment is accurate and current and complies 
313.14 	with the requirements of this chapter.   The review must be completed by a staff person 
313.15 	qualified according to Minnesota Rules, part 9530.6450, subpart 5. The license holder must 
313.16 	document that the review was completed and that the previously completed assessment is 
313.17 	accurate and current, or the license holder must complete an updated or new assessment.

313.18 	Sec. 7. [245F.07] STABILIZATION PLANNING.
313.19 		Subdivision 1.Stabilization plan. Within 12 hours of admission, a license 
313.20 	holder must develop an individualized stabilization plan for each patient accepted for 
313.21 	stabilization services. The plan must be based on the patient's initial health assessment 
313.22 	and continually updated based on new information gathered about the patient's condition 
313.23 	from the comprehensive assessment, medical evaluation and consultation, and ongoing 
313.24 	monitoring and observations of the patient. The patient must have an opportunity to have 
313.25 	direct involvement in the development of the plan. The stabilization plan must:
313.26 	(1) identify medical needs and goals to be achieved while the patient is receiving 
313.27 	services;
313.28 	(2) specify stabilization services to address the identified medical needs and goals, 
313.29 	including amount and frequency of services;
313.30 	(3) specify the participation of others in the stabilization planning process and 
313.31 	specific services where appropriated; and 
313.32 	(4) document the patient's participation in developing the content of the stabilization 
313.33 	plan and any updates.
314.1 		Subd. 2.Progress notes. Progress notes must be entered in the patient's file at least 
314.2 	daily and immediately following any significant event, including any change that impacts 
314.3 	the medical, behavioral, or legal status of the patient. Progress notes must:
314.4 	(1) include documentation of the patient's involvement in the stabilization services, 
314.5 	including the type and amount of each stabilization service;
314.6 	(2) include the monitoring and observations of the patient's medical needs;
314.7 	(3) include documentation of referrals made to other services or agencies;
314.8 	(4) specify the participation of others; and
314.9 	(5) be legible, signed, and dated by the staff person completing the documentation.
314.10 		Subd. 3.Discharge plan. Before a patient leaves the facility, the license holder 
314.11 	must conduct discharge planning for the patient, document discharge planning in the 
314.12 	patient's record, and provide the patient with a copy of the discharge plan. The discharge 
314.13 	plan must include:
314.14 	(1) referrals made to other services or agencies at the time of transition;
314.15 	(2) the patient's plan for follow-up, aftercare, or other poststabilization services;
314.16 	(3) documentation of the patient's participation in the development of the transition 
314.17 	plan;
314.18 	(4) any service that will continue after discharge under the direction of the license 
314.19 	holder; and
314.20 	(5) a stabilization summary and final evaluation of the patient's progress toward 
314.21 	treatment objectives.

314.22 	Sec. 8. [245F.08] STABILIZATION SERVICES.
314.23 		Subdivision 1.General. The license holder must encourage patients to remain in 
314.24 	care for an appropriate duration as determined by the patient's stabilization plan, and must 
314.25 	encourage all patients to enter programs for ongoing recovery as clinically indicated. In 
314.26 	addition, the license holder must offer services that are patient-centered, trauma-informed, 
314.27 	and culturally appropriate. Culturally appropriate services must include translation services 
314.28 	and dietary services that meet a patient's dietary needs. All services provided to the patient 
314.29 	must be documented in the patient's medical record. The following services must be 
314.30 	offered unless clinically inappropriate and the justifying clinical rationale is documented:
314.31 	(1) individual or group motivational counseling sessions;
314.32 	(2) individual advocacy and case management services;
314.33 	(3) medical services as required in section 245F.12;
314.34 	(4) care coordination provided according to subdivision 2;
314.35 	(5) peer recovery support services provided according to subdivision 3;
315.1 	(6) patient education provided according to subdivision 4; and
315.2 	(7) referrals to mutual aid, self-help, and support groups.
315.3 		Subd. 2.Care coordination. Care coordination services must be initiated for each 
315.4 	patient upon admission. The license holder must identify the staff person responsible for 
315.5 	the provision of each service. Care coordination services must include:
315.6 	(1) coordination with significant others to assist in the stabilization planning process 
315.7 	whenever possible;
315.8 	(2) coordination with and follow-up to appropriate medical services as identified by 
315.9 	the nurse or licensed practitioner;
315.10 	(3) referral to substance use disorder services as indicated by the comprehensive 
315.11 	assessment;
315.12 	(4) referral to mental health services as identified in the comprehensive assessment;
315.13 	(5) referrals to economic assistance, social services, and prenatal care in accordance 
315.14 	with the patient's needs;
315.15 	(6) review and approval of the transition plan prior to discharge, except in an 
315.16 	emergency, by a staff member able to provide direct patient contact;
315.17 	(7) documentation of the provision of care coordination services in the patient's 
315.18 	file; and
315.19 	(8) addressing cultural and socioeconomic factors affecting the patient's access to 
315.20 	services.
315.21 		Subd. 3.Peer recovery support services. (a) Peers in recovery serve as mentors or 
315.22 	recovery-support partners for individuals in recovery, and may provide encouragement, 
315.23 	self-disclosure of recovery experiences, transportation to appointments, assistance with 
315.24 	finding resources that will help locate housing, job search resources, and assistance finding 
315.25 	and participating in support groups.
315.26 	(b) Peer recovery support services are provided by a recovery peer and must be 
315.27 	supervised by the responsible staff person.
315.28 		Subd. 4.Patient education. A license holder must provide education to each 
315.29 	patient on the following:
315.30 	(1) substance use disorder, including the effects of alcohol and other drugs, specific 
315.31 	information about the effects of substance use on unborn children, and the signs and 
315.32 	symptoms of fetal alcohol spectrum disorders;
315.33 	(2) tuberculosis and reporting known cases of tuberculosis disease to health care 
315.34 	authorities according to section 144.4804;
315.35 	(3) Hepatitis C treatment and prevention;
315.36 	(4) HIV as required in section 245A.19, paragraphs (b) and (c);
316.1 	(5) nicotine cessation options, if applicable;
316.2 	(6) opioid tolerance and overdose risks, if applicable; and
316.3 	(7) long-term withdrawal issues related to use of barbiturates and benzodiazepines, 
316.4 	if applicable.
316.5 		Subd. 5.Mutual aid, self-help, and support groups. The license holder must 
316.6 	refer patients to mutual aid, self-help, and support groups when clinically indicated and 
316.7 	to the extent available in the community.

316.8 	Sec. 9. [245F.09] PROTECTIVE PROCEDURES.
316.9 		Subdivision 1.Use of protective procedures. (a) Programs must incorporate 
316.10 	person-centered planning and trauma-informed care into its protective procedure policies. 
316.11 	Protective procedures may be used only in cases where a less restrictive alternative will 
316.12 	not protect the patient or others from harm and when the patient is in imminent danger 
316.13 	of harming self or others. When a program uses a protective procedure, the program 
316.14 	must continuously observe the patient until the patient may safely be left for 15-minute 
316.15 	intervals. Use of the procedure must end when the patient is no longer in imminent danger 
316.16 	of harming self or others.
316.17 	(b) Protective procedures may not be used:
316.18 	(1) for disciplinary purposes;
316.19 	(2) to enforce program rules;
316.20 	(3) for the convenience of staff;
316.21 	(4) as a part of any patient's health monitoring plan; or
316.22 	(5) for any reason except in response to specific, current behaviors which create an 
316.23 	imminent danger of harm to the patient or others.
316.24 		Subd. 2.Protective procedures plan. A license holder must have a written policy 
316.25 	and procedure that establishes the protective procedures that program staff must follow 
316.26 	when a patient is in imminent danger of harming self or others. The policy must be 
316.27 	appropriate to the type of facility and the level of staff training. The protective procedures 
316.28 	policy must include:
316.29 	(1) an approval signed and dated by the program director and medical director prior 
316.30 	to implementation. Any changes to the policy must also be approved, signed, and dated by 
316.31 	the current program director and the medical director prior to implementation;
316.32 	(2) which protective procedures the license holder will use to prevent patients from 
316.33 	imminent danger of harming self or others;
316.34 	(3) the emergency conditions under which the protective procedures are permitted 
316.35 	to be used, if any;
317.1 	(4) the patient's health conditions that limit the specific procedures that may be used 
317.2 	and alternative means of ensuring safety;
317.3 	(5) emergency resources the program staff must contact when a patient's behavior 
317.4 	cannot be controlled by the procedures established in the policy;
317.5 	(6) the training that staff must have before using any protective procedure;
317.6 	(7) documentation of approved therapeutic holds;
317.7 	(8) the use of law enforcement personnel as described in subdivision 4;
317.8 	(9) standards governing emergency use of seclusion. Seclusion must be used only 
317.9 	when less restrictive measures are ineffective or not feasible. The standards in items (i) to 
317.10 	(vii) must be met when seclusion is used with a patient:
317.11 	(i) seclusion must be employed solely for the purpose of preventing a patient from 
317.12 	imminent danger of harming self or others;
317.13 	(ii) seclusion rooms must be equipped in a manner that prevents patients from 
317.14 	self-harm using projections, windows, electrical fixtures, or hard objects, and must allow 
317.15 	the patient to be readily observed without being interrupted;
317.16 	(iii) seclusion must be authorized by the program director, a licensed physician, or 
317.17 	a registered nurse. If one of these individuals is not present in the facility, the program 
317.18 	director or a licensed physician or registered nurse must be contacted and authorization 
317.19 	must be obtained within 30 minutes of initiating seclusion, according to written policies;
317.20 	(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
317.21 	(v) once the condition of a patient in seclusion has been determined to be safe 
317.22 	enough to end continuous observation, a patient in seclusion must be observed at a 
317.23 	minimum of every 15 minutes for the duration of seclusion and must always be within 
317.24 	hearing range of program staff;
317.25 	(vi) a process for program staff to use to remove a patient to other resources available 
317.26 	to the facility if seclusion does not sufficiently assure patient safety; and
317.27 	(vii) a seclusion area may be used for other purposes, such as intensive observation, if 
317.28 	the room meets normal standards of care for the purpose and if the room is not locked; and
317.29 	(10) physical holds may only be used when less restrictive measures are not feasible. 
317.30 	The standards in items (i) to (iv) must be met when physical holds are used with a patient:
317.31 	(i) physical holds must be employed solely for preventing a patient from imminent 
317.32 	danger of harming self or others;
317.33 	(ii) physical holds must be authorized by the program director, a licensed physician, 
317.34 	or a registered nurse. If one of these individuals is not present in the facility, the program 
317.35 	director or a licensed physician or a registered nurse must be contacted and authorization 
318.1 	must be obtained within 30 minutes of initiating a physical hold, according to written 
318.2 	policies;
318.3 	(iii) the patient's health concerns must be considered in deciding whether to use 
318.4 	physical holds and which holds are appropriate for the patient; and
318.5 	(iv) only approved holds may be utilized. Prone holds are not allowed and must 
318.6 	not be authorized.
318.7 		Subd. 3.Records. Each use of a protective procedure must be documented in the 
318.8 	patient record. The patient record must include:
318.9 	(1) a description of specific patient behavior precipitating a decision to use a 
318.10 	protective procedure, including date, time, and program staff present;
318.11 	(2) the specific means used to limit the patient's behavior;
318.12 	(3) the time the protective procedure began, the time the protective procedure ended, 
318.13 	and the time of each staff observation of the patient during the procedure;
318.14 	(4) the names of the program staff authorizing the use of the protective procedure, 
318.15 	the time of the authorization, and the program staff directly involved in the protective 
318.16 	procedure and the observation process;
318.17 	(5) a brief description of the purpose for using the protective procedure, including 
318.18 	less restrictive interventions used prior to the decision to use the protective procedure 
318.19 	and a description of the behavioral results obtained through the use of the procedure. If 
318.20 	a less restrictive intervention was not used, the reasons for not using a less restrictive 
318.21 	intervention must be documented;
318.22 	(6) documentation by the responsible staff person on duty of reassessment of the 
318.23 	patient at least every 15 minutes to determine if seclusion or the physical hold can be 
318.24 	terminated;
318.25 	(7) a description of the physical holds used in escorting a patient; and
318.26 	(8) any injury to the patient that occurred during the use of a protective procedure.
318.27 		Subd. 4.Use of law enforcement. The program must maintain a central log 
318.28 	documenting each incident involving use of law enforcement, including:
318.29 	(1) the date and time law enforcement arrived at and left the program;
318.30 	(2) the reason for the use of law enforcement;
318.31 	(3) if law enforcement used force or a protective procedure and which protective 
318.32 	procedure was used; and
318.33 	(4) whether any injuries occurred.
318.34 		Subd. 5.Administrative review. (a) The license holder must keep a record of all 
318.35 	patient incidents and protective procedures used.  An administrative review of each use 
318.36 	of protective procedures must be completed within 72 hours by someone other than the 
319.1 	person who used the protective procedure. The record of the administrative review of the 
319.2 	use of protective procedures must state whether:
319.3 	(1) the required documentation was recorded for each use of a protective procedure;
319.4 	(2) the protective procedure was used according to the policy and procedures;
319.5 	(3) the staff who implemented the protective procedure was properly trained; and
319.6 	(4) the behavior met the standards for imminent danger of harming self or others.
319.7 	(b) The license holder must conduct and document a quarterly review of the use of 
319.8 	protective procedures with the goal of reducing the use of protective procedures. The 
319.9 	review must include:
319.10 	(1) any patterns or problems indicated by similarities in the time of day, day of the 
319.11 	week, duration of the use of a protective procedure, individuals involved, or other factors 
319.12 	associated with the use of protective procedures;
319.13 	(2) any injuries resulting from the use of protective procedures;
319.14 	(3) whether law enforcement was involved in the use of a protective procedure;
319.15 	(4) actions needed to correct deficiencies in the program's implementation of 
319.16 	protective procedures;
319.17 	(5) an assessment of opportunities missed to avoid the use of protective procedures; 
319.18 	and
319.19 	(6) proposed actions to be taken to minimize the use of protective procedures.

319.20 	Sec. 10. [245F.10] PATIENT RIGHTS AND GRIEVANCE PROCEDURES.
319.21 		Subdivision 1.Patient rights. Patients have the rights in sections 144.651, 
319.22 	148F.165, and 253B.03, as applicable. The license holder must give each patient, upon 
319.23 	admission, a written statement of patient rights. Program staff must review the statement 
319.24 	with the patient.
319.25 		Subd. 2.Grievance procedure. Upon admission, the license holder must explain 
319.26 	the grievance procedure to the patient or patient's representative. The grievance procedure 
319.27 	must be posted in a place visible to the patient and must be made available to current and 
319.28 	former patients upon request. A license holder's written grievance procedure must include:
319.29 	(1) staff assistance in developing and processing the grievance;
319.30 	(2) an initial response to the patient who filed the grievance within 24 hours of the 
319.31 	program's receipt of the grievance, and timelines for additional steps to be taken to resolve 
319.32 	the grievance, including access to the person with the highest level of authority in the 
319.33 	program if the grievance cannot be resolved by other staff members; and
319.34 	(3) the addresses and telephone numbers of the Department of Human Services 
319.35 	Licensing Division, Department of Health Office of Health Facilities Complaints, Board 
320.1 	of Behavioral Health and Therapy, Board of Medical Practice, Board of Nursing, and 
320.2 	Office of the Ombudsman for Mental Health and Developmental Disabilities.

320.3 	Sec. 11. [245F.11] PATIENT PROPERTY MANAGEMENT.
320.4 	A license holder must meet the requirements for handling patient funds and property 
320.5 	in section 245A.04, subdivision 13, except:
320.6 	(1) a license holder must establish policies regarding the use of personal property to 
320.7 	assure that program activities and the rights of other patients are not infringed, and may 
320.8 	take temporary custody of personal property if these policies are violated;
320.9 	(2) a license holder must retain the patient's property for a minimum of seven days 
320.10 	after discharge if the patient does not reclaim the property after discharge; and
320.11 	(3) the license holder must return to the patient all of the patient's property held in 
320.12 	trust at discharge, regardless of discharge status, except that:
320.13 	(i) drugs, drug paraphernalia, and drug containers that are forfeited under section 
320.14 	609.5316 must be destroyed by staff or given over to the custody of a local law 
320.15 	enforcement agency, according to Code of Federal Regulations, title 42, sections 2.1 to 
320.16 	2.67, and title 45, parts 160 to 164; and
320.17 	(ii) weapons, explosives, and other property that may cause serious harm to self 
320.18 	or others must be transferred to a local law enforcement agency. The patient must be 
320.19 	notified of the transfer and the right to reclaim the property if the patient has a legal right 
320.20 	to possess the item.

320.21 	Sec. 12. [245F.12] MEDICAL SERVICES.
320.22 		Subdivision 1.Services provided at all programs. Withdrawal management 
320.23 	programs must have:
320.24 	(1) a standardized data collection tool for collecting health-related information about 
320.25 	each patient. The data collection tool must be developed in collaboration with a registered 
320.26 	nurse and approved and signed by the medical director; and
320.27 	(2) written procedures for a nurse to assess and monitor patient health within the 
320.28 	nurse's scope of practice. The procedures must:
320.29 	(i) be approved by the medical director;
320.30 	(ii) include a follow-up screening conducted between four and 12 hours after service 
320.31 	initiation to collect information relating to acute intoxication, other health complaints, and 
320.32 	behavioral risk factors that the patient may not have communicated at service initiation;
321.1 	(iii) specify the physical signs and symptoms that, when present, require consultation 
321.2 	with a registered nurse or a physician and that require transfer to an acute care facility or 
321.3 	a higher level of care than that provided by the program;
321.4 	(iv) specify those staff members responsible for monitoring patient health and 
321.5 	provide for hourly observation and for more frequent observation if the initial health 
321.6 	assessment or follow-up screening indicates a need for intensive physical or behavioral 
321.7 	health monitoring; and
321.8 	(v) specify the actions to be taken to address specific complicating conditions, 
321.9 	including pregnancy or the presence of physical signs or symptoms of any other medical 
321.10 	condition.
321.11 		Subd. 2.Services provided at clinically managed programs. In addition to the 
321.12 	services listed in subdivision 1, clinically managed programs must:
321.13 	(1) have a licensed practical nurse on site 24 hours a day and a medical director;
321.14 	(2) provide an initial health assessment conducted by a nurse upon admission;
321.15 	(3) provide daily on-site medical evaluation and consultation with a registered 
321.16 	nurse and have a registered nurse available by telephone or in person for consultation 
321.17 	24 hours a day;
321.18 	(4) have an individual who meets the qualification requirements of a medical director 
321.19 	available by telephone or in person for consultation 24 hours a day; and
321.20 	(5) have appropriately licensed staff available to administer medications according 
321.21 	to prescriber-approved orders.
321.22 		Subd. 3.Services provided at medically monitored programs. In addition to the 
321.23 	services listed in subdivision 1, medically monitored programs must have a registered 
321.24 	nurse on site 24 hours a day and a medical director. Medically monitored programs must 
321.25 	provide intensive inpatient withdrawal management services which must include:
321.26 	(1) an initial health assessment conducted by a registered nurse upon admission;
321.27 	(2) the availability of a medical evaluation and consultation with a registered nurse 
321.28 	24 hours a day;
321.29 	(3) the availability of a licensed professional who meets the qualification requirements 
321.30 	of a medical director by telephone or in person for consultation 24 hours a day;
321.31 	(4) the ability to be seen within 24 hours or sooner by an individual who meets the 
321.32 	qualification requirements of a medical director if the initial health assessment indicates 
321.33 	the need to be seen;
321.34 	(5) the availability of on-site monitoring of patient care seven days a week by an 
321.35 	individual who meets the qualification requirements of a medical director; and
322.1 	(6) appropriately licensed staff available to administer medications according to 
322.2 	prescriber-approved orders.

322.3 	Sec. 13. [245F.13] MEDICATIONS.
322.4 		Subdivision 1.Administration of medications.  A license holder must employ or 
322.5 	contract with a registered nurse to develop the policies and procedures for medication 
322.6 	administration. A registered nurse must provide supervision as defined in section 148.171, 
322.7 	subdivision 23, for the administration of medications. For clinically managed programs, 
322.8 	the registered nurse supervision must include on-site supervision at least monthly or more 
322.9 	often as warranted by the health needs of the patient. The medication administration 
322.10 	policies and procedures must include:
322.11 	(1) a provision that patients may carry emergency medication such as nitroglycerin 
322.12 	as instructed by their  prescriber;
322.13 	(2) requirements for recording the patient's use of medication, including staff 
322.14 	signatures with date and time;
322.15 	(3) guidelines regarding when to inform a licensed practitioner or a registered nurse 
322.16 	of problems with medication administration, including failure to administer, patient 
322.17 	refusal of a medication, adverse reactions, or errors; and
322.18 	(4) procedures for acceptance, documentation, and implementation of prescriptions, 
322.19 	whether written, oral, telephonic, or electronic.
322.20 		Subd. 2.Control of drugs. A license holder must have in place and implement 
322.21 	written policies and procedures relating to control of drugs. The policies and procedures 
322.22 	must be developed by a registered nurse and must contain the following provisions:
322.23 	(1) a requirement that all drugs must be stored in a locked compartment. Schedule II 
322.24 	drugs, as defined in section 152.02, subdivision 3, must be stored in a separately locked 
322.25 	compartment that is permanently affixed to the physical plant or a medication cart;
322.26 	(2) a system for accounting for all scheduled drugs each shift;
322.27 	(3) a procedure for recording a patient's use of medication, including staff signatures 
322.28 	with time and date;
322.29 	(4) a procedure for destruction of discontinued, outdated, or deteriorated medications;
322.30 	(5) a statement that only authorized personnel are permitted to have access to the 
322.31 	keys to the locked drug compartments; and
322.32 	(6) a statement that no legend drug supply for one patient may be given to another 
322.33 	patient.

322.34 	Sec. 14. [245F.14] STAFFING REQUIREMENTS AND DUTIES.
323.1 		Subdivision 1.Program director. A license holder must employ or contract with a 
323.2 	person, on a full-time basis, to serve as program director. The program director must be 
323.3 	responsible for all aspects of the facility and the services delivered to the license holder's 
323.4 	patients. An individual may serve as program director for more than one program owned 
323.5 	by the same license holder.
323.6 		Subd. 2.Responsible staff person. During all hours of operation, a license holder 
323.7 	must designate a staff member as the responsible staff person to be present and awake 
323.8 	in the facility and be responsible for the program. The responsible staff person must 
323.9 	have decision-making authority over the day-to-day operation of the program as well 
323.10 	as the authority to direct the activity of or terminate the shift of any staff member who 
323.11 	has direct patient contact.
323.12 		Subd. 3.Technician required. A license holder must have one technician awake 
323.13 	and on duty at all times for every ten patients in the program. A license holder may assign 
323.14 	technicians according to the need for care of the patients, except that the same technician 
323.15 	must not be responsible for more than 15 patients at one time. For purposes of establishing 
323.16 	this ratio, all staff whose qualifications meet or exceed those for technicians under section 
323.17 	245F.15, subdivision 6, and who are performing the duties of a technician may be counted 
323.18 	as technicians. The same individual may not be counted as both a technician and an 
323.19 	alcohol and drug counselor.
323.20 		Subd. 4.Registered nurse required. A license holder must employ or contract 
323.21 	with a registered nurse, who must be available 24 hours a day by telephone or in person 
323.22 	for consultation. The registered nurse is responsible for:
323.23 	(1) establishing and implementing procedures for the provision of nursing care and 
323.24 	delegated medical care, including:
323.25 	(i) a health monitoring plan;
323.26 	(ii) a medication control plan;
323.27 	(iii) training and competency evaluations for staff performing delegated medical and 
323.28 	nursing functions;
323.29 	(iv) handling serious illness, accident, or injury to patients;
323.30 	(v) an infection control program; and
323.31 	(vi) a first aid kit;
323.32 	(2) delegating nursing functions to other staff consistent with their education, 
323.33 	competence, and legal authorization;
323.34 	(3) assigning, supervising, and evaluating the performance of nursing tasks; and
323.35 	(4) implementing condition-specific protocols in compliance with section 151.37, 
323.36 	subdivision 2.
324.1 		Subd. 5.Medical director required. A license holder must have a medical director 
324.2 	available for medical supervision. The medical director is responsible for ensuring the 
324.3 	accurate and safe provision of all health-related services and procedures. A license 
324.4 	holder must obtain and document the medical director's annual approval of the following 
324.5 	procedures before the procedures may be used:
324.6 	(1) admission, discharge, and transfer criteria and procedures;
324.7 	(2) a health services plan;
324.8 	(3) physical indicators for a referral to a physician, registered nurse, or hospital, and 
324.9 	procedures for referral;
324.10 	(4) procedures to follow in case of accident, injury, or death of a patient;
324.11 	(5) formulation of condition-specific protocols regarding the medications that 
324.12 	require a withdrawal regimen that will be administered to patients;
324.13 	(6) an infection control program;
324.14 	(7) protective procedures; and
324.15 	(8) a medication control plan.
324.16 		Subd. 6.Alcohol and drug counselor. A withdrawal management program must 
324.17 	provide one full-time equivalent alcohol and drug counselor for every 16 patients served 
324.18 	by the program.
324.19 		Subd. 7.Ensuring staff-to-patient ratio. The responsible staff person under 
324.20 	subdivision 2 must ensure that the program does not exceed the staff-to-patient ratios in 
324.21 	subdivisions 3 and 6 and must inform admitting staff of the current staffed capacity of 
324.22 	the program for that shift. A license holder must have a written policy for documenting 
324.23 	staff-to-patient ratios for each shift and actions to take when staffed capacity is reached.

