1.1 	A bill for an act
1.2 	relating to human services; modifying certain provisions governing autism 
1.3 	early intensive intervention benefit;amending Minnesota Statutes 2014, section 
1.4 	256B.0949.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2014, section 256B.0949, is amended to read:
1.7 	256B.0949 AUTISM EARLY INTENSIVE DEVELOPMENTAL AND 
1.8 	BEHAVIORAL INTERVENTION BENEFIT.
1.9 		Subdivision 1.Purpose. This section creates a new the early intensive 
1.10 	developmental and behavioral intervention (EIDBI)  benefit to provide early intensive 
1.11 	intervention to a child with an autism spectrum disorder diagnosis or related condition. 
1.12 	This benefit must provide coverage for diagnosis a comprehensive, multidisciplinary 
1.13 	assessment, ongoing progress evaluation, and medically necessary early intensive 
1.14 	treatment of autism spectrum disorder or related conditions.
1.15 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in 
1.16 	this subdivision have the meanings given.
1.17 	(b) "Agency" means the legal entity that is enrolled with Minnesota health care 
1.18 	programs as a medical assistance provider according to Minnesota Rules, part 9505.0195, 
1.19 	to provide EIDBI and that has the legal responsibility to ensure that its employees or 
1.20 	contractors carry out the responsibilities defined in this section. The definition of "agency" 
1.21 	includes licensed individual professionals who practice independently and act as an agency.
1.22 	(b)(c) "Autism spectrum disorder diagnosis" is defined by diagnostic code 299 or 
1.23 	"ASD" has the meaning given  in the current version of the Diagnostic and Statistical 
1.24 	Manual of Mental Disorders (DSM).
2.1 	(d) "ASD and related conditions" means a condition that is found to be closely 
2.2 	related to autism spectrum disorder and may include but is not limited to autism, 
2.3 	Asperger's syndrome, pervasive developmental disorder-not otherwise specified, fetal 
2.4 	alcohol spectrum disorder, Rhett's syndrome, and autism-related diagnosis as identified 
2.5 	under the current version of the DSM and meets all of the following criteria: 
2.6 	(1) is severe and chronic; 
2.7 	(2) results in impairment of adaptive behavior and function similar to that of persons 
2.8 	with ASD; 
2.9 	(3) requires treatment or services similar to those required for persons with ASD; 
2.10 	(4) results in substantial functional limitations in three core developmental deficits 
2.11 	of ASD: social interaction; nonverbal or social communication; and restrictive, repetitive 
2.12 	behaviors or hyperreactivity or hyporeactivity to sensory input; and may include deficits 
2.13 	in one or more of the following related developmental domains:
2.14 	(i) self-regulation; 
2.15 	(ii) self-care; 
2.16 	(iii) behavioral challenges; 
2.17 	(iv) expressive communication; 
2.18 	(v) receptive communication; 
2.19 	(vi) cognitive functioning; 
2.20 	(vii) safety; and
2.21 	(viii) level of support needed; and 
2.22 	(5) is not attributable to mental illness as defined in section 245.462, subdivision 20, 
2.23 	or an emotional disturbance as defined in section 245.4871, subdivision 15. For purposes 
2.24 	of this section, notwithstanding section 245.462, subdivision 20, or 245.4871, subdivision 
2.25 	15, mental illness does not include autism or other pervasive developmental disorders.
2.26 	(c) (e) "Child" means a person under the age of 18 20 years of age or younger.
2.27 	(f) "Clinical supervision" means the overall responsibility for the control and 
2.28 	direction of EIDBI service delivery, including individual treatment planning, staff 
2.29 	supervision, progress monitoring, and treatment review for each client. Clinical 
2.30 	supervision is provided by a QSP who takes full professional responsibility for the 
2.31 	services provided by each of the supervisees. All EIDBI services must be billed by and 
2.32 	either provided by or under the clinical supervision of a QSP.
2.33 	(d) (g) "Commissioner" means the commissioner of human services, unless 
2.34 	otherwise specified.
3.1 	(h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a 
3.2 	comprehensive evaluation of a child's developmental status to determine medical necessity 
3.3 	for EIDBI based on the requirements in section 256B.0949, subdivision 5. 
3.4 	(e) (i) "Early intensive developmental and behavioral intervention benefit" or 
3.5 	"EIDBI" means autism treatment options intensive interventions based in behavioral and 
3.6 	developmental science, which may include modalities such as applied behavior analysis, 
3.7 	developmental treatment approaches, and naturalistic and parent training models that 
3.8 	include the services covered under subdivision 11.
3.9 	(f) (j) "Generalizable goals" means results or gains that are observed during a variety 
3.10 	of activities over time with different people, such as providers, family members, other 
3.11 	adults, and children, and in different environments including, but not limited to, clinics, 
3.12 	homes, schools, and the community.
3.13 	(k) "Individual treatment plan" or "ITP" means the person-centered, individualized 
3.14 	written plan of care that integrates and coordinates child and family information from the 
3.15 	comprehensive multidisciplinary evaluation for a child who meets medical necessity for 
3.16 	the early intensive developmental and behavioral intervention benefit. An individual 
3.17 	treatment plan must meet the standards in section 256B.0949, subdivision 6. 
3.18 	(l) "Legal representative" means the parent of a person who is under 18 years of age, 
3.19 	a court-appointed guardian, or other representative with legal authority to make decisions 
3.20 	about services for a person. Other representatives with legal authority to make decisions 
3.21 	include but are not limited to a health care agent or an attorney-in-fact authorized through 
3.22 	a health care directive or power of attorney.
3.23 	(m) "Level I treatment provider" means a person who meets the EIDBI provider 
3.24 	qualifications under subdivision 16, paragraph (a).
3.25 	(n) "Level II treatment provider" means a person who meets the EIDBI provider 
3.26 	qualifications under subdivision 16, paragraph (b).
3.27 	(o) "Level III treatment provider" means a person who meets the EIDBI provider 
3.28 	qualifications under subdivision 16, paragraph (c).
3.29 	(g) (p) "Mental health professional" has the meaning given in section 245.4871, 
3.30 	subdivision 27, clauses (1) to (6).
3.31 	(q) "Person-centered" means services that respond to the identified needs, interests, 
3.32 	values, preferences, and desired outcomes of the child and the child's legal representative. 
3.33 	Person-centered planning identifies what is important to the child and the child's legal 
3.34 	representative, respects each child's history, dignity, and cultural background, and allows 
3.35 	inclusion and participation in the child's community.
4.1 	(r) "Qualified CMDE provider" means a person meeting the CMDE provider 
4.2 	qualification requirements under subdivision 5a.
4.3 	(s) "Qualified EIDBI professional" means a person who is a QSP or a level I, level 
4.4 	II, or level III treatment provider.
4.5 	(t) "Qualified supervising professional" or "QSP" means a person who meets the 
4.6 	EIDBI provider qualifications under subdivision 16, paragraph (d).
4.7 		Subd. 3.Initial EIDBI eligibility. This benefit is available to a child enrolled in 
4.8 	medical assistance who:
4.9 	(1) has an autism spectrum disordera diagnosis of ASD or a related condition that 
4.10 	meets the criteria of subdivision 4;
4.11 	(2) has had a diagnostic assessment described in subdivision 5, which recommends 
4.12 	early intensive intervention services is medically stable; and
4.13 	(3) meets the criteria for medically necessary autism early intensive intervention 
4.14 	services. does not need 24-hour medical or nursing monitoring or procedures; and
4.15 	(4) received a comprehensive multidisciplinary evaluation as described in 
4.16 	subdivision 5 that recommends EIDBI services based on medical necessity criteria 
4.17 	published by the commissioner.
