1.1 	A bill for an act
1.2 	relating to human services; modifying provisions governing children and families 
1.3 	services, chemical and mental health services, operations, health care, and 
1.4 	community supports; making various technical corrections;amending Minnesota 
1.5 	Statutes 2016, sections 144D.04, subdivision 2, by adding a subdivision; 245.095; 
1.6 	245.462, subdivisions 6, 11; 245.464, subdivision 2; 245.466, subdivision 2; 
1.7 	245.470, subdivision 2; 245.4871, subdivisions 9a, 14, by adding a subdivision; 
1.8 	245.4875, subdivision 2; 245.488, subdivision 2; 245.735, subdivision 3; 245.8261, 
1.9 	subdivision 1; 245A.02, subdivisions 5a, 8, 9, 12, by adding subdivisions; 245A.03, 
1.10 	subdivisions 1, 7; 245A.04, subdivisions 2, 4, 6, 7, 10, 14, by adding a subdivision; 
1.11 	245A.05; 245A.11, by adding subdivisions; 245D.02, subdivision 20; 245D.03, 
1.12 	subdivision 1; 245D.04, subdivision 3; 245D.071, subdivision 3; 245D.09, 
1.13 	subdivision 5a; 245D.11, subdivision 4; 245D.24, subdivision 3; 253B.02, 
1.14 	subdivision 9; 254B.15, subdivisions 4, 5; 256.01, subdivision 29; 256.045, 
1.15 	subdivision 3; 256B.02, subdivision 7; 256B.04, subdivision 21; 256B.055, 
1.16 	subdivision 12; 256B.0615; 256B.0616; 256B.0622, subdivisions 2, 2b, 3a, 4, 7a, 
1.17 	7b; 256B.0623, subdivision 2; 256B.0624, subdivisions 1, 2, 3, 4; 256B.0625, 
1.18 	subdivisions 43, 60a; 256B.064, subdivision 1b; 256B.0651, subdivision 17; 
1.19 	256B.0659, subdivisions 3, 12, 14, 21, 23, 24; 256B.0911, subdivision 3a; 
1.20 	256B.092, subdivisions 1a, 14; 256B.0943, subdivisions 1, 2, 4, 7, 8, 9; 256B.0946, 
1.21 	subdivisions 1, 1a, 4, 6; 256B.0947, subdivisions 3a, 7; 256B.49, subdivisions 13, 
1.22 	25; 256B.4912, by adding a subdivision; 256B.4913, by adding a subdivision; 
1.23 	256B.4914, subdivisions 3, 5, 8, 16; 256B.84; 256B.85, subdivision 12b; 256D.051, 
1.24 	subdivisions 1, 1a, 2, 3, 3a, 3b, 6b, 8, 18; 256G.01, subdivision 4; 256G.02, 
1.25 	subdivision 4; 256G.09, subdivision 2; 256G.10; 256J.751, subdivisions 2, 5, by 
1.26 	adding subdivisions; 256N.02, subdivisions 10, 16, 17, 18; 256N.22, subdivision 
1.27 	1; 256N.23, subdivision 6; 256N.24, subdivisions 1, 8, 11, 12, 14; 256N.28, 
1.28 	subdivision 6; 256P.02, subdivisions 1, 1a; 256P.08, subdivision 4; 626.5572, 
1.29 	subdivision 21; proposing coding for new law in Minnesota Statutes, chapters 245; 
1.30 	245A; repealing Minnesota Statutes 2016, sections 119B.125, subdivision 8; 
1.31 	245.469; 245.4879; 256B.0624, subdivisions 4a, 5, 6, 7, 8, 9, 10, 11; 256B.0625, 
1.32 	subdivision 35a; 256B.0944; Minnesota Rules, parts 9555.6255; 9555.7100; 
1.33 	9555.7200; 9555.7300; 9555.7600.
1.34 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.1 	ARTICLE 1
2.2 	CHILDREN AND FAMILIES SERVICES

2.3 	Section 1. Minnesota Statutes 2016, section 256D.051, subdivision 1, is amended to read:
2.4 		Subdivision 1.Food stamp employment and training program. The commissioner 
2.5 	shall implement a food stamp employment and training program in order to meet the food 
2.6 	stamp employment and training participation requirements of the United States Department 
2.7 	of Agriculture. Unless exempt under subdivision 3a, each adult recipient in the unit must 
2.8 	participate in the food stamp employment and training program each month that the person 
2.9 	is eligible for food stamps. The person's participation in food stamp employment and training 
2.10 	services must begin no later than the first day of the calendar month following the 
2.11 	determination of eligibility for food stamps. With the county agency's consent, and To the 
2.12 	extent of available resources, the person a recipient may voluntarily continue volunteer to 
2.13 	participate in food stamp employment and training services for up to three additional 
2.14 	consecutive months immediately following termination of food stamp benefits in order to 
2.15 	complete the provisions of the person's employability development plan. A recipient who 
2.16 	volunteers for employment and training services is subject to the work requirements in Code 
2.17 	of Federal Regulations, title 7, section 273.7.

2.18 	EFFECTIVE DATE. This section is effective October 1, 2017.

2.19 	Sec. 2. Minnesota Statutes 2016, section 256D.051, subdivision 1a, is amended to read:
2.20 		Subd. 1a.Notices and sanctions. (a) At the time the county agency notifies the household 
2.21 	that it is eligible for food stamps, the county agency must inform all mandatory employment 
2.22 	and training services participants as identified in subdivision 1 in the household that they 
2.23 	must comply with all food stamp employment and training program requirements each 
2.24 	month, including the requirement to attend an initial orientation to the food stamp 
2.25 	employment and training program and that food stamp eligibility will end unless the 
2.26 	participants comply with the requirements specified in the notice an adult of the opportunity 
2.27 	to volunteer for and participate in SNAP employment and training activities, provide plain 
2.28 	language material that explains the benefits of voluntary participation, and provide the name 
2.29 	and address of the county's designated employment and training service provider.
2.30 	(b) A participant who fails without good cause to comply with food stamp employment 
2.31 	and training program requirements of this section, including attendance at orientation, will 
2.32 	lose food stamp eligibility for the following periods: The county must inform each recipient 
2.33 	who is an able-bodied adult without dependents that the recipient's SNAP benefits are limited 
3.1 	to three months in a 36-month period from the first full month of application unless the 
3.2 	recipient meets the work requirements in Code of Federal Regulations, title 7, section 273.7.
3.3 	(1) for the first occurrence, for one month or until the person complies with the 
3.4 	requirements not previously complied with, whichever is longer;
3.5 	(2) for the second occurrence, for three months or until the person complies with the 
3.6 	requirements not previously complied with, whichever is longer; or
3.7 	(3) for the third and any subsequent occurrence, for six months or until the person 
3.8 	complies with the requirements not previously complied with, whichever is longer.
3.9 	If the participant is not the food stamp head of household, the person shall be considered 
3.10 	an ineligible household member for food stamp purposes. If the participant is the food stamp 
3.11 	head of household, the entire household is ineligible for food stamps as provided in Code 
3.12 	of Federal Regulations, title 7, section 273.7(g). "Good cause" means circumstances beyond 
3.13 	the control of the participant, such as illness or injury, illness or injury of another household 
3.14 	member requiring the participant's presence, a household emergency, or the inability to 
3.15 	obtain child care for children between the ages of six and 12 or to obtain transportation 
3.16 	needed in order for the participant to meet the food stamp employment and training program 
3.17 	participation requirements.
3.18 	(c) The county agency shall mail or hand deliver a notice to the participant not later than 
3.19 	five days after determining that the participant has failed without good cause to comply 
3.20 	with food stamp employment and training program requirements which specifies the 
3.21 	requirements that were not complied with, the factual basis for the determination of 
3.22 	noncompliance, and the right to reinstate eligibility upon a showing of good cause for failure 
3.23 	to meet the requirements. The notice must ask the reason for the noncompliance and identify 
3.24 	the participant's appeal rights. The notice must request that the participant inform the county 
3.25 	agency if the participant believes that good cause existed for the failure to comply and must 
3.26 	state that the county agency intends to terminate eligibility for food stamp benefits due to 
3.27 	failure to comply with food stamp employment and training program requirements.
3.28 	(d) If the county agency determines that the participant did not comply during the month 
3.29 	with all food stamp employment and training program requirements that were in effect, and 
3.30 	if the county agency determines that good cause was not present, the county must provide 
3.31 	a ten-day notice of termination of food stamp benefits. The amount of food stamps that are 
3.32 	withheld from the household and determination of the impact of the sanction on other 
3.33 	household members is governed by Code of Federal Regulations, title 7, section 273.7.
4.1 	(e) The participant may appeal the termination of food stamp benefits under the provisions 
4.2 	of section 256.045.

4.3 	EFFECTIVE DATE. This section is effective October 1, 2017.

4.4 	Sec. 3. Minnesota Statutes 2016, section 256D.051, subdivision 2, is amended to read:
4.5 		Subd. 2.County agency duties. (a) The county agency shall provide to food stamp 
4.6 	recipients a food stamp employment and training program. The program must include:
4.7 	(1) orientation to the food stamp employment and training program;
4.8 	(2) an individualized employability assessment and an individualized employability 
4.9 	development plan that includes assessment of literacy, ability to communicate in the English 
4.10 	language, educational and employment history, and that estimates the length of time it will 
4.11 	take the participant to obtain employment. The employability assessment and development 
4.12 	plan must be completed in consultation with the participant, must assess the participant's 
4.13 	assets, barriers, and strengths, and must identify steps necessary to overcome barriers to 
4.14 	employment. A copy of the employability development plan must be provided to the 
4.15 	registrant;
4.16 	(3) referral to available accredited remedial or skills training or career pathways programs 
4.17 	designed to address participant's barriers to employment;
4.18 	(4) referral to available programs that provide subsidized or unsubsidized employment 
4.19 	as necessary;
4.20 	(5) a job search program, including job seeking skills training; and
4.21 	(6) other activities, to the extent of available resources designed by the county agency 
4.22 	to prepare the participant for permanent employment.
4.23 	In order to allow time for job search, the county agency may not require an individual 
4.24 	to participate in the food stamp employment and training program for more than 32 hours 
4.25 	a week. The county agency shall require an individual to spend at least eight hours a week 
4.26 	in job search or other food stamp employment and training program activities.
4.27 	(b) The county agency shall prepare an annual plan for the operation of its food stamp 
4.28 	employment and training program. The plan must be submitted to and approved by the 
4.29 	commissioner of employment and economic development. The plan must include:
4.30 	(1) a description of the services to be offered by the county agency;
5.1 	(2) a plan to coordinate the activities of all public entities and private nonprofit entities 
5.2 	providing employment-related services in order to avoid duplication of effort and to provide
5.3 	a wide range of allowable activities and services more efficiently;
5.4 	(3) a description of the factors that will be taken into account when determining a client's 
5.5 	employability development plan; and
5.6 	(4) provisions to ensure that the a county agency's employment and training service 
5.7 	provider provides each recipient with an orientation, employability assessment, and 
5.8 	employability development plan as specified in paragraph (a), clauses (1) and (2), within 
5.9 	30 days of the recipient's eligibility for assistance request to participate in employment and 
5.10 	training.

5.11 	EFFECTIVE DATE. This section is effective October 1, 2017.

5.12 	Sec. 4. Minnesota Statutes 2016, section 256D.051, subdivision 3, is amended to read:
5.13 		Subd. 3.Participant duties. In order to receive food stamp assistance employment and 
5.14 	training services, a registrant participant who volunteers shall: (1) cooperate with the county 
5.15 	agency in all aspects of the food stamp employment and training program; and (2) accept 
5.16 	any suitable employment, including employment offered through the Job Training Partnership 
5.17 	Act, and other employment and training options; and (3) participate in food stamp 
5.18 	employment and training activities assigned by the county agency. The county agency may 
5.19 	terminate employment and training assistance to a registrant voluntary participant who fails 
5.20 	to cooperate in the food stamp employment and training program, as provided in subdivision 
5.21 	1a unless good cause is provided.

5.22 	EFFECTIVE DATE. This section is effective October 1, 2017.

5.23 	Sec. 5. Minnesota Statutes 2016, section 256D.051, subdivision 3a, is amended to read:
5.24 		Subd. 3a.Requirement to register work. (a) To the extent required under Code of 
5.25 	Federal Regulations, title 7, section 273.7(a), each applicant for and recipient of food stamps 
5.26 	is required to register for work as a condition of eligibility for food stamp benefits. Applicants 
5.27 	and recipients are registered by signing an application or annual reapplication for food 
5.28 	stamps, and must be informed that they are registering for work by signing the form.
5.29 	(b) The commissioner shall determine, within federal requirements, persons required to 
5.30 	participate in the food stamp employment and training (FSET) program.
5.31 	(c) The following food stamp recipients are exempt from mandatory participation in 
5.32 	food stamp employment and training services:
6.1 	(1) recipients of benefits under the Minnesota family investment program, Minnesota 
6.2 	supplemental aid program, or the general assistance program;
6.3 	(2) a child;
6.4 	(3) a recipient over age 55;
6.5 	(4) a recipient who has a mental or physical illness, injury, or incapacity which is expected 
6.6 	to continue for at least 30 days and which impairs the recipient's ability to obtain or retain 
6.7 	employment as evidenced by professional certification or the receipt of temporary or 
6.8 	permanent disability benefits issued by a private or government source;
6.9 	(5) a parent or other household member responsible for the care of either a dependent 
6.10 	child in the household who is under age six or a person in the household who is professionally 
6.11 	certified as having a physical or mental illness, injury, or incapacity. Only one parent or 
6.12 	other household member may claim exemption under this provision;
6.13 	(6) a recipient receiving unemployment insurance or who has applied for unemployment 
6.14 	insurance and has been required to register for work with the Department of Employment 
6.15 	and Economic Development as part of the unemployment insurance application process;
6.16 	(7) a recipient participating each week in a drug addiction or alcohol abuse treatment 
6.17 	and rehabilitation program, provided the operators of the treatment and rehabilitation 
6.18 	program, in consultation with the county agency, recommend that the recipient not participate 
6.19 	in the food stamp employment and training program;
6.20 	(8) a recipient employed or self-employed for 30 or more hours per week at employment 
6.21 	paying at least minimum wage, or who earns wages from employment equal to or exceeding 
6.22 	30 hours multiplied by the federal minimum wage; or
6.23 	(9) a student enrolled at least half time in any school, training program, or institution of 
6.24 	higher education. When determining if a student meets this criteria, the school's, program's 
6.25 	or institution's criteria for being enrolled half time shall be used.

6.26 	EFFECTIVE DATE. This section is effective October 1, 2017.

6.27 	Sec. 6. Minnesota Statutes 2016, section 256D.051, subdivision 3b, is amended to read:
6.28 		Subd. 3b.Orientation. The county agency or its employment and training service 
6.29 	provider providers must provide an orientation to food stamp employment and training 
6.30 	services to each nonexempt food stamp recipient within 30 days of the date that food stamp 
6.31 	eligibility is determined the recipient agreed to volunteer. The orientation must inform the 
6.32 	participant of the requirement to participate benefits of participating in services, the date, 
7.1 	time, and address to report to for services, the name and telephone number of the food stamp 
7.2 	employment and training service provider, the consequences for failure without good cause 
7.3 	to comply, the services and support services available through food stamp employment and 
7.4 	training services and other providers of similar services, and must encourage the participant 
7.5 	to view the food stamp program as a temporary means of supplementing the family's food 
7.6 	needs until the family achieves self-sufficiency through employment. The orientation may 
7.7 	be provided through audio-visual methods, but the participant must have the opportunity 
7.8 	for face-to-face interaction with county agency staff.

7.9 	EFFECTIVE DATE. This section is effective October 1, 2017.

7.10 	Sec. 7. Minnesota Statutes 2016, section 256D.051, subdivision 6b, is amended to read:
7.11 		Subd. 6b.Federal reimbursement. (a) Federal financial participation from the United 
7.12 	States Department of Agriculture for food stamp employment and training expenditures 
7.13 	that are eligible for reimbursement through the food stamp employment and training program 
7.14 	are dedicated funds and are annually appropriated to the commissioner of human services 
7.15 	for the operation of the food stamp employment and training program.
7.16 	(b) The appropriation must be used for skill attainment through employment, training, 
7.17 	and support services for food stamp participants. By February 15, 2017, the commissioner 
7.18 	shall report to the chairs and ranking minority members of the legislative committees having 
7.19 	jurisdiction over the food stamp employment and training program on the progress of 
7.20 	securing additional federal reimbursement dollars under this program.
7.21 	(c) Federal financial participation for the nonstate portion of food stamp employment 
7.22 	and training costs must be paid to the county agency or service provider that incurred the 
7.23 	costs at a rate to be determined by the Departments of Human Services and Employment 
7.24 	and Economic Development.

7.25 	EFFECTIVE DATE. This section is effective October 1, 2017.

7.26 	Sec. 8. Minnesota Statutes 2016, section 256D.051, subdivision 8, is amended to read:
7.27 		Subd. 8.Voluntary quit. A person who is required to participate in food stamp 
7.28 	employment and training services is not eligible for food stamps if, without good cause, the 
7.29 	person refuses a legitimate offer of, or quits, suitable employment within 60 30 days before 
7.30 	the date of application. A person who is required to participate in food stamp employment 
7.31 	and training services and, without good cause, voluntarily quits suitable employment or 
8.1 	refuses a legitimate offer of suitable employment while receiving food stamps shall be 
8.2 	terminated from the food stamp program as specified in subdivision 1a.

8.3 	EFFECTIVE DATE. This section is effective October 1, 2017.

8.4 	Sec. 9. Minnesota Statutes 2016, section 256D.051, subdivision 18, is amended to read:
8.5 		Subd. 18.Work experience placements. (a) To the extent of available resources, each 
8.6 	county agency must may establish and operate a work experience component in the food 
8.7 	stamp employment and training program for recipients who are subject to a federal limit of 
8.8 	three months of food stamp eligibility in any 36-month period. The purpose of the work 
8.9 	experience component is to enhance the participant's employability, self-sufficiency, and 
8.10 	to provide meaningful, productive work activities.
8.11 	(b) The commissioner shall assist counties in the design and implementation of these 
8.12 	components. The commissioner must ensure that job placements under a work experience 
8.13 	component comply with section 256J.72. Written or oral concurrence with job duties of 
8.14 	persons placed under the community work experience program shall be obtained from the 
8.15 	appropriate exclusive bargaining representative.
8.16 	(c) Worksites developed under this section are limited to projects that serve a useful 
8.17 	public service such as health, social service, environmental protection, education, urban 
8.18 	and rural development and redevelopment, welfare, recreation, public facilities, public 
8.19 	safety, community service, services to aged or disabled citizens, and child care. To the 
8.20 	extent possible, the prior training, skills, and experience of a recipient must be used in 
8.21 	making appropriate work experience assignments.
8.22 	(d) Structured, supervised volunteer uncompensated work with an agency or organization 
8.23 	that is monitored by the county service provider may, with the approval of the county agency, 
8.24 	be used as a work experience placement.
8.25 	(e) As a condition of placing a person receiving food stamps in a program under this 
8.26 	subdivision, the county agency shall first provide the recipient the opportunity:
8.27 	(1) for placement in suitable subsidized or unsubsidized employment through participation 
8.28 	in job search under section 256D.051; or
8.29 	(2) for placement in suitable employment through participation in on-the-job training a 
8.30 	paid work experience, if such employment is available.; or
8.31 	(3) for placement in an educational program designed to increase job skills and 
8.32 	employability.
9.1 	(f) The county agency shall limit the maximum monthly number of hours that any 
9.2 	participant may work in a work experience placement to a number equal to the amount of 
9.3 	the family's monthly food stamp allotment divided by the greater of the federal minimum 
9.4 	wage or the applicable state minimum wage.
9.5 	After a participant has been assigned to a position for nine months, the participant may 
9.6 	not continue in that assignment unless the maximum number of hours a participant works 
9.7 	is no greater than the amount of the food stamp benefit divided by the rate of pay for 
9.8 	individuals employed in the same or similar occupations by the same employer at the same 
9.9 	site.
9.10 	(g) The participant's employability development plan must include the length of time 
9.11 	needed in the work experience program, the need to continue job seeking activities while 
9.12 	participating in work experience, and the participant's employment goals.
9.13 	(h) After each six months of a recipient's participation in a work experience job placement, 
9.14 	and at the conclusion of each work experience assignment under this section, the county 
9.15 	agency shall reassess and revise, as appropriate, the participant's employability development 
9.16 	plan.
9.17 	(i) A participant has good cause for failure to cooperate with a work experience job 
9.18 	placement if, in the judgment of the employment and training service provider, the reason 
9.19 	for failure is reasonable and justified. Good cause for purposes of this section is defined in 
9.20 	subdivision 1a, paragraph (b).
9.21 	(j) A recipient who has failed without good cause to participate in or comply with the 
9.22 	work experience job placement shall be terminated from participation in work experience 
9.23 	job activities. If the recipient is not exempt from mandatory food stamp employment and 
9.24 	training program participation under subdivision 3a, the recipient will be assigned to other 
9.25 	mandatory program activities. If the recipient is exempt from mandatory participation but 
9.26 	is participating as a volunteer, the person shall be terminated from the food stamp 
9.27 	employment and training program.

9.28 	EFFECTIVE DATE. This section is effective October 1, 2017.

9.29 	Sec. 10. Minnesota Statutes 2016, section 256J.751, subdivision 2, is amended to read:
9.30 		Subd. 2.Quarterly comparison report TANF work participation rates. (a) The 
9.31 	commissioner shall report quarterly to all counties on each county's performance on the 
9.32 	following measures:
9.33 	(1) percent of MFIP caseload working in paid employment;
10.1 	(2) percent of MFIP caseload receiving only the food portion of assistance;
10.2 	(3) number of MFIP cases that have left assistance;
10.3 	(4) median placement wage rate;
10.4 	(5) caseload by months of TANF assistance;
10.5 	(6) percent of MFIP and diversionary work program (DWP) cases off cash assistance 
10.6 	or working 30 or more hours per week at one-year, two-year, and three-year follow-up 
10.7 	points from a baseline quarter. This measure is called the self-support index. The 
10.8 	commissioner shall report quarterly an expected range of performance for each county, 
10.9 	county grouping, and tribe on the self-support index. The expected range shall be derived 
10.10 	by a statistical methodology developed by the commissioner in consultation with the counties 
10.11 	and tribes. The statistical methodology shall control differences across counties in economic 
10.12 	conditions and demographics of the MFIP and DWP case load; and
10.13 	(7) the TANF work participation rate, defined as the participation requirements specified 
10.14 	under Public Law 109-171, the Deficit Reduction Act of 2005.
10.15 	(b) The commissioner shall not apply the limits on vocational educational training and 
10.16 	education activities under Code of Federal Regulations, title 45, section 261.33(c), when 
10.17 	determining TANF work participation rates for individual counties under this subdivision.

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

10.19 	Sec. 11. Minnesota Statutes 2016, section 256J.751, is amended by adding a subdivision 
10.20 	to read:
10.21 		Subd. 2a.Comparison reports. The commissioner, in cooperation with counties, tribes, 
10.22 	and employment services agencies, shall develop and provide monthly and quarterly reports 
10.23 	to all counties, tribes, and employment services agencies on each county's and tribe's 
10.24 	performance, including work participation rate and racial and geographic data that measures 
10.25 	disparities within MFIP.

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

10.27 	Sec. 12. Minnesota Statutes 2016, section 256J.751, is amended by adding a subdivision 
10.28 	to read:
10.29 		Subd. 4a.Self-support index. The self-support index is the percentage of MFIP and 
10.30 	diversionary work program (DWP) cases off cash assistance or working 30 hours or more 
10.31 	per week at one-, two-, and three-year follow-up points from a baseline quarter. The 
11.1 	commissioner shall report quarterly an expected range of performance for each county, 
11.2 	county grouping, and tribe on the self-support index. The expected range shall be based on 
11.3 	a statistical methodology developed by the commissioner in consultation with the counties 
11.4 	and tribes. The statistical methodology shall control differences across counties in economic 
11.5 	conditions and demographics of the MFIP and DWP caseload.

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

11.7 	Sec. 13. Minnesota Statutes 2016, section 256J.751, subdivision 5, is amended to read:
11.8 		Subd. 5.Failure to meet federal performance standards. (a) If sanctions occur for 
11.9 	failure to meet the performance standards specified in title 1 of Public Law 104-193 of the 
11.10 	Personal Responsibility and Work Opportunity Act of 1996, and under Public Law 109-171, 
11.11 	the Deficit Reduction Act of 2005, the state shall pay 88 percent of the sanction. The 
11.12 	remaining 12 percent of the sanction will be paid by the counties. The county portion of the 
11.13 	sanction will be distributed across all counties in proportion to each county's percentage of 
11.14 	the MFIP average monthly caseload during the period for which the sanction was applied.
11.15 	(b) If a county fails to meet the performance standards specified in title 1 of Public Law 
11.16 	104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and Public Law 
11.17 	109-171, the Deficit Reduction Act of 2005, for any year, the commissioner shall work with 
11.18 	counties to organize a joint state-county technical assistance team to work with the county. 
11.19 	The commissioner shall coordinate any technical assistance with other departments and 
11.20 	agencies including the Departments of Employment and Economic Development and 
11.21 	Education as necessary to achieve the purpose of this paragraph.
11.22 	(c) For state performance measures, a low-performing county is one that:
11.23 	(1) performs below the bottom of their expected range for the measure in subdivision 
11.24 	2, clause (6), 5 in an annualized measurement reported in October of each year; or
11.25 	(2) performs below 40 percent for the measure in subdivision 2, clause (7) TANF work 
11.26 	participation rate, as averaged across the four quarterly measurements for the year, or the 
11.27 	ten counties with the lowest rates if more than ten are below 40 percent.
11.28 	(d) Low-performing counties under paragraph (c) must engage in corrective action 
11.29 	planning as defined by the commissioner. The commissioner may coordinate technical 
11.30 	assistance as specified in paragraph (b) for low-performing counties under paragraph (c).

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

12.1 	Sec. 14. Minnesota Statutes 2016, section 256N.02, subdivision 10, is amended to read:
12.2 		Subd. 10.Financially responsible agency. "Financially responsible agency" means the 
12.3 	agency that is financially responsible for a child. These agencies include both local social 
12.4 	service agencies under section 393.07 and tribal social service agencies authorized in section 
12.5 	256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative, and 
12.6 	Minnesota tribes who assume financial responsibility of children from other states. Under 
12.7 	Northstar Care for Children, the agency that is financially responsible at the time of placement 
12.8 	for foster care continues to be responsible under section 256N.27 for the local share of any 
12.9 	maintenance payments, even after finalization of the adoption ofor transfer of permanent 
12.10 	legal and physical custody of a child.

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

12.12 	Sec. 15. Minnesota Statutes 2016, section 256N.02, subdivision 16, is amended to read:
12.13 		Subd. 16.Permanent legal and physical custody. "Permanent legal and physical 
12.14 	custody" means (1) a full transfer of permanent legal and physical custody ordered by a 
12.15 	Minnesota juvenile court under section 260C.515, subdivision 4, to a relative ordered by a 
12.16 	Minnesota juvenile court under section 260C.515, subdivision 4 who is not a parent as 
12.17 	defined in section 260C.007, subdivision 25, or (2) for a child under jurisdiction of a tribal 
12.18 	court, a judicial determination under a similar provision in tribal code which means that a 
12.19 	relative will assume the duty and authority to provide care, control, and protection of a child 
12.20 	who is residing in foster care, and to make decisions regarding the child's education, health 
12.21 	care, and general welfare until adulthood. For purposes of establishing eligibility for Northstar 
12.22 	kinship assistance, permanent legal and physical custody shall not include joint legal custody, 
12.23 	joint physical custody, or joint legal and physical custody between a child's parent and 
12.24 	relative custodian.

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

12.26 	Sec. 16. Minnesota Statutes 2016, section 256N.02, subdivision 17, is amended to read:
12.27 		Subd. 17.Reassessment. "Reassessment" means an update of a previous assessment 
12.28 	through the process under section 256N.24 for a child who has been continuously eligible 
12.29 	for Northstar Care for Children, or when a child identified as an at-risk child (Level A) 
12.30 	under guardianship or adoption assistance has manifested the disability upon which eligibility 
12.31 	for the agreement was based according to section 256N.25, subdivision 3, paragraph (b). 
12.32 	A reassessment may be used to update an initial assessment, a special assessment, or a 
12.33 	previous reassessment.

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

13.2 	Sec. 17. Minnesota Statutes 2016, section 256N.02, subdivision 18, is amended to read:
13.3 		Subd. 18.Relative. "Relative," as described in section 260C.007, subdivision 27, means 
13.4 	a person related to the child by blood, marriage, or adoption,; the legal parent, guardian, or 
13.5 	custodian of the child's sibling; or an individual who is an important friend with whom the 
13.6 	child has resided or had significant contact. For an Indian child, relative, as described in 
13.7 	section 260C.007, subdivision 26b, means a person who is a member of the Indian child's 
13.8 	family as defined in the Indian Child Welfare Act of 1978, United States Code, title 25, 
13.9 	section 1903, paragraphs (2), (6), and (9).

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

13.11 	Sec. 18. Minnesota Statutes 2016, section 256N.22, subdivision 1, is amended to read:
13.12 		Subdivision 1.General eligibility requirements. (a) To be eligible for Northstar kinship 
13.13 	assistance under this section, there must be a judicial determination under section 260C.515, 
13.14 	subdivision 4, that a transfer of permanent legal and physical custody to a relative who is 
13.15 	not a parent is in the child's best interest. For a child under jurisdiction of a tribal court, a 
13.16 	judicial determination under a similar provision in tribal code indicating that a relative will 
13.17 	assume the duty and authority to provide care, control, and protection of a child who is 
13.18 	residing in foster care, and to make decisions regarding the child's education, health care, 
13.19 	and general welfare until adulthood, and that this is in the child's best interest is considered 
13.20 	equivalent. A child whose parent shares legal, physical, or legal and physical custody with 
13.21 	a relative custodian is not eligible for Northstar kinship assistance. Additionally, a child 
13.22 	must:
13.23 	(1) have been removed from the child's home pursuant to a voluntary placement 
13.24 	agreement or court order;
13.25 	(2)(i) have resided with the prospective relative custodian who has been a licensed child 
13.26 	foster parent for at least six consecutive months; or
13.27 	(ii) have received from the commissioner an exemption from the requirement in item 
13.28 	(i) that the prospective relative custodian has been a licensed child foster parent for at least 
13.29 	six consecutive months, based on a determination that:
13.30 	(A) an expedited move to permanency is in the child's best interest;
13.31 	(B) expedited permanency cannot be completed without provision of Northstar kinship 
13.32 	assistance;
14.1 	(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as 
14.2 	defined in section 260C.212, subdivision 2, on a permanent basis;
14.3 	(D) the child and prospective relative custodian meet the eligibility requirements of this 
14.4 	section; and
14.5 	(E) efforts were made by the legally responsible agency to place the child with the 
14.6 	prospective relative custodian as a licensed child foster parent for six consecutive months 
14.7 	before permanency, or an explanation why these efforts were not in the child's best interests;
14.8 	(3) meet the agency determinations regarding permanency requirements in subdivision 
14.9 	2;
14.10 	(4) meet the applicable citizenship and immigration requirements in subdivision 3;
14.11 	(5) have been consulted regarding the proposed transfer of permanent legal and physical 
14.12 	custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years 
14.13 	of age prior to the transfer of permanent legal and physical custody; and
14.14 	(6) have a written, binding agreement under section 256N.25 among the caregiver or 
14.15 	caregivers, the financially responsible agency, and the commissioner established prior to 
14.16 	transfer of permanent legal and physical custody.
14.17 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
14.18 	custodian or custodians must meet the applicable background study requirements in 
14.19 	subdivision 4.
14.20 	(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any 
14.21 	additional criteria in section 473(d) of the Social Security Act. The sibling of a child who 
14.22 	meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social 
14.23 	Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling 
14.24 	are placed with the same prospective relative custodian or custodians, and the legally 
14.25 	responsible agency, relatives, and commissioner agree on the appropriateness of the 
14.26 	arrangement for the sibling. A child who meets all eligibility criteria except those specific 
14.27 	to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid 
14.28 	through funds other than title IV-E.

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

14.30 	Sec. 19. Minnesota Statutes 2016, section 256N.23, subdivision 6, is amended to read:
14.31 		Subd. 6.Exclusions. The commissioner must not enter into an adoption assistance 
14.32 	agreement with the following individuals:
15.1 	(1) a child's biological parent or stepparent;
15.2 	(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the 
15.3 	child resided immediately prior to child welfare involvement unless:
15.4 	(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an 
15.5 	order under chapter 260C or equivalent provisions of tribal code and the agency had 
15.6 	placement and care responsibility for permanency planning for the child; and
15.7 	(ii) the child is under guardianship of the commissioner of human services according to 
15.8 	the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal 
15.9 	court after termination of parental rights, suspension of parental rights, or a finding by the 
15.10 	tribal court that the child cannot safely return to the care of the parent;
15.11 	(3) an individual adopting a child who is the subject of a direct adoptive placement under 
15.12 	section 259.47 or the equivalent in tribal code;
15.13 	(4) a child's legal custodian or guardian who is now adopting the child, except for a 
15.14 	relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving 
15.15 	Northstar kinship assistance benefits; or
15.16 	(5) an individual who is adopting a child who is not a citizen or resident of the United 
15.17 	States and was either adopted in another country or brought to the United States for the 
15.18 	purposes of adoption.

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

15.20 	Sec. 20. Minnesota Statutes 2016, section 256N.24, subdivision 1, is amended to read:
15.21 		Subdivision 1.Assessment. (a) Each child eligible under sections 256N.21, 256N.22, 
15.22 	and 256N.23, must be assessed to determine the benefits the child may receive under section 
15.23 	256N.26, in accordance with the assessment tool, process, and requirements specified in 
15.24 	subdivision 2.
15.25 	(b) If an agency applies the emergency foster care rate for initial placement under section 
15.26 	256N.26, the agency may wait up to 30 days to complete the initial assessment.
15.27 	(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic 
15.28 	level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
15.29 	(d) An assessment must not be completed for:
16.1 	(1) a child eligible for Northstar kinship assistance under section 256N.22 or adoption 
16.2 	assistance under section 256N.23 who is determined to be an at-risk child. A child under 
16.3 	this clause must be assigned level A under section 256N.26, subdivision 1; and
16.4 	(2) a child transitioning into Northstar Care for Children under section 256N.28, 
16.5 	subdivision 7, unless the commissioner determines an assessment is appropriate.

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

16.7 	Sec. 21. Minnesota Statutes 2016, section 256N.24, subdivision 8, is amended to read:
16.8 		Subd. 8.Completing the special assessment. (a) The special assessment must be 
16.9 	completed in consultation with the child's caregiver. Face-to-face contact with the caregiver 
16.10 	is not required to complete the special assessment.
16.11 	(b) If a new special assessment is required prior to the effective date of the Northstar 
16.12 	kinship assistance agreement, it must be completed by the financially responsible agency, 
16.13 	in consultation with the legally responsible agency if different. If the prospective relative 
16.14 	custodian is unable or unwilling to cooperate with the special assessment process, the child 
16.15 	shall be assigned the basic level, level B under section 256N.26, subdivision 3, unless the 
16.16 	child is known to be an at-risk child, in which case, the child shall be assigned level A under 
16.17 	section 256N.26, subdivision 1.
16.18 	(c) If a special assessment is required prior to the effective date of the adoption assistance 
16.19 	agreement, it must be completed by the financially responsible agency, in consultation with 
16.20 	the legally responsible agency if different. If there is no financially responsible agency, the 
16.21 	special assessment must be completed by the agency designated by the commissioner. If 
16.22 	the prospective adoptive parent is unable or unwilling to cooperate with the special 
16.23 	assessment process, the child must be assigned the basic level, level B under section 256N.26, 
16.24 	subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall 
16.25 	be assigned level A under section 256N.26, subdivision 1.
16.26 	(d) Notice to the prospective relative custodians or prospective adoptive parents must 
16.27 	be provided as specified in subdivision 13.

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

16.29 	Sec. 22. Minnesota Statutes 2016, section 256N.24, subdivision 11, is amended to read:
16.30 		Subd. 11.Completion of reassessment. (a) The reassessment must be completed in 
16.31 	consultation with the child's caregiver. Face-to-face contact with the caregiver is not required 
16.32 	to complete the reassessment.
17.1 	(b) For foster children eligible under section 256N.21, reassessments must be completed 
17.2 	by the financially responsible agency, in consultation with the legally responsible agency 
17.3 	if different.
17.4 	(c) If reassessment is required after the effective date of the Northstar kinship assistance 
17.5 	agreement, the reassessment must be completed by the financially responsible agency.
17.6 	(d) If a reassessment is required after the effective date of the adoption assistance 
17.7 	agreement, it must be completed by the financially responsible agency or, if there is no 
17.8 	financially responsible agency, the agency designated by the commissioner.
17.9 	(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the 
17.10 	child must be assessed at level B under section 256N.26, subdivision 3, unless the child has 
17.11 	an a Northstar adoption assistance or Northstar kinship assistance agreement in place and 
17.12 	is known to be an at-risk child, in which case the child must be assessed at level A under 
17.13 	section 256N.26, subdivision 1.

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

17.15 	Sec. 23. Minnesota Statutes 2016, section 256N.24, subdivision 12, is amended to read:
17.16 		Subd. 12.Approval of initial assessments, special assessments, and reassessments.
 17.17 	(a) Any agency completing initial assessments, special assessments, or reassessments must 
17.18 	designate one or more supervisors or other staff to examine and approve assessments 
17.19 	completed by others in the agency under subdivision 2. The person approving an assessment 
17.20 	must not be the case manager or staff member completing that assessment.
17.21 	(b) In cases where a special assessment or reassessment for guardian Northstar kinship
17.22 	assistance and adoption assistance is required under subdivision 8 or 11, the commissioner 
17.23 	shall review and approve the assessment as part of the eligibility determination process 
17.24 	outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section 
17.25 	256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum 
17.26 	for the negotiated agreement amount under section 256N.25.
17.27 	(c) The new rate is effective the calendar month that the assessment is approved, or the 
17.28 	effective date of the agreement, whichever is later.

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

18.1 	Sec. 24. Minnesota Statutes 2016, section 256N.24, subdivision 14, is amended to read:
18.2 		Subd. 14.Assessment tool determines rate of benefits. The assessment tool established 
18.3 	by the commissioner in subdivision 2 determines the monthly benefit level for children in 
18.4 	foster care. The monthly payment for guardian Northstar kinship assistance or adoption 
18.5 	assistance may be negotiated up to the monthly benefit level under foster care for those 
18.6 	children eligible for a payment under section 256N.26, subdivision 1.

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

18.8 	Sec. 25. Minnesota Statutes 2016, section 256N.28, subdivision 6, is amended to read:
18.9 		Subd. 6.Appeals and fair hearings. (a) A caregiver has the right to appeal to the 
18.10 	commissioner under section 256.045 when eligibility for Northstar Care for Children is 
18.11 	denied, and when payment or the agreement for an eligible child is modified or terminated.
18.12 	(b) A relative custodian or adoptive parent has additional rights to appeal to the 
18.13 	commissioner pursuant to section 256.045. These rights include when the commissioner 
18.14 	terminates or modifies the Northstar kinship assistance or adoption assistance agreement 
18.15 	or when the commissioner denies an application for Northstar kinship assistance or adoption 
18.16 	assistance. A prospective relative custodian or adoptive parent who disagrees with a decision 
18.17 	by the commissioner before transfer of permanent legal and physical custody or finalization 
18.18 	of the adoption may request review of the decision by the commissioner or may appeal the 
18.19 	decision under section 256.045. A Northstar kinship assistance or adoption assistance 
18.20 	agreement must be signed and in effect before the court order that transfers permanent legal 
18.21 	and physical custody or the adoption finalization; however, in some cases, there may be 
18.22 	extenuating circumstances as to why an agreement was not entered into before finalization 
18.23 	of permanency for the child. Caregivers who believe that extenuating circumstances exist 
18.24 	as to why an agreement was not entered into before finalization of permanency in the case 
18.25 	of their child may request a fair hearing. Caregivers have the responsibility of proving that 
18.26 	extenuating circumstances exist. Caregivers must be required to provide written 
18.27 	documentation of each eligibility criterion at the fair hearing. Examples of extenuating 
18.28 	circumstances include: relevant facts regarding the child were known by the placing agency 
18.29 	and not presented to the caregivers before transfer of permanent legal and physical custody 
18.30 	or finalization of the adoption, or failure by the commissioner or a designee to advise 
18.31 	potential caregivers about the availability of Northstar kinship assistance or adoption 
18.32 	assistance for children in the state foster care system. If a human services judge finds through 
18.33 	the fair hearing process that extenuating circumstances existed and that the child met all 
18.34 	other eligibility criteria at the time the transfer of permanent legal and physical custody was 
19.1 	ordered or the adoption was finalized, the effective date and any associated federal financial 
19.2 	participation shall be retroactive from the date of the request for a fair hearing.

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

19.4 	Sec. 26. Minnesota Statutes 2016, section 256P.02, subdivision 1, is amended to read:
19.5 		Subdivision 1.Property ownership. (a) The agency must apply paragraphs (b) to (e) 
19.6 	to determine the value of personal property. The agency must use the equity value of legally 
19.7 	available personal property to determine whether an applicant or participant is eligible for 
19.8 	assistance.
19.9 	(b) When personal property is jointly owned by two or more persons, the agency shall 
19.10 	assume that each person owns an equal share, except that either person owns the entire sum 
19.11 	of a joint personal checking or savings account. When an applicant or participant documents 
19.12 	greater or lesser ownership, the agency must use that greater or lesser share to determine 
19.13 	the equity value held by the applicant or participant. Other types of ownership must be 
19.14 	evaluated according to law.
19.15 	(c) Personal property owned by the applicant or participant must be presumed legally 
19.16 	available to the applicant or participant unless the applicant or participant documents that 
19.17 	the property is not legally available to the applicant or participant. When personal property 
19.18 	is not legally available, its equity value must not be applied against the limits of subdivision 
19.19 	2.
19.20 	(d) An applicant must disclose whether the applicant has transferred personal property 
19.21 	valued in excess of the property limits in subdivision 2 for which reasonable compensation 
19.22 	was not received within one year prior to application. A participant must disclose all transfers 
19.23 	of property valued in excess of these limits, according to the reporting requirements in 
19.24 	section 256J.30, subdivision 9. When a transfer of personal property without reasonable 
19.25 	compensation has occurred:
19.26 	(1) the person who transferred the property must provide the property's description, 
19.27 	information needed to determine the property's equity value, the names of the persons who 
19.28 	received the property, and the circumstances of and reasons for the transfer; and
19.29 	(2) when the transferred property can be reasonably reacquired, or when reasonable 
19.30 	compensation can be secured, the property is presumed legally available to the applicant or 
19.31 	participant.
19.32 	(e) A participant may build the equity value of personal property to the limits in 
19.33 	subdivision 2.
20.1 	(f) Any lump sum payment that remains in the third month after the month of receipt is 
20.2 	counted in the asset limit.

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

20.4 	Sec. 27. Minnesota Statutes 2016, section 256P.02, subdivision 1a, is amended to read:
20.5 		Subd. 1a.Exemption. Participants who qualify for child care assistance programs under 
20.6 	chapter 119B and funds under chapter 256Q are exempt from this section.

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

20.8 	ARTICLE 2
20.9 	CHEMICAL AND MENTAL HEALTH SERVICES

20.10 	Section 1. Minnesota Statutes 2016, section 245.462, subdivision 6, is amended to read:
20.11 		Subd. 6.Community support services program. "Community support services program" 
20.12 	means services, other than inpatient or residential treatment services, provided or coordinated 
20.13 	by an identified program and staff under the clinical supervision of a mental health 
20.14 	professional designed to help adults with serious and persistent mental illness to function 
20.15 	and remain in the community. A community support services program includes:
20.16 	(1) client outreach,;
20.17 	(2) medication monitoring,;
20.18 	(3) assistance in independent living skills,;
20.19 	(4) development of employability and work-related opportunities,;
20.20 	(5) crisis assistance, planning to develop a written plan identifying warning signs of a 
20.21 	crisis, available resources, and actions to mitigate the crisis;
20.22 	(6) psychosocial rehabilitation,;
20.23 	(7) help in applying for government benefits,; and
20.24 	(8) housing support services.
20.25 	The community support services program must be coordinated with the case management 
20.26 	services specified in section 245.4711. Crisis planning shall be coordinated with crisis 
20.27 	services under section 245.991.

20.28 	EFFECTIVE DATE. This section is effective August 1, 2017.

21.1 	Sec. 2. Minnesota Statutes 2016, section 245.462, subdivision 11, is amended to read:
21.2 		Subd. 11.Emergency services. "Emergency services" means an immediate response 
21.3 	service available on a 24-hour, seven-day-a-week basis for persons having a psychiatric 
21.4 	crisis, a mental health crisis, or emergency as defined in section 245.991.