324.24 	Sec. 15. [245F.15] STAFF QUALIFICATIONS.
324.25 		Subdivision 1.Qualifications for all staff who have direct patient contact. (a) All 
324.26 	staff who have direct patient contact must be at least 18 years of age and must, at the time 
324.27 	of hiring, document that they meet the requirements in paragraph (b), (c), or (d).
324.28 	(b) Program directors, supervisors, nurses, and alcohol and drug counselors must be 
324.29 	free of substance use problems for at least two years immediately preceding their hiring 
324.30 	and must sign a statement attesting to that fact.
324.31 	(c) Recovery peers must be free of substance use problems for at least one year 
324.32 	immediately preceding their hiring and must sign a statement attesting to that fact.
324.33 	(d) Technicians and other support staff must be free of substance use problems 
324.34 	for at least six months immediately preceding their hiring and must sign a statement 
324.35 	attesting to that fact.  
325.1 		Subd. 2.Continuing employment; no substance use problems. License holders 
325.2 	must require staff to be free from substance use problems as a condition of continuing 
325.3 	employment. Staff are not required to sign statements attesting to their freedom from 
325.4 	substance use problems after the initial statement required by subdivision 1. Staff with 
325.5 	substance use problems must be immediately removed from any responsibilities that 
325.6 	include direct patient contact.
325.7 		Subd. 3.Program director qualifications. A program director must:
325.8 	(1) have at least one year of work experience in direct service to individuals 
325.9 	with substance use disorders or one year of work experience in the management or 
325.10 	administration of direct service to individuals with substance use disorders;
325.11 	(2) have a baccalaureate degree or three years of work experience in administration 
325.12 	or personnel supervision in human services; and
325.13 	(3) know and understand the implications of this chapter and chapters 245A and 
325.14 	245C, and sections 253B.04, 253B.05, 626.556, 626.557, and 626.5572.
325.15 		Subd. 4.Alcohol and drug counselor qualifications. An alcohol and drug 
325.16 	counselor must meet the requirements in Minnesota Rules, part 9530.6450, subpart 5.
325.17 		Subd. 5.Responsible staff person qualifications. Each responsible staff person 
325.18 	must know and understand the implications of this chapter and sections 245A.65, 
325.19 	253B.04, 253B.05, 626.556, 626.557, and 626.5572. In a clinically managed program, the 
325.20 	responsible staff person must be a licensed practiced nurse employed by or under contract 
325.21 	with the license holder. In a medically monitored program, the responsible staff person 
325.22 	must be a registered nurse, program director, or physician.
325.23 		Subd. 6.Technician qualifications.  A technician employed by a program must 
325.24 	demonstrate competency, prior to direct patient contact, in the following areas:
325.25 	(1) knowledge of the client bill of rights in section 148F.165 and staff responsibilities 
325.26 	in sections 144.651 and 253B.03;
325.27 	(2) knowledge of and the ability to perform basic health screening procedures with 
325.28 	intoxicated patients that consist of:
325.29 	(i) blood pressure, pulse, temperature, and respiration readings;
325.30 	(ii) interviewing to obtain relevant medical history and current health complaints; and
325.31 	(iii) visual observation of a patient's health status, including monitoring a patient's 
325.32 	behavior as it relates to health status;
325.33 	(3) a current first aid certificate from the American Red Cross or an equivalent 
325.34 	organization; a current cardiopulmonary resuscitation certificate from the American Red 
325.35 	Cross, the American Heart Association, a community organization, or an equivalent 
325.36 	organization; and knowledge of first aid for seizures, trauma, and loss of consciousness; and
326.1 	(4) knowledge of and ability to perform basic activities of daily living and personal 
326.2 	hygiene.
326.3 		Subd. 7.Recovering peer qualifications. Recovery peers must:
326.4 	(1) be at least 21 years of age and have a high school diploma or its equivalent;
326.5 	(2) have a minimum of one year in recovery from substance use disorder;
326.6 	(3) have completed a curriculum designated by the commissioner that teaches 
326.7 	specific skills and training in the domains of ethics and boundaries, advocacy, mentoring 
326.8 	and education, and recovery and wellness support; and
326.9 	(4) receive supervision in areas specific to the domains of their role by qualified 
326.10 	supervisory staff.
326.11 		Subd. 8.Personal relationships. A license holder must have a written policy 
326.12 	addressing personal relationships between patients and staff who have direct patient 
326.13 	contact. The policy must:
326.14 	(1) prohibit direct patient contact between a patient and a staff member if the staff 
326.15 	member has had a personal relationship with the patient within two years prior to the 
326.16 	patient's admission to the program;
326.17 	(2) prohibit access to a patient's clinical records by a staff member who has had a 
326.18 	personal relationship with the patient within two years prior to the patient's admission, 
326.19 	unless the patient consents in writing; and
326.20 	(3) prohibit a clinical relationship between a staff member and a patient if the staff 
326.21 	member has had a personal relationship with the patient within two years prior to the 
326.22 	patient's admission. If a personal relationship exists, the staff member must report the 
326.23 	relationship to the staff member's supervisor and recuse the staff member from a clinical 
326.24 	relationship with that patient.

326.25 	Sec. 16. [245F.16] PERSONNEL POLICIES AND PROCEDURES.
326.26 		Subdivision 1.Policy requirements. A license holder must have written personnel 
326.27 	policies and must make them available to staff members at all times. The personnel 
326.28 	policies must:
326.29 	(1) ensure that staff member's retention, promotion, job assignment, or pay are not 
326.30 	affected by a good faith communication between the staff member and the Department 
326.31 	of Human Services, Department of Health, Ombudsman for Mental Health and 
326.32 	Developmental Disabilities, law enforcement, or local agencies that investigate complaints 
326.33 	regarding patient rights, health, or safety;
327.1 	(2) include a job description for each position that specifies job responsibilities, 
327.2 	degree of authority to execute job responsibilities, standards of job performance related to 
327.3 	specified job responsibilities, and qualifications;
327.4 	(3) provide for written job performance evaluations for staff members of the license 
327.5 	holder at least annually;
327.6 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
327.7 	dismissal, including policies that address substance use problems and meet the requirements 
327.8 	of section 245F.15, subdivisions 1 and 2. The policies and procedures must list behaviors 
327.9 	or incidents that are considered substance use problems. The list must include:
327.10 	(i) receiving treatment for substance use disorder within the period specified for the 
327.11 	position in the staff qualification requirements;
327.12 	(ii) substance use that has a negative impact on the staff member's job performance;
327.13 	(iii) substance use that affects the credibility of treatment services with patients, 
327.14 	referral sources, or other members of the community; and
327.15 	(iv) symptoms of intoxication or withdrawal on the job;
327.16 	(5) include policies prohibiting personal involvement with patients and policies 
327.17 	prohibiting patient maltreatment as specified under chapter 604 and sections 245A.65, 
327.18 	626.556, 626.557, and 626.5572;
327.19 	(6) include a chart or description of organizational structure indicating the lines 
327.20 	of authority and responsibilities;
327.21 	(7) include a written plan for new staff member orientation that, at a minimum, 
327.22 	includes training related to the specific job functions for which the staff member was hired, 
327.23 	program policies and procedures, patient needs, and the areas identified in subdivision 2, 
327.24 	paragraphs (b) to (e); and
327.25 	(8) include a policy on the confidentiality of patient information.
327.26 		Subd. 2.Staff development. (a) A license holder must ensure that each staff 
327.27 	member receives orientation training before providing direct patient care and at least 
327.28 	30 hours of continuing education every two years.  A written record must be kept to 
327.29 	demonstrate completion of training requirements.
327.30 	(b) Within 72 hours of beginning employment, all staff having direct patient contact 
327.31 	must be provided orientation on the following:
327.32 	(1) specific license holder and staff responsibilities for patient confidentiality;
327.33 	(2) standards governing the use of protective procedures;
327.34 	(3) patient ethical boundaries and patient rights, including the rights of patients 
327.35 	admitted under chapter 253B;
327.36 	(4) infection control procedures;
328.1 	(5) mandatory reporting under sections 245A.65, 626.556, and 626.557, including 
328.2 	specific training covering the facility's policies concerning obtaining patient releases 
328.3 	of information;
328.4 	(6) HIV minimum standards as required in section 245A.19;
328.5 	(7) motivational counseling techniques and identifying stages of change; and
328.6 	(8) eight hours of training on the program's protective procedures policy required in 
328.7 	section 245F.09, including:
328.8 	(i) approved therapeutic holds;
328.9 	(ii) protective procedures used to prevent patients from imminent danger of harming 
328.10 	self or others;
328.11 	(iii) the emergency conditions under which the protective procedures may be used, if 
328.12 	any;
328.13 	(iv) documentation standards for using protective procedures;
328.14 	(v) how to monitor and respond to patient distress; and
328.15 	(vi) person-centered planning and trauma-informed care.
328.16 	(c) All staff having direct patient contact must be provided annual training on the 
328.17 	following:
328.18 	(1) infection control procedures;
328.19 	(2) mandatory reporting under sections 245A.65, 626.556, and 626.557, including 
328.20 	specific training covering the facility's policies concerning obtaining patient releases 
328.21 	of information;
328.22 	(3) HIV minimum standards as required in section 245A.19; and
328.23 	(4) motivational counseling techniques and identifying stages of change.
328.24 	(d) All staff having direct patient contact must be provided training every two 
328.25 	years on the following:
328.26 	(1) specific license holder and staff responsibilities for patient confidentiality;
328.27 	(2) standards governing use of protective procedures, including:
328.28 	(i) approved therapeutic holds;
328.29 	(ii) protective procedures used to prevent patients from imminent danger of harming 
328.30 	self or others;
328.31 	(iii) the emergency conditions under which the protective procedures may be used, if 
328.32 	any;
328.33 	(iv) documentation standards for using protective procedures;
328.34 	(v) how to monitor and respond to patient distress; and
328.35 	(vi) person-centered planning and trauma-informed care; and
329.1 	(3) patient ethical boundaries and patient rights, including the rights of patients 
329.2 	admitted under chapter 253B.
329.3 	(e) Continuing education that is completed in areas outside of the required topics 
329.4 	must provide information to the staff person that is useful to the performance of the 
329.5 	individual staff person's duties.

329.6 	Sec. 17. [245F.18] POLICY AND PROCEDURES MANUAL.
329.7 	A license holder must develop a written policy and procedures manual that is 
329.8 	alphabetically indexed and has a table of contents, so that staff have immediate access 
329.9 	to all policies and procedures, and that consumers of the services and other authorized 
329.10 	parties have access to all policies and procedures. The manual must contain the following 
329.11 	materials:
329.12 	(1) a description of patient education services as required in section 245F.06;
329.13 	(2) personnel policies that comply with section 245F.16;
329.14 	(3) admission information and referral and discharge policies that comply with 
329.15 	section 245F.05;
329.16 	(4) a health monitoring plan that complies with section 245F.12;
329.17 	(5) a protective procedures policy that complies with section 245F.09, if the program 
329.18 	elects to use protective procedures;
329.19 	(6) policies and procedures for assuring appropriate patient-to-staff ratios that 
329.20 	comply with section 245F.14;
329.21 	(7) policies and procedures for assessing and documenting the susceptibility for 
329.22 	risk of abuse to the patient as the basis for the individual abuse prevention plan required 
329.23 	by section 245A.65;
329.24 	(8) procedures for mandatory reporting as required by sections 245A.65, 626.556, 
329.25 	and 626.557;
329.26 	(9) a medication control plan that complies with section 245F.13; and
329.27 	(10) policies and procedures regarding HIV that meet the minimum standards 
329.28 	under section 245A.19.

329.29 	Sec. 18. [245F.21] PAYMENT METHODOLOGY.
329.30 	The commissioner shall develop a payment methodology for services provided 
329.31 	under this chapter or by an Indian Health Services facility or a facility owned and operated 
329.32 	by a tribe or tribal organization operating under Public Law 93-638 as a 638 facility. The 
329.33 	commissioner shall seek federal approval for the methodology. Upon federal approval, the 
330.1 	commissioner must seek and obtain legislative approval of the funding methodology to 
330.2 	support the service.

330.3 	ARTICLE 11
330.4 	HEALTH-RELATED LICENSING BOARDS

330.5 	Section 1. Minnesota Statutes 2014, section 146B.01, subdivision 28, is amended to 
330.6 	read:
330.7 		Subd. 28.Supervision. "Supervision" means the physical presence of a technician 
330.8 	licensed under this chapter while a body art procedure is being performed. and includes:
330.9 	(1) direct supervision, which means the constant physical presence of a technician 
330.10 	licensed under this chapter within five feet and the line of sight of the temporary technician 
330.11 	who is performing a body art procedure; and
330.12 	(2) indirect supervision, which means the constant physical presence of a technician 
330.13 	licensed under this chapter in the establishment while a body art procedure is being 
330.14 	performed by a temporary technician.

330.15 	Sec. 2. Minnesota Statutes 2014, section 146B.03, subdivision 4, is amended to read:
330.16 		Subd. 4.Licensure requirements. (a) An applicant for licensure under this section 
330.17 	shall submit to the commissioner on a form provided by the commissioner:
330.18 	(1) proof that the applicant is over the age of 18;
330.19 	(2) the type of license the applicant is applying for;
330.20 	(3) all fees required under section 146B.10;
330.21 	(4) proof of completing a minimum of 200 hours of supervised experience within 
330.22 	each area for which the applicant is seeking a license, and must include an affidavit from 
330.23 	the supervising licensed technician;
330.24 	(5) proof of having satisfactorily completed coursework within the year preceding 
330.25 	application and approved by the commissioner on bloodborne pathogens, the prevention 
330.26 	of disease transmission, infection control, and aseptic technique. Courses to be considered 
330.27 	for approval by the commissioner may include, but are not limited to, those administered 
330.28 	by one of the following:
330.29 	(i) the American Red Cross;
330.30 	(ii) United States Occupational Safety and Health Administration (OSHA); or
330.31 	(iii) the Alliance of Professional Tattooists; and
330.32 	(6) any other relevant information requested by the commissioner.
331.1 	The licensure requirements of this paragraph are effective for all applicants for new 
331.2 	licenses issued before January 1, 2016.
331.3 	(b) An applicant for licensure under this section shall submit to the commissioner 
331.4 	on a form provided by the commissioner:
331.5 	(1) proof that the applicant is over the age of 18;
331.6 	(2) the type of license the applicant is applying for;
331.7 	(3) all fees required under section 146B.10;
331.8 	(4) a log showing completion of the supervised experience as specified in 
331.9 	subdivision 12;
331.10 	(5) a signed affidavit from each licensed technician who the applicant listed as 
331.11 	providing supervision for each required activity;
331.12 	(6) proof of having satisfactorily completed a minimum of five hours of coursework, 
331.13 	within the year preceding application and approved by the commissioner, on bloodborne 
331.14 	pathogens, the prevention of disease transmission, infection control, and aseptic technique. 
331.15 	Courses to be considered for approval by the commissioner may include, but are not 
331.16 	limited to, those administered by one of the following:
331.17 	(i) the American Red Cross;
331.18 	(ii) the United States Occupational Safety and Health Administration (OSHA); or
331.19 	(iii) the Alliance of Professional Tattooists; and
331.20 	(7) any other relevant information requested by the commissioner.
331.21 	The licensure requirements of this paragraph shall be effective for all applicants for new 
331.22 	licenses issued on or after January 1, 2016.

331.23 	Sec. 3. Minnesota Statutes 2014, section 146B.03, subdivision 6, is amended to read:
331.24 		Subd. 6.Licensure term; renewal. (a) A technician's license is valid for two 
331.25 	years from the date of issuance and may be renewed upon payment of the renewal fee 
331.26 	established under section 146B.10.
331.27 	(b) At renewal, a licensee must submit proof of continuing education approved by 
331.28 	the commissioner in the areas identified in subdivision 4, paragraph (b), clause (5) (6).
331.29 	(c) The commissioner shall notify the technician of the pending expiration of a 
331.30 	technician license at least 90 days prior to license expiration.

331.31 	Sec. 4. Minnesota Statutes 2014, section 146B.03, is amended by adding a subdivision 
331.32 	to read:
331.33 		Subd. 12.Required supervised experience. An applicant for a body art technician 
331.34 	license shall complete the following minimum supervised experience for licensure:
332.1 	(1) an applicant for a tattoo technician license or a dual body art technician license 
332.2 	must complete a minimum of 200 hours of tattoo experience under supervision; and
332.3 	(2) an applicant for a body piercing technician license or a dual body art technician 
332.4 	license must perform 250 body piercings under direct supervision and 250 body piercings 
332.5 	under indirect supervision.

332.6 	Sec. 5. Minnesota Statutes 2014, section 146B.07, subdivision 1, is amended to read:
332.7 		Subdivision 1.Proof of age. (a) A technician shall require proof of age from clients 
332.8 	who state they are 18 years of age or older before performing any body art procedure on a 
332.9 	client. Proof of age must be established by one of the following methods:
332.10 	(1) a valid driver's license or identification card issued by the state of Minnesota or 
332.11 	another state that includes a photograph and date of birth of the individual;
332.12 	(2) a valid military identification card issued by the United States Department of 
332.13 	Defense;
332.14 	(3) a valid passport;
332.15 	(4) a resident alien card; or
332.16 	(5) a tribal identification card.
332.17 	(b) Before performing any body art procedure, the technician must provide the client 
332.18 	with a disclosure and authorization form that indicates whether the client has:
332.19 	(1) diabetes;
332.20 	(2) a history of hemophilia;
332.21 	(3) a history of skin diseases, skin lesions, or skin sensitivities to soap or disinfectants;
332.22 	(4) a history of epilepsy, seizures, fainting, or narcolepsy;
332.23 	(5) any condition that requires the client to take medications such as anticoagulants 
332.24 	that thin the blood or interfere with blood clotting; or
332.25 	(6) any other information that would aid the technician in the body art procedure 
332.26 	process evaluation.
332.27 	(c) The form must include a statement informing the client that the technician shall 
332.28 	not perform a body art procedure if the client fails to complete or sign the disclosure and 
332.29 	authorization form, and the technician may decline to perform a body art procedure if the 
332.30 	client has any identified health conditions.
332.31 	(d) The technician shall ask the client to sign and date the disclosure and 
332.32 	authorization form confirming that the information listed on the form is accurate.
332.33 	(e) Before performing any body art procedure, the technician shall offer and make 
332.34 	available to the client personal draping, as appropriate.

333.1 	Sec. 6. Minnesota Statutes 2014, section 146B.07, subdivision 2, is amended to read:
333.2 		Subd. 2.Parent or legal guardian consent; prohibitions. (a) A technician may 
333.3 	perform body piercings on an individual under the age of 18 if when:
333.4 	(1)  the individual's parent or legal guardian is present and;
333.5 	(2) the parent or legal guardian provides personal identification as provided in 
333.6 	subdivision 1, paragraph (a), clauses (1) to (5);
333.7 	(3) the individual under age 18 provides proof of identification and age as provided 
333.8 	in subdivision 1, paragraph (a), clauses (1) to (5), by a current student identification, 
333.9 	or by another method that includes a photograph and the name of the individual from 
333.10 	an official source;
333.11 	(4) the parent or legal guardian provides other documentation to reasonably establish 
333.12 	that the individual is the parent or the legal guardian of the individual under age 18 who is 
333.13 	seeking a body piercing;
333.14 	(5)  a consent form and the authorization form under subdivision 1, paragraph (b) is 
333.15 	signed by the parent or legal guardian in the presence of the technician,; and
333.16 	(6) the piercing is not prohibited under paragraph (c).
333.17 	(b) No technician shall tattoo any individual under the age of 18 regardless of 
333.18 	parental or guardian consent.
333.19 	(c) No nipple or genital piercing, branding, scarification, suspension, subdermal 
333.20 	implantation, microdermal, or tongue bifurcation shall be performed by any technician on 
333.21 	any individual under the age of 18 regardless of parental or guardian consent.
333.22 	(d) No technician shall perform body art procedures on any individual who appears 
333.23 	to be under the influence of alcohol, controlled substances as defined in section 152.01, 
333.24 	subdivision 4, or hazardous substances as defined in rules adopted under chapter 182.
333.25 	(e) No technician shall perform body art procedures while under the influence of 
333.26 	alcohol, controlled substances as defined under section 152.01, subdivision 4, or hazardous 
333.27 	substances as defined in the rules adopted under chapter 182.
333.28 	(f) No technician shall administer anesthetic injections or other medications.

333.29 	Sec. 7. Minnesota Statutes 2014, section 147.091, subdivision 1, is amended to read:
333.30 		Subdivision 1.Grounds listed. The board may refuse to grant a license, may 
333.31 	refuse to grant registration to perform interstate telemedicine services, or may impose 
333.32 	disciplinary action as described in section 147.141 against any physician. The following 
333.33 	conduct is prohibited and is grounds for disciplinary action:
334.1 	(a) Failure to demonstrate the qualifications or satisfy the requirements for a license 
334.2 	contained in this chapter or rules of the board. The burden of proof shall be upon the 
334.3 	applicant to demonstrate such qualifications or satisfaction of such requirements.
334.4 	(b) Obtaining a license by fraud or cheating, or attempting to subvert the licensing 
334.5 	examination process. Conduct which subverts or attempts to subvert the licensing 
334.6 	examination process includes, but is not limited to: (1) conduct which violates the 
334.7 	security of the examination materials, such as removing examination materials from the 
334.8 	examination room or having unauthorized possession of any portion of a future, current, or 
334.9 	previously administered licensing examination; (2) conduct which violates the standard of 
334.10 	test administration, such as communicating with another examinee during administration 
334.11 	of the examination, copying another examinee's answers, permitting another examinee 
334.12 	to copy one's answers, or possessing unauthorized materials; or (3) impersonating an 
334.13 	examinee or permitting an impersonator to take the examination on one's own behalf.
334.14 	(c) Conviction, during the previous five years, of a felony reasonably related to the 
334.15 	practice of medicine or osteopathy. Conviction as used in this subdivision shall include 
334.16 	a conviction of an offense which if committed in this state would be deemed a felony 
334.17 	without regard to its designation elsewhere, or a criminal proceeding where a finding or 
334.18 	verdict of guilt is made or returned but the adjudication of guilt is either withheld or 
334.19 	not entered thereon.
334.20 	(d) Revocation, suspension, restriction, limitation, or other disciplinary action 
334.21 	against the person's medical license in another state or jurisdiction, failure to report to the 
334.22 	board that charges regarding the person's license have been brought in another state or 
334.23 	jurisdiction, or having been refused a license by any other state or jurisdiction.
334.24 	(e) Advertising which is false or misleading, which violates any rule of the board, 
334.25 	or which claims without substantiation the positive cure of any disease, or professional 
334.26 	superiority to or greater skill than that possessed by another physician.
334.27 	(f) Violating a rule promulgated by the board or an order of the board, a state, or 
334.28 	federal law which relates to the practice of medicine, or in part regulates the practice of 
334.29 	medicine including without limitation sections 604.201, 609.344, and 609.345, or a state 
334.30 	or federal narcotics or controlled substance law.
334.31 	(g) Engaging in any unethical conduct; conduct likely to deceive, defraud, or harm 
334.32 	the public, or demonstrating a willful or careless disregard for the health, welfare or safety 
334.33 	of a patient; or medical practice which is professionally incompetent, in that it may create 
334.34 	unnecessary danger to any patient's life, health, or safety, in any of which cases, proof 
334.35 	of actual injury need not be established.
335.1 	(h) Failure to supervise a physician assistant or failure to supervise a physician 
335.2 	under any agreement with the board.
335.3 	(i) Aiding or abetting an unlicensed person in the practice of medicine, except that 
335.4 	it is not a violation of this paragraph for a physician to employ, supervise, or delegate 
335.5 	functions to a qualified person who may or may not be required to obtain a license or 
335.6 	registration to provide health services if that person is practicing within the scope of that 
335.7 	person's license or registration or delegated authority.
335.8 	(j) Adjudication as mentally incompetent, mentally ill or developmentally disabled, 
335.9 	or as a chemically dependent person, a person dangerous to the public, a sexually 
335.10 	dangerous person, or a person who has a sexual psychopathic personality by a court of 
335.11 	competent jurisdiction, within or without this state. Such adjudication shall automatically 
335.12 	suspend a license for the duration thereof unless the board orders otherwise.
335.13 	(k) Engaging in unprofessional conduct. Unprofessional conduct shall include 
335.14 	any departure from or the failure to conform to the minimal standards of acceptable 
335.15 	and prevailing medical practice in which proceeding actual injury to a patient need not 
335.16 	be established.
335.17 	(l) Inability to practice medicine with reasonable skill and safety to patients by 
335.18 	reason of illness, drunkenness, use of drugs, narcotics, chemicals or any other type of 
335.19 	material or as a result of any mental or physical condition, including deterioration through 
335.20 	the aging process or loss of motor skills.
335.21 	(m) Revealing a privileged communication from or relating to a patient except when 
335.22 	otherwise required or permitted by law.
335.23 	(n) Failure by a doctor of osteopathy to identify the school of healing in the 
335.24 	professional use of the doctor's name by one of the following terms: osteopathic physician 
335.25 	and surgeon, doctor of osteopathy, or D.O.
335.26 	(o) Improper management of medical records, including failure to maintain adequate 
335.27 	medical records, to comply with a patient's request made pursuant to sections 144.291 to 
335.28 	144.298 or to furnish a medical record or report required by law.
335.29 	(p) Fee splitting, including without limitation:
335.30 	(1) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, 
335.31 	or remuneration, directly or indirectly, primarily for the referral of patients or the 
335.32 	prescription of drugs or devices;
335.33 	(2) dividing fees with another physician or a professional corporation, unless the 
335.34 	division is in proportion to the services provided and the responsibility assumed by each 
335.35 	professional and the physician has disclosed the terms of the division;
336.1 	(3) referring a patient to any health care provider as defined in sections 144.291 to 
336.2 	144.298 in which the referring physician has a "financial or economic interest," as defined 
336.3 	in section 144.6521, subdivision 3, unless the physician has disclosed the physician's 
336.4 	financial or economic interest in accordance with section 144.6521; and
336.5 	(4) dispensing for profit any drug or device, unless the physician has disclosed the 
336.6 	physician's own profit interest.
336.7 	The physician must make the disclosures required in this clause in advance and in writing 
336.8 	to the patient and must include in the disclosure a statement that the patient is free to 
336.9 	choose a different health care provider. This clause does not apply to the distribution 
336.10 	of revenues from a partnership, group practice, nonprofit corporation, or professional 
336.11 	corporation to its partners, shareholders, members, or employees if the revenues consist 
336.12 	only of fees for services performed by the physician or under a physician's direct 
336.13 	supervision, or to the division or distribution of prepaid or capitated health care premiums, 
336.14 	or fee-for-service withhold amounts paid under contracts established under other state law.
336.15 	(q) Engaging in abusive or fraudulent billing practices, including violations of the 
336.16 	federal Medicare and Medicaid laws or state medical assistance laws.
336.17 	(r) Becoming addicted or habituated to a drug or intoxicant.
336.18 	(s) Prescribing a drug or device for other than medically accepted therapeutic or 
336.19 	experimental or investigative purposes authorized by a state or federal agency or referring 
336.20 	a patient to any health care provider as defined in sections 144.291 to 144.298 for services 
336.21 	or tests not medically indicated at the time of referral.
336.22 	(t) Engaging in conduct with a patient which is sexual or may reasonably be 
336.23 	interpreted by the patient as sexual, or in any verbal behavior which is seductive or 
336.24 	sexually demeaning to a patient.
336.25 	(u) Failure to make reports as required by section 147.111 or to cooperate with an 
336.26 	investigation of the board as required by section 147.131.
336.27 	(v) Knowingly providing false or misleading information that is directly related 
336.28 	to the care of that patient unless done for an accepted therapeutic purpose such as the 
336.29 	administration of a placebo.
336.30 	(w) Aiding suicide or aiding attempted suicide in violation of section 609.215 as 
336.31 	established by any of the following:
336.32 	(1) a copy of the record of criminal conviction or plea of guilty for a felony in 
336.33 	violation of section 609.215, subdivision 1 or 2;
336.34 	(2) a copy of the record of a judgment of contempt of court for violating an 
336.35 	injunction issued under section 609.215, subdivision 4;
337.1 	(3) a copy of the record of a judgment assessing damages under section 609.215, 
337.2 	subdivision 5; or
337.3 	(4) a finding by the board that the person violated section 609.215, subdivision 
337.4 	1 or 2. The board shall investigate any complaint of a violation of section 609.215, 
337.5 	subdivision 1 or 2.
337.6 	(x) Practice of a board-regulated profession under lapsed or nonrenewed credentials.
337.7 	(y) Failure to repay a state or federally secured student loan in accordance with 
337.8 	the provisions of the loan.
337.9 	(z) (y) Providing interstate telemedicine services other than according to section 
337.10 	147.032.