4.18 		Subd. 3a.Culturally and linguistically appropriate requirement. The child's 
4.19 	and family's primary spoken language, culture, preferences, goals, and values must 
4.20 	be reflected throughout the process of diagnosis, CMDE, ITP development, progress 
4.21 	monitoring, family or caregiver training and counseling services, and coordination of 
4.22 	care. The qualified CMDE provider and QSP must determine the most effective way to 
4.23 	adapt the evaluation, treatment recommendations, and ITP to the culture, language, and 
4.24 	values of the child and family. A language interpreter who is fluent in both languages, 
4.25 	with training or knowledge of related diagnostic and medical treatment terminology, 
4.26 	must be provided when the child or child's legal representative is not able to speak, read, 
4.27 	write, or understand the English language at a level that allows the child or child's legal 
4.28 	representative to interact with the CMDE provider, QSP, or a level I, level II, or level 
4.29 	III treatment provider. The language interpreter must be fluent in both languages, with 
4.30 	training or knowledge of related diagnostic and medical treatment terminology.
4.31 		Subd. 4.Diagnosis. (a) A diagnosis of ASD or a related condition  must:
4.32 	(1) be based upon current DSM criteria including direct observations of the child and 
4.33 	reports information from parents the child's legal representative  or primary caregivers; and
4.34 	(2) be completed by either (i) a licensed physician or advanced practice registered 
4.35 	nurse or (ii) a mental health professional; and
5.1 	(3) meet the requirements of Minnesota Rules, part 9505.0372, subpart 1, items 
5.2 	B and C.
5.3 	(b) Additional diagnostic assessment information may be considered  to complete 
5.4 	a diagnostic assessment including from specialized tests administered through special 
5.5 	education evaluations and licensed school personnel, and from professionals licensed 
5.6 	in the fields of medicine, speech and language, psychology, occupational therapy, and 
5.7 	physical therapy. A diagnostic assessment may include treatment recommendations.
5.8 		Subd. 5.Diagnostic assessment Comprehensive multidisciplinary evaluation 
5.9 	(CMDE). The following information and assessments must be performed, reviewed, and 
5.10 	relied upon for the eligibility determination, treatment and services recommendations, and 
5.11 	treatment plan development for the child:
5.12 	(1) an assessment of the child's developmental skills, functional behavior, needs, and 
5.13 	capacities based on direct observation of the child which must be administered by a licensed 
5.14 	mental health professional, must include medical or assessment information from the 
5.15 	child's physician or advanced practice registered nurse, and may also include observations 
5.16 	from family members, school personnel, child care providers, or other caregivers, as 
5.17 	well as any medical or assessment information from other licensed professionals such as 
5.18 	rehabilitation therapists, licensed school personnel, or mental health professionals; and
5.19 	(2) an assessment of parental or caregiver capacity to participate in therapy including 
5.20 	the type and level of parental or caregiver involvement and training recommended.
5.21 	(a) A CMDE must be completed to determine medical necessity of EIDBI services. 
5.22 	The CMDE must be administered by a qualified CMDE provider. Nothing prohibits a 
5.23 	child or the child's legal representative from requesting an independent qualified CMDE 
5.24 	provider of their choice. An agency shall not require a child to receive a CMDE from a 
5.25 	particular qualified CMDE provider. The CMDE must include and document information 
5.26 	from medical and mental health professionals.
5.27 	(b) The CMDE must include and document the following:
5.28 	(1) information from a diagnostic assessment that meets the requirements under 
5.29 	subdivision 4;
5.30 	(2) information gathered from family members and primary child care providers; 
5.31 	(3) a face-to-face assessment of the child's degree of severity of core features of 
5.32 	ASD and related conditions, as well as other areas of functional development, including 
5.33 	cognition, learning and play, social or interpersonal interaction, verbal and nonverbal 
5.34 	communication, self-care, behavioral challenges and self-regulation, safety, and level 
5.35 	of support needed;
6.1 	(4) a review and consideration of diagnostic and other related assessment 
6.2 	information from other qualified or licensed health care or other professionals working 
6.3 	with the child, including medical and pharmacological information from a licensed 
6.4 	physician or advanced practice nurse; the child's rehabilitation therapists; licensed school 
6.5 	personnel; and other mental health professionals;
6.6 	(5) referrals to other needed clinical, medical, educational, rehabilitation, or social 
6.7 	services; 
6.8 	(6) the child's legal representative or caregiver preferences for involvement in 
6.9 	the child's treatment that is culturally and linguistically appropriate as required under 
6.10 	subdivision 3a; 
6.11 	(7) a discussion with the child's legal representative and family of the options and 
6.12 	recommendations for the type and level of the child's legal representative or caregiver 
6.13 	training and preferred involvement in the child's treatment; 
6.14 	(8) a discussion with the child and the child's legal representative of the 
6.15 	recommendations for EIDBI medical necessity, including recommendations for a 
6.16 	minimum and maximum range of suggested EIDBI treatment intensity;
6.17 	(9) a discussion with the child and the child's legal representative of all EIDBI 
6.18 	treatment modalities recognized by the Department of Human Services available at the 
6.19 	time of the CMDE, including differences in how the treatment modalities are implemented;
6.20 	(10) a summary of information provided to the child's legal representative in a 
6.21 	manner by which they can understand the results and recommendations of the CMDE and 
6.22 	can make informed decisions about treatment options. The provision of information may 
6.23 	include a coordinated conference, as requested by the child's legal representative;
6.24 	(11) a determination regarding how frequently to monitor the child's progress if 
6.25 	monitoring is required more frequently than every six months; and
6.26 	(12) a determination of the most effective way to adapt the recommendations of 
6.27 	the CMDE to the culture, language, and values of the family irrespective of whence 
6.28 	the child and family.
6.29 	(c) The CMDE must be updated after each 12 months of treatment, or more 
6.30 	frequently as determined by a qualified CMDE provider. The CMDE update must: 
6.31 	(1) consider the agency's progress evaluation results and make a determination of 
6.32 	the child's progress toward achieving generalizable and functional goals contained in 
6.33 	the treatment plan;
6.34 	(2) identify any significant changes in the child's condition or family circumstances;
6.35 	(3) document and provide rationale for any recommended changes in EIDBI services, 
6.36 	including the need for continuation or discontinuation of medically necessary EIDBI; and 
7.1 	(4) be submitted to the commissioner in a manner determined by the commissioner 
7.2 	for the authorization of EIDBI services.