21.5 	EFFECTIVE DATE. This section is effective August 1, 2017.

21.6 	Sec. 3. Minnesota Statutes 2016, section 245.464, subdivision 2, is amended to read:
21.7 		Subd. 2.Priorities. By January 1, 1990, the commissioner shall require that each of the 
21.8 	treatment services and management activities described in sections 245.469 to 245.477
21.9 	245.470 to 245.477 and 245.991 are developed for adults with mental illness within available 
21.10 	resources based on the following ranked priorities:
21.11 	(1) the provision of locally available emergencycrisis services;
21.12 	(2) the provision of locally available services to all adults with serious and persistent 
21.13 	mental illness and all adults with acute mental illness;
21.14 	(3) the provision of specialized services regionally available to meet the special needs 
21.15 	of all adults with serious and persistent mental illness and all adults with acute mental illness;
21.16 	(4) the provision of locally available services to adults with other mental illness; and
21.17 	(5) the provision of education and preventive mental health services targeted at high-risk 
21.18 	populations.

21.19 	EFFECTIVE DATE. This section is effective August 1, 2017.

21.20 	Sec. 4. Minnesota Statutes 2016, section 245.466, subdivision 2, is amended to read:
21.21 		Subd. 2.Adult mental health services. The adult mental health service system developed 
21.22 	by each county board must include the following services:
21.23 	(1) education and prevention services in accordance with section 245.468;
21.24 	(2) emergency crisis services in accordance with section 245.469 245.991;
21.25 	(3) outpatient services in accordance with section 245.470;
21.26 	(4) community support program services in accordance with section 245.4711;
21.27 	(5) residential treatment services in accordance with section 245.472;
21.28 	(6) acute care hospital inpatient treatment services in accordance with section 245.473;
21.29 	(7) regional treatment center inpatient services in accordance with section 245.474;
22.1 	(8) screening in accordance with section 245.476; and
22.2 	(9) case management in accordance with sections 245.462, subdivision 3; and 245.4711.

22.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

22.4 	Sec. 5. Minnesota Statutes 2016, section 245.470, subdivision 2, is amended to read:
22.5 		Subd. 2.Specific requirements. The county board shall require that all service providers 
22.6 	of outpatient services:
22.7 	(1) meet the professional qualifications contained in sections 245.461 to 245.486;
22.8 	(2) use a multidisciplinary mental health professional staff including at a minimum, 
22.9 	arrangements for psychiatric consultation, licensed psychologist consultation, and other 
22.10 	necessary multidisciplinary mental health professionals;
22.11 	(3) develop individual treatment plans;
22.12 	(4) provide initial appointments within three weeks, except in emergencies where there 
22.13 	must be immediate access as described in section 245.469 245.991; and
22.14 	(5) establish fee schedules approved by the county board that are based on a client's 
22.15 	ability to pay.

22.16 	EFFECTIVE DATE. This section is effective August 1, 2017.

22.17 	Sec. 6. Minnesota Statutes 2016, section 245.4871, subdivision 9a, is amended to read:
22.18 		Subd. 9a.Crisis assistance planning. "Crisis assistance planning" means assistance to 
22.19 	the child, the child's family, and all providers of services to the child to: recognize factors 
22.20 	precipitating a mental health crisis, identify behaviors related to the crisis, and be informed 
22.21 	of available resources to resolve the crisis. Crisis assistance requires the development of a 
22.22 	plan which addresses prevention and intervention strategies to be used in a potential crisis. 
22.23 	Other interventions include: (1) arranging for admission to acute care hospital inpatient 
22.24 	treatment; (2) crisis placement; (3) community resources for follow-up; and (4) emotional 
22.25 	support to the family during crisis. Crisis assistance does not include services designed to 
22.26 	secure the safety of a child who is at risk of abuse or neglect or necessary emergency services.
22.27 	the development of a written plan to assist a child's family to contend with a potential crisis 
22.28 	and is distinct from the immediate provision of intervention services as defined in section 
22.29 	245.991, subdivision 2, paragraph (g). The plan addresses prevention and intervention 
22.30 	strategies to be used in a crisis. The plan identifies factors that might precipitate a crisis and 
22.31 	behaviors related to the emergence of a crisis, and the resources available to resolve a crisis.

23.1 	EFFECTIVE DATE. This section is effective August 1, 2017.

23.2 	Sec. 7. Minnesota Statutes 2016, section 245.4871, subdivision 14, is amended to read:
23.3 		Subd. 14.Emergency services. "Emergency services" means an immediate response 
23.4 	service available on a 24-hour, seven-day-a-week basis for each child having a psychiatric 
23.5 	crisis, a mental health crisis, or a mental health emergency as defined in section 245.991.

23.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

23.7 	Sec. 8. Minnesota Statutes 2016, section 245.4875, subdivision 2, is amended to read:
23.8 		Subd. 2.Children's mental health services. The children's mental health service system 
23.9 	developed by each county board must include the following services:
23.10 	(1) education and prevention services according to section 245.4877;
23.11 	(2) mental health identification and intervention services according to section 245.4878;
23.12 	(3) emergency services according to section 245.4879 245.991;
23.13 	(4) outpatient services according to section 245.488;
23.14 	(5) family community support services according to section 245.4881;
23.15 	(6) day treatment services according to section 245.4884, subdivision 2;
23.16 	(7) residential treatment services according to section 245.4882;
23.17 	(8) acute care hospital inpatient treatment services according to section 245.4883;
23.18 	(9) screening according to section 245.4885;
23.19 	(10) case management according to section 245.4881;
23.20 	(11) therapeutic support of foster care according to section 245.4884, subdivision 4;
23.21 	(12) professional home-based family treatment according to section 245.4884, subdivision 
23.22 	4; and
23.23 	(13) mental health crisis services according to section 245.488, subdivision 3.

23.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

23.25 	Sec. 9. Minnesota Statutes 2016, section 245.488, subdivision 2, is amended to read:
23.26 		Subd. 2.Specific requirements. The county board shall require that a service provider 
23.27 	of outpatient services to children:
24.1 	(1) meets the professional qualifications contained in sections 245.487 to 245.4889;
24.2 	(2) uses a multidisciplinary mental health professional staff including, at a minimum, 
24.3 	arrangements for psychiatric consultation, licensed psychologist consultation, and other 
24.4 	necessary multidisciplinary mental health professionals;
24.5 	(3) develops individual treatment plans; and
24.6 	(4) provides initial appointments within three weeks, except in emergencies where there 
24.7 	must be immediate access as described in section 245.4879 245.991.

24.8 	EFFECTIVE DATE. This section is effective August 1, 2017.

24.9 	Sec. 10. Minnesota Statutes 2016, section 245.735, subdivision 3, is amended to read:
24.10 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
24.11 	establish a state certification process for certified community behavioral health clinics 
24.12 	(CCBHCs) to be eligible for the prospective payment system in paragraph (f). Entities that 
24.13 	choose to be CCBHCs must:
24.14 	(1) comply with the CCBHC criteria published by the United States Department of 
24.15 	Health and Human Services;
24.16 	(2) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
24.17 	including licensed mental health professionals, and staff who are culturally and linguistically 
24.18 	trained to serve the needs of the clinic's patient population;
24.19 	(3) ensure that clinic services are available and accessible to patients of all ages and 
24.20 	genders and that crisis management services are available 24 hours per day;
24.21 	(4) establish fees for clinic services for nonmedical assistance patients using a sliding 
24.22 	fee scale that ensures that services to patients are not denied or limited due to a patient's 
24.23 	inability to pay for services;
24.24 	(5) comply with quality assurance reporting requirements and other reporting 
24.25 	requirements, including any required reporting of encounter data, clinical outcomes data, 
24.26 	and quality data;
24.27 	(6) provide crisis mental health services, withdrawal management services, emergency 
24.28 	crisis intervention services, and stabilization services; screening, assessment, and diagnosis 
24.29 	services, including risk assessments and level of care determinations; patient-centered 
24.30 	treatment planning; outpatient mental health and substance use services; targeted case 
24.31 	management; psychiatric rehabilitation services; peer support and counselor services and 
25.1 	family support services; and intensive community-based mental health services, including 
25.2 	mental health services for members of the armed forces and veterans;
25.3 	(7) provide coordination of care across settings and providers to ensure seamless 
25.4 	transitions for patients across the full spectrum of health services, including acute, chronic, 
25.5 	and behavioral needs. Care coordination may be accomplished through partnerships or 
25.6 	formal contracts with:
25.7 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified 
25.8 	health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or 
25.9 	community-based mental health providers; and
25.10 	(ii) other community services, supports, and providers, including schools, child welfare 
25.11 	agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally 
25.12 	licensed health care and mental health facilities, urban Indian health clinics, Department of 
25.13 	Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, 
25.14 	and hospital outpatient clinics;
25.15 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
25.16 	(9) be certified to provide integrated treatment for co-occurring mental illness and 
25.17 	substance use disorders in adults or children under Minnesota Rules, chapter 9533, effective 
25.18 	July 1, 2017;
25.19 	(10) comply with standards relating to mental health services in Minnesota Rules, parts 
25.20 	9505.0370 to 9505.0372;
25.21 	(11) be licensed to provide chemical dependency treatment under Minnesota Rules, parts 
25.22 	9530.6405 to 9530.6505;
25.23 	(12) be certified to provide children's therapeutic services and supports under section 
25.24 	256B.0943;
25.25 	(13) be certified to provide adult rehabilitative mental health services under section 
25.26 	256B.0623;
25.27 	(14) be enrolled to provide mental health crisis response services under section 256B.0624
25.28 	245.991;
25.29 	(15) be enrolled to provide mental health targeted case management under section 
25.30 	256B.0625, subdivision 20;
25.31 	(16) comply with standards relating to mental health case management in Minnesota 
25.32 	Rules, parts 9520.0900 to 9520.0926; and
26.1 	(17) provide services that comply with the evidence-based practices described in 
26.2 	paragraph (e).
26.3 	(b) If an entity is unable to provide one or more of the services listed in paragraph (a), 
26.4 	clauses (6) to (17), the commissioner may certify the entity as a CCBHC, if the entity has 
26.5 	a current contract with another entity that has the required authority to provide that service 
26.6 	and that meets federal CCBHC criteria as a designated collaborating organization, or, to 
26.7 	the extent allowed by the federal CCBHC criteria, the commissioner may approve a referral 
26.8 	arrangement. The CCBHC must meet federal requirements regarding the type and scope of 
26.9 	services to be provided directly by the CCBHC.
26.10 	(c) Notwithstanding any other law that requires a county contract or other form of county 
26.11 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets 
26.12 	CCBHC requirements may receive the prospective payment under paragraph (f) for those 
26.13 	services without a county contract or county approval. There is no county share when 
26.14 	medical assistance pays the CCBHC prospective payment. As part of the certification process 
26.15 	in paragraph (a), the commissioner shall require a letter of support from the CCBHC's host 
26.16 	county confirming that the CCBHC and the county or counties it serves have an ongoing 
26.17 	relationship to facilitate access and continuity of care, especially for individuals who are 
26.18 	uninsured or who may go on and off medical assistance.
26.19 	(d) When the standards listed in paragraph (a) or other applicable standards conflict or 
26.20 	address similar issues in duplicative or incompatible ways, the commissioner may grant 
26.21 	variances to state requirements if the variances do not conflict with federal requirements. 
26.22 	If standards overlap, the commissioner may substitute all or a part of a licensure or 
26.23 	certification that is substantially the same as another licensure or certification. The 
26.24 	commissioner shall consult with stakeholders, as described in subdivision 4, before granting 
26.25 	variances under this provision.
26.26 	(e) The commissioner shall issue a list of required evidence-based practices to be 
26.27 	delivered by CCBHCs, and may also provide a list of recommended evidence-based practices. 
26.28 	The commissioner may update the list to reflect advances in outcomes research and medical 
26.29 	services for persons living with mental illnesses or substance use disorders. The commissioner 
26.30 	shall take into consideration the adequacy of evidence to support the efficacy of the practice, 
26.31 	the quality of workforce available, and the current availability of the practice in the state. 
26.32 	At least 30 days before issuing the initial list and any revisions, the commissioner shall 
26.33 	provide stakeholders with an opportunity to comment.
27.1 	(f) The commissioner shall establish standards and methodologies for a prospective 
27.2 	payment system for medical assistance payments for services delivered by certified 
27.3 	community behavioral health clinics, in accordance with guidance issued by the Centers 
27.4 	for Medicare and Medicaid Services. During the operation of the demonstration project, 
27.5 	payments shall comply with federal requirements for an enhanced federal medical assistance 
27.6 	percentage. The commissioner may include quality bonus payment in the prospective 
27.7 	payment system based on federal criteria and on a clinic's provision of the evidence-based 
27.8 	practices in paragraph (e). The prospective payment system does not apply to MinnesotaCare. 
27.9 	Implementation of the prospective payment system is effective July 1, 2017, or upon federal 
27.10 	approval, whichever is later.
27.11 	(g) The commissioner shall seek federal approval to continue federal financial 
27.12 	participation in payment for CCBHC services after the federal demonstration period ends 
27.13 	for clinics that were certified as CCBHCs during the demonstration period and that continue 
27.14 	to meet the CCBHC certification standards in paragraph (a). Payment for CCBHC services 
27.15 	shall cease effective July 1, 2019, if continued federal financial participation for the payment 
27.16 	of CCBHC services cannot be obtained.
27.17 	(h) The commissioner may certify at least one CCBHC located in an urban area and at 
27.18 	least one CCBHC located in a rural area, as defined by federal criteria. To the extent allowed 
27.19 	by federal law, the commissioner may limit the number of certified clinics so that the 
27.20 	projected claims for certified clinics will not exceed the funds budgeted for this purpose. 
27.21 	The commissioner shall give preference to clinics that:
27.22 	(1) provide a comprehensive range of services and evidence-based practices for all age 
27.23 	groups, with services being fully coordinated and integrated; and
27.24 	(2) enhance the state's ability to meet the federal priorities to be selected as a CCBHC 
27.25 	demonstration state.
27.26 	(i) The commissioner shall recertify CCBHCs at least every three years. The 
27.27 	commissioner shall establish a process for decertification and shall require corrective action, 
27.28 	medical assistance repayment, or decertification of a CCBHC that no longer meets the 
27.29 	requirements in this section or that fails to meet the standards provided by the commissioner 
27.30 	in the application and certification process.

27.31 	EFFECTIVE DATE. This section is effective August 1, 2017.

28.1 	Sec. 11. Minnesota Statutes 2016, section 245.8261, subdivision 1, is amended to read:
28.2 		Subdivision 1.Scope. (a) This section applies to providers of the following mental health 
28.3 	services for children:
28.4 	(1) emergency services as defined in sections 245.4871, subdivision 14, and 245.4879
28.5 	245.991;
28.6 	(2) family community support services as defined in section 245.4871, subdivision 17;
28.7 	(3) day treatment services as defined in section 245.4871, subdivision 10;
28.8 	(4) therapeutic support of foster care as defined in section 245.4871, subdivision 34;
28.9 	(5) professional home-based family treatment as defined in sections 245.4871, subdivision 
28.10 	31, and 245.4884, subdivision 3; and
28.11 	(6) mental health crisis services as defined in sections 245.4871, subdivision 24a, and 
28.12 	245.488, subdivision 3.
28.13 	(b) Providers of mental health services for children under paragraph (a) must meet the 
28.14 	requirements of this section before using a restrictive procedure with a child.

28.15 	EFFECTIVE DATE. This section is effective August 1, 2017.

28.16 	Sec. 12. [245.991] MENTAL HEALTH CRISIS SERVICES.
28.17 		Subdivision 1.Availability of crisis services. (a) By August 1, 2017, a county board 
28.18 	must provide or contract for crisis services within the county to meet the needs of children 
28.19 	and adults in the county experiencing a crisis 24 hours a day, seven days a week. The 
28.20 	provider entity shall seek reimbursement under available health insurance for the recipient. 
28.21 	If the recipient lacks insurance that covers this service, or cannot afford the cost-sharing, a 
28.22 	provider entity may require a recipient to pay a fee according to section 245.481. A provider 
28.23 	entity shall not delay the timely provision of crisis services because of delays in determining 
28.24 	this fee or because of the unwillingness or inability of the recipient to pay the fee. Crisis 
28.25 	services must include screening, assessment, intervention services, and appropriate case 
28.26 	disposition, including stabilization services. A tribal authority that accepts crisis grant 
28.27 	funding has the same responsibilities within the tribal authority's designated service area.
28.28 	(b) Crisis services must:
28.29 	(1) promote the safety and emotional stability of a recipient;
28.30 	(2) minimize further deterioration of a recipient;
28.31 	(3) help a recipient to obtain ongoing care and treatment;
29.1 	(4) prevent a recipient's placement in a setting that is more intensive, costly, or restrictive 
29.2 	than necessary and appropriate to meet a recipient's needs when clinically appropriate; and
29.3 	(5) provide support, psychoeducation, and referrals to third parties, including family 
29.4 	members, friends, or service providers, for a recipient in need of crisis services.
29.5 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
29.6 	given them.
29.7 	(a) "Adult" means a recipient 18 years of age or older.
29.8 	(b) "Assessment" means an immediate face-to-face assessment by a mental health 
29.9 	practitioner under the clinical supervision of a mental health professional, a physician, or 
29.10 	a mental health professional.
29.11 	(c) "Certified family peer specialist" is an individual qualified to provide services under 
29.12 	section 256B.0616 and who is under the supervision of a mental health professional.
29.13 	(d) "Certified peer specialist" is an individual qualified to provide services under section 
29.14 	256B.0615 and who is under the supervision of a mental health professional.
29.15 	(e) "Commissioner" means the commissioner of human services.
29.16 	(f) "Crisis" is a behavioral, emotional, or psychiatric situation that without the provision 
29.17 	of crisis response services, would likely result in significantly reduced levels of functioning 
29.18 	in primary activities of daily living, or in an emergency situation, or in the placement of the 
29.19 	recipient in a more restrictive setting, including, but not limited to, inpatient hospitalization. 
29.20 	Crisis includes a behavioral, emotional, or psychiatric situation that causes an immediate 
29.21 	need for mental health services consistent with section 62Q.55. A crisis is not limited to the 
29.22 	standards for emergency admission or transportation in section 253B.05.
29.23 	(g) "Intervention services" means face-to-face, short-term intensive mental health services 
29.24 	initiated during a crisis to help the recipient cope with immediate stressors, identify and 
29.25 	utilize available resources and strengths, engage in voluntary treatment, and begin to return 
29.26 	to the recipient's baseline level of functioning.
29.27 	(h) "Mental health practitioner" is a crisis team member defined by section 245.462, 
29.28 	subdivision 17, or 245.4871, subdivision 26, and is under the clinical supervision of a mental 
29.29 	health professional on the team.
29.30 	(i) "Mental health professional" has the meaning given in section 245.462, subdivision 
29.31 	18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6).
30.1 	(j) "Screening" is the process by which a provider entity gathers information, determines 
30.2 	if a potential crisis exists, identifies parties involved, and determines an appropriate response.
30.3 	(k) "Stabilization services" means individualized mental health services provided to a 
30.4 	recipient following intervention services that are designed to restore the recipient to the 
30.5 	recipient's prior functional level. Stabilization services does not include inpatient, partial 
30.6 	hospitalization, or day treatment. Stabilization services include family psychoeducation.
30.7 	(l) "Warm handoff" means a referral or transfer of a recipient to other services, facilitated 
30.8 	by outreach performed by the crisis team. A warm handoff includes follow-up with the 
30.9 	target provider entity or recipient.
30.10 		Subd. 3.Eligibility. (a) Crisis services are available to recipients of all ages.
30.11 	(b) For the purposes of an assessment, an eligible recipient is an individual who is 
30.12 	screened as potentially experiencing a crisis.
30.13 	(c) For the purpose of  intervention services, an eligible recipient is an individual who 
30.14 	is assessed as experiencing a crisis and for whom intervention services are necessary.
30.15 	(d) For the purpose of stabilization services, an eligible recipient is an individual who 
30.16 	is assessed as experiencing a crisis and for whom stabilization services are necessary.
30.17 	(e) For the purpose of residential stabilization services, an eligible recipient is an adult 
30.18 	who is assessed as experiencing a crisis and for whom residential stabilization services are 
30.19 	necessary.
30.20 		Subd. 4.Provider entity standards. (a) The commissioner shall establish a certification 
30.21 	process and recertification process to determine whether a provider entity meets the 
30.22 	requirements in this section. A certification may be valid for up to three years, or a shorter 
30.23 	period as determined by the commissioner.
30.24 	(b) The commissioner shall establish a process for decertification of a provider entity 
30.25 	and shall require corrective action, medical assistance repayment, or decertification of a 
30.26 	provider entity that no longer meets the requirements in this section or that fails to meet the 
30.27 	clinical quality standards or administrative standards provided by the commissioner in the 
30.28 	application and certification process.
30.29 	(c) A provider entity is an entity that is:
30.30 	(1) operated by a county board;
30.31 	(2) under a provider contract with the county board in the county where the potential 
30.32 	crisis occurs. To provide services under this clause, the provider entity must directly provide 
31.1 	the service or, if the service is subcontracted, maintain responsibility for the service and 
31.2 	billing; or
31.3 	(3) an Indian health service facility or facility owned and operated by a tribe or tribal 
31.4 	organization operating under United States Code, title 25, section 450f.
31.5 	(d) The commissioner must certify that a provider entity has the ability to:
31.6 	(1) recruit, hire, manage, and train mental health professionals, mental health practitioners, 
31.7 	certified peer specialists, and rehabilitation workers;
31.8 	(2) provide adequate administrative ability to ensure availability of services;
31.9 	(3) ensure adequate preservice and in-service training;
31.10 	(4) ensure that staff are skilled in delivering crisis services to any recipient, regardless 
31.11 	of the recipient's age, a recipient's needs within a family system, and in engaging a recipient's 
31.12 	legal guardian or family as applicable;
31.13 	(5) ensure that staff are capable of implementing culturally responsive treatment identified 
31.14 	in the treatment plan that is meaningful and appropriate as determined by the recipient's 
31.15 	culture, beliefs, values, and language;
31.16 	(6) ensure coordination with live interpreter and written translation services to provide 
31.17 	care and treatment plans that are accessible to the recipient;
31.18 	(7) ensure a flexible response to the recipient's changing intervention and care needs as 
31.19 	identified by the recipient;
31.20 	(8) ensure that a mental health practitioner and a mental health professional have 
31.21 	communication tools to promptly communicate and consult about assessment and intervention 
31.22 	services as services occur;
31.23 	(9) coordinate with and recommend the use of crisis services by other responders, 
31.24 	including 911 dispatch, community hospitals, ambulance services, transportation services, 
31.25 	social services, law enforcement, and schools through regularly scheduled interagency 
31.26 	meetings;
31.27 	(10) ensure that screening, assessment, and intervention services are available in the 
31.28 	designated service area 24 hours a day, seven days a week;
31.29 	(11) coordinate services with detoxification or withdrawal management services to 
31.30 	ensure a recipient receives care that is responsive to chemical and mental health needs;
32.1 	(12) ensure that services are coordinated with other mental health service providers, 
32.2 	county mental health authorities, or federally recognized American Indian authorities and 
32.3 	others as necessary, with the consent of the adult. Services must also be coordinated with 
32.4 	the recipient's case manager if the adult is receiving case management services;
32.5 	(13) ensure that services are provided consistent with sections 245.461 to 245.486 and 
32.6 	245.487 to 245.4887;
32.7 	(14) submit information as required by the state;
32.8 	(15) maintain staff training and personnel files, including documentation of staff 
32.9 	completion of required training modules;
32.10 	(16) establish and maintain a quality assurance and evaluation plan to evaluate the 
32.11 	outcomes of services and recipient satisfaction, including notifying recipients of the process 
32.12 	by which the county accepts and responds to concerns;
32.13 	(17) maintain records as required by applicable laws;
32.14 	(18) comply with all applicable laws and statutes;
32.15 	(19) demonstrate that the provider entity is enrolled as a medical assistance provider;
32.16 	(20) develop and maintain written policies and procedures regarding service provision 
32.17 	and administration of the provider entity, including safety of staff and recipients in a high-risk 
32.18 	situation;
32.19 	(21) directly provide or connect a recipient through a warm handoff to stabilization 
32.20 	services or other ongoing supports as indicated in a recipient's treatment plan;
32.21 	(22) respond to a call for crisis services in a designated service area, or according to a 
32.22 	written agreement with the local mental health authority for an adjacent area;
32.23 	(23) document protocol used when delivering services by telemedicine, as provided by 
32.24 	sections 62A.67 to 62A.672, including responsibilities of the originating site, means to 
32.25 	promote recipient safety, timelines for connection and response, and steps to be taken in 
32.26 	the event of lost connection; and
32.27 	(24) develop and publicly post a written policy containing criteria for providing services, 
32.28 	and the response to a call for a person who is ineligible for service.
32.29 	(e) A crisis provider that is certified to provide crisis services before August 1, 2017, 
32.30 	may continue to operate according to standards in Minnesota Statutes 2016, sections 245.469, 
32.31 	245.4879, 256B.0624, and 256B.0944, until certified by the commissioner under this section 
32.32 	or January 1, 2019, whichever comes first. This paragraph expires January 1, 2019.
33.1 		Subd. 5.Crisis team. (a) A crisis team is comprised of at least two members, one of 
33.2 	whom must be qualified as a mental health professional. A second member must be qualified 
33.3 	as a mental health professional or mental health practitioner. Additional staff should be 
33.4 	added to reflect the needs of the area served.
33.5 	(b) Staff for a crisis team must be qualified to provide services in the following ways:
33.6 	(1) mental health professional;
33.7 	(2) mental health practitioner;
33.8 	(3) certified peer specialist; or
33.9 	(4) certified family peer specialist.
33.10 	(c) Assessment and intervention services must be led by a mental health professional, 
33.11 	or a mental health practitioner under the supervision of a mental health professional as 
33.12 	described in subdivision 11.
33.13 	(d) At least one member of the crisis team must provide assessment and intervention 
33.14 	services when needed. Crisis team members must have experience in assessments, crisis 
33.15 	intervention techniques, treatment engagement strategies, working with families, and clinical 
33.16 	decision making under emergency conditions, and have knowledge of local services and 
33.17 	resources.
33.18 		Subd. 6.Screening standards. (a) A crisis team shall conduct a screening for a recipient 
33.19 	to determine the need for further services. A screening must be available by telephone and 
33.20 	may be performed by alternate means as clinically appropriate.
33.21 	(b) In conducting a screening, a provider entity shall:
33.22 	(1) employ evidence-based practices as identified by the commissioner to reduce the 
33.23 	risk of the recipient's suicide and self-injurious behavior;
33.24 	(2) work with the recipient to establish a plan and time frame for responding to the crisis, 
33.25 	including immediate needs for support by telephone or text message until a face-to-face 
33.26 	response can arrive;
33.27 	(3) coordinate response with other emergency responders as appropriate;
33.28 	(4) consider other available services to determine which intervention service would best 
33.29 	address the recipient's needs and circumstances;
33.30 	(5) document significant factors related to the determination of a crisis, including prior 
33.31 	calls to the crisis team, recent presentation at an emergency department, known calls to 911 
34.1 	or law enforcement, or the presence of third parties with knowledge of a potential recipient's 
34.2 	history or current needs;
34.3 	(6) screen for the needs of a third-party caller, including a recipient who primarily 
34.4 	identifies as a family member or a caregiver but also presents signs of a crisis; and
34.5 	(7) provide psychoeducation to third-party callers, including education on the available 
34.6 	means for reducing self-harm.
34.7 	(c) A provider entity shall consider the following to indicate a positive screening unless 
34.8 	the provider entity documents specific evidence to show why crisis response was clinically 
34.9 	inappropriate:
34.10 	(1) the recipient presented in an emergency department or urgent care setting, and the 
34.11 	health care team at that location requested crisis services; or
34.12 	(2) a peace officer requested crisis services for a recipient who may be subject to 
34.13 	transportation under section 253B.05 for a mental health crisis.
34.14 	(d) Direct contact with the recipient is not required before initiating an assessment or 
34.15 	intervention service. A crisis team may gather relevant information from a third party at the 
34.16 	scene to establish the need for services and potential safety factors.
34.17 	(e) A crisis team that receives a call for services outside of the team's coverage area shall 
34.18 	offer to connect the recipient with a crisis team serving the recipient's location.
34.19 	(f) A crisis team shall consider input from a recipient, a recipient's guardian, or a 
34.20 	recipient's family whenever possible in determining if a potential crisis exists and face-to-face 
34.21 	assessment is necessary.
34.22 		Subd. 7.Assessment. (a) If screening indicates a potential crisis, an assessment must 
34.23 	be completed. An assessment evaluates any immediate needs for services and, as time 
34.24 	permits, the recipient's current life situation, sources of stress, mental health problems and 
34.25 	symptoms, strengths, cultural considerations, support network, vulnerabilities, current 
34.26 	functioning, and the recipient's preferences as communicated directly by the recipient, or 
34.27 	as communicated in a health care directive as described in chapters 145C and 253B, the 
34.28 	treatment plan described under subdivision 8, paragraph (b); a crisis prevention plan; or 
34.29 	wellness recovery action plan. An assessment includes, when feasible, assessing whether 
34.30 	the recipient is willing to voluntarily accept treatment, determining whether the recipient 
34.31 	has an advance directive, and obtaining information and history from an involved family 
34.32 	member or caregiver.
35.1 	(b) An assessment is provided face-to-face by a crisis team outside of an inpatient hospital 
35.2 	setting. A service must be provided promptly and respond to the recipient's location whenever 
35.3 	possible, including community or clinical settings. As clinically appropriate, a crisis team 
35.4 	must coordinate a response with other health care providers if a recipient requires 
35.5 	detoxification, withdrawal management, or medical stabilization services in addition to 
35.6 	crisis services.
35.7 	(c) A crisis team shall consider input from a recipient, a recipient's guardian, or a 
35.8 	recipient's family whenever possible in determining if a crisis exists.
35.9 	(d) If after an assessment, a crisis provider entity refers a recipient to an acute setting, 
35.10 	including an emergency department, in-patient hospitalization, or crisis residential treatment, 
35.11 	a crisis team member who performed or conferred on the assessment must contact the 
35.12 	provider entity and consult with the triage nurse or other staff responsible for intake. The 
35.13 	crisis team member must convey key findings or concerns that led to the referral. This 
35.14 	consultation shall occur with the recipient's consent, the recipient's legal guardian's consent, 
35.15 	or as allowed by section 144.293, subdivision 5.
35.16 		Subd. 8.Intervention. (a) If the assessment determines intervention services are needed, 
35.17 	the intervention services must be provided promptly. At least one crisis team member must 
35.18 	provide the intervention services face-to-face with a recipient. If a mental health practitioner 
35.19 	is providing in-person services, the mental health practitioner must seek clinical supervision 
35.20 	as required under subdivision 11, including obtaining approval before acting as a health 
35.21 	officer as defined in section 253B.02.
35.22 	(b) The crisis team must develop a crisis intervention treatment plan as soon as appropriate 
35.23 	but no later than 24 hours after the initial face-to-face intervention. The crisis intervention 
35.24 	treatment plan must:
35.25 	(1) address the recipient's needs and problems noted in the assessment;
35.26 	(2) include measurable short-term goals;
35.27 	(3) address cultural considerations;
35.28 	(4) specify the frequency and type of services to be provided to achieve the recipient's 
35.29 	goals and reduce or eliminate the crisis; and
35.30 	(5) be updated as needed to reflect current goals and services.
35.31 	(c) If the crisis team refers a recipient to an acute setting, as described in subdivision 7, 
35.32 	paragraph (d), a crisis team member must send a copy of the crisis intervention treatment 
35.33 	plan by secure electronic transmission to the provider entity to which the recipient was 
36.1 	referred. This release shall occur with the recipient's consent, the recipient's legal guardian's 
36.2 	consent, or as allowed by section 144.293, subdivision 5.
36.3 	(d) The crisis team must document when short-term goals are met and when no further 
36.4 	crisis services are required.
36.5 	(e) If the recipient's crisis is stabilized, but the recipient needs a referral to another service, 
36.6 	the crisis team must provide a warm handoff to those services. If the recipient has a case 
36.7 	manager, planning for other services must be coordinated with the case manager.
36.8 	(f) If the recipient's crisis is stabilized and the recipient does not have an advance 
36.9 	directive, the case manager or crisis team shall offer to work with the recipient to develop 
36.10 	one.
36.11 		Subd. 9.Stabilization service. (a) Stabilization services must be provided by qualified 
36.12 	staff. Stabilization services may be provided in the recipient's home, the home of a family 
36.13 	member or friend of the recipient, another community setting, or a short-term supervised, 
36.14 	licensed residential program. Stabilization services include family psychoeducation and 
36.15 	must meet the following requirements:
36.16 	(1) include a stabilization treatment plan that meets the criteria in subdivision 13;
36.17 	(2) staff must be qualified as defined in subdivision 10; and
36.18 	(3) service must be delivered according to the treatment plan and include face-to-face 
36.19 	contact with the recipient by qualified staff for further assessment, help with referrals, 
36.20 	updating of the stabilization treatment plan, supportive counseling, skills training, and 
36.21 	collaboration with other service providers in the community.
36.22 	(b) If stabilization services are provided to an adult in a supervised, licensed residential 
36.23 	setting, the adult must have daily face-to-face contact with a qualified mental health 
36.24 	practitioner or professional. The program must have 24-hour-a-day residential staffing that 
36.25 	may include staff who do not meet the qualifications in subdivision 10. The residential staff 
36.26 	must have 24-hour-a-day immediate direct or telephone access to a qualified mental health 
36.27 	professional or practitioner.
36.28 	(c) If stabilization services are provided to an adult in a supervised, licensed residential 
36.29 	setting that serves no more than four adult residents, and one or more adults are present at 
36.30 	the setting to receive stabilization services, the residential staff must include, for at least 
36.31 	eight hours per day, at least one staff member who meets the qualifications in subdivision 
36.32 	10.
37.1 	(d) If stabilization services are provided to an adult in a supervised, licensed residential 
37.2 	setting that serves more than four adult residents, and one or more are adults receiving 
37.3 	stabilization services, the residential staff must include, for 24 hours a day, at least one staff 
37.4 	member who meets the qualifications in subdivision 10. During the first 48 hours that an 
37.5 	adult is in the residential program, the residential program must have at least two staff 
37.6 	members working 24 hours a day. After the first 48 hours that an adult is in the residential 
37.7 	program, staff levels may be adjusted according to the needs of the adult as specified in the 
37.8 	stabilization treatment plan.
37.9 		Subd. 10.Stabilization staff qualifications. (a) Stabilization services must be provided 
37.10 	by a qualified individual staff member. A qualified individual staff member includes:
37.11 	(1) a mental health professional;
37.12 	(2) a mental health practitioner;
37.13 	(3) a certified peer specialist;
37.14 	(4) a certified family peer specialist; or
37.15 	(5) a mental health rehabilitation worker who meets the criteria in section 256B.0623, 
37.16 	subdivision 5, clause (4), and works under the clinical supervision of a mental health 
37.17 	professional or under the direction of a mental health practitioner.
37.18 	(b) Except for a mental health professional, a stabilization staff member must have 
37.19 	completed at least 30 hours of training in intervention and stabilization services during the 
37.20 	past two years.
37.21 		Subd. 11.Supervision. A mental health practitioner may provide assessment and 
37.22 	intervention services if the following clinical supervision requirements are met:
37.23 	(1) the qualified provider entity accepts full responsibility for any service provided;
37.24 	(2) the mental health professional who is an employee or under contract with the qualified 
37.25 	provider, must be immediately available in person or by telephone for clinical supervision;
37.26 	(3) the mental health professional is consulted, in person or by telephone, during the 
37.27 	first three hours when a mental health practitioner provides on-site service;
37.28 	(4) the mental health professional must:
37.29 	(i) review and approve the assessment and crisis intervention treatment plan;
37.30 	(ii) document the consultation; and
38.1 	(iii) sign the assessment and crisis intervention treatment plan within the next business 
38.2 	day;
38.3 	(5) if the intervention services continue into a second calendar day, a mental health 
38.4 	professional must contact the recipient face-to-face on the second day to provide service 
38.5 	and update the crisis intervention treatment plan;
38.6 	(6) the on-site observation must be documented in the recipient's record and signed by 
38.7 	the mental health professional; and
38.8 	(7) specific consultation and approval must be obtained from the mental health 
38.9 	professional before a mental health practitioner acts as a health officer as defined in section 
38.10 	253B.02, subdivision 9.
38.11 		Subd. 12.Recipient file. (a) A provider entity must maintain for each assessment, 
38.12 	intervention, or stabilization recipient a file that complies with the requirements established 
38.13 	by the commissioner. The file must contain the following information:
38.14 	(1) the crisis intervention treatment plan signed by the recipient or the recipient's legal 
38.15 	guardian, mental health professional, and mental health practitioner who developed the 
38.16 	crisis treatment plan, or if the recipient or the recipient's legal guardian refused to sign the 
38.17 	plan, the date, and the reason as to why the recipient or the recipient's legal guardian would 
38.18 	not sign the plan, as stated by the recipient or the recipient's legal guardian;
38.19 	(2) signed release forms;
38.20 	(3) recipient's health information and current medications;
38.21 	(4) emergency contacts for the recipient;
38.22 	(5) case records that document the date of service, place of service delivery, signature 
38.23 	of the provider entity of the service, and the nature, extent, and units of service;
38.24 	(6) documentation of in-person and telephone contact with the recipient's family or other 
38.25 	supporters;
38.26 	(7) documentation of required clinical supervision by a mental health professional;
38.27 	(8) a summary of consultation between crisis team members;
38.28 	(9) any written information by the recipient or the recipient's legal guardian that the 
38.29 	recipient or the recipient's legal guardian wants in the file; and
38.30 	(10) the recipient's advance directive if available.
39.1 	(b) For a recipient of crisis stabilization services, a provider entity must also maintain 
39.2 	a copy of the stabilization treatment plan as defined in subdivision 13. If a recipient was 
39.3 	referred to crisis stabilization from a different provider entity, an assessment or referral may 
39.4 	be substituted for the crisis intervention treatment plan in clause (1).
39.5 		Subd. 13.Stabilization treatment plan. (a) A written stabilization treatment plan must 
39.6 	be completed within 24 hours of beginning services for the recipient. A stabilization treatment 
39.7 	plan must be developed by a mental health professional or mental health practitioner under 
39.8 	the clinical supervision of a mental health professional. The stabilization treatment plan 
39.9 	must include, at a minimum:
39.10 	(1) problems identified in the assessment;
39.11 	(2) the recipient's strengths and resources;
39.12 	(3) concrete, measurable short-term goals to be achieved, including time frames for 
39.13 	achievement;
39.14 	(4) specific objectives directed toward achieving each goal;
39.15 	(5) planned frequency and type of service initiated;
39.16 	(6) a crisis response action plan;
39.17 	(7) progress notes on the outcome of goals;
39.18 	(8) each specific provider, when applicable; and
39.19 	(9) a documentation of the participants involved in the service planning. The recipient, 
39.20 	if possible, must be a participant.
39.21 	(b) The recipient or the recipient's legal guardian must sign the stabilization treatment 
39.22 	plan or if the recipient or the recipient's legal guardian refused to sign the plan, the date and 
39.23 	the reason why the recipient or the recipient's legal guardian would not sign the plan, as 
39.24 	stated by the recipient or the recipient's legal guardian. A copy of the plan must be given 
39.25 	to the recipient and the recipient's legal guardian. The mental health professional must 
39.26 	approve and sign any treatment plan. If a treatment plan completed by a referring entity, 
39.27 	such as an in-patient hospital, meets the criteria in this subdivision, it may be adopted by 
39.28 	the crisis team for the purpose of stabilization services.
39.29 		Subd. 14.Crisis service infrastructure. The commissioner must:
39.30 	(1) develop a central phone number to route calls to the appropriate crisis service;
40.1 	(2) provide telephone consultation 24 hours a day to a crisis team that is serving a person 
40.2 	with a traumatic brain injury or an intellectual disability and who is experiencing a crisis;
40.3 	(3) expand crisis services across the state, including rural areas of the state;
40.4 	(4) examine access to crisis service by population; and
40.5 	(5) establish and implement state standards for crisis services.

40.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

40.7 	Sec. 13. Minnesota Statutes 2016, section 245D.02, subdivision 20, is amended to read:
40.8 		Subd. 20.Mental health crisis intervention team. "Mental health crisis intervention 
40.9 	team" means a mental health crisis response provider as identified in section 256B.0624, 
40.10 	subdivision 2, paragraph (d), for adults, and in section 256B.0944, subdivision 1, paragraph 
40.11 	(d), for children 245.991.

40.12 	EFFECTIVE DATE. This section is effective August 1, 2017.

40.13 	Sec. 14. Minnesota Statutes 2016, section 253B.02, subdivision 9, is amended to read:
40.14 		Subd. 9.Health officer. "Health officer" means:
40.15 	(1) a licensed physician;
40.16 	(2) a licensed psychologist mental health professional as defined in section 245.462, 
40.17 	subdivision 18, clauses (1) to (6);
40.18 	(3) a licensed social worker;
40.19 	(4) (3) a registered nurse working in an emergency room of a hospital;
40.20 	(5) (4) a psychiatric or public health nurse as defined in section 145A.02, subdivision 
40.21 	18;
40.22 	(6) (5) an advanced practice registered nurse (APRN) as defined in section 148.171, 
40.23 	subdivision 3;
40.24 	(7) (6) a mental health practitioner as defined in section 245.462, subdivision 17, with 
40.25 	the consultation and approval by a mental health professional providing mental health mobile
40.26 	crisis intervention services as described under section 256B.0624 245.991; or
40.27 	(8) (7) a formally designated member of a prepetition screening unit established by 
40.28 	section 253B.07.

40.29 	EFFECTIVE DATE. This section is effective August 1, 2017.

41.1 	Sec. 15. Minnesota Statutes 2016, section 256B.0615, is amended to read:
41.2 	256B.0615 MENTAL HEALTH CERTIFIED PEER SPECIALIST.
41.3 		Subdivision 1.Scope. Medical assistance covers mental health certified peer specialist 
41.4 	services, as established in subdivision 2, subject to federal approval, if provided to recipients 
41.5 	who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and 
41.6 	are provided by a certified peer specialist who has completed the training under subdivision 
41.7 	5.
41.8 		Subd. 2.Establishment. The commissioner of human services shall establish a certified 
41.9 	peer specialist program model, which:
41.10 	(1) provides nonclinical peer support counseling services by certified peer specialists;
41.11 	(2) provides a part of a wraparound continuum of services in conjunction with other 
41.12 	community mental health services;
41.13 	(3) is individualized to the consumer; and
41.14 	(4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of 
41.15 	natural supports, and maintenance of skills learned in other support services.
41.16 		Subd. 3.Eligibility. Peer support services may be made available to consumers of (1) 
41.17 	intensive residential treatment services under section 256B.0622; (2) adult rehabilitative 
41.18 	mental health services under section 256B.0623; and (3) crisis stabilization and mental 
41.19 	health mobile crisis intervention services under section 256B.0624.
41.20 		Subd. 4.Peer support specialist program service providers. The commissioner shall 
41.21 	develop a process to certify peer support specialist programs specialists, in accordance with 
41.22 	the federal guidelines, in order for the program to bill for reimbursable services. Peer support 
41.23 	programs may be freestanding or within existing mental health community provider centers.
41.24 		Subd. 5.Certified peer specialist training and certification. The commissioner of 
41.25 	human services shall develop a training and certification process for certified peer specialists, 
41.26 	who must be at least 21 years of age and have a high school diploma or its equivalent. The 
41.27 	candidates must have had a primary diagnosis of mental illness, be a current or former 
41.28 	consumer of mental health services, and must demonstrate leadership and advocacy skills 
41.29 	and a strong dedication to recovery. The training curriculum must teach participating 
41.30 	consumers specific skills relevant to providing peer support to other consumers. In addition 
41.31 	to initial training and certification, the commissioner shall develop ongoing continuing 
41.32 	educational workshops on pertinent issues related to peer support counseling services.