337.11 	Sec. 8. Minnesota Statutes 2014, section 148.271, is amended to read:
337.12 	148.271 EXEMPTIONS.
337.13 	The provisions of sections 148.171 to 148.285 shall not prohibit:
337.14 	(1) The furnishing of nursing assistance in an emergency.
337.15 	(2) The practice of advanced practice, professional, or practical nursing by any 
337.16 	legally qualified advanced practice, registered, or licensed practical nurse of another state 
337.17 	who is employed by the United States government or any bureau, division, or agency 
337.18 	thereof while in the discharge of official duties.
337.19 	(3) The practice of any profession or occupation licensed by the state, other than 
337.20 	advanced practice, professional, or practical nursing, by any person duly licensed to 
337.21 	practice the profession or occupation, or the performance by a person of any acts properly 
337.22 	coming within the scope of the profession, occupation, or license.
337.23 	(4) The provision of a nursing or nursing-related service by an unlicensed assistive 
337.24 	person who has been delegated or assigned the specific function and is supervised by a 
337.25 	registered nurse or monitored by a licensed practical nurse.
337.26 	(5) The care of the sick with or without compensation when done in a nursing home 
337.27 	covered by the provisions of section 144A.09, subdivision 1.
337.28 	(6) Professional nursing practice or advanced practice registered nursing practice by 
337.29 	a registered nurse or practical nursing practice by a licensed practical nurse licensed in 
337.30 	another state or territory who is in Minnesota as a student enrolled in a formal, structured 
337.31 	course of study, such as a course leading to a higher degree, certification in a nursing 
337.32 	specialty, or to enhance skills in a clinical field, while the student is practicing in the course.
337.33 	(7) Professional or practical nursing practice by a student practicing under the 
337.34 	supervision of an instructor while the student is enrolled in a nursing program approved by 
337.35 	the board under section 148.251.
338.1 	(8) Advanced practice registered nursing as defined in section 148.171, subdivisions 
338.2 	5, 10, 11, 13, and 21, by a registered nurse who is licensed and currently registered in 
338.3 	Minnesota or another United States jurisdiction and who is enrolled as a student in a 
338.4 	formal graduate education program leading to eligibility for certification and licensure 
338.5 	as an advanced practice registered nurse.
338.6 	(9) Professional nursing practice or advanced practice registered nursing practice by 
338.7 	a registered nurse or advanced practice registered nurse licensed in another state, territory, 
338.8 	or jurisdiction who is in Minnesota temporarily:
338.9 	(i) providing continuing or in-service education;
338.10 	(ii) serving as a guest lecturer;
338.11 	(iii) presenting at a conference; or
338.12 	(iv) teaching didactic content via distance education to a student located in 
338.13 	Minnesota who is enrolled in a formal, structured course of study, such as a course leading 
338.14 	to a higher degree or certification in a nursing specialty.

338.15 	Sec. 9. Minnesota Statutes 2014, section 148.52, is amended to read:
338.16 	148.52 BOARD OF OPTOMETRY.
338.17 	The Board of Optometry shall consist of two public members as defined by section 
338.18 	214.02 and five qualified Minnesota licensed optometrists appointed by the governor. 
338.19 	Membership terms, compensation of members, removal of members, the filling of 
338.20 	membership vacancies, and fiscal year and reporting requirements shall be as provided in 
338.21 	sections 214.07 to 214.09.
338.22 	The provision of staff, administrative services and office space; the review and 
338.23 	processing of complaints; the setting of board fees; and other provisions relating to board 
338.24 	operations shall be as provided in chapter 214.

338.25 	Sec. 10. Minnesota Statutes 2014, section 148.54, is amended to read:
338.26 	148.54 BOARD; SEAL.
338.27 	The Board of Optometry shall elect from among its members a president, vice 
338.28 	president, and secretary and may adopt a seal.

338.29 	Sec. 11. Minnesota Statutes 2014, section 148.57, subdivision 1, is amended to read:
338.30 		Subdivision 1.Examination. (a) A person not authorized to practice optometry in 
338.31 	the state and desiring to do so shall apply to the state Board of Optometry by filling out 
338.32 	and swearing to an application for a license granted by the board and accompanied by a 
338.33 	fee in an amount of $87 established by the board, not to exceed the amount specified in 
339.1 	section 148.59. With the submission of the application form, the candidate shall prove 
339.2 	that the candidate:
339.3 	(1) is of good moral character;
339.4 	(2) has obtained a clinical doctorate degree from a board-approved school or college 
339.5 	of optometry, or is currently enrolled in the final year of study at such an institution; and
339.6 	(3) has passed all parts of an examination.
339.7 	(b) The examination shall include both a written portion and a clinical practical 
339.8 	portion and shall thoroughly test the fitness of the candidate to practice in this state. In 
339.9 	regard to the written and clinical practical examinations, the board may:
339.10 	(1) prepare, administer, and grade the examination itself;
339.11 	(2) recognize and approve in whole or in part an examination prepared, administered 
339.12 	and graded by a national board of examiners in optometry; or
339.13 	(3) administer a recognized and approved examination prepared and graded by or 
339.14 	under the direction of a national board of examiners in optometry.
339.15 	(c) The board shall issue a license to each applicant who satisfactorily passes the 
339.16 	examinations and fulfills the other requirements stated in this section and section 148.575 
339.17 	for board certification for the use of legend drugs. Applicants for initial licensure do not 
339.18 	need to apply for or possess a certificate as referred to in sections 148.571 to 148.574. The 
339.19 	fees mentioned in this section are for the use of the board and in no case shall be refunded.

339.20 	Sec. 12. Minnesota Statutes 2014, section 148.57, subdivision 2, is amended to read:
339.21 		Subd. 2.Endorsement. (a) An optometrist who holds a current license from 
339.22 	another state, and who has practiced in that state not less than three years immediately 
339.23 	preceding application, may apply for licensure in Minnesota by filling out and swearing 
339.24 	to an application for license by endorsement furnished by the board. The completed 
339.25 	application with all required documentation shall be filed at the board office along with a 
339.26 	fee of $87 established by the board, not to exceed the amount specified in section 148.59. 
339.27 	The application fee shall be for the use of the board and in no case shall be refunded.
339.28 	(b) To verify that the applicant possesses the knowledge and ability essential to the 
339.29 	practice of optometry in this state, the applicant must provide evidence of:
339.30 	(1) having obtained a clinical doctorate degree from a board-approved school 
339.31 	or college of optometry;
339.32 	(2) successful completion of both written and practical examinations for licensure in 
339.33 	the applicant's original state of licensure that thoroughly tested the fitness of the applicant 
339.34 	to practice;
339.35 	(3) successful completion of an examination of Minnesota state optometry laws;
340.1 	(4) compliance with the requirements for board certification in section 148.575;
340.2 	(5) compliance with all continuing education required for license renewal in every 
340.3 	state in which the applicant currently holds an active license to practice; and
340.4 	(6) being in good standing with every state board from which a license has been 
340.5 	issued.
340.6 	(c) Documentation from a national certification system or program, approved by 
340.7 	the board, which supports any of the listed requirements, may be used as evidence. The 
340.8 	applicant may then be issued a license if the requirements for licensure in the other state 
340.9 	are deemed by the board to be equivalent to those of sections 148.52 to 148.62.

340.10 	Sec. 13. Minnesota Statutes 2014, section 148.57, is amended by adding a subdivision 
340.11 	to read:
340.12 		Subd. 5.Change of address.  A person regulated by the board shall maintain a 
340.13 	current name and address with the board and shall notify the board in writing within 30 
340.14 	days of any change in name or address. If a name change only is requested, the regulated 
340.15 	person must request revised credentials and return the current credentials to the board. 
340.16 	The board may require the regulated person to substantiate the name change by submitting 
340.17 	official documentation from a court of law or agency authorized under law to receive and 
340.18 	officially record a name change. If an address change only is requested, no request for 
340.19 	revised credentials is required. If the regulated person's current credentials have been lost, 
340.20 	stolen, or destroyed, the person shall provide a written explanation to the board.

340.21 	Sec. 14. Minnesota Statutes 2014, section 148.574, is amended to read:
340.22 	148.574 PROHIBITIONS RELATING TO LEGEND DRUGS; 
340.23 	AUTHORIZING SALES BY PHARMACISTS UNDER CERTAIN CONDITIONS.
340.24 	An optometrist shall not purchase, possess, administer, prescribe or give any legend 
340.25 	drug as defined in section 151.01 or 152.02 to any person except as is expressly authorized 
340.26 	by sections 148.571 to 148.577. Nothing in chapter 151 shall prevent a pharmacist from 
340.27 	selling topical ocular drugs to an optometrist authorized to use such drugs according to 
340.28 	sections 148.571 to 148.577. Notwithstanding sections 151.37 and 152.12, an optometrist 
340.29 	is prohibited from dispensing legend drugs at retail, unless the legend drug is within the 
340.30 	scope designated in section 148.56, subdivision 1, and is administered to the eye through 
340.31 	an ophthalmic good as defined in section 145.711, subdivision 4.

340.32 	Sec. 15. Minnesota Statutes 2014, section 148.575, subdivision 2, is amended to read:
341.1 		Subd. 2.Board certified Requirements defined. "Board certified" means that A 
341.2 	licensed optometrist has been issued a certificate by the Board of Optometry certifying 
341.3 	that the optometrist has complied shall comply with the following requirements for the use 
341.4 	of legend drugs described in section 148.576:
341.5 	(1) successful completion of at least 60 hours of study in general and ocular 
341.6 	pharmacology emphasizing drugs used for examination or treatment purposes, their 
341.7 	systemic effects and management or referral of adverse reactions;
341.8 	(2) (1) successful completion of at least 100 hours of study in the examination, 
341.9 	diagnosis, and treatment of conditions of the human eye with legend drugs;
341.10 	(3) (2) successful completion of two years of supervised clinical experience in 
341.11 	differential diagnosis of eye disease or disorders as part of optometric training or one year 
341.12 	of that experience and ten years of actual clinical experience as a licensed optometrist; and
341.13 	(4) (3) successful completion of a nationally standardized examination approved or 
341.14 	administered by the board on the subject of treatment and management of ocular disease.

341.15 	Sec. 16. Minnesota Statutes 2014, section 148.577, is amended to read:
341.16 	148.577 STANDARD OF CARE.
341.17 	A licensed optometrist who is board certified under section 148.575 is held to the 
341.18 	same standard of care in the use of those legend drugs as physicians licensed by the state 
341.19 	of Minnesota.

341.20 	Sec. 17. Minnesota Statutes 2014, section 148.59, is amended to read:
341.21 	148.59 LICENSE RENEWAL; FEE LICENSE AND REGISTRATION FEES.
341.22 	A licensed optometrist shall pay to the state Board of Optometry a fee as set by the 
341.23 	board in order to renew a license as provided by board rule. No fees shall be refunded. 
341.24 	Fees may not exceed the following amounts but may be adjusted lower by board direction 
341.25 	and are for the exclusive use of the board: 
341.26 	(1) optometry licensure application, $160;
341.27 	(2) optometry annual licensure renewal, $135;
341.28 	(3) optometry late penalty fee, $75;
341.29 	(4) annual license renewal card, $10;
341.30 	(5) continuing education provider application, $45;
341.31 	(6) emeritus registration, $10;
341.32 	(7) endorsement/reciprocity application, $160;
341.33 	(8) replacement of initial license, $12; and
341.34 	(9) license verification, $50.

342.1 	Sec. 18. Minnesota Statutes 2014, section 148.603, is amended to read:
342.2 	148.603 FORMS OF GROUNDS FOR DISCIPLINARY ACTIONS ACTION.
342.3 	When grounds exist under section 148.57, subdivision 3, or other statute or rule 
342.4 	which the board is authorized to enforce, the board may take one or more of the following 
342.5 	disciplinary actions, provided that disciplinary or corrective action may not be imposed 
342.6 	by the board on any regulated person except after a contested case hearing conducted 
342.7 	pursuant to chapter 14 or by consent of the parties:
342.8 	(1) deny an application for a credential;
342.9 	(2) revoke the regulated person's credential;
342.10 	(3) suspend the regulated person's credential;
342.11 	(4) impose limitations on the regulated person's credential;
342.12 	(5) impose conditions on the regulated person's credential;
342.13 	(6) censure or reprimand the regulated person;
342.14 	(7) impose a civil penalty not exceeding $10,000 for each separate violation, the 
342.15 	amount of the civil penalty to be fixed so as to deprive the person of any economic 
342.16 	advantage gained by reason of the violation or to discourage similar violations or to 
342.17 	reimburse the board for the cost of the investigation and proceeding. For purposes of 
342.18 	this section, the cost of the investigation and proceeding may include, but is not limited 
342.19 	to, fees paid for services provided by the Office of Administrative Hearings, legal and 
342.20 	investigative services provided by the Office of the Attorney General, court reporters, 
342.21 	witnesses, reproduction of records, board members' per diem compensation, board staff 
342.22 	time, and travel costs and expenses incurred by board staff and board members; or
342.23 	(8) when grounds exist under section 148.57, subdivision 3, or a board rule, enter 
342.24 	into an agreement with the regulated person for corrective action which may include 
342.25 	requiring the regulated person:
342.26 	(i) to complete an educational course or activity;
342.27 	(ii) to submit to the executive director or designated board member a written 
342.28 	protocol or reports designed to prevent future violations of the same kind;
342.29 	(iii) to meet with a board member or board designee to discuss prevention of future 
342.30 	violations of the same kind; or
342.31 	(iv) to perform other action justified by the facts.
342.32 	Listing the measures in clause (8) does not preclude the board from including 
342.33 	them in an order for disciplinary action. The board may refuse to grant a license or 
342.34 	may impose disciplinary action as described in section 148.607 against any optometrist 
342.35 	for the following:
343.1 	(1) failure to demonstrate the qualifications or satisfy the requirements for a license 
343.2 	contained in this chapter or in rules of the board. The burden of proof shall be on the 
343.3 	applicant to demonstrate the qualifications or the satisfaction of the requirements;
343.4 	(2) obtaining a license by fraud or cheating, or attempting to subvert the licensing 
343.5 	examination process. Conduct which subverts or attempts to subvert the licensing 
343.6 	examination process includes, but is not limited to: (i) conduct which violates the 
343.7 	security of the examination materials, such as removing examination materials from the 
343.8 	examination room or having unauthorized possession of any portion of a future, current, or 
343.9 	previously administered licensing examination; (ii) conduct which violates the standard of 
343.10 	test administration, such as communicating with another examinee during administration 
343.11 	of the examination, copying another examinee's answers, permitting another examinee 
343.12 	to copy one's answers, or possessing unauthorized materials; or (iii) impersonating an 
343.13 	examinee or permitting an impersonator to take the examination on one's own behalf;
343.14 	(3) conviction, during the previous five years, of a felony or gross misdemeanor, 
343.15 	reasonably related to the practice of optometry. Conviction as used in this section shall 
343.16 	include a conviction of an offense which if committed in this state would be deemed a 
343.17 	felony or gross misdemeanor without regard to its designation elsewhere, or a criminal 
343.18 	proceeding where a finding or verdict of guilt is made or returned but the adjudication of 
343.19 	guilt is either withheld or not entered thereon;
343.20 	(4) revocation, suspension, restriction, limitation, or other disciplinary action against 
343.21 	the person's optometry license in another state or jurisdiction, failure to report to the 
343.22 	board that charges regarding the person's license have been brought in another state or 
343.23 	jurisdiction, or having been refused a license by any other state or jurisdiction;
343.24 	(5) advertising which is false or misleading, which violates any rule of the board, or 
343.25 	which claims without substantiation the positive cure of any disease;
343.26 	(6) violating a rule adopted by the board or an order of the board, a state or federal 
343.27 	law, which relates to the practice of optometry, or a state or federal narcotics or controlled 
343.28 	substance law;
343.29 	(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm 
343.30 	the public, or demonstrating a willful or careless disregard for the health, welfare, or 
343.31 	safety of a patient; or practice of optometry which is professionally incompetent, in that 
343.32 	it may create unnecessary danger to any patient's life, health, or safety, which in any of 
343.33 	the cases, proof of actual injury need not be established;
343.34 	(8) failure to supervise an optometrist's assistant or failure to supervise an 
343.35 	optometrist under any agreement with the board;
344.1 	(9) aiding or abetting an unlicensed person in the practice of optometry, except that 
344.2 	it is not a violation of this section for an optometrist to employ, supervise, or delegate 
344.3 	functions to a qualified person who may or may not be required to obtain a license or 
344.4 	registration to provide health services if that person is practicing within the scope of that 
344.5 	person's license or registration or delegated authority;
344.6 	(10) adjudication as mentally incompetent, mentally ill, or developmentally 
344.7 	disabled, or as a chemically dependent person, a person dangerous to the public, a sexually 
344.8 	dangerous person, or a person who has a sexual psychopathic personality by a court of 
344.9 	competent jurisdiction, within or without this state. Such adjudication shall automatically 
344.10 	suspend a license for the duration of the license unless the board orders otherwise;
344.11 	(11) engaging in unprofessional conduct which includes any departure from or the 
344.12 	failure to conform to the minimal standards of acceptable and prevailing practice in which 
344.13 	case actual injury to a patient need not be established;
344.14 	(12) inability to practice optometry with reasonable skill and safety to patients 
344.15 	by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type of 
344.16 	material or as a result of any mental or physical condition, including deterioration through 
344.17 	the aging process or loss of motor skills;
344.18 	(13) revealing a privileged communication from or relating to a patient except when 
344.19 	otherwise required or permitted by law;
344.20 	(14) improper management of medical records, including failure to maintain 
344.21 	adequate medical records, to comply with a patient's request made pursuant to sections 
344.22 	144.291 to 144.298 or to furnish a medical record or report required by law;
344.23 	(15) fee splitting, including without limitation:
344.24 	(i) paying, offering to pay, receiving, or agreeing to receive a commission, rebate, or 
344.25 	remuneration, directly or indirectly, primarily for the referral of patients or the prescription 
344.26 	of drugs or devices; and
344.27 	(ii) dividing fees with another optometrist, other health care provider, or a 
344.28 	professional corporation, unless the division is in proportion to the services provided 
344.29 	and the responsibility assumed by each professional and the optometrist has disclosed 
344.30 	the terms of the division;
344.31 	(16) engaging in abusive or fraudulent billing practices, including violations of the 
344.32 	federal Medicare and Medicaid laws or state medical assistance laws;
344.33 	(17) becoming addicted or habituated to a drug or intoxicant;
344.34 	(18) prescribing a drug or device for other than accepted therapeutic or experimental 
344.35 	or investigative purposes authorized by the state or a federal agency;
345.1 	(19) engaging in conduct with a patient which is sexual or may reasonably be 
345.2 	interpreted by the patient as sexual, or in any verbal behavior which is seductive or 
345.3 	sexually demeaning to a patient;
345.4 	(20) failure to make reports as required by section 148.604 or to cooperate with an 
345.5 	investigation of the board as required by section 148.606;
345.6 	(21) knowingly providing false or misleading information that is directly related to 
345.7 	the care of a patient; and
345.8 	(22) practice of a board-regulated profession under lapsed or nonrenewed credentials.

345.9 	Sec. 19. [148.604] REPORTING OBLIGATIONS.
345.10 		Subdivision 1.Permission to report. A person who has knowledge of any conduct 
345.11 	constituting grounds for discipline under sections 148.52 to 148.62 may report the 
345.12 	violation to the board.
345.13 		Subd. 2.Institutions. Any hospital, clinic, prepaid medical plan, or other health 
345.14 	care institution or organization located in this state shall report to the board any action 
345.15 	taken by the institution or organization or any of its administrators or medical or other 
345.16 	committees to revoke, suspend, restrict, or condition an optometrist's privilege to practice 
345.17 	or treat patients in the institution, or as part of the organization, any denial of privileges, 
345.18 	or any other disciplinary action. The institution or organization shall also report the 
345.19 	resignation of any optometrist prior to the conclusion of any disciplinary proceeding, or 
345.20 	prior to the commencement of formal charges but after the optometrist had knowledge 
345.21 	that formal charges were contemplated or in preparation. Each report made under this 
345.22 	subdivision must state the nature of the action taken, state in detail the reasons for 
345.23 	the action, and identify the specific patient medical records upon which the action was 
345.24 	based. No report shall be required of an optometrist voluntarily limiting the practice of 
345.25 	the optometrist at a hospital provided that the optometrist notifies all hospitals where the 
345.26 	optometrist has privileges of the voluntary limitation and the reasons for it.
345.27 		Subd. 3.Licensed professionals. A licensed optometrist shall report to the board 
345.28 	personal knowledge of any conduct by any optometrist which the person reasonably 
345.29 	believes constitutes grounds for disciplinary action under sections 148.52 to 148.62, 
345.30 	including any conduct indicating that the person may be incompetent, may have engaged 
345.31 	in unprofessional conduct, or may be physically unable to safely engage in the practice 
345.32 	of optometry.
345.33 		Subd. 4.Self-reporting. An optometrist shall report to the board any personal 
345.34 	action which would require that a report be filed with the board by any person, health care 
345.35 	facility, business, or organization pursuant to subdivisions 2 and 3.
346.1 		Subd. 5.Deadlines; forms; rulemaking. Reports required by subdivisions 2 to 
346.2 	4 must be submitted not later than 30 days after the occurrence of the reportable event 
346.3 	or transaction. The board may provide forms for the submission of reports required by 
346.4 	this section, may require that reports be submitted on the forms provided, and may adopt 
346.5 	rules necessary to ensure prompt and accurate reporting.
346.6 		Subd. 6.Subpoenas. The board may issue subpoenas for the production of any 
346.7 	reports required by subdivisions 2 to 4 or any related documents.

