3E Relating to the state health and human services budgets;

ARTICLE 1 - CHILDREN AND FAMILY SERVICES

Modifying child care programs, human services background studies, compliance, the public assistance definition, community social services family assets for independence, group residential housing, the Minnesota family investment program (MFIP), the homeless youth act, Northstar care for children, recognition of parentage, adoption assistance, juvenile safety and placement, child and medical support, the uniform interstate family support act, and minor maltreatment reporting; requiring employees with child protection duties to have a background study and providing for funding; requiring the commissioner of human services (DHS) to establish a child fatality and near fatality review team; providing child protection grants to address child welfare disparities; providing a child protection grant allocation; modifying foster care requirements; making conforming changes; requiring consumer reporting for arrears; requiring a group residential housing report on program improvement requirements; establishing a child support work group; requiring the commissioner to update the child maltreatment screening guidelines, provide training to child protection supervisors, and develop a new child protection distribution formula; establishing a legislative task force for child protection

ARTICLE 2 - CHEMICAL AND MENTAL HEALTH SERVICES

Providing for the sharing of human services welfare system mental health data with health care systems; modifying adult mental health services pilot projects, the adult mental health act, children's mental health grants, civil commitment, and chemical dependency treatment; modifying medical assistance (MA) mental health certified peer specialist, intensive rehabilitative mental health services, adult crisis response services, and covered services; establishing an excellence in mental health demonstration project; modifying provisions related to individuals who are committed as mentally ill and dangerous to the public; imposing certain duties on the special review board and the head of the treatment facility; increasing chemical dependency provider rates; requiring the commissioner of human services (DHS) to develop Clubhouse program services standards and a payment methodology, report on excellence in mental health demonstration project progress, conduct a comprehensive analysis of community-based mental health services rate-setting methodology, and report on human services data sharing; providing a contingent comprehensive mental health program in Beltrami county

ARTICLE 3 - WITHDRAWAL MANAGEMENT PROGRAMS

Establishing purpose, policy, and standards for withdrawal management programs licensed by the commissioner of human services (DHS); providing regulations for program licensure, admission and discharge policies, screening and comprehensive assessment, stabilization planning and services, protective procedures, patient rights and grievance procedures, patient property management, medical services and availability of qualified medical professionals, medications, staffing requirements, duties, qualifications, personnel policies, procedures, files, policy and procedures manual development, patient records, data collection requirements, and payment methodology development; making technical changes

ARTICLE 4 - DIRECT CARE AND TREATMENT

Clarifying and continuing health insurance coverage for former state employees assaulted and injured by inmates and patients at state facilities; modifying certain provisions relating to county portion for cost of care for chemical dependency services

ARTICLE 5 - SIMPLIFICATION OF PUBLIC ASSISTANCE PROGRAMS

Modifying certain income calculations relating to public assistance eligibility; establishing provisions relating to the reporting of income, certain exempted individuals, and income inclusions; modifying certain provisions relating to the reporting of income, specifying certain exemptions, reporting requirements, changes that must be reported and certain reporting of specific programs; modifying certain provisions related to the correction of overpayments and underpayments; repealing certain provisions relating to overpayments and under payments and certain rules

ARTICLE 6 - NURSING FACILITY PAYMENT REFORM AND WORKFORCE DEVELOPMENT

Providing for long-term care workforce needs; establishing the home and community-based services employee scholarship program and allowing a scholarship per diem for nursing facilities without scholarship per diems; modifying a Polk county nursing home replacement bed exception; modifying the medical assistance (MA) alternative care program monthly limit increase, the elderly waiver monthly cost limits, the Medicaid waiver for elderly services, nursing facility rate determination, nursing facilities alternate rates, and the value-based nursing facility reimbursement system; requiring construction project rate adjustments for certain nursing facilities; requiring the commissioner to develop performance-based incentive payments; requiring the commissioner to adjust the rates of facilities meeting resident special dietary needs criteria; specifying the operating rate for a Golden Valley nursing facility; requiring nursing facility payment for employer health insurance costs under certain conditions; requiring a nursing facility payment reform report; requiring a property rate setting study based on a rental value for nursing facilities; repealing nursing facility reimbursement system facility type groups, hospital-attached nursing facility status, determination of proximity adjustments, determination of efficiency incentive, phase-in of rebased operating payment rates, implementation delay, and repeal of rebased operating payment rates