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

42.2 	Sec. 16. Minnesota Statutes 2016, section 256B.0616, is amended to read:
42.3 	256B.0616 MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST.
42.4 		Subdivision 1.Scope. Medical assistance covers mental health certified family peer 
42.5 	specialists services, as established in subdivision 2, subject to federal approval, if provided 
42.6 	to recipients who have an emotional disturbance or severe emotional disturbance under 
42.7 	chapter 245, and are provided by a certified family peer specialist who has completed the 
42.8 	training under subdivision 5. A family peer specialist cannot provide services to the peer 
42.9 	specialist's family.
42.10 		Subd. 2.Establishment. The commissioner of human services shall establish a certified 
42.11 	family peer specialists program model support specialist service which increases the child's 
42.12 	ability to function within the child's home, school, and community by:
42.13 	(1) provides providing nonclinical family peer support counseling, building on the 
42.14 	strengths of families and helping to help them achieve desired outcomes;
42.15 	(2) collaborates collaborating with others other services that are providing care or support 
42.16 	to the family;
42.17 	(3) provides nonadversarial advocacy teaching the family self-advocacy skills;
42.18 	(4) promotes supporting the individual family culture in the treatment milieu;
42.19 	(5) links linking parents to other parents in the community;
42.20 	(6) offers support and encouragement;
42.21 	(7) assists (6) assisting parents in developing to develop coping mechanisms and 
42.22 	problem-solving skills;
42.23 	(8) promotes (7) promoting resiliency, self-advocacy, development of natural supports, 
42.24 	and maintenance of skills learned in other support services;
42.25 	(9) establishes (8) establishing and provides providing peer-led parent support groups; 
42.26 	and
42.27 	(10) increases the child's ability to function better within the child's home, school, and 
42.28 	community by (9) educating parents on community resources, assisting with problem solving,
42.29 	and educating parents on mental illnesses.
43.1 		Subd. 3.Eligibility. Family peer support services may be located provided in inpatient
43.2 	hospitalization, partial hospitalization programs, residential treatment, treatment foster care, 
43.3 	day treatment, children's therapeutic services and supports, or and crisis services.
43.4 		Subd. 4.Peer support specialist program providers. The commissioner shall develop 
43.5 	a process to certify family peer support specialist programs specialists, in accordance with 
43.6 	the federal guidelines, in order for the program to bill for reimbursable services. Family 
43.7 	peer support programs must operate within an existing mental health community provider 
43.8 	or center.
43.9 		Subd. 5.Certified family peer specialist training and certification. The commissioner 
43.10 	shall develop a training and certification process for certified family peer specialists who 
43.11 	must be at least 21 years of age and have a high school diploma or its equivalent. The 
43.12 	candidates must have raised or be currently raising a child with a mental illness, have had 
43.13 	experience navigating the children's mental health system, and must demonstrate leadership 
43.14 	and advocacy skills and a strong dedication to family-driven and family-focused services. 
43.15 	The training curriculum must teach participating family peer specialists specific skills 
43.16 	relevant to providing provide peer support to other parents. In addition to initial training 
43.17 	and certification, the commissioner shall develop ongoing continuing educational workshops 
43.18 	on pertinent issues related to family peer support counseling services.

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

43.20 	Sec. 17. Minnesota Statutes 2016, section 256B.0622, subdivision 2, is amended to read:
43.21 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
43.22 	meanings given them.
43.23 	(b) "ACT team" means the group of interdisciplinary mental health staff who work as 
43.24 	a team to provide assertive community treatment.
43.25 	(c) "Assertive community treatment" means intensive nonresidential treatment and 
43.26 	rehabilitative mental health services provided according to the assertive community treatment 
43.27 	model. Assertive community treatment provides a single, fixed point of responsibility for 
43.28 	treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per 
43.29 	day, seven days per week, in a community-based setting.
43.30 	(d) "Individual treatment plan" means the document that results from a person-centered 
43.31 	planning process of determining real-life outcomes with clients and developing strategies 
43.32 	to achieve those outcomes.
44.1 	(e) "Assertive engagement" means the use of collaborative strategies to engage clients 
44.2 	to receive services.
44.3 	(f) "Benefits and finance support" means assisting clients in capably managing financial 
44.4 	affairs. Services include, but are not limited to, assisting clients in applying for benefits; 
44.5 	assisting with redetermination of benefits; providing financial crisis management; teaching 
44.6 	and supporting budgeting skills and asset development; and coordinating with a client's 
44.7 	representative payee, if applicable.
44.8 	(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness 
44.9 	and substance use disorders and is characterized by assertive outreach, stage-wise 
44.10 	comprehensive treatment, treatment goal setting, and flexibility to work within each stage 
44.11 	of treatment. Services include, but are not limited to, assessing and tracking clients' stages 
44.12 	of change readiness and treatment; applying the appropriate treatment based on stages of 
44.13 	change, such as outreach and motivational interviewing techniques to work with clients in 
44.14 	earlier stages of change readiness and cognitive behavioral approaches and relapse prevention 
44.15 	to work with clients in later stages of change; and facilitating access to community supports.
44.16 	(h) "Crisis assessment and intervention" means mental health crisis response services 
44.17 	as defined in section 256B.0624, subdivision 2, paragraphs (c) to (e) 245.991, subdivisions 
44.18 	7 to 9.
44.19 	(i) "Employment services" means assisting clients to work at jobs of their choosing. 
44.20 	Services must follow the principles of the individual placement and support (IPS) 
44.21 	employment model, including focusing on competitive employment; emphasizing individual 
44.22 	client preferences and strengths; ensuring employment services are integrated with mental 
44.23 	health services; conducting rapid job searches and systematic job development according 
44.24 	to client preferences and choices; providing benefits counseling; and offering all services 
44.25 	in an individualized and time-unlimited manner. Services shall also include educating clients 
44.26 	about opportunities and benefits of work and school and assisting the client in learning job 
44.27 	skills, navigating the work place, and managing work relationships.
44.28 	(j) "Family psychoeducation and support" means services provided to the client's family 
44.29 	and other natural supports to restore and strengthen the client's unique social and family 
44.30 	relationships. Services include, but are not limited to, individualized psychoeducation about 
44.31 	the client's illness and the role of the family and other significant people in the therapeutic 
44.32 	process; family intervention to restore contact, resolve conflict, and maintain relationships 
44.33 	with family and other significant people in the client's life; ongoing communication and 
44.34 	collaboration between the ACT team and the family; introduction and referral to family 
45.1 	self-help programs and advocacy organizations that promote recovery and family 
45.2 	engagement, individual supportive counseling, parenting training, and service coordination 
45.3 	to help clients fulfill parenting responsibilities; coordinating services for the child and 
45.4 	restoring relationships with children who are not in the client's custody; and coordinating 
45.5 	with child welfare and family agencies, if applicable. These services must be provided with 
45.6 	the client's agreement and consent.
45.7 	(k) "Housing access support" means assisting clients to find, obtain, retain, and move 
45.8 	to safe and adequate housing of their choice. Housing access support includes, but is not 
45.9 	limited to, locating housing options with a focus on integrated independent settings; applying 
45.10 	for housing subsidies, programs, or resources; assisting the client in developing relationships 
45.11 	with local landlords; providing tenancy support and advocacy for the individual's tenancy 
45.12 	rights at the client's home; and assisting with relocation.
45.13 	(l) "Individual treatment team" means a minimum of three members of the ACT team 
45.14 	who are responsible for consistently carrying out most of a client's assertive community 
45.15 	treatment services.
45.16 	(m) "Intensive residential treatment services treatment team" means all staff who provide 
45.17 	intensive residential treatment services under this section to clients. At a minimum, this 
45.18 	includes the clinical supervisor; mental health professionals as defined in section 245.462, 
45.19 	subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462, 
45.20 	subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 
45.21 	5, clause (4); and mental health certified peer specialists under section 256B.0615.
45.22 	(n) "Intensive residential treatment services" means short-term, time-limited services 
45.23 	provided in a residential setting to clients who are in need of more restrictive settings and 
45.24 	are at risk of significant functional deterioration if they do not receive these services. Services 
45.25 	are designed to develop and enhance psychiatric stability, personal and emotional adjustment, 
45.26 	self-sufficiency, and skills to live in a more independent setting. Services must be directed 
45.27 	toward a targeted discharge date with specified client outcomes.
45.28 	(o) "Medication assistance and support" means assisting clients in accessing medication, 
45.29 	developing the ability to take medications with greater independence, and providing 
45.30 	medication setup. This includes the prescription, administration, and order of medication 
45.31 	by appropriate medical staff.
45.32 	(p) "Medication education" means educating clients on the role and effects of medications 
45.33 	in treating symptoms of mental illness and the side effects of medications.
46.1 	(q) "Overnight staff" means a member of the intensive residential treatment services 
46.2 	team who is responsible during hours when clients are typically asleep.
46.3 	(r) "Mental health certified peer specialist services" has the meaning given in section 
46.4 	256B.0615.
46.5 	(s) "Physical health services" means any service or treatment to meet the physical health 
46.6 	needs of the client to support the client's mental health recovery. Services include, but are 
46.7 	not limited to, education on primary health issues, including wellness education; medication 
46.8 	administration and monitoring; providing and coordinating medical screening and follow-up; 
46.9 	scheduling routine and acute medical and dental care visits; tobacco cessation strategies; 
46.10 	assisting clients in attending appointments; communicating with other providers; and 
46.11 	integrating all physical and mental health treatment.
46.12 	(t) "Primary team member" means the person who leads and coordinates the activities 
46.13 	of the individual treatment team and is the individual treatment team member who has 
46.14 	primary responsibility for establishing and maintaining a therapeutic relationship with the 
46.15 	client on a continuing basis.
46.16 	(u) "Rehabilitative mental health services" means mental health services that are 
46.17 	rehabilitative and enable the client to develop and enhance psychiatric stability, social 
46.18 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
46.19 	community skills, when these abilities are impaired by the symptoms of mental illness.
46.20 	(v) "Symptom management" means supporting clients in identifying and targeting the 
46.21 	symptoms and occurrence patterns of their mental illness and developing strategies to reduce 
46.22 	the impact of those symptoms.
46.23 	(w) "Therapeutic interventions" means empirically supported techniques to address 
46.24 	specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional 
46.25 	dysregulation, and trauma symptoms. Interventions include empirically supported 
46.26 	psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy, 
46.27 	acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.
46.28 	(x) "Wellness self-management and prevention" means a combination of approaches to 
46.29 	working with the client to build and apply skills related to recovery, and to support the client 
46.30 	in participating in leisure and recreational activities, civic participation, and meaningful 
46.31 	structure.

46.32 	EFFECTIVE DATE. This section is effective August 1, 2017.

47.1 	Sec. 18. Minnesota Statutes 2016, section 256B.0622, subdivision 3a, is amended to read:
47.2 		Subd. 3a.Provider certification and contract requirements for assertive community 
47.3 	treatment. (a) The assertive community treatment provider entity must:
47.4 	(1) have a contract with the host county to provide assertive community treatment 
47.5 	services; and
47.6 	(2) have each ACT team be certified by the state following the certification process and 
47.7 	procedures developed by the commissioner. The certification process determines whether 
47.8 	the ACT team meets the standards for assertive community treatment under this section as 
47.9 	well as minimum program fidelity standards as measured by a nationally recognized fidelity 
47.10 	tool approved by the commissioner. Recertification must occur at least every three years.
47.11 	(b) An ACT team certified under this subdivision must meet the following standards:
47.12 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
47.13 	(2) have adequate administrative ability to ensure availability of services;
47.14 	(3) ensure adequate preservice and ongoing training for staff;
47.15 	(4) ensure that staff is capable of implementing culturally specific services that are 
47.16 	culturally responsive and appropriate as determined by the client's culture, beliefs, values, 
47.17 	and language as identified in the individual treatment plan;
47.18 	(5) ensure flexibility in service delivery to respond to the changing and intermittent care 
47.19 	needs of a client as identified by the client and the individual treatment plan;
47.20 	(6) develop and maintain client files, individual treatment plans, and contact charting;
47.21 	(7) develop and maintain staff training and personnel files;
47.22 	(8) submit information as required by the state;
47.23 	(9) keep all necessary records required by law;
47.24 	(10) comply with all applicable laws;
47.25 	(11) be an enrolled Medicaid provider;
47.26 	(12) establish and maintain a quality assurance plan to determine specific service 
47.27 	outcomes and the client's satisfaction with services; and
47.28 	(13) develop and maintain written policies and procedures regarding service provision 
47.29 	and administration of the provider entity.
48.1 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
48.2 	The commissioner shall establish a process for decertification of an ACT team and shall 
48.3 	require corrective action, medical assistance repayment, or decertification of an ACT team 
48.4 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
48.5 	standards or administrative standards provided by the commissioner in the application and 
48.6 	certification process. The decertification is subject to appeal to the state.
48.7 	(d) A provider entity must specify in the provider entity's application what geographic 
48.8 	area and populations will be served by the proposed program. A provider entity must 
48.9 	document that the capacity or program specialties of existing programs are not sufficient 
48.10 	to meet the service needs of the target population. A provider entity must submit evidence 
48.11 	of ongoing relationships with other providers and levels of care to facilitate referrals to and 
48.12 	from the proposed program.
48.13 	(e) A provider entity must submit documentation that the provider entity requested a 
48.14 	statement of need from each county board and tribal authority that serves as a local mental 
48.15 	health authority in the proposed service area. The statement of need must specify if the local 
48.16 	mental health authority supports or does not support the need for the proposed program and 
48.17 	the basis for this determination. If a local mental health authority does not respond within 
48.18 	60 days of the receipt of the request, the commissioner shall determine the need for the 
48.19 	program based on the documentation submitted by the provider entity.

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

48.21 	Sec. 19. Minnesota Statutes 2016, section 256B.0622, subdivision 4, is amended to read:
48.22 		Subd. 4.Provider entity licensure and contract requirements for intensive residential 
48.23 	treatment services. (a) The intensive residential treatment services provider entity must:
48.24 	(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
48.25 	(2) not exceed 16 beds per site; and
48.26 	(3) comply with the additional standards in this section; and.
48.27 	(4) have a contract with the host county to provide these services.
48.28 	(b) The commissioner shall develop procedures for counties and providers to submit 
48.29 	contracts and other documentation as needed to allow the commissioner to determine whether 
48.30 	the standards in this section are met.
48.31 	(c) A provider entity must specify in the provider entity's application what geographic 
48.32 	area and populations will be served by the proposed program. A provider entity must 
49.1 	document that the capacity or program specialties of existing programs are not sufficient 
49.2 	to meet the service needs of the target population. A provider entity must submit evidence 
49.3 	of ongoing relationships with other providers and levels of care to facilitate referrals to and 
49.4 	from the proposed program.
49.5 	(d) A provider entity must submit documentation that the provider entity requested a 
49.6 	statement of need from each county board and tribal authority that serves as a local mental 
49.7 	health authority in the proposed service area. The statement of need must specify if the local 
49.8 	mental health authority supports or does not support the need for the proposed program and 
49.9 	the basis for this determination. If a local mental health authority does not respond within 
49.10 	60 days of the receipt of the request, the commissioner shall determine the need for the 
49.11 	program based on the documentation submitted by the provider entity.

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

49.13 	Sec. 20. Minnesota Statutes 2016, section 256B.0622, subdivision 7a, is amended to read:
49.14 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
49.15 	The required treatment staff qualifications and roles for an ACT team are:
49.16 	(1) the team leader:
49.17 	(i) shall be a licensed mental health professional who is qualified under Minnesota Rules, 
49.18 	part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible 
49.19 	for licensure and are otherwise qualified may also fulfill this role but must obtain full 
49.20 	licensure within 24 months of assuming the role of team leader;
49.21 	(ii) must be an active member of the ACT team and provide some direct services to 
49.22 	clients;
49.23 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
49.24 	responsible for overseeing the administrative operations of the team, providing clinical 
49.25 	oversight of services in conjunction with the psychiatrist or psychiatric care provider, and 
49.26 	supervising team members to ensure delivery of best and ethical practices; and
49.27 	(iv) must be available to provide overall clinical oversight to the ACT team after regular 
49.28 	business hours and on weekends and holidays. The team leader may delegate this duty to 
49.29 	another qualified member of the ACT team;
49.30 	(2) the psychiatric care provider:
49.31 	(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and 
49.32 	Neurology or eligible for board certification or certified by the American Osteopathic Board 
50.1 	of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who 
50.2 	is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A. The psychiatric care 
50.3 	provider must have demonstrated clinical experience working with individuals with serious 
50.4 	and persistent mental illness;
50.5 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
50.6 	screening and admitting clients; monitoring clients' treatment and team member service 
50.7 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
50.8 	and health-related conditions; actively collaborating with nurses; and helping provide clinical 
50.9 	supervision to the team;
50.10 	(iii) shall fulfill the following functions for assertive community treatment clients: 
50.11 	provide assessment and treatment of clients' symptoms and response to medications, including 
50.12 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
50.13 	to clients, with medication decisions based on shared decision making; monitor clients' 
50.14 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
50.15 	community visits;
50.16 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
50.17 	for mental health treatment and shall communicate directly with the client's inpatient 
50.18 	psychiatric care providers to ensure continuity of care;
50.19 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
50.20 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
50.21 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
50.22 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
50.23 	may share this role;
50.24 	(vi) may not provide specific roles and responsibilities by telemedicine unless approved 
50.25 	by the commissioner; and
50.26 	(vii) shall provide psychiatric backup to the program after regular business hours and 
50.27 	on weekends and holidays. The psychiatric care provider may delegate this duty to another 
50.28 	qualified psychiatric provider;
50.29 	(3) the lead mental health professional:
50.30 	(i) shall be a licensed mental health professional who is qualified under Minnesota Rules, 
50.31 	part 9505.0371, subpart 5, item A. An individual who is not licensed but who is eligible for 
50.32 	licensure and is otherwise qualified may also fulfill the mental health professional role but 
50.33 	must obtain full licensure within 24 months of assuming the role;
51.1 	(ii) is responsible for the provision of individual supportive therapy, symptom 
51.2 	management, and empirically supported psychotherapy as specified in a person's treatment 
51.3 	plan and must use empirically supported techniques to address a wide range of clinical and 
51.4 	behavioral needs for this population;
51.5 	(iii) conduct comprehensive assessment of psychiatric history including but not limited 
51.6 	to onset, course and effect of illness, past treatment and responses, and risk behaviors; 
51.7 	mental status; and diagnosis and educate the ACT team in identifying and choosing the 
51.8 	appropriate interventions for psychiatric needs; and
51.9 	(iv) provide direct clinical services including individual supportive therapy and 
51.10 	psychotherapy to clients on an individual, group, and family basis to teach behavioral 
51.11 	symptom-management techniques to alleviate and manage symptoms not reduced with 
51.12 	medication and promote personal growth and development by assisting clients to adapt and 
51.13 	cope with internal and external stresses;
51.14 	(3)(4) the nursing staff:
51.15 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
51.16 	of whom at least one has a minimum of one-year experience working with adults with 
51.17 	serious mental illness and a working knowledge of psychiatric medications. No more than 
51.18 	two individuals can share a full-time equivalent position;
51.19 	(ii) are responsible for managing medication, administering and documenting medication 
51.20 	treatment, and managing a secure medication room; and
51.21 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
51.22 	as prescribed; screen and monitor clients' mental and physical health conditions and 
51.23 	medication side effects; engage in health promotion, prevention, and education activities; 
51.24 	communicate and coordinate services with other medical providers; facilitate the development 
51.25 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
51.26 	psychiatric and physical health symptoms and medication side effects;
51.27 	(4) (5) the co-occurring disorder specialist:
51.28 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
51.29 	specific training on co-occurring disorders that is consistent with national evidence-based 
51.30 	practices. The training must include practical knowledge of common substances and how 
51.31 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
51.32 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
51.33 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
52.1 	may also be an individual who is a licensed alcohol and drug counselor as described in 
52.2 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
52.3 	and other requirements in Minnesota Rules, part 9530.6450, subpart 5. No more than two 
52.4 	co-occurring disorder specialists may occupy this role; and
52.5 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
52.6 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
52.7 	team members on co-occurring disorders;
52.8 	(5) (6) the employment and vocational specialist:
52.9 	(i) shall be a full-time employment and vocational specialist who has at least one-year 
52.10 	experience providing employment services or advanced education that involved field training 
52.11 	in employment and vocational services to individuals with mental illness. An individual 
52.12 	who does not meet these qualifications may also serve as the employment and vocational 
52.13 	specialist upon completing a training plan approved by the commissioner;
52.14 	(ii) shall provide or facilitate the provision of employment and vocational services to 
52.15 	clients. The employment and vocational specialist serves as a consultant and educator to 
52.16 	fellow ACT team members on these services; and
52.17 	(iii) should not refer individuals to receive any type of employment or vocational services 
52.18 	or linkage by providers outside of the ACT team;
52.19 	(6) (7) the mental health certified peer specialist:
52.20 	(i) shall be a full-time equivalent mental health certified peer specialist as defined in 
52.21 	section 256B.0615. No more than two individuals can share this position. The mental health 
52.22 	certified peer specialist is a fully integrated team member who provides highly individualized 
52.23 	services in the community and promotes the self-determination and shared decision-making 
52.24 	abilities of clients. This requirement may be waived due to workforce shortages upon 
52.25 	approval of the commissioner;
52.26 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
52.27 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
52.28 	in developing advance directives; and
52.29 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
52.30 	wellness and resilience, provide consultation to team members, promote a culture where 
52.31 	the clients' points of view and preferences are recognized, understood, respected, and 
52.32 	integrated into treatment, and serve in a manner equivalent to other team members;
53.1 	(7) (8) the program administrative assistant shall be a full-time office-based program 
53.2 	administrative assistant position assigned to solely work with the ACT team, providing a 
53.3 	range of supports to the team, clients, and families; and
53.4 	(8) (9) additional staff:
53.5 	(i) shall be based on team size. Additional treatment team staff may include licensed 
53.6 	mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item 
53.7 	A; mental health practitioners as defined in Minnesota Rules, part 9505.0370, subpart 17; 
53.8 	or mental health rehabilitation workers as defined in section 256B.0623, subdivision 5, 
53.9 	clause (4). These individuals shall have the knowledge, skills, and abilities required by the 
53.10 	population served to carry out rehabilitation and support functions; and
53.11 	(ii) shall be selected based on specific program needs or the population served.
53.12 	(b) Each ACT team must clearly document schedules for all ACT team members.
53.13 	(c) Each ACT team member must serve as a primary team member for clients assigned 
53.14 	by the team leader and are responsible for facilitating the individual treatment plan process 
53.15 	for those clients. The primary team member for a client is the responsible team member 
53.16 	knowledgeable about the client's life and circumstances and writes the individual treatment 
53.17 	plan. The primary team member provides individual supportive therapy or counseling, and 
53.18 	provides primary support and education to the client's family and support system.
53.19 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
53.20 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
53.21 	member shall be proficient in their respective discipline and be able to work collaboratively 
53.22 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
53.23 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
53.24 	community treatment.
53.25 	(e) Each ACT team member must fulfill training requirements established by the 
53.26 	commissioner.

53.27 	Sec. 21. Minnesota Statutes 2016, section 256B.0622, subdivision 7b, is amended to read:
53.28 		Subd. 7b.Assertive community treatment program size and opportunities. (a) Each 
53.29 	ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
53.30 	Staff-to-client ratios shall be based on team size as follows:
53.31 	(1) a small ACT team must:
54.1 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
54.2 	the program assistant and the psychiatric care provider;
54.3 	(ii) serve an annual average maximum of no more than 50 clients;
54.4 	(iii) ensure at least one full-time equivalent position for every eight clients served;
54.5 	(iv) schedule ACT team staff for at least eight-hour shift coverage on weekdays and 
54.6 	on-call duty to provide crisis services and deliver services after hours when staff are not 
54.7 	working;
54.8 	(v) provide crisis services during business hours if the small ACT team does not have 
54.9 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
54.10 	the ACT team may arrange for coverage for crisis assessment and intervention services 
54.11 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
54.12 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
54.13 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
54.14 	the crisis-intervention services provider;
54.15 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
54.16 	evenings or on weekend days or holidays, when necessary;
54.17 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
54.18 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
54.19 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
54.20 	be arranged and a mechanism of timely communication and coordination established in 
54.21 	writing;
54.22 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
54.23 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
54.24 	equivalent nursing, one full-time substance abuse specialist, one full-time equivalent mental 
54.25 	health certified peer specialist, one full-time vocational specialist, one full-time program 
54.26 	assistant, and at least one additional full-time ACT team member who has is a mental health 
54.27 	professional or practitioner status; and
54.28 	(2) a midsize ACT team shall:
54.29 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
54.30 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
54.31 	to two full-time equivalent nursing staff, one full-time substance abuse specialist, one 
54.32 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
54.33 	one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT 
55.1 	members, with at least one dedicated full-time staff member with mental health professional 
55.2 	status. Remaining team members may have mental health professional or practitioner status;
55.3 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
55.4 	assistant and the psychiatric care provider;
55.5 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
55.6 	(iv) ensure at least one full-time equivalent position for every nine clients served;
55.7 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
55.8 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
55.9 	specifications, staff are regularly scheduled to provide the necessary services on a 
55.10 	client-by-client basis in the evenings and on weekends and holidays;
55.11 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
55.12 	when staff are not working;
55.13 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
55.14 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
55.15 	which the ACT team communicates routinely with the crisis-intervention provider and the 
55.16 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
55.17 	by the crisis-intervention services provider; and
55.18 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
55.19 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
55.20 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
55.21 	and a mechanism of timely communication and coordination established in writing;
55.22 	(3) a large ACT team must:
55.23 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
55.24 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
55.25 	one full-time substance abuse specialist, one full-time equivalent mental health certified 
55.26 	peer specialist, one full-time vocational specialist, one full-time program assistant, and at 
55.27 	least two additional full-time equivalent ACT team members, with at least one dedicated 
55.28 	full-time staff member with mental health professional status. Remaining team members 
55.29 	may have mental health professional or mental health practitioner status;
55.30 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
55.31 	assistant and psychiatric care provider;
55.32 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
56.1 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
56.2 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
56.3 	second shift providing services at least 12 hours per day weekdays. For weekends and 
56.4 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
56.5 	with a minimum of two staff each weekend day and every holiday;
56.6 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
56.7 	when staff are not working; and
56.8 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
56.9 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
56.10 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
56.11 	and a mechanism of timely communication and coordination established in writing.
56.12 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
56.13 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
56.14 	exceed a one-to-ten staff-to-client ratio.

56.15 	Sec. 22. Minnesota Statutes 2016, section 256B.0623, subdivision 2, is amended to read:
56.16 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
56.17 	given them.
56.18 	(a) "Adult rehabilitative mental health services" means mental health services which are 
56.19 	rehabilitative and enable the recipient to develop and enhance psychiatric stability, social 
56.20 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
56.21 	community skills, when these abilities are impaired by the symptoms of mental illness. 
56.22 	Adult rehabilitative mental health services are also appropriate when provided to enable a 
56.23 	recipient to retain stability and functioning, if the recipient would be at risk of significant 
56.24 	functional decompensation or more restrictive service settings without these services.
56.25 	(1) Adult rehabilitative mental health services instruct, assist, and support the recipient 
56.26 	in areas such as: interpersonal communication skills, community resource utilization and 
56.27 	integration skills, crisis assistance planning as defined in section 245.462, subdivision 6, 
56.28 	relapse prevention skills, health care directives, budgeting and shopping skills, healthy 
56.29 	lifestyle skills and practices, cooking and nutrition skills, transportation skills, medication 
56.30 	education and monitoring, mental illness symptom management skills, household 
56.31 	management skills, employment-related skills, parenting skills, and transition to community 
56.32 	living services.
57.1 	(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's 
57.2 	home or another community setting or in groups.
57.3 	(b) "Medication education services" means services provided individually or in groups 
57.4 	which focus on educating the recipient about mental illness and symptoms; the role and 
57.5 	effects of medications in treating symptoms of mental illness; and the side effects of 
57.6 	medications. Medication education is coordinated with medication management services 
57.7 	and does not duplicate it. Medication education services are provided by physicians, 
57.8 	pharmacists, physician assistants, or registered nurses.
57.9 	(c) "Transition to community living services" means services which maintain continuity 
57.10 	of contact between the rehabilitation services provider and the recipient and which facilitate 
57.11 	discharge from a hospital, residential treatment program under Minnesota Rules, chapter 
57.12 	9505, board and lodging facility, or nursing home. Transition to community living services 
57.13 	are not intended to provide other areas of adult rehabilitative mental health services.

57.14 	EFFECTIVE DATE. This section is effective August 1, 2017.

57.15 	Sec. 23. Minnesota Statutes 2016, section 256B.0624, subdivision 1, is amended to read:
57.16 		Subdivision 1.Scope. Medical assistance covers adult mental health crisis response 
57.17 	services as defined in subdivision 2, paragraphs (c) to (e) section 245.991, subject to federal 
57.18 	approval, if provided to a recipient as defined in subdivision 3 and provided by a qualified 
57.19 	provider entity as defined in this section and by a qualified individual provider working 
57.20 	within the provider's scope of practice and as defined in this subdivision and identified in 
57.21 	the recipient's individual crisis treatment plan as defined in subdivision 11 section 245.991
57.22 	and if determined to be medically necessary.

57.23 	EFFECTIVE DATE. This section is effective August 1, 2017.

57.24 	Sec. 24. Minnesota Statutes 2016, section 256B.0624, subdivision 2, is amended to read:
57.25 		Subd. 2.Definitions. For purposes of this section, The following terms used in this 
57.26 	section have the meanings given them in section 245.991, subdivision 2.
57.27 	(a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation 
57.28 	which, but for the provision of crisis response services, would likely result in significantly 
57.29 	reduced levels of functioning in primary activities of daily living, or in an emergency 
57.30 	situation, or in the placement of the recipient in a more restrictive setting, including, but 
57.31 	not limited to, inpatient hospitalization.
58.1 	(b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation 
58.2 	which causes an immediate need for mental health services and is consistent with section 
58.3 	62Q.55.
58.4 	A mental health crisis or emergency is determined for medical assistance service 
58.5 	reimbursement by a physician, a mental health professional, or crisis mental health 
58.6 	practitioner with input from the recipient whenever possible.
58.7 	(c) "Mental health crisis assessment" means an immediate face-to-face assessment by 
58.8 	a physician, a mental health professional, or mental health practitioner under the clinical 
58.9 	supervision of a mental health professional, following a screening that suggests that the 
58.10 	adult may be experiencing a mental health crisis or mental health emergency situation. It 
58.11 	includes, when feasible, assessing whether the person might be willing to voluntarily accept 
58.12 	treatment, determining whether the person has an advance directive, and obtaining 
58.13 	information and history from involved family members or caretakers.
58.14 	(d) "Mental health mobile crisis intervention services" means face-to-face, short-term 
58.15 	intensive mental health services initiated during a mental health crisis or mental health 
58.16 	emergency to help the recipient cope with immediate stressors, identify and utilize available 
58.17 	resources and strengths, engage in voluntary treatment, and begin to return to the recipient's 
58.18 	baseline level of functioning. The services, including screening and treatment plan 
58.19 	recommendations, must be culturally and linguistically appropriate.
58.20 	(1) This service is provided on site by a mobile crisis intervention team outside of an 
58.21 	inpatient hospital setting. Mental health mobile crisis intervention services must be available 
58.22 	24 hours a day, seven days a week.
58.23 	(2) The initial screening must consider other available services to determine which 
58.24 	service intervention would best address the recipient's needs and circumstances.
58.25 	(3) The mobile crisis intervention team must be available to meet promptly face-to-face 
58.26 	with a person in mental health crisis or emergency in a community setting or hospital 
58.27 	emergency room.
58.28 	(4) The intervention must consist of a mental health crisis assessment and a crisis 
58.29 	treatment plan.
58.30 	(5) The team must be available to individuals who are experiencing a co-occurring 
58.31 	substance use disorder, who do not need the level of care provided in a detoxification facility.
59.1 	(6) The treatment plan must include recommendations for any needed crisis stabilization 
59.2 	services for the recipient, including engagement in treatment planning and family 
59.3 	psychoeducation.
59.4 	(e) "Mental health crisis stabilization services" means individualized mental health 
59.5 	services provided to a recipient following crisis intervention services which are designed 
59.6 	to restore the recipient to the recipient's prior functional level. Mental health crisis 
59.7 	stabilization services may be provided in the recipient's home, the home of a family member 
59.8 	or friend of the recipient, another community setting, or a short-term supervised, licensed 
59.9 	residential program. Mental health crisis stabilization does not include partial hospitalization 
59.10 	or day treatment. Mental health crisis stabilization services includes family psychoeducation.

59.11 	EFFECTIVE DATE. This section is effective August 1, 2017.

59.12 	Sec. 25. Minnesota Statutes 2016, section 256B.0624, subdivision 3, is amended to read:
59.13 		Subd. 3.Eligibility. An eligible recipient is an individual who:
59.14 	(1) is age 18 or older;
59.15 	(2) is screened as possibly experiencing a mental health crisis or emergency where a 
59.16 	mental health crisis assessment is needed; and
59.17 	(3) is assessed as experiencing a mental health crisis or emergency, and mental health 
59.18 	crisis intervention or crisis intervention and stabilization services are determined to be 
59.19 	medically necessary.
59.20 	(a) An eligible adult recipient is an individual who:
59.21 	(1) is eligible for medical assistance;
59.22 	(2) is 18 years of age or older;
59.23 	(3) for the purposes of an assessment, is screened as potentially experiencing a crisis;
59.24 	(4) for the purposes of intervention services, is assessed as experiencing a crisis and for 
59.25 	whom intervention services are necessary;
59.26 	(5) for the purposes of stabilization services, is assessed as experiencing a crisis and for 
59.27 	whom stabilization services are necessary; and
59.28 	(6) for the purposes of residential stabilization services, is assessed as experiencing a 
59.29 	crisis and for whom residential stabilization services are necessary.
59.30 	(b) An eligible child recipient is an individual who:
60.1 	(1) is eligible for medical assistance;
60.2 	(2) is younger than 18 years of age;
60.3 	(3) for the purposes of an assessment, is screened as potentially experiencing a crisis;
60.4 	(4) for the purposes of intervention services, is assessed as experiencing a crisis and for 
60.5 	whom intervention services are necessary; and
60.6 	(5) for the purposes of stabilization services, is assessed as experiencing a crisis and for 
60.7 	whom stabilization services are necessary.
60.8 	(c) A crisis is determined for medical assistance service reimbursement by a physician, 
60.9 	a mental health professional, or a mental health practitioner who is a member of the crisis 
60.10 	team with input from the recipient, the recipient's guardian, or the recipient's family whenever 
60.11 	possible.

60.12 	EFFECTIVE DATE. This section is effective August 1, 2017.

60.13 	Sec. 26. Minnesota Statutes 2016, section 256B.0624, subdivision 4, is amended to read:
60.14 		Subd. 4.Provider entity standards. (a) A provider entity is an entity that meets the 
60.15 	standards listed in paragraph (b) and: section 245.991, subdivision 4, and is a currently 
60.16 	enrolled medical assistance provider.
60.17 	(1) is a county board operated entity; or
60.18 	(2) is a provider entity that is under contract with the county board in the county where 
60.19 	the potential crisis or emergency is occurring. To provide services under this section, the 
60.20 	provider entity must directly provide the services; or if services are subcontracted, the 
60.21 	provider entity must maintain responsibility for services and billing.
60.22 	(b) The adult mental health crisis response services provider entity must have the capacity 
60.23 	to meet and carry out the following standards:
60.24 	(1) has the capacity to recruit, hire, and manage and train mental health professionals, 
60.25 	practitioners, and rehabilitation workers;
60.26 	(2) has adequate administrative ability to ensure availability of services;
60.27 	(3) is able to ensure adequate preservice and in-service training;
60.28 	(4) is able to ensure that staff providing these services are skilled in the delivery of 
60.29 	mental health crisis response services to recipients;
61.1 	(5) is able to ensure that staff are capable of implementing culturally specific treatment 
61.2 	identified in the individual treatment plan that is meaningful and appropriate as determined 
61.3 	by the recipient's culture, beliefs, values, and language;
61.4 	(6) is able to ensure enough flexibility to respond to the changing intervention and care 
61.5 	needs of a recipient as identified by the recipient during the service partnership between 
61.6 	the recipient and providers;
61.7 	(7) is able to ensure that mental health professionals and mental health practitioners have 
61.8 	the communication tools and procedures to communicate and consult promptly about crisis 
61.9 	assessment and interventions as services occur;
61.10 	(8) is able to coordinate these services with county emergency services, community 
61.11 	hospitals, ambulance, transportation services, social services, law enforcement, and mental 
61.12 	health crisis services through regularly scheduled interagency meetings;
61.13 	(9) is able to ensure that mental health crisis assessment and mobile crisis intervention 
61.14 	services are available 24 hours a day, seven days a week;
61.15 	(10) is able to ensure that services are coordinated with other mental health service 
61.16 	providers, county mental health authorities, or federally recognized American Indian 
61.17 	authorities and others as necessary, with the consent of the adult. Services must also be 
61.18 	coordinated with the recipient's case manager if the adult is receiving case management 
61.19 	services;
61.20 	(11) is able to ensure that crisis intervention services are provided in a manner consistent 
61.21 	with sections 245.461 to 245.486;
61.22 	(12) is able to submit information as required by the state;
61.23 	(13) maintains staff training and personnel files;
61.24 	(14) is able to establish and maintain a quality assurance and evaluation plan to evaluate 
61.25 	the outcomes of services and recipient satisfaction;
61.26 	(15) is able to keep records as required by applicable laws;
61.27 	(16) is able to comply with all applicable laws and statutes;
61.28 	(17) is an enrolled medical assistance provider; and
61.29 	(18) develops and maintains written policies and procedures regarding service provision 
61.30 	and administration of the provider entity, including safety of staff and recipients in high-risk 
61.31 	situations.

62.1 	EFFECTIVE DATE. This section is effective August 1, 2017.

62.2 	Sec. 27. Minnesota Statutes 2016, section 256B.092, subdivision 14, is amended to read:
62.3 		Subd. 14.Reduce avoidable behavioral crisis emergency room admissions, 
62.4 	psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons 
62.5 	receiving home and community-based services authorized under this section who have had 
62.6 	two or more admissions within a calendar year to an emergency room, psychiatric unit, or 
62.7 	institution must receive consultation from a mental health professional as defined in section 
62.8 	245.462, subdivision 18, or a behavioral professional as defined in the home and 
62.9 	community-based services state plan within 30 days of discharge. The mental health 
62.10 	professional or behavioral professional must:
62.11 	(1) conduct a functional assessment of the crisis incident as defined in section 245D.02, 
62.12 	subdivision 11, which led to the hospitalization with the goal of developing proactive 
62.13 	strategies as well as necessary reactive strategies to reduce the likelihood of future avoidable 
62.14 	hospitalizations due to a behavioral crisis;
62.15 	(2) use the results of the functional assessment to amend the coordinated service and 
62.16 	support plan set forth in section 245D.02, subdivision 4b, to address the potential need for 
62.17 	additional staff training, increased staffing, access to crisis mobility services, mental health 
62.18 	services, use of technology, and crisis stabilization services in section 256B.0624, subdivision 
62.19 	7 245.991; and
62.20 	(3) identify the need for additional consultation, testing, and mental health crisis 
62.21 	intervention team services as defined in section 245D.02, subdivision 20, psychotropic 
62.22 	medication use and monitoring under section 245D.051, and the frequency and duration of 
62.23 	ongoing consultation.
62.24 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, the 
62.25 	Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

62.26 	EFFECTIVE DATE. This section is effective August 1, 2017.

62.27 	Sec. 28. Minnesota Statutes 2016, section 256B.0943, subdivision 1, is amended to read:
62.28 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
62.29 	meanings given them.
62.30 	(a) "Children's therapeutic services and supports" means the flexible package of mental 
62.31 	health services for children who require varying therapeutic and rehabilitative levels of 
62.32 	intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871, 
63.1 	subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision 
63.2 	20. The services are time-limited interventions that are delivered using various treatment 
63.3 	modalities and combinations of services designed to reach treatment outcomes identified 
63.4 	in the individual treatment plan.
63.5 	(b) "Clinical supervision" means the overall responsibility of the mental health 
63.6 	professional for the control and direction of individualized treatment planning, service 
63.7 	delivery, and treatment review for each client. A mental health professional who is an 
63.8 	enrolled Minnesota health care program provider accepts full professional responsibility 
63.9 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
63.10 	and oversees or directs the supervisee's work.
63.11 	(c) "Clinical trainee" means a mental health practitioner who meets the qualifications 
63.12 	specified in Minnesota Rules, part 9505.0371, subpart 5, item C.
63.13 	(d) "Crisis planning" means the development of a written plan to assist a child's family 
63.14 	to contend with a potential crisis and is distinct from the immediate provision of crisis 
63.15 	intervention services. The plan addresses prevention and intervention strategies to be used 
63.16 	in a crisis. It identifies factors that might precipitate a mental health crisis, identify behaviors 
63.17 	related to the emergence of a crisis, and resources available to resolve a crisis.
63.18 	(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a. Crisis 
63.19 	assistance entails the development of a written plan to assist a child's family to contend with 
63.20 	a potential crisis and is distinct from the immediate provision of crisis intervention services.
63.21 	(e) "Culturally competent provider" means a provider who understands and can utilize 
63.22 	to a client's benefit the client's culture when providing services to the client. A provider 
63.23 	may be culturally competent because the provider is of the same cultural or ethnic group 
63.24 	as the client or the provider has developed the knowledge and skills through training and 
63.25 	experience to provide services to culturally diverse clients.
63.26 	(f) "Day treatment program" for children means a site-based structured mental health 
63.27 	program consisting of psychotherapy for three or more individuals and individual or group 
63.28 	skills training provided by a multidisciplinary team, under the clinical supervision of a 
63.29 	mental health professional.
63.30 	(g) "Diagnostic assessment" has the meaning given in Minnesota Rules, part 9505.0372, 
63.31 	subpart 1.
63.32 	(h) "Direct service time" means the time that a mental health professional, clinical trainee, 
63.33 	mental health practitioner, or mental health behavioral aide spends face-to-face with a client 
64.1 	and the client's family or providing covered telemedicine services. Direct service time 
64.2 	includes time in which the provider obtains a client's history, develops a client's treatment 
64.3 	plan, records individual treatment outcomes, or provides service components of children's 
64.4 	therapeutic services and supports. Direct service time does not include time doing work 
64.5 	before and after providing direct services, including scheduling or maintaining clinical 
64.6 	records.
64.7 	(i) "Direction of mental health behavioral aide" means the activities of a mental health 
64.8 	professional or mental health practitioner in guiding the mental health behavioral aide in 
64.9 	providing services to a client. The direction of a mental health behavioral aide must be based 
64.10 	on the client's individualized treatment plan and meet the requirements in subdivision 6, 
64.11 	paragraph (b), clause (5).
64.12 	(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
64.13 	(k) "Individual behavioral plan" means a plan of intervention, treatment, and services 
64.14 	for a child written by a mental health professional or mental health practitioner, under the 
64.15 	clinical supervision of a mental health professional, to guide the work of the mental health 
64.16 	behavioral aide. The individual behavioral plan may be incorporated into the child's individual 
64.17 	treatment plan so long as the behavioral plan is separately communicable to the mental 
64.18 	health behavioral aide.
64.19 	(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part 9505.0371, 
64.20 	subpart 7.
64.21 	(m) "Mental health behavioral aide services" means medically necessary one-on-one 
64.22 	activities performed by a trained paraprofessional qualified as provided in subdivision 7, 
64.23 	paragraph (b), clause (3), to assist a child retain or generalize psychosocial skills as previously 
64.24 	trained by a mental health professional or mental health practitioner and as described in the 
64.25 	child's individual treatment plan and individual behavior plan. Activities involve working 
64.26 	directly with the child or child's family as provided in subdivision 9, paragraph (b), clause 
64.27 	(4).
64.28 	(n) "Mental health practitioner" means an individual as defined in Minnesota Rules, part 
64.29 	9505.0370, subpart 17.
64.30 	(o) "Mental health professional" means an individual as defined in Minnesota Rules, 
64.31 	part 9505.0370, subpart 18.
64.32 	(p) "Mental health service plan development" includes:
65.1 	(1) the development, review, and revision of a child's individual treatment plan, as 
65.2 	provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of the client 
65.3 	or client's parents, primary caregiver, or other person authorized to consent to mental health 
65.4 	services for the client, and including arrangement of treatment and support activities specified 
65.5 	in the individual treatment plan; and
65.6 	(2) administering standardized outcome measurement instruments, determined and 
65.7 	updated by the commissioner, as periodically needed to evaluate the effectiveness of 
65.8 	treatment for children receiving clinical services and reporting outcome measures, as required 
65.9 	by the commissioner.
65.10 	(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given 
65.11 	in section 245.462, subdivision 20, paragraph (a).
65.12 	(r) "Psychotherapy" means the treatment of mental or emotional disorders or 
65.13 	maladjustment by psychological means. Psychotherapy may be provided in many modalities 
65.14 	in accordance with Minnesota Rules, part 9505.0372, subpart 6, including patient and/or 
65.15 	family psychotherapy; family psychotherapy; psychotherapy for crisis; group psychotherapy; 
65.16 	or multiple-family psychotherapy. Beginning with the American Medical Association's 
65.17 	Current Procedural Terminology, standard edition, 2014, the procedure "individual 
65.18 	psychotherapy" is replaced with "patient and/or family psychotherapy," a substantive change 
65.19 	that permits the therapist to work with the client's family without the client present to obtain 
65.20 	information about the client or to explain the client's treatment plan to the family. 
65.21 	Psychotherapy is appropriate for crisis response when a child has become dysregulated or 
65.22 	experienced new trauma since the diagnostic assessment was completed and needs 
65.23 	psychotherapy to address issues not currently included in the child's individual treatment 
65.24 	plan.
65.25 	(s) "Rehabilitative services" or "psychiatric rehabilitation services" means a series or 
65.26 	multidisciplinary combination of psychiatric and psychosocial interventions to: (1) restore 
65.27 	a child or adolescent to an age-appropriate developmental trajectory that had been disrupted 
65.28 	by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with, 
65.29 	counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the 
65.30 	course of a psychiatric illness. Psychiatric rehabilitation services for children combine 
65.31 	psychotherapy to address internal psychological, emotional, and intellectual processing 
65.32 	deficits, and skills training to restore personal and social functioning. Psychiatric 
65.33 	rehabilitation services establish a progressive series of goals with each achievement building 
65.34 	upon a prior achievement. Continuing progress toward goals is expected, and rehabilitative 
65.35 	potential ceases when successive improvement is not observable over a period of time.
66.1 	(t) "Skills training" means individual, family, or group training, delivered by or under 
66.2 	the supervision of a mental health professional, designed to facilitate the acquisition of 
66.3 	psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate 
66.4 	developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child 
66.5 	to self-monitor, compensate for, cope with, counteract, or replace skills deficits or 
66.6 	maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject 
66.7 	to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

66.8 	EFFECTIVE DATE. This section is effective August 1, 2017.

66.9 	Sec. 29. Minnesota Statutes 2016, section 256B.0943, subdivision 2, is amended to read:
66.10 		Subd. 2.Covered service components of children's therapeutic services and supports.
 66.11 	(a) Subject to federal approval, medical assistance covers medically necessary children's 
66.12 	therapeutic services and supports as defined in this section that an eligible provider entity 
66.13 	certified under subdivision 4 provides to a client eligible under subdivision 3.
66.14 	(b) The service components of children's therapeutic services and supports are:
66.15 	(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis, 
66.16 	and group psychotherapy;
66.17 	(2) individual, family, or group skills training provided by a mental health professional 
66.18 	or mental health practitioner;
66.19 	(3) crisis assistance planning;
66.20 	(4) mental health behavioral aide services;
66.21 	(5) direction of a mental health behavioral aide;
66.22 	(6) mental health service plan development; and
66.23 	(7) children's day treatment.