7.3 		Subd. 5a.CMDE provider qualification requirements. A qualified CMDE 
7.4 	provider must:
7.5 	(1) be a licensed physician or advanced practice registered nurse or a mental health 
7.6 	professional or a mental health practitioner who meets the requirements of a clinical 
7.7 	trainee as defined in Minnesota Rules, part 9505.0371, subpart 5, item C;
7.8 	(2) have at least 2,000 hours of clinical experience in the evaluation and treatment 
7.9 	of children with ASD or equivalent documented coursework at the graduate level by an 
7.10 	accredited university in the following content areas: ASD diagnosis, ASD treatment 
7.11 	strategies, and child development; 
7.12 	(3) be able to diagnose, evaluate, or provide treatment within the provider's scope 
7.13 	of practice and professional license; and 
7.14 	(4) have knowledge and provide information about the range of current EIDBI 
7.15 	treatment modalities recognized by the commissioner.
7.16 		Subd. 6.Individual treatment plan (ITP). (a) The qualified EIDBI professional, 
7.17 	except a level III treatment provider, who integrates and coordinates child and family 
7.18 	information from the CMDE and progress-monitoring process to develop the ITP must 
7.19 	develop and monitor the ITP. 
7.20 	(b) The ITP must be individualized, person-centered, and culturally and linguistically 
7.21 	appropriate, as required under subdivision 3a. The ITP must specify the medically 
7.22 	necessary treatment and services, including baseline data, primary goals and target 
7.23 	objectives, progress-monitoring results and goal mastery data, and any significant changes 
7.24 	in the child's condition or family circumstances. Each child's treatment plan ITP must be:
7.25 	(1) based on the diagnostic assessment and CMDE summary information specified 
7.26 	in subdivisions 4 and 5;
7.27 	(2) coordinated with medically necessary occupational, physical, and speech and 
7.28 	language therapies, special education, and other services the child and family are receiving;
7.29 	(3) family-centered;
7.30 	(4) culturally sensitive; and
7.31 	(5) individualized based on the child's developmental status and the child's and 
7.32 	family's identified needs.
7.33 	(b) (c) The treatment plan ITP must specify the primary treatment goals and target 
7.34 	objectives, including baseline measures and projected dates of accomplishment. The 
7.35 	ITP must include:
8.1 	(1) child's goals which are developmentally appropriate, functional, and 
8.2 	generalizable;
8.3 	(2) treatment modality;
8.4 	(3) treatment intensity;
8.5 	(4) setting; and
8.6 	(5) level and type of parental or caregiver involvement.
8.7 	(1) the treatment method to meet the goals and objectives, including: 
8.8 	(i) frequency, intensity, location, and duration of each service provided; 
8.9 	(ii) level of parent or caregiver training and counseling; 
8.10 	(iii) any changes or modifications to the physical and social environments necessary 
8.11 	when the services are provided; 
8.12 	(iv) any specialized equipment and materials required;
8.13 	(v) techniques that support and are consistent with the child's communication mode 
8.14 	and learning style; and
8.15 	(vi) names of staff with overall responsibility for supervising staff and implementing 
8.16 	the service or services; 
8.17 	(2) the discharge criteria that shall be used and a defined transition plan to assist 
8.18 	the child and the child's legal representative to transition to other services. The transition 
8.19 	plan shall include: 
8.20 	(i) protocols for changing service when medically necessary;
8.21 	(ii) how the transition will occur;
8.22 	(iii) the time allowed to make the transition. Up to 30 days of continued service 
8.23 	is allowed while the transition plan is being developed. Services during this plan 
8.24 	development period shall be consistent with the ITP. The plan development period begins 
8.25 	when the child or the child's legal representative receives notice of termination of EIDBI 
8.26 	and ends when EIDBI is terminated; and
8.27 	(iv) a description of how the parent or guardian will be informed of and involved in 
8.28 	the transition.
8.29 	(c) (d) Implementation of the treatment ITP must be supervised by a qualified 
8.30 	supervising professional with expertise and training in autism and child development who 
8.31 	is a licensed physician, advanced practice registered nurse, or mental health professional 
8.32 	(QSP).
8.33 	(d) (e) The treatment plan ITP must be submitted to the commissioner for approval 
8.34 	in a manner determined by the commissioner for this purpose.
8.35 	(e) Services authorized must be consistent with the child's approved treatment plan.
9.1 	(f) Services included in the treatment plan ITP must meet all applicable requirements 
9.2 	for medical necessity and coverage.
9.3 		Subd. 6a.Coordination with other benefits. (a) Services provided under this 
9.4 	benefit do not replace services provided in a child's individualized education plan. Each 
9.5 	child's ITP must document that EIDBI services supplement, but do not include or replace 
9.6 	special education and related services defined in the child's individualized education 
9.7 	plan when the service is available under the Individuals with Disabilities Education 
9.8 	Improvement Act of 2004 through a local education agency. Birth to three programs and 
9.9 	additional resources shall also coordinate with EIDBI services.
9.10 	(b) The commissioner shall integrate medical authorization procedures for this 
9.11 	benefit with authorization procedures for other health and mental health services and 
9.12 	home and community-based services to ensure that the child receives services that are the 
9.13 	most appropriate and effective in meeting the child's needs.
9.14 		Subd. 7.Ongoing eligibility Progress evaluation monitoring. (a) An independent 
9.15 	A progress evaluation conducted by a licensed mental health professional with expertise 
9.16 	and training in autism spectrum disorder and child development must be completed after 
9.17 	each six months of treatment, or more frequently as determined by the commissioner 
9.18 	qualified CMDE provider, to determine if progress is being made toward achieving 
9.19 	targeted functional and generalizable goals and meeting functional goals contained 
9.20 	specified in the treatment plan ITP. Based on the results of progress monitoring and 
9.21 	evaluation, the ITP must be adjusted as needed and must document that the child continues 
9.22 	to meet medical necessity for EIDBI or is referred to other services.
9.23 	(b) The progress evaluation must be overseen and signed by the qualified supervising 
9.24 	professional. The progress evaluation must include:
9.25 	(1) the treating provider's report;
9.26 	(2) parental or caregiver input from the child's caregiver or the child's legal 
9.27 	representative;
9.28 	(3) an independent observation of the child which can be that is  performed by the 
9.29 	child'sa QSP or a level I or level II treatment provider and may include observation 
9.30 	information from licensed special education staff or other licensed health care providers;
9.31 	(4) documentation of current level of performance on primary treatment goal 
9.32 	domains including when goals and objectives are achieved, changed, or discontinued;
9.33 	(5) any significant changes in the child's condition or family circumstances;
9.34 	(4)(6) any treatment plan modifications and the rationale for any changes made 
9.35 	including treatment modality, intensity, frequency, and duration; and
9.36 	(5)(7) recommendations for continued treatment services.
10.1 	(c) Progress evaluations must be submitted to the commissioner in a manner 
10.2 	determined by the commissioner for this purpose the reauthorization of EIDBI services.
10.3 	(d) A child who continues to achieve generalizable goals and make reasonable 
10.4 	progress toward treatment goals as specified in the treatment plan ITP is eligible to 
10.5 	continue receiving this benefit EIDBI services.
10.6 	(e) A child's treatment shall continue during the progress evaluation using the 
10.7 	process determined under subdivision 8, clause (8) this subdivision. Treatment may 
10.8 	continue during an appeal pursuant to section 256.045.