ARTICLE 7 - CONTINUING CARE

Establishing the Minnesota ABLE plan and accounts; modifying and expanding certain background study requirements for the department of health and tribal organizations; providing regulations for correction orders and conditional licenses for programs licensed as home and community-based services; providing for settlement agreements related to licensing sanctions; modifying certain licensing requirements for foster care providers; modifying home and community-based services standards, incident response and reporting provisions, environment and safety requirements, permitted actions and procedures, service planning requirements and review, staff qualifications, annual training, and staff ratio provisions; modifying parental contribution amounts for children with disabilities services; eliminating the authority of the commissioner of human services (DHS) to transfer funds between the medical assistance (MA) account and the home and community-based services transitions grants account; requiring the Minnesota board on aging to award regional and local dementia competitive grants; modifying the MA excess income standard; reducing premium payments for the MA employed persons with disabilities (MA-EPD) program; modifying MA assets availability for a community spouse; requiring the commissioner to manage home and community-based waiver allocations to fully use available waiver funding; modifying commissioner recoupment of spending in excess of allocation; specifying county and tribal agency responsibility for spending annual state allocations and spending in excess of state allocation; specifying county and tribal agency allocation authorization responsibility; modifying MA rate stabilization adjustment; requiring the commissioner to offer annual training for county personnel and to maintain online instruction; modifying the individual staffing definition; removing the requirement for a monitoring technology review panel; requiring the commissioner to develop and implement a methodology to determine shared staffing levels; modifying rate exception request requirements; modifying residency ratio restrictions for home and community-based settings for people with disabilities; "Achieving a Better Life Experience (ABLE) Act"; establishing accounts for certain persons with disabilities; ratifying a labor agreement between the state of Minnesota and the service employees international union healthcare Minnesota; providing a rate increase for direct support services providers workforce negotiations; requiring the commissioner to submit an amendment to establish an exception to the consumer-directed community supports budget methodology to provide more funds; requiring the commissioner to develop an initiative for a home and community-based services incentive pool; requiring certain reporting; providing an instruction to the commissioner; repealing the requirement for the commissioner to seek an amendment for exception to consumer-directed community supports budget methodology

ARTICLE 8 - HEALTH DEPARTMENT AND PUBLIC HEALTH

Eliminating a transfer from the health care access fund to the medical education and research costs fund; modifying health information exchange definitions, certificate of authority to provide health information exchange services, coordination procedures, and fees; adding an additional accrediting organization for ambulatory health care permitting the commissioner of health to use the all-payer claims health care data to compile public use files of summary data; requiring a projected spending baseline report and certain outcomes reporting and savings determination from the commissioner of health; requiring certain transfers to the health care access fund; expanding the health professional education loan forgiveness program by adding dental therapists, advanced dental therapists, mental health professionals, pharmacists, and public health nurses; modifying the health education loan program loan forgiveness; establishing a primary care residency expansion grant program; establishing and providing for the international medical graduates assistance program to address barriers to medical practice and to assist immigrant international medical graduates to enter the state health care delivery system in order to increase primary care access in rural and underserved areas; regulating patient information services; authorizing providers to release deceased patient health care records to other providers for treatment purposes; requiring the commissioner to establish a statewide initiative for early dental prevention and to increase awareness among communities of color and recent immigrants on the importance of early preventive dental intervention for infants and toddlers; "Minnesota Radon Licensing Act", requiring radon mitigation systems tags and annual licensing of persons selling devices or services for radon detection; defining violence against health care workers; requiring hospitals to design and implement preparedness and incident response action plans, establish committees and methodology, and provide training; prohibiting interference with law enforcement reporting; requiring hospitals to provide certain notices for patients placed in observation status and postacute care discharge planning requirements; changing lead training course permit fees; modifying certain provisions of the Minnesota Poisoning Prevention Act relating to lead standards; authorizing the commissioner to develop a list of authorized entities where allergens capable of anaphylaxis are present; authorizing persons or entities to obtain and store epinephrine auto-injectors; modifying certain provisions relating to registration of supplemental nursing services agencies; modifying the definition of a residential hospice facility; providing enforcement of dementia care training standards for staff working in housing with services settings and for housing management; modifying abortion recording and reporting required data; "Born Alive Infant Protection Act", defining born alive infant, providing civil cause of action and disciplinary actions against certain persons performing abortions under certain conditions, providing privacy protection in court proceedings, providing for status of born alive infant; providing health equity grants to Isuroon, an organization dedicated to building Somali women's self-sufficiency; modifying the statewide health improvement local community grants to include dementia populations; modifying the funding formula for community health boards; modifying certain mortuary science state examination, internship, continuing education, fees, establishment update, and funeral provider reports; expanding the lodging establishment definition; establishing a working group on violence against Asian women and children