66.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

66.25 	Sec. 30. Minnesota Statutes 2016, section 256B.0943, subdivision 4, is amended to read:
66.26 		Subd. 4.Provider entity certification. (a) The commissioner shall establish an initial 
66.27 	provider entity application and certification process and recertification process to determine 
66.28 	whether a provider entity has an administrative and clinical infrastructure that meets the 
66.29 	requirements in subdivisions 5 and 6. A provider entity must be certified for the three core 
66.30 	rehabilitation services of psychotherapy, skills training, and crisis assistance planning. The 
67.1 	commissioner shall recertify a provider entity at least every three years. The commissioner 
67.2 	shall establish a process for decertification of a provider entity and shall require corrective 
67.3 	action, medical assistance repayment, or decertification of a provider entity that no longer 
67.4 	meets the requirements in this section or that fails to meet the clinical quality standards or 
67.5 	administrative standards provided by the commissioner in the application and certification 
67.6 	process.
67.7 	(b) For purposes of this section, a provider entity must be:
67.8 	(1) an Indian health services facility or a facility owned and operated by a tribe or tribal 
67.9 	organization operating as a 638 facility under Public Law 93-638United States Code, title 
67.10 	25, section 450f, certified by the state;
67.11 	(2) a county-operated entity certified by the state; or
67.12 	(3) a noncounty entity certified by the state.

67.13 	EFFECTIVE DATE. This section is effective August 1, 2017.

67.14 	Sec. 31. Minnesota Statutes 2016, section 256B.0943, subdivision 7, is amended to read:
67.15 		Subd. 7.Qualifications of individual and team providers. (a) An individual or team 
67.16 	provider working within the scope of the provider's practice or qualifications may provide 
67.17 	service components of children's therapeutic services and supports that are identified as 
67.18 	medically necessary in a client's individual treatment plan.
67.19 	(b) An individual provider must be qualified as:
67.20 	(1) a mental health professional as defined in subdivision 1, paragraph (o); or
67.21 	(2) a mental health practitioner or clinical trainee. The mental health practitioner or 
67.22 	clinical trainee must work under the clinical supervision of a mental health professional; or
67.23 	(3) a mental health behavioral aide working under the clinical supervision of a mental 
67.24 	health professional to implement the rehabilitative mental health services previously 
67.25 	introduced by a mental health professional or practitioner and identified in the client's 
67.26 	individual treatment plan and individual behavior plan.
67.27 	(A) A level I mental health behavioral aide must:
67.28 	(i) be at least 18 years old;
67.29 	(ii) have a high school diploma or general equivalency diploma (GED) or two years of 
67.30 	experience as a primary caregiver to a child with severe emotional disturbance within the 
67.31 	previous ten years; and
68.1 	(iii) meet preservice training and continuing education requirements under subdivision 
68.2 	8.
68.3 	(B) A level II mental health behavioral aide must:
68.4 	(i) be at least 18 years old;
68.5 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
68.6 	clinical services in the treatment of mental illness concerning children or adolescents or 
68.7 	complete a certificate program established under subdivision 8a; and
68.8 	(iii) meet preservice training and continuing education requirements in subdivision 8.
68.9 	(c) A day treatment multidisciplinary team must include at least one mental health 
68.10 	professional or clinical trainee and one mental health practitioner.

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

68.12 	Sec. 32. Minnesota Statutes 2016, section 256B.0943, subdivision 8, is amended to read:
68.13 		Subd. 8.Required preservice training and continuing education. (a) A provider entity 
68.14 	shall establish a plan training program to provide preservice training and continuing education 
68.15 	for staff. The plan training program must clearly describe the type of training provided by 
68.16 	the entity necessary to obtain new skills and maintain current skills and obtain new skills 
68.17 	and that relates to the provider entity's goals and objectives for services offered to provide 
68.18 	appropriate services.
68.19 	(b) A provider entity that employs a mental health behavioral aide under this section 
68.20 	must require the mental health behavioral aide to complete 30 hours of preservice training. 
68.21 	The preservice training must include parent team training. The preservice training must 
68.22 	include 15 hours of in-person training of a mental health behavioral aide in mental health 
68.23 	services delivery and eight hours of parent team training. Before providing services to a 
68.24 	client, the aide must complete 24 hours of training, including training on the role and 
68.25 	limitations of a behavioral aide, boundaries, ethics, confidentiality, the federal Health 
68.26 	Insurance Portability and Accountability Act of 1996 (HIPAA), child development, 
68.27 	documentation, crisis deescalation skills, and common medications, their side effects and 
68.28 	impact on symptoms. A provider entity's policies are not considered part of the 24 hours of 
68.29 	required training.
68.30 	Within 60 days of employment, the aide must complete six hours of Department of 
68.31 	Human Services approved or delivered parent team training. Curricula for parent team 
69.1 	training must be approved in advance by the commissioner. Components of parent team 
69.2 	training include:
69.3 	(1) partnering with parents as partners;
69.4 	(2) fundamentals of family support understanding and supporting families;
69.5 	(3) fundamentals of policy and decision making impact on siblings;
69.6 	(4) defining equal partnership the role of culture in family structures; and
69.7 	(5) complexities of the parent and service provider partnership in multiple service delivery 
69.8 	systems due to system strengths and weaknesses;
69.9 	(6) sibling impacts;
69.10 	(7) (5) community resources and support networks; and.
69.11 	(8) community resources.
69.12 	(c) A provider entity that employs a mental health practitioner and a mental health 
69.13 	behavioral aide to provide children's therapeutic services and supports under this section 
69.14 	must require the mental health practitioner and mental health behavioral aide to complete 
69.15 	20 hours of continuing education every two calendar years. The continuing education must 
69.16 	be related to serving the needs of a child with emotional disturbance in the child's home 
69.17 	environment and the child's family.
69.18 	(d) The provider entity must document the mental health practitioner's or mental health 
69.19 	behavioral aide's annual completion of the required continuing education. The documentation 
69.20 	must include the date, subject, and number of hours of the continuing education, and 
69.21 	attendance records, as verified by the staff member's signature, job title, and the instructor's 
69.22 	name. The provider entity must keep documentation for each employee, including records 
69.23 	of attendance at professional workshops and conferences, at a central location and in the 
69.24 	employee's personnel file.

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

69.26 	Sec. 33. Minnesota Statutes 2016, section 256B.0943, subdivision 9, is amended to read:
69.27 		Subd. 9.Service delivery criteria. (a) In delivering services under this section, a certified 
69.28 	provider entity must ensure that:
69.29 	(1) each individual provider's caseload size permits the provider to deliver services to 
69.30 	both clients with severe, complex needs and clients with less intensive needs. The provider's 
69.31 	caseload size should reasonably enable the provider to play an active role in service planning, 
70.1 	monitoring, and delivering services to meet the client's and client's family's needs, as specified 
70.2 	in each client's individual treatment plan;
70.3 	(2) site-based programs, including day treatment programs, provide staffing and facilities 
70.4 	to ensure the client's health, safety, and protection of rights, and that the programs are able 
70.5 	to implement each client's individual treatment plan; and
70.6 	(3) a day treatment program is provided to a group of clients by a multidisciplinary team 
70.7 	under the clinical supervision of a mental health professional. The day treatment program 
70.8 	must be provided in and by: (i) an outpatient hospital accredited by the Joint Commission 
70.9 	on Accreditation of Health Organizations and licensed under sections 144.50 to 144.55; (ii) 
70.10 	a community mental health center under section 245.62; or (iii) an entity that is certified 
70.11 	under subdivision 4 to operate a program that meets the requirements of section 245.4884, 
70.12 	subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 
70.13 	program must stabilize the client's mental health status while developing and improving the 
70.14 	client's independent living and socialization skills. The goal of the day treatment program 
70.15 	must be to reduce or relieve the effects of mental illness and provide training to enable the 
70.16 	client to live in the community. The program must be available year-round at least three to 
70.17 	five days per week, two or three hours per day, unless the normal five-day school week is 
70.18 	shortened by a holiday, weather-related cancellation, or other districtwide reduction in a 
70.19 	school week. A child transitioning into or out of day treatment must receive a minimum 
70.20 	treatment of one day a week for a two-hour time block. The two-hour time block must 
70.21 	include at least one hour of patient and/or family or group psychotherapy. The remainder 
70.22 	of the structured treatment program may include patient and/or family or group 
70.23 	psychotherapy, and individual or group skills training, if included in the client's individual 
70.24 	treatment plan. Day treatment programs are not part of inpatient or residential treatment 
70.25 	services. When a day treatment group that meets the minimum group size requirement 
70.26 	temporarily falls below the minimum group size because of a member's temporary absence, 
70.27 	medical assistance covers a group session conducted for the group members in attendance. 
70.28 	A day treatment program may provide fewer than the minimally required hours for a 
70.29 	particular child during a billing period in which the child is transitioning into, or out of, the 
70.30 	program.
70.31 	(b) To be eligible for medical assistance payment, a provider entity must deliver the 
70.32 	service components of children's therapeutic services and supports in compliance with the 
70.33 	following requirements:
70.34 	(1) patient and/or family, family, and group psychotherapy must be delivered as specified 
70.35 	in Minnesota Rules, part 9505.0372, subpart 6. Psychotherapy to address the child's 
71.1 	underlying mental health disorder must be documented as part of the child's ongoing 
71.2 	treatment. A provider must deliver, or arrange for, medically necessary psychotherapy, 
71.3 	unless the child's parent or caregiver chooses not to receive it. When a provider delivering 
71.4 	other services to a child under this section deems it not medically necessary to provide 
71.5 	psychotherapy to the child for a period of 90 days or longer, the provider entity must 
71.6 	document the medical reasons why psychotherapy is not necessary. When a provider 
71.7 	determines that a child needs psychotherapy but psychotherapy cannot be delivered due to 
71.8 	a shortage of licensed mental health professionals in the child's community, the provider 
71.9 	must document the lack of access in the child's medical record;
71.10 	(2) individual, family, or group skills training must be provided by a mental health 
71.11 	professional or a mental health practitioner who is delivering services that fall within the 
71.12 	scope of the provider's practice and is supervised by a mental health professional who 
71.13 	accepts full professional responsibility for the training. Skills training is subject to the 
71.14 	following requirements:
71.15 	(i) a mental health professional, clinical trainee, or mental health practitioner shall provide 
71.16 	skills training;
71.17 	(ii) skills training delivered to a child or the child's family must be targeted to the specific 
71.18 	deficits or maladaptations of the child's mental health disorder and must be prescribed in 
71.19 	the child's individual treatment plan;
71.20 	(iii) the mental health professional delivering or supervising the delivery of skills training 
71.21 	must document any underlying psychiatric condition and must document how skills training 
71.22 	is being used in conjunction with psychotherapy to address the underlying condition;
71.23 	(iv) skills training delivered to the child's family must teach skills needed by parents to 
71.24 	enhance the child's skill development, to help the child utilize daily life skills taught by a 
71.25 	mental health professional, clinical trainee, or mental health practitioner, and to develop or 
71.26 	maintain a home environment that supports the child's progressive use of skills;
71.27 	(v) group skills training may be provided to multiple recipients who, because of the 
71.28 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
71.29 	interaction in a group setting, which must be staffed as follows:
71.30 	(A) one mental health professional or one clinical trainee or mental health practitioner 
71.31 	under supervision of a licensed mental health professional must work with a group of three 
71.32 	to eight clients; or
72.1 	(B) two mental health professionals, two clinical trainees or mental health practitioners 
72.2 	under supervision of a licensed mental health professional, or one mental health professional 
72.3 	or clinical trainee and one mental health practitioner must work with a group of nine to 12 
72.4 	clients;
72.5 	(vi) a mental health professional, clinical trainee, or mental health practitioner must have 
72.6 	taught the psychosocial skill before a mental health behavioral aide may practice that skill 
72.7 	with the client; and
72.8 	(vii) for group skills training, when a skills group that meets the minimum group size 
72.9 	requirement temporarily falls below the minimum group size because of a group member's 
72.10 	temporary absence, the provider may conduct the session for the group members in 
72.11 	attendance;
72.12 	(3) crisis assistance planning to a child and family must include development of a written 
72.13 	plan that anticipates the particular factors specific to the child that may precipitate a 
72.14 	psychiatric crisis for the child in the near future. The written plan must document actions 
72.15 	that the family should be prepared to take to resolve or stabilize a crisis, such as advance 
72.16 	arrangements for direct intervention and support services to the child and the child's family. 
72.17 	Crisis assistance planning must include preparing resources designed to address abrupt or 
72.18 	substantial changes in the functioning of the child or the child's family when sudden change 
72.19 	in behavior or a loss of usual coping mechanisms is observed, or the child begins to present 
72.20 	a danger to self or others;
72.21 	(4) mental health behavioral aide services must be medically necessary treatment services, 
72.22 	identified in the child's individual treatment plan and individual behavior plan, which are 
72.23 	performed minimally by a paraprofessional qualified according to subdivision 7, paragraph 
72.24 	(b), clause (3), and which are designed to improve the functioning of the child in the 
72.25 	progressive use of developmentally appropriate psychosocial skills. Activities involve 
72.26 	working directly with the child, child-peer groupings, or child-family groupings to practice, 
72.27 	repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously 
72.28 	taught by a mental health professional, clinical trainee, or mental health practitioner including:
72.29 	(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions 
72.30 	so that the child progressively recognizes and responds to the cues independently;
72.31 	(ii) performing as a practice partner or role-play partner;
72.32 	(iii) reinforcing the child's accomplishments;
72.33 	(iv) generalizing skill-building activities in the child's multiple natural settings;
73.1 	(v) assigning further practice activities; and
73.2 	(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 
73.3 	behavior that puts the child or other person at risk of injury.
73.4 	To be eligible for medical assistance payment, mental health behavioral aide services must 
73.5 	be delivered to a child who has been diagnosed with an emotional disturbance or a mental 
73.6 	illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must 
73.7 	implement treatment strategies in the individual treatment plan and the individual behavior 
73.8 	plan as developed by the mental health professional, clinical trainee, or mental health 
73.9 	practitioner providing direction for the mental health behavioral aide. The mental health 
73.10 	behavioral aide must document the delivery of services in written progress notes. Progress 
73.11 	notes must reflect implementation of the treatment strategies, as performed by the mental 
73.12 	health behavioral aide and the child's responses to the treatment strategies;
73.13 	(5) direction of a mental health behavioral aide must include the following:
73.14 	(i) ongoing face-to-face observation of the mental health behavioral aide delivering 
73.15 	services to a child by a mental health professional or mental health practitioner for at least 
73.16 	a total of one hour during every 40 hours of service provided to a child; and
73.17 	(ii) immediate accessibility of the mental health professional, clinical trainee, or mental 
73.18 	health practitioner to the mental health behavioral aide during service provision;
73.19 	(6) mental health service plan development must be performed in consultation with the 
73.20 	child's family and, when appropriate, with other key participants in the child's life by the 
73.21 	child's treating mental health professional or clinical trainee or by a mental health practitioner 
73.22 	and approved by the treating mental health professional. Treatment plan drafting consists 
73.23 	of development, review, and revision by face-to-face or electronic communication. The 
73.24 	provider must document events, including the time spent with the family and other key 
73.25 	participants in the child's life to review, revise, and sign the individual treatment plan; and
73.26 	(7) to be eligible for payment, a diagnostic assessment must be complete with regard to 
73.27 	all required components, including multiple assessment appointments required for an 
73.28 	extended diagnostic assessment and the written report. Dates of the multiple assessment 
73.29 	appointments must be noted in the client's clinical record.

73.30 	EFFECTIVE DATE. This section is effective August 1, 2017.

74.1 	Sec. 34. Minnesota Statutes 2016, section 256B.0946, subdivision 1, is amended to read:
74.2 		Subdivision 1.Required covered service components. (a) Effective May 23, 2013, 
74.3 	and subject to federal approval, medical assistance covers medically necessary intensive 
74.4 	treatment services described under paragraph (b) that are provided by a provider entity 
74.5 	eligible under subdivision 3 to a client eligible under subdivision 2 who is placed in a foster 
74.6 	home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or placed in a foster 
74.7 	home licensed under the regulations established by a federally recognized Minnesota tribe.
74.8 	(b) Intensive treatment services to children with mental illness residing in foster family 
74.9 	settings that comprise specific required service components provided in clauses (1) to (5) 
74.10 	are reimbursed by medical assistance when they meet the following standards:
74.11 	(1) psychotherapy provided by a mental health professional as defined in Minnesota 
74.12 	Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota 
74.13 	Rules, part 9505.0371, subpart 5, item C;
74.14 	(2) crisis assistance planning provided according to standards for children's therapeutic 
74.15 	services and supports in section 256B.0943;
74.16 	(3) individual, family, and group psychoeducation services, defined in subdivision 1a, 
74.17 	paragraph (q), provided by a mental health professional or a clinical trainee;
74.18 	(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental 
74.19 	health professional or a clinical trainee; and
74.20 	(5) service delivery payment requirements as provided under subdivision 4.

74.21 	EFFECTIVE DATE. This section is effective August 1, 2017.

74.22 	Sec. 35. Minnesota Statutes 2016, section 256B.0946, subdivision 1a, is amended to read:
74.23 		Subd. 1a.Definitions. For the purposes of this section, the following terms have the 
74.24 	meanings given them.
74.25 	(a) "Clinical care consultation" means communication from a treating clinician to other 
74.26 	providers working with the same client to inform, inquire, and instruct regarding the client's 
74.27 	symptoms, strategies for effective engagement, care and intervention needs, and treatment 
74.28 	expectations across service settings, including but not limited to the client's school, social 
74.29 	services, day care, probation, home, primary care, medication prescribers, disabilities 
74.30 	services, and other mental health providers and to direct and coordinate clinical service 
74.31 	components provided to the client and family.
75.1 	(b) "Clinical supervision" means the documented time a clinical supervisor and supervisee 
75.2 	spend together to discuss the supervisee's work, to review individual client cases, and for 
75.3 	the supervisee's professional development. It includes the documented oversight and 
75.4 	supervision responsibility for planning, implementation, and evaluation of services for a 
75.5 	client's mental health treatment.
75.6 	(c) "Clinical supervisor" means the mental health professional who is responsible for 
75.7 	clinical supervision.
75.8 	(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, subpart 
75.9 	5, item C;
75.10 	(e) "Crisis assistance planning" has the meaning given in section 245.4871, subdivision 
75.11 	9a, including the development of a plan that addresses prevention and intervention strategies 
75.12 	to be used in a potential crisis, but does not include actual crisis intervention.
75.13 	(f) "Culturally appropriate" means providing mental health services in a manner that 
75.14 	incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370, 
75.15 	subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural 
75.16 	strengths and resources to promote overall wellness.
75.17 	(g) "Culture" means the distinct ways of living and understanding the world that are 
75.18 	used by a group of people and are transmitted from one generation to another or adopted 
75.19 	by an individual.
75.20 	(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part 9505.0370, 
75.21 	subpart 11.
75.22 	(i) "Family" means a person who is identified by the client or the client's parent or 
75.23 	guardian as being important to the client's mental health treatment. Family may include, 
75.24 	but is not limited to, parents, foster parents, children, spouse, committed partners, former 
75.25 	spouses, persons related by blood or adoption, persons who are a part of the client's 
75.26 	permanency plan, or persons who are presently residing together as a family unit.
75.27 	(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
75.28 	(k) "Foster family setting" means the foster home in which the license holder resides.
75.29 	(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part 9505.0370, 
75.30 	subpart 15.
75.31 	(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part 
75.32 	9505.0370, subpart 17.
76.1 	(n) "Mental health professional" has the meaning given in Minnesota Rules, part 
76.2 	9505.0370, subpart 18.
76.3 	(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, subpart 
76.4 	20.
76.5 	(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
76.6 	(q) "Psychoeducation services" means information or demonstration provided to an 
76.7 	individual, family, or group to explain, educate, and support the individual, family, or group 
76.8 	in understanding a child's symptoms of mental illness, the impact on the child's development, 
76.9 	and needed components of treatment and skill development so that the individual, family, 
76.10 	or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders, 
76.11 	and achieve optimal mental health and long-term resilience.
76.12 	(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, subpart 
76.13 	27.
76.14 	(s) "Team consultation and treatment planning" means the coordination of treatment 
76.15 	plans and consultation among providers in a group concerning the treatment needs of the 
76.16 	child, including disseminating the child's treatment service schedule to all members of the 
76.17 	service team. Team members must include all mental health professionals working with the 
76.18 	child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and 
76.19 	at least two of the following: an individualized education program case manager; probation 
76.20 	agent; children's mental health case manager; child welfare worker, including adoption or 
76.21 	guardianship worker; primary care provider; foster parent; and any other member of the 
76.22 	child's service team.

76.23 	EFFECTIVE DATE. This section is effective August 1, 2017.

76.24 	Sec. 36. Minnesota Statutes 2016, section 256B.0946, subdivision 4, is amended to read:
76.25 		Subd. 4.Service delivery payment requirements. (a) To be eligible for payment under 
76.26 	this section, a provider must develop and practice written policies and procedures for 
76.27 	intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply 
76.28 	with the following requirements in paragraphs (b) to (n).
76.29 	(b) A qualified clinical supervisor, as defined in and performing in compliance with 
76.30 	Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and 
76.31 	provision of services described in this section.
77.1 	(c) Each client receiving treatment services must receive an extended diagnostic 
77.2 	assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 30 
77.3 	days of enrollment in this service unless the client has a previous extended diagnostic 
77.4 	assessment that the client, parent, and mental health professional agree still accurately 
77.5 	describes the client's current mental health functioning.
77.6 	(d) Each previous and current mental health, school, and physical health treatment 
77.7 	provider must be contacted to request documentation of treatment and assessments that the 
77.8 	eligible client has received. This information must be reviewed and incorporated into the 
77.9 	diagnostic assessment and team consultation and treatment planning review process.
77.10 	(e) Each client receiving treatment must be assessed for a trauma history, and the client's 
77.11 	treatment plan must document how the results of the assessment will be incorporated into 
77.12 	treatment.
77.13 	(f) Each client receiving treatment services must have an individual treatment plan that 
77.14 	is reviewed, evaluated, and signed every 90 days using the team consultation and treatment 
77.15 	planning process, as defined in subdivision 1a, paragraph (s).
77.16 	(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided in 
77.17 	accordance with the client's individual treatment plan.
77.18 	(h) Each client must have a crisis assistance plan within ten days of initiating services 
77.19 	and must have access to clinical phone support 24 hours per day, seven days per week, 
77.20 	during the course of treatment. The crisis plan must demonstrate coordination with the local 
77.21 	or regional mobile crisis intervention team provider entity as defined in section 245.991, 
77.22 	subdivision 4.
77.23 	(i) Services must be delivered and documented at least three days per week, equaling at 
77.24 	least six hours of treatment per week, unless reduced units of service are specified on the 
77.25 	treatment plan as part of transition or on a discharge plan to another service or level of care. 
77.26 	Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
77.27 	(j) Location of service delivery must be in the client's home, day care setting, school, or 
77.28 	other community-based setting that is specified on the client's individualized treatment plan.
77.29 	(k) Treatment must be developmentally and culturally appropriate for the client.
77.30 	(l) Services must be delivered in continual collaboration and consultation with the client's 
77.31 	medical providers and, in particular, with prescribers of psychotropic medications, including 
77.32 	those prescribed on an off-label basis. Members of the service team must be aware of the 
77.33 	medication regimen and potential side effects.
78.1 	(m) Parents, siblings, foster parents, and members of the child's permanency plan must 
78.2 	be involved in treatment and service delivery unless otherwise noted in the treatment plan.
78.3 	(n) Transition planning for the child must be conducted starting with the first treatment 
78.4 	plan and must be addressed throughout treatment to support the child's permanency plan 
78.5 	and postdischarge mental health service needs.

78.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

78.7 	Sec. 37. Minnesota Statutes 2016, section 256B.0946, subdivision 6, is amended to read:
78.8 		Subd. 6.Excluded services. (a) Services in clauses (1) to (7) are not covered under this 
78.9 	section and are not eligible for medical assistance payment as components of intensive 
78.10 	treatment in foster care services, but may be billed separately:
78.11 	(1) inpatient psychiatric hospital treatment;
78.12 	(2) mental health targeted case management;
78.13 	(3) partial hospitalization;
78.14 	(4) medication management;
78.15 	(5) children's mental health day treatment services;
78.16 	(6) crisis response services under section 256B.0944 256B.0624; and
78.17 	(7) transportation.
78.18 	(b) Children receiving intensive treatment in foster care services are not eligible for 
78.19 	medical assistance reimbursement for the following services while receiving intensive 
78.20 	treatment in foster care:
78.21 	(1) psychotherapy and skills training components of children's therapeutic services and 
78.22 	supports under section 256B.0625, subdivision 35b;
78.23 	(2) mental health behavioral aide services as defined in section 256B.0943, subdivision 
78.24 	1, paragraph (m);
78.25 	(3) home and community-based waiver services;
78.26 	(4) mental health residential treatment; and
78.27 	(5) room and board costs as defined in section 256I.03, subdivision 6.

78.28 	EFFECTIVE DATE. This section is effective August 1, 2017.

79.1 	Sec. 38. Minnesota Statutes 2016, section 256B.0947, subdivision 3a, is amended to read:
79.2 		Subd. 3a.Required service components. (a) Subject to federal approval, medical 
79.3 	assistance covers all medically necessary intensive nonresidential rehabilitative mental 
79.4 	health services and supports, as defined in this section, under a single daily rate per client. 
79.5 	Services and supports must be delivered by an eligible provider under subdivision 5 to an 
79.6 	eligible client under subdivision 3.
79.7 	(b) Intensive nonresidential rehabilitative mental health services, supports, and ancillary 
79.8 	activities covered by the single daily rate per client must include the following, as needed 
79.9 	by the individual client:
79.10 	(1) individual, family, and group psychotherapy;
79.11 	(2) individual, family, and group skills training, as defined in section 256B.0943, 
79.12 	subdivision 1, paragraph (t);
79.13 	(3) crisis assistance planning as defined in section 245.4871, subdivision 9a, which 
79.14 	includes recognition of factors precipitating a mental health crisis, identification of behaviors 
79.15 	related to the crisis, and the development of a plan to address prevention, intervention, and 
79.16 	follow-up strategies to be used in the lead-up to or onset of, and conclusion of, a mental 
79.17 	health crisis; crisis assistance planning does not mean crisis response services or crisis
79.18 	intervention services provided in section 256B.0944 245.991;
79.19 	(4) medication management provided by a physician or an advanced practice registered 
79.20 	nurse with certification in psychiatric and mental health care;
79.21 	(5) mental health case management as provided in section 256B.0625, subdivision 20;
79.22 	(6) medication education services as defined in this section;
79.23 	(7) care coordination by a client-specific lead worker assigned by and responsible to the 
79.24 	treatment team;
79.25 	(8) psychoeducation of and consultation and coordination with the client's biological, 
79.26 	adoptive, or foster family and, in the case of a youth living independently, the client's 
79.27 	immediate nonfamilial support network;
79.28 	(9) clinical consultation to a client's employer or school or to other service agencies or 
79.29 	to the courts to assist in managing the mental illness or co-occurring disorder and to develop 
79.30 	client support systems;
79.31 	(10) coordination with, or performance of, crisis intervention and stabilization services 
79.32 	as defined in section 256B.0944 245.991, subdivision 2;
80.1 	(11) assessment of a client's treatment progress and effectiveness of services using 
80.2 	standardized outcome measures published by the commissioner;
80.3 	(12) transition services as defined in this section;
80.4 	(13) integrated dual disorders treatment as defined in this section; and
80.5 	(14) housing access support.
80.6 	(c) The provider shall ensure and document the following by means of performing the 
80.7 	required function or by contracting with a qualified person or entity:
80.8 	(1) client access to crisis intervention services, as defined in section 256B.0944 245.991, 
80.9 	and available 24 hours per day and seven days per week;
80.10 	(2) completion of an extended diagnostic assessment, as defined in Minnesota Rules, 
80.11 	part 9505.0372, subpart 1, item C; and
80.12 	(3) determination of the client's needed level of care using an instrument approved and 
80.13 	periodically updated by the commissioner.

80.14 	EFFECTIVE DATE. This section is effective August 1, 2017.

80.15 	Sec. 39. Minnesota Statutes 2016, section 256B.0947, subdivision 7, is amended to read:
80.16 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
80.17 	section must be based on one daily encounter rate per provider inclusive of the following 
80.18 	services received by an eligible client in a given calendar day: all rehabilitative services, 
80.19 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
80.20 	services under this section, and crisis response services under section 256B.0944 256B.0624.
80.21 	(b) Payment must not be made to more than one entity for each client for services 
80.22 	provided under this section on a given day. If services under this section are provided by a 
80.23 	team that includes staff from more than one entity, the team shall determine how to distribute 
80.24 	the payment among the members.
80.25 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
80.26 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
80.27 	developing these rates, the commissioner shall consider:
80.28 	(1) the cost for similar services in the health care trade area;
80.29 	(2) actual costs incurred by entities providing the services;
80.30 	(3) the intensity and frequency of services to be provided to each client;
81.1 	(4) the degree to which clients will receive services other than services under this section; 
81.2 	and
81.3 	(5) the costs of other services that will be separately reimbursed.
81.4 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
81.5 	same service to other payers.

81.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

81.7 	Sec. 40. Minnesota Statutes 2016, section 256B.49, subdivision 25, is amended to read:
81.8 		Subd. 25.Reduce avoidable behavioral crisis emergency room admissions, 
81.9 	psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons 
81.10 	receiving home and community-based services authorized under this section who have two 
81.11 	or more admissions within a calendar year to an emergency room, psychiatric unit, or 
81.12 	institution must receive consultation from a mental health professional as defined in section 
81.13 	245.462, subdivision 18, or a behavioral professional as defined in the home and 
81.14 	community-based services state plan within 30 days of discharge. The mental health 
81.15 	professional or behavioral professional must:
81.16 	(1) conduct a functional assessment of the crisis incident as defined in section 245D.02, 
81.17 	subdivision 11, which led to the hospitalization with the goal of developing proactive 
81.18 	strategies as well as necessary reactive strategies to reduce the likelihood of future avoidable 
81.19 	hospitalizations due to a behavioral crisis;
81.20 	(2) use the results of the functional assessment to amend the coordinated service and 
81.21 	support plan in section 245D.02, subdivision 4b, to address the potential need for additional 
81.22 	staff training, increased staffing, access to crisis mobility services, mental health services, 
81.23 	use of technology, and crisis stabilization services in section 256B.0624, subdivision 7
81.24 	245.991; and
81.25 	(3) identify the need for additional consultation, testing, mental health crisis intervention 
81.26 	team services as defined in section 245D.02, subdivision 20, psychotropic medication use 
81.27 	and monitoring under section 245D.051, and the frequency and duration of ongoing 
81.28 	consultation.
81.29 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, the 
81.30 	Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

81.31 	EFFECTIVE DATE. This section is effective August 1, 2017.

82.1 	Sec. 41. Minnesota Statutes 2016, section 256B.84, is amended to read:
82.2 	256B.84 AMERICAN INDIAN CONTRACTING PROVISIONS.
82.3 	Notwithstanding other state laws or rules, Indian health services and agencies operated 
82.4 	by Indian tribes are not required to have a county contract or county certification to enroll 
82.5 	as providers of adult rehabilitative mental health services under section 256B.0623; and 
82.6 	adult mental health crisis response services under section 256B.0624 245.991. In order to 
82.7 	enroll as providers of these services, Indian health services and agencies operated by Indian 
82.8 	tribes must meet the vendor of medical care requirements in section 256B.02, subdivision 
82.9 	7.

82.10 	EFFECTIVE DATE. This section is effective August 1, 2017.

82.11 	Sec. 42. REVISOR'S INSTRUCTION.
 82.12 	The revisor shall make necessary cross-reference changes and remove statutory 
82.13 	cross-references in Minnesota Statutes and Minnesota Rules to conform with the 
82.14 	recodification and repealer in this article. The revisor may make technical and other necessary 
82.15 	changes to sentence structure to preserve the meaning of the text. The revisor may alter the 
82.16 	statutory coding in this article to incorporate statutory changes made by other laws during 
82.17 	the 2017 regular legislative session. If a provision repealed by this article is also amended 
82.18 	by other law during the 2017 regular legislative session, the revisor shall merge the 
82.19 	amendment into the recodification, notwithstanding Minnesota Statutes, section 645.30.

82.20 	EFFECTIVE DATE. This section is effective August 1, 2017.

82.21 	Sec. 43.  REPEALER.
 82.22 	Minnesota Statutes 2016, sections 245.469; 245.4879; 256B.0624, subdivisions 4a, 5, 
82.23 	6, 7, 8, 9, 10, and 11; 256B.0625, subdivision 35a; and 256B.0944, are repealed.

82.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

82.25 	ARTICLE 3
82.26 	OPERATIONS

82.27 	Section 1. Minnesota Statutes 2016, section 245.095, is amended to read:
82.28 	245.095 LIMITS ON RECEIVING PUBLIC FUNDS.
82.29 		Subdivision 1.Prohibition. (a) If a provider, vendor, or individual enrolled, licensed, 
82.30 	or receiving funds under a grant contract, or registered in any program administered by the 
83.1 	commissioner, including under the commissioner's powers and authorities in section 256.01,
83.2 	is excluded from any that program administered by the commissioner, including under the 
83.3 	commissioner's powers and authorities in section 256.01, the commissioner shall:
83.4 	(1) prohibit the excluded provider, vendor, or individual from enrolling or, becoming 
83.5 	licensed, receiving grant funds, or registering in any other program administered by the 
83.6 	commissioner.; and
83.7 	(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider, 
83.8 	vendor, or individual in any other program administered by the commissioner.
83.9 	(b) The duration of this prohibition, disenrollment, revocation, suspension, 
83.10 	disqualification, or debarment must last for the longest applicable sanction or disqualifying 
83.11 	period in effect for the provider, vendor, or individual permitted by state or federal law.
83.12 		Subd. 2.Definitions. (a) For purposes of this section, the following definitions have the 
83.13 	meanings given them.
83.14 	(b) "Excluded" means disenrolled, disqualified,subject tohas a license revocation or 
83.15 	suspensionthat has been revoked or suspended under chapter 245A, disqualified, or subject 
83.16 	to vendor debarmenthas been debarred or suspended under Minnesota Rules, part 1230.1150, 
83.17 	or excluded pursuant to section 256B.064, subdivision 3.
83.18 	(c) "Individual" means a natural person providing products or services as a provider or 
83.19 	vendor.
83.20 	(d) "Provider" means an owner, controlling individual, license holder, director, or 
83.21 	managerial official.

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

83.23 	Sec. 2. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
83.24 	read:
83.25 		Subd. 3b.Authorized agent. "Authorized agent" means the controlling individual 
83.26 	designated by the license holder to be responsible for communicating with the commissioner 
83.27 	of human services on all matters provided for in this chapter and on whom service of all 
83.28 	notices and orders must be made, pursuant to section 245A.04, subdivision 1.

83.29 	EFFECTIVE DATE. This section is effective August 1, 2017.

84.1 	Sec. 3. Minnesota Statutes 2016, section 245A.02, subdivision 5a, is amended to read:
84.2 		Subd. 5a.Controlling individual. (a) "Controlling individual" means a public body, 
84.3 	governmental agency, business entity, officer, owner, or managerial official whose 
84.4 	responsibilities include the direction of the management or policies of a program. For 
84.5 	purposes of this subdivision, owner means an individual who has direct or indirect ownership 
84.6 	interest in a corporation, partnership, or other business association issued a license under 
84.7 	this chapter. the owner of a program or service licensed under this chapter and the following 
84.8 	individuals, if applicable:
84.9 	(1) each officer of the organization, including the chief executive officer and chief 
84.10 	financial officer;
84.11 	(2) the individual designated as the authorized agent pursuant to section 245A.04, 
84.12 	subdivision 1;
84.13 	(3) the individual designated as the compliance officer pursuant to section 256B.04, 
84.14 	subdivision 21; and
84.15 	(4) each managerial official whose responsibilities include the direction of the 
84.16 	management or policies of a program.
84.17 	For purposes of this subdivision, managerial official means those individuals who have 
84.18 	the decision-making authority related to the operation of the program, and the responsibility 
84.19 	for the ongoing management of or direction of the policies, services, or employees of the 
84.20 	program. A site director who has no ownership interest in the program is not considered to 
84.21 	be a managerial official for purposes of this definition.
84.22 	(b) Controlling individual does not include:
84.23 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
84.24 	loan and thrift company, investment banking firm, or insurance company unless the entity 
84.25 	operates a program directly or through a subsidiary;
84.26 	(2) an individual who is a state or federal official, or state or federal employee, or a 
84.27 	member or employee of the governing body of a political subdivision of the state or federal 
84.28 	government that operates one or more programs, unless the individual is also an officer, 
84.29 	owner, or managerial official of the program, receives remuneration from the program, or 
84.30 	owns any of the beneficial interests not excluded in this subdivision;
84.31 	(3) an individual who owns less than five percent of the outstanding common shares of 
84.32 	a corporation:
85.1 	(i) whose securities are exempt under section 80A.45, clause (6); or
85.2 	(ii) whose transactions are exempt under section 80A.46, clause (2); or
85.3 	(4) an individual who is a member of an organization exempt from taxation under section 
85.4 	290.05, unless the individual is also an officer, owner, or managerial official of the program 
85.5 	or owns any of the beneficial interests not excluded in this subdivision. This clause does 
85.6 	not exclude from the definition of controlling individual an organization that is exempt from 
85.7 	taxation.
85.8 	(c) For purposes of this subdivision, "managerial official" means those individuals who 
85.9 	have the decision-making authority related to the operation of the program, and the 
85.10 	responsibility for the ongoing management of or direction of the policies, services, or 
85.11 	employees of the program. A site director who has no ownership interest in the program is 
85.12 	not considered to be a managerial official for purposes of this definition.

85.13 	EFFECTIVE DATE. This section is effective August 1, 2017.

85.14 	Sec. 4. Minnesota Statutes 2016, section 245A.02, subdivision 8, is amended to read:
85.15 		Subd. 8.License. "License" means a certificate issued by the commissioner under section 
85.16 	245A.04 authorizing the license holder to provide a specified program for a specified period 
85.17 	of time and in accordance with the terms of the license and the rules of the commissioner.

85.18 	EFFECTIVE DATE. This section is effective August 1, 2017.

85.19 	Sec. 5. Minnesota Statutes 2016, section 245A.02, subdivision 9, is amended to read:
85.20 		Subd. 9.License holder. "License holder" means an individual, corporation, partnership, 
85.21 	voluntary association, or other an individual, organization, or government entity that is 
85.22 	legally responsible for the operation of the program or service, and has been granted a 
85.23 	license by the commissioner under this chapter or chapter 245D and the rules of the 
85.24 	commissioner, and is a controlling individual.

85.25 	EFFECTIVE DATE. This section is effective August 1, 2017.

85.26 	Sec. 6. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
85.27 	read:
85.28 		Subd. 10b.Organization.  "Organization" means a domestic or foreign corporation, 
85.29 	nonprofit corporation, limited liability company, partnership, limited partnership, limited 
85.30 	liability partnership, association, voluntary association, and any other legal or commercial 
85.31 	entity. For purposes of this chapter, organization does not include a government entity.

86.1 	EFFECTIVE DATE. This section is effective August 1, 2017.

86.2 	Sec. 7. Minnesota Statutes 2016, section 245A.02, subdivision 12, is amended to read:
86.3 		Subd. 12.Private agency. "Private agency" means an individual, corporation, partnership, 
86.4 	voluntary association an individual or other organization, other than a county agency, or a 
86.5 	court with jurisdiction, that places persons who cannot remain in their own homes in 
86.6 	residential programs, foster care, or adoptive homes.

86.7 	EFFECTIVE DATE. This section is effective August 1, 2017.

86.8 	Sec. 8. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
86.9 	read:
86.10 		Subd. 12a.Provisional license.  "Provisional license" means a license of limited duration 
86.11 	not to exceed 15 months issued under section 245A.04, subdivision 7, paragraph (g), or 
86.12 	245A.045.

86.13 	EFFECTIVE DATE. This section is effective August 1, 2017.

86.14 	Sec. 9. Minnesota Statutes 2016, section 245A.03, subdivision 1, is amended to read:
86.15 		Subdivision 1.License required. Unless licensed by the commissioner under this chapter, 
86.16 	an individual, corporation, partnership, voluntary association, other organization, or 
86.17 	controlling individual government entity must not:
86.18 	(1) operate a residential or a nonresidential program;
86.19 	(2) receive a child or adult for care, supervision, or placement in foster care or adoption;
86.20 	(3) help plan the placement of a child or adult in foster care or adoption or engage in 
86.21 	placement activities as defined in section 259.21, subdivision 9, in this state, whether or not 
86.22 	the adoption occurs in this state; or
86.23 	(4) advertise a residential or nonresidential program.

86.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

86.25 	Sec. 10. Minnesota Statutes 2016, section 245A.04, subdivision 2, is amended to read:
86.26 		Subd. 2.Notification of affected municipality. The commissioner must not issue a 
86.27 	license under this chapter without giving 30 calendar days' written notice to the affected 
86.28 	municipality or other political subdivision unless the program is considered a permitted 
86.29 	single-family residential use under sections 245A.11 and 245A.14. The commissioner may 
87.1 	provide the notice through electronic communication. The notification must be given before 
87.2 	the first issuance of a license under this chapter and annually after that time if annual 
87.3 	notification is requested in writing by the affected municipality or other political subdivision. 
87.4 	State funds must not be made available to or be spent by an agency or department of state, 
87.5 	county, or municipal government for payment to a residential or nonresidential program 
87.6 	licensed under this chapter until the provisions of this subdivision have been complied with 
87.7 	in full. The provisions of this subdivision shall not apply to programs located in hospitals.

87.8 	EFFECTIVE DATE. This section is effective August 1, 2017.

87.9 	Sec. 11. Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:
87.10 		Subd. 4.Inspections; waiver. (a) Before issuing an initial a license under this chapter, 
87.11 	the commissioner shall conduct an inspection of the program. The inspection must include 
87.12 	but is not limited to:
87.13 	(1) an inspection of the physical plant;
87.14 	(2) an inspection of records and documents;
87.15 	(3) an evaluation of the program by consumers of the program; and
87.16 	(4) observation of the program in operation.
87.17 	For the purposes of this subdivision, "consumer" means a person who receives the 
87.18 	services of a licensed program licensed under this chapter, the person's legal guardian, or 
87.19 	the parent or individual having legal custody of a child who receives the services of a licensed
87.20 	program licensed under this chapter.
87.21 	(b) The evaluation required in paragraph (a), clause (3) or the observation in paragraph 
87.22 	(a), clause (4) is not required prior to issuing an initial a license under subdivision 7. If the 
87.23 	commissioner issues an initial a license under subdivision 7 this chapter, these requirements 
87.24 	must be completed within one year after the issuance of an initial the license.