10.9 		Subd. 8.Refining the benefit with stakeholders. The commissioner must develop 
10.10 	the implementation refine the details of the benefit in consultation with stakeholders and 
10.11 	consider recommendations from the Health Services Advisory Council, the Department 
10.12 	of Human Services Autism Spectrum Disorder Early Intensive Developmental and 
10.13 	Behavioral Intervention Benefit Advisory Council, the Legislative Autism Spectrum 
10.14 	Disorder Task Force,the EIDBI learning collaborative, and the ASD Interagency Task 
10.15 	Force of the Departments of Health, Education, Employment and Economic Development, 
10.16 	and Human Services. The commissioner must release these details for a 30-day public 
10.17 	comment period prior to submission to the federal government for approval. The 
10.18 	implementation details must include, but are not limited to, the following components:
10.19 	(1) a definition of the qualifications, standards, and roles of the treatment team, 
10.20 	including recommendations after stakeholder consultation on whether board-certified 
10.21 	behavior analysts and other types of professionals certified in other treatment approaches 
10.22 	recognized by the Department of Human Services or  trained in autism spectrum disorder 
10.23 	and child development should be added as mental health or other professionals for qualified 
10.24 	to provide EIDBI treatment supervision or other functions under medical assistance;
10.25 	(2) development of initial,refinement of uniform parameters for comprehensive 
10.26 	multidisciplinary diagnostic assessment information evaluation and progress evaluation 
10.27 	ongoing progress-monitoring standards;
10.28 	(3) the design of an effective and consistent process for assessing parent the child's 
10.29 	legal representative's  and caregiver capacity caregiver's preferences and options to 
10.30 	participate in the child's early intervention treatment and efficacy of methods of involving 
10.31 	the parents to involve and educate the child's legal representative and caregivers in the 
10.32 	treatment of the child;
10.33 	(4) formulation of a collaborative process in which professionals have 
10.34 	opportunities to collectively inform provider standards and qualifications; standards for a 
10.35 	comprehensive, multidisciplinary diagnostic assessmentevaluation; medical necessity 
10.36 	determination; efficacy of treatment apparatus, including modality, intensity, frequency, 
11.1 	and duration; and progress evaluation progress-monitoring processes and standards to 
11.2 	support quality improvement of early intensive interventionEIDBI services;
11.3 	(5) coordination of this benefit and its interaction with other services provided by 
11.4 	the Departments of Human Services, Health, Employment and Economic Development, 
11.5 	and Education;
11.6 	(6) evaluation, on an ongoing basis, of research regarding the program EIDBI 
11.7 	outcomes and efficacy of treatment modalities methods provided to children under this 
11.8 	benefit; and
11.9 	(7) determination of the availability of licensed physicians, nurse practitioners, 
11.10 	and mental health professionals qualified EIDBI providers with necessary expertise and 
11.11 	training in autism spectrum disorder and related conditions throughout the state to assess 
11.12 	whether there are sufficient professionals to require involvement of both a physician or 
11.13 	nurse practitioner and a mental health professional to provide timely access and prevent 
11.14 	delay in the diagnosis and CMDE and treatment of young children, so as to implement 
11.15 	subdivision 4, and to ensure treatment is effective, timely, and accessible; and ASD and 
11.16 	related conditions.
11.17 	(8) development of the process for the progress evaluation that will be used to 
11.18 	determine the ongoing eligibility, including necessary documentation, timelines, and 
11.19 	responsibilities of all parties.
11.20 		Subd. 9.Revision of treatment options. (a) The commissioner may revise covered 
11.21 	treatment options as needed based on outcome data and other evidence. EIDBI treatment 
11.22 	methods approved by the Department of Human Services must:
11.23 	(1) cause no harm to the individual child or family;
11.24 	(2) be provided in an individualized manner to meet the varied needs of each child 
11.25 	and family;
11.26 	(3) be developmentally appropriate and highly structured, with well-defined goals 
11.27 	and objectives that provide a strategic direction for treatment;
11.28 	(4) be regularly evaluated and adjusted as needed;
11.29 	(5) be based in recognized principles of developmental and behavioral science;
11.30 	(6) utilize sound practices that are replicable across providers and maintain the 
11.31 	fidelity of the specific approach;
11.32 	(7) demonstrate an evidentiary basis;
11.33 	(8) have goals and objectives that are measurable, achievable, and regularly 
11.34 	evaluated to ensure that adequate progress is being made;
11.35 	(9) be provided intensively with a high adult-to-child ratio;
12.1 	(10) include active family participation in decision-making, knowledge and capacity 
12.2 	building, and developing and implementing the child's ITP; and 
12.3 	(11) be provided in a culturally and linguistically appropriate manner as required 
12.4 	under subdivision 3a.
12.5 	(b) Before the changes revisions in Department of Human Services recognized 
12.6 	treatment modalities become effective, the commissioner must provide public notice of 
12.7 	the changes, the reasons for the change, and a 30-day public comment period to those 
12.8 	who request notice through an electronic list accessible to the public on the department's 
12.9 	Web site.
12.10 		Subd. 10.Coordination between agencies. The commissioners of human services 
12.11 	and education must develop the capacity to coordinate services and information including 
12.12 	diagnostic, functional, developmental, medical, and educational assessments; service 
12.13 	delivery; and progress evaluations across health and education sectors.
12.14 		Subd. 11.Federal approval of the autism benefit. (a) This section shall apply 
12.15 	to state plan services under title XIX of the Social Security Act when federal approval 
12.16 	is granted under a 1915(i) waiver or other authority which allows children eligible for 
12.17 	medical assistance through the TEFRA option under section 256B.055, subdivision 12, to 
12.18 	qualify and includes children eligible for medical assistance in families over 150 percent 
12.19 	of the federal poverty guidelines.
12.20 	(b) The commissioner may use the federal authority for a Medicaid state plan 
12.21 	amendment under Early and Periodic Screening Diagnosis and Treatment (EPSDT), 
12.22 	United States Code, title 42, section 1396D(R)(5), or other Medicaid provision for any 
12.23 	aspect or type of treatment covered in this section if new federal guidance is helpful 
12.24 	in achieving one or more of the purposes of this section in a cost-effective manner. 
12.25 	Notwithstanding subdivisions 2 and 3, any treatment services submitted for federal 
12.26 	approval under EPSDT shall include appropriate medical criteria to qualify for the service 
12.27 	and shall cover children through age 20.
12.28 		Subd. 12.Autism benefit; training provided. After approval of the autism early 
12.29 	intensive intervention benefit under this section by the Centers for Medicare and Medicaid 
12.30 	Services, the commissioner shall provide statewide training on the benefit for culturally 
12.31 	and linguistically diverse communities. Training for autism service providers on culturally 
12.32 	appropriate practices must be online, accessible, and available in multiple languages. The 
12.33 	training for families, lead agencies, advocates, and other interested parties must provide 
12.34 	information about the benefit and how to access it.
12.35 		Subd. 13.Covered services. (a) The following services are eligible for 
12.36 	reimbursement by medical assistance under this section: 
13.1 	(1) EIDBI interventions. EIDBI interventions are a variety of individualized, 
13.2 	intensive treatment methods approved by the department that are based in behavioral 
13.3 	and developmental science consistent with best practices on effectiveness. Services 
13.4 	must address the participant's medically necessary treatment goals and be provided by 
13.5 	a qualified supervising professional or a level I, level II, or level III treatment provider. 