346.8 	Sec. 20. [148.605] IMMUNITY.
346.9 		Subdivision 1.Reporting. Any person, health care facility, business, or organization 
346.10 	is immune from civil liability or criminal prosecution for submitting a report to the 
346.11 	board pursuant to section 148.604 or for otherwise reporting to the board violations or 
346.12 	alleged violations of section 148.603, if they are acting in good faith and in the exercise 
346.13 	of reasonable care.
346.14 		Subd. 2.Investigation; indemnification. (a) Members of the board, persons 
346.15 	employed by the board, and consultants retained by the board for the purpose of 
346.16 	investigation of violations, the preparation of charges, and management of board orders on 
346.17 	behalf of the board are immune from civil liability and criminal prosecution for any actions, 
346.18 	transactions, or publications in the execution of, or relating to, their duties under sections 
346.19 	148.52 to 148.62, if they are acting in good faith and in the exercise of reasonable care.
346.20 	(b) Members of the board and persons employed by the board or engaged in 
346.21 	maintaining records and making reports regarding adverse health care events are immune 
346.22 	from civil liability and criminal prosecution for any actions, transactions, or publications 
346.23 	in the execution of, or relating to, their duties under sections 148.52 to 148.62, if they are 
346.24 	acting in good faith and in the exercise of reasonable care.
346.25 	(c) For purposes of this section, a member of the board or a consultant described in 
346.26 	paragraph (a) is considered a state employee under section 3.736, subdivision 9.

346.27 	Sec. 21. [148.606] OPTOMETRIST COOPERATION.
346.28 	An optometrist who is the subject of an investigation by or on behalf of the board 
346.29 	shall cooperate fully with the investigation. Cooperation includes responding fully and 
346.30 	promptly to any question raised by or on behalf of the board relating to the subject of the 
346.31 	investigation and providing copies of patient medical records, as reasonably requested 
346.32 	by the board, to assist the board in its investigation. If the board does not have written 
346.33 	consent from a patient permitting access to the patient's records, the optometrist shall 
346.34 	delete any data in the record which identifies the patient before providing it to the board. 
347.1 	The board shall maintain any records obtained pursuant to this section as investigative 
347.2 	data pursuant to chapter 13.

347.3 	Sec. 22. [148.607] DISCIPLINARY ACTIONS.
347.4 	When the board finds that a licensed optometrist under section 148.57 has violated a 
347.5 	provision or provisions of sections 148.52 to 148.62, it may do one or more of the following:
347.6 	(1) revoke the license;
347.7 	(2) suspend the license;
347.8 	(3) impose limitations or conditions on the optometrist's practice of optometry, 
347.9 	including the limitation of scope of practice to designated field specialties; the imposition 
347.10 	of retraining or rehabilitation requirements; the requirement of practice under supervision; 
347.11 	or the conditioning of continued practice on demonstration of knowledge or skills by 
347.12 	appropriate examination or other review of skill and competence;
347.13 	(4) impose a civil penalty not exceeding $10,000 for each separate violation, the 
347.14 	amount of the civil penalty to be fixed so as to deprive the optometrist of any economic 
347.15 	advantage gained by reason of the violation charged or to reimburse the board for the cost 
347.16 	of the investigation and proceeding; and
347.17 	(5) censure or reprimand the licensed optometrist.

347.18 	Sec. 23. Minnesota Statutes 2014, section 148E.075, is amended to read:
347.19 	148E.075 INACTIVE LICENSES ALTERNATE LICENSES.
347.20 		Subdivision 1.Inactive status Temporary leave license. (a) A licensee qualifies 
347.21 	for inactive status under either of the circumstances described in paragraph (b) or (c).
347.22 	(b) A licensee qualifies for inactive status when the licensee is granted temporary 
347.23 	leave from active practice. A licensee qualifies for temporary leave from active practice if 
347.24 	the licensee demonstrates to the satisfaction of the board that the licensee is not engaged 
347.25 	in the practice of social work in any setting, including settings in which social workers are 
347.26 	exempt from licensure according to section 148E.065. A licensee who is granted temporary 
347.27 	leave from active practice may reactivate the license according to section 148E.080.
347.28 	(b) A licensee may maintain a temporary leave license for no more than four 
347.29 	consecutive years.
347.30 	(c) A licensee qualifies for inactive status when a licensee is granted an emeritus 
347.31 	license. A licensee qualifies for an emeritus license if the licensee demonstrates to the 
347.32 	satisfaction of the board that:
347.33 	(1) the licensee is retired from social work practice; and
348.1 	(2) the licensee is not engaged in the practice of social work in any setting, including 
348.2 	settings in which social workers are exempt from licensure according to section 148E.065.
348.3 	A licensee who possesses an emeritus license may reactivate the license according to 
348.4 	section 148E.080.
348.5 	(c) A licensee who is granted temporary leave from active practice may reactivate 
348.6 	the license according to section 148E.080. If a licensee does not apply for reactivation 
348.7 	within 60 days following the end of the consecutive four-year period, the license 
348.8 	automatically expires. An individual with an expired license may apply for new licensure 
348.9 	according to section 148E.055.
348.10 	(d) Except as provided in paragraph (e), a licensee who holds a temporary leave 
348.11 	license must not practice, attempt to practice, offer to practice, or advertise or hold out as 
348.12 	authorized to practice social work.
348.13 	(e) The board may grant a variance to the requirements of paragraph (d) if a licensee 
348.14 	on temporary leave license provides emergency social work services. A variance is 
348.15 	granted only if the board provides the variance in writing to the licensee. The board may 
348.16 	impose conditions or restrictions on the variance.
348.17 	(f) In making representations of professional status to the public, when holding a 
348.18 	temporary leave license, a licensee must state that the license is not active and that the 
348.19 	licensee cannot practice social work.
348.20 		Subd. 1a.Emeritus inactive license. (a) A licensee qualifies for an emeritus inactive 
348.21 	license if the licensee demonstrates to the satisfaction of the board that the licensee is:
348.22 	(1) retired from social work practice; and
348.23 	(2) not engaged in the practice of social work in any setting, including settings in 
348.24 	which social workers are exempt from licensure according to section 148E.065.
348.25 	(b) A licensee with an emeritus inactive license may apply for reactivation according 
348.26 	to section 148E.080 only during the four years following the granting of the emeritus 
348.27 	inactive license. However, after four years following the granting of the emeritus inactive 
348.28 	license, an individual may apply for new licensure according to section 148E.055.
348.29 	(c) Except as provided in paragraph (d), a licensee who holds an emeritus inactive 
348.30 	license must not practice, attempt to practice, offer to practice, or advertise or hold out as 
348.31 	authorized to practice social work.
348.32 	(d) The board may grant a variance to the requirements of paragraph (c) if a licensee 
348.33 	on emeritus inactive license provides emergency social work services. A variance is 
348.34 	granted only if the board provides the variance in writing to the licensee. The board may 
348.35 	impose conditions or restrictions on the variance.
349.1 	(e) In making representations of professional status to the public, when holding 
349.2 	an emeritus inactive license, a licensee must state that the license is not active and that 
349.3 	the licensee cannot practice social work.
349.4 		Subd. 1b.Emeritus active license. (a) A licensee qualifies for an emeritus active 
349.5 	license if the applicant demonstrates to the satisfaction of the board that the licensee is:
349.6 	(1) retired from social work practice; and
349.7 	(2) in compliance with the supervised practice requirements, as applicable, under 
349.8 	sections 148E.100 to 148E.125.
349.9 	(b) A licensee who is issued an emeritus active license is only authorized to engage in:
349.10 	(1) pro bono or unpaid social work practice as specified in section 148E.010, 
349.11 	subdivisions 6 and 11; or
349.12 	(2) paid social work practice not to exceed 240 clock hours per calendar year, for the 
349.13 	exclusive purpose to provide licensing supervision as specified in sections 148E.100 to 
349.14 	148E.125; and
349.15 	(3) the authorized scope of practice specified in section 148E.050.
349.16 	(c) An emeritus active license must be renewed according to the requirements 
349.17 	specified in section 148E.070, subdivisions 1, 2, 3, 4, and 5.
349.18 	(d) At the time of license renewal a licensee must provide evidence satisfactory to the 
349.19 	board that the licensee has, during the renewal term, completed 20 clock hours of continuing 
349.20 	education, including at least two clock hours in ethics, as specified in section 148E.130:
349.21 	(1) for licensed independent clinical social workers, at least 12 clock hours must be 
349.22 	in the clinical content areas specified in section 148E.055, subdivision 5; and
349.23 	(2) for social workers providing supervision according to sections 148E.100 to 
349.24 	148E.125, at least three clock hours must be in the practice of supervision.
349.25 	(e) Independent study hours must not consist of more than eight clock hours of 
349.26 	continuing education per renewal term.
349.27 	(f) Failure to renew an active emeritus license on the expiration date will result in an 
349.28 	expired license as specified in section 148E.070, subdivision 5.
349.29 	(g) The board may grant a variance to the requirements of paragraph (b) if a licensee 
349.30 	holding an emeritus active license provides emergency social work services. A variance is 
349.31 	granted only if the board provides the variance in writing to the licensee. The board may 
349.32 	impose conditions or restrictions on the variance.
349.33 	(h) In making representations of professional status to the public, when holding an 
349.34 	emeritus active license, a licensee must state that an emeritus active license authorizes only 
349.35 	pro bono or unpaid social work practice, or paid social work practice not to exceed 240 
350.1 	clock hours per calendar year, for the exclusive purpose to provide licensing supervision 
350.2 	as specified in sections 148E.100 to 148E.125.
350.3 	(i) Notwithstanding the time limit and emeritus active license renewal requirements 
350.4 	specified in this section, a licensee who possesses an emeritus active license may 
350.5 	reactivate the license according to section 148E.080 or apply for new licensure according 
350.6 	to section 148E.055.
350.7 		Subd. 2.Application. A licensee may apply for inactive status temporary leave 
350.8 	license, emeritus inactive license, or emeritus active license:
350.9 	(1) at any time when currently licensed under section 148E.055, 148E.0555, 
350.10 	148E.0556, or 148E.0557, or when licensed as specified in section 148E.075, by 
350.11 	submitting an application for a temporary leave from active practice or for an emeritus 
350.12 	license form required by the board; or
350.13 	(2) as an alternative to applying for the renewal of a license by so recording on the 
350.14 	application for license renewal form required by the board and submitting the completed, 
350.15 	signed application to the board.
350.16 	An application that is not completed or signed, or that is not accompanied by the 
350.17 	correct fee, must be returned to the applicant, along with any fee submitted, and is void. 
350.18 	For applications submitted electronically, a "signed application" means providing an 
350.19 	attestation as specified by the board.
350.20 		Subd. 3.Fee. (a) Regardless of when the application for inactive status temporary 
350.21 	leave license or emeritus inactive license is submitted, the temporary leave license or 
350.22 	emeritus inactive license fee specified in section 148E.180, whichever is applicable, must 
350.23 	accompany the application. A licensee who is approved for inactive status temporary 
350.24 	leave license or emeritus inactive license before the license expiration date is not entitled 
350.25 	to receive a refund for any portion of the license or renewal fee.
350.26 	(b) If an application for temporary leave or emeritus active license is received after 
350.27 	the license expiration date, the licensee must pay a renewal late fee as specified in section 
350.28 	148E.180 in addition to the temporary leave fee.
350.29 	(c) Regardless of when the application for emeritus active license is submitted, 
350.30 	the emeritus active license fee is one-half of the renewal fee for the applicable license 
350.31 	specified in section 148E.180, subdivision 3, and must accompany the application. A 
350.32 	licensee who is approved for emeritus active license before the license expiration date is 
350.33 	not entitled to receive a refund for any portion of the license or renewal fee.
350.34 		Subd. 4.Time limits for temporary leaves. A licensee may maintain an inactive 
350.35 	license on temporary leave for no more than five consecutive years. If a licensee does 
351.1 	not apply for reactivation within 60 days following the end of the consecutive five-year 
351.2 	period, the license automatically expires.
351.3 		Subd. 5.Time limits for emeritus license. A licensee with an emeritus license may 
351.4 	not apply for reactivation according to section 148E.080 after five years following the 
351.5 	granting of the emeritus license. However, after five years following the granting of the 
351.6 	emeritus license, an individual may apply for new licensure according to section 148E.055.
351.7 		Subd. 6.Prohibition on practice. (a) Except as provided in paragraph (b), a 
351.8 	licensee whose license is inactive must not practice, attempt to practice, offer to practice, 
351.9 	or advertise or hold out as authorized to practice social work.
351.10 	(b) The board may grant a variance to the requirements of paragraph (a) if a licensee 
351.11 	on inactive status provides emergency social work services. A variance is granted only 
351.12 	if the board provides the variance in writing to the licensee. The board may impose 
351.13 	conditions or restrictions on the variance.
351.14 		Subd. 7.Representations of professional status. In making representations of 
351.15 	professional status to the public, a licensee whose license is inactive must state that the 
351.16 	license is inactive and that the licensee cannot practice social work.
351.17 		Subd. 8.Disciplinary or other action. The board may resolve any pending 
351.18 	complaints against a licensee before approving an application for inactive status an 
351.19 	alternate license specified in this section. The board may take action according to sections 
351.20 	148E.255 to 148E.270 against a licensee whose license is inactive who is issued an 
351.21 	alternate license specified in this section based on conduct occurring before the license is 
351.22 	inactive or conduct occurring while the license is inactive effective.

351.23 	Sec. 24. Minnesota Statutes 2014, section 148E.080, subdivision 1, is amended to read:
351.24 		Subdivision 1.Mailing notices to licensees on temporary leave. The board must 
351.25 	mail a notice for reactivation to a licensee on temporary leave at least 45 days before the 
351.26 	expiration date of the license according to section 148E.075, subdivision 4 1. Mailing 
351.27 	the notice by United States mail to the licensee's last known mailing address constitutes 
351.28 	valid mailing. Failure to receive the reactivation notice does not relieve a licensee of the 
351.29 	obligation to comply with the provisions of this section to reactivate a license.

351.30 	Sec. 25. Minnesota Statutes 2014, section 148E.080, subdivision 2, is amended to read:
351.31 		Subd. 2.Reactivation from a temporary leave or emeritus status. To reactivate a 
351.32 	license from a temporary leave or emeritus status, a licensee must do the following within 
351.33 	the time period specified in section 148E.075, subdivisions 4 and 5 1, 1a, and 1b:
351.34 	(1) complete an application form specified by the board;
352.1 	(2) document compliance with the continuing education requirements specified in 
352.2 	subdivision 4;
352.3 	(3) submit a supervision plan, if required;
352.4 	(4) pay the reactivation of an inactive licensee a license fee specified in section 
352.5 	148E.180; and
352.6 	(5) pay the wall certificate fee according to section 148E.095, subdivision 1, 
352.7 	paragraph (b) or (c), if the licensee needs a duplicate license.

352.8 	Sec. 26. Minnesota Statutes 2014, section 148E.180, subdivision 2, is amended to read:
352.9 		Subd. 2.License fees. License fees are as follows:
352.10 	(1) for a licensed social worker, $81;
352.11 	(2) for a licensed graduate social worker, $144;
352.12 	(3) for a licensed independent social worker, $216;
352.13 	(4) for a licensed independent clinical social worker, $238.50;
352.14 	(5) for an emeritus inactive license, $43.20; and
352.15 	(6) for an emeritus active license, one-half of the renewal fee specified in subdivision 
352.16 	3; and
352.17 	(7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
352.18 	If the licensee's initial license term is less or more than 24 months, the required 
352.19 	license fees must be prorated proportionately.

352.20 	Sec. 27. Minnesota Statutes 2014, section 148E.180, subdivision 5, is amended to read:
352.21 		Subd. 5.Late fees. Late fees are as follows:
352.22 	(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3; and
352.23 	(2) supervision plan late fee, $40.; and
352.24 	(3) license late fee, $100 plus the prorated share of the license fee specified in 
352.25 	subdivision 2 for the number of months during which the individual practiced social 
352.26 	work without a license.

352.27 	Sec. 28. Minnesota Statutes 2014, section 150A.091, subdivision 4, is amended to read:
352.28 		Subd. 4.Annual license fees. Each limited faculty or resident dentist shall submit 
352.29 	with an annual license renewal application a fee established by the board not to exceed 
352.30 	the following amounts:
352.31 	(1) limited faculty dentist, $168; and
352.32 	(2) resident dentist or dental provider, $59 $85.

353.1 	Sec. 29. Minnesota Statutes 2014, section 150A.091, subdivision 5, is amended to read:
353.2 		Subd. 5.Biennial license or permit fees. Each of the following applicants shall 
353.3 	submit with a biennial license or permit renewal application a fee as established by the 
353.4 	board, not to exceed the following amounts:
353.5 	(1) dentist or full faculty dentist, $336 $475;
353.6 	(2) dental therapist, $180 $300;
353.7 	(3) dental hygienist, $118 $200;
353.8 	(4) licensed dental assistant, $80 $150; and
353.9 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
353.10 	subpart 3, $24.

353.11 	Sec. 30. Minnesota Statutes 2014, section 150A.091, subdivision 11, is amended to read:
353.12 		Subd. 11.Certificate application fee for anesthesia/sedation. Each dentist 
353.13 	shall submit with a general anesthesia or moderate sedation application or, a contracted 
353.14 	sedation provider application, or biennial renewal,  a fee as established by the board not to 
353.15 	exceed the following amounts:
353.16 	(1) for both a general anesthesia and moderate sedation application, $250 $400;
353.17 	(2) for a general anesthesia application only, $250 $400;
353.18 	(3) for a moderate sedation application only, $250 $400; and
353.19 	(4) for a contracted sedation provider application, $250 $400.

353.20 	Sec. 31. Minnesota Statutes 2014, section 150A.091, is amended by adding a 
353.21 	subdivision to read:
353.22 		Subd. 17.Advanced dental therapy examination fee. Any dental therapist eligible 
353.23 	to sit for the advanced dental therapy certification examination must submit with the 
353.24 	application a fee as established by the board, not to exceed $250.

353.25 	Sec. 32. Minnesota Statutes 2014, section 150A.091, is amended by adding a 
353.26 	subdivision to read:
353.27 		Subd. 18.Corporation or professional firm late fee. Any corporation or 
353.28 	professional firm whose annual fee is not postmarked or otherwise received by the board 
353.29 	by the due date of December 31 shall, in addition to the fee, submit a late fee as established 
353.30 	by the board, not to exceed $15.

353.31 	Sec. 33. Minnesota Statutes 2014, section 150A.31, is amended to read:
353.32 	150A.31 FEES.
354.1 	(a) The initial biennial registration fee is $50.
354.2 	(b) The biennial renewal registration fee is $25 not to exceed $80.
354.3 	(c) The fees specified in this section are nonrefundable and shall be deposited in 
354.4 	the state government special revenue fund.

354.5 	Sec. 34. Minnesota Statutes 2014, section 151.01, subdivision 15a, is amended to read:
354.6 		Subd. 15a.Pharmacy technician.  "Pharmacy technician" means a person not 
354.7 	licensed as a pharmacist or registered as a pharmacist intern, who assists the pharmacist 
354.8 	in the preparation and dispensing of medications by performing computer entry of 
354.9 	prescription data and other manipulative tasks. A pharmacy technician shall not perform 
354.10 	tasks specifically reserved to a licensed pharmacist or requiring has been trained in 
354.11 	pharmacy tasks that do not require the professional judgment of a licensed pharmacist. A 
354.12 	pharmacy technician may not perform tasks specifically reserved to a licensed pharmacist.

354.13 	Sec. 35. Minnesota Statutes 2014, section 151.01, subdivision 27, is amended to read:
354.14 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
354.15 	(1) interpretation and evaluation of prescription drug orders;
354.16 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by 
354.17 	a manufacturer or packager of nonprescription drugs or commercially packaged legend 
354.18 	drugs and devices);
354.19 	(3) participation in clinical interpretations and monitoring of drug therapy for 
354.20 	assurance of safe and effective use of drugs, including the performance of laboratory tests 
354.21 	that are waived under the federal Clinical Laboratory Improvement Act of 1988, United 
354.22 	States Code, title 42, section 263a et seq., provided that a pharmacist may interpret the 
354.23 	results of laboratory tests but may modify drug therapy only pursuant to a protocol or 
354.24 	collaborative practice agreement;
354.25 	(4) participation in drug and therapeutic device selection; drug administration for first 
354.26 	dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
354.27 	(5) participation in administration of influenza vaccines to all eligible individuals ten 
354.28 	six years of age and older and all other vaccines to patients 18 13 years of age and older 
354.29 	by written protocol with a physician licensed under chapter 147, a physician assistant 
354.30 	authorized to prescribe drugs under chapter 147A, or an advanced practice registered 
354.31 	nurse authorized to prescribe drugs under section 148.235, provided that:
354.32 	(i) the protocol includes, at a minimum:
354.33 	(A) the name, dose, and route of each vaccine that may be given;
354.34 	(B) the patient population for whom the vaccine may be given;
355.1 	(C) contraindications and precautions to the vaccine;
355.2 	(D) the procedure for handling an adverse reaction;
355.3 	(E) the name, signature, and address of the physician, physician assistant, or 
355.4 	advanced practice registered nurse;
355.5 	(F) a telephone number at which the physician, physician assistant, or advanced 
355.6 	practice registered nurse can be contacted; and
355.7 	(G) the date and time period for which the protocol is valid;
355.8 	(ii) the pharmacist has successfully completed a program approved by the 
355.9 	Accreditation Council for Pharmacy Education specifically for the administration of 
355.10 	immunizations or a program approved by the board;
355.11 	(iii) the pharmacist utilizes the Minnesota Immunization Information Connection 
355.12 	to assess the immunization status of individuals prior to the administration of vaccines, 
355.13 	except when administering influenza vaccines to individuals age nine and older;
355.14 	(iv) the pharmacist reports the administration of the immunization to the patient's 
355.15 	primary physician or clinic or to the Minnesota Immunization Information Connection; and
355.16 	(iv) (v) the pharmacist complies with guidelines for vaccines and immunizations 
355.17 	established by the federal Advisory Committee on Immunization Practices, except that a 
355.18 	pharmacist does not need to comply with those portions of the guidelines that establish 
355.19 	immunization schedules when administering a vaccine pursuant to a valid, patient-specific 
355.20 	order issued by a physician licensed under chapter 147, a physician assistant authorized to 
355.21 	prescribe drugs under chapter 147A, or an advanced practice nurse authorized to prescribe 
355.22 	drugs under section 148.235, provided that the order is consistent with the United States 
355.23 	Food and Drug Administration approved labeling of the vaccine;
355.24 	(6) participation in the initiation, management, modification, and discontinuation 
355.25 	of drug therapy according to a written protocol or collaborative practice agreement 
355.26 	between: (i) one or more pharmacists and one or more dentists, optometrists, physicians, 
355.27 	podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more physician 
355.28 	assistants authorized to prescribe, dispense, and administer under chapter 147A, or 
355.29 	advanced practice nurses authorized to prescribe, dispense, and administer under section 
355.30 	148.235. Any changes in drug therapy made pursuant to a protocol or collaborative 
355.31 	practice agreement must be documented by the pharmacist in the patient's medical record 
355.32 	or reported by the pharmacist to a practitioner responsible for the patient's care;
355.33 	(7) participation in the storage of drugs and the maintenance of records;
355.34 	(8) patient counseling on therapeutic values, content, hazards, and uses of drugs 
355.35 	and devices; and
356.1 	(9) offering or performing those acts, services, operations, or transactions necessary 
356.2 	in the conduct, operation, management, and control of a pharmacy.

356.3 	Sec. 36. Minnesota Statutes 2014, section 151.02, is amended to read:
356.4 	151.02 STATE BOARD OF PHARMACY.
356.5 	The Minnesota State Board of Pharmacy shall consist of two three public members 
356.6 	as defined by section 214.02 and five six pharmacists actively engaged in the practice of 
356.7 	pharmacy in this state. Each of said pharmacists shall have had at least five consecutive 
356.8 	years of practical experience as a pharmacist immediately preceding appointment.

356.9 	Sec. 37. Minnesota Statutes 2014, section 151.065, subdivision 1, is amended to read:
356.10 		Subdivision 1.Application fees. Application fees for licensure and registration 
356.11 	are as follows:
356.12 	(1) pharmacist licensed by examination, $130 $145;
356.13 	(2) pharmacist licensed by reciprocity, $225 $240;
356.14 	(3) pharmacy intern, $30 $37.50;
356.15 	(4) pharmacy technician, $30 $37.50;
356.16 	(5) pharmacy, $190 $225;
356.17 	(6) drug wholesaler, legend drugs only, $200 $235;
356.18 	(7) drug wholesaler, legend and nonlegend drugs, $200 $235;
356.19 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175 $210;
356.20 	(9) drug wholesaler, medical gases, $150 $175;
356.21 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125 $150;
356.22 	(11) drug manufacturer, legend drugs only, $200 $235;
356.23 	(12) drug manufacturer, legend and nonlegend drugs, $200 $235;
356.24 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175 $210;
356.25 	(14) drug manufacturer, medical gases, $150 $185;
356.26 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125 $150;
356.27 	(16) medical gas distributor, $75 $110;
356.28 	(17) controlled substance researcher, $50 $75; and
356.29 	(18) pharmacy professional corporation, $100 $125.

356.30 	Sec. 38. Minnesota Statutes 2014, section 151.065, subdivision 2, is amended to read:
356.31 		Subd. 2.Original license fee. The pharmacist original licensure fee, $130 $145.