87.25 	EFFECTIVE DATE. This section is effective August 1, 2017.

87.26 	Sec. 12. Minnesota Statutes 2016, section 245A.04, subdivision 6, is amended to read:
87.27 		Subd. 6.Commissioner's evaluation. (a) Before issuing, denying, suspending, revoking, 
87.28 	or making conditional a license, the commissioner shall evaluate information gathered under 
87.29 	this section. The commissioner's evaluation shall consider the requirements of statutes and 
87.30 	rules applicable to the program or services for which the applicant is seeking to be licensed, 
88.1 	including the disqualification standards set forth in chapter 245C, and shall evaluate facts, 
88.2 	conditions, or circumstances concerning:
88.3 	(1) the program's operation,;
88.4 	(2) the well-being of persons served by the program,;
88.5 	(3) available consumer evaluations of the program, and;
88.6 	(4) information about the qualifications of the personnel employed by the applicant or 
88.7 	license holder.; and
88.8 	(5) the applicant's ability to demonstrate competent knowledge of the applicable laws 
88.9 	and rules including but not limited to this chapter and chapters 119B and 245C.
88.10 	(b) The commissioner shall also evaluate the results of the study required in subdivision 
88.11 	3 and determine whether a risk of harm to the persons served by the program exists. In 
88.12 	conducting this evaluation, the commissioner shall apply the disqualification standards set 
88.13 	forth in chapter 245C.

88.14 	EFFECTIVE DATE. This section is effective August 1, 2017.

88.15 	Sec. 13. Minnesota Statutes 2016, section 245A.04, subdivision 7, is amended to read:
88.16 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
88.17 	the program complies with all applicable rules and laws, the commissioner shall issue a 
88.18 	license consistent with this section or, if applicable, a temporary change of ownership license 
88.19 	under section 245A.043, or a provisional license under section 245A.045. At minimum, the 
88.20 	license shall state:
88.21 	(1) the name of the license holder;
88.22 	(2) the address of the program;
88.23 	(3) the effective date and expiration date of the license;
88.24 	(4) the type of license;
88.25 	(5) the maximum number and ages of persons that may receive services from the program; 
88.26 	and
88.27 	(6) any special conditions of licensure.
88.28 	(b) The commissioner may issue an initial a license for a period not to exceed two years 
88.29 	if:
89.1 	(1) the commissioner is unable to conduct the evaluation or observation required by 
89.2 	subdivision 4, paragraph (a), clauses (3) and (4), because the program is not yet operational;
89.3 	(2) certain records and documents are not available because persons are not yet receiving 
89.4 	services from the program; and
89.5 	(3) the applicant complies with applicable laws and rules in all other respects.
89.6 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
89.7 	or persons will be placed or cared for in the licensed program. A license shall not be 
89.8 	transferable to another individual, corporation, partnership, voluntary association, other 
89.9 	organization, or controlling individual or to another location.
89.10 	(d) A license holder must notify the commissioner and obtain the commissioner's approval 
89.11 	before making any changes that would alter the license information listed under paragraph 
89.12 	(a).
89.13 	(e) (d) Except as provided in paragraphs (g) (f) and (h) (g), the commissioner shall not 
89.14 	issue or reissue a license if the applicant, license holder, or controlling individual has:
89.15 	(1) been disqualified and the disqualification was not set aside and no variance has been 
89.16 	granted;
89.17 	(2) been denied a license under this chapter, including a license following the expiration 
89.18 	of a provisional license under section 245A.045, within the past two years;
89.19 	(3) had a license issued under this chapter revoked within the past five years;
89.20 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
89.21 	for which payment is delinquent; or
89.22 	(5) failed to submit the information required of an applicant under subdivision 1, 
89.23 	paragraph (f) or (g), after being requested by the commissioner.
89.24 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
89.25 	holder and controlling individual may not hold any license under chapter 245A or 245D for 
89.26 	five years following the revocation, and other licenses held by the applicant, license holder, 
89.27 	or controlling individual shall also be revoked.
89.28 	(f) (e) The commissioner shall not issue or reissue a license under this chapter if an 
89.29 	individual living in the household where the licensed services will be provided as specified 
89.30 	under section 245C.03, subdivision 1, has been disqualified and the disqualification has not 
89.31 	been set aside and no variance has been granted.
90.1 	(g) (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), and section 245A.045, 
90.2 	subdivision 2, when a license issued under this chapter has been suspended or revoked and 
90.3 	the suspension or revocation is under appeal, the program may continue to operate pending 
90.4 	a final order from the commissioner. If the license under suspension or revocation will 
90.5 	expire before a final order is issued, a temporary provisional license may be issued provided 
90.6 	any applicable license fee is paid before the temporary provisional license is issued.
90.7 	(h) (g) Notwithstanding paragraph (g) (f), when a revocation is based on the 
90.8 	disqualification of a controlling individual or license holder, and the controlling individual 
90.9 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
90.10 	contact with persons receiving services or is ordered to be under continuous, direct 
90.11 	supervision when providing direct contact services, the program may continue to operate 
90.12 	only if the program complies with the order and submits documentation demonstrating 
90.13 	compliance with the order. If the disqualified individual fails to submit a timely request for 
90.14 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
90.15 	order to immediately remove the individual from direct contact or to be under continuous, 
90.16 	direct supervision remains in effect pending the outcome of a hearing and final order from 
90.17 	the commissioner.
90.18 	(i) (h) For purposes of reimbursement for meals only, under the Child and Adult Care 
90.19 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
90.20 	part 226, relocation within the same county by a licensed family day care provider, shall 
90.21 	be considered an extension of the license for a period of no more than 30 calendar days or 
90.22 	until the new license is issued, whichever occurs first, provided the county agency has 
90.23 	determined the family day care provider meets licensure requirements at the new location.
90.24 	(j) (i) Unless otherwise specified by statute, all licenses issued under this chapter expire 
90.25 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
90.26 	apply for and be granted a new license to operate the program or the program must not be 
90.27 	operated after the expiration date.
90.28 	(k) (j) The commissioner shall not issue or reissue a license under this chapter if it has 
90.29 	been determined that a tribal licensing authority has established jurisdiction to license the 
90.30 	program or service.

90.31 	EFFECTIVE DATE. This section is effective August 1, 2017.

91.1 	Sec. 14. Minnesota Statutes 2016, section 245A.04, is amended by adding a subdivision 
91.2 	to read:
91.3 		Subd. 7a.Notification required. (a) A license holder must notify the commissioner and 
91.4 	obtain the commissioner's approval before making any change that would alter the license 
91.5 	information listed under subdivision 7, paragraph (a).
91.6 	(b) At least 30 days before the effective date of a change, the license holder must notify 
91.7 	the commissioner in writing of any:
91.8 	(1) change to the license holder's authorized agent as defined in section 245A.02, 
91.9 	subdivision 3b;
91.10 	(2) change to the license holder's controlling individual as defined in section 245A.02, 
91.11 	subdivision 5a;
91.12 	(3) change to license holder information on file with the secretary of state;
91.13 	(4) change to a program's business structure;
91.14 	(5) change in the location of the program or service licensed under this chapter; and
91.15 	(6) change in the federal or state tax identification number associated with the license 
91.16 	holder.
91.17 	(c) When a license holder notifies the commissioner of a change to the business structure 
91.18 	governing the licensed program or services but is not selling the business, the license holder 
91.19 	must provide amended articles of incorporation and other documentation of the change and 
91.20 	any other information requested by the commissioner.

91.21 	EFFECTIVE DATE. This section is effective August 1, 2017.

91.22 	Sec. 15. Minnesota Statutes 2016, section 245A.04, subdivision 10, is amended to read:
91.23 		Subd. 10.Adoption agency; additional requirements. In addition to the other 
91.24 	requirements of this section, an individual, corporation, partnership, voluntary association, 
91.25 	other or organization, or controlling individual applying for a license to place children for 
91.26 	adoption must:
91.27 	(1) incorporate as a nonprofit corporation under chapter 317A;
91.28 	(2) file with the application for licensure a copy of the disclosure form required under 
91.29 	section 259.37, subdivision 2;
91.30 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
91.31 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
92.1 	to and storage of records by the agency which has agreed, according to rule established by 
92.2 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
92.3 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
92.4 	bond must be made in favor of the agency which has agreed to receive the records; and
92.5 	(4) submit a certified audit to the commissioner each year the license is renewed as 
92.6 	required under section 245A.03, subdivision 1.

92.7 	EFFECTIVE DATE. This section is effective August 1, 2017.

92.8 	Sec. 16. [245A.043] LICENSE APPLICATION AFTER A CHANGE OF 
92.9 	OWNERSHIP.
92.10 		Subdivision 1.Transfer prohibited. A license issued under this chapter is only valid 
92.11 	for a premises and individual, organization, or government entity identified by the 
92.12 	commissioner on the license. A license is not transferable or assignable.
92.13 		Subd. 2.Change of ownership. If the commissioner determines that there will be a 
92.14 	change in ownership, the commissioner shall require submission of a new license application. 
92.15 	A change in ownership occurs when:
92.16 	(1) the license holder sells or transfers 100 percent of the property, stock, or assets;
92.17 	(2) the license holder merges with another organization;
92.18 	(3) the license holder consolidates with two or more organizations, resulting in the 
92.19 	creation of a new organization;
92.20 	(4) there is a change in the federal tax identification number associated with the license 
92.21 	holder; or
92.22 	(5) there is a turnover of each controlling individual associated with the license within 
92.23 	a 12-month period. A change to the license holder's controlling individuals, including a 
92.24 	change due to a transfer of stock, is not a change in ownership if at least one controlling 
92.25 	individual who was listed on the license for at least 12 consecutive months continues to be 
92.26 	a controlling individual after the reported change.
92.27 		Subd. 3.Change of ownership requirements. (a) A license holder who intends to 
92.28 	change the ownership of the program or service as defined in subdivision 2 to a party that 
92.29 	intends to assume operation without an interruption in service longer than 60 days after 
92.30 	acquiring the program or service must provide the commissioner with written notice of the 
92.31 	proposed sale or change on a form provided by the commissioner, at least 60 days before 
93.1 	the anticipated date of the change in program owner. For purposes of this subdivision and 
93.2 	subdivision 4, "party" means the party that intends to operate the service or program.
93.3 	(b) The party must submit a license application under this chapter on the form and in 
93.4 	the manner prescribed by the commissioner at least 30 days before the change of program 
93.5 	ownership is complete, and must include documentation to support the upcoming change. 
93.6 	The party must comply with background study requirements under chapter 245C and shall 
93.7 	pay the application fee required in section 245A.10. A party that intends to assume operation 
93.8 	without an interruption in service longer than 60 days after acquiring the program or service 
93.9 	is exempt from the requirements of Minnesota Rules, part 9530.6800.
93.10 	(c) The commissioner may develop streamlined application procedures for when the 
93.11 	party is an existing license holder under this chapter and is acquiring a program licensed 
93.12 	under this chapter or service in the same service class as one or more licensed programs or 
93.13 	services it operates and those licenses are in substantial compliance according to the licensing 
93.14 	standards in this chapter and applicable rules. For purposes of this subdivision, "substantial 
93.15 	compliance" means the commissioner did not issue, within the past 12 months, a sanction 
93.16 	under section 245A.045 or 245A.07 against a license held by the party or made a license 
93.17 	held by the party conditional according to section 245A.06 within the past 12 months.
93.18 	(d) Except when a temporary change of ownership license is issued pursuant to 
93.19 	subdivision 5, the existing license holder is solely responsible for operating the program 
93.20 	according to applicable rules and statutes until a license under this chapter is issued to the 
93.21 	party.
93.22 	(e) If a licensing inspection of the program or service was conducted within the previous 
93.23 	12 months and the existing license holder's license record demonstrates substantial 
93.24 	compliance with the applicable licensing requirements, the commissioner may waive the 
93.25 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
93.26 	commissioner proof that the premises was inspected by a fire marshal or that the fire marshal 
93.27 	deemed that an inspection was not warranted and proof that the premises was inspected for 
93.28 	compliance with the building code or that no inspection was deemed warranted.
93.29 	(f) If the party is seeking a license for a program or service that has an outstanding 
93.30 	correction order, the party must submit a letter with the license application identifying how 
93.31 	and within what length of time the party will resolve the outstanding correction order and 
93.32 	come into full compliance with the licensing requirements.
93.33 	(g) Any action taken under section 245A.06 or 245A.07 against the existing license 
93.34 	holder's license at the time the party is applying for a license, including when the existing 
94.1 	license holder is operating under a conditional license or is subject to a revocation, shall 
94.2 	remain in effect until the commissioner determines that the grounds for the action are 
94.3 	corrected or no longer exist.
94.4 	(h) The commissioner shall evaluate the application of the party according to section 
94.5 	245A.04, subdivision 6. Pursuant to section 245A.04, subdivision 7, if the commissioner 
94.6 	determines that the party complies with applicable laws and rules, the commissioner may 
94.7 	issue a license or a temporary change of ownership license.
94.8 	(i) The commissioner may deny an application as provided in section 245A.05. An 
94.9 	applicant whose application was denied by the commissioner may appeal the denial according 
94.10 	to section 245A.05.
94.11 	(j) This subdivision does not apply to a licensed program or service located in a home 
94.12 	where the license holder resides.
94.13 		Subd. 4.Temporary change of ownership license. (a) After receiving the party's 
94.14 	application and upon the written request of the existing license holder and the party, the 
94.15 	commissioner may issue a temporary change of ownership license to the party while the 
94.16 	commissioner evaluates the party's application. Until a decision is made to grant or deny a 
94.17 	license under this chapter, the existing license holder and the party shall both be responsible 
94.18 	for operating the program or service according to applicable laws and rules, and the sale or 
94.19 	transfer of the license holder's ownership interest in the licensed program or service does 
94.20 	not terminate the existing license.
94.21 	(b) The commissioner may establish criteria to issue a temporary change of ownership 
94.22 	license when a license holder's death, divorce, or other event affecting the ownership of the 
94.23 	program when an applicant seeks to assume operation of the program or service to ensure 
94.24 	continuity of the program or service while a license application is evaluated. This subdivision 
94.25 	applies to any program or service licensed under this chapter.

94.26 	EFFECTIVE DATE. This section is effective August 1, 2017.

94.27 	Sec. 17. [245A.045] PROVISIONAL LICENSE.
94.28 		Subdivision 1.When a provisional license shall be required. (a) Before issuing a 
94.29 	license under section 245A.04, subdivision 7, the commissioner shall issue a provisional 
94.30 	license for a period of up to 15 months if the applicant or license holder:
94.31 	(1) is licensed but does not hold a license in the same service class for which a license 
94.32 	application was submitted;
95.1 	(2) was licensed in the same service class for less than 12 months at the time the 
95.2 	application was submitted;
95.3 	(3) was in substantial, but not complete, compliance with applicable requirements for 
95.4 	licensure under section 245A.04 but demonstrates the potential to comply with all applicable 
95.5 	laws and rules by the end of the provisional license term, if the commissioner determines 
95.6 	that the deficiencies identified do not adversely affect the health, welfare, or safety of a 
95.7 	client; or
95.8 	(4) is identified as the buyer of a program that (i) was licensed under this chapter for 
95.9 	less than 12 months, (ii) has an outstanding correction order violation, (iii) is operating 
95.10 	under a conditional license, (iv) was issued a revocation order, or (v) is buying a program 
95.11 	that is currently operating under a provisional license.
95.12 	(b) The commissioner may place terms and conditions on the provisional license as the 
95.13 	commissioner determines necessary until the applicant achieves full compliance with 
95.14 	applicable statutes and rules before the expiration of the provisional license. The decision 
95.15 	to issue a provisional license under this section instead of a license under section 245A.04, 
95.16 	subdivision 7, is not appealable.
95.17 	(c) Before the expiration of the provisional license, the commissioner shall conduct at 
95.18 	least one unannounced inspection of the program. At least 60 days before the expiration of 
95.19 	the provisional license, the license holder of a provisional license must apply for a license 
95.20 	under section 245A.04, subdivision 7, in a manner prescribed by the commissioner. The 
95.21 	commissioner may grant or deny the application to convert a provisional license according 
95.22 	to section 245A.05. An applicant whose application is denied by the commissioner may 
95.23 	appeal the denial according to section 245A.05.
95.24 		Subd. 2.Sanctions for provisional license. (a) The commissioner may issue the 
95.25 	following sanctions against a program or service of a license holder who does not comply 
95.26 	with an applicable law or rule:
95.27 	(1) a fine or temporary immediate suspension under section 245A.07; or
95.28 	(2) a revocation under this subdivision.
95.29 	(b) The commissioner may revoke a provisional license if the commissioner identifies 
95.30 	any of the following:
95.31 	(1) a license holder failed to fully comply with applicable laws or rules including chapters 
95.32 	119B, 245A, and 245C;
96.1 	(2) a license holder, a controlling individual, or an individual living in the household 
96.2 	where the licensed services are provided or is otherwise subject to a background study has 
96.3 	a disqualification that was not set aside under section 245C.22;
96.4 	(3) a license holder knowingly withheld relevant information from or gave false or 
96.5 	misleading information to the commissioner in connection with an application for a license 
96.6 	or the background study status of an individual, during an investigation, or regarding 
96.7 	compliance with applicable laws or rules;
96.8 	(4) a license holder or controlling individual is prohibited from becoming licensed 
96.9 	pursuant to section 245.095;
96.10 	(5) a license holder adds or removes a controlling individual identified in the license 
96.11 	application within the first 12 months of operation; or
96.12 	(6) a license holder fails to demonstrate competency in licensing statutes and rules.
96.13 	(c) When revoking a provisional license under this section, the commissioner shall 
96.14 	consider facts, conditions, or circumstances concerning the program's operation, the 
96.15 	well-being of persons served by the program, available consumer evaluations of the program, 
96.16 	information about the qualifications of the personnel employed by the license holder, and 
96.17 	the program's overall development of competency in demonstrating compliance with 
96.18 	applicable statutes and rules.
96.19 	(d) The commissioner must notify by certified mail or personal service a license holder 
96.20 	when the license holder's provisional license is revoked. If mailed, the notice must be mailed 
96.21 	to the address shown on the application or the last known address of the license holder. The 
96.22 	notice must state the reason for revocation.
96.23 	(e) If a provisional license is revoked, the notice must inform the license holder of the 
96.24 	right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 
96.25 	to 1400.8612. The license holder may appeal a revocation order. The appeal of a revocation 
96.26 	order must be made in writing by certified mail or personal service. If mailed, the appeal 
96.27 	must be postmarked and sent to the commissioner within ten calendar days after the license 
96.28 	holder receives notice. If a request is made by personal service, it must be received by the 
96.29 	commissioner within ten calendar days after the license holder received notice. Except as 
96.30 	provided in subdivision 2, paragraph (c), if a license holder submits a timely appeal of a 
96.31 	revocation order, the license holder may continue to operate the program as provided in 
96.32 	section 245A.04, subdivision 7, paragraphs (f) and (g), until the commissioner issues a final 
96.33 	order on the revocation. The hearing must be conducted according to section 245A.08.
97.1 		Subd. 3.Exclusions. This section does not apply to the following programs or services: 
97.2 	family child care, child foster care, family adult day services, adult foster care, and 
97.3 	community residential settings.

97.4 	EFFECTIVE DATE. This section is effective August 1, 2017.

97.5 	Sec. 18. Minnesota Statutes 2016, section 245A.05, is amended to read:
97.6 	245A.05 DENIAL OF APPLICATION.
97.7 	(a) The commissioner may deny a license if an applicant or controlling individual:
97.8 	(1) fails to submit a substantially complete application after receiving notice from the 
97.9 	commissioner under section 245A.04, subdivision 1;
97.10 	(2) fails to comply with applicable laws or rules;
97.11 	(3) knowingly withholds relevant information from or gives false or misleading 
97.12 	information to the commissioner in connection with an application for a license or during 
97.13 	an investigation;
97.14 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
97.15 	variance has been granted;
97.16 	(5) has an individual living in the household who received a background study under 
97.17 	section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that 
97.18 	has not been set aside under section 245C.22, and no variance has been granted;
97.19 	(6) is associated with an individual who received a background study under section 
97.20 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
97.21 	children or vulnerable adults, and who has a disqualification that has not been set aside 
97.22 	under section 245C.22, and no variance has been granted; or
97.23 	(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g).;
97.24 	(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision 
97.25 	6;
97.26 	(9) has a history of noncompliance as a license holder or controlling individual with 
97.27 	applicable laws or rules including but not limited to this chapter and chapters 199B and 
97.28 	245C; or
97.29 	(10) is prohibited from holding a license according to section 245.095.
97.30 	(b) An applicant whose application has been denied by the commissioner must be given 
97.31 	notice of the denial. Notice must be given by certified mail or personal service. The notice 
98.1 	must state the reasons the application was denied and must inform the applicant of the right 
98.2 	to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 
98.3 	1400.8612. The applicant may appeal the denial by notifying the commissioner in writing 
98.4 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
98.5 	the commissioner within 20 calendar days after the applicant received the notice of denial. 
98.6 	If an appeal request is made by personal service, it must be received by the commissioner 
98.7 	within 20 calendar days after the applicant received the notice of denial. Section 245A.08
98.8 	applies to hearings held to appeal the commissioner's denial of an application.

98.9 	EFFECTIVE DATE. This section is effective August 1, 2017.

98.10 	Sec. 19. Minnesota Statutes 2016, section 256B.02, subdivision 7, is amended to read:
98.11 		Subd. 7.Vendor of medical care. (a) "Vendor of medical care" means any person or 
98.12 	persons furnishing, within the scope of the vendor's respective license, any or all of the 
98.13 	following goods or services: medical, surgical, hospital, ambulatory surgical center services, 
98.14 	optical, visual, dental and nursing services; drugs and medical supplies; appliances; 
98.15 	laboratory, diagnostic, and therapeutic services; nursing home and convalescent care; 
98.16 	screening and health assessment services provided by public health nurses as defined in 
98.17 	section 145A.02, subdivision 18; health care services provided at the residence of the patient 
98.18 	if the services are performed by a public health nurse and the nurse indicates in a statement 
98.19 	submitted under oath that the services were actually provided; and such other medical 
98.20 	services or supplies provided or prescribed by persons authorized by state law to give such 
98.21 	services and supplies, including services under section 256B.4912. For purposes of this 
98.22 	chapter, the term includes a person or entity that furnishes a good or service eligible for 
98.23 	medical assistance or federally approved waiver plan payments under this chapter. The term 
98.24 	includes, but is not limited to, directors and officers of corporations or members of 
98.25 	partnerships who, either individually or jointly with another or others, have the legal control, 
98.26 	supervision, or responsibility of submitting claims for reimbursement to the medical 
98.27 	assistance program. The term only includes directors and officers of corporations who 
98.28 	personally receive a portion of the distributed assets upon liquidation or dissolution, and 
98.29 	their liability is limited to the portion of the claim that bears the same proportion to the total 
98.30 	claim as their share of the distributed assets bears to the total distributed assets.
98.31 	(b) "Vendor of medical care" also includes any person who is credentialed as a health 
98.32 	professional under standards set by the governing body of a federally recognized Indian 
98.33 	tribe authorized under an agreement with the federal government according to United States 
98.34 	Code, title 25, section 450f, to provide health services to its members, and who through a 
99.1 	tribal facility provides covered services to American Indian people within a contract health 
99.2 	service delivery area of a Minnesota reservation, as defined under Code of Federal 
99.3 	Regulations, title 42, section 36.22.
99.4 	(c) A federally recognized Indian tribe that intends to implement standards for 
99.5 	credentialing health professionals must submit the standards to the commissioner of human 
99.6 	services, along with evidence of meeting, exceeding, or being exempt from corresponding 
99.7 	state standards. The commissioner shall maintain a copy of the standards and supporting 
99.8 	evidence, and shall use those standards to enroll tribal-approved health professionals as 
99.9 	medical assistance providers. For purposes of this section, "Indian" and "Indian tribe" mean 
99.10 	persons or entities that meet the definition in United States Code, title 25, section 450b.

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

99.12 	Sec. 20. Minnesota Statutes 2016, section 256B.04, subdivision 21, is amended to read:
99.13 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for Medicare 
99.14 	and Medicaid Services determines that a provider is designated "high-risk," the commissioner 
99.15 	may withhold payment from providers within that category upon initial enrollment for a 
99.16 	90-day period. The withholding for each provider must begin on the date of the first 
99.17 	submission of a claim.
99.18 	(b) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
99.19 	or is licensed as a home care provider by the Department of Health under chapter 144A and 
99.20 	has a home and community-based services designation on the home care license under 
99.21 	section 144A.484, must designate an individual as the entity's compliance officer. The 
99.22 	compliance officer must:
99.23 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
99.24 	regulations and to prevent inappropriate claims submissions;
99.25 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
99.26 	provider entity including billers, on the policies and procedures under clause (1);
99.27 	(3) respond to allegations of improper conduct related to the provision or billing of 
99.28 	medical assistance services, and implement action to remediate any resulting problems;
99.29 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
99.30 	regulations;
99.31 	(5) promptly report to the commissioner any identified violations of medical assistance 
99.32 	laws or regulations; and
100.1 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
100.2 	overpayment, report the overpayment to the commissioner and make arrangements with 
100.3 	the commissioner for the commissioner's recovery of the overpayment.
100.4 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
100.5 	provider within a particular industry sector or category establish a compliance program that 
100.6 	contains the core elements established by the Centers for Medicare and Medicaid Services.
100.7 	(c) The commissioner may revoke the enrollment of an ordering or rendering provider 
100.8 	for a period of not more than one year, if the provider fails to maintain and, upon request 
100.9 	from the commissioner, provide access to documentation relating to written orders or requests 
100.10 	for payment for durable medical equipment, certifications for home health services, or 
100.11 	referrals for other items or services written or ordered by such provider, when the 
100.12 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
100.13 	to maintain documentation or provide access to documentation on more than one occasion. 
100.14 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
100.15 	under the provisions of section 256B.064.
100.16 	(d) The commissioner shall terminate or deny the enrollment of any individual or entity 
100.17 	if the individual or entity has been terminated from participation in Medicare or under the 
100.18 	Medicaid program or Children's Health Insurance Program of any other state.
100.19 	(e) As a condition of enrollment in medical assistance, the commissioner shall require 
100.20 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
100.21 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
100.22 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
100.23 	designated contractors to conduct unannounced on-site inspections of any provider location. 
100.24 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
100.25 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
100.26 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
100.27 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
100.28 	The commissioner's designations are not subject to administrative appeal.
100.29 	(f) As a condition of enrollment in medical assistance, the commissioner shall require 
100.30 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
100.31 	provider of five percent or higher, consent to criminal background checks, including 
100.32 	fingerprinting, when required to do so under state law or by a determination by the 
100.33 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
100.34 	high-risk for fraud, waste, or abuse.
101.1 	(g)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
101.2 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
101.3 	meeting the durable medical equipment provider and supplier definition in clause (3), 
101.4 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
101.5 	annually renewed and designates the Minnesota Department of Human Services as the 
101.6 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
101.7 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
101.8 	federally qualified health center, a home health agency, the Indian Health Service, a 
101.9 	pharmacy, and a rural health clinic.
101.10 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
101.11 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
101.12 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
101.13 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
101.14 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
101.15 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
101.16 	fees in pursuing a claim on the bond. The surety bond must be in a form approved by the 
101.17 	commissioner, renewed annually, and allow for recovery of the entire value of the bond for 
101.18 	up to five years from the date of submission of a claim for medical assistance payment if 
101.19 	the enrolled provider violates this chapter or Minnesota Rules, chapter 9505, regardless of 
101.20 	the actual loss.
101.21 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
101.22 	purchase medical equipment or supplies for sale or rental to the general public and is able 
101.23 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
101.24 	sale or rental.
101.25 	(h) The Department of Human Services may require a provider to purchase a surety 
101.26 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
101.27 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
101.28 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
101.29 	provider or category of providers is designated high-risk pursuant to paragraph (a) and as 
101.30 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
101.31 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
101.32 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
101.33 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
101.34 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
101.35 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

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

102.2 	Sec. 21. Minnesota Statutes 2016, section 256B.0625, subdivision 43, is amended to read:
102.3 		Subd. 43.Mental health provider travel time. (a) Medical assistance covers provider 
102.4 	travel time if a recipient's individual treatment plan recipient requires the provision of mental 
102.5 	health services outside of the provider's normal usual place of business. This does not include 
102.6 	any travel time which is included in other billable services, and is only covered when the 
102.7 	mental health service being provided to a recipient is covered under medical assistance.
102.8 	(b) Mental health provider travel time under this subdivision covers the time the provider 
102.9 	is in transit to deliver a mental health service to a recipient at a location that is not the 
102.10 	provider's usual place of business or to the next location for delivery of a covered mental 
102.11 	health service, and the time a provider is in transit returning from the location of the last 
102.12 	recipient who received services on that day to the provider's usual place of business. A 
102.13 	provider must travel the most direct route available. Mental health provider travel time does 
102.14 	not include time for scheduled or unscheduled stops, meal breaks, or vehicle maintenance 
102.15 	or repair, including refueling or vehicle emergencies. Recipient transport is not covered 
102.16 	under this subdivision.
102.17 	(c) Mental health provider travel time under this subdivision is only covered when the 
102.18 	mental health service being provided is covered under medical assistance and only when 
102.19 	the covered service is delivered and billed. Mental health provider travel time is not covered 
102.20 	when the mental health service being provided otherwise includes provider travel time or 
102.21 	when the service is site based.
102.22 	(d) If the first occurrence of mental health provider travel time in a day begins at a 
102.23 	location other than the provider's usual place of business, the provider shall bill for the lesser 
102.24 	of the travel time between the location and the recipient and the travel time between the 
102.25 	provider's usual place of business and the recipient. This provision does not apply to mental 
102.26 	health crisis services provided under section 256B.0624 outside of normal business hours 
102.27 	if on-call staff are being dispatched directly from a location other than the provider's usual 
102.28 	place of business.
102.29 	(e) Mental health provider travel time may be billed for not more than one round trip 
102.30 	per recipient per day.
102.31 	(f) As a condition of payment, a provider must document each occurrence of mental 
102.32 	health provider travel time according to this subdivision. Program funds paid for mental 
102.33 	health provider travel time that is not documented according to this subdivision shall be 
103.1 	recovered by the department. The documentation may be collected and maintained 
103.2 	electronically or in paper form but must be made available and produced upon request. A 
103.3 	provider must compile records that meet the following requirements for each occurrence:
103.4 	(1) the record must be in English and must be legible according to the standard of a 
103.5 	reasonable person;
103.6 	(2) the recipient's name and date of birth or individual identification number must be on 
103.7 	each page of the record;
103.8 	(3) the reason the provider must travel to provide services, if not otherwise documented 
103.9 	in the recipient's individual treatment plan; and
103.10 	(4) each entry in the record must document:
103.11 	(i) the date on which the entry is made;
103.12 	(ii) the date the travel occurred;
103.13 	(iii) the printed last name, first name, and middle initial of the provider and the provider's 
103.14 	identification number, if the provider has one;
103.15 	(iv) the signature of the traveling provider stating that the provider understands that it 
103.16 	is a federal crime to provide false information on service billings for medical assistance 
103.17 	payments;
103.18 	(v) the location of the provider's usual place of business;
103.19 	(vi) the address, or the description if the address is not available, of both the origination 
103.20 	site and destination site and the travel time for the most direct route from the origination 
103.21 	site to the destination site;
103.22 	(vii) any unusual travel conditions that may cause a need to bill for additional time over 
103.23 	and above what an electronic source document shows the mileage and time necessary to 
103.24 	travel from the origination site to destination site;
103.25 	(viii) the time the provider left the origination site and the time the provider arrived at 
103.26 	the destination site, with a.m. and p.m. designations; and
103.27 	(ix) the electronic source documentation used to calculate the most direct route detailing 
103.28 	driving directions, mileage, and time.

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

104.1 	Sec. 22. Minnesota Statutes 2016, section 256B.064, subdivision 1b, is amended to read:
104.2 		Subd. 1b.Sanctions available. The commissioner may impose the following sanctions 
104.3 	for the conduct described in subdivision 1a: suspension or withholding of payments to a 
104.4 	vendor and suspending or terminating participation in the program, or imposition of a fine 
104.5 	under subdivision 2, paragraph (f). When imposing sanctions under this section, the 
104.6 	commissioner shall consider the nature, chronicity, or severity of the conduct and the effect 
104.7 	of the conduct on the health and safety of persons served by the vendor. The commissioner 
104.8 	shall suspend a vendor's participation in the program for a minimum of five years if the 
104.9 	vendor is convicted of a crime, received a stay of adjudication, or entered a court-ordered 
104.10 	diversion program for an offense related to provision of a health service under medical 
104.11 	assistance or health care fraud. Regardless of imposition of sanctions, the commissioner 
104.12 	may make a referral to the appropriate state licensing board.

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

104.14 	Sec. 23. Minnesota Statutes 2016, section 256B.0651, subdivision 17, is amended to read:
104.15 		Subd. 17.Recipient protection. (a) Providers of home care services must provide each 
104.16 	recipient with a copy of the home care bill of rights under section 144A.44 at least 30 days 
104.17 	prior to terminating services to a recipient, if the termination results from provider sanctions 
104.18 	under section 256B.064, such as a payment withhold, a suspension of participation, or a 
104.19 	termination of participation. If a home care provider determines it is unable to continue 
104.20 	providing services to a recipient, the provider must notify the recipient, the recipient's 
104.21 	responsible party, and the commissioner 30 days prior to terminating services to the recipient 
104.22 	because of an action under section 256B.064, and must assist the commissioner and lead 
104.23 	agency in supporting the recipient in transitioning to another home care provider of the 
104.24 	recipient's choice.
104.25 	(b) In the event of a payment withhold from a home care provider, a suspension of 
104.26 	participation, or a termination of participation of a home care provider under section 
104.27 	256B.064, the commissioner may inform the Office of Ombudsman for Long-Term Care 
104.28 	and the lead agencies for all recipients with active service agreements with the provider. At 
104.29 	the commissioner's request, the lead agencies must contact recipients to ensure that the 
104.30 	recipients are continuing to receive needed care, and that the recipients have been given 
104.31 	free choice of provider if they transfer to another home care provider. In addition, the 
104.32 	commissioner or the commissioner's delegate may directly notify recipients who receive 
104.33 	care from the provider that payments have been or will be withheld or that the provider's 
104.34 	participation in medical assistance has been or will be suspended or terminated, if the 
105.1 	commissioner determines that notification is necessary to protect the welfare of the recipients. 
105.2 	For purposes of this subdivision, "lead agencies" means counties, tribes, and managed care 
105.3 	organizations.

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

105.5 	Sec. 24. Minnesota Statutes 2016, section 256B.0659, subdivision 3, is amended to read:
105.6 		Subd. 3.Noncovered Personal care assistance services not covered. (a) Personal care 
105.7 	assistance services are not eligible for medical assistance payment under this section when 
105.8 	provided:
105.9 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal guardian, 
105.10 	licensed foster provider, except as allowed under section 256B.0652, subdivision 10, or 
105.11 	responsible party;
105.12 	(2) in order to meet staffing or license requirements in a residential or child care setting;
105.13 	(3) solely as a child care or babysitting service; or
105.14 	(4) without authorization by the commissioner or the commissioner's designee.; or
105.15 	(5) on dates not within the frequency requirements of subdivision 14, paragraph (c), and 
105.16 	subdivision 19, paragraph (a).
105.17 	(b) The following personal care services are not eligible for medical assistance payment 
105.18 	under this section when provided in residential settings:
105.19 	(1) when the provider of home care services who is not related by blood, marriage, or 
105.20 	adoption owns or otherwise controls the living arrangement, including licensed or unlicensed 
105.21 	services; or
105.22 	(2) when personal care assistance services are the responsibility of a residential or 
105.23 	program license holder under the terms of a service agreement and administrative rules.
105.24 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible for 
105.25 	medical assistance reimbursement for personal care assistance services under this section 
105.26 	include:
105.27 	(1) sterile procedures;
105.28 	(2) injections of fluids and medications into veins, muscles, or skin;
105.29 	(3) home maintenance or chore services;
106.1 	(4) homemaker services not an integral part of assessed personal care assistance services 
106.2 	needed by a recipient;
106.3 	(5) application of restraints or implementation of procedures under section 245.825;
106.4 	(6) instrumental activities of daily living for children under the age of 18, except when 
106.5 	immediate attention is needed for health or hygiene reasons integral to the personal care 
106.6 	services and the need is listed in the service plan by the assessor; and
106.7 	(7) assessments for personal care assistance services by personal care assistance provider 
106.8 	agencies or by independently enrolled registered nurses.

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

106.10 	Sec. 25. Minnesota Statutes 2016, section 256B.0659, subdivision 12, is amended to read:
106.11 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
106.12 	care assistance services for a recipient must be documented daily by each personal care 
106.13 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
106.14 	Web-based, electronic, or paper documentation. The completed form must be submitted on 
106.15 	a monthly basis to the provider and kept in the recipient's health record.
106.16 	(b) The activity documentation must correspond to the personal care assistance care plan 
106.17 	and be reviewed by the qualified professional.
106.18 	(c) The personal care assistant time sheet must be on a form approved by the 
106.19 	commissioner documenting time the personal care assistant provides services in the home. 
106.20 	The following criteria must be included in the time sheet:
106.21 	(1) full name of personal care assistant and individual provider number;
106.22 	(2) provider name and telephone numbers;
106.23 	(3) full name of recipient and either the recipient's medical assistance identification 
106.24 	number or date of birth;
106.25 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
106.26 	with a.m. or p.m. notations;
106.27 	(5) signatures of recipient or the responsible party;
106.28 	(6) personal signature of the personal care assistant;
106.29 	(7) any shared care provided, if applicable;
107.1 	(8) a statement that it is a federal crime to provide false information on personal care 
107.2 	service billings for medical assistance payments; and
107.3 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.

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

107.5 	Sec. 26. Minnesota Statutes 2016, section 256B.0659, subdivision 14, is amended to read:
107.6 		Subd. 14.Qualified professional; duties. (a) Effective January 1, 2010, all personal 
107.7 	care assistants must be supervised by a qualified professional.
107.8 	(b) Through direct training, observation, return demonstrations, and consultation with 
107.9 	the staff and the recipient, the qualified professional must ensure and document that the 
107.10 	personal care assistant is:
107.11 	(1) capable of providing the required personal care assistance services;
107.12 	(2) knowledgeable about the plan of personal care assistance services before services 
107.13 	are performed; and
107.14 	(3) able to identify conditions that should be immediately brought to the attention of the 
107.15 	qualified professional.
107.16 	(c) The qualified professional shall evaluate the personal care assistant within the first 
107.17 	14 days of starting to provide regularly scheduled services for a recipient, or sooner as 
107.18 	determined by the qualified professional, except for the personal care assistance choice 
107.19 	option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified 
107.20 	professional shall evaluate the personal care assistance services for a recipient through direct 
107.21 	observation of a personal care assistant's work. The qualified professional may conduct 
107.22 	additional training and evaluation visits, based upon the needs of the recipient and the 
107.23 	personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal 
107.24 	care assistance services provided to a recipient do not require direct observation of each 
107.25 	personal care assistant's work and shall occur:
107.26 	(1) at least every 90 days thereafter for the first year of a recipient's services;
107.27 	(2) every 120 days after the first year of a recipient's service or whenever needed for 
107.28 	response to a recipient's request for increased supervision of the personal care assistance 
107.29 	staff; and
107.30 	(3) after the first 180 days of a recipient's service, supervisory visits may alternate 
107.31 	between unscheduled phone or Internet technology and in-person visits, unless the in-person 
107.32 	visits are needed according to the care plan.
108.1 	(d) Communication with the recipient is a part of the evaluation process of the personal 
108.2 	care assistance staff.
108.3 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
108.4 	assistance services including the following information:
108.5 	(1) satisfaction level of the recipient with personal care assistance services;
108.6 	(2) review of the month-to-month plan for use of personal care assistance services;
108.7 	(3) review of documentation of personal care assistance services provided;
108.8 	(4) whether the personal care assistance services are meeting the goals of the service as 
108.9 	stated in the personal care assistance care plan and service plan;
108.10 	(5) a written record of the results of the evaluation and actions taken to correct any 
108.11 	deficiencies in the work of a personal care assistant; and
108.12 	(6) revision of the personal care assistance care plan as necessary in consultation with 
108.13 	the recipient or responsible party, to meet the needs of the recipient.
108.14 	(f) The qualified professional shall complete the required documentation in the agency 
108.15 	recipient and employee files and the recipient's home, including the following documentation:
108.16 	(1) the personal care assistance care plan based on the service plan and individualized 
108.17 	needs of the recipient;
108.18 	(2) a month-to-month plan for use of personal care assistance services;
108.19 	(3) changes in need of the recipient requiring a change to the level of service and the 
108.20 	personal care assistance care plan;
108.21 	(4) evaluation results of supervision visits and identified issues with personal care 
108.22 	assistance staff with actions taken;
108.23 	(5) all communication with the recipient and personal care assistance staff; and
108.24 	(6) hands-on training or individualized training for the care of the recipient.;
108.25 	(7) the month, day, and year, and arrival and departure times with a.m. or p.m. 
108.26 	designations of each visit or call to the recipient when services are provided; and
108.27 	(8) the total amount of time of each service visit with the recipient.
108.28 	(g) The documentation in paragraph (f) must be done on agency templates.
108.29 	(h) The services that are not eligible for payment as qualified professional services 
108.30 	include:
109.1 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
109.2 	nursing tasks;
109.3 	(2) the time spent documenting services;
109.4 	(2) (3) agency administrative activities;
109.5 	(3) (4) training other than the individualized training required to provide care for a 
109.6 	recipient; and
109.7 	(4) (5) any other activity that is not described in this section.

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

109.9 	Sec. 27. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
109.10 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
109.11 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
109.12 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
109.13 	a format determined by the commissioner, information and documentation that includes, 
109.14 	but is not limited to, the following:
109.15 	(1) the personal care assistance provider agency's current contact information including 
109.16 	address, telephone number, and e-mail address;
109.17 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
109.18 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
109.19 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
109.20 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
109.21 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
109.22 	allow for recovery of costs and fees in pursuing a claim on the bond the entire value of the 
109.23 	bond for up to five years from the date of submission of a claim for medical assistance 
109.24 	payment if the enrolled provider violates this chapter or Minnesota Rules, chapter 9505, 
109.25 	regardless of the actual loss;
109.26 	(3) proof of fidelity bond coverage in the amount of $20,000;
109.27 	(4) proof of workers' compensation insurance coverage;
109.28 	(5) proof of liability insurance;
109.29 	(6) a description of the personal care assistance provider agency's organization identifying 
109.30 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
109.31 	of the directors, owners, or staff to other service providers;
110.1 	(7) a copy of the personal care assistance provider agency's written policies and 
110.2 	procedures including: hiring of employees; training requirements; service delivery; and 
110.3 	employee and consumer safety including process for notification and resolution of consumer 
110.4 	grievances, identification and prevention of communicable diseases, and employee 
110.5 	misconduct;
110.6 	(8) copies of all other forms the personal care assistance provider agency uses in the 
110.7 	course of daily business including, but not limited to:
110.8 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
110.9 	varies from the standard time sheet for personal care assistance services approved by the 
110.10 	commissioner, and a letter requesting approval of the personal care assistance provider 
110.11 	agency's nonstandard time sheet;
110.12 	(ii) the personal care assistance provider agency's template for the personal care assistance 
110.13 	care plan; and
110.14 	(iii) the personal care assistance provider agency's template for the written agreement 
110.15 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
110.16 	(9) a list of all training and classes that the personal care assistance provider agency 
110.17 	requires of its staff providing personal care assistance services;
110.18 	(10) documentation that the personal care assistance provider agency and staff have 
110.19 	successfully completed all the training required by this section;
110.20 	(11) documentation of the agency's marketing practices;
110.21 	(12) disclosure of ownership, leasing, or management of all residential properties that 
110.22 	is used or could be used for providing home care services;
110.23 	(13) documentation that the agency will use the following percentages of revenue 
110.24 	generated from the medical assistance rate paid for personal care assistance services for 
110.25 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
110.26 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
110.27 	providers. The revenue generated by the qualified professional and the reasonable costs 
110.28 	associated with the qualified professional shall not be used in making this calculation; and
110.29 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
110.30 	free exercise of their right to choose service providers by requiring personal care assistants 
110.31 	to sign an agreement not to work with any particular personal care assistance recipient or 
110.32 	for another personal care assistance provider agency after leaving the agency and that the 
111.1 	agency is not taking action on any such agreements or requirements regardless of the date 
111.2 	signed.
111.3 	(b) Personal care assistance provider agencies shall provide the information specified 
111.4 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
111.5 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
111.6 	the information specified in paragraph (a) from all personal care assistance providers 
111.7 	beginning July 1, 2009.
111.8 	(c) All personal care assistance provider agencies shall require all employees in 
111.9 	management and supervisory positions and owners of the agency who are active in the 
111.10 	day-to-day management and operations of the agency to complete mandatory training as 
111.11 	determined by the commissioner before enrollment of the agency as a provider. Employees 
111.12 	in management and supervisory positions and owners who are active in the day-to-day 
111.13 	operations of an agency who have completed the required training as an employee with a 
111.14 	personal care assistance provider agency do not need to repeat the required training if they 
111.15 	are hired by another agency, if they have completed the training within the past three years. 
111.16 	By September 1, 2010, the required training must be available with meaningful access 
111.17 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
111.18 	or any guidance from the United States Health and Human Services Department. The 
111.19 	required training must be available online or by electronic remote connection. The required 
111.20 	training must provide for competency testing. Personal care assistance provider agency 
111.21 	billing staff shall complete training about personal care assistance program financial 
111.22 	management. This training is effective July 1, 2009. Any personal care assistance provider 
111.23 	agency enrolled before that date shall, if it has not already, complete the provider training 
111.24 	within 18 months of July 1, 2009. Any new owners or employees in management and 
111.25 	supervisory positions involved in the day-to-day operations are required to complete 
111.26 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
111.27 	agencies certified for participation in Medicare as home health agencies are exempt from 
111.28 	the training required in this subdivision. When available, Medicare-certified home health 
111.29 	agency owners, supervisors, or managers must successfully complete the competency test.