13.6 	Services are targeted to develop, enhance, or maintain the individual developmental skills 
13.7 	of a child with ASD and related conditions to improve functional communication, social 
13.8 	or interpersonal interaction, behavioral challenges and self-regulation, cognition, learning 
13.9 	and play, self-care, safety, and level of support needed;
13.10 	(2) EIDBI intervention observation and direction. EIDBI intervention observation 
13.11 	and direction is the clinical direction and oversight by a QSP or a level I or level 
13.12 	II treatment provider regarding provision of EIDBI services to a child, including 
13.13 	developmental and behavioral techniques, progress measurement, data collection, function 
13.14 	of behaviors, and generalization of acquired skills for the direct benefit of a child. EIDBI 
13.15 	intervention observation and direction informs any modifications of the methods to 
13.16 	support the accomplishment of outcomes in the ITP. Observation and direction provides a 
13.17 	real-time response to EIDBI interventions to maximize the benefit to the child;
13.18 	(3) CMDE. CMDE is a comprehensive evaluation of the child's developmental 
13.19 	status to determine medical necessity for EIDBI services and meets the requirements of 
13.20 	subdivision 5. The services must be provided by a qualified CMDE provider;
13.21 	(4) ITP development and monitoring. ITP development and monitoring is 
13.22 	development of the initial, annual, and progress monitoring of ITPs. This service 
13.23 	documents, provides oversight and on-going evaluation of child treatment and progress 
13.24 	on targeted goals and objectives, and integrates and coordinates child and family 
13.25 	information from the CMDE and progress monitoring evaluations. The ITP must meet 
13.26 	the requirements of subdivision 6. Progress monitoring must meet the requirements of 
13.27 	subdivision 7. This service must be reviewed and completed by a QSP, and may include 
13.28 	input from a level I or level II treatment provider;
13.29 	(5) Family caregiver training and counseling. Family caregiver training and 
13.30 	counseling is specialized training and education a family or primary caregiver receives 
13.31 	to understand their child's developmental status and help with their child's needs and 
13.32 	development. This service must be provided by a QSP or a level I or level II treatment 
13.33 	provider;
13.34 	(6) Coordinated care conferences. A coordinated care conference is a face-to-face 
13.35 	meeting with the child and family to review the CMDE or progress monitoring results 
13.36 	and to coordinate and integrate services across providers and service-delivery systems to 
14.1 	develop the ITP. This service must be provided by a QSP and may include the CMDE 
14.2 	provider or the level I or level II treatment provider;
14.3 	(7) Allowable travel time. Travel time is allowable billing for traveling to and from 
14.4 	the recipient's home, a community setting, or place of service outside of an EIDBI center, 
14.5 	clinic, or office from a specified location to provide face-to-face EIDBI intervention, 
14.6 	observation and direction, or family caregiver training and counseling. EIDBI recipients 
14.7 	must have an ITP specifying why the provider must travel to the recipient's home, a 
14.8 	community setting, or place of service outside of an EIDBI center, clinic, or office; and
14.9 	(8) medically necessary EIDBI services and consultations delivered by a licensed 
14.10 	health care provider via telemedicine in the same manner as if the service or consultation 
14.11 	was delivered in person. Coverage is limited to three telemedicine services per enrollee 
14.12 	per calendar week.
14.13 	(b) EIDBI interventions under paragraph (a), clause (1), include, but are not limited to:
14.14 	(1) applied behavioral analysis (ABA);
14.15 	(2) developmental individual-difference relationship-based model (DIR/Floortime);
14.16 	(3) early start Denver model (ESDM);
14.17 	(4) PLAY project; or
14.18 	(5) relationship development intervention (RDI).
14.19 	(c) A provider may use one or more of the treatment interventions in paragraph 
14.20 	(b) as the primary modality for treatment as a covered service, or several treatment 
14.21 	interventions in combination as the primary modality of treatment, as approved by the 
14.22 	commissioner. Additional treatment interventions may be used upon approval by the 
14.23 	commissioner. A provider that identifies and provides assurance of qualifications for a 
14.24 	single specific treatment modality must document the required qualifications to meet 
14.25 	fidelity to the specific model.
14.26 		Subd. 14.Noncovered services. The following services are not eligible for medical 
14.27 	assistance payment as EIDBI under this section:
14.28 	(1) service components of EIDBI simultaneously provided by more than one 
14.29 	provider entity unless prior authorization is obtained;
14.30 	(2) provision of the same service by multiple providers within the same agency 
14.31 	at the same clock time;
14.32 	(3) EIDBI provided in violation of medical assistance policy in Minnesota Rules, 
14.33 	part 9505.0220;
14.34 	(4) service components of EIDBI that are the responsibility of a residential or 
14.35 	program license holder, including foster care providers under the terms of a service 
14.36 	agreement or administrative rules governing licensure;
15.1 	(5) adjunctive activities that may be offered by a provider entity but are not 
15.2 	otherwise covered by medical assistance, including:
15.3 	(i) a service that is primarily recreation oriented or that is provided in a setting that is 
15.4 	not medically supervised. This includes sports activities, exercise groups, activities such 
15.5 	as craft hours, leisure time, social hours, meal or snack time, trips to community activities, 
15.6 	and tours, unless the activities in this item are primarily treatment oriented and provided 
15.7 	pursuant to an ITP;
15.8 	(ii) a social or educational service that does not have or cannot reasonably be 
15.9 	expected to have a therapeutic outcome related to the child's diagnosis; or
15.10 	(iii) prevention or education programs provided to the community;
15.11 	(6) a service that is not identified in the child's ITP;
15.12 	(7) a service provided pursuant to an ITP that has not been approved or updated as 
15.13 	required by this section;
15.14 	(8) a service not documented in the child's health service record or not documented 
15.15 	in the manner required by this chapter or by Minnesota Rules, part 9505.2175;
15.16 	(9) a service provided by an individual who does not meet the qualifications to 
15.17 	render the service or by an individual for whom the provider does not have documentation 
15.18 	showing that the individual meets the required qualifications;
15.19 	(10) a service that is primarily respite, custodial, day care, or educational;
15.20 	(11) a service that replaces special education or related services defined in the child's 
15.21 	individualized education plan (IEP) or individual family service plan (IFSP) when the 
15.22 	service is available under the Individuals with Disabilities Education Improvement Act of 
15.23 	2004 through a local education agency; 
15.24 	(12) children's therapeutic services and supports reimbursed under section 
15.25 	256B.0943; or
15.26 	(13) physical, speech, occupational therapies, or personal care assistance reimbursed 
15.27 	under section 256B.0625.