ARTICLE 9 - HEALTH CARE DELIVERY

"Minnesota Telemedicine Act"; relating to health insurance; requiring coverage for telemedicine for health carriers; regulating coverage of telemedicine; requiring health care quality measures and payment methods to identify and adjust for health disparities related to race, ethnicity, language, and country of origin risk factors; establishing a certification process for community medical response emergency medical technicians (CEMT); modifying automated drug distribution; requiring the commissioner to establish telemedicine health care provider criteria; expanding the use of automated drug distribution systems for certain licensed board care homes; requiring a proposal for child protection focused community medical response emergency medical technician (CEMT) model; requiring the commissioner to determine services and payment rates for services to be performed by community medical response emergency medical technicians and covered by medical assistance (MA); requiring the commissioner to evaluate the effect of MA and MinnesotaCare coverage for community medical response emergency medical technician services

ARTICLE 10 - HEALTH LICENSING BOARDS

Requiring board of optometry members to be licensed, modifying board provisions, grounds for disciplinary actions, reporting, immunity, and optometrist cooperation; modifying inactive status licenses for the board of social work practice by establishing a temporary leave license; increasing dentistry fees; modifying the scope of practice of a pharmacy technician and increasing the permitted ratio of pharmacy technicians to pharmacists, authorizing pharmacists to participate in the administration of influenza vaccines to eligible individuals, increasing board membership requirements and pharmacy fees; repealing certain optometrist and board of social work practice provisions

ARTICLE 11 - HEALTH CARE

Requiring certain health insurer third-party payments to occur within a certain time frame; allowing University of Minnesota (U of M) school of dentistry licensed dental residents medical assistance (MA) enrollment; regulating nonemergency medical transportation provider under MA and modifying payment rates; requiring department of transportation (DOT) safety checks, distinctive decal issuance, fee payment, rule compliance, and variance application; requiring background studies for certain special transportation service providers; requiring third-party payers to provide certain information to the commissioner of human services (DHS); changing the hospital cost index; modifying hospital inpatient services payment rates; modifying conditions for interim payments; requiring periodic data matching to evaluate continued MA and MinnesotaCare eligibility; requiring the commissioner to award grants for legal services; permitting U of M dental faculty or residents to be enrolled as MA providers; modifying certain coverage provisions for medication therapy services; modifying nonemergency medical transportation; permitting MA coverage for certain mental health services provided by physician assistants in outpatient settings; removing a provision for the commissioner to set reimbursement rates for specific categories of medical supplies at levels below the Medicare payment rate; modifying MA part B Medicare crossover claims limitation by excluding payments to federally qualified health centers and rural health clinics; modifying MA co-payments; establishing an opioid prescribing improvement program; requiring the commissioner to establish health homes for populations with serious mental illness; authorizing the commissioner to establish a health care delivery pilot program to test alternative and innovative integrated health care delivery networks; modifying pre-paid health plans and requiring the commissioner to conduct ad hoc audits of managed care and county-based purchasing plans; requiring the legislative auditor to conduct third party financial audits of managed care and county based plans; expanding MA physician reimbursement criteria and increasing payment rates for certain services provided by a hospital that specializes in the treatment of cerebral palsy and other conditions; modifying payment rates for critical access hospitals and dental services; modifying critical access dental provider provisions and payment for certain primary care services and immunization administration; modifying reimbursement for basic care services and the Medicare payment limit; providing integrated care for high-risk pregnant women; modifying MinnesotaCare; requiring a task force on health care financing and a health disparities payment enhancement methodology; repealing certain provisions relating to hospital payment rates, prepaid health plans and MinnesotaCare administration, application, and provider payment