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

111.31 	Sec. 28. Minnesota Statutes 2016, section 256B.4912, is amended by adding a subdivision 
111.32 	to read:
111.33 		Subd. 11.Service documentation and billing requirements. (a) Only a service provided 
111.34 	as specified in a federally approved waiver plan, as authorized under sections 256B.0913, 
112.1 	256B.0915, 256B.092, and 256B.49, is eligible for payment. Services provided on days and 
112.2 	times other than the days and hours of operation specified on any license that is required 
112.3 	under chapter 245A or 245D are not reimbursable under the program. As a condition of 
112.4 	payment, a home and community-based waiver provider must document each time a service 
112.5 	was provided to a recipient. Services not documented according to this subdivision or not 
112.6 	specified in a federally approved waiver plan are not reimbursable under the program and 
112.7 	may be recovered by the department according to section 256B.064 and Minnesota Rules, 
112.8 	parts 9505.2160 to 9505.2245. For payment of a service, documentation must meet the 
112.9 	standards in paragraphs (b) to (j).
112.10 	(b) The service delivered to a recipient must be documented in the provider's record of 
112.11 	service delivery.
112.12 	(c) The recipient's name and recipient identification number must be entered on each 
112.13 	document.
112.14 	(d) The provider's record of service delivery must be in English and must be legible 
112.15 	according to the standard of a reasonable person.
112.16 	(e) The provider's record of service delivery must contain a statement that it is a federal 
112.17 	crime to provide false information on service billings for medical assistance or services 
112.18 	under a federally approved waiver plan, as authorized under sections 256B.0913, 256B.0915, 
112.19 	256B.092, and 256B.49.
112.20 	(f) If an entry is a time-based service, each entry in the provider's record of service 
112.21 	delivery must contain:
112.22 	(1) the date that the entry was made;
112.23 	(2) the day, month, and year when the service was provided;
112.24 	(3) the service name or description of the service provided;
112.25 	(4) the start and stop times with a.m. and p.m. designations, except for case management 
112.26 	services as defined under sections 256B.0913, subdivision 7, 256B.0915, subdivision 1a, 
112.27 	256B.092, subdivision 1a, and 256B.49, subdivision 13;
112.28 	(5) the name, signature, and title, if any, of the provider of service. If the service is 
112.29 	provided by multiple staff members, the provider may designate a staff member responsible 
112.30 	for verifying services and completing the documentation required by this paragraph.
112.31 	(g) For all other services each record must contain:
112.32 	(1) the date the entry of service delivery was made;
113.1 	(2) the day, month, and year when the service was provided;
113.2 	(3) a service name or description of the service provided;
113.3 	(4) the name, signature, and title, if any, of the person providing the service. If the service 
113.4 	is provided by multiple staff, the provider may designate a staff person responsible for 
113.5 	verifying services and completing the documentation required by this paragraph; and
113.6 	(5) for services provided under section 245D.03, subdivision 1, paragraph (c), clause 
113.7 	(3), entries into the record under this subdivision shall occur at least monthly.
113.8 	(h) If the service billed is transportation, each entry must contain the information from 
113.9 	paragraphs (b) to (e) and (g). A provider must:
113.10 	(1) maintain odometer and other records pursuant to section 256B.0625, subdivision 
113.11 	17b, clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver 
113.12 	for a transportation service that is billed by mileage, except if the provider is a common 
113.13 	carrier as defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or publicly operated 
113.14 	transit systems. This documentation may be collected and maintained electronically or in 
113.15 	paper form, but must be made available and produced upon request;
113.16 	(2) maintain documentation demonstrating that a vehicle and a driver meets the standards 
113.17 	determined by the Department of Human Services on vehicle and driver qualifications;
113.18 	(3) only bill a waivered transportation service if the transportation is not to or from a 
113.19 	health care service available through the Medicaid state plan; and
113.20 	(4) only bill a waivered transportation service when the rate for waiver service does not 
113.21 	include transportation.
113.22 	(i) If the service provided is equipment or supplies, the documentation must contain the 
113.23 	information from paragraphs (b) to (e) and:
113.24 	(1) the recipient's assessed need for the equipment or supplies and the reason the 
113.25 	equipment or supplies are not covered by the Medicaid state plan;
113.26 	(2) the type and brand name of equipment or supplies delivered to or purchased by the 
113.27 	recipient, including whether the equipment or supplies were rented or purchased;
113.28 	(3) the quantity of supplies delivered or purchased;
113.29 	(4) the shipping invoice or a delivery service tracking log or other documentation showing 
113.30 	the date of delivery that proves the equipment or supplies were delivered to the recipient 
113.31 	or a receipt if the equipment or supplies were purchased by the recipient; and
114.1 	(5) the cost of equipment or supplies if the amount paid for the service depends on the 
114.2 	cost.
114.3 	(j) A service defined as "adult day care" under section 245A.02, subdivision 2a, and 
114.4 	licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, must meet the documentation 
114.5 	standards specified in paragraphs (b) to (f) and must comply with the following:
114.6 	(1) individual recipient's service records must contain the following:
114.7 	(i) the recipient's needs assessment and current plan of care according to section 
114.8 	245A.143, subdivisions 4 to 7, or Minnesota Rules, part 9555.9700, if applicable; and
114.9 	(ii) attendance records as specified under section 245A.14, subdivision 14, paragraph 
114.10 	(c), the date of attendance must be documented on the attendance record with the day, month, 
114.11 	and year noted, and the pick-up and drop-off time must be noted on the attendance record 
114.12 	in hours and minutes, with a.m. and p.m. designations;
114.13 	(2) entity records must contain the following:
114.14 	(i) the monthly and quarterly program requirements in Minnesota Rules, part 9555.9710, 
114.15 	subparts 1, items E and H, and 3, 4, and 6, if applicable;
114.16 	(ii) the names and qualifications of the registered physical therapists, registered nurses, 
114.17 	and registered dietitian who provide services to the adult day care or nonresidential program; 
114.18 	and
114.19 	(iii) the location where the service was provided and, if the location is an alternate 
114.20 	location than the primary place of service, the record must contain the address, or the 
114.21 	description if the address is not available, of both the origin and destination location, the 
114.22 	length of time at the alternate location with a.m. and p.m. designations, and a list of 
114.23 	participants who went to the alternate location.

114.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

114.25 	Sec. 29. Minnesota Statutes 2016, section 256G.01, subdivision 4, is amended to read:
114.26 		Subd. 4.Additional coverage. The provisions in sections 256G.02, subdivision 4, 
114.27 	paragraphs (a) to (d); 256G.02, subdivisions 5 to 8; 256G.03; 256G.04; 256G.05; and 
114.28 	256G.07, subdivisions 1 to 3, apply to the following financial assistance programs: the aid 
114.29 	to families with dependent children program formerly codified in sections 256.72 to 256.87, 
114.30 	Minnesota family investment program; medical assistance; general assistance; the family 
114.31 	general assistance program formerly codified in sections 256D.01 to 256D.23; general 
115.1 	assistance medical care formerly codified in chapter 256D; and Minnesota supplemental 
115.2 	aid.

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

115.4 	Sec. 30. Minnesota Statutes 2016, section 256G.02, subdivision 4, is amended to read:
115.5 		Subd. 4.County of financial responsibility. (a) "County of financial responsibility" 
115.6 	has the meanings in paragraphs (b) to (f).
115.7 	(b) For an applicant who resides in the state and is not in a facility described in 
115.8 	subdivision 6, it means the county in which the applicant resides at the time of application.
115.9 	(c) For an applicant who resides in a facility described in subdivision 6, it means the 
115.10 	county in which the applicant last resided in nonexcluded status immediately before entering 
115.11 	the facility.
115.12 	(d) For an applicant who has not resided in this state for any time other than the excluded 
115.13 	time, and subject to the limitations in section 256G.03, subdivision 2, it means the county 
115.14 	in which the applicant resides at the time of making application.
115.15 	(e) For an individual already having a social service case open in one county, financial 
115.16 	responsibility for any additional social services attaches to the case that has the earliest date 
115.17 	of application and has been open without interruption. This provision does not apply to 
115.18 	financial assistance programs listed in section 256G.01, subdivision 4.
115.19 	(f) Notwithstanding paragraphs (b) to (e), the county of financial responsibility for 
115.20 	semi-independent living services provided under section 252.275, and chapter 245D, is the 
115.21 	county of residence in nonexcluded status immediately before the placement into or request 
115.22 	for those services.

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

115.24 	Sec. 31. Minnesota Statutes 2016, section 256G.09, subdivision 2, is amended to read:
115.25 		Subd. 2.Financial disputes. (a) If the county receiving the transmittal does not believe 
115.26 	it is financially responsible, it should provide shall submit to the department and provide 
115.27 	to the initially responsible county a request for department resolution of financial 
115.28 	responsibility dispute form, with a statement of all facts and documents necessary for the 
115.29 	department to make the requested determination of financial responsibility. The submission 
115.30 	must clearly state the program area in dispute, the application date or commitment date for 
115.31 	the program in dispute, and must state the specific basis upon which the submitting county 
116.1 	is denying financial responsibility. If the receiving county fails to submit the dispute 
116.2 	resolution form to the department, the initially responsible county may submit the form to 
116.3 	the department and provide a copy to the receiving county.
116.4 	(b) The initially responsible county responding to the dispute resolution request then 
116.5 	has 15 30 calendar days to submit its position and any supporting evidence to the department. 
116.6 	The absence of a submission by the initially responsible county or the responding county 
116.7 	does not limit the right of the department to issue a binding opinion based on the evidence 
116.8 	actually submitted.
116.9 	(c) The department shall not issue an advisory opinion. A county may not submit a case 
116.10 	must not be submitted to the department under the dispute resolution process until the local 
116.11 	agency taking the application or making the commitment has made an initial determination 
116.12 	about eligibility and financial responsibility, and services have been initiated. This paragraph 
116.13 	does not prohibit the submission of closed cases that otherwise meet the applicable statute 
116.14 	of limitations.

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

116.16 	Sec. 32. Minnesota Statutes 2016, section 256G.10, is amended to read:
116.17 	256G.10 DERIVATIVE SETTLEMENT.
116.18 	The residence of the parent of a minor child, with whom that child last lived in a 
116.19 	nonexcluded time setting, or guardian of a ward shall determine the residence of the child 
116.20 	or ward for all social services governed by this chapter. If the child lived with each parent 
116.21 	separately, then the residence of the parent with whom the child lived most recently shall 
116.22 	determine the residence of the child for all social services governed by this chapter.
116.23 	For purposes of this chapter, a minor child is defined as being under 18 years of age 
116.24 	unless otherwise specified in a program administered by the commissioner.
116.25 	Physical or legal custody has no bearing on residence determinations. This section does 
116.26 	not, however, apply to situations involving another state, limit the application of an interstate 
116.27 	compact, or apply to situations involving state wards where the commissioner is defined 
116.28 	by law as the guardian.

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

117.1 	ARTICLE 4
117.2 	HEALTH CARE

117.3 	Section 1. Minnesota Statutes 2016, section 256.01, subdivision 29, is amended to read:
117.4 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
117.5 	determinations of disability by the commissioner's state medical review team under sections 
117.6 	256B.055, subdivision subdivisions 7, paragraph (b), and 12;256B.057, subdivision 9, and 
117.7 	256B.055, subdivision 12, the commissioner shall review all medical evidence submitted 
117.8 	by county agencies with a referral and seek additional information from providers, applicants, 
117.9 	and enrollees to support the determination of disability where necessary. Disability shall 
117.10 	be determined according to the rules of title XVI and title XIX of the Social Security Act 
117.11 	and pertinent rules and policies of the Social Security Administration.
117.12 	(b) Prior to a denial or withdrawal of a requested determination of disability due to 
117.13 	insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary 
117.14 	and appropriate to a determination of disability, and (2) assist applicants and enrollees to 
117.15 	obtain the evidence, including, but not limited to, medical examinations and electronic 
117.16 	medical records.
117.17 	(c) The commissioner shall provide the chairs of the legislative committees with 
117.18 	jurisdiction over health and human services finance and budget the following information 
117.19 	on the activities of the state medical review team by February 1 of each year:
117.20 	(1) the number of applications to the state medical review team that were denied, 
117.21 	approved, or withdrawn;
117.22 	(2) the average length of time from receipt of the application to a decision;
117.23 	(3) the number of appeals, appeal results, and the length of time taken from the date the 
117.24 	person involved requested an appeal for a written decision to be made on each appeal;
117.25 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
117.26 	history within three months of application, and whether an application for Social Security 
117.27 	or Supplemental Security Income benefits is pending; and
117.28 	(5) specific information on the medical certification, licensure, or other credentials of 
117.29 	the person or persons performing the medical review determinations and length of time in 
117.30 	that position.
117.31 	(d) Any appeal made under section 256.045, subdivision 3, of a disability determination 
117.32 	made by the state medical review team must be decided according to the timelines under 
118.1 	section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within 
118.2 	the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be 
118.3 	immediately reviewed by the chief human services judge.

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

118.5 	Sec. 2. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
118.6 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
118.7 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
118.8 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
118.9 	a format determined by the commissioner, information and documentation that includes, 
118.10 	but is not limited to, the following:
118.11 	(1) the personal care assistance provider agency's current contact information including 
118.12 	address, telephone number, and e-mail address;
118.13 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
118.14 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
118.15 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
118.16 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
118.17 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
118.18 	allow for recovery of costs and fees in pursuing a claim on the bond;
118.19 	(3) proof of fidelity bond coverage in the amount of $20,000;
118.20 	(4) proof of workers' compensation insurance coverage;
118.21 	(5) proof of liability insurance;
118.22 	(6) a description of the personal care assistance provider agency's organization identifying 
118.23 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
118.24 	of the directors, owners, or staff to other service providers;
118.25 	(7) a copy of the personal care assistance provider agency's written policies and 
118.26 	procedures including: hiring of employees; training requirements; service delivery; and 
118.27 	employee and consumer safety including process for notification and resolution of consumer 
118.28 	grievances, identification and prevention of communicable diseases, and employee 
118.29 	misconduct;
118.30 	(8) copies of all other forms the personal care assistance provider agency uses in the 
118.31 	course of daily business including, but not limited to:
119.1 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
119.2 	varies from the standard time sheet for personal care assistance services approved by the 
119.3 	commissioner, and a letter requesting approval of the personal care assistance provider 
119.4 	agency's nonstandard time sheet;
119.5 	(ii) the personal care assistance provider agency's template for the personal care assistance 
119.6 	care plan; and
119.7 	(iii) the personal care assistance provider agency's template for the written agreement 
119.8 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
119.9 	(9) a list of all training and classes that the personal care assistance provider agency 
119.10 	requires of its staff providing personal care assistance services;
119.11 	(10) documentation that the personal care assistance provider agency and staff have 
119.12 	successfully completed all the training required by this section;
119.13 	(11) documentation of the agency's marketing practices;
119.14 	(12) disclosure of ownership, leasing, or management of all residential properties that 
119.15 	is used or could be used for providing home care services;
119.16 	(13) documentation that the agency will use the following percentages of revenue 
119.17 	generated from the medical assistance rate paid for personal care assistance services for 
119.18 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
119.19 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
119.20 	providers. The revenue generated by the qualified professional and the reasonable costs 
119.21 	associated with the qualified professional shall not be used in making this calculation; and
119.22 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
119.23 	free exercise of their right to choose service providers by requiring personal care assistants 
119.24 	to sign an agreement not to work with any particular personal care assistance recipient or 
119.25 	for another personal care assistance provider agency after leaving the agency and that the 
119.26 	agency is not taking action on any such agreements or requirements regardless of the date 
119.27 	signed.
119.28 	(b) Personal care assistance provider agencies shall provide the information specified 
119.29 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
119.30 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
119.31 	the information specified in paragraph (a) from all personal care assistance providers 
119.32 	beginning July 1, 2009.
120.1 	(c) All personal care assistance provider agencies shall require all employees in 
120.2 	management and supervisory positions and owners of the agency who are active in the 
120.3 	day-to-day management and operations of the agency to complete mandatory training as 
120.4 	determined by the commissioner before submitting an application for enrollment of the 
120.5 	agency as a provider. All personal care provider agencies shall also require qualified 
120.6 	professionals to complete the training required by subdivision 13 before submitting an 
120.7 	application for enrollment of the agency as a provider. Employees in management and 
120.8 	supervisory positions and owners who are active in the day-to-day operations of an agency 
120.9 	who have completed the required training as an employee with a personal care assistance 
120.10 	provider agency do not need to repeat the required training if they are hired by another 
120.11 	agency, if they have completed the training within the past three years. By September 1, 
120.12 	2010, the required training must be available with meaningful access according to title VI 
120.13 	of the Civil Rights Act and federal regulations adopted under that law or any guidance from 
120.14 	the United States Health and Human Services Department. The required training must be 
120.15 	available online or by electronic remote connection. The required training must provide for 
120.16 	competency testing. Personal care assistance provider agency billing staff shall complete 
120.17 	training about personal care assistance program financial management. This training is 
120.18 	effective July 1, 2009. Any personal care assistance provider agency enrolled before that 
120.19 	date shall, if it has not already, complete the provider training within 18 months of July 1, 
120.20 	2009. Any new owners or employees in management and supervisory positions involved 
120.21 	in the day-to-day operations are required to complete mandatory training as a requisite of 
120.22 	working for the agency. Personal care assistance provider agencies certified for participation 
120.23 	in Medicare as home health agencies are exempt from the training required in this 
120.24 	subdivision. When available, Medicare-certified home health agency owners, supervisors, 
120.25 	or managers must successfully complete the competency test.

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

120.27 	Sec. 3. Minnesota Statutes 2016, section 256B.0659, subdivision 23, is amended to read:
120.28 		Subd. 23.Enrollment requirements following termination. (a) A terminated personal 
120.29 	care assistance provider agency, including all named individuals on the current enrollment 
120.30 	disclosure form and known or discovered affiliates of the personal care assistance provider 
120.31 	agency, is not eligible to enroll as a personal care assistance provider agency for two years 
120.32 	following the termination.
121.1 	(b) After the two-year period in paragraph (a), if the provider seeks to reenroll as a 
121.2 	personal care assistance provider agency, the personal care assistance provider agency must 
121.3 	be placed on a one-year probation period, beginning after completion of the following:
121.4 	(1) the department's provider trainings under this section; and
121.5 	(2) initial enrollment requirements under subdivision 21.
121.6 	(c) During the probationary period the commissioner shall complete site visits and request 
121.7 	submission of documentation to review compliance with program policy.
121.8 	(d) This subdivision does not apply to a personal care assistance provider agency 
121.9 	terminated solely for failure to timely and completely comply with the requirements of 
121.10 	revalidation required by section 256B.04, subdivision 22.

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

121.12 	ARTICLE 5
121.13 	COMMUNITY SUPPORTS

121.14 	Section 1. Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:
121.15 		Subd. 2.Contents of contract.  A housing with services contract, which need not be 
121.16 	entitled as such to comply with this section, shall include at least the following elements in 
121.17 	itself or through supporting documents or attachments:
121.18 	(1) the name, street address, and mailing address of the establishment;
121.19 	(2) the name and mailing address of the owner or owners of the establishment and, if 
121.20 	the owner or owners is not a natural person, identification of the type of business entity of 
121.21 	the owner or owners;
121.22 	(3) the name and mailing address of the managing agent, through management agreement 
121.23 	or lease agreement, of the establishment, if different from the owner or owners;
121.24 	(4) the name and address of at least one natural person who is authorized to accept service 
121.25 	of process on behalf of the owner or owners and managing agent;
121.26 	(5) a statement describing the registration and licensure status of the establishment and 
121.27 	any provider providing health-related or supportive services under an arrangement with the 
121.28 	establishment;
121.29 	(6) the term of the contract;
122.1 	(7) a description of the services to be provided to the resident in the base rate to be paid 
122.2 	by resident, including a delineation of the portion of the base rate that constitutes rent and 
122.3 	a delineation of charges for each service included in the base rate;
122.4 	(8) a description of any additional services, including home care services, available for 
122.5 	an additional fee from the establishment directly or through arrangements with the 
122.6 	establishment, and a schedule of fees charged for these services;
122.7 	(9) a description of the process through which the contract may be modified, amended, 
122.8 	or terminated, including whether a move to a different room or sharing a room would be 
122.9 	required in the event that the tenant can no longer pay the current rent;
122.10 	(10) a description of the establishment's complaint resolution process available to residents 
122.11 	including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
122.12 	(11) the resident's designated representative, if any;
122.13 	(12) the establishment's referral procedures if the contract is terminated;
122.14 	(13) requirements of residency used by the establishment to determine who may reside 
122.15 	or continue to reside in the housing with services establishment;
122.16 	(14) billing and payment procedures and requirements;
122.17 	(15) a statement regarding the ability of residents a resident to receive services from 
122.18 	service providers with whom the establishment does not have an arrangement;
122.19 	(16) a statement regarding the availability of public funds for payment for residence or 
122.20 	services in the establishment; and
122.21 	(17) a statement regarding the availability of and contact information for long-term care 
122.22 	consultation services under section 256B.0911 in the county in which the establishment is 
122.23 	located.

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

122.25 	Sec. 2. Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to 
122.26 	read:
122.27 		Subd. 2a.Additional contract requirements. (a) For a resident receiving one or more 
122.28 	health-related services from the establishment's arranged home care provider, as defined in 
122.29 	section 144D.01, subdivision 6, the contract must include the requirements in paragraph 
122.30 	(b), clauses (1) to (5). A restriction of a resident's rights under this subdivision is allowed 
122.31 	only if determined necessary for health and safety reasons identified by the home care 
123.1 	provider's registered nurse in an initial assessment or reassessment as defined under section 
123.2 	144A.4791, subdivision 8, and documented in the written service plan under section 
123.3 	144A.4791, subdivision 9. Any restrictions of those rights for people served under sections 
123.4 	256B.0915 and 256B.49 must be documented in the resident's coordinated service and 
123.5 	support plan as defined under sections 256B.0915, subdivision 6, and 256B.49, subdivision 
123.6 	15.
123.7 	(b) The contract must include a statement:
123.8 	(1) regarding the ability of a resident to furnish and decorate the resident's unit within 
123.9 	the terms of the lease;
123.10 	(2) regarding the resident's right to access food at any time;
123.11 	(3) regarding a resident's right to choose the resident's visitors and times of visits;
123.12 	(4) regarding the resident's right to choose a roommate if sharing a unit; and
123.13 	(5) notifying the resident of the resident's right to have and use a lockable door to the 
123.14 	resident's unit. The landlord shall provide the locks on the unit. Only a staff member with 
123.15 	a specific need to enter the unit shall have keys, and advance notice must be given to the 
123.16 	resident before entrance, when possible.

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

123.18 	Sec. 3. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
123.19 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
123.20 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
123.21 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
123.22 	for a physical location that will not be the primary residence of the license holder for the 
123.23 	entire period of licensure. If a license is issued during this moratorium, and the license 
123.24 	holder changes the license holder's primary residence away from the physical location of 
123.25 	the foster care license, the commissioner shall revoke the license according to section 
123.26 	245A.07. The commissioner shall not issue an initial license for a community residential 
123.27 	setting licensed under chapter 245D. Exceptions to the moratorium include:
123.28 	(1) foster care settings that are required to be registered under chapter 144D;
123.29 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
123.30 	community residential setting licenses replacing adult foster care licenses in existence on 
123.31 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
123.32 	(b);
124.1 	(3) new foster care licenses or community residential setting licenses determined to be 
124.2 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
124.3 	or regional treatment center; restructuring of state-operated services that limits the capacity 
124.4 	of state-operated facilities; or allowing movement to the community for people who no 
124.5 	longer require the level of care provided in state-operated facilities as provided under section 
124.6 	256B.092, subdivision 13, or 256B.49, subdivision 24;
124.7 	(4) new foster care licenses or community residential setting licenses determined to be 
124.8 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
124.9 	or
124.10 	(5) new foster care licenses or community residential setting licenses determined to be 
124.11 	needed by the commissioner for the transition of people from personal care assistance to 
124.12 	the home and community-based services.
124.13 	When approving an exception under this paragraph, the commissioner shall consider the 
124.14 	resource need determination process in paragraph (d), the availability of foster care licensed 
124.15 	beds in the geographic area in which the licensee seeks to operate, and the recommendation 
124.16 	of the local county board. The determination by the commissioner is final and not subject 
124.17 	to appeal.
124.18 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
124.19 	community residential settings as defined under this subdivision. As part of the determination, 
124.20 	the commissioner shall consider the availability of foster care capacity in the area in which 
124.21 	the licensee seeks to operate, and the recommendation of the local county board. The 
124.22 	determination by the commissioner must be final. A determination of need is not required 
124.23 	for a change in ownership at the same address.
124.24 	(c) When an adult resident served by the program moves out of a foster home that is not 
124.25 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
124.26 	paragraph (f), or the adult community residential setting, the county shall immediately 
124.27 	inform the Department of Human Services Licensing Division. The department shall decrease 
124.28 	the statewide licensed capacity for adult foster care settings where the physical location is 
124.29 	not the primary residence of the license holder, or for adult community residential settings, 
124.30 	if the voluntary changes described in paragraph (e) are not sufficient to meet the savings 
124.31 	required by reductions in licensed bed capacity under Laws 2011, First Special Session 
124.32 	chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term care 
124.33 	residential services capacity within budgetary limits. Implementation of the statewide 
124.34 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
125.1 	up to 128 beds by June 30, 2014, using the needs determination process. Prior to any 
125.2 	involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies 
125.3 	and license holders to determine which adult foster care settings, where the physical location 
125.4 	is not the primary residence of the license holder, or community residential settings, are 
125.5 	licensed for up to five beds, but have operated at less than full capacity for 12 or more 
125.6 	months as of March 1, 2014. The settings that meet these criteria must be the first to be 
125.7 	considered for an involuntary decrease in statewide licensed capacity, up to a maximum of 
125.8 	35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall 
125.9 	prioritize the selection of those beds to be closed based on the length of time the beds have 
125.10 	been vacant. The longer a bed has been vacant, the higher priority it must be given for 
125.11 	closure. Under this paragraph, the commissioner has the authority to reduce unused licensed 
125.12 	capacity of a current foster care program, or the community residential settings, to accomplish 
125.13 	the consolidation or closure of settings. Under this paragraph, the commissioner has the 
125.14 	authority to manage statewide capacity, including adjusting the capacity available to each 
125.15 	county and adjusting statewide available capacity, to meet the statewide needs identified 
125.16 	through the resource need determination process in paragraph (e) (d). A decreased licensed 
125.17 	capacity according to this paragraph is not subject to appeal under this chapter.
125.18 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
125.19 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
125.20 	residents whose primary diagnosis is mental illness and the license holder is certified under 
125.21 	the requirements in subdivision 6a or section 245D.33.
125.22 	(e) (d) A resource need determination process, managed at the state level, using the 
125.23 	available reports required by section 144A.351, and other data and information shall be 
125.24 	used to determine where the reduced capacity required under paragraph (c) will be 
125.25 	implemented. The commissioner shall consult with the stakeholders described in section 
125.26 	144A.351, and employ a variety of methods to improve the state's capacity to meet long-term 
125.27 	care service needs within budgetary limits, including seeking proposals from service providers 
125.28 	or lead agencies to change service type, capacity, or location to improve services, increase 
125.29 	the independence of residents, and better meet needs identified by the long-term care services 
125.30 	reports and statewide data and information. By February 1, 2013, and August 1, 2014, and 
125.31 	each following year, the commissioner shall provide information and data on the overall 
125.32 	capacity of licensed long-term care services, actions taken under this subdivision to manage 
125.33 	statewide long-term care services and supports resources, and any recommendations for 
125.34 	change to the legislative committees with jurisdiction over health and human services budget.
126.1 	(e) The commissioner must notify a license holder when its corporate foster care or 
126.2 	community residential setting licensed beds are reduced under this section.  The notice of 
126.3 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
126.4 	mail or personal service.  The notice must state why the licensed beds are reduced and must 
126.5 	inform the license holder of its right to request reconsideration by the commissioner. The 
126.6 	license holder's request for reconsideration must be in writing. If mailed, the request for 
126.7 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
126.8 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
126.9 	reconsideration is made by personal service, it must be received by the commissioner within 
126.10 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
126.11 	(f) At the time of application and reapplication for licensure, the applicant and the license 
126.12 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
126.13 	required to inform the commissioner whether the physical location where the foster care 
126.14 	will be provided is or will be the primary residence of the license holder for the entire period 
126.15 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
126.16 	or license holder must notify the commissioner immediately. The commissioner shall print 
126.17 	on the foster care license certificate whether or not the physical location is the primary 
126.18 	residence of the license holder.
126.19 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
126.20 	primary residence of the license holder and that also provide services in the foster care home 
126.21 	that are covered by a federally approved home and community-based services waiver, as 
126.22 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
126.23 	licensing division that the license holder provides or intends to provide these waiver-funded 
126.24 	services.

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

126.26 	Sec. 4. Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:
126.27 		Subd. 14.Policies and procedures for program administration required and 
126.28 	enforceable. (a) The license holder shall develop program policies and procedures necessary 
126.29 	to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota 
126.30 	Rules.
126.31 	(b) The license holder shall:
126.32 	(1) provide training to program staff related to their duties in implementing the program's 
126.33 	policies and procedures developed under paragraph (a);
127.1 	(2) document the provision of this training; and
127.2 	(3) monitor implementation of policies and procedures by program staff.
127.3 	(c) The license holder shall keep program policies and procedures readily accessible to 
127.4 	staff and index the policies and procedures with a table of contents or another method 
127.5 	approved by the commissioner.
127.6 	(d) An adult foster care license holder that provides foster care services to a resident 
127.7 	under section 256B.0915 must annually provide a copy of the resident termination policy 
127.8 	under section 245A.11, subdivision 11, to a resident covered by the policy.

127.9 	Sec. 5. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
127.10 	read:
127.11 		Subd. 9.Adult foster care bedrooms. (a) A resident receiving services must have a 
127.12 	choice of roommate. Each roommate must consent in writing to sharing a bedroom with 
127.13 	one another. The license holder is responsible for notifying a resident of the resident's right 
127.14 	to request a change of roommate.
127.15 	(b) The license holder must provide a lock for each resident's bedroom door, unless 
127.16 	otherwise indicated for the resident's health, safety, or well-being. A restriction on the use 
127.17 	of the lock must be documented and justified in the resident's individual abuse prevention 
127.18 	plan required by sections 626.557, subdivision 14, and 245A.65, subdivision 2, paragraph 
127.19 	(b). For a resident served under section 256B.0915, the case manager must be part of the 
127.20 	interdisciplinary team under section 245A.65, subdivision 2, paragraph (b).

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

127.22 	Sec. 6. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
127.23 	read:
127.24 		Subd. 10.Adult foster care resident rights. (a) The license holder shall ensure that a 
127.25 	resident and a resident's legal representative are given, at admission:
127.26 	(1) an explanation and copy of the resident's rights specified in paragraph (b);
127.27 	(2) a written summary of the Vulnerable Adults Protection Act prepared by the 
127.28 	department; and
127.29 	(3) the name, address, and telephone number of the local agency to which a resident or 
127.30 	a resident's legal representative may submit an oral or written complaint.
127.31 	(b) Adult foster care resident rights include the right to:
128.1 	(1) have daily, private access to and use of a non-coin-operated telephone for local and 
128.2 	long-distance telephone calls made collect or paid for by the resident;
128.3 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
128.4 	correspondence or communication;
128.5 	(3) have use of and free access to common areas in the residence and the freedom to 
128.6 	come and go from the residence at will;
128.7 	(4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious 
128.8 	adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy 
128.9 	in the resident's bedroom;
128.10 	(5) keep, use, and access the resident's personal clothing and possessions as space permits, 
128.11 	unless this right infringes on the health, safety, or rights of another resident or household 
128.12 	member, including the right to access the resident's personal possessions at any time;
128.13 	(6) choose the resident's visitors and time of visits and participate in activities of 
128.14 	commercial, religious, political, and community groups without interference if the activities 
128.15 	do not infringe on the rights of another resident or household member;
128.16 	(7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents 
128.17 	of the adult foster home, the residents have the right to share a bedroom and bed;
128.18 	(8) privacy, including use of the lock on the resident's bedroom door or unit door. A 
128.19 	resident's privacy must be respected by license holders, caregivers, household members, 
128.20 	and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking 
128.21 	consent before entering, except in an emergency;
128.22 	(9) furnish and decorate the resident's bedroom or living unit;
128.23 	(10) engage in chosen activities and have an individual schedule supported by the license 
128.24 	holder that meets the resident's preferences;
128.25 	(11) freedom and support to access food at any time;
128.26 	(12) have personal, financial, service, health, and medical information kept private, and 
128.27 	be advised of disclosure of this information by the license holder;
128.28 	(13) access records and recorded information about the resident according to applicable 
128.29 	state and federal law, regulation, or rule;
128.30 	(14) be free from maltreatment;
129.1 	(15) be treated with courtesy and respect and receive respectful treatment of the resident's 
129.2 	property;
129.3 	(16) reasonable observance of cultural and ethnic practice and religion;
129.4 	(17) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
129.5 	and sexual orientation;
129.6 	(18) be informed of and use the license holder's grievance policy and procedures, 
129.7 	including how to contact the highest level of authority in the program;
129.8 	(19) assert the resident's rights personally, or have the rights asserted by the resident's 
129.9 	family, authorized representative, or legal representative, without retaliation; and
129.10 	(20) give or withhold written informed consent to participate in any research or 
129.11 	experimental treatment.
129.12 	(c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8), 
129.13 	(10), and (11), is allowed only if determined necessary to ensure the health, safety, and 
129.14 	well-being of the resident. Any restriction of a resident's right must be documented and 
129.15 	justified in the resident's individual abuse prevention plan required by sections 626.557, 
129.16 	subdivision 14, and 245A.65, subdivision 2, paragraph (b). For a resident served under 
129.17 	section 256B.0915, the case manager must be part of the interdisciplinary team under section 
129.18 	245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least 
129.19 	restrictive manner necessary to protect the resident and provide support to reduce or eliminate 
129.20 	the need for the restriction.

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

129.22 	Sec. 7. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
129.23 	read:
129.24 		Subd. 11.Adult foster care service termination for elderly waiver participants. (a) 
129.25 	This subdivision applies to foster care services for a resident served under section 256B.0915.
129.26 	(b) The foster care license holder must establish policies and procedures for service 
129.27 	termination that promote continuity of care and service coordination with the resident and 
129.28 	the case manager and with another licensed caregiver, if any, who also provides support to 
129.29 	the resident. The policy must include the requirements specified in paragraphs (c) to (h).
129.30 	(c) The license holder must allow a resident to remain in the program and cannot terminate 
129.31 	services unless:
130.1 	(1) the termination is necessary for the resident's health, safety, and well-being and the 
130.2 	resident's needs cannot be met in the facility;
130.3 	(2) the safety of the resident or another resident in the program is endangered and positive 
130.4 	support strategies were attempted and have not achieved and effectively maintained safety 
130.5 	for the resident or another resident in the program;
130.6 	(3) the health, safety, and well-being of the resident or another resident in the program 
130.7 	would otherwise be endangered;
130.8 	(4) the program was not paid for services;
130.9 	(5) the program ceases to operate; or
130.10 	(6) the resident was terminated by the lead agency from waiver eligibility.
130.11 	(d) Before giving notice of service termination, the license holder must document the 
130.12 	action taken to minimize or eliminate the need for termination. The action taken by the 
130.13 	license holder must include, at a minimum:
130.14 	(1) consultation with the resident's interdisciplinary team to identify and resolve issues 
130.15 	leading to a notice of service termination; and
130.16 	(2) a request to the case manager or other professional consultation or intervention 
130.17 	services to support the resident in the program. This requirement does not apply to a notice 
130.18 	of service termination issued under paragraph (c), clause (4) or (5).
130.19 	(e) If, based on the best interests of the resident, the circumstances at the time of notice 
130.20 	were such that the license holder was unable to take the action specified in paragraph (d), 
130.21 	the license holder must document the specific circumstances and the reason the license 
130.22 	holder was unable to take the action.
130.23 	(f) The license holder must notify the resident or the resident's legal representative and 
130.24 	the case manager in writing of the intended service termination. The notice must include:
130.25 	(1) the reason for the action;
130.26 	(2) except for service termination under paragraph (c), clause (4) or (5), a summary of 
130.27 	the action taken to minimize or eliminate the need for termination and the reason the action 
130.28 	failed to prevent the termination;
130.29 	(3) the resident's right to appeal the service termination under section 256.045, subdivision 
130.30 	3, paragraph (a); and
131.1 	(4) the resident's right to seek a temporary order staying the service termination according 
131.2 	to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
131.3 	(g) Notice of the proposed service termination must be given at least 30 days before 
131.4 	terminating a resident's service.
131.5 	(h) After the resident receives the notice of service termination and before the services 
131.6 	are terminated, the license holder must:
131.7 	(1) work with the support team or expanded support team to develop reasonable 
131.8 	alternatives to support continuity of care and to protect the resident;
131.9 	(2) provide information requested by the resident or case manager; and
131.10 	(3) maintain information about the service termination, including the written notice of 
131.11 	service termination, in the resident's record.

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

131.13 	Sec. 8. Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:
131.14 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
131.15 	and community-based services to persons with disabilities and persons age 65 and older 
131.16 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
131.17 	basic support services and intensive support services.
131.18 	(b) Basic support services provide the level of assistance, supervision, and care that is 
131.19 	necessary to ensure the health and welfare of the person and do not include services that 
131.20 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
131.21 	person. Basic support services include:
131.22 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
131.23 	subdivision 15, and under the brain injury, community alternative care, community access 
131.24 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
131.25 	out-of-home respite care provided to children in a family child foster care home licensed 
131.26 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
131.27 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
131.28 	or successor provisions; and section 245D.061 or successor provisions, which must be 
131.29 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
131.30 	subpart 4;
131.31 	(2) adult companion services as defined under the brain injury, community access for 
131.32 	disability inclusion, and elderly waiver plans, excluding adult companion services provided 
132.1 	under the Corporation for National and Community Services Senior Companion Program 
132.2 	established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
132.3 	(3) personal support as defined under the developmental disability waiver plan;
132.4 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
132.5 	community access for disability inclusion and developmental disability waiver plans;
132.6 	(5) night supervision services as defined under the brain injury waiver plan; and
132.7 	(6) homemaker services as defined under the community access for disability inclusion, 
132.8 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
132.9 	excluding providers licensed by the Department of Health under chapter 144A and those 
132.10 	providers providing cleaning services only.
132.11 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
132.12 	to ensure the health and welfare of the person and services specifically directed toward the 
132.13 	training, habilitation, or rehabilitation of the person. Intensive support services include:
132.14 	(1) intervention services, including:
132.15 	(i) behavioral support services as defined under the brain injury and community access 
132.16 	for disability inclusion waiver plans;
132.17 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
132.18 	disability waiver plan; and
132.19 	(iii) specialist services as defined under the current developmental disability waiver 
132.20 	plan;
132.21 	(2) in-home support services, including:
132.22 	(i) in-home family support and supported living services as defined under the 
132.23 	developmental disability waiver plan;
132.24 	(ii) independent living services training as defined under the brain injury and community 
132.25 	access for disability inclusion waiver plans; and
132.26 	(iii) semi-independent living services; and
132.27 	(iv) individualized home supports services as defined under the brain injury, community 
132.28 	alternative care, and community access for disability inclusion waiver plans;
132.29 	(3) residential supports and services, including:
133.1 	(i) supported living services as defined under the developmental disability waiver plan 
133.2 	provided in a family or corporate child foster care residence, a family adult foster care 
133.3 	residence, a community residential setting, or a supervised living facility;
133.4 	(ii) foster care services as defined in the brain injury, community alternative care, and 
133.5 	community access for disability inclusion waiver plans provided in a family or corporate 
133.6 	child foster care residence, a family adult foster care residence, or a community residential 
133.7 	setting; and
133.8 	(iii) residential services provided to more than four persons with developmental 
133.9 	disabilities in a supervised living facility, including ICFs/DD;
133.10 	(4) day services, including:
133.11 	(i) structured day services as defined under the brain injury waiver plan;
133.12 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
133.13 	under the developmental disability waiver plan; and
133.14 	(iii) prevocational services as defined under the brain injury and community access for 
133.15 	disability inclusion waiver plans; and
133.16 	(5) supported employment as defined under the brain injury, developmental disability, 
133.17 	and community access for disability inclusion waiver plans.

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

133.19 	Sec. 9. Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:
133.20 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include the 
133.21 	right to:
133.22 	(1) have personal, financial, service, health, and medical information kept private, and 
133.23 	be advised of disclosure of this information by the license holder;
133.24 	(2) access records and recorded information about the person in accordance with 
133.25 	applicable state and federal law, regulation, or rule;
133.26 	(3) be free from maltreatment;
133.27 	(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited 
133.28 	procedure identified in section 245D.06, subdivision 5, or successor provisions, except for: 
133.29 	(i) emergency use of manual restraint to protect the person from imminent danger to self 
133.30 	or others according to the requirements in section 245D.061 or successor provisions; or (ii) 
134.1 	the use of safety interventions as part of a positive support transition plan under section 
134.2 	245D.06, subdivision 8, or successor provisions;
134.3 	(5) receive services in a clean and safe environment when the license holder is the owner, 
134.4 	lessor, or tenant of the service site;
134.5 	(6) be treated with courtesy and respect and receive respectful treatment of the person's 
134.6 	property;
134.7 	(7) reasonable observance of cultural and ethnic practice and religion;
134.8 	(8) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
134.9 	and sexual orientation;
134.10 	(9) be informed of and use the license holder's grievance policy and procedures, including 
134.11 	knowing how to contact persons responsible for addressing problems and to appeal under 
134.12 	section 256.045;
134.13 	(10) know the name, telephone number, and the Web site, e-mail, and street addresses 
134.14 	of protection and advocacy services, including the appropriate state-appointed ombudsman, 
134.15 	and a brief description of how to file a complaint with these offices;
134.16 	(11) assert these rights personally, or have them asserted by the person's family, 
134.17 	authorized representative, or legal representative, without retaliation;
134.18 	(12) give or withhold written informed consent to participate in any research or 
134.19 	experimental treatment;
134.20 	(13) associate with other persons of the person's choice;
134.21 	(14) personal privacy, including the right to use the lock on the person's bedroom or unit 
134.22 	door; and
134.23 	(15) engage in chosen activities; and
134.24 	(16) access to the person's personal possessions at any time, including financial resources.
134.25 	(b) For a person residing in a residential site licensed according to chapter 245A, or 
134.26 	where the license holder is the owner, lessor, or tenant of the residential service site, 
134.27 	protection-related rights also include the right to:
134.28 	(1) have daily, private access to and use of a non-coin-operated telephone for local calls 
134.29 	and long-distance calls made collect or paid for by the person;
134.30 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
134.31 	correspondence or communication;
135.1 	(3) have use of and free access to common areas in the residence and the freedom to 
135.2 	come and go from the residence at will; and
135.3 	(4) choose the person's visitors and time of visits and have privacy for visits with the 
135.4 	person's spouse, next of kin, legal counsel, religious advisor adviser, or others, in accordance 
135.5 	with section 363A.09 of the Human Rights Act, including privacy in the person's bedroom.;
135.6 	(5) the freedom and support to access food at any time;
135.7 	(6) the freedom to furnish and decorate the person's bedroom or living unit;
135.8 	(7) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling 
135.9 	paint, mold, vermin, and insects;
135.10 	(8) a setting that is free from hazards that threaten the person's health or safety;
135.11 	(9) a setting that meets state and local building and zoning definitions of a dwelling unit 
135.12 	in a residential occupancy; and
135.13 	(10) have access to potable water and three nutritionally balanced meals and nutritious 
135.14 	snacks between meals each day.
135.15 	(c) Restriction of a person's rights under paragraph (a), clauses (13) to (15) (16), or 
135.16 	paragraph (b) is allowed only if determined necessary to ensure the health, safety, and 
135.17 	well-being of the person. Any restriction of those rights must be documented in the person's 
135.18 	coordinated service and support plan or coordinated service and support plan addendum. 
135.19 	The restriction must be implemented in the least restrictive alternative manner necessary 
135.20 	to protect the person and provide support to reduce or eliminate the need for the restriction 
135.21 	in the most integrated setting and inclusive manner. The documentation must include the 
135.22 	following information:
135.23 	(1) the justification for the restriction based on an assessment of the person's vulnerability 
135.24 	related to exercising the right without restriction;
135.25 	(2) the objective measures set as conditions for ending the restriction;
135.26 	(3) a schedule for reviewing the need for the restriction based on the conditions for 
135.27 	ending the restriction to occur semiannually from the date of initial approval, at a minimum, 
135.28 	or more frequently if requested by the person, the person's legal representative, if any, and 
135.29 	case manager; and
135.30 	(4) signed and dated approval for the restriction from the person, or the person's legal 
135.31 	representative, if any. A restriction may be implemented only when the required approval 
136.1 	has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the 
136.2 	right must be immediately and fully restored.