356.32 	Sec. 39. Minnesota Statutes 2014, section 151.065, subdivision 3, is amended to read:
357.1 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
357.2 	are as follows:
357.3 	(1) pharmacist, $130 $145;
357.4 	(2) pharmacy technician, $30 $37.50;
357.5 	(3) pharmacy, $190 $225;
357.6 	(4) drug wholesaler, legend drugs only, $200 $235;
357.7 	(5) drug wholesaler, legend and nonlegend drugs, $200 $235;
357.8 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175 $210;
357.9 	(7) drug wholesaler, medical gases, $150 $185;
357.10 	(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125 $150;
357.11 	(9) drug manufacturer, legend drugs only, $200 $235;
357.12 	(10) drug manufacturer, legend and nonlegend drugs, $200 $235;
357.13 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175 $210;
357.14 	(12) drug manufacturer, medical gases, $150 $185;
357.15 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125 $150;
357.16 	(14) medical gas distributor, $75 $110;
357.17 	(15) controlled substance researcher, $50 $75; and
357.18 	(16) pharmacy professional corporation, $45 $75.

357.19 	Sec. 40. Minnesota Statutes 2014, section 151.065, subdivision 4, is amended to read:
357.20 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
357.21 	and certificates are as follows:
357.22 	(1) intern affidavit, $15 $20;
357.23 	(2) duplicate small license, $15 $20; and
357.24 	(3) duplicate large certificate, $25 $30.

357.25 	Sec. 41. Minnesota Statutes 2014, section 151.102, is amended to read:
357.26 	151.102 PHARMACY TECHNICIAN.
357.27 		Subdivision 1.General. A pharmacy technician may assist a pharmacist in the 
357.28 	practice of pharmacy by performing nonjudgmental tasks and that are not reserved to, and 
357.29 	do not require the professional judgment of, a licensed pharmacist. A pharmacy technician 
357.30 	works under the personal and direct supervision of the pharmacist. A pharmacist may 
357.31 	supervise two up to three technicians, as long as the. A pharmacist assumes responsibility 
357.32 	is responsible for all the functions work performed by the technicians who are under the 
357.33 	supervision of the pharmacist. A pharmacy may exceed the ratio of pharmacy technicians 
357.34 	to pharmacists permitted in this subdivision or in rule by a total of one technician at 
358.1 	any given time in the pharmacy, provided at least one technician in the pharmacy 
358.2 	holds a valid certification from the Pharmacy Technician Certification Board or from 
358.3 	another national certification body for pharmacy technicians that requires passage of a 
358.4 	nationally recognized, psychometrically valid certification examination for certification as 
358.5 	determined by the Board of Pharmacy. The Board of Pharmacy may, by rule, set ratios of 
358.6 	technicians to pharmacists greater than two three to one for the functions specified in rule. 
358.7 	The delegation of any duties, tasks, or functions by a pharmacist to a pharmacy technician 
358.8 	is subject to continuing review and becomes the professional and personal responsibility of 
358.9 	the pharmacist who directed the pharmacy technician to perform the duty, task, or function.
358.10 		Subd. 2.Waivers by board permitted. A pharmacist in charge in a pharmacy may 
358.11 	petition the board for authorization to allow a pharmacist to supervise more than two three 
358.12 	pharmacy technicians. The pharmacist's petition must include provisions addressing the 
358.13 	maintenance of how patient care and safety will be maintained. A petition filed with the 
358.14 	board under this subdivision shall be deemed approved 90 days after the board receives 
358.15 	the petition, unless the board denies the petition within 90 days of receipt and notifies the 
358.16 	petitioning pharmacist of the petition's denial and the board's reasons for denial.
358.17 		Subd. 3.Registration fee. The board shall not register an individual as a pharmacy 
358.18 	technician unless all applicable fees specified in section 151.065 have been paid.

358.19 	Sec. 42. Minnesota Statutes 2014, section 214.077, is amended to read:
358.20 	214.077 TEMPORARY LICENSE SUSPENSION; IMMINENT RISK OF 
358.21 	SERIOUS HARM.
358.22 	(a) Notwithstanding any provision of a health-related professional practice act, 
358.23 	when a health-related licensing board receives a complaint regarding a regulated person 
358.24 	and has probable cause to believe that the regulated person has violated a statute or rule 
358.25 	that the health-related licensing board is empowered to enforce, and continued practice 
358.26 	by the regulated person presents an imminent risk of serious harm, the health-related 
358.27 	licensing board shall issue an order temporarily suspend suspending the regulated person's 
358.28 	professional license authority to practice. The temporary suspension order shall take 
358.29 	effect upon written notice to the regulated person and shall specify the reason for the 
358.30 	suspension., including the statute or rule alleged to have been violated. The temporary 
358.31 	suspension order shall take effect upon personal service on the regulated person or the 
358.32 	regulated person's attorney, or upon the third calendar day after the order is served by first 
358.33 	class mail to the most recent address provided to the health-related licensing board for the 
358.34 	regulated person or the regulated person's attorney.
359.1 	(b) The temporary suspension shall remain in effect until the appropriate 
359.2 	health-related licensing board or the commissioner completes an investigation, holds a 
359.3 	contested case hearing pursuant to the Administrative Procedure Act, and issues a final 
359.4 	order in the matter after a hearing as provided for in this section.
359.5 	(c) At the time it issues the temporary suspension notice order, the appropriate 
359.6 	health-related licensing board shall schedule a disciplinary contested case hearing, on the 
359.7 	merits of whether discipline is warranted, to be held before the licensing board or pursuant 
359.8 	to the Administrative Procedure Act. The regulated person shall be provided with at least 
359.9 	ten days' notice of any contested case hearing held pursuant to this section. The contested 
359.10 	case hearing shall be scheduled to begin no later than 30 days after issuance the effective 
359.11 	service of the temporary suspension order.
359.12 	(d) The administrative law judge presiding over the contested case hearing shall 
359.13 	issue a report and recommendation to the health-related licensing board no later than 30 
359.14 	days after the final day of the contested case hearing. The health-related licensing board 
359.15 	shall issue a final order pursuant to sections 14.61 and 14.62 within 30 days of receipt 
359.16 	of the administrative law judge's report and recommendations. Except as provided in 
359.17 	paragraph (e), if the health-related licensing board has not issued a final order pursuant to 
359.18 	sections 14.61 and 14.62 within 30 days of receipt of the administrative law judge's report 
359.19 	and recommendations, the temporary suspension shall be lifted.
359.20 	(d) (e) If the board has not completed its investigation and issued a final order within 
359.21 	30 days, the temporary suspension shall be lifted, unless the regulated person requests a 
359.22 	delay in the disciplinary proceedings for any reason, upon which the temporary suspension 
359.23 	shall remain in place until the completion of the investigation. the regulated person 
359.24 	requests a delay in the contested case proceedings provided for in paragraphs (c) and (d) 
359.25 	for any reason, the temporary suspension shall remain in effect until the health-related 
359.26 	licensing board issues a final order pursuant to sections 14.61 and 14.62.
359.27 	(f) For the purposes of this section, "health-related licensing board" does not include 
359.28 	the Office of Unlicensed Complementary and Alternative Health Practices.

359.29 	Sec. 43. Minnesota Statutes 2014, section 214.10, subdivision 2, is amended to read:
359.30 		Subd. 2.Investigation and hearing. The designee of the attorney general providing 
359.31 	legal services to a board shall evaluate the communications forwarded by the board or its 
359.32 	members or staff. If the communication alleges a violation of statute or rule which the 
359.33 	board is to enforce, the designee is empowered to investigate the facts alleged in the 
359.34 	communication. In the process of evaluation and investigation, the designee shall consult 
359.35 	with or seek the assistance of the executive director, executive secretary, or, if the board 
360.1 	determines, a member of the board who has been appointed by the board to assist the 
360.2 	designee. The designee may also consult with or seek the assistance of any other qualified 
360.3 	persons who are not members of the board who the designee believes will materially aid 
360.4 	in the process of evaluation or investigation. The executive director, executive secretary, 
360.5 	or the consulted board member may attempt to correct improper activities and redress 
360.6 	grievances through education, conference, conciliation and persuasion, and in these 
360.7 	attempts may be assisted by the designee of the attorney general. If the attempts at 
360.8 	correction or redress do not produce satisfactory results in the opinion of the executive 
360.9 	director, executive secretary, or the consulted board member, or if after investigation the 
360.10 	designee providing legal services to the board, the executive director, executive secretary, 
360.11 	or the consulted board member believes that the communication and the investigation 
360.12 	suggest illegal or unauthorized activities warranting board action, the person having the 
360.13 	belief shall inform the executive director or executive secretary of the board who shall 
360.14 	schedule a disciplinary contested case hearing in accordance with chapter 14. Before 
360.15 	directing the holding of a disciplinary contested case hearing, the executive director, 
360.16 	executive secretary, or the designee of the attorney general shall have considered the 
360.17 	recommendations of the consulted board member. Before scheduling a disciplinary 
360.18 	contested case hearing, the executive director or executive secretary must have received 
360.19 	a verified written complaint from the complaining party. A board member who was 
360.20 	consulted during the course of an investigation may participate at the hearing but may not 
360.21 	vote on any matter pertaining to the case. The executive director or executive secretary 
360.22 	of the board shall promptly inform the complaining party of the final disposition of the 
360.23 	complaint. Nothing in this section shall preclude the board from scheduling, on its own 
360.24 	motion, a disciplinary contested case hearing based upon the findings or report of the 
360.25 	board's executive director or executive secretary, a board member or the designee of the 
360.26 	attorney general assigned to the board. Nothing in this section shall preclude a member of 
360.27 	the board, executive director, or executive secretary from initiating a complaint.

360.28 	Sec. 44. Minnesota Statutes 2014, section 214.10, subdivision 2a, is amended to read:
360.29 		Subd. 2a.Proceedings. A board shall initiate proceedings to suspend or revoke 
360.30 	a license or shall refuse to renew a license of a person licensed by the board who is 
360.31 	convicted in a court of competent jurisdiction of violating section 609.224, subdivision 2, 
360.32 	paragraph (c) 609.2231, subdivision 8, 609.23, 609.231, 609.2325, 609.233, 609.2335, 
360.33 	609.234, 609.465, 609.466, 609.52, or 609.72, subdivision 3.

360.34 	Sec. 45. Minnesota Statutes 2014, section 214.32, subdivision 6, is amended to read:
361.1 		Subd. 6.Duties of a participating board. Upon receiving a report from the 
361.2 	program manager in accordance with section 214.33, subdivision 3, that a regulated 
361.3 	person has been discharged from the program due to noncompliance based on allegations 
361.4 	that the regulated person has engaged in conduct that might cause risk to the public, 
361.5 	when and if the participating health-related licensing board has probable cause to believe 
361.6 	continued practice by the regulated person presents an imminent risk of serious harm, the 
361.7 	health-related licensing board shall temporarily suspend the regulated person's professional 
361.8 	license until the completion of a disciplinary investigation. The board must complete the 
361.9 	disciplinary investigation within 30 days of receipt of the report from the program. If the 
361.10 	investigation is not completed by the board within 30 days, the temporary suspension shall 
361.11 	be lifted, unless the regulated person requests a delay in the disciplinary proceedings 
361.12 	for any reason, upon which the temporary suspension shall remain in place until the 
361.13 	completion of the investigation proceed pursuant to the requirements in section 214.077.

361.14 	Sec. 46.  REPEALER.
 361.15 	Minnesota Statutes 2014, sections 148.57, subdivisions 3 and 4; 148.571; 148.572; 
361.16 	148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, and 6; 148.576; 148E.060, 
361.17 	subdivision 12; 148E.075, subdivisions 4, 5, 6, and 7; and 214.105, are repealed.

361.18 	ARTICLE 12
361.19 	PUBLIC ASSISTANCE SIMPLIFICATION

361.20 	Section 1. Minnesota Statutes 2014, section 119B.011, subdivision 15, is amended to 
361.21 	read:
361.22 		Subd. 15.Income. "Income" means earned or unearned income received by all 
361.23 	family members, includingas defined under section 256P.01, subdivision 3, unearned 
361.24 	income as defined under section 256P.01, subdivision 8, and public assistance cash benefits 
361.25 	and, including the Minnesota family investment program, diversionary work program, 
361.26 	work benefit, Minnesota supplemental aid, general assistance, refugee cash assistance,  
361.27 	at-home infant child care subsidy payments, unless specifically excluded and child support 
361.28 	and maintenance distributed to the family under section 256.741, subdivision 15. The 
361.29 	following are excluded deducted  from income: funds used to pay for health insurance 
361.30 	premiums for family members, Supplemental Security Income, scholarships, work-study 
361.31 	income, and grants that cover costs or reimbursement for tuition, fees, books, and 
361.32 	educational supplies; student loans for tuition, fees, books, supplies, and living expenses; 
361.33 	state and federal earned income tax credits; assistance specifically excluded as income by 
361.34 	law; in-kind income such as food support, energy assistance, foster care assistance, medical 
362.1 	assistance, child care assistance, and housing subsidies; earned income of full-time or 
362.2 	part-time students up to the age of 19, who have not earned a high school diploma or GED 
362.3 	high school equivalency diploma including earnings from summer employment; grant 
362.4 	awards under the family subsidy program; nonrecurring lump-sum income only to the 
362.5 	extent that it is earmarked and used for the purpose for which it is paid; and any income 
362.6 	assigned to the public authority according to section 256.741 and child or spousal support 
362.7 	paid to or on behalf of a person or persons who live outside of the household. Income 
362.8 	sources not included in this subdivision and section 256P.06, subdivision 3, are not counted.

362.9 	Sec. 2. Minnesota Statutes 2014, section 119B.025, subdivision 1, is amended to read:
362.10 		Subdivision 1.Factors which must be verified. (a) The county shall verify the 
362.11 	following at all initial child care applications using the universal application:
362.12 	(1) identity of adults;
362.13 	(2) presence of the minor child in the home, if questionable;
362.14 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible 
362.15 	relative caretaker, or the spouses of any of the foregoing;
362.16 	(4) age;
362.17 	(5) immigration status, if related to eligibility;
362.18 	(6) Social Security number, if given;
362.19 	(7) income;
362.20 	(8) spousal support and child support payments made to persons outside the 
362.21 	household;
362.22 	(9) residence; and
362.23 	(10) inconsistent information, if related to eligibility.
362.24 	(b) If a family did not use the universal application or child care addendum to apply 
362.25 	for child care assistance, the family must complete the universal application or child care 
362.26 	addendum at its next eligibility redetermination and the county must verify the factors 
362.27 	listed in paragraph (a) as part of that redetermination. Once a family has completed a 
362.28 	universal application or child care addendum, the county shall use the redetermination 
362.29 	form described in paragraph (c) for that family's subsequent redeterminations. Eligibility 
362.30 	must be redetermined at least every six months. A family is considered to have met the 
362.31 	eligibility redetermination requirement if a complete redetermination form and all required 
362.32 	verifications are received within 30 days after the date the form was due. Assistance shall 
362.33 	be payable retroactively from the redetermination due date. For a family where at least 
362.34 	one parent is under the age of 21, does not have a high school or general equivalency 
362.35 	diploma, and is a student in a school district or another similar program that provides or 
363.1 	arranges for child care, as well as parenting, social services, career and employment 
363.2 	supports, and academic support to achieve high school graduation, the redetermination of 
363.3 	eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of 
363.4 	the student's school year. If a family reports a change in an eligibility factor before the 
363.5 	family's next regularly scheduled redetermination, the county must recalculate eligibility 
363.6 	without requiring verification of any eligibility factor that did not change. Changes must 
363.7 	be reported as required by section 256P.07. A change in income occurs on the day the 
363.8 	participant received the first payment reflecting the change in income.
363.9 	(c) The commissioner shall develop a redetermination form to redetermine eligibility 
363.10 	and a change report form to report changes that minimize paperwork for the county and 
363.11 	the participant.

363.12 	Sec. 3. Minnesota Statutes 2014, section 119B.035, subdivision 4, is amended to read:
363.13 		Subd. 4.Assistance. (a) A family is limited to a lifetime total of 12 months of 
363.14 	assistance under subdivision 2. The maximum rate of assistance is equal to 68 percent 
363.15 	of the rate established under section 119B.13 for care of infants in licensed family child 
363.16 	care in the applicant's county of residence.
363.17 	(b) A participating family must report income and other family changes as specified in 
363.18 	sections 256P.06 and 256P.07, and the county's plan under section 119B.08, subdivision 3.
363.19 	(c) Persons who are admitted to the at-home infant child care program retain their 
363.20 	position in any basic sliding fee program. Persons leaving the at-home infant child care 
363.21 	program reenter the basic sliding fee program at the position they would have occupied.
363.22 	(d) Assistance under this section does not establish an employer-employee 
363.23 	relationship between any member of the assisted family and the county or state.

363.24 	Sec. 4. Minnesota Statutes 2014, section 119B.09, subdivision 4, is amended to read:
363.25 		Subd. 4.Eligibility; annual income; calculation. Annual income of the applicant 
363.26 	family is the current monthly income of the family multiplied by 12 or the income for 
363.27 	the 12-month period immediately preceding the date of application, or income calculated 
363.28 	by the method which provides the most accurate assessment of income available to the 
363.29 	family. Self-employment income must be calculated based on gross receipts less operating 
363.30 	expenses. Income must be recalculated when the family's income changes, but no less 
363.31 	often than every six months. For a family where at least one parent is under the age of 
363.32 	21, does not have a high school or general equivalency diploma, and is a student in a 
363.33 	school district or another similar program that provides or arranges for child care, as well 
363.34 	as parenting, social services, career and employment supports, and academic support to 
364.1 	achieve high school graduation, income must be recalculated when the family's income 
364.2 	changes, but otherwise shall be deferred beyond six months, but not to exceed 12 months, 
364.3 	to the end of the student's school year. Included lump sums counted as income under 
364.4 	section 256P.06, subdivision 3, must be annualized over 12 months. Income must be 
364.5 	verified with documentary evidence. If the applicant does not have sufficient evidence of 
364.6 	income, verification must be obtained from the source of the income.

364.7 	Sec. 5. Minnesota Statutes 2014, section 256D.01, subdivision 1a, is amended to read:
364.8 		Subd. 1a.Standards. (a) A principal objective in providing general assistance is 
364.9 	to provide for single adults, childless couples, or children as defined in section 256D.02, 
364.10 	subdivision 6, ineligible for federal programs who are unable to provide for themselves. 
364.11 	The minimum standard of assistance determines the total amount of the general assistance 
364.12 	grant without separate standards for shelter, utilities, or other needs.
364.13 	(b) The commissioner shall set the standard of assistance for an assistance unit 
364.14 	consisting of an adult recipient who is childless and unmarried or living apart from 
364.15 	children and spouse and who does not live with a parent or parents or a legal custodian. 
364.16 	When the other standards specified in this subdivision increase, this standard must also be 
364.17 	increased by the same percentage.
364.18 	(c) For an assistance unit consisting of a single adult who lives with a parent or 
364.19 	parents, the general assistance standard of assistance is the amount that the aid to families 
364.20 	with dependent children standard of assistance, in effect on July 16, 1996, would increase 
364.21 	if the recipient were added as an additional minor child to an assistance unit consisting 
364.22 	of the recipient's parent and all of that parent's family members, except that the standard 
364.23 	may not exceed the standard for a general assistance recipient living alone. Benefits 
364.24 	received by a responsible relative of the assistance unit under the Supplemental Security 
364.25 	Income program, a workers' compensation program, the Minnesota supplemental aid 
364.26 	program, or any other program based on the responsible relative's disability, and any 
364.27 	benefits received by a responsible relative of the assistance unit under the Social Security 
364.28 	retirement program, may not be counted in the determination of eligibility or benefit 
364.29 	level for the assistance unit. Except as provided below, the assistance unit is ineligible 
364.30 	for general assistance if the available resources or the countable income of the assistance 
364.31 	unit and the parent or parents with whom the assistance unit lives are such that a family 
364.32 	consisting of the assistance unit's parent or parents, the parent or parents' other family 
364.33 	members and the assistance unit as the only or additional minor child would be financially 
364.34 	ineligible for general assistance. For the purposes of calculating the countable income 
364.35 	of the assistance unit's parent or parents, the calculation methods, income deductions, 
365.1 	exclusions, and disregards used when calculating the countable income for a single adult 
365.2 	or childless couple must be used follow the provisions under section 256P.06.
365.3 	(d) For an assistance unit consisting of a childless couple, the standards of assistance 
365.4 	are the same as the first and second adult standards of the aid to families with dependent 
365.5 	children program in effect on July 16, 1996. If one member of the couple is not included 
365.6 	in the general assistance grant, the standard of assistance for the other is the second adult 
365.7 	standard of the aid to families with dependent children program as of July 16, 1996.

365.8 	Sec. 6. Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision 
365.9 	to read:
365.10 		Subd. 1a.Assistance unit. "Assistance unit" means an individual who is, or an 
365.11 	eligible married couple who live together who are, applying for or receiving benefits 
365.12 	under this chapter.

365.13 	Sec. 7. Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision 
365.14 	to read:
365.15 		Subd. 1b.Cash assistance benefit. "Cash assistance benefit" means any payment 
365.16 	received as a disability benefit, including veterans or workers' compensation; old age, 
365.17 	survivors, and disability insurance; railroad retirement benefits; unemployment benefits; 
365.18 	and benefits under any federally aided categorical assistance program, Supplemental 
365.19 	Security Income, or other assistance program.

365.20 	Sec. 8. Minnesota Statutes 2014, section 256D.02, subdivision 8, is amended to read:
365.21 		Subd. 8.Income. "Income" means any form of income, including remuneration 
365.22 	for services performed as an employee and earned income from rental income and 
365.23 	self-employment earnings as described under section 256P.05 earned income as defined 
365.24 	under section 256P.01, subdivision 3, and unearned income as defined under section 
365.25 	256P.01, subdivision 8.
365.26 	Income includes any payments received as an annuity, retirement, or disability 
365.27 	benefit, including veteran's or workers' compensation; old age, survivors, and disability 
365.28 	insurance; railroad retirement benefits; unemployment benefits; and benefits under any 
365.29 	federally aided categorical assistance program, supplementary security income, or other 
365.30 	assistance program; rents, dividends, interest and royalties; and support and maintenance 
365.31 	payments. Such payments may not be considered as available to meet the needs of any 
365.32 	person other than the person for whose benefit they are received, unless that person is 
365.33 	a family member or a spouse and the income is not excluded under section 256D.01, 
366.1 	subdivision 1a. Goods and services provided in lieu of cash payment shall be excluded 
366.2 	from the definition of income, except that payments made for room, board, tuition or 
366.3 	fees by a parent, on behalf of a child enrolled as a full-time student in a postsecondary 
366.4 	institution, and payments made on behalf of an applicant or participant which the applicant 
366.5 	or participant could legally demand to receive personally in cash, must be included as 
366.6 	income. Benefits of an applicant or participant, such as those administered by the Social 
366.7 	Security Administration, that are paid to a representative payee, and are spent on behalf of 
366.8 	the applicant or participant, are considered available income of the applicant or participant.

366.9 	Sec. 9. Minnesota Statutes 2014, section 256D.06, subdivision 1, is amended to read:
366.10 		Subdivision 1.Eligibility; amount of assistance. General assistance shall be 
366.11 	granted in an amount that when added to the nonexemptcountable income as determined 
366.12 	to be actually available to the assistance unit under section 256P.06, the total amount 
366.13 	equals the applicable standard of assistance for general assistance. In determining 
366.14 	eligibility for and the amount of assistance for an individual or married couple, the agency 
366.15 	shall apply the earned income disregard as determined in section 256P.03.

366.16 	Sec. 10. Minnesota Statutes 2014, section 256D.405, subdivision 3, is amended to read:
366.17 		Subd. 3.Reports. Participants must report changes in circumstances according to 
366.18 	section 256P.07 that affect eligibility or assistance payment amounts within ten days of the 
366.19 	change. Participants who do not receive SSI because of excess income must complete a 
366.20 	monthly report form if they have earned income, if they have income deemed to them 
366.21 	from a financially responsible relative with whom the participant resides, or if they have 
366.22 	income deemed to them by a sponsor. If the report form is not received before the end of 
366.23 	the month in which it is due, the county agency must terminate assistance. The termination 
366.24 	shall be effective on the first day of the month following the month in which the report 
366.25 	was due. If a complete report is received within the month the assistance was terminated, 
366.26 	the assistance unit is considered to have continued its application for assistance, effective 
366.27 	the first day of the month the assistance was terminated.

366.28 	Sec. 11. Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision 
366.29 	to read:
366.30 		Subd. 1b.Assistance unit. "Assistance unit" means an individual who is applying 
366.31 	for or receiving benefits under this chapter.

366.32 	Sec. 12. Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:
367.1 		Subd. 7.Countable income. "Countable income" means all income received by an 
367.2 	applicant or recipient as described under section 256P.06, less any applicable exclusions 
367.3 	or disregards. For a recipient of any cash benefit from the SSI program, countable income 
367.4 	means the SSI benefit limit in effect at the time the person is in a GRH, less the medical 
367.5 	assistance personal needs allowance. If the SSI limit has been reduced for a person due to 
367.6 	events occurring prior to the persons entering the GRH setting, countable income means 
367.7 	actual income less any applicable exclusions and disregards.