ARTICLE 12 - MNSURE

Eliminating the MNsure board; regulating MNsure operations; prohibiting MNsure from offering certain product lines; requiring the commissioner of human services (DHS) to develop a proposal to allow small employers the ability to receive the small business health care tax credit; requiring the commissioner of commerce to seek waivers for MNsure to allow persons to purchase qualified health plans outside of MNsure directly from health plan companies; repealing governance, expiration, and the legislative oversight committee

ARTICLE 13 - HUMAN SERVICES FORECAST ADJUSTMENTS

Providing a department of human services (DHS) forecast adjustment for grants

ARTICLE 14 - HEALTH AND HUMAN SERVICES APPROPRIATIONS

Providing for deposit, adjustments, transfers, expenditure reporting, and counting requirements; appropriating money to the commissioner of human services (DHS) for central office operations, IT, MNsure, periodic data matching for medical assistance (MA) and MinnesotaCare, financial institution data match and payment of fees, child support work group, health care, continuing care, training of direct support services providers, deaf and hard-of-hearing services division, nursing facilities, chemical and mental health, MFIP/DWP, child care assistance, general assistance, emergency general assistance, Minnesota supplemental aid, group residential housing, Northstar care for children, MinnesotaCare, MA, behavioral health services, chemical dependency treatment grants, basic sliding fee child care assistance grants and waiting list allocation, child care development grants, child support enforcement grants, children's services grants, safe place for newborns, child protection, adoption assistance, mobile food shelf grants, the homeless youth act, Stearns county veterans housing, safe harbor, Minnesota food assistance, transition populations, dementia grants, deaf, deafblind, and hard-of-hearing grants, the state quality council, adult mental health grants, culturally specific mental health grants, sustainability grants, Beltrami county mental health services, service and supports for first episode psychosis, adverse childhood experiences, chemical dependency prevention, fetal alcohol syndrome grants, increased capacity at Anoka regional treatment center, the community addiction recovery (C.A.R.E.) program, and the Minnesota sex offender program ; appropriating money to the commissioner of health for the violence against Asian women working group, the MERC program, poison information center grants, advanced care planning, early dental prevention initiatives, the international medical graduate assistance program, federally qualified health centers, organ donation, primary care residency, the Somali women's health pilot program, menthol cigarette usage in African-American community intervention grants, the targeted home visiting system, opiate antagonists, local and tribal public health grants, HCBS employee scholarships, family planning special projects, positive alternatives, safe harbor for sexually exploited youth, health care grants for uninsured individuals, TANF appropriations, health professional loan forgiveness, Minnesota stroke system, prevention of violence in health care, and health care savings determinations; appropriating money to the health-related boards and appropriating money for the volunteer health care provider program, retirement costs, the Cooper/Sams volunteer ambulance program, the ambulance training grant, and regional grants; requiring the commissioner of commerce to develop a proposal to allow individuals to purchase qualified health plans outside of MNsure directly from health plan companies and to receive advanced premium tax credits and cost-sharing reductions; appropriating money to the commissioner of human services for the health care access fund; prohibiting the commissioner of health and human services from using indirect cost allocations to pay for operational costs
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