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

136.4 	Sec. 10. Minnesota Statutes 2016, section 245D.071, subdivision 3, is amended to read:
136.5 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
136.6 	the license holder must complete a preliminary coordinated service and support plan 
136.7 	addendum based on the coordinated service and support plan.
136.8 	(b) Within the scope of services, the license holder must, at a minimum, complete 
136.9 	assessments in the following areas before the 45-day planning meeting:
136.10 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
136.11 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
136.12 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
136.13 	or treatment orders, preventative screening, and medical and dental appointments;
136.14 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
136.15 	service setting, including, when applicable, risk of falling, mobility, regulating water 
136.16 	temperature, community survival skills, water safety skills, and sensory disabilities; and
136.17 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
136.18 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
136.19 	or termination of services by the license holder, or other symptoms or behaviors that may 
136.20 	jeopardize the health and welfare of the person or others.
136.21 	Assessments must produce information about the person that describes the person's overall 
136.22 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
136.23 	based on the person's status within the last 12 months at the time of service initiation. 
136.24 	Assessments based on older information must be documented and justified. Assessments 
136.25 	must be conducted annually at a minimum or within 30 days of a written request from the 
136.26 	person or the person's legal representative or case manager. The results must be reviewed 
136.27 	by the support team or expanded support team as part of a service plan review.
136.28 	(c) Within 45 days of service initiation, the license holder must meet with the person, 
136.29 	the person's legal representative, the case manager, and other members of the support team 
136.30 	or expanded support team to determine the following based on information obtained from 
136.31 	the assessments identified in paragraph (b), the person's identified needs in the coordinated 
136.32 	service and support plan, and the requirements in subdivision 4 and section 245D.07, 
136.33 	subdivision 1a:
137.1 	(1) the scope of the services to be provided to support the person's daily needs and 
137.2 	activities;
137.3 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
137.4 	desired outcomes;
137.5 	(3) the person's preferences for how services and supports are provided, including how 
137.6 	the provider will support the person to have control of the person's schedule;
137.7 	(4) whether the current service setting is the most integrated setting available and 
137.8 	appropriate for the person; and
137.9 	(5) how services must be coordinated across other providers licensed under this chapter 
137.10 	serving the person and members of the support team or expanded support team to ensure 
137.11 	continuity of care and coordination of services for the person.

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

137.13 	Sec. 11. Minnesota Statutes 2016, section 245D.09, subdivision 5a, is amended to read:
137.14 		Subd. 5a.Alternative sources of training. The commissioner may approve online 
137.15 	training and competency-based assessments in place of a specific number of hours of training 
137.16 	in the topics covered in subdivision 4.
137.17 	Orientation or training received by the staff person from sources other than the license 
137.18 	holder in the same subjects as identified in subdivision 4 may count toward the orientation 
137.19 	and annual training requirements if received in the 12-month period before the staff person's 
137.20 	date of hire. The license holder must maintain documentation of the training received from 
137.21 	other sources and of each staff person's competency in the required area according to the 
137.22 	requirements in subdivision 3.

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

137.24 	Sec. 12. Minnesota Statutes 2016, section 245D.11, subdivision 4, is amended to read:
137.25 		Subd. 4.Admission criteria. The license holder must establish policies and procedures 
137.26 	that promote continuity of care by ensuring that admission or service initiation criteria:
137.27 	(1) is consistent with the service-related rights identified in section 245D.04, subdivisions 
137.28 	2, clauses (4) to (7), and 3, clause (8);
137.29 	(2) identifies the criteria to be applied in determining whether the license holder can 
137.30 	develop services to meet the needs specified in the person's coordinated service and support 
137.31 	plan;
138.1 	(3) requires a license holder providing services in a health care facility to comply with 
138.2 	the requirements in section 243.166, subdivision 4b, to provide notification to residents 
138.3 	when a registered predatory offender is admitted into the program or to a potential admission 
138.4 	when the facility was already serving a registered predatory offender. For purposes of this 
138.5 	clause, "health care facility" means a facility licensed by the commissioner as a residential 
138.6 	facility under chapter 245A to provide adult foster care or residential services to persons 
138.7 	with disabilities; and
138.8 	(4) requires that when a person or the person's legal representative requests services 
138.9 	from the license holder, a refusal to admit the person must be based on an evaluation of the 
138.10 	person's assessed needs and the license holder's lack of capacity to meet the needs of the 
138.11 	person. The license holder must not refuse to admit a person based solely on the type of 
138.12 	residential services the person is receiving, or solely on the person's severity of disability, 
138.13 	orthopedic or neurological handicaps, sight or hearing impairments, lack of communication 
138.14 	skills, physical disabilities, toilet habits, behavioral disorders, or past failure to make progress. 
138.15 	Documentation of the basis for refusal must be provided to the person or the person's legal 
138.16 	representative and case manager upon request.; and
138.17 	(5) requires the person or the person's legal representative and license holder to sign and 
138.18 	date the residency agreement when the license holder provides foster care or supported 
138.19 	living services under section 245D.03, subdivision 1, paragraph (c), clause (3), item (i) or 
138.20 	(ii), to a person living in a community residential setting defined in section 245D.02, 
138.21 	subdivision 4a; an adult foster home defined in Minnesota Rules, part 9555.5105, subpart 
138.22 	5; or a foster family home defined in Minnesota Rules, part 9560.0521, subpart 12. The 
138.23 	residency agreement must include service termination requirements specified in section 
138.24 	245D.10, subdivision 3a, paragraphs (b) to (f). The residency agreement must be reviewed 
138.25 	annually, dated, and signed by the person or the person's legal representative and license 
138.26 	holder.

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

138.28 	Sec. 13. Minnesota Statutes 2016, section 245D.24, subdivision 3, is amended to read:
138.29 		Subd. 3.Bedrooms. (a) People Each person receiving services must have a choice of 
138.30 	roommate and must mutually consent, in writing, to sharing a bedroom with one another. 
138.31 	No more than two people receiving services may share one bedroom.
138.32 	(b) A single occupancy bedroom must have at least 80 square feet of floor space with a 
138.33 	7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor 
138.34 	space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and other 
139.1 	habitable rooms by floor-to-ceiling walls containing no openings except doorways and must 
139.2 	not serve as a corridor to another room used in daily living.
139.3 	(c) A person's personal possessions and items for the person's own use are the only items 
139.4 	permitted to be stored in a person's bedroom.
139.5 	(d) Unless otherwise documented through assessment as a safety concern for the person, 
139.6 	each person must be provided with the following furnishings:
139.7 	(1) a separate bed of proper size and height for the convenience and comfort of the 
139.8 	person, with a clean mattress in good repair;
139.9 	(2) clean bedding appropriate for the season for each person;
139.10 	(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal 
139.11 	possessions and clothing; and
139.12 	(4) a mirror for grooming.
139.13 	(e) When possible, a person must be allowed to have items of furniture that the person 
139.14 	personally owns in the bedroom, unless doing so would interfere with safety precautions, 
139.15 	violate a building or fire code, or interfere with another person's use of the bedroom. A 
139.16 	person may choose not to have a cabinet, dresser, shelves, or a mirror in the bedroom, as 
139.17 	otherwise required under paragraph (d), clause (3) or (4). A person may choose to use a 
139.18 	mattress other than an innerspring mattress and may choose not to have the mattress on a 
139.19 	mattress frame or support. If a person chooses not to have a piece of required furniture, the 
139.20 	license holder must document this choice and is not required to provide the item. If a person 
139.21 	chooses to use a mattress other than an innerspring mattress or chooses not to have a mattress 
139.22 	frame or support, the license holder must document this choice and allow the alternative 
139.23 	desired by the person.
139.24 	(f) A person must be allowed to bring personal possessions into the bedroom and other 
139.25 	designated storage space, if such space is available, in the residence. The person must be 
139.26 	allowed to accumulate possessions to the extent the residence is able to accommodate them, 
139.27 	unless doing so is contraindicated for the person's physical or mental health, would interfere 
139.28 	with safety precautions or another person's use of the bedroom, or would violate a building 
139.29 	or fire code. The license holder must allow for locked storage of personal items. Any 
139.30 	restriction on the possession or locked storage of personal items, including requiring a 
139.31 	person to use a lock provided by the license holder, must comply with section 245D.04, 
139.32 	subdivision 3, paragraph (c), and allow the person to be present if and when the license 
139.33 	holder opens the lock.
140.1 	(g) A person must be allowed to lock the person's bedroom door. The license holder 
140.2 	must document and assess the physical plant and the environment, and the population served, 
140.3 	and identify the risk factors that require using locked doors, and the specific action taken 
140.4 	to minimize the safety risk to a person receiving services at the site.

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

140.6 	Sec. 14. Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:
140.7 		Subd. 3.State agency hearings. (a) State agency hearings are available for the following:
140.8 	(1) any person applying for, receiving or having received public assistance, medical 
140.9 	care, or a program of social services granted by the state agency or a county agency or the 
140.10 	federal Food Stamp Act whose application for assistance is denied, not acted upon with 
140.11 	reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed 
140.12 	to have been incorrectly paid;
140.13 	(2) any patient or relative aggrieved by an order of the commissioner under section 
140.14 	252.27;
140.15 	(3) a party aggrieved by a ruling of a prepaid health plan;
140.16 	(4) except as provided under chapter 245C, any individual or facility determined by a 
140.17 	lead investigative agency to have maltreated a vulnerable adult under section 626.557 after 
140.18 	they have exercised their right to administrative reconsideration under section 626.557;
140.19 	(5) any person whose claim for foster care payment according to a placement of the 
140.20 	child resulting from a child protection assessment under section 626.556 is denied or not 
140.21 	acted upon with reasonable promptness, regardless of funding source;
140.22 	(6) any person to whom a right of appeal according to this section is given by other 
140.23 	provision of law;
140.24 	(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver 
140.25 	under section 256B.15;
140.26 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
140.27 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
140.28 	(9) except as provided under chapter 245A, an individual or facility determined to have 
140.29 	maltreated a minor under section 626.556, after the individual or facility has exercised the 
140.30 	right to administrative reconsideration under section 626.556;
141.1 	(10) except as provided under chapter 245C, an individual disqualified under sections 
141.2 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
141.3 	on the basis of serious or recurring maltreatment; a preponderance of the evidence that the 
141.4 	individual has committed an act or acts that meet the definition of any of the crimes listed 
141.5 	in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section 
141.6 	626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment 
141.7 	determination under clause (4) or (9) and a disqualification under this clause in which the 
141.8 	basis for a disqualification is serious or recurring maltreatment, shall be consolidated into 
141.9 	a single fair hearing. In such cases, the scope of review by the human services judge shall 
141.10 	include both the maltreatment determination and the disqualification. The failure to exercise 
141.11 	the right to an administrative reconsideration shall not be a bar to a hearing under this section 
141.12 	if federal law provides an individual the right to a hearing to dispute a finding of 
141.13 	maltreatment;
141.14 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
141.15 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
141.16 	Department of Human Services or a county agency. The scope of the appeal is the validity 
141.17 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
141.18 	the debt;
141.19 	(12) a person issued a notice of service termination under section 245D.10, subdivision 
141.20 	3a, from residential supports and services as defined in section 245D.03, subdivision 1, 
141.21 	paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; or
141.22 	(13) an individual disability waiver recipient based on a denial of a request for a rate 
141.23 	exception under section 256B.4914.; or
141.24 	(14) a person issued a notice of service termination under section 245A.11, subdivision 
141.25 	11, that is not otherwise subject to appeal under subdivision 4a.
141.26 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10), 
141.27 	is the only administrative appeal to the final agency determination specifically, including 
141.28 	a challenge to the accuracy and completeness of data under section 13.04. Hearings requested 
141.29 	under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or 
141.30 	after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged 
141.31 	to have maltreated a resident prior to October 1, 1995, shall be held as a contested case 
141.32 	proceeding under the provisions of chapter 14. Hearings requested under paragraph (a), 
141.33 	clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A 
141.34 	hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only 
142.1 	available when there is no district court action pending. If such action is filed in district 
142.2 	court while an administrative review is pending that arises out of some or all of the events 
142.3 	or circumstances on which the appeal is based, the administrative review must be suspended 
142.4 	until the judicial actions are completed. If the district court proceedings are completed, 
142.5 	dismissed, or overturned, the matter may be considered in an administrative hearing.
142.6 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
142.7 	administrative appeal.
142.8 	(d) The scope of hearings involving claims to foster care payments under paragraph (a), 
142.9 	clause (5), shall be limited to the issue of whether the county is legally responsible for a 
142.10 	child's placement under court order or voluntary placement agreement and, if so, the correct 
142.11 	amount of foster care payment to be made on the child's behalf and shall not include review 
142.12 	of the propriety of the county's child protection determination or child placement decision.
142.13 	(e) The scope of hearings under paragraph (a), clause clauses (12) and (14), shall be 
142.14 	limited to whether the proposed termination of services is authorized under section 245D.10, 
142.15 	subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements 
142.16 	of section 245D.10, subdivision 3a, paragraph paragraphs (c) to (e), or 245A.11, subdivision 
142.17 	2a, paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of 
142.18 	termination of services, the scope of the hearing shall also include whether the case 
142.19 	management provider has finalized arrangements for a residential facility, a program, or 
142.20 	services that will meet the assessed needs of the recipient by the effective date of the service 
142.21 	termination.
142.22 	(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
142.23 	under contract with a county agency to provide social services is not a party and may not 
142.24 	request a hearing under this section, except if assisting a recipient as provided in subdivision 
142.25 	4.
142.26 	(g) An applicant or recipient is not entitled to receive social services beyond the services 
142.27 	prescribed under chapter 256M or other social services the person is eligible for under state 
142.28 	law.
142.29 	(h) The commissioner may summarily affirm the county or state agency's proposed 
142.30 	action without a hearing when the sole issue is an automatic change due to a change in state 
142.31 	or federal law.
142.32 	(i) Unless federal or Minnesota law specifies a different time frame in which to file an 
142.33 	appeal, an individual or organization specified in this section may contest the specified 
142.34 	action, decision, or final disposition before the state agency by submitting a written request 
143.1 	for a hearing to the state agency within 30 days after receiving written notice of the action, 
143.2 	decision, or final disposition, or within 90 days of such written notice if the applicant, 
143.3 	recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision 
143.4 	13, why the request was not submitted within the 30-day time limit. The individual filing 
143.5 	the appeal has the burden of proving good cause by a preponderance of the evidence.

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

143.7 	Sec. 15. Minnesota Statutes 2016, section 256B.0659, subdivision 24, is amended to read:
143.8 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
143.9 	assistance provider agency shall:
143.10 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
143.11 	of the required provider training;
143.12 	(2) comply with general medical assistance coverage requirements;
143.13 	(3) demonstrate compliance with law and policies of the personal care assistance program 
143.14 	to be determined by the commissioner;
143.15 	(4) comply with background study requirements;
143.16 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
143.17 	professional;
143.18 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
143.19 	or other electronic means to potential recipients, guardians, or family members;
143.20 	(7) pay the personal care assistant and qualified professional based on actual hours of 
143.21 	services provided;
143.22 	(8) withhold and pay all applicable federal and state taxes;
143.23 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 percent 
143.24 	of the revenue generated by the medical assistance rate for personal care assistance services 
143.25 	for employee personal care assistant wages and benefits. The revenue generated by the 
143.26 	qualified professional and the reasonable costs associated with the qualified professional 
143.27 	shall not be used in making this calculation;
143.28 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
143.29 	compensation, liability insurance, and other benefits, if any;
143.30 	(11) enter into a written agreement under subdivision 20 before services are provided;
144.1 	(12) report suspected neglect and abuse to the common entry point according to section 
144.2 	256B.0651;
144.3 	(13) provide the recipient with a copy of the home care bill of rights at start of service; 
144.4 	and
144.5 	(14) request reassessments at least 60 days prior to the end of the current authorization 
144.6 	for personal care assistance services, on forms provided by the commissioner.; and
144.7 	(15) provide written notice to a recipient at least 30 calendar days before the service 
144.8 	termination becomes effective except when:
144.9 	(i) the recipient engages in conduct that significantly alters the terms of the recipient's 
144.10 	personal care assistance care plan with the agency;
144.11 	(ii) the recipient or another person present at the setting where services are provided 
144.12 	engage in conduct that creates an imminent risk of harm to the personal care assistant or 
144.13 	other agency staff;
144.14 	(iii) the agency cannot safely meet the recipient's needs because an emergency or a 
144.15 	significant change in the recipient's condition occurred within a 24-hour period causing the 
144.16 	recipient's service needs to exceed the recipient's identified needs in the personal care 
144.17 	assistance care plan; or
144.18 	(iv) a recipient initiates a request to terminate personal care assistance services, the 
144.19 	agency must give the recipient a written acknowledgment of the recipient's service 
144.20 	termination request that includes the date the request was received by the agency and the 
144.21 	requested date of termination.

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

144.23 	Sec. 16. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
144.24 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
144.25 	planning, or other assistance intended to support community-based living, including persons 
144.26 	who need assessment in order to determine waiver or alternative care program eligibility, 
144.27 	must be visited by a long-term care consultation team within 20 calendar days after the date 
144.28 	on which an assessment was requested or recommended. Upon statewide implementation 
144.29 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
144.30 	requesting personal care assistance services and home care nursing. The commissioner shall 
144.31 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
144.32 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
145.1 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
145.2 	assessors to conduct the assessment. For a person with complex health care needs, a public 
145.3 	health or registered nurse from the team must be consulted.
145.4 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
145.5 	be used to complete a comprehensive, person-centered assessment. The assessment must 
145.6 	include the health, psychological, functional, environmental, and social needs of the 
145.7 	individual necessary to develop a community support plan that meets the individual's needs 
145.8 	and preferences.
145.9 	(d) The assessment must be conducted in a face-to-face interview with the person being 
145.10 	assessed and the person's legal representative. At the request of the person, other individuals 
145.11 	may participate in the assessment to provide information on the needs, strengths, and 
145.12 	preferences of the person necessary to develop a community support plan that ensures the 
145.13 	person's health and safety. Except for legal representatives or family members invited by 
145.14 	the person, persons participating in the assessment may not be a provider of service or have 
145.15 	any financial interest in the provision of services. For persons who are to be assessed for 
145.16 	elderly waiver customized living services under section 256B.0915, with the permission of 
145.17 	the person being assessed or the person's designated or legal representative, the client's 
145.18 	current or proposed provider of services may submit a copy of the provider's nursing 
145.19 	assessment or written report outlining its recommendations regarding the client's care needs. 
145.20 	The person conducting the assessment must notify the provider of the date by which this 
145.21 	information is to be submitted. This information shall be provided to the person conducting 
145.22 	the assessment prior to the assessment. For a person who is to be assessed for waiver services 
145.23 	under section 256B.092 or 256B.49, with the permission of the person being assessed or 
145.24 	the person's designated legal representative, the person's current provider of services may 
145.25 	submit a written report outlining recommendations regarding the person's care needs prepared 
145.26 	by a direct service employee with at least 20 hours of service to that client. The person 
145.27 	conducting the assessment or reassessment must notify the provider of the date by which 
145.28 	this information is to be submitted. This information shall be provided to the person 
145.29 	conducting the assessment and the person or the person's legal representative, and must be 
145.30 	considered prior to the finalization of the assessment or reassessment.
145.31 	(e) The person or the person's legal representative must be provided with a written 
145.32 	community support plan within 40 calendar days of the assessment visit, regardless of 
145.33 	whether the individual is eligible for Minnesota health care programs. The written community 
145.34 	support plan must include:
145.35 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
146.1 	(2) the individual's options and choices to meet identified needs, including all available 
146.2 	options for case management services and providers, including service provided in a 
146.3 	non-disability-specific setting;
146.4 	(3) identification of health and safety risks and how those risks will be addressed, 
146.5 	including personal risk management strategies;
146.6 	(4) referral information; and
146.7 	(5) informal caregiver supports, if applicable.
146.8 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
146.9 	(b), clause (1), the person or person's representative must also receive a copy of the home 
146.10 	care service plan developed by the certified assessor.
146.11 	(f) A person may request assistance in identifying community supports without 
146.12 	participating in a complete assessment. Upon a request for assistance identifying community 
146.13 	support, the person must be transferred or referred to long-term care options counseling 
146.14 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
146.15 	telephone assistance and follow up.
146.16 	(g) The person has the right to make the final decision between institutional placement 
146.17 	and community placement after the recommendations have been provided, except as provided 
146.18 	in section 256.975, subdivision 7a, paragraph (d).
146.19 	(h) The lead agency must give the person receiving assessment or support planning, or 
146.20 	the person's legal representative, materials, and forms supplied by the commissioner 
146.21 	containing the following information:
146.22 	(1) written recommendations for community-based services and consumer-directed 
146.23 	options;
146.24 	(2) documentation that the most cost-effective alternatives available were offered to the 
146.25 	individual. For purposes of this clause, "cost-effective" means community services and 
146.26 	living arrangements that cost the same as or less than institutional care. For an individual 
146.27 	found to meet eligibility criteria for home and community-based service programs under 
146.28 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
146.29 	approved waiver plan for each program;
146.30 	(3) the need for and purpose of preadmission screening conducted by long-term care 
146.31 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
146.32 	nursing facility placement. If the individual selects nursing facility placement, the lead 
146.33 	agency shall forward information needed to complete the level of care determinations and 
147.1 	screening for developmental disability and mental illness collected during the assessment 
147.2 	to the long-term care options counselor using forms provided by the commissioner;
147.3 	(4) the role of long-term care consultation assessment and support planning in eligibility 
147.4 	determination for waiver and alternative care programs, and state plan home care, case 
147.5 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
147.6 	and (b);
147.7 	(5) information about Minnesota health care programs;
147.8 	(6) the person's freedom to accept or reject the recommendations of the team;
147.9 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
147.10 	Act, chapter 13;
147.11 	(8) the certified assessor's decision regarding the person's need for institutional level of 
147.12 	care as determined under criteria established in subdivision 4e and the certified assessor's 
147.13 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
147.14 	paragraphs (a), clause (6), and (b); and
147.15 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
147.16 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
147.17 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
147.18 	or the lead agency's final decisions regarding public programs eligibility according to section 
147.19 	256.045, subdivision 3.
147.20 	(i) Face-to-face assessment completed as part of eligibility determination for the 
147.21 	alternative care, elderly waiver, community access for disability inclusion, community 
147.22 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
147.23 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
147.24 	the date of assessment.
147.25 	(j) The effective eligibility start date for programs in paragraph (i) can never be prior to 
147.26 	the date of assessment. If an assessment was completed more than 60 days before the 
147.27 	effective waiver or alternative care program eligibility start date, assessment and support 
147.28 	plan information must be updated and documented in the department's Medicaid Management 
147.29 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
147.30 	state plan services, the effective date of eligibility for programs included in paragraph (i) 
147.31 	cannot be prior to the date the most recent updated assessment is completed.

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

148.1 	Sec. 17. Minnesota Statutes 2016, section 256B.092, subdivision 1a, is amended to read:
148.2 		Subd. 1a.Case management services. (a) Each recipient of a home and community-based 
148.3 	waiver shall be provided case management services by qualified vendors as described in 
148.4 	the federally approved waiver application.
148.5 	(b) Case management service activities provided to or arranged for a person include:
148.6 	(1) development of the coordinated service and support plan under subdivision 1b;
148.7 	(2) informing the individual or the individual's legal guardian or conservator, or parent 
148.8 	if the person is a minor, of service options;
148.9 	(3) consulting with relevant medical experts or service providers;
148.10 	(4) assisting the person in the identification of potential providers, including services 
148.11 	provided in a non-disability-specific setting;
148.12 	(5) assisting the person to access services and assisting in appeals under section 256.045;
148.13 	(6) coordination of services, if coordination is not provided by another service provider;
148.14 	(7) evaluation and monitoring of the services identified in the coordinated service and 
148.15 	support plan, which must incorporate at least one annual face-to-face visit by the case 
148.16 	manager with each person; and
148.17 	(8) reviewing coordinated service and support plans and providing the lead agency with 
148.18 	recommendations for service authorization based upon the individual's needs identified in 
148.19 	the coordinated service and support plan.
148.20 	(c) Case management service activities that are provided to the person with a 
148.21 	developmental disability shall be provided directly by county agencies or under contract. 
148.22 	Case management services must be provided by a public or private agency that is enrolled 
148.23 	as a medical assistance provider determined by the commissioner to meet all of the 
148.24 	requirements in the approved federal waiver plans. Case management services must not be 
148.25 	provided to a recipient by a private agency that has a financial interest in the provision of 
148.26 	any other services included in the recipient's coordinated service and support plan. For 
148.27 	purposes of this section, "private agency" means any agency that is not identified as a lead 
148.28 	agency under section 256B.0911, subdivision 1a, paragraph (e).
148.29 	(d) Case managers are responsible for service provisions listed in paragraphs (a) and 
148.30 	(b). Case managers shall collaborate with consumers, families, legal representatives, and 
148.31 	relevant medical experts and service providers in the development and annual review of the 
148.32 	coordinated service and support plan and habilitation plan.
149.1 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
149.2 	the case manager shall participate in the development and ongoing evaluation of the plan 
149.3 	with the expanded support team. At least quarterly, the case manager, in consultation with 
149.4 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
149.5 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
149.6 	identify whether the plan has been developed and implemented in a manner to achieve the 
149.7 	following within the required timelines:
149.8 	(1) phasing out the use of prohibited procedures;
149.9 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
149.10 	timeline; and
149.11 	(3) accomplishment of identified outcomes.
149.12 	If adequate progress is not being made, the case manager shall consult with the person's 
149.13 	expanded support team to identify needed modifications and whether additional professional 
149.14 	support is required to provide consultation.
149.15 	(f) The Department of Human Services shall offer ongoing education in case management 
149.16 	to case managers. Case managers shall receive no less than ten hours of case management 
149.17 	education and disability-related training each year.

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

149.19 	Sec. 18. Minnesota Statutes 2016, section 256B.49, subdivision 13, is amended to read:
149.20 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
149.21 	shall be provided case management services by qualified vendors as described in the federally 
149.22 	approved waiver application. The case management service activities provided must include:
149.23 	(1) finalizing the written coordinated service and support plan within ten working days 
149.24 	after the case manager receives the plan from the certified assessor;
149.25 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
149.26 	options;
149.27 	(3) assisting the recipient in the identification of potential service providers and available 
149.28 	options for case management service and providers, including services provided in 
149.29 	non-disability-specific setting;
149.30 	(4) assisting the recipient to access services and assisting with appeals under section 
149.31 	256.045; and
150.1 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
150.2 	plan.
150.3 	(b) The case manager may delegate certain aspects of the case management service 
150.4 	activities to another individual provided there is oversight by the case manager. The case 
150.5 	manager may not delegate those aspects which require professional judgment including:
150.6 	(1) finalizing the coordinated service and support plan;
150.7 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
150.8 	approved coordinated service and support plan; and
150.9 	(3) adjustments to the coordinated service and support plan.
150.10 	(c) Case management services must be provided by a public or private agency that is 
150.11 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
150.12 	the requirements in the approved federal waiver plans. Case management services must not 
150.13 	be provided to a recipient by a private agency that has any financial interest in the provision 
150.14 	of any other services included in the recipient's coordinated service and support plan. For 
150.15 	purposes of this section, "private agency" means any agency that is not identified as a lead 
150.16 	agency under section 256B.0911, subdivision 1a, paragraph (e).
150.17 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
150.18 	the case manager shall participate in the development and ongoing evaluation of the plan 
150.19 	with the expanded support team. At least quarterly, the case manager, in consultation with 
150.20 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
150.21 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
150.22 	identify whether the plan has been developed and implemented in a manner to achieve the 
150.23 	following within the required timelines:
150.24 	(1) phasing out the use of prohibited procedures;
150.25 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
150.26 	timeline; and
150.27 	(3) accomplishment of identified outcomes.
150.28 	If adequate progress is not being made, the case manager shall consult with the person's 
150.29 	expanded support team to identify needed modifications and whether additional professional 
150.30 	support is required to provide consultation.

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

151.1 	Sec. 19. Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision 
151.2 	to read:
151.3 		Subd. 7.New services. A service added to section 256B.4914 after January 1, 2014, is 
151.4 	not subject to rate stabilization adjustment in this section.

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

151.6 	Sec. 20. Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:
151.7 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
151.8 	home and community-based services waivers under sections 256B.092 and 256B.49, 
151.9 	including the following, as defined in the federally approved home and community-based 
151.10 	services plan:
151.11 	(1) 24-hour customized living;
151.12 	(2) adult day care;
151.13 	(3) adult day care bath;
151.14 	(4) behavioral programming;
151.15 	(5) companion services;
151.16 	(6) customized living;
151.17 	(7) day training and habilitation;
151.18 	(8) housing access coordination;
151.19 	(9) independent living skills;
151.20 	(10) in-home family support;
151.21 	(11) night supervision;
151.22 	(12) personal support;
151.23 	(13) prevocational services;
151.24 	(14) residential care services;
151.25 	(15) residential support services;
151.26 	(16) respite services;
151.27 	(17) structured day services;
151.28 	(18) supported employment services;
152.1 	(19) supported living services;
152.2 	(20) transportation services; and
152.3 	(21) individualized home supports; and
152.4 	(22) other services as approved by the federal government in the state home and 
152.5 	community-based services plan.

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

152.7 	Sec. 21. Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:
152.8 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
152.9 	is established to determine staffing costs associated with providing services to individuals 
152.10 	receiving home and community-based services. For purposes of developing and calculating 
152.11 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
152.12 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
152.13 	the most recent edition of the Occupational Handbook must be used. The base wage index 
152.14 	must be calculated as follows:
152.15 	(1) for residential direct care staff, the sum of:
152.16 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
152.17 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide (SOC 
152.18 	code 31-1012); and 20 percent of the median wage for social and human services aide (SOC 
152.19 	code 21-1093); and
152.20 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
152.21 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
152.22 	(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012); 
152.23 	20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20 
152.24 	percent of the median wage for social and human services aide (SOC code 21-1093);
152.25 	(2) for day services, 20 percent of the median wage for nursing aide (SOC code 31-1012); 
152.26 	20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 60 
152.27 	percent of the median wage for social and human services aide (SOC code 21-1093);
152.28 	(3) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in a 
152.29 	family foster care setting, the wage is $2.80 per hour;
152.30 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
152.31 	counselors (SOC code 21-1014);
153.1 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
153.2 	counseling and school psychologist (SOC code 19-3031);
153.3 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
153.4 	technicians (SOC code 29-2053);
153.5 	(7) for supportive living services staff, 20 percent of the median wage for nursing aide 
153.6 	(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC code 
153.7 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
153.8 	21-1093);
153.9 	(8) for housing access coordination staff, 50 percent of the median wage for community 
153.10 	and social services specialist (SOC code 21-1099); and 50 percent of the median wage for 
153.11 	social and human services aide (SOC code 21-1093);
153.12 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
153.13 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
153.14 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
153.15 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
153.16 	code 29-2053);
153.17 	(10) for independent living skills staff, 40 percent of the median wage for community 
153.18 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
153.19 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
153.20 	technician (SOC code 29-2053);
153.21 	(11) for individualized home supports services staff, 40 percent of the median wage for 
153.22 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
153.23 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
153.24 	wage for psychiatric technician (SOC code 29-2053).
153.25 	(11) (12) for supported employment staff, 20 percent of the median wage for nursing 
153.26 	aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC 
153.27 	code 29-2053); and 60 percent of the median wage for social and human services aide (SOC 
153.28 	code 21-1093);
153.29 	(12) (13) for adult companion staff, 50 percent of the median wage for personal and 
153.30 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
153.31 	orderlies, and attendants (SOC code 31-1012);
153.32 	(13) (14) for night supervision staff, 20 percent of the median wage for home health 
153.33 	aide (SOC code 31-1011); 20 percent of the median wage for personal and home health 
154.1 	aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 
154.2 	31-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
154.3 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
154.4 	(14) (15) for respite staff, 50 percent of the median wage for personal and home care 
154.5 	aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, 
154.6 	and attendants (SOC code 31-1012);
154.7 	(15) (16) for personal support staff, 50 percent of the median wage for personal and 
154.8 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
154.9 	orderlies, and attendants (SOC code 31-1012);
154.10 	(16) (17) for supervisory staff, the basic wage is $17.43 per hour with exception of the 
154.11 	supervisor of behavior analyst and behavior specialists, which must be $30.75 per hour;
154.12 	(17) (18) for registered nurse, the basic wage is $30.82 per hour; and
154.13 	(18) (19) for licensed practical nurse, the basic wage is $18.64 per hour.
154.14 	(b) Component values for residential support services are:
154.15 	(1) supervisory span of control ratio: 11 percent;
154.16 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
154.17 	(3) employee-related cost ratio: 23.6 percent;
154.18 	(4) general administrative support ratio: 13.25 percent;
154.19 	(5) program-related expense ratio: 1.3 percent; and
154.20 	(6) absence and utilization factor ratio: 3.9 percent.
154.21 	(c) Component values for family foster care are:
154.22 	(1) supervisory span of control ratio: 11 percent;
154.23 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
154.24 	(3) employee-related cost ratio: 23.6 percent;
154.25 	(4) general administrative support ratio: 3.3 percent;
154.26 	(5) program-related expense ratio: 1.3 percent; and
154.27 	(6) absence factor: 1.7 percent.
154.28 	(d) Component values for day services for all services are:
154.29 	(1) supervisory span of control ratio: 11 percent;
155.1 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
155.2 	(3) employee-related cost ratio: 23.6 percent;
155.3 	(4) program plan support ratio: 5.6 percent;
155.4 	(5) client programming and support ratio: ten percent;
155.5 	(6) general administrative support ratio: 13.25 percent;
155.6 	(7) program-related expense ratio: 1.8 percent; and
155.7 	(8) absence and utilization factor ratio: 3.9 percent.
155.8 	(e) Component values for unit-based services with programming are:
155.9 	(1) supervisory span of control ratio: 11 percent;
155.10 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
155.11 	(3) employee-related cost ratio: 23.6 percent;
155.12 	(4) program plan supports ratio: 3.1 percent;
155.13 	(5) client programming and supports ratio: 8.6 percent;
155.14 	(6) general administrative support ratio: 13.25 percent;
155.15 	(7) program-related expense ratio: 6.1 percent; and
155.16 	(8) absence and utilization factor ratio: 3.9 percent.
155.17 	(f) Component values for unit-based services without programming except respite are:
155.18 	(1) supervisory span of control ratio: 11 percent;
155.19 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
155.20 	(3) employee-related cost ratio: 23.6 percent;
155.21 	(4) program plan support ratio: 3.1 percent;
155.22 	(5) client programming and support ratio: 8.6 percent;
155.23 	(6) general administrative support ratio: 13.25 percent;
155.24 	(7) program-related expense ratio: 6.1 percent; and
155.25 	(8) absence and utilization factor ratio: 3.9 percent.
155.26 	(g) Component values for unit-based services without programming for respite are:
155.27 	(1) supervisory span of control ratio: 11 percent;
156.1 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
156.2 	(3) employee-related cost ratio: 23.6 percent;
156.3 	(4) general administrative support ratio: 13.25 percent;
156.4 	(5) program-related expense ratio: 6.1 percent; and
156.5 	(6) absence and utilization factor ratio: 3.9 percent.
156.6 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
156.7 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
156.8 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
156.9 	values and load them into the rate management system. This adjustment occurs every five 
156.10 	years. For adjustments in 2021 and beyond, the commissioner shall use the data available 
156.11 	on December 31 of the calendar year five years prior.
156.12 	(i) On July 1, 2017, the commissioner shall update the framework components in 
156.13 	paragraphs (b) to (g); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (16) and 
156.14 	(17), for changes in the Consumer Price Index. The commissioner will adjust these values 
156.15 	higher or lower by the percentage change in the Consumer Price Index-All Items, United 
156.16 	States city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner 
156.17 	shall publish these updated values and load them into the rate management system. This 
156.18 	adjustment occurs every five years. For adjustments in 2021 and beyond, the commissioner 
156.19 	shall use the data available on January 1 of the calendar year four years prior and January 
156.20 	1 of the current calendar year.

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

156.22 	Sec. 22. Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:
156.23 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
156.24 	services with programming, including behavior programming, housing access coordination, 
156.25 	in-home family support, independent living skills training, individualized home supports,
156.26 	hourly supported living services, and supported employment provided to an individual 
156.27 	outside of any day or residential service plan must be calculated as follows, unless the 
156.28 	services are authorized separately under subdivision 6 or 7:
156.29 	(1) determine the number of units of service to meet a recipient's needs;
156.30 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
156.31 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
156.32 	5;
157.1 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
157.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
157.3 	to the result of clause (2). This is defined as the customized direct-care rate;
157.4 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
157.5 	5, paragraph (a), or the customized direct-care rate;
157.6 	(5) multiply the number of direct staff hours by the product of the supervision span of 
157.7 	control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision 
157.8 	wage in subdivision 5, paragraph (a), clause (16);
157.9 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
157.10 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause 
157.11 	(2). This is defined as the direct staffing rate;
157.12 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
157.13 	plan supports ratio in subdivision 5, paragraph (e), clause (4);
157.14 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
157.15 	employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
157.16 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
157.17 	the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
157.18 	(10) this is the subtotal rate;
157.19 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
157.20 	and the absence and utilization factor ratio;
157.21 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
157.22 	total payment amount;
157.23 	(13) for supported employment provided in a shared manner, divide the total payment 
157.24 	amount in clause (12) by the number of service recipients, not to exceed three. For 
157.25 	independent living skills training and individualized home supports provided in a shared 
157.26 	manner, divide the total payment amount in clause (12) by the number of service recipients, 
157.27 	not to exceed two; and
157.28 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
157.29 	to adjust for regional differences in the cost of providing services.

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

158.1 	Sec. 23. Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:
158.2 		Subd. 16.Budget neutrality adjustments. (a) The commissioner shall use the following 
158.3 	adjustments to the rate generated by the framework to assure budget neutrality until the rate 
158.4 	information is available to implement paragraph (b). The rate generated by the framework 
158.5 	shall be multiplied by the appropriate factor, as designated below:
158.6 	(1) for residential services: 1.003;
158.7 	(2) for day services: 1.000;
158.8 	(3) for unit-based services with programming: 0.941; and
158.9 	(4) for unit-based services without programming: 0.796.
158.10 	(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated 
158.11 	spending for all home and community-based waiver services under the new payment rates 
158.12 	defined in subdivisions 6 to 9 with estimated spending for the same recipients and services 
158.13 	under the rates in effect on July 1, 2013. This comparison must distinguish spending under 
158.14 	each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and 
158.15 	services for one or more service months after the new rates have gone into effect. The 
158.16 	commissioner shall consult with the commissioner of management and budget on this 
158.17 	analysis to ensure budget neutrality. If estimated spending under the new rates for services 
158.18 	under one or more subdivisions differs in this comparison by 0.3 percent or more, the 
158.19 	commissioner shall assure aggregate budget neutrality across all service areas by adjusting 
158.20 	the budget neutrality factor in paragraph (a) in each subdivision so that total estimated 
158.21 	spending for each subdivision under the new rates matches estimated spending under the 
158.22 	rates in effect on July 1, 2013.
158.23 	(c) A service rate developed using values in subdivision 5, paragraph (a), clause (11), 
158.24 	is not subject to budget neutrality adjustments.

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

158.26 	Sec. 24. Minnesota Statutes 2016, section 256B.85, subdivision 12b, is amended to read:
158.27 		Subd. 12b.CFSS agency-provider requirements; notice regarding termination of 
158.28 	services. (a) An agency-provider must provide written notice when it intends to terminate 
158.29 	services with a participant at least ten 30 calendar days before the proposed service 
158.30 	termination is to become effective, except in cases where:
158.31 	(1) the participant engages in conduct that significantly alters the terms of the CFSS 
158.32 	service delivery plan with the agency-provider;
159.1 	(2) the participant or other persons at the setting where services are being provided 
159.2 	engage in conduct that creates an imminent risk of harm to the support worker or other 
159.3 	agency-provider staff; or
159.4 	(3) an emergency or a significant change in the participant's condition occurs within a 
159.5 	24-hour period that results in the participant's service needs exceeding the participant's 
159.6 	identified needs in the current CFSS service delivery plan so that the agency-provider cannot 
159.7 	safely meet the participant's needs.
159.8 	(b) When a participant initiates a request to terminate CFSS services with the 
159.9 	agency-provider, the agency-provider must give the participant a written acknowledgement
159.10 	acknowledgment of the participant's service termination request that includes the date the 
159.11 	request was received by the agency-provider and the requested date of termination.
159.12 	(c) The agency-provider must participate in a coordinated transfer of the participant to 
159.13 	a new agency-provider to ensure continuity of care.

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

159.15 	Sec. 25.  REPEALER.
 159.16 	Minnesota Rules, part 9555.6255, is repealed.

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

159.18 	ARTICLE 6
159.19 	TECHNICAL CORRECTIONS

159.20 	Section 1. Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision 
159.21 	to read:
159.22 		Subd. 11a.Diagnostic assessment. "Diagnostic assessment" has the meaning given in 
159.23 	Minnesota Rules, part 9505.0370, subpart 11, and is delivered according to part 9505.0372, 
159.24 	subpart 1.