15.28 		Subd. 15.Service recipient rights. (a) A child or the child's legal representative 
15.29 	has the right to: 
15.30 	(1) participate in the development, implementation, and evaluation of all aspects of 
15.31 	the child's and family's services; 
15.32 	(2) designate an advocate of the child's or the child's legal representative's choice to 
15.33 	be present in all aspects of the child's and family's services at the request of the child's 
15.34 	legal representative;
16.1 	(3) know, in advance, the limits to services available from the provider to meet the 
16.2 	child's and family's service and support needs, including limits in the knowledge, skills, 
16.3 	and abilities of the agency; 
16.4 	(4) know the agency policy on assigning staff to individual children; 
16.5 	(5) know if the legal representative or another private party may have to pay for any 
16.6 	charges; 
16.7 	(6) know the charges for services before the child or family receives services and 
16.8 	receive advance notice if the charges change; 
16.9 	(7) know who shall pay for the services before services begin; 
16.10 	(8) know who is the qualified supervising professional with clinical responsibility 
16.11 	for the child's ITP;
16.12 	(9) know who to contact within the agency if the child or the child's legal 
16.13 	representative has any concerns about the child's or family's services;
16.14 	(10) receive a copy of the agency's admission criteria and policies and procedures 
16.15 	related to temporary service suspension and service termination; 
16.16 	(11) receive reasonable accommodations to observe the child while receiving 
16.17 	services; 
16.18 	(12) receive services from qualified and competent staff identified in the child's ITP; 
16.19 	(13) receive services in a manner that respects and takes into consideration the 
16.20 	child's and family's culture, values, religion, and preferences; 
16.21 	(14) receive reasonable accommodations for observance of cultural and ethnic 
16.22 	practices or religion; 
16.23 	(15) refuse or stop services and receive information about what might happen if the 
16.24 	child or the child's legal representative refuses or stops services;
16.25 	(16) access the child's and family's records as defined in federal and state law, 
16.26 	regulation, or rule; 
16.27 	(17) be free from bias and harassment about race, gender, age, disability, spirituality, 
16.28 	and sexual orientation; 
16.29 	(18) be free from physical, verbal and sexual abuse, and neglect; 
16.30 	(19) be free from restraint, time out, or seclusion, except when in imminent danger 
16.31 	to self or others; 
16.32 	(20) be in the company of or under the supervision of a responsible adult at all 
16.33 	times and ensure the hand-to-hand or eye-to-eye exchange of responsibility, as needed, 
16.34 	from the staff member to the legal representative or adults designated by the child's legal 
16.35 	representative; 
16.36 	(21) be safe at all times; 
17.1 	(22) be treated with courtesy and respect; 
17.2 	(23) give or withhold written informed consent to participate in any research or 
17.3 	experimental treatment without penalty or retaliation; 
17.4 	(24) have personal, financial, service, health, and medical information kept private; 
17.5 	(25) know if the agency gives the child's or family's private information to any 
17.6 	other person or agency; 
17.7 	(26) assert all the rights in this subdivision without retaliation; 
17.8 	(27) receive respectful treatment of the child's or family's property; 
17.9 	(28) receive services in a clean and safe environment when the agency is the owner, 
17.10 	lessor, or tenant of the property; 
17.11 	(29) receive a copy of the provider's written grievance policies and procedures; 
17.12 	(30) receive information about how to file a complaint regarding the child's or 
17.13 	family's services, including how to file an appeal under section 256.045; 
17.14 	(31) receive contact information for disability advocacy services and the appropriate 
17.15 	state-appointed ombudsman including the name, telephone number, Web site, e-mail, 
17.16 	and street addresses; 
17.17 	(32) receive information about how to get a second opinion for medical necessity 
17.18 	recommendations for EIDBI services and the child's ITP; 
17.19 	(33) receive prompt and reasonable response to questions and requests related to 
17.20 	the child's or family's services; 
17.21 	(34) protect the recipient's personal privacy including, for children older than 
17.22 	preschool, and younger children based on individual needs, the right to privacy when 
17.23 	toileting and having personal cares performed; and
17.24 	(35) receive notification from the agency within 24 hours if the child is injured while 
17.25 	receiving services, including what occurred and how agency staff responded to the injury.
17.26 		Subd. 16.EIDBI provider qualifications. (a) A level I treatment provider must be 
17.27 	employed by an EIDBI agency and:
17.28 	(1) have at least 2,000 hours of supervised clinical experience or training in 
17.29 	examining or treating children with ASD or equivalent documented coursework at the 
17.30 	graduate level by an accredited university in ASD diagnostics, ASD developmental 
17.31 	and behavioral treatment strategies, and typical child development or an equivalent 
17.32 	combination of documented coursework or hours of experience; and
17.33 	(2) have at least one of the following:
17.34 	(i) a master's degree in behavioral health or child development or allied fields, 
17.35 	including, but not limited to mental health, special education, social work, psychology, 
17.36 	speech pathology, or occupational therapy from an accredited college or university; 
18.1 	(ii) a bachelor's degree in a behavioral health or child development field from 
18.2 	an accredited college or university and advanced certification in a treatment method 
18.3 	recognized by the Department of Human Services; or
18.4 	(iii) a board-certified assistant behavioral analyst with 4,000 hours of supervised 
18.5 	clinical experience including meeting all registration, supervision, and continuing 
18.6 	education requirements of the certification.
18.7 	(b) A level II treatment provider must be employed by an EIDBI provider agency 
18.8 	and be either:
18.9 	(1) a person who:
18.10 	(i) has a bachelor's degree from an accredited college or university in a behavioral or 
18.11 	child development science or allied field including but not limited to mental health, special 
18.12 	education, social work, psychology, speech pathology, or occupational therapy; and
18.13 	(ii) has at least 1,000 hours of clinical experience or training in examining or 
18.14 	treating children with ASD or equivalent documented coursework at the graduate level 
18.15 	by an accredited university in ASD diagnostics, ASD developmental and behavioral 
18.16 	treatment strategies, and typical child development or a combination of coursework or 
18.17 	hours of experience, or certification as a board-certified assistant behavior analyst from the 
18.18 	National Behavior Analyst Certification Board or is a registered behavior technician as 
18.19 	defined by the National Behavior Analyst Certification Board or is certified in one of the 
18.20 	other treatment modalities recognized by the Department of Human Services;
18.21 	(2) a person who:
18.22 	(i) has an associate's degree in a behavioral or child development science or allied 
18.23 	field including but not limited to mental health, special education, social work, psychology, 
18.24 	speech pathology, or occupational therapy from an accredited college or university; and
18.25 	(ii) has at least 2,000 hours of supervised clinical experience in delivering treatment 
18.26 	to children with ASD. Hours worked as a behavioral aide or level III treatment provider 
18.27 	may be included in the required hours of experience;
18.28 	(3) a person who has at least 4,000 hours of supervised clinical experience in 
18.29 	delivering treatment to children with ASD. Hours worked as a mental health behavioral 
18.30 	aide or developmental or level III treatment provider may be included in the required 
18.31 	hours of experience;
18.32 	(4) a person who is a graduate student in a behavioral science, child development 
18.33 	science, or allied field and is receiving clinical supervision by a qualified supervising 
18.34 	professional affiliated with an agency to meet the clinical training requirements for 
18.35 	experience and training with children with ASD; or
18.36 	(5) a person who is at least 18 years old and who:
19.1 	(i) is fluent in the non-English language spoken in the child's home or works with a 
19.2 	tribal entity that represents the child's culture;
19.3 	(ii) meets level III EIDBI training requirements; and
19.4 	(iii) receives observation and direction from a qualified supervising professional or 
19.5 	qualified level I treatment provider at least once a week until 1,000 hours of supervised 
19.6 	clinical experience is met.