367.8 	Sec. 13. Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:
367.9 		Subdivision 1.Individual eligibility requirements. An individual is eligible for 
367.10 	and entitled to a group residential housing payment to be made on the individual's behalf 
367.11 	if the agency has approved the individual's residence in a group residential housing setting 
367.12 	and the individual meets the requirements in paragraph (a) or (b).
367.13 	(a) The individual is aged, blind, or is over 18 years of age and disabled as 
367.14 	determined under the criteria used by the title II program of the Social Security Act, and 
367.15 	meets the resource restrictions and standards of section 256P.02, and the individual's 
367.16 	countable income after deducting the (1) exclusions and disregards of the SSI program, 
367.17 	(2) the medical assistance personal needs allowance under section 256B.35, and (3) an 
367.18 	amount equal to the income actually made available to a community spouse by an elderly 
367.19 	waiver participant under the provisions of sections 256B.0575, paragraph (a), clause 
367.20 	(4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's 
367.21 	agreement with the provider of group residential housing in which the individual resides.
367.22 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 
367.23 	1, paragraph (a), and the individual's resources are less than the standards specified by 
367.24 	section 256P.02, and the individual's countable income as determined under sections 
367.25 	256D.01 to 256D.21 section 256P.06, less the medical assistance personal needs allowance 
367.26 	under section 256B.35 is less than the monthly rate specified in the agency's agreement 
367.27 	with the provider of group residential housing in which the individual resides.

367.28 	Sec. 14. Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:
367.29 		Subd. 6.Reports. Recipients must report changes in circumstances according 
367.30 	to section 256P.07 that affect eligibility or group residential housing payment amounts 
367.31 	within ten days of the change. Recipients with countable earned income must complete 
367.32 	a monthly household report form. If the report form is not received before the end of 
367.33 	the month in which it is due, the county agency must terminate eligibility for group 
367.34 	residential housing payments. The termination shall be effective on the first day of the 
368.1 	month following the month in which the report was due. If a complete report is received 
368.2 	within the month eligibility was terminated, the individual is considered to have continued 
368.3 	an application for group residential housing payment effective the first day of the month 
368.4 	the eligibility was terminated.

368.5 	Sec. 15. Minnesota Statutes 2014, section 256J.08, subdivision 26, is amended to read:
368.6 		Subd. 26.Earned income. "Earned income" means cash or in-kind income earned 
368.7 	through the receipt of wages, salary, commissions, profit from employment activities, net 
368.8 	profit from self-employment activities, payments made by an employer for regularly 
368.9 	accrued vacation or sick leave, and any other profit from activity earned through effort or 
368.10 	labor. The income must be in return for, or as a result of, legal activity has the meaning 
368.11 	given in section 256P.01, subdivision 3.

368.12 	Sec. 16. Minnesota Statutes 2014, section 256J.08, subdivision 86, is amended to read:
368.13 		Subd. 86.Unearned income. "Unearned income" means income received by 
368.14 	a person that does not meet the definition of earned income. Unearned income includes 
368.15 	income from a contract for deed, interest, dividends, unemployment benefits, disability 
368.16 	insurance payments, veterans benefits, pension payments, return on capital investment, 
368.17 	insurance payments or settlements, severance payments, child support and maintenance 
368.18 	payments, and payments for illness or disability whether the premium payments are 
368.19 	made in whole or in part by an employer or participant has the meaning given in section 
368.20 	256P.01, subdivision 8.

368.21 	Sec. 17. Minnesota Statutes 2014, section 256J.30, subdivision 1, is amended to read:
368.22 		Subdivision 1.Applicant reporting requirements. An applicant must provide 
368.23 	information on an application form and supplemental forms about the applicant's 
368.24 	circumstances which affect MFIP eligibility or the assistance payment. An applicant must 
368.25 	report changes identified in subdivision 9 while the application is pending. When an 
368.26 	applicant does not accurately report information on an application, both an overpayment 
368.27 	and a referral for a fraud investigation may result. When an applicant does not provide 
368.28 	information or documentation, the receipt of the assistance payment may be delayed or the 
368.29 	application may be denied depending on the type of information required and its effect on 
368.30 	eligibility according to section 256P.07.

368.31 	Sec. 18. Minnesota Statutes 2014, section 256J.30, subdivision 9, is amended to read:
369.1 		Subd. 9.Changes that must be reported. A caregiver must report the changes or 
369.2 	anticipated changes specified in clauses (1) to (15) within ten days of the date they occur, 
369.3 	at the time of the periodic recertification of eligibility under section 256P.04, subdivisions 
369.4 	8 and 9, or within eight calendar days of a reporting period as in subdivision 5, whichever 
369.5 	occurs first. A caregiver must report other changes at the time of the periodic recertification 
369.6 	of eligibility under section 256P.04, subdivisions 8 and 9, or at the end of a reporting period 
369.7 	under subdivision 5, as applicable. A caregiver must make these reports in writing to the 
369.8 	agency. When an agency could have reduced or terminated assistance for one or more 
369.9 	payment months if a delay in reporting a change specified under clauses (1) to (14) had 
369.10 	not occurred, the agency must determine whether a timely notice under section 256J.31, 
369.11 	subdivision 4, could have been issued on the day that the change occurred. When a timely 
369.12 	notice could have been issued, each month's overpayment subsequent to that notice must be 
369.13 	considered a client error overpayment under section 256J.38. Calculation of overpayments 
369.14 	for late reporting under clause (15) is specified in section 256J.09, subdivision 9. Changes 
369.15 	in circumstances which must be reported within ten days must also be reported on the 
369.16 	MFIP household report form for the reporting period in which those changes occurred. 
369.17 	Within ten days, a caregiver must report: changes as specified under section 256P.07.
369.18 	(1) a change in initial employment;
369.19 	(2) a change in initial receipt of unearned income;
369.20 	(3) a recurring change in unearned income;
369.21 	(4) a nonrecurring change of unearned income that exceeds $30;
369.22 	(5) the receipt of a lump sum;
369.23 	(6) an increase in assets that may cause the assistance unit to exceed asset limits;
369.24 	(7) a change in the physical or mental status of an incapacitated member of the 
369.25 	assistance unit if the physical or mental status is the basis for reducing the hourly 
369.26 	participation requirements under section 256J.55, subdivision 1, or the type of activities 
369.27 	included in an employment plan under section 256J.521, subdivision 2;
369.28 	(8) a change in employment status;
369.29 	(9) the marriage or divorce of an assistance unit member;
369.30 	(10) the death of a parent, minor child, or financially responsible person;
369.31 	(11) a change in address or living quarters of the assistance unit;
369.32 	(12) the sale, purchase, or other transfer of property;
369.33 	(13) a change in school attendance of a caregiver under age 20 or an employed child;
369.34 	(14) filing a lawsuit, a workers' compensation claim, or a monetary claim against a 
369.35 	third party; and
370.1 	(15) a change in household composition, including births, returns to and departures 
370.2 	from the home of assistance unit members and financially responsible persons, or a change 
370.3 	in the custody of a minor child.

370.4 	Sec. 19. Minnesota Statutes 2014, section 256J.35, is amended to read:
370.5 	256J.35 AMOUNT OF ASSISTANCE PAYMENT.
370.6 	Except as provided in paragraphs (a) to (d), the amount of an assistance payment is 
370.7 	equal to the difference between the MFIP standard of need or the Minnesota family wage 
370.8 	level in section 256J.24 and countable income.
370.9 	(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing 
370.10 	assistance grant of $110 per month, unless:
370.11 	(1) the housing assistance unit is currently receiving public and assisted rental 
370.12 	subsidies provided through the Department of Housing and Urban Development (HUD) 
370.13 	and is subject to section 256J.37, subdivision 3a; or
370.14 	(2) the assistance unit is a child-only case under section 256J.88.
370.15 	(b) When MFIP eligibility exists for the month of application, the amount of the 
370.16 	assistance payment for the month of application must be prorated from the date of 
370.17 	application or the date all other eligibility factors are met for that applicant, whichever is 
370.18 	later. This provision applies when an applicant loses at least one day of MFIP eligibility.
370.19 	(c) MFIP overpayments to an assistance unit must be recouped according to section 
370.20 	256J.38, subdivision 4 256P.08, subdivision 6.
370.21 	(d) An initial assistance payment must not be made to an applicant who is not 
370.22 	eligible on the date payment is made.

370.23 	Sec. 20. Minnesota Statutes 2014, section 256J.40, is amended to read:
370.24 	256J.40 FAIR HEARINGS.
370.25 	Caregivers receiving a notice of intent to sanction or a notice of adverse action that 
370.26 	includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or 
370.27 	termination of benefits may request a fair hearing. A request for a fair hearing must be 
370.28 	submitted in writing to the county agency or to the commissioner and must be mailed 
370.29 	within 30 days after a participant or former participant receives written notice of the 
370.30 	agency's action or within 90 days when a participant or former participant shows good 
370.31 	cause for not submitting the request within 30 days. A former participant who receives a 
370.32 	notice of adverse action due to an overpayment may appeal the adverse action according 
370.33 	to the requirements in this section. Issues that may be appealed are:
370.34 	(1) the amount of the assistance payment;
371.1 	(2) a suspension, reduction, denial, or termination of assistance;
371.2 	(3) the basis for an overpayment, the calculated amount of an overpayment, and 
371.3 	the level of recoupment;
371.4 	(4) the eligibility for an assistance payment; and
371.5 	(5) the use of protective or vendor payments under section 256J.39, subdivision 2, 
371.6 	clauses (1) to (3).
371.7 	Except for benefits issued under section 256J.95, a county agency must not reduce, 
371.8 	suspend, or terminate payment when an aggrieved participant requests a fair hearing 
371.9 	prior to the effective date of the adverse action or within ten days of the mailing of the 
371.10 	notice of adverse action, whichever is later, unless the participant requests in writing not 
371.11 	to receive continued assistance pending a hearing decision. An appeal request cannot 
371.12 	extend benefits for the diversionary work program under section 256J.95 beyond the 
371.13 	four-month time limit. Assistance issued pending a fair hearing is subject to recovery 
371.14 	under section 256J.38 256P.08 when as a result of the fair hearing decision the participant 
371.15 	is determined ineligible for assistance or the amount of the assistance received. A county 
371.16 	agency may increase or reduce an assistance payment while an appeal is pending when the 
371.17 	circumstances of the participant change and are not related to the issue on appeal. The 
371.18 	commissioner's order is binding on a county agency. No additional notice is required to 
371.19 	enforce the commissioner's order.
371.20 	A county agency shall reimburse appellants for reasonable and necessary expenses 
371.21 	of attendance at the hearing, such as child care and transportation costs and for the 
371.22 	transportation expenses of the appellant's witnesses and representatives to and from the 
371.23 	hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings 
371.24 	must be conducted at a reasonable time and date by an impartial human services judge 
371.25 	employed by the department. The hearing may be conducted by telephone or at a site that 
371.26 	is readily accessible to persons with disabilities.
371.27 	The appellant may introduce new or additional evidence relevant to the issues on 
371.28 	appeal. Recommendations of the human services judge and decisions of the commissioner 
371.29 	must be based on evidence in the hearing record and are not limited to a review of the 
371.30 	county agency action.

371.31 	Sec. 21. Minnesota Statutes 2014, section 256J.95, subdivision 19, is amended to read:
371.32 		Subd. 19.DWP overpayments and underpayments. DWP benefits are subject 
371.33 	to overpayments and underpayments. Anytime an overpayment or an underpayment is 
371.34 	determined for DWP, the correction shall be calculated using prospective budgeting. 
371.35 	Corrections shall be determined based on the policy in section 256J.34, subdivision 1, 
372.1 	paragraphs (a), (b), and (c). ATM errors must be recovered as specified in section 256J.38, 
372.2 	subdivision 5 256P.08, subdivision 7. Cross program recoupment of overpayments cannot 
372.3 	be assigned to or from DWP.

372.4 	Sec. 22. Minnesota Statutes 2014, section 256P.001, is amended to read:
372.5 	256P.001 APPLICABILITY.
372.6 	General assistance and Minnesota supplemental aid under chapter 256D, child care 
372.7 	assistance programs under chapter 119B,  and programs governed by chapter 256I or 256J 
372.8 	are subject to the requirements of this chapter, unless otherwise specified or exempted.

372.9 	Sec. 23. Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision 
372.10 	to read:
372.11 		Subd. 2a.Assistance unit. "Assistance unit" is defined by program area under 
372.12 	sections 119B.011, subdivision 13; 256D.02, subdivision 1a; 256D.35, subdivision 3a; 
372.13 	256I.03, subdivision 1b; and 256J.08, subdivision 7.

372.14 	Sec. 24. Minnesota Statutes 2014, section 256P.01, subdivision 3, is amended to read:
372.15 		Subd. 3.Earned income. "Earned income" means cash or in-kind income earned 
372.16 	through the receipt of wages, salary, commissions, bonuses, tips, gratuities, profit from 
372.17 	employment activities, net profit from self-employment activities, payments made by 
372.18 	an employer for regularly accrued vacation or sick leave, and anyseverance pay based 
372.19 	on accrued leave time, payments from training programs at a rate at or greater than the 
372.20 	state's minimum wage, royalties, honoraria, or other profit from activity earned through 
372.21 	effortthat results from the client's work, service, effort, or labor. The income must be in 
372.22 	return for, or as a result of, legal activity.

372.23 	Sec. 25. Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision 
372.24 	to read:
372.25 		Subd. 8.Unearned income. "Unearned income" has the meaning given in section 
372.26 	256P.06, subdivision 3, clause (2).

372.27 	Sec. 26. Minnesota Statutes 2014, section 256P.02, is amended by adding a subdivision 
372.28 	to read:
372.29 		Subd. 1a.Exemption. Participants who qualify for child care assistance programs 
372.30 	under chapter 119B are exempt from this section.

373.1 	Sec. 27. Minnesota Statutes 2014, section 256P.03, subdivision 1, is amended to read:
373.2 		Subdivision 1.Exempted programs. Participants who qualify for child care 
373.3 	assistance programs under chapter 119B, Minnesota supplemental aid under chapter 
373.4 	256D, and for group residential housing under chapter 256I on the basis of eligibility for 
373.5 	Supplemental Security Income are exempt from this section.

373.6 	Sec. 28. Minnesota Statutes 2014, section 256P.04, subdivision 1, is amended to read:
373.7 		Subdivision 1.Exemption. Participants who receive Minnesota supplemental aid 
373.8 	and who maintain Supplemental Security Income eligibility under chapters 256D and 256I 
373.9 	are exempt from the reporting requirements of this section, except that the policies and 
373.10 	procedures for transfers of assets are those used by the medical assistance program under 
373.11 	section 256B.0595. Participants who receive child care assistance under chapter 119B are 
373.12 	exempt from the requirements of this section.

373.13 	Sec. 29. Minnesota Statutes 2014, section 256P.04, subdivision 4, is amended to read:
373.14 		Subd. 4.Factors to be verified. (a) The agency shall verify the following at 
373.15 	application:
373.16 	(1) identity of adults;
373.17 	(2) age, if necessary to determine eligibility;
373.18 	(3) immigration status;
373.19 	(4) income;
373.20 	(5) spousal support and child support payments made to persons outside the 
373.21 	household;
373.22 	(6) vehicles;
373.23 	(7) checking and savings accounts;
373.24 	(8) inconsistent information, if related to eligibility;
373.25 	(9) residence; and
373.26 	(10) Social Security number.; and
373.27 	(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), 
373.28 	item (ix), for the intended purpose in which it was given and received.
373.29 	(b) Applicants who are qualified noncitizens and victims of domestic violence as 
373.30 	defined under section 256J.08, subdivision 73, clause (7), are not required to verify the 
373.31 	information in paragraph (a), clause (10). When a Social Security number is not provided 
373.32 	to the agency for verification, this requirement is satisfied when each member of the 
373.33 	assistance unit cooperates with the procedures for verification of Social Security numbers, 
374.1 	issuance of duplicate cards, and issuance of new numbers which have been established 
374.2 	jointly between the Social Security Administration and the commissioner.

374.3 	Sec. 30. Minnesota Statutes 2014, section 256P.05, subdivision 1, is amended to read:
374.4 		Subdivision 1.Exempted programs. Participants who qualify for child care 
374.5 	assistance programs under chapter 119B, Minnesota supplemental aid under chapter 
374.6 	256D, and for group residential housing under chapter 256I on the basis of eligibility for 
374.7 	Supplemental Security Income are exempt from this section.

374.8 	Sec. 31. [256P.06] INCOME CALCULATIONS.
374.9 		Subdivision 1.Reporting of income. To determine eligibility, the county agency 
374.10 	must evaluate income received by members of the assistance unit, or by other persons 
374.11 	whose income is considered available to the assistance unit, and only count income that 
374.12 	is available to the assistance unit. Income is available if the individual has legal access 
374.13 	to the income.
374.14 		Subd. 2.Exempted individuals. The following members of an assistance unit 
374.15 	under chapters 119B and 256J are exempt from having their earned income count towards 
374.16 	the income of an assistance unit:
374.17 	(1) children under six years old;
374.18 	(2) caregivers under 20 years of age enrolled at least half time in school; and
374.19 	(3) minors enrolled in school full time.
374.20 		Subd. 3.Income inclusions. The following must be included in determining the 
374.21 	income of an assistance unit:
374.22 	(1) earned income; and
374.23 	(2) unearned income, which includes:
374.24 	(i) interest and dividends from investments and savings;
374.25 	(ii) capital gains as defined by the Internal Revenue Service from any sale of real 
374.26 	property;
374.27 	(iii) proceeds from rent and contract for deed payments in excess of the principal 
374.28 	and interest portion owed on property;
374.29 	(iv) income from trusts, excluding special needs and supplemental needs trusts;
374.30 	(v) interest income from loans made by the participant or household;
374.31 	(vi) cash prizes and winnings;
374.32 	(vii) unemployment insurance income;
374.33 	(viii) retirement, survivors, and disability insurance payments;
375.1 	(ix) nonrecurring income over $60 per quarter unless earmarked and used for the 
375.2 	purpose for which it is intended. Income and use of this income is subject to verification 
375.3 	requirements under section 256P.04;
375.4 	(x) retirement benefits;
375.5 	(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 
375.6 	256I, and 256J;
375.7 	(xii) tribal per capita payments unless excluded by federal and state law;
375.8 	(xiii) income and payments from service and rehabilitation programs that meet 
375.9 	or exceed the state's minimum wage rate;
375.10 	(xiv) income from members of the United States armed forces unless excluded from 
375.11 	income taxes according to federal or state law; and
375.12 	(xv) child and spousal support.

375.13 	Sec. 32. [256P.07] REPORTING OF INCOME AND CHANGES.
375.14 		Subdivision 1.Exempted programs. Participants who qualify for Minnesota 
375.15 	supplemental aid under chapter 256D and for group residential housing under chapter 256I 
375.16 	on the basis of eligibility for Supplemental Security Income are exempt from this section.
375.17 		Subd. 2.Reporting requirements. An applicant or participant must provide 
375.18 	information on an application and any subsequent reporting forms about the assistance 
375.19 	unit's circumstances that affect eligibility or benefits. An applicant or assistance unit must 
375.20 	report changes identified in subdivision 3. When information is not accurately reported, 
375.21 	both an overpayment and a referral for a fraud investigation may result. When information 
375.22 	or documentation is not provided, the receipt of any benefit may be delayed or denied, 
375.23 	depending on the type of information required and its effect on eligibility.
375.24 		Subd. 3.Changes that must be reported. An assistance unit must report the 
375.25 	changes or anticipated changes specified in clauses (1) to (12) within ten days of the date 
375.26 	they occur, at the time of recertification of eligibility under section 256P.04, subdivisions 
375.27 	8 and 9, or within eight calendar days of a reporting period, whichever occurs first. An 
375.28 	assistance unit must report other changes at the time of recertification of eligibility under 
375.29 	section 256P.04, subdivisions 8 and 9, or at the end of a reporting period, as applicable. 
375.30 	When an agency could have reduced or terminated assistance for one or more payment 
375.31 	months if a delay in reporting a change specified under clauses (1) to (12) had not 
375.32 	occurred, the agency must determine whether a timely notice could have been issued 
375.33 	on the day that the change occurred. When a timely notice could have been issued, 
375.34 	each month's overpayment subsequent to that notice must be considered a client error 
375.35 	overpayment under section 119B.11, subdivision 2a; 256D.09, subdivision 6; 256D.49, 
376.1 	subdivision 3; 256J.38; or 256P.08. Changes in circumstances that must be reported within 
376.2 	ten days must also be reported for the reporting period in which those changes occurred. 
376.3 	Within ten days, an assistance unit must report a:
376.4 	(1) change in earned income of $100 per month or greater;
376.5 	(2) change in unearned income of $50 per month or greater;
376.6 	(3) change in employment status and hours;
376.7 	(4) change in address or residence;
376.8 	(5) change in household composition with the exception of programs under chapter 
376.9 	256I;
376.10 	(6) receipt of a lump-sum payment;
376.11 	(7) increase in assets if over $9,000 with the exception of programs under chapter 
376.12 	119B;
376.13 	(8) change in citizenship or immigration status;
376.14 	(9) change in family status with the exception of programs under chapter 256I;
376.15 	(10) change in disability status of a unit member, with the exception of programs 
376.16 	under chapter 119B;
376.17 	(11) new rent subsidy or a change in rent subsidy; and
376.18 	(12) sale, purchase, or transfer of real property.
376.19 		Subd. 4.MFIP-specific reporting. In addition to subdivision 3, an assistance unit 
376.20 	under chapter 256J, within ten days of the change, must report:
376.21 	(1) a pregnancy not resulting in birth when there are no other minor children; and
376.22 	(2) a change in school attendance of a parent under 20 years of age or of an 
376.23 	employed child.
376.24 		Subd. 5.DWP-specific reporting. In addition to subdivisions 3 and 4, an assistance 
376.25 	unit participating in the diversionary work program under section 256J.95 must report 
376.26 	on an application:
376.27 	(1) shelter expenses; and
376.28 	(2) utility expenses.
376.29 		Subd. 6.Child care assistance programs-specific reporting. In addition to 
376.30 	subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must 
376.31 	report a:
376.32 	(1) change in a parentally responsible individual's visitation schedule or custody 
376.33 	arrangement for any child receiving child care assistance program benefits; and
376.34 	(2) change in authorized activity status.
376.35 		Subd. 7.Minnesota supplemental aid-specific reporting. In addition to 
376.36 	subdivision 3, an assistance unit participating in the Minnesota supplemental aid program 
377.1 	under section 256D.44, subdivision 5, paragraph (f), within ten days of the change, must 
377.2 	report shelter expenses.