19.7 	(c) A level III treatment provider must be employed by an EIDBI provider agency, 
19.8 	have completed the level III training requirement, be at least 18 years old, and have at 
19.9 	least one of the following:
19.10 	(1) a high school diploma or general equivalency diploma (GED);
19.11 	(2) fluency in the non-English language spoken in the child's home or works with a 
19.12 	tribal entity that represents the child's culture; or
19.13 	(3) one year of experience as a primary PCA, community health worker, waiver 
19.14 	service provider, or special education assistant to a child with ASD within the previous 
19.15 	five years.
19.16 	(d) A qualified supervising professional must be employed by an EIDBI agency 
19.17 	and be:
19.18 	(1) a licensed mental health professional who has at least 2,000 hours of supervised 
19.19 	clinical experience or training in examining or treating children with ASD or equivalent 
19.20 	documented coursework at the graduate level by an accredited university in ASD 
19.21 	diagnostics, ASD developmental and behavioral treatment strategies, and typical child 
19.22 	development; or
19.23 	(2) a developmental or behavioral pediatrician who has at least 2,000 hours of 
19.24 	supervised clinical experience or training in the examining or treating of children with 
19.25 	ASD or related conditions or equivalent documented coursework at the graduate level 
19.26 	by an accredited university in the areas of ASD diagnostics, ASD developmental and 
19.27 	behavioral treatment strategies, and typical child development.
19.28 		Subd. 17.Agency responsibilities. (a) The agency must: 
19.29 	(1) exercise and protect the service recipient's rights; 
19.30 	(2) offer services that are person-centered and culturally and linguistically 
19.31 	appropriate as required under subdivision 3a;
19.32 	(3) allow people to make informed decisions concerning CMDE, treatment 
19.33 	recommendations, alternatives considered, and possible risks of services; 
19.34 	(4) have a written policy that identifies steps to resolve issues collaboratively when 
19.35 	possible; 
20.1 	(5) except for emergency situations, provide a minimum of two weeks' notice of 
20.2 	transition from EIDBI services prior to implementing a transition plan with the family; 
20.3 	(6) provide notice as soon as possible when issues arise about provision of EIDBI 
20.4 	services;
20.5 	(7) provide the legal representative with prompt notification if the child is injured 
20.6 	while being served by the agency. An incident report must be completed by the agency 
20.7 	staff member in charge of the child. Copies of all incident and injury reports must remain 
20.8 	on file at the agency for at least one year. An incident is when any of the following occur:
20.9 	(i) an illness, accident, or injury which requires first aid treatment;
20.10 	(ii) a bump or blow to the head; or
20.11 	(iii) an unusual or unexpected event which jeopardizes the safety of children or staff 
20.12 	including a child leaving the agency unattended; and
20.13 	(8) prior to starting services, provide the child or the child's legal representative a 
20.14 	plain-spoken description of the treatment method or methods that the child shall receive, 
20.15 	including the staffing certification levels and training of the staff who shall provide the 
20.16 	treatment or treatments.
20.17 	(b) Within five working days of starting services and annually thereafter, agencies 
20.18 	must provide the child or the child's legal representative with: 
20.19 	(1) a written copy of the child's rights and agency responsibilities; 
20.20 	(2) a verbal explanation of rights and responsibilities; 
20.21 	(3) reasonable accommodations to provide the information in other formats or 
20.22 	languages as needed to facilitate understanding of the rights; and 
20.23 	(4) documentation in the child's file of the date that the child or the child's 
20.24 	legal representative received a copy and explanation of the client's rights and agency 
20.25 	responsibilities.
20.26 		Subd. 18.Procedures when a child's rights are restricted. Restriction of a child's 
20.27 	rights under subdivision 15 is allowed only if determined necessary to ensure the health, 
20.28 	safety, and well-being of the child, or to support the therapeutic goals in a child's ITP. Any 
20.29 	restriction of those rights must be documented in the child's ITP. The restriction must be 
20.30 	implemented in the least restrictive alternative manner necessary to protect the child and 
20.31 	provide support to reduce or eliminate the need for the restriction in the most integrated 
20.32 	setting and inclusive manner. The documentation must include the following information: 
20.33 	(1) the justification for the restriction based on an assessment of the child's 
20.34 	vulnerability related to exercising the right without restriction; 
20.35 	(2) the objective measures set as conditions for ending the restriction; 
21.1 	(3) a schedule for reviewing the need for the restriction based on the conditions 
21.2 	for ending the restriction to occur semiannually from the date of initial approval, at a 
21.3 	minimum, or more frequently if requested by the child, the child's legal representative, or 
21.4 	case manager; and 
21.5 	(4) signed and dated approval for the restriction from the child or the child's legal 
21.6 	representative. A restriction may be implemented only when the required approval has 
21.7 	been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the 
21.8 	right must be immediately and fully restored.
21.9 		Subd. 19.EIDBI agency qualifications, general requirements, and duties. (a) 
21.10 	EIDBI agencies delivering services under this section shall: 
21.11 	(1) enroll as a medical assistance Minnesota health care programs provider 
21.12 	according to Minnesota Rules, part 9505.0195, and meet all applicable provider standards 
21.13 	and requirements; 
21.14 	(2) demonstrate compliance with federal and state laws and policies for EIDBI; 
21.15 	(3) verify and maintain records of all services provided to the child or the child's 
21.16 	legal representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197; 
21.17 	(4) not have had a lead agency contract or provider agreement discontinued due to 
21.18 	fraud, or not have had an owner, board member, or manager fail a state or FBI-based 
21.19 	criminal background check while enrolled or seeking enrollment as a Minnesota health 
21.20 	care programs provider; 
21.21 	(5) have established business practices that include written policies and procedures, 
21.22 	internal controls, and a system that demonstrates the organization's ability to deliver 
21.23 	quality EIDBI services; and 
21.24 	(6) have an office located in Minnesota. 
21.25 	(b) EIDBI agencies shall: 
21.26 	(1) report maltreatment as required under sections 626.556 and 626.557; 
21.27 	(2) provide the child or the child's legal representative with a copy of the 
21.28 	service-related rights under subdivision 15 at the start of services;
21.29 	(3) comply with any data requests from the department consistent with the 
21.30 	Government Data Practices Act under chapter 13 and section 256B.27; and
21.31 	(4) provide training for all agency staff on the Maltreatment of Minors Act 
21.32 	requirements and responsibilities, including mandated and voluntary reporting, 
21.33 	nonretaliation, and agency policy for all staff on how to report suspected abuse and neglect.
21.34 		Subd. 20.Requirements for EIDBI agency infrastructure. (a) To be an eligible 
21.35 	agency under this section, an agency must have an administrative infrastructure that 
21.36 	establishes authority and accountability for decision making and oversight of functions, 
22.1 	including finance, personnel, system management, clinical practice, and individual 
22.2 	treatment outcomes measurement. The agency must have written policies and procedures 
22.3 	that it reviews and updates every three years and distributes to staff initially and makes 
22.4 	available to staff at all times.
22.5 	(b) The administrative infrastructure written policies and procedures must include:
22.6 	(1) personnel procedures, including a process for:
22.7 	(i) recruiting, hiring, training, and retention of culturally and linguistically competent 
22.8 	providers;
22.9 	(ii) conducting a criminal background check on all direct service providers and 
22.10 	volunteers;
22.11 	(iii) investigating, reporting, and acting on violations of ethical conduct standards;
22.12 	(iv) investigating, reporting, and acting on violations of data privacy policies that 
22.13 	are compliant with federal and state laws;
22.14 	(v) utilizing volunteers, including screening applicants, training and supervising 
22.15 	volunteers, and providing liability coverage for volunteers;
22.16 	(vi) documenting staff time in a manner that allows matching of staff time records 
22.17 	with service delivery records;
22.18 	(vii) documenting that staff meet the applicable provider qualification criteria, 
22.19 	training criteria, and clinical supervision requirements; and
22.20 	(viii) arranging for qualified backup staff when the usual staff is not available;
22.21 	(2) fiscal procedures, including internal fiscal control practices and a process for 
22.22 	collecting revenue that is compliant with federal and state laws;
22.23 	(3) quality assurance procedures including an annual, confidential family survey of 
22.24 	satisfaction with services provided, including cultural appropriateness of services provided;
22.25 	(4) a limited English proficiency (LEP) plan in compliance with title VI of the 
22.26 	Civil Rights Act of 1965;
22.27 	(5) communication and language assistance in compliance with national standards 
22.28 	for culturally and linguistically appropriate services (CLAS), as published by the United 
22.29 	States Department of Health and Human Services; and
22.30 	(6) a process to establish and maintain individual client records. The records must 
22.31 	include:
22.32 	(i) the child's personal information;
22.33 	(ii) forms applicable to data privacy;
22.34 	(iii) the child's diagnostic assessment, if available; comprehensive multidisciplinary 
22.35 	evaluation under subdivision 5; updates to any assessments or the CMDE; and results of 
22.36 	tests, ITP, progress monitoring, and individual service plan;
23.1 	(iv) documentation of service delivery, including start and stop times for each service;
23.2 	(v) telephone contacts;
23.3 	(vi) discharge plan;
23.4 	(vii) documentation of other services received by the child, to the extent known by 
23.5 	the EIDBI agency;
23.6 	(viii) documentation that the child or the child's legal representative received a copy 
23.7 	of the service recipient rights described in subdivision 15; and
23.8 	(ix) insurance information, if applicable.
23.9 	(c) EIDBI agencies must develop a staff orientation and training plan that documents 
23.10 	compliance with this paragraph. Required training includes: 
23.11 	(1) Culturally Relevant Direct Care Services in Diverse Populations training 
23.12 	recognized by the Department of Human Services. This training must be completed by all 
23.13 	EIDBI agency direct service staff and individual providers;
23.14 	(2) EIDBI agency policies and practices training. This training must be completed by 
23.15 	all EIDBI direct service staff and individual providers and must cover the following topics: 
23.16 	(i) agency or provider policies, standards, and responsibilities; 
23.17 	(ii) individual provider roles and responsibilities; 
23.18 	(iii) client rights required under subdivision 15; 
23.19 	(iv) person-centered planning and service delivery; 
23.20 	(v) data privacy and collection; 
23.21 	(vi) fraud detection and prevention; 
23.22 	(vii) infection control; 
23.23 	(viii) maintaining professional boundaries; 
23.24 	(ix) mandated reporting of suspected maltreatment or abuse; 
23.25 	(x) roles and responsibilities of team members; 
23.26 	(xi) service documentation requirements and expectations; and 
23.27 	(xii) procedures related to restriction of a child's rights under subdivision 16; and
23.28 	(3) EIDBI level III basic training. This training must be completed by all level III 
23.29 	providers within six months of the date of becoming an enrolled individual MHCP EIDBI 
23.30 	provider and documented in the personnel file maintained at the enrolled agency. Level 
23.31 	III training must include: 
23.32 	(i) an overview of the EIDBI benefit. This includes a history of the EIDBI benefit, 
23.33 	purpose, eligibility, provider standards and qualifications, and department-recognized 
23.34 	treatment methods; 
23.35 	(ii) orientation to ASD that covers the core features of ASD and related conditions 
23.36 	and comorbid conditions, red flags for atypical development in children, and understanding 
24.1 	and supporting individuals with ASD and related conditions, including strategies to 
24.2 	address challenges in cognition, social interaction, communication, behavior and sensory 
24.3 	regulation, and other key functional areas of development; 
24.4 	(iii) positive behavioral support strategies; 
24.5 	(iv) working with families and caregivers; and 
24.6 	(v) understanding and supporting the ITP.
24.7 	(d) The training components in paragraph (c) may be developed and provided by 
24.8 	the agency if the components meet the requirements of paragraph (c), if the provider's 
24.9 	training is approved by the commissioner.
24.10 		Subd. 21.Commissioner's access. When the commissioner is investigating a 
24.11 	possible overpayment of Medicaid funds, the commissioner must be given immediate 
24.12 	access without prior notice to the provider during regular business hours and to 
24.13 	documentation and records related to services provided and submission of claims for 
24.14 	services provided. Denying the commissioner access to records is cause for immediate 
24.15 	suspension of payment and terminating the agency's enrollment according to section 
24.16 	256B.064.
24.17 		Subd. 22.Provider shortage; commissioner authority for exceptions. (a) In 
24.18 	consultation with the EIDBI advisory council, the commissioner shall determine if a 
24.19 	shortage of qualified providers exists. A shortage means a lack of availability of providers 
24.20 	that results in the delay of access to diagnosis, CMDE, or treatment of children with 
24.21 	ASD and related conditions. The commissioner shall consider geographic factors when 
24.22 	determining the prevalence of a shortage. The commissioner may determine that a shortage 
24.23 	exists only in a specific region of the state, multiple regions of the state, or statewide.
24.24 	(b) If the commissioner determines that a shortage exists under paragraph (a), the 
24.25 	commissioner, in consultation with the EIDBI advisory council, shall establish processes 
24.26 	and criteria for granting exceptions under this subdivision. The commissioner may grant 
24.27 	exceptions to the following requirements:
24.28 	(1) QSP or level I, level II, or level III treatment provider qualification criteria in 
24.29 	subdivision 16; and
24.30 	(2) CMDE requirements in subdivision 5a.
24.31 	(c) When the commissioner determines that a provider shortage no longer exists, the 
24.32 	commissioner shall submit a notice to the chairs and ranking minority members of the 
24.33 	house of representatives and senate committees with oversight over health and human 
24.34 	services. This notice shall be posted for public comment for at least 30 days prior to the 
24.35 	termination of the exception authority. Until the shortage ends, the commissioner shall 
24.36 	provide an update annually to the chairs and ranking minority members of the house of 
25.1 	representatives and senate committees with jurisdiction over health and human services on 
25.2 	the status of the provider shortage and exception process.

25.3 	Sec. 2. EFFECTIVE DATES.
 25.4 	(a) The amendments to Minnesota Statutes, section 256B.0949, subdivisions 1, 5a, 
25.5 	13, 14, and 22, are effective the day following final enactment.
25.6 	(b) The amendments to Minnesota Statutes, section 256B.0949, subdivisions 2 to 
25.7 	3a, 5, 6 to 9, and 15 to 21, are effective August 1, 2016.
25.8 	(c) The amendments to Minnesota Statutes, section 256B.0949, subdivision 4, are 
25.9 	effective January 1, 2017.