377.3 	Sec. 33. [256P.08] CORRECTION OF OVERPAYMENTS AND 
377.4 	UNDERPAYMENTS.
377.5 		Subdivision 1.Exempted programs. Participants who qualify for child care 
377.6 	assistance programs under chapter 119B or group residential housing under chapter 256I 
377.7 	are exempt from this section.
377.8 		Subd. 2.Scope of overpayment. (a) When a participant or former participant 
377.9 	receives an overpayment due to client or ATM error, or due to assistance received while 
377.10 	an appeal is pending and the participant or former participant is determined ineligible 
377.11 	for assistance or for less assistance than was received, except as provided for interim 
377.12 	assistance in section 256D.06, subdivision 5, the county agency must recoup or recover 
377.13 	the overpayment using the following methods:
377.14 	(1) reconstruct each affected budget month and corresponding payment month;
377.15 	(2) use the policies and procedures that were in effect for the payment month; and
377.16 	(3) do not allow employment disregards in the calculation of the overpayment when 
377.17 	the unit has not reported within two calendar months following the end of the month in 
377.18 	which the income was received.
377.19 	(b) Establishment of an overpayment is limited to six years prior to the month of 
377.20 	discovery due to client error or an intentional program violation determined under section 
377.21 	256.046. 
377.22 	(c) A participant or former participant is not responsible for overpayments due to 
377.23 	agency error, unless the amount of the overpayment is large enough that a reasonable 
377.24 	person would know it is an error.
377.25 		Subd. 3.Notice of overpayment. When a county agency discovers that a participant 
377.26 	or former participant has received an overpayment for one or more months, the county 
377.27 	agency must notify the participant or former participant of the overpayment in writing. 
377.28 	A notice of overpayment must specify the reason for the overpayment, the authority for 
377.29 	citing the overpayment, the time period in which the overpayment occurred, the amount of 
377.30 	the overpayment, and the participant's or former participant's right to appeal. No limit 
377.31 	applies to the period in which the county agency is required to recoup or recover an 
377.32 	overpayment according to subdivisions 5 and 6.
377.33 		Subd. 4.Recovering general assistance and Minnesota supplemental aid 
377.34 	overpayments. (a) If an amount of assistance is paid to an assistance unit in excess of the 
378.1 	payment due, it shall be recoverable by the agency. The agency shall give written notice to 
378.2 	the participant of its intention to recover the overpayment.
378.3 	(b) If the individual is no longer receiving assistance, the agency may request 
378.4 	voluntary repayment or pursue civil recovery.
378.5 	(c) If the individual is receiving assistance, except as provided for interim assistance 
378.6 	in section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover 
378.7 	the overpayment by withholding an amount equal to:
378.8 	(1) three percent of the assistance unit's standard of need for all Minnesota 
378.9 	supplemental aid assistance units, and nonfraud cases for general assistance; and
378.10 	(2) ten percent where fraud has occurred in general assistance cases; or
378.11 	(3) the amount of the monthly general assistance or Minnesota supplemental aid 
378.12 	payment, whichever is less.
378.13 	(d) In cases when there is both an overpayment and underpayment, the county 
378.14 	agency shall offset one against the other in correcting the payment.
378.15 	(e) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
378.16 	in addition to the assistance reductions provided in this subdivision, to include further 
378.17 	voluntary reductions in the grant level agreed to in writing by the individual, until the 
378.18 	total amount of the overpayment is repaid.
378.19 	(f) The county agency shall make reasonable efforts to recover overpayments to 
378.20 	individuals no longer on assistance. The agency need not attempt to recover overpayments 
378.21 	of less than $35 paid to an individual no longer on assistance if the individual does not 
378.22 	receive assistance again within three years, unless the individual has been convicted of 
378.23 	violating section 256.98.
378.24 	(g) Establishment of an overpayment is limited to 12 months prior to the month of 
378.25 	discovery due to agency error and six years prior to the month of discovery due to client 
378.26 	error or an intentional program violation determined under section 256.046.
378.27 	(h) Residents of licensed residential facilities shall not have overpayments recovered 
378.28 	from their personal needs allowance.
378.29 	(i) Overpayments by another maintenance benefit program shall not be recovered 
378.30 	from the general assistance or Minnesota supplemental aid grant.
378.31 		Subd. 5.Recovering MFIP overpayments. A county agency must initiate efforts to 
378.32 	recover overpayments paid to a former participant or caregiver. Caregivers, both parental 
378.33 	and nonparental, and minor caregivers of an assistance unit at the time an overpayment 
378.34 	occurs, whether receiving assistance or not, are jointly and individually liable for repayment 
378.35 	of the overpayment. The county agency must request repayment from the former 
378.36 	participants and caregivers. When an agreement for repayment is not completed within six 
379.1 	months of the date of discovery or when there is a default on an agreement for repayment 
379.2 	after six months, the county agency must initiate recovery consistent with chapter 270A or 
379.3 	section 541.05. When a person has been convicted of fraud under section 256.98, recovery 
379.4 	must be sought regardless of the amount of overpayment. When an overpayment is less 
379.5 	than $35, and is not the result of a fraud conviction under section 256.98, the county agency 
379.6 	must not seek recovery under this subdivision. The county agency must retain information 
379.7 	about all overpayments regardless of the amount. When an adult, adult caregiver, or minor 
379.8 	caregiver reapplies for assistance, the overpayment must be recouped under subdivision 6.
379.9 		Subd. 6.Recouping overpayments from MFIP participants. A participant may 
379.10 	voluntarily repay, in part or in full, an overpayment even if assistance is reduced under this 
379.11 	subdivision, until  the total amount of the overpayment is repaid. When an overpayment 
379.12 	occurs due to fraud, the county agency must recover from the overpaid assistance unit, 
379.13 	including child-only cases, ten percent of the applicable standard or the amount of the 
379.14 	monthly assistance payment, whichever is less. When a nonfraud overpayment occurs, 
379.15 	the county agency must recover from the overpaid assistance unit, including child-only 
379.16 	cases, three percent of the MFIP standard of need or the amount of the monthly assistance 
379.17 	payment, whichever is less.
379.18 		Subd. 7.Recovering automatic teller machine errors. For recipients receiving 
379.19 	benefits by electronic benefit transfer, if the overpayment is a result of an ATM dispensing 
379.20 	funds in error to the recipient, the agency may recover the ATM error by immediately 
379.21 	withdrawing funds from the recipient's electronic benefit transfer account, up to the 
379.22 	amount of the error.
379.23 		Subd. 8.Scope of underpayments. A county agency must issue a corrective 
379.24 	payment for underpayments made to a participant or to a person who would be a 
379.25 	participant if an agency or client error causing the underpayment had not occurred. 
379.26 	Corrective payments are limited to 12 months prior to the month of discovery. The county 
379.27 	agency must issue the corrective payment according to subdivision 10.
379.28 		Subd. 9.Identifying the underpayment. An underpayment may be identified by 
379.29 	a county agency, participant, former participant, or person who would be a participant 
379.30 	except for agency or client error.
379.31 		Subd. 10.Issuing corrective payments. A county agency must correct an 
379.32 	underpayment within seven calendar days after the underpayment has been identified, 
379.33 	by adding the corrective payment amount to the monthly assistance payment of the 
379.34 	participant, issuing a separate payment to a participant or former participant, or reducing 
379.35 	an existing overpayment balance. When an underpayment occurs in a payment month 
379.36 	and is not identified until the next payment month or later, the county agency must first 
380.1 	subtract the underpayment from any overpayment balance before issuing the corrective 
380.2 	payment. The county agency must not apply an underpayment in a current payment month 
380.3 	against an overpayment balance. When an underpayment in the current payment month 
380.4 	is identified, the corrective payment must be issued  within seven calendar days after the 
380.5 	underpayment is identified. Corrective payments must be excluded when determining the 
380.6 	applicant's or participant's income and resources for the month of payment. The county 
380.7 	agency must correct underpayments using the following methods:
380.8 	(1) reconstruct each affected budget month and corresponding payment month; and 
380.9 	(2) use the policies and procedures that were in effect for the payment month.
380.10 		Subd. 11.Appeals. A participant may appeal an underpayment, an overpayment, 
380.11 	and a reduction in an assistance payment made to recoup the overpayment under 
380.12 	subdivisions 4 and 6. The participant's appeal of each issue must be timely under section 
380.13 	256.045. When an appeal based on the notice issued under subdivision 3 is not timely, the 
380.14 	fact or the amount of that overpayment must not be considered as a part of a later appeal, 
380.15 	including an appeal of a reduction in an assistance payment to recoup that overpayment.

380.16 	Sec. 34.  REPEALER.
 380.17 	(a) Minnesota Statutes 2014, sections 256D.0513; 256D.06, subdivision 8; 256D.09, 
380.18 	subdivision 6; 256D.49; and 256J.38, are repealed.
380.19 	(b) Minnesota Rules, part 3400.0170, subparts 5, 6, 12, and 13, are repealed.

380.20 	Sec. 35. EFFECTIVE DATE.
 380.21 	Sections 1 to 34 are effective August 1, 2016.

380.22 	ARTICLE 13
380.23 	HUMAN SERVICES FORECAST ADJUSTMENTS

380.24	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
380.25 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted 
380.26 	from the appropriations in Laws 2013, chapter 108, article 14, as amended by Laws 2014, 
380.27 	chapter 312, article 30, from the general fund, or any other fund named, to the Department 
380.28 	of Human Services for the purposes specified in this article, to be available for the fiscal 
380.29 	years indicated for each purpose. The figure "2015" used in this article means that the 
380.30 	appropriations listed are available for the fiscal year ending June 30, 2015.

380.31
380.32	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

380.33	Subdivision 1.Total Appropriation
 	$
	(255,104,000)

381.1	Appropriations by Fund
	
381.2		2015
		
381.3	General Fund
	(125,910,000)
		
381.4	Health Care Access
	(123,113,000)
		
381.5	TANF
	(6,081,000)

381.6	Subd. 2.Forecasted Programs
 					
381.7	(a) MFIP/DWP Grants

381.8	Appropriations by Fund
	
381.9	General Fund
	(1,977,000)
		
381.10	TANF
	(7,079,000)

381.11	(b) MFIP Child Care Assistance Grants
		9,733,000

381.12	(c) General Assistance Grants
		(1,423,000)

381.13	(d) Minnesota Supplemental Aid Grants
		(1,121,000)

381.14	(e) Group Residential Housing Grants
		(6,314,000)

381.15	(f) MinnesotaCare Grants
		(75,675,000)
			
381.16 	This appropriation is from the health care 
381.17 	access fund.

381.18	(g) Medical Assistance Grants

381.19	Appropriations by Fund
	
381.20	General Fund
	(124,557,000)
		
381.21	Health Care Access
	(47,438,000)

381.22	(h) Alternative Care Grants
		0

381.23	(i) CD Entitlement Grants
		(251,000)

381.24	Subd. 3.Technical Activities
 		998,000
			
381.25 	This appropriation is from the TANF fund.

381.26 	Sec. 3. EFFECTIVE DATE.
 381.27 	Sections 1 and 2 are effective the day following final enactment.

381.28 	ARTICLE 14
381.29 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

381.30	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
382.1 	The sums shown in the columns marked "Appropriations" are appropriated to the 
382.2 	agencies and for the purposes specified in this article. The appropriations are from the 
382.3 	general fund, or another named fund, and are available for the fiscal years indicated 
382.4 	for each purpose. The figures "2016" and "2017" used in this article mean that the 
382.5 	appropriations listed under them are available for the fiscal year ending June 30, 2016, or 
382.6 	June 30, 2017, respectively. "The first year" is fiscal year 2016. "The second year" is fiscal 
382.7 	year 2017. "The biennium" is fiscal years 2016 and 2017.

382.8				APPROPRIATIONS
	
382.9				Available for the Year
	
382.10				Ending June 30
	
382.11					2016
		2017

382.12
382.13	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

382.14	Subdivision 1.Total Appropriation
 	$  
	6,780,637,000
	$  
	6,830,093,000

382.15	Appropriations by Fund
	
382.16		2016
	2017
	
382.17	General 
	5,530,299,000  
	5,953,258,000
	
382.18
382.19	State Government 
Special Revenue
	4,514,000
	4,274,000
	
382.20	Health Care Access
	969,037,000 
	599,313,000
	
382.21	Federal TANF
	274,897,000
	271,358,000
	
382.22	Lottery Prize
	1,890,000
	1,890,000
	
382.23 	Receipts for Systems Projects. 
382.24 	Appropriations and federal receipts for  
382.25 	information systems projects for MAXIS, 
382.26 	PRISM, MMIS, ISDS, and SSIS must 
382.27 	be deposited in the state systems account 
382.28 	authorized in Minnesota Statutes, section 
382.29 	256.014. Money appropriated for computer 
382.30 	projects approved by the commissioner 
382.31 	of the Office of MN.IT Services, funded 
382.32 	by the legislature, and approved by the 
382.33 	commissioner of management and budget 
382.34 	may be transferred from one project to 
382.35 	another and from development to operations 
382.36 	as the commissioner of human services 
382.37 	considers necessary. Any unexpended 
383.1 	balance in the appropriation for these 
383.2 	projects does not cancel but is available for 
383.3 	ongoing development and operations.
383.4 	Nonfederal Share Transfers. The 
383.5 	nonfederal share of activities for which 
383.6 	federal administrative reimbursement is 
383.7 	appropriated to the commissioner may be 
383.8 	transferred to the special revenue fund.
383.9 	TANF Maintenance of Effort. (a) In order 
383.10 	to meet the basic maintenance of effort 
383.11 	(MOE) requirements of the TANF block grant 
383.12 	specified under Code of Federal Regulations, 
383.13 	title 45, section 263.1, the commissioner may 
383.14 	only report nonfederal money expended for 
383.15 	allowable activities listed in the following 
383.16 	clauses as TANF/MOE expenditures:
383.17 	(1) MFIP cash, diversionary work program, 
383.18 	and food assistance benefits under Minnesota 
383.19 	Statutes, chapter 256J;
383.20 	(2) the child care assistance programs 
383.21 	under Minnesota Statutes, sections 119B.03 
383.22 	and 119B.05, and county child care 
383.23 	administrative costs under Minnesota 
383.24 	Statutes, section 119B.15;
383.25 	(3) state and county MFIP administrative 
383.26 	costs under Minnesota Statutes, chapters 
383.27 	256J and 256K;
383.28 	(4) state, county, and tribal MFIP 
383.29 	employment services under Minnesota 
383.30 	Statutes, chapters 256J and 256K;
383.31 	(5) expenditures made on behalf of legal  
383.32 	noncitizen MFIP recipients who qualify for 
383.33 	the MinnesotaCare program under Minnesota 
383.34 	Statutes, chapter 256L;
384.1 	(6) qualifying working family credit 
384.2 	expenditures under Minnesota Statutes, 
384.3 	section 290.0671; and
384.4 	(7) qualifying Minnesota education credit 
384.5 	expenditures under Minnesota Statutes, 
384.6 	section 290.0674.
384.7 	(b) The commissioner shall ensure that 
384.8 	sufficient qualified nonfederal expenditures 
384.9 	are made each year to meet the state's 
384.10 	TANF/MOE requirements. For the activities 
384.11 	listed in paragraph (a), clauses (2) to 
384.12 	(7), the commissioner may only report 
384.13 	expenditures that are excluded from the 
384.14 	definition of assistance under Code of 
384.15 	Federal Regulations, title 45, section 260.31.
384.16 	(c) For fiscal years beginning with state fiscal 
384.17 	year 2003, the commissioner shall ensure 
384.18 	that the maintenance of effort used by the 
384.19 	commissioner of management and budget 
384.20 	for the February and November forecasts 
384.21 	required under Minnesota Statutes, section 
384.22 	16A.103, contains expenditures under 
384.23 	paragraph (a), clause (1), equal to at least 16 
384.24 	percent of the total required under Code of 
384.25 	Federal Regulations, title 45, section 263.1.
384.26 	(d) The requirement in Minnesota Statutes, 
384.27 	section 256.011, subdivision 3, that federal 
384.28 	grants or aids secured or obtained under that 
384.29 	subdivision be used to reduce any direct 
384.30 	appropriations provided by law, does not 
384.31 	apply if the grants or aids are federal TANF 
384.32 	funds.
384.33 	(e) For the federal fiscal years beginning on 
384.34 	or after October 1, 2007, the commissioner 
384.35 	may not claim an amount of TANF/MOE in 
385.1 	excess of the 75 percent standard in Code 
385.2 	of Federal Regulations, title 45, section 
385.3 	263.1(a)(2), except:
385.4 	(1) to the extent necessary to meet the 80 
385.5 	percent standard under Code of Federal  
385.6 	Regulations, title 45, section 263.1(a)(1), 
385.7 	if it is determined by the commissioner 
385.8 	that the state will not meet the TANF work 
385.9 	participation target rate for the current year;
385.10 	(2) to provide any additional amounts 
385.11 	under Code of Federal Regulations, title 45, 
385.12 	section 264.5, that relate to replacement of 
385.13 	TANF funds due to the operation of TANF 
385.14 	penalties; and
385.15 	(3) to provide any additional amounts that 
385.16 	may contribute to avoiding or reducing 
385.17 	TANF work participation penalties through  
385.18 	the operation of the excess MOE provisions 
385.19 	of Code of Federal Regulations, title 45, 
385.20 	section 261.43(a)(2). 
385.21 	(f) For the purposes of paragraph (e), clauses 
385.22 	(1) to (3), the commissioner may supplement 
385.23 	the MOE claim with working family credit 
385.24 	expenditures or other qualified expenditures 
385.25 	to the extent such expenditures are otherwise 
385.26 	available after considering the expenditures 
385.27 	allowed in this subdivision.
385.28 	(g) Notwithstanding any contrary provision 
385.29 	in this article, paragraphs (a) to (f) expire 
385.30 	June 30, 2019.
385.31 	Working Family Credit Expenditure 
385.32 	as TANF/MOE. The commissioner may 
385.33 	claim as TANF maintenance of effort up to 
385.34 	$6,707,000 per year of working family credit 
385.35 	expenditures in each fiscal year.

386.1	Subd. 2.Central Office
 					
386.2 	The amounts that may be spent from this 
386.3 	appropriation for each purpose are as follows:

386.4	(a) Operations

386.5	Appropriations by Fund
	
386.6	General 
	87,842,000  
	82,809,000
	
386.7
386.8	State Government 
Special Revenue
	4,389,000
	4,149,000
	
386.9	Health Care Access
	12,826,000
	12,841,000
	
386.10	Federal TANF
	100,000
	100,000
	
386.11 	Administrative Recovery; Set-Aside. The 
386.12 	commissioner may invoice local entities 
386.13 	through the SWIFT accounting system as an 
386.14 	alternative means to recover the actual cost 
386.15 	of administering the following provisions:
386.16 	(1) Minnesota Statutes, section 125A.744, 
386.17 	subdivision 3;
386.18 	(2) Minnesota Statutes, section 245.495, 
386.19 	paragraph (b);
386.20 	(3) Minnesota Statutes, section 256B.0625, 
386.21 	subdivision 20, paragraph (k);
386.22 	(4) Minnesota Statutes, section 256B.0924, 
386.23 	subdivision 6, paragraph (g);
386.24 	(5) Minnesota Statutes, section 256B.0945, 
386.25 	subdivision 4, paragraph (d); and
386.26 	(6) Minnesota Statutes, section 256F.10, 
386.27 	subdivision 6, paragraph (b).
386.28 	IT Appropriations Generally. This 
386.29 	appropriation includes funds for information 
386.30 	technology projects, services, and support. 
386.31 	Notwithstanding  Minnesota Statutes, 
386.32 	section 16E.0466, funding for information 
386.33 	technology project costs shall be incorporated 
386.34 	into the service level agreement and paid 
387.1 	to the Office of MN.IT Services by the 
387.2 	Department of Human Services under 
387.3 	the rates and mechanism specified in that 
387.4 	agreement.

387.5	(b) Children and Families

387.6	Appropriations by Fund
	
387.7	General 
	8,476,000  
	8,267,000
	
387.8	Federal TANF
	2,582,000
	2,582,000
	
387.9 	Financial Institution Data Match and 
387.10 	Payment of Fees. The commissioner is 
387.11 	authorized to allocate up to $310,000 each 
387.12 	year in fiscal year 2016 and fiscal year 
387.13 	2017 from the PRISM special revenue 
387.14 	account to make payments to financial 
387.15 	institutions in exchange for performing 
387.16 	data matches between account information 
387.17 	held by financial institutions and the public 
387.18 	authority's database of child support obligors 
387.19 	as authorized by Minnesota Statutes, section 
387.20 	13B.06, subdivision 7.
387.21 	Child Support Work Group. $12,000 in 
387.22 	fiscal year 2016 is from the general fund for 
387.23 	facilitation of the duties of the child support 
387.24 	work group.
387.25 	Stearns County Veterans Housing. $85,000 
387.26 	in fiscal year 2016 and $85,000 in fiscal year 
387.27 	2017 are from the general fund for a grant 
387.28 	to Stearns County to provide administrative 
387.29 	funding in support of a service provider 
387.30 	serving veterans in Stearns County. The 
387.31 	administrative funding grant may be used to 
387.32 	support group residential housing services, 
387.33 	corrections-related services, veteran services, 
387.34 	and other social services related to the service 
388.1 	provider serving veterans in Stearns County. 
388.2 	This is a onetime appropriation.

388.3	(c) Health Care

388.4	Appropriations by Fund
	
388.5	General 
	15,932,000  
	20,036,000
	
388.6	Health Care Access
	24,764,000
	24,122,000

388.7	(d) Continuing Care

388.8	Appropriations by Fund
	
388.9	General
	27,585,000 
	25,786,000
	
388.10
388.11	State Government 
Special Revenue
	125,000
	125,000
	
388.12 	Nursing Facilities. $890,000 in fiscal year 
388.13 	2016 is from the general fund for the nursing 
388.14 	facility property rate setting appraisals and 
388.15 	study. This is a onetime appropriation.

388.16	(e) Chemical and Mental Health

388.17	Appropriations by Fund
	
388.18	General 
	4,895,000 
	5,095,000
	
388.19	Lottery Prize
	157,000
	157,000

388.20	Subd. 3.Forecasted Programs
 					
388.21 	The amounts that may be spent from this 
388.22 	appropriation for each purpose are as follows:

388.23	(a) MFIP/DWP

388.24	Appropriations by Fund
	
388.25	General
	82,355,000
	86,086,000
	
388.26	Federal TANF
	93,093,000
	88,798,000

388.27	(b) MFIP Child Care Assistance 
		98,920,000 
		105,921,000

388.28	(c) General Assistance
		55,117,000
		57,847,000
	
388.29 	General Assistance Standard. The 
388.30 	commissioner shall set the monthly standard 
388.31 	of assistance for general assistance units 
388.32 	consisting of an adult recipient who is 
388.33 	childless and unmarried or living apart 
388.34 	from parents or a legal guardian at $203. 
389.1 	The commissioner may reduce this amount 
389.2 	according to Laws 1997, chapter 85, article 
389.3 	3, section 54.
389.4 	Emergency General Assistance. The 
389.5 	amount appropriated for emergency 
389.6 	general assistance is limited to no more 
389.7 	than $6,729,812 in fiscal year 2016 and 
389.8 	$6,729,812 in fiscal year 2017. Funds 
389.9 	to counties shall be allocated by the 
389.10 	commissioner using the allocation method 
389.11 	under Minnesota Statutes, section 256D.06.

389.12	(d) Minnesota Supplemental Aid
		39,668,000
		41,169,000

389.13	(e) Group Residential Housing 
		155,753,000 
		167,194,000

389.14	(f) Northstar Care for Children
		41,096,000
		46,336,000

389.15	(g) MinnesotaCare 
		234,982,000 
		20,854,000
	
389.16 	This appropriation is from the health care 
389.17 	access fund.

389.18	(h) Medical Assistance

389.19	Appropriations by Fund
	
389.20	General 
	4,180,159,000  
	4,565,620,000
	
389.21	Health Care Access 
	692,374,000 
	537,281,000
	
389.22 	Contingent Rate Reductions. If the 
389.23 	commissioner determines that contract 
389.24 	negotiations to reduce managed care and 
389.25 	county-based purchasing plan administrative 
389.26 	costs, and implementation of statewide 
389.27 	competitive bidding, will not achieve a state 
389.28 	general fund savings of $150,000,000 for 
389.29 	the biennium beginning July 1, 2015, the 
389.30 	commissioner shall calculate an estimate 
389.31 	of the shortfall in savings, and, for the 
389.32 	fiscal year beginning July 1, 2016, shall 
389.33 	reduce medical assistance provider payment 
389.34 	rates, including but not limited to rates to 
390.1 	individual health care providers and provider 
390.2 	agencies, hospitals, other residential settings, 
390.3 	and capitation rates provided to managed 
390.4 	care and county-based purchasing plans, but 
390.5 	excluding nursing facilities, by the amount 
390.6 	necessary to recoup the shortfall in savings 
390.7 	over that fiscal year.
390.8 	Base Adjustment. The health care 
390.9 	access fund base for medical assistance 
390.10 	is $476,236,000 in fiscal year 2018 and 
390.11 	$275,118,000 in fiscal year 2019.

390.12	(i) Alternative Care 
		42,704,000 
		43,421,000
	
390.13 	Alternative Care Transfer. Any money 
390.14 	allocated to the alternative care program  that 
390.15 	is not spent for the purposes indicated does 
390.16 	not cancel but must be transferred to the 
390.17 	medical assistance account.

390.18	(j) Chemical Dependency Treatment Fund 
		81,863,000 
		85,660,000

390.19	Subd. 4.Grant Programs
 					
390.20 	The amounts that may be spent from this 
390.21 	appropriation for each purpose are as follows:

390.22	(a) Support Services Grants

390.23	Appropriations by Fund
	
390.24	General
	13,133,000
	8,715,000
	
390.25	Federal TANF
	96,311,000
	96,311,000

390.26
390.27	(b) Basic Sliding Fee Child Care Assistance 
Grants 
		44,318,000 
		47,518,000

390.28	(c) Child Care Development Grants
		1,737,000
		1,737,000

390.29	(d) Child Support Enforcement Grants
		50,000
		50,000

390.30	(e) Children's Services Grants

390.31	Appropriations by Fund
	
390.32	General 
	39,015,000 
	38,665,000
	
390.33	Federal TANF
	140,000
	140,000
	
391.1 	Safe Place for Newborns. $350,000 in 
391.2 	fiscal year 2016 is from the general fund to 
391.3 	distribute information on the Safe Place for 
391.4 	Newborns law in Minnesota. The purpose 
391.5 	of this appropriation is to increase public 
391.6 	awareness of the law.
391.7 	Title IV-E Adoption Assistance. Additional 
391.8 	federal reimbursement to the state as a result 
391.9 	of the Fostering Connections to Success 
391.10 	and Increasing Adoptions Act's expanded 
391.11 	eligibility for title IV-E adoption assistance 
391.12 	is appropriated to the commissioner 
391.13 	for postadoption services, including a 
391.14 	parent-to-parent support network.
391.15 	Adoption Assistance Incentive Grants. 
391.16 	Federal funds available during fiscal years 
391.17 	2016 and 2017 for adoption incentive grants 
391.18 	are appropriated to the commissioner for 
391.19 	these purposes.

391.20	(f) Children and Community Service Grants
		56,301,000
		56,301,000

391.21	(g) Children and Economic Support Grants
		25,281,000
		25,291,000
	
391.22 	Homeless Youth Act. $2,000,000 in fiscal 
391.23 	year 2016 and $2,000,000 in fiscal year 2017 
391.24 	are from the general fund for purposes of 
391.25 	Minnesota Statutes, section 256K.45.
391.26 	Mobile Food Shelf Grants. (a) $1,000,000 
391.27 	in fiscal year 2016 and $1,000,000 in fiscal 
391.28 	year 2017 are from the general fund for 
391.29 	transfer to Hunger Solutions. This is a 
391.30 	onetime appropriation and is available until 
391.31 	June 30, 2017.
391.32 	(b) Hunger Solutions shall award grants of 
391.33 	up to $75,000 on a competitive basis. Grant 
391.34 	applications must include:
392.1 	(1) the location of the project;
392.2 	(2) a description of the mobile program, 
392.3 	including size and scope;
392.4 	(3) evidence regarding the unserved or 
392.5 	underserved nature of the community in 
392.6 	which the project is to be located;
392.7 	(4) evidence of community support for the 
392.8 	project;
392.9 	(5) the total cost of the project;
392.10 	(6) the amount of the grant request and how 
392.11 	funds will be used;
392.12 	(7) sources of funding or in-kind 
392.13 	contributions for the project that will 
392.14 	supplement any grant award; 
392.15 	(8) a commitment to mobile programs by the 
392.16 	applicant and an ongoing commitment to 
392.17 	maintain the mobile program; and
392.18 	(9) any additional information requested by 
392.19 	Hunger Solutions.
392.20 	(c) Priority may be given to applicants who:
392.21 	(1) serve underserved areas;
392.22 	(2) create a new or expand an existing mobile 
392.23 	program;
392.24 	(3) serve areas where a high amount of need 
392.25 	is identified;
392.26 	(4) provide evidence of strong support for the 
392.27 	project from citizens and other institutions in 
392.28 	the community;
392.29 	(5) leverage funding for the project from 
392.30 	other private and public sources; and
392.31 	(6) commit to maintaining the program on a 
392.32 	multilayer basis.
393.1 	Safe Harbor. (a) $1,000,000 in fiscal year 
393.2 	2016 and $1,000,000 in fiscal year 2017 are 
393.3 	from the general fund for emergency shelter 
393.4 	and transitional and long-term housing beds 
393.5 	for sexually exploited youth and youth at risk 
393.6 	of sexual exploitation.
393.7 	(b) $150,000 in fiscal year 2016 and 
393.8 	$150,000 in fiscal year 2017 are from the 
393.9 	general fund for statewide youth outreach 
393.10 	workers connecting sexually exploited youth 
393.11 	and youth at risk of sexual exploitation with 
393.12 	shelter and services.
393.13 	Minnesota Food Assistance Program. 
393.14 	Unexpended funds for the Minnesota food 
393.15 	assistance program for fiscal year 2016 do 
393.16 	not cancel but are available for this purpose 
393.17 	in fiscal year 2017.

393.18	(h) Health Care Grants

393.19	Appropriations by Fund
	
393.20	General
	410,000
	410,000
	
393.21	Health Care Access
	3,341,000
	3,465,000

393.22	(i) Other Long-Term Grants
		1,551,000 
		3,069,000

393.23	(j) Aging and Adult Services Grants
		28,463,000
		29,407,000
	
393.24 	Dementia Grants.  $750,000 in fiscal year 
393.25 	2016 and $750,000 in fiscal year 2017 are 
393.26 	from the general fund for the Minnesota 
393.27 	Board on Aging for regional and local 
393.28 	dementia grants authorized in Minnesota 
393.29 	Statutes, section 256.975, subdivision 11. 
393.30 	This amount shall be added to the base. Up 
393.31 	to one percent of each appropriation may be 
393.32 	used by the board to administer the regional 
393.33 	and local dementia grants.

393.34	(k) Deaf and Hard-of-Hearing Grants
		2,875,000
		2,961,000
	
394.1 	Deaf and Hard-of-Hearing Services 
394.2 	Division. $650,000 in fiscal year 2016 
394.3 	and $500,000 in fiscal year 2017 are 
394.4 	from the general fund for the Deaf and 
394.5 	Hard-of-Hearing Services Division under 
394.6 	Minnesota Statutes, 256C.233. This 
394.7 	appropriation is added to the base. The funds 
394.8 	must be used:
394.9 	(1) to provide linguistically and culturally 
394.10 	appropriate mental health services;
394.11 	(2) to ensure that each regional advisory 
394.12 	committee meets at least quarterly;
394.13 	(3) to increase the number of deafblind 
394.14 	Minnesotans receiving services;
394.15 	(4) to conduct an analysis of how the regional 
394.16 	offices and staff are operated, in consultation 
394.17 	with the Commission of Deaf, DeafBlind, 
394.18 	and Hard of Hearing Minnesotans;
394.19 	(5) during fiscal year 2016, to provide direct 
394.20 	services to clients and purchase additional 
394.21 	technology for the technology labs; and
394.22 	(6) to conduct an analysis of whether 
394.23 	deafblind services are being provided in the 
394.24 	best and most efficient way possible, with 
394.25 	input from deafblind Minnesotans receiving 
394.26 	services.
394.27 	Grants. $350,000 in fiscal year 2016 and 
394.28 	$500,000 in fiscal year 2017 are from the 
394.29 	general fund for deaf and hard-of-hearing 
394.30 	grants. The funds must be used to increase the 
394.31 	number of deafblind Minnesotans receiving 
394.32 	services under Minnesota Statutes, section 
394.33 	256C.261, and to provide linguistically and 
394.34 	culturally appropriate mental health services 
395.1 	to children who are deaf, deafblind, and 
395.2 	hard-of-hearing.

395.3	(l) Disabilities Grants
		20,647,000
		22,045,000

395.4	(m) Adult Mental Health Grants

395.5	Appropriations by Fund
	
395.6	General
	71,042,000
	71,542,000
	
395.7	Health Care Access
	750,000
	750,000
	
395.8	Lottery Prize
	1,733,000
	1,733,000
	
395.9 	Funding Usage. Up to 75 percent of a fiscal 
395.10 	year's appropriation for adult mental health 
395.11 	grants may be used to fund allocations in that 
395.12 	portion of the fiscal year ending December 
395.13 	31.
395.14 	Comprehensive Mental Health Center. 
395.15 	$1,500,000 for the 2016-2017 biennium is 
395.16 	from the general fund for a grant to Beltrami 
395.17 	County to fund the planning and development 
395.18 	of a comprehensive mental health center.
395.19 	Problem Gambling. $225,000 in fiscal year 
395.20 	2016 and $225,000 in fiscal year 2017 are 
395.21 	from the lottery prize fund for a grant to the 
395.22 	state affiliate  recognized by the National 
395.23 	Council on  Problem Gambling. The affiliate 
395.24 	must  provide services to increase public 
395.25 	awareness of problem gambling, education, 
395.26 	and training for individuals and organizations 
395.27 	providing effective treatment services to 
395.28 	problem gamblers and their families, and 
395.29 	research related to problem gambling.

395.30	(n) Child Mental Health Grants
		23,136,000
		23,963,000
	
395.31 	Funding Usage. Up to 75 percent of a fiscal 
395.32 	year's appropriation for child mental health 
395.33 	grants may be used to fund allocations in that 
396.1 	portion of the fiscal year ending December 
396.2 	31.
396.3 	Special Projects. (a) $600,000 in fiscal year 
396.4 	2016 and $500,000 in fiscal year 2017 are 
396.5 	from the general fund to fund special projects 
396.6 	to provide intensive treatment and supports 
396.7 	to adolescents and young adults who are 
396.8 	experiencing their first psychotic or manic 
396.9 	episode. Projects must utilize all available 
396.10 	funding streams.
396.11 	(b) Of the fiscal year 2016 appropriation, 
396.12 	$100,000 must be used by the special projects 
396.13 	to conduct outreach, training, and guidance. 
396.14 	This money is available until spent.
396.15 	Chemical Dependency Prevention. 
396.16 	$150,000 in fiscal year 2016 and $150,000 in 
396.17 	fiscal year 2017 are from the general fund for 
396.18 	grants to nonprofit organizations to provide 
396.19 	chemical dependency prevention programs 
396.20 	in secondary schools. When making 
396.21 	grants, the commissioner must consider the 
396.22 	expertise, prior experience, and outcomes 
396.23 	achieved by applicants that have provided 
396.24 	prevention programming in secondary 
396.25 	education environments. An applicant for the 
396.26 	grant funds must provide verification to the 
396.27 	commissioner that the applicant has available 
396.28 	and will contribute sufficient funds to match 
396.29 	the grant given by the commissioner. Unspent 
396.30 	funds cancel at the end of each fiscal year.

396.31
396.32	(o) Chemical Dependency Treatment Support 
Grants
		1,161,000
		1,161,000

396.33	Subd. 5.DCT State-Operated Services
 					
396.34 	Transfer Authority for State-Operated 
396.35 	Services. Money appropriated for 
397.1 	state-operated services may be transferred 
397.2 	between fiscal years of the biennium 
397.3 	with the approval of the commissioner of 
397.4 	management and budget.
397.5 	The amounts that may be spent from the 
397.6 	appropriation for each purpose are as follows:

397.7
397.8	(a) DCT State-Operated Services Mental 
Health
		124,319,000
		124,290,000
	
397.9 	Dedicated Receipts Available. Of the 
397.10 	revenue received under Minnesota Statutes, 
397.11 	section 246.18, subdivision 8, paragraph 
397.12 	(a), up to $1,000,000 each year is available 
397.13 	for the purposes of Minnesota Statutes, 
397.14 	section 246.18, subdivision 8, paragraph 
397.15 	(b), clause (1); up to $1,000,000 each year 
397.16 	is available to transfer to the adult mental 
397.17 	health grants budget activity for the purposes 
397.18 	of Minnesota Statutes, section 246.18, 
397.19 	subdivision 8, paragraph (b), clause (2); and 
397.20 	up to $2,713,000 each year is available for 
397.21 	the purposes of Minnesota Statutes, section 
397.22 	246.18, subdivision 8, paragraph (b), clause 
397.23 	(3).

397.24
397.25	(b) DCT State-Operated Services Enterprise 
Services
		-0-
		385,000

397.26
397.27	(c) DCT State-Operated Services Minnesota 
Security Hospital
		74,750,000
		74,756,000

397.28
397.29	Subd. 6.DCT Minnesota Sex Offender 
Program
 		79,745,000
		79,745,000
	
397.30 	Transfer Authority for Minnesota Sex 
397.31 	Offender Program. Money appropriated 
397.32 	for  the Minnesota sex offender program 
397.33 	may be transferred between fiscal years 
397.34 	of the biennium with the approval of the 
397.35 	commissioner of management and budget.

398.1	Subd. 7.Technical Activities
 		82,671,000
		83,427,000
	
398.2 	This appropriation is from the federal TANF 
398.3 	fund.

398.4	Sec. 3. COMMISSIONER OF HEALTH

398.5	Subdivision 1.Total Appropriation
 	$  
	156,186,000
	$  
	154,326,000

398.6	Appropriations by Fund
	
398.7		2016
	2017
	
398.8	General 
	89,351,000  
	88,078,000
	
398.9398.10
	State Government 
Special Revenue
	51,706,000
	51,719,000
	
398.11	Health Care Access
	11,243,000
	10,643,000
	
398.12	Federal TANF
	3,886,000
	3,886,000
	
398.13 	The amounts that may be spent for each 
398.14 	purpose are specified in the following 
398.15 	subdivisions.

398.16	Subd. 2.Health Improvement

398.17	Appropriations by Fund
	
398.18	General 
	70,012,000 
	68,747,000
	
398.19
398.20	State Government 
Special Revenue
	6,177,000
	6,072,000
	
398.21	Health Care Access
	11,243,000
	10,643,000
	
398.22	Federal TANF
	3,886,000
	3,886,000
	
398.23 	(a) $250,000 in the biennium ending June 
398.24 	30, 2017, is from the general fund to 
398.25 	award a grant to a statewide advance care 
398.26 	planning resource organization that has 
398.27 	expertise in convening and coordinating 
398.28 	community-based strategies to encourage 
398.29 	individuals, families, caregivers, and health 
398.30 	care providers to begin conversations 
398.31 	regarding end-of-life care choices that 
398.32 	express an individual's health care values 
398.33 	and preferences and are based on informed 
398.34 	health care decisions. This is a onetime 
398.35 	appropriation.
399.1 	(b) $200,000 in fiscal year 2016 is from the 
399.2 	general fund to provide a grant to the Leech 
399.3 	Lake Band of Ojibwe ambulance service for 
399.4 	equipment upgrades.
399.5 	(c) $800,000 in fiscal year 2016 and $800,000 
399.6 	in fiscal year 2017 are from the general fund 
399.7 	for regional poison information centers under 
399.8 	Minnesota Statutes, section 145.93. This 
399.9 	appropriation is added to the base.
399.10 	(d) $1,000,000 in fiscal year 2016 and 
399.11 	$1,000,000 in fiscal year 2017 are from the 
399.12 	general fund to provide subsidies to federally 
399.13 	qualified health centers under Minnesota 
399.14 	Statutes, section 145.9269. This is a onetime 
399.15 	appropriation.
399.16 	(e) $350,000 in fiscal year 2016 and $350,000 
399.17 	in fiscal year 2017 are from the general fund 
399.18 	for the Minnesota stroke system under the 
399.19 	heart disease and stroke prevention unit 
399.20 	under the Department of Health.
399.21 	(f) $500,000 in fiscal year 2016 and $500,000 
399.22 	in fiscal year 2017 are from the general fund 
399.23 	for the Smile Healthy Minnesota 2016 grant 
399.24 	program under Minnesota Statutes, section 
399.25 	145.9299. The appropriation is available 
399.26 	until expended.
399.27 	(g) $200,000 in fiscal year 2016 is from the 
399.28 	general fund for the purposes of establishing 
399.29 	a grant program used to develop and create 
399.30 	culturally appropriate outreach programs that 
399.31 	provide education about the importance of 
399.32 	organ donation. Grants shall be awarded to 
399.33 	a federally designated organ procurement 
399.34 	organization and hospital system that 
400.1 	performs transplants. This is a onetime 
400.2 	appropriation.
400.3 	(h) $6,500,000 in fiscal year 2016 and 
400.4 	$6,500,000 in fiscal year 2017 are from the 
400.5 	general fund for the purposes of the primary 
400.6 	care residency expansion grant program 
400.7 	under Minnesota Statutes, section 144.1506.
400.8 	(i) $250,000 in fiscal year 2016 is from the 
400.9 	general fund for a grant to a community 
400.10 	health center to partner with a nonprofit 
400.11 	organization that helps Somali women, for 
400.12 	the community health center and nonprofit 
400.13 	organization to do the following:
400.14 	(1) choose a primary care physician;
400.15 	(2) provide high quality, compassionate, and 
400.16 	ethically sound health care services to all;
400.17 	(3) engage in dialogue with patients to 
400.18 	determine their care expectations;
400.19 	(4) counsel patients regarding the benefits of 
400.20 	preventative health care and early screening, 
400.21 	intervention, and treatment; and
400.22 	(5) advocate for increased public awareness 
400.23 	of the benefits of preventative health care 
400.24 	and early screening and intervention.
400.25 	The community health center shall report 
400.26 	the progress of the nonprofit organization to 
400.27 	the commissioner by July 1, 2016. This is a 
400.28 	onetime appropriation.
400.29 	(j) $270,000 in fiscal year 2016 and $20,000 
400.30 	in fiscal year 2017 are from the general fund 
400.31 	to the commissioner of health for grants to 
400.32 	educate emergency medical services persons 
400.33 	on the use of an opiate antagonist in the event 
400.34 	of an opioid of heroin overdose. The funding 
401.1 	must be distributed proportionately to the 
401.2 	eight regional emergency medical services 
401.3 	programs based on the need of the regions, 
401.4 	as determined by the commissioner by using 
401.5 	existing data. The regional emergency 
401.6 	medical services programs must submit an 
401.7 	application for a grant to the commissioner 
401.8 	by September 1, 2015. This is a onetime 
401.9 	appropriation.
401.10 	(k) $1,500,000 in fiscal year 2016 and 
401.11 	$1,500,000 in fiscal year 2017 are from the 
401.12 	general fund for the purposes of the home 
401.13 	and community-based services employee 
401.14 	scholarship program under Minnesota 
401.15 	Statutes, section 144.1503.
401.16 	TANF Appropriations. (a) $1,156,000 of 
401.17 	the TANF funds is appropriated each year of 
401.18 	the biennium to the commissioner for family 
401.19 	planning grants under Minnesota Statutes, 
401.20 	section 145.925.
401.21 	(b) $2,000,000 of the TANF funds is 
401.22 	appropriated each year of the biennium to 
401.23 	the commissioner for decreasing racial and 
401.24 	ethnic disparities in infant mortality rates 
401.25 	under Minnesota Statutes, section 145.928, 
401.26 	subdivision 7.
401.27 	(c) The commissioner may use up to 6.23 
401.28 	percent of the funds appropriated each fiscal 
401.29 	year to conduct the ongoing evaluations 
401.30 	required under Minnesota Statutes, section 
401.31 	145A.17, subdivision 7, and training and 
401.32 	technical assistance as required under 
401.33 	Minnesota Statutes, section 145A.17, 
401.34 	subdivisions 4 and 5.
402.1 	TANF Carryforward. Any unexpended  
402.2 	balance of the TANF appropriation in the 
402.3 	first year of the biennium does not cancel but 
402.4 	is available for the second year.

402.5	Subd. 3.Health Protection

402.6	Appropriations by Fund
	
402.7	General
	12,381,000
	12,381,000
	
402.8
402.9	State Government 
Special Revenue
	45,529,000
	45,647,000

402.10	Subd. 4.Administrative Support Services
 		6,958,000
		6,950,000

402.11	Sec. 4. HEALTH-RELATED BOARDS

402.12	Subdivision 1.Total Appropriation
 	$
	19,707,000
	$
	19,597,000
	
402.13 	This appropriation is from the state 
402.14 	government special revenue fund. The 
402.15 	amounts that may be spent for each purpose 
402.16 	are specified in the following subdivisions.

402.17	Subd. 2.Board of Chiropractic Examiners
 		507,000
		513,000

402.18	Subd. 3.Board of Dentistry
 		2,192,000
		2,206,000
	
402.19 	This appropriation includes $864,000 in fiscal 
402.20 	year 2016 and $878,000 in fiscal year 2017 
402.21 	for the health professional services program.

402.22
402.23	Subd. 4.Board of Dietetics and Nutrition 
Practice
 		113,000
		115,000

402.24
402.25	Subd. 5.Board of Marriage and Family 
Therapy
 		234,000
		237,000

402.26	Subd. 6.Board of Medical Practice
 		3,933,000
		3,962,000

402.27	Subd. 7.Board of Nursing
 		4,189,000
		4,243,000

402.28
402.29	Subd. 8.Board of Nursing Home 
Administrators
 		2,365,000
		2,062,000
	
402.30 	Administrative Services Unit - Operating 
402.31 	Costs. Of this appropriation, $1,482,000 
402.32 	in fiscal year 2016 and $1,497,000 in 
402.33 	fiscal year 2017 are for operating costs 
403.1 	of the administrative services unit. The 
403.2 	administrative services unit may receive 
403.3 	and expend reimbursements for services 
403.4 	performed by other agencies.
403.5 	Administrative Services Unit - Volunteer 
403.6 	Health Care Provider Program. Of this 
403.7 	appropriation, $150,000 in fiscal year 2016 
403.8 	and $150,000 in fiscal year 2017 are to pay 
403.9 	for medical professional liability coverage 
403.10 	required under Minnesota Statutes, section 
403.11 	214.40.
403.12 	Administrative Services Unit - Retirement 
403.13 	Costs. Of this appropriation, $320,000 in 
403.14 	fiscal year 2016 is a onetime appropriation 
403.15 	to the administrative services unit to pay for 
403.16 	the retirement costs of health-related board 
403.17 	employees. This funding may be transferred 
403.18 	to the health board incurring the retirement 
403.19 	costs. These funds are available either year 
403.20 	of the biennium.
403.21 	Administrative Services Unit - Contested 
403.22 	Cases and Other Legal Proceedings. Of 
403.23 	this appropriation, $200,000 in fiscal year 
403.24 	2016 and $200,000 in fiscal year 2017 are 
403.25 	for costs of contested case hearings and other 
403.26 	unanticipated costs of legal proceedings 
403.27 	involving health-related boards funded 
403.28 	under this section. Upon certification by a 
403.29 	health-related board to the administrative 
403.30 	services unit that the costs will be incurred 
403.31 	and that there is insufficient money available 
403.32 	to pay for the costs out of money currently 
403.33 	available to that board, the administrative 
403.34 	services unit is authorized to transfer money 
403.35 	from this appropriation to the board for 
404.1 	payment of those costs with the approval 
404.2 	of the commissioner of management and 
404.3 	budget.

404.4	Subd. 9.Board of Optometry
 		138,000
		143,000

404.5	Subd. 10.Board of Pharmacy
 		2,847,000
		2,888,000

404.6	Subd. 11.Board of Physical Therapy
 		354,000
		359,000

404.7	Subd. 12.Board of Podiatry
 		78,000
		79,000

404.8	Subd. 13.Board of Psychology
 		874,000
		884,000

404.9	Subd. 14.Board of Social Work
 		1,141,000
		1,155,000

404.10	Subd. 15.Board of Veterinary Medicine
 		262,000
		265,000

404.11
404.12	Subd. 16.Board of Behavioral Health and 
Therapy
 		480,000
		486,000

404.13
404.14	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	2,773,000
	$
	2,772,000
	
404.15 	Regional Grants. $585,000 in fiscal year 
404.16 	2016 and $585,000 in fiscal year 2017 are 
404.17 	for regional emergency medical services 
404.18 	programs, to be distributed equally to the 
404.19 	eight emergency medical service regions.
404.20 	Cooper/Sams Volunteer Ambulance 
404.21 	Program. (a) $700,000 in fiscal year 2016 
404.22 	and $700,000 in fiscal year 2017 are for the 
404.23 	Cooper/Sams volunteer ambulance program 
404.24 	under Minnesota Statutes, section 144E.40.
404.25 	(b) Of this amount, $611,000 in fiscal year  
404.26 	2016 and $611,000 in fiscal year 2017 
404.27 	are for the ambulance service personnel 
404.28 	longevity award and incentive program under 
404.29 	Minnesota Statutes, section 144E.40.
404.30 	(c) Of this amount, $89,000 in fiscal year 
404.31 	2016 and $89,000 in fiscal year 2017 are 
404.32 	for the operations of the ambulance service 
404.33 	personnel longevity award and incentive 
405.1 	program under Minnesota Statutes, section 
405.2 	144E.40.
405.3 	Ambulance Training Grants. $361,000 in 
405.4 	fiscal year 2016 and $361,000 in fiscal year 
405.5 	2017 are for training grants.
405.6 	EMSRB Board Operations. $1,095,000 in 
405.7 	fiscal year 2016 and $1,095,000 in fiscal year 
405.8 	2017 are for board operations.

405.9	Sec. 6. COUNCIL ON DISABILITY
 	$
	795,000
	$
	761,000
	
405.10 	(a) $69,000 each fiscal year is for one 
405.11 	full-time equivalent to coordinate the 
405.12 	Minnesota State Council on Disability's 
405.13 	communication with the disability 
405.14 	community.
405.15 	(b) $78,000 in fiscal years 2016 and 2017 is 
405.16 	from the general fund to provide consultation 
405.17 	services to state agencies, developers, and 
405.18 	the public regarding compliance with the 
405.19 	State Building Code and the Americans with 
405.20 	Disabilities Act.
405.21 	(c) $30,000 in fiscal year 2016 is for a 
405.22 	computer system upgrade and installation 
405.23 	to track agency performance and services 
405.24 	provided to the public.

405.25
405.26
405.27	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$ 
	1,829,000
	$
	1,854,000

405.28	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	334,000
	$
	334,000

405.29	Sec. 9. COMMISSIONER OF COMMERCE
 	$
	210,000
	$
	213,000
	
405.30 	The commissioner of commerce shall 
405.31 	use existing grants issued by the federal 
405.32 	government for the exchange to establish 
406.1 	a federally facilitated exchange as required 
406.2 	under article 3, section 24.

406.3 	Sec. 10. APPROPRIATION.
 406.4 	$196,000,000 is appropriated in fiscal year 2015 from the general fund to the 
406.5 	commissioner of human services for transfer to the health care access fund. These funds 
406.6 	do not cancel until June 30, 2017. Notwithstanding any law to the contrary, these funds 
406.7 	are not subject to transfer. 

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

406.9 	Sec. 11. Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision 
406.10 	to read:
406.11 		Subd. 40.Nonfederal share transfers. The nonfederal share of activities for 
406.12 	which federal administrative reimbursement is appropriated to the commissioner may 
406.13 	be transferred to the special revenue fund.

406.14 	Sec. 12. TRANSFERS.
 406.15 		Subdivision 1.Grants. The commissioner of human services, with the approval of 
406.16 	the commissioner of management and budget, may transfer unencumbered appropriation 
406.17 	balances for the biennium ending June 30, 2017, within fiscal years among the MFIP, 
406.18 	general assistance, general assistance medical care under Minnesota Statutes 2009 
406.19 	Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP 
406.20 	child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental 
406.21 	aid, and group residential housing programs, the entitlement portion of Northstar Care 
406.22 	for Children under Minnesota Statutes, chapter 256N, and the entitlement portion of 
406.23 	the chemical dependency consolidated treatment fund, and between fiscal years of the 
406.24 	biennium. The commissioner shall inform the chairs and ranking minority members of 
406.25 	the senate Health and Human Services Finance Division and the house of representatives 
406.26 	Health and Human Services Finance Committee quarterly about transfers made under 
406.27 	this subdivision.
406.28 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
406.29 	money may be transferred within the Departments of Health and Human Services as the 
406.30 	commissioners consider necessary, with the advance approval of the commissioner of 
406.31 	management and budget. The commissioner shall inform the chairs and ranking minority 
406.32 	members of the senate Health and Human Services Finance Division and the house of 
407.1 	representatives Health and Human Services Finance Committee quarterly about transfers 
407.2 	made under this subdivision.

407.3 	Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
 407.4 	The commissioners of health and human services shall not use indirect cost 
407.5 	allocations to pay for the operational costs of any program for which they are responsible.

407.6 	Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
 407.7 	All uncodified language contained in this article expires on June 30, 2017, unless a 
407.8 	different expiration date is explicit.

407.9 	Sec. 15. EFFECTIVE DATE.
 407.10 	This article is effective July 1, 2015, unless a different effective date is specified.