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

159.26 	Sec. 2. Minnesota Statutes 2016, section 245.735, subdivision 3, is amended to read:
159.27 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
159.28 	establish a state certification process for a certified community behavioral health clinics 
159.29 	(CCBHCs) clinic (CCBHC) to be eligible for the prospective payment system in paragraph 
159.30 	(f). Entities that choose to be CCBHCs a CCBHC must:
160.1 	(1) comply with the CCBHC criteria published by the United States Department of 
160.2 	Health and Human Services;
160.3 	(2) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
160.4 	including licensed mental health professionals, and staff who are culturally and linguistically 
160.5 	trained to serve the needs of the clinic's patient population;
160.6 	(3) ensure that clinic services are available and accessible to patients of all ages and 
160.7 	genders and that crisis management services are available 24 hours per day;
160.8 	(4) establish fees for clinic services for nonmedical assistance patients using a sliding 
160.9 	fee scale that ensures that services to patients are not denied or limited due to a patient's 
160.10 	inability to pay for services;
160.11 	(5) comply with quality assurance reporting requirements and other reporting 
160.12 	requirements, including any required reporting of encounter data, clinical outcomes data, 
160.13 	and quality data;
160.14 	(6) provide crisis mental health services, withdrawal management services, emergency 
160.15 	crisis intervention services, and stabilization services; screening, assessment, and diagnosis 
160.16 	services, including risk assessments and level of care determinations; patient-centered 
160.17 	treatment planning; outpatient mental health and substance use services; targeted case 
160.18 	management; psychiatric rehabilitation services; peer support and counselor services and 
160.19 	family support services; and intensive community-based mental health services, including 
160.20 	mental health services for members of the armed forces and veterans;
160.21 	(7) provide coordination of care across settings and providers to ensure seamless 
160.22 	transitions for patients across the full spectrum of health services, including acute, chronic, 
160.23 	and behavioral needs. Care coordination may be accomplished through partnerships or 
160.24 	formal contracts with:
160.25 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified 
160.26 	health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or 
160.27 	community-based mental health providers; and
160.28 	(ii) other community services, supports, and providers, including schools, child welfare 
160.29 	agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally 
160.30 	licensed health care and mental health facilities, urban Indian health clinics, Department of 
160.31 	Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, 
160.32 	and hospital outpatient clinics;
160.33 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
161.1 	(9) be certified to provide integrated treatment for co-occurring mental illness and 
161.2 	substance use disorders in adults or children under Minnesota Rules, chapter 9533, effective 
161.3 	July 1, 2017;
161.4 	(10) comply with standards relating to mental health services in Minnesota Rules, parts 
161.5 	9505.0370 to 9505.0372;
161.6 	(11) be licensed to provide chemical dependency treatment under Minnesota Rules, parts 
161.7 	9530.6405 to 9530.6505;
161.8 	(12) be certified to provide children's therapeutic services and supports under section 
161.9 	256B.0943;
161.10 	(13) be certified to provide adult rehabilitative mental health services under section 
161.11 	256B.0623;
161.12 	(14) be enrolled to provide mental health crisis response services under section 
161.13 	256B.0624;
161.14 	(15) be enrolled to provide mental health targeted case management under section 
161.15 	256B.0625, subdivision 20;
161.16 	(16) comply with standards relating to mental health case management in Minnesota 
161.17 	Rules, parts 9520.0900 to 9520.0926; and
161.18 	(17) provide services that comply with the evidence-based practices described in 
161.19 	paragraph (e).
161.20 	(b) If an entity is unable to provide one or more of the services listed in paragraph (a), 
161.21 	clauses (6) to (17), the commissioner may certify the entity as a CCBHC, if the entity has 
161.22 	a current contract with another entity that has the required authority to provide that service 
161.23 	and that meets federal CCBHC criteria as a designated collaborating organization, or, to 
161.24 	the extent allowed by the federal CCBHC criteria, the commissioner may approve a referral 
161.25 	arrangement. The CCBHC must meet federal requirements regarding the type and scope of 
161.26 	services to be provided directly by the CCBHC.
161.27 	(c) Notwithstanding any other law that requires a county contract or other form of county 
161.28 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets 
161.29 	CCBHC requirements may receive the prospective payment under paragraph (f) for those 
161.30 	services without a county contract or county approval. There is no county share when 
161.31 	medical assistance pays the CCBHC prospective payment. As part of the certification process 
161.32 	in paragraph (a), the commissioner shall require a letter of support from the CCBHC's host 
161.33 	county confirming that the CCBHC and the county or counties it serves have an ongoing 
162.1 	relationship to facilitate access and continuity of care, especially for individuals who are 
162.2 	uninsured or who may go on and off medical assistance.
162.3 	(d) When the standards listed in paragraph (a) or other applicable standards conflict or 
162.4 	address similar issues in duplicative or incompatible ways, the commissioner may grant 
162.5 	variances to state requirements if the variances do not conflict with federal requirements. 
162.6 	If standards overlap, the commissioner may substitute all or a part of a licensure or 
162.7 	certification that is substantially the same as another licensure or certification. The 
162.8 	commissioner shall consult with stakeholders, as described in subdivision 4, before granting 
162.9 	variances under this provision.
162.10 	(e) The commissioner shall issue a list of required evidence-based practices to be 
162.11 	delivered by CCBHCs a CCBHC, and may also provide a list of recommended 
162.12 	evidence-based practices. The commissioner may update the list to reflect advances in 
162.13 	outcomes research and medical services for persons living with mental illnesses or substance 
162.14 	use disorders. The commissioner shall take into consideration the adequacy of evidence to 
162.15 	support the efficacy of the practice, the quality of workforce available, and the current 
162.16 	availability of the practice in the state. At least 30 days before issuing the initial list and 
162.17 	any revisions, the commissioner shall provide stakeholders with an opportunity to comment.
162.18 	(f) The commissioner shall establish standards and methodologies for a prospective 
162.19 	payment system for medical assistance payments for services delivered by certified 
162.20 	community behavioral health clinics a CCBHC, in accordance with guidance issued by the 
162.21 	Centers for Medicare and Medicaid Services. During the operation of the demonstration 
162.22 	project, payments shall comply with federal requirements for an enhanced federal medical 
162.23 	assistance percentage. The commissioner may include quality bonus payment in the 
162.24 	prospective payment system based on federal criteria and on a clinic's provision of the 
162.25 	evidence-based practices in paragraph (e). The prospective payment system does not apply 
162.26 	to MinnesotaCare. Implementation of the prospective payment system is effective July 1, 
162.27 	2017, or upon federal approval, whichever is later.
162.28 	(g) The commissioner shall seek federal approval to continue federal financial 
162.29 	participation in payment for CCBHC services after the federal demonstration period ends 
162.30 	for clinics that were certified as CCBHCs a CCBHC during the demonstration period and 
162.31 	that continue to meet the CCBHC certification standards in paragraph (a). Payment for 
162.32 	CCBHC services shall cease effective July 1, 2019, if continued federal financial participation 
162.33 	for the payment of CCBHC services cannot be obtained.
163.1 	(h) The commissioner may certify at least one CCBHC located in an urban area and at 
163.2 	least one CCBHC located in a rural area, as defined by federal criteria. To the extent allowed 
163.3 	by federal law, the commissioner may limit the number of certified clinics so that the 
163.4 	projected claims for certified clinics will not exceed the funds budgeted for this purpose. 
163.5 	The commissioner shall give preference to clinics that:
163.6 	(1) provide a comprehensive range of services and evidence-based practices for all age 
163.7 	groups, with services being fully coordinated and integrated; and
163.8 	(2) enhance the state's ability to meet the federal priorities to be selected as a CCBHC 
163.9 	demonstration state.
163.10 	(i) The commissioner shall recertify CCBHCs a CCBHC at least every three years. The 
163.11 	commissioner shall establish a process for decertification and shall require corrective action, 
163.12 	medical assistance repayment, or decertification of a CCBHC that no longer meets the 
163.13 	requirements in this section or that fails to meet the standards provided by the commissioner 
163.14 	in the application and certification process.

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

163.16 	Sec. 3. Minnesota Statutes 2016, section 254B.15, subdivision 4, is amended to read:
163.17 		Subd. 4.Legislative update. No later than February 1, 2017, the commissioner shall 
163.18 	present an update on the progress of the proposal to members of the legislative committees 
163.19 	in the house of representatives and senate with jurisdiction over health and human services 
163.20 	policy and finance on the progress of the proposal and shall make recommendations on any 
163.21 	legislative changes and state appropriations necessary to implement the proposal.

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

163.23 	Sec. 4. Minnesota Statutes 2016, section 254B.15, subdivision 5, is amended to read:
163.24 		Subd. 5.Stakeholder input. In developing the proposal, the commissioner shall consult 
163.25 	with consumers, providers, counties, tribes, health plans managed care organizations, and 
163.26 	other stakeholders.

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

163.28 	Sec. 5. Minnesota Statutes 2016, section 256B.055, subdivision 12, is amended to read:
163.29 		Subd. 12.Disabled children. (a) A person is eligible for medical assistance if the person 
163.30 	is under age 19 and qualifies as a disabled individual under United States Code, title 42, 
163.31 	section 1382c(a), and would be eligible for medical assistance under the state plan if residing 
164.1 	in a medical institution, and the child requires a level of care provided in a hospital, nursing 
164.2 	facility, or intermediate care facility for persons with developmental disabilities, for whom 
164.3 	home care is appropriate, provided that the cost to medical assistance under this section is 
164.4 	not more than the amount that medical assistance would pay for if the child resides in an 
164.5 	institution. After the child is determined to be eligible under this section, the commissioner 
164.6 	shall review the child's disability under United States Code, title 42, section 1382c(a) and 
164.7 	level of care defined under this section no more often than annually and may elect, based 
164.8 	on the recommendation of health care professionals under contract with the state medical 
164.9 	review team, to extend the review of disability and level of care up to a maximum of four 
164.10 	years. The commissioner's decision on the frequency of continuing review of disability and 
164.11 	level of care is not subject to administrative appeal under section 256.045. The county 
164.12 	agency shall send a notice of disability review to the enrollee six months prior to the date 
164.13 	the recertification of disability is due. Nothing in this subdivision shall be construed as 
164.14 	affecting other redeterminations of medical assistance eligibility under this chapter and 
164.15 	annual cost-effective reviews under this section.
164.16 	(b) For purposes of this subdivision, "hospital" means an institution as defined in section 
164.17 	144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 4640.3600, and 
164.18 	licensed pursuant to sections 144.50 to 144.58. For purposes of this subdivision, a child 
164.19 	requires a level of care provided in a hospital if the child is determined by the commissioner 
164.20 	to need an extensive array of health services, including mental health services, for an 
164.21 	undetermined period of time, whose health condition requires frequent monitoring and 
164.22 	treatment by a health care professional or by a person supervised by a health care 
164.23 	professional, who would reside in a hospital or require frequent hospitalization if these 
164.24 	services were not provided, and the daily care needs are more complex than a nursing facility 
164.25 	level of care.
164.26 	A child with serious emotional disturbance requires a level of care provided in a hospital 
164.27 	if the commissioner determines that the individual requires 24-hour supervision because 
164.28 	the person exhibits recurrent or frequent suicidal or homicidal ideation or behavior, recurrent 
164.29 	or frequent psychosomatic disorders or somatopsychic disorders that may become life 
164.30 	threatening, recurrent or frequent severe socially unacceptable behavior associated with 
164.31 	psychiatric disorder, ongoing and chronic psychosis or severe, ongoing and chronic 
164.32 	developmental problems requiring continuous skilled observation, or severe disabling 
164.33 	symptoms for which office-centered outpatient treatment is not adequate, and which overall 
164.34 	severely impact the individual's ability to function.
165.1 	(c) For purposes of this subdivision, "nursing facility" means a facility which provides 
165.2 	nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to sections 
165.3 	144A.02 to 144A.10, which is appropriate if a person is in active restorative treatment; is 
165.4 	in need of special treatments provided or supervised by a licensed nurse; or has unpredictable 
165.5 	episodes of active disease processes requiring immediate judgment by a licensed nurse. For 
165.6 	purposes of this subdivision, a child requires the level of care provided in a nursing facility 
165.7 	if the child is determined by the commissioner to meet the requirements of the preadmission 
165.8 	screening assessment document under section 256B.0911, adjusted to address age-appropriate 
165.9 	standards for children age 18 and under.
165.10 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
165.11 	developmental disabilities" or "ICF/DD" means a program licensed to provide services to 
165.12 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
165.13 	physical plant licensed as a supervised living facility under chapter 144, which together are 
165.14 	certified by the Minnesota Department of Health as meeting the standards in Code of Federal 
165.15 	Regulations, title 42, part 483, for an intermediate care facility which provides services for 
165.16 	persons with developmental disabilities who require 24-hour supervision and active treatment 
165.17 	for medical, behavioral, or habilitation needs. For purposes of this subdivision, a child 
165.18 	requires a level of care provided in an ICF/DD if the commissioner finds that the child has 
165.19 	a developmental disability in accordance with section 256B.092, is in need of a 24-hour 
165.20 	plan of care and active treatment similar to persons with developmental disabilities, and 
165.21 	there is a reasonable indication that the child will need ICF/DD services.
165.22 	(e) For purposes of this subdivision, a person requires the level of care provided in a 
165.23 	nursing facility if the person requires 24-hour monitoring or supervision and a plan of mental 
165.24 	health treatment because of specific symptoms or functional impairments associated with 
165.25 	a serious mental illness or disorder diagnosis, which meet severity criteria for mental health 
165.26 	established by the commissioner and published in March 1997 as the Minnesota Mental 
165.27 	Health Level of Care for Children and Adolescents with Severe Emotional Disorders.
165.28 	(f) The determination of the level of care needed by the child shall be made by the 
165.29 	commissioner based on information supplied to the commissioner by the parent or guardian, 
165.30 	the child's physician or physicians, and other professionals as requested by the commissioner. 
165.31 	The commissioner shall establish a screening team to conduct the level of care determinations 
165.32 	according to this subdivision.
165.33 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
165.34 	must assess the case to determine whether:
166.1 	(1) the child qualifies as a disabled individual under United States Code, title 42, section 
166.2 	1382c(a), and would be eligible for medical assistance if residing in a medical institution; 
166.3 	and
166.4 	(2) the cost of medical assistance services for the child, if eligible under this subdivision, 
166.5 	would not be more than the cost to medical assistance if the child resides in a medical 
166.6 	institution to be determined as follows:. The commissioner shall presume that the cost of 
166.7 	medical assistance services for a child who meets the conditions in paragraph (b), (c), (d), 
166.8 	or (e) is not more than the cost to medical assistance if the child resides in a medical 
166.9 	institution.
166.10 	(i) for a child who requires a level of care provided in an ICF/DD, the cost of care for 
166.11 	the child in an institution shall be determined using the average payment rate established 
166.12 	for the regional treatment centers that are certified as ICF's/DD;
166.13 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
166.14 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
166.15 	Rules, part 9505.3520, items F and G; and
166.16 	(iii) for a child who requires a level of care provided in a nursing facility according to 
166.17 	paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota Rules, 
166.18 	part 9505.3040, except that the nursing facility average rate shall be adjusted to reflect rates 
166.19 	which would be paid for children under age 16. The commissioner may authorize an amount 
166.20 	up to the amount medical assistance would pay for a child referred to the commissioner by 
166.21 	the preadmission screening team under section 256B.0911.

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

166.23 	Sec. 6. Minnesota Statutes 2016, section 256B.0622, subdivision 2, is amended to read:
166.24 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
166.25 	meanings given them.
166.26 	(b) "ACT team" means the group of interdisciplinary mental health staff who work as 
166.27 	a team to provide assertive community treatment.
166.28 	(c) "Assertive community treatment" means intensive nonresidential treatment and 
166.29 	rehabilitative mental health services provided according to the assertive community treatment 
166.30 	model. Assertive community treatment provides a single, fixed point of responsibility for 
166.31 	treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per 
166.32 	day, seven days per week, in a community-based setting.
167.1 	(d) "Individual treatment plan" means the document that results from a person-centered 
167.2 	planning process of determining real-life outcomes with clients and developing strategies 
167.3 	to achieve those outcomes.
167.4 	(e) "Assertive engagement" means the use of collaborative strategies to engage clients 
167.5 	to receive services.
167.6 	(f) "Benefits and finance support" means assisting clients in capably managing financial 
167.7 	affairs. Services include, but are not limited to, assisting clients in applying for benefits; 
167.8 	assisting with redetermination of benefits; providing financial crisis management; teaching 
167.9 	and supporting budgeting skills and asset development; and coordinating with a client's 
167.10 	representative payee, if applicable.
167.11 	(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness 
167.12 	and substance use disorders and is characterized by assertive outreach, stage-wise 
167.13 	comprehensive treatment, treatment goal setting, and flexibility to work within each stage 
167.14 	of treatment. Services include, but are not limited to, assessing and tracking clients' stages 
167.15 	of change readiness and treatment; applying the appropriate treatment based on stages of 
167.16 	change, such as outreach and motivational interviewing techniques to work with clients in 
167.17 	earlier stages of change readiness and cognitive behavioral approaches and relapse prevention 
167.18 	to work with clients in later stages of change; and facilitating access to community supports.
167.19 	(h) "Crisis assessment and intervention" means mental health crisis response services 
167.20 	as defined in section 256B.0624, subdivision 2, paragraphs (c) to (e).
167.21 	(i) "Employment services" means assisting clients to work at jobs of their choosing. 
167.22 	Services must follow the principles of the individual placement and support (IPS) 
167.23 	employment model, including focusing on competitive employment; emphasizing individual 
167.24 	client preferences and strengths; ensuring employment services are integrated with mental 
167.25 	health services; conducting rapid job searches and systematic job development according 
167.26 	to client preferences and choices; providing benefits counseling; and offering all services 
167.27 	in an individualized and time-unlimited manner. Services shall also include educating clients 
167.28 	about opportunities and benefits of work and school and assisting the client in learning job 
167.29 	skills, navigating the work place, and managing work relationships.
167.30 	(j) "Family psychoeducation and support" means services provided to the client's family 
167.31 	and other natural supports to restore and strengthen the client's unique social and family 
167.32 	relationships. Services include, but are not limited to, individualized psychoeducation about 
167.33 	the client's illness and the role of the family and other significant people in the therapeutic 
167.34 	process; family intervention to restore contact, resolve conflict, and maintain relationships 
168.1 	with family and other significant people in the client's life; ongoing communication and 
168.2 	collaboration between the ACT team and the family; introduction and referral to family 
168.3 	self-help programs and advocacy organizations that promote recovery and family 
168.4 	engagement, individual supportive counseling, parenting training, and service coordination 
168.5 	to help clients fulfill parenting responsibilities; coordinating services for the child and 
168.6 	restoring relationships with children who are not in the client's custody; and coordinating 
168.7 	with child welfare and family agencies, if applicable. These services must be provided with 
168.8 	the client's agreement and consent.
168.9 	(k) "Housing access support" means assisting clients to find, obtain, retain, and move 
168.10 	to safe and adequate housing of their the client's choice. Housing access support includes, 
168.11 	but is not limited to, locating housing options with a focus on integrated independent settings; 
168.12 	applying for housing subsidies, programs, or resources; assisting the client in developing 
168.13 	relationships with local landlords; providing tenancy support and advocacy for the individual's 
168.14 	tenancy rights at the client's home; and assisting with relocation.
168.15 	(l) "Individual treatment team" means a minimum of three members of the ACT team 
168.16 	who are responsible for consistently carrying out most of a client's assertive community 
168.17 	treatment services.
168.18 	(m) "Intensive residential treatment services treatment team" means all staff who provide 
168.19 	intensive residential treatment services under this section to clients. At a minimum, this 
168.20 	includes the clinical supervisor; mental health professionals as defined in section 245.462, 
168.21 	subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462, 
168.22 	subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 
168.23 	5, clause (4); and mental health certified peer specialists under section 256B.0615.
168.24 	(n) "Intensive residential treatment services" means short-term, time-limited services 
168.25 	provided in a residential setting to clients who are in need of more restrictive settings and 
168.26 	are at risk of significant functional deterioration if they do not receive these services. Services 
168.27 	are designed to develop and enhance psychiatric stability, personal and emotional adjustment, 
168.28 	self-sufficiency, and skills to live in a more independent setting. Services must be directed 
168.29 	toward a targeted discharge date with specified client outcomes.
168.30 	(o) "Medication assistance and support" means assisting clients in accessing medication, 
168.31 	developing the ability to take medications with greater independence, and providing 
168.32 	medication setup. This includes the prescription, administration, and order of medication 
168.33 	by appropriate medical staff.
169.1 	(p) "Medication education" means educating clients on the role and effects of medications 
169.2 	in treating symptoms of mental illness and the side effects of medications.
169.3 	(q) "Overnight staff" means a member of the intensive residential treatment services 
169.4 	team who is responsible during hours when clients are typically asleep.
169.5 	(r) "Mental health certified peer specialist services" has the meaning given in section 
169.6 	256B.0615.
169.7 	(s) "Physical health services" means any service or treatment to meet the physical health 
169.8 	needs of the client to support the client's mental health recovery. Services include, but are 
169.9 	not limited to, education on primary health issues, including wellness education; medication 
169.10 	administration and monitoring; providing and coordinating medical screening and follow-up; 
169.11 	scheduling routine and acute medical and dental care visits; tobacco cessation strategies; 
169.12 	assisting clients in attending appointments; communicating with other providers; and 
169.13 	integrating all physical and mental health treatment.
169.14 	(t) "Primary team member" means the person who leads and coordinates the activities 
169.15 	of the individual treatment team and is the individual treatment team member who has 
169.16 	primary responsibility for establishing and maintaining a therapeutic relationship with the 
169.17 	client on a continuing basis.
169.18 	(u) "Rehabilitative mental health services" means mental health services that are 
169.19 	rehabilitative and enable the client to develop and enhance psychiatric stability, social 
169.20 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
169.21 	community skills, when these abilities are impaired by the symptoms of mental illness.
169.22 	(v) "Symptom management" means supporting clients in identifying and targeting the 
169.23 	symptoms and occurrence patterns of their mental illness and developing strategies to reduce 
169.24 	the impact of those symptoms.
169.25 	(w) "Therapeutic interventions" means empirically supported techniques to address 
169.26 	specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional 
169.27 	dysregulation, and trauma symptoms. Interventions include empirically supported 
169.28 	psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy, 
169.29 	acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.
169.30 	(x) "Wellness self-management and prevention" means a combination of approaches to 
169.31 	working with the client to build and apply skills related to recovery, and to support the client 
169.32 	in participating in leisure and recreational activities, civic participation, and meaningful 
169.33 	structure.

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

170.2 	Sec. 7. Minnesota Statutes 2016, section 256B.0622, subdivision 2b, is amended to read:
170.3 		Subd. 2b.Continuing stay and discharge criteria for assertive community treatment.
 170.4 	(a) A client receiving assertive community treatment is eligible to continue receiving services 
170.5 	if:
170.6 	(1) the client has not achieved the desired outcomes of their the client's individual 
170.7 	treatment plan;
170.8 	(2) the client's level of functioning has not been restored, improved, or sustained over 
170.9 	the time frame outlined in the individual treatment plan;
170.10 	(3) the client continues to be at risk for relapse based on current clinical assessment, 
170.11 	history, or the tenuous nature of the functional gains; or
170.12 	(4) the client is functioning effectively with this service and discharge would otherwise 
170.13 	be indicated but without continued services the client's functioning would decline; and
170.14 	(5) one of the following must also apply:
170.15 	(i) the client has achieved current individual treatment plan goals but additional goals 
170.16 	are indicated as evidenced by documented symptoms;
170.17 	(ii) the client is making satisfactory progress toward meeting goals and there is 
170.18 	documentation that supports that continuation of this service shall be effective in addressing 
170.19 	the goals outlined in the individual treatment plan;
170.20 	(iii) the client is making progress, but the specific interventions in the individual treatment 
170.21 	plan need to be modified so that greater gains, which are consistent with the client's potential 
170.22 	level of functioning, are possible; or
170.23 	(iv) the client fails to make progress or demonstrates regression in meeting goals through 
170.24 	the interventions outlined in the individual treatment plan.
170.25 	(b) Clients receiving assertive community treatment are eligible to be discharged if they 
170.26 	meet at least one of the following criteria:
170.27 	(1) the client and the ACT team determine that assertive community treatment services 
170.28 	are no longer needed based on the attainment of goals as identified in the individual treatment 
170.29 	plan and a less intensive level of care would adequately address current goals;
171.1 	(2) the client moves out of the ACT team's service area and the ACT team has facilitated 
171.2 	the referral to either a new ACT team or other appropriate mental health service and has 
171.3 	assisted the individual in the transition process;
171.4 	(3) the client, or the client's legal guardian when applicable, chooses to withdraw from 
171.5 	assertive community treatment services and documented attempts by the ACT team to 
171.6 	re-engage the client with the service have not been successful;
171.7 	(4) the client has a demonstrated need for a medical nursing home placement lasting 
171.8 	more than three months, as determined by a physician;
171.9 	(5) the client is hospitalized, in residential treatment, or in jail for a period of greater 
171.10 	than three months. However, the ACT team must make provisions for the client to return 
171.11 	to the ACT team upon their discharge or release from the hospital or jail if the client still 
171.12 	meets eligibility criteria for assertive community treatment and the team is not at full capacity;
171.13 	(6) the ACT team is unable to locate, contact, and engage the client for a period of greater 
171.14 	than three months after persistent efforts by the ACT team to locate the client; or
171.15 	(7) the client requests a discharge, despite repeated and proactive efforts by the ACT 
171.16 	team to engage the client in service planning. The ACT team must develop a transition plan 
171.17 	to arrange for alternate treatment for clients in this situation who have a history of suicide 
171.18 	attempts, assault, or forensic involvement.
171.19 	(c) For all clients who are discharged from assertive community treatment to another 
171.20 	service provider within the ACT team's service area there is a three-month transfer period, 
171.21 	from the date of discharge, during which a client who does not adjust well to the new service, 
171.22 	may voluntarily return to the ACT team. During this period, the ACT team must maintain 
171.23 	contact with the client's new service provider.

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

171.25 	Sec. 8. Minnesota Statutes 2016, section 256B.0622, subdivision 7a, is amended to read:
171.26 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
171.27 	The required treatment staff qualifications and roles for an ACT team are:
171.28 	(1) the team leader:
171.29 	(i) shall be a licensed mental health professional who is qualified under Minnesota Rules, 
171.30 	part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible 
171.31 	for licensure and are otherwise qualified may also fulfill this role but must obtain full 
171.32 	licensure within 24 months of assuming the role of team leader;
172.1 	(ii) must be an active member of the ACT team and provide some direct services to 
172.2 	clients;
172.3 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
172.4 	responsible for overseeing the administrative operations of the team, providing clinical 
172.5 	oversight of services in conjunction with the psychiatrist or psychiatric care provider, and 
172.6 	supervising team members to ensure delivery of best and ethical practices; and
172.7 	(iv) must be available to provide overall clinical oversight to the ACT team after regular 
172.8 	business hours and on weekends and holidays. The team leader may delegate this duty to 
172.9 	another qualified member of the ACT team;
172.10 	(2) the psychiatric care provider:
172.11 	(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and 
172.12 	Neurology or eligible for board certification or certified by the American Osteopathic Board 
172.13 	of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who 
172.14 	is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A. The psychiatric care 
172.15 	provider must have demonstrated clinical experience working with individuals with serious 
172.16 	and persistent mental illness;
172.17 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
172.18 	screening and admitting clients; monitoring clients' treatment and team member service 
172.19 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
172.20 	and health-related conditions; actively collaborating with nurses; and helping provide clinical 
172.21 	supervision to the team;
172.22 	(iii) shall fulfill the following functions for assertive community treatment clients: 
172.23 	provide assessment and treatment of clients' symptoms and response to medications, including 
172.24 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
172.25 	to clients, with medication decisions based on shared decision making; monitor clients' 
172.26 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
172.27 	community visits;
172.28 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
172.29 	for mental health treatment and shall communicate directly with the client's inpatient 
172.30 	psychiatric care providers to ensure continuity of care;
172.31 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
172.32 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
172.33 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
173.1 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
173.2 	may share this role;
173.3 	(vi) may not provide specific roles and responsibilities by telemedicine unless approved 
173.4 	by the commissioner; and
173.5 	(vii) shall provide psychiatric backup to the program after regular business hours and 
173.6 	on weekends and holidays. The psychiatric care provider may delegate this duty to another 
173.7 	qualified psychiatric provider;
173.8 	(3) the nursing staff:
173.9 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
173.10 	of whom at least one has a minimum of one-year experience working with adults with 
173.11 	serious mental illness and a working knowledge of psychiatric medications. No more than 
173.12 	two individuals can share a full-time equivalent position;
173.13 	(ii) are responsible for managing medication, administering and documenting medication 
173.14 	treatment, and managing a secure medication room; and
173.15 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
173.16 	as prescribed; screen and monitor clients' mental and physical health conditions and 
173.17 	medication side effects; engage in health promotion, prevention, and education activities; 
173.18 	communicate and coordinate services with other medical providers; facilitate the development 
173.19 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
173.20 	psychiatric and physical health symptoms and medication side effects;
173.21 	(4) the co-occurring disorder specialist:
173.22 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
173.23 	specific training on co-occurring disorders that is consistent with national evidence-based 
173.24 	practices. The training must include practical knowledge of common substances and how 
173.25 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
173.26 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
173.27 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
173.28 	may also be an individual who is a licensed alcohol and drug counselor as described in 
173.29 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
173.30 	and other requirements in Minnesota Rules, part 9530.6450, subpart 5. No more than two 
173.31 	co-occurring disorder specialists may occupy this role; and
174.1 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
174.2 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
174.3 	team members on co-occurring disorders;
174.4 	(5) the vocational specialist:
174.5 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
174.6 	employment services or advanced education that involved field training in vocational services 
174.7 	to individuals with mental illness. An individual who does not meet these qualifications 
174.8 	may also serve as the vocational specialist upon completing a training plan approved by the 
174.9 	commissioner;
174.10 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
174.11 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
174.12 	and
174.13 	(iii) should not refer individuals to receive any type of vocational services or linkage by 
174.14 	providers outside of the ACT team;
174.15 	(6) the mental health certified peer specialist:
174.16 	(i) shall be a full-time equivalent mental health certified peer specialist as defined in 
174.17 	section 256B.0615. No more than two individuals can share this position. The mental health 
174.18 	certified peer specialist is a fully integrated team member who provides highly individualized 
174.19 	services in the community and promotes the self-determination and shared decision-making 
174.20 	abilities of clients. This requirement may be waived due to workforce shortages upon 
174.21 	approval of the commissioner;
174.22 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
174.23 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
174.24 	in developing advance directives; and
174.25 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
174.26 	wellness and resilience, provide consultation to team members, promote a culture where 
174.27 	the clients' points of view and preferences are recognized, understood, respected, and 
174.28 	integrated into treatment, and serve in a manner equivalent to other team members;
174.29 	(7) the program administrative assistant shall be a full-time office-based program 
174.30 	administrative assistant position assigned to solely work with the ACT team, providing a 
174.31 	range of supports to the team, clients, and families; and
174.32 	(8) additional staff:
175.1 	(i) shall be based on team size. Additional treatment team staff may include licensed 
175.2 	mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item 
175.3 	A; mental health practitioners as defined in Minnesota Rules, part 9505.0370, subpart 17; 
175.4 	or mental health rehabilitation workers as defined in section 256B.0623, subdivision 5, 
175.5 	clause (4). These individuals shall have the knowledge, skills, and abilities required by the 
175.6 	population served to carry out rehabilitation and support functions; and
175.7 	(ii) shall be selected based on specific program needs or the population served.
175.8 	(b) Each ACT team must clearly document schedules for all ACT team members.
175.9 	(c) Each ACT team member must serve as a primary team member for clients assigned 
175.10 	by the team leader and are responsible for facilitating the individual treatment plan process 
175.11 	for those clients. The primary team member for a client is the responsible team member 
175.12 	knowledgeable about the client's life and circumstances and writes the individual treatment 
175.13 	plan. The primary team member provides individual supportive therapy or counseling, and 
175.14 	provides primary support and education to the client's family and support system.
175.15 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
175.16 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
175.17 	member shall be proficient in their the staff member's respective discipline and be able to 
175.18 	work collaboratively as a member of a multidisciplinary team to deliver the majority of the 
175.19 	treatment, rehabilitation, and support services clients require to fully benefit from receiving 
175.20 	assertive community treatment.
175.21 	(e) Each ACT team member must fulfill training requirements established by the 
175.22 	commissioner.

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

175.24 	Sec. 9. Minnesota Statutes 2016, section 256B.0625, subdivision 60a, is amended to read:
175.25 		Subd. 60a.Community emergency medical technician services. (a) Medical assistance 
175.26 	covers services provided by a community emergency medical technician community medical 
175.27 	response emergency medical technician (CEMT) who is certified under section 144E.275, 
175.28 	subdivision 7, when the services are provided in accordance with this subdivision.
175.29 	(b) A CEMT may provide a posthospital discharge visit when ordered by a treating 
175.30 	physician. The posthospital discharge visit includes:
175.31 	(1) verbal or visual reminders of discharge orders;
175.32 	(2) recording and reporting of vital signs to the patient's primary care provider;
176.1 	(3) medication access confirmation;
176.2 	(4) food access confirmation; and
176.3 	(5) identification of home hazards.
176.4 	(c) An individual who has repeat ambulance calls due to falls, has been discharged from 
176.5 	a nursing home, or has been identified by the individual's primary care provider as at risk 
176.6 	for nursing home placement, may receive a safety evaluation visit from a CEMT when 
176.7 	ordered by a primary care provider in accordance with the individual's care plan. A safety 
176.8 	evaluation visit includes:
176.9 	(1) medication access confirmation;
176.10 	(2) food access confirmation; and
176.11 	(3) identification of home hazards.
176.12 	(d) A CEMT shall be paid at $9.75 per 15-minute increment. A safety evaluation visit 
176.13 	may not be billed for the same day as a posthospital discharge visit for the same individual.

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

176.15 	Sec. 10. Minnesota Statutes 2016, section 256P.08, subdivision 4, is amended to read:
176.16 		Subd. 4.Recovering general assistance and Minnesota supplemental aid 
176.17 	overpayments. (a) If an amount of assistance is paid to an assistance unit in excess of the 
176.18 	payment due, it shall be recoverable by the agency. The agency shall give written notice to 
176.19 	the participant of its intention to recover the overpayment.
176.20 	(b) If the individual is no longer receiving assistance, the agency may request voluntary 
176.21 	repayment or pursue civil recovery.
176.22 	(c) If the individual is receiving assistance, except as provided for interim assistance in 
176.23 	section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover the 
176.24 	overpayment by withholding an amount equal to:
176.25 	(1) three percent of the assistance unit's standard of need for all Minnesota supplemental 
176.26 	aid assistance units, and nonfraud cases for general assistance; and or
176.27 	(2) ten percent where fraud has occurred in general assistance cases; or
176.28 	(3) the amount of the monthly general assistance or Minnesota supplemental aid payment, 
176.29 	whichever is less.
177.1 	(d) In cases when there is both an overpayment and underpayment, the county agency 
177.2 	shall offset one against the other in correcting the payment.
177.3 	(e) Overpayments may also be voluntarily repaid, in part or in full, by the individual, in 
177.4 	addition to the assistance reductions provided in this subdivision, to include further voluntary 
177.5 	reductions in the grant level agreed to in writing by the individual, until the total amount 
177.6 	of the overpayment is repaid.
177.7 	(f) The county agency shall make reasonable efforts to recover overpayments to 
177.8 	individuals no longer on assistance. The agency need not attempt to recover overpayments 
177.9 	of less than $35 paid to an individual no longer on assistance if the individual does not 
177.10 	receive assistance again within three years, unless the individual has been convicted of 
177.11 	violating section 256.98.
177.12 	(g) Establishment of an overpayment is limited to 12 months prior to the month of 
177.13 	discovery due to agency error and six years prior to the month of discovery due to client 
177.14 	error or an intentional program violation determined under section 256.046.
177.15 	(h) Residents of licensed residential facilities shall not have overpayments recovered 
177.16 	from their personal needs allowance.
177.17 	(i) Overpayments by another maintenance benefit program shall not be recovered from 
177.18 	the general assistance or Minnesota supplemental aid grant.

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

177.20 	Sec. 11. Minnesota Statutes 2016, section 626.5572, subdivision 21, is amended to read:
177.21 		Subd. 21.Vulnerable adult. (a) "Vulnerable adult" means any person 18 years of age 
177.22 	or older who:
177.23 	(1) is a resident or inpatient of a facility;
177.24 	(2) receives services required to be licensed under chapter 245A, except that a person 
177.25 	receiving outpatient services for treatment of chemical dependency or mental illness, or one 
177.26 	who is served in the Minnesota sex offender program on a court-hold order for commitment, 
177.27 	or is committed as a sexual psychopathic personality or as a sexually dangerous person 
177.28 	under chapter 253B, is not considered a vulnerable adult unless the person meets the 
177.29 	requirements of clause (4);
177.30 	(3) receives services from a home care provider required to be licensed under sections 
177.31 	144A.43 to 144A.482 section 144A.471; or from a person or organization that offers, 
177.32 	provides, or arranges for personal care assistance services under the medical assistance 
178.1 	program as authorized under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653, 
178.2 	256B.0654, 256B.0659, or 256B.85; or
178.3 	(4) regardless of residence or whether any type of service is received, possesses a physical 
178.4 	or mental infirmity or other physical, mental, or emotional dysfunction:
178.5 	(i) that impairs the individual's ability to provide adequately for the individual's own 
178.6 	care without assistance, including the provision of food, shelter, clothing, health care, or 
178.7 	supervision; and
178.8 	(ii) because of the dysfunction or infirmity and the need for care or services, the individual 
178.9 	has an impaired ability to protect the individual's self from maltreatment.
178.10 	(b) For purposes of this subdivision, "care or services" means care or services for the 
178.11 	health, safety, welfare, or maintenance of an individual.

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

178.13 	Sec. 12. REVISOR'S INSTRUCTION.
 178.14 	In each section of Minnesota Statutes referred to in column A, the revisor of statutes 
178.15 	shall delete the reference in column B and insert the reference in column C. The revisor 
178.16 	shall make changes necessary to correct the punctuation, grammar, or structure of the 
178.17 	remaining text and preserve its meaning.

178.18	Column A
	Column B
	Column C
	
178.19178.20178.21
178.22	144.651, subd. 20, 29
	Older Americans Act, section 
307(a)(12)
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, section 
3027(a)(12) (2016)
	
178.23178.24
178.25
178.26	256.01, subd. 2, 24
	United States Code, title 42, 
section 3001, the Older 
Americans Act Amendments 
of 2006
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 3001 
- 3058ff (2016)
	
178.27178.28
178.29
178.30178.31	256.974
	Older Americans Act, as 
amended, United States Code, 
title 42, section 3027(a)(9) and 
3058g(a)
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 
3027(a)(9) and 3058g(a) 
(2016)
	
178.32178.33178.34
178.35
178.36	256.974
	Code of Federal Regulations, 
title 45, parts 1321 and 1327
	Code of Federal Regulations, 
title 45, parts 1321 (2015) and 
1324 (Federal Register, 
volume 81, page 35644 
(2016))
	
178.37178.38
178.39178.40	256.9744, subd. 1
	Older Americans Act, as 
amended, United States Code, 
title 42, section 3058g(d)
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, section 
3058g(d) (2016)
	
179.1179.2179.3
179.4	256.975, subd. 2
	Older Americans Act of 1965, 
as amended
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 3001 
- 3058ff (2016)
	
179.5179.6
179.7
179.8	256.975, subd. 7
	United States Code, title 42, 
section 3001, the Older 
Americans Act Amendments 
of 2006
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 3001 
- 3058ff (2016)
	
179.9179.10
179.11
179.12
	256.977, subd. 3
	Older Americans Act
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 3001 
- 3058ff (2016)
	
179.13179.14179.15
179.16	256B.0917, subd. 1c
	title III of the Older Americans 
Act
	Older Americans Act of 1965, 
as amended, United States 
Code, title 42, sections 3021 
- 3030s-2 (2016)

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

179.18 	Sec. 13.  REPEALER.
 179.19 	(a) Minnesota Statutes 2016, section 119B.125, subdivision 8, is repealed.
179.20 	(b) Minnesota Rules, parts 9555.7100; 9555.7200; 9555.7300; and 9555.7600, are 
179.21 	repealed.

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

APPENDIX 

Repealed Minnesota Statutes: HF1245-1 

119B.125 PROVIDER REQUIREMENTS.Subd. 8.Overpayment claim for failure to comply with access to records requirement. 
(a) In establishing an overpayment claim under subdivision 6 for failure to provide access to attendance records, the county or commissioner is limited to the six years prior to the date the county or the commissioner requested the attendance records. 

(b) When the commissioner or county establishes an overpayment claim against a current or former provider, the commissioner or county must provide notice of the claim to the provider. A notice of overpayment claim must specify the reason for the overpayment, the authority for making the overpayment claim, the time period in which the overpayment occurred, the amount of the overpayment, and the provider's right to appeal. 

(c) The commissioner or county may seek to recover overpayments paid to a current or former provider. When a provider has been convicted of fraud under section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent billing for a program administered by the commissioner or a county, recovery may be sought regardless of the amount of overpayment. 

245.469 EMERGENCY SERVICES.Subdivision 1.Availability of emergency services. 
By July 1, 1988, county boards must provide or contract for enough emergency services within the county to meet the needs of adults in the county who are experiencing an emotional crisis or mental illness. Clients may be required to pay a fee according to section 245.481. Emergency services must include assessment, crisis intervention, and appropriate case disposition. Emergency services must: 

(1) promote the safety and emotional stability of adults with mental illness or emotional crises; 

(2) minimize further deterioration of adults with mental illness or emotional crises; 

(3) help adults with mental illness or emotional crises to obtain ongoing care and treatment; and 

(4) prevent placement in settings that are more intensive, costly, or restrictive than necessary and appropriate to meet client needs. 

Subd. 2.Specific requirements. 
(a) The county board shall require that all service providers of emergency services to adults with mental illness provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll-free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional. 

(b) The commissioner may waive the requirement in paragraph (a) that the evening, weekend, and holiday service be provided by a mental health professional or mental health practitioner after January 1, 1991, if the county documents that: 

(1) mental health professionals or mental health practitioners are unavailable to provide this service; 

(2) services are provided by a designated person with training in human services who receives clinical supervision from a mental health professional; and 

(3) the service provider is not also the provider of fire and public safety emergency services. 

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the evening, weekend, and holiday service not be provided by the provider of fire and public safety emergency services if: 

(1) every person who will be providing the first telephone contact has received at least eight hours of training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(2) every person who will be providing the first telephone contact will annually receive at least four hours of continued training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(3) the local social service agency has provided public education about available emergency mental health services and can assure potential users of emergency services that their calls will be handled appropriately; 

(4) the local social service agency agrees to provide the commissioner with accurate data on the number of emergency mental health service calls received; 

(5) the local social service agency agrees to monitor the frequency and quality of emergency services; and 

(6) the local social service agency describes how it will comply with paragraph (d). 

(d) Whenever emergency service during nonbusiness hours is provided by anyone other than a mental health professional, a mental health professional must be available on call for an emergency assessment and crisis intervention services, and must be available for at least telephone consultation within 30 minutes. 

Subd. 3.Mental health crisis services. 
The commissioner of human services shall increase access to mental health crisis services for children and adults. In order to increase access, the commissioner must: 

(1) develop a central phone number where calls can be routed to the appropriate crisis services; 

(2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving people with traumatic brain injury or intellectual disabilities who are experiencing a mental health crisis; 

(3) expand crisis services across the state, including rural areas of the state and examining access per population; 

(4) establish and implement state standards for crisis services; and 

(5) provide grants to adult mental health initiatives, counties, tribes, or community mental health providers to establish new mental health crisis residential service capacity. 

Priority will be given to regions that do not have a mental health crisis residential services program, do not have an inpatient psychiatric unit within the region, do not have an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis residential or intensive residential treatment beds available to meet the needs of the residents in the region. At least 50 percent of the funds must be distributed to programs in rural Minnesota. Grant funds may be used for start-up costs, including but not limited to renovations, furnishings, and staff training. Grant applications shall provide details on how the intended service will address identified needs and shall demonstrate collaboration with crisis teams, other mental health providers, hospitals, and police. 

245.4879 EMERGENCY SERVICES.Subdivision 1.Availability of emergency services. 
County boards must provide or contract for enough mental health emergency services within the county to meet the needs of children, and children's families when clinically appropriate, in the county who are experiencing an emotional crisis or emotional disturbance. The county board shall ensure that parents, providers, and county residents are informed about when and how to access emergency mental health services for children. A child or the child's parent may be required to pay a fee according to section 245.481. Emergency service providers shall not delay the timely provision of emergency service because of delays in determining this fee or because of the unwillingness or inability of the parent to pay the fee. Emergency services must include assessment, crisis intervention, and appropriate case disposition. Emergency services must: 

(1) promote the safety and emotional stability of children with emotional disturbances or emotional crises; 

(2) minimize further deterioration of the child with emotional disturbance or emotional crisis; 

(3) help each child with an emotional disturbance or emotional crisis to obtain ongoing care and treatment; and 

(4) prevent placement in settings that are more intensive, costly, or restrictive than necessary and appropriate to meet the child's needs. 

Subd. 2.Specific requirements. 
(a) The county board shall require that all service providers of emergency services to the child with an emotional disturbance provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll-free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional. 

(b) The commissioner may waive the requirement in paragraph (a) that the evening, weekend, and holiday service be provided by a mental health professional or mental health practitioner after January 1, 1991, if the county documents that: 

(1) mental health professionals or mental health practitioners are unavailable to provide this service; 

(2) services are provided by a designated person with training in human services who receives clinical supervision from a mental health professional; and 

(3) the service provider is not also the provider of fire and public safety emergency services. 

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the evening, weekend, and holiday service not be provided by the provider of fire and public safety emergency services if: 

(1) every person who will be providing the first telephone contact has received at least eight hours of training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(2) every person who will be providing the first telephone contact will annually receive at least four hours of continued training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(3) the local social service agency has provided public education about available emergency mental health services and can assure potential users of emergency services that their calls will be handled appropriately; 

(4) the local social service agency agrees to provide the commissioner with accurate data on the number of emergency mental health service calls received; 

(5) the local social service agency agrees to monitor the frequency and quality of emergency services; and 

(6) the local social service agency describes how it will comply with paragraph (d). 

(d) When emergency service during nonbusiness hours is provided by anyone other than a mental health professional, a mental health professional must be available on call for an emergency assessment and crisis intervention services, and must be available for at least telephone consultation within 30 minutes. 

256B.0624 ADULT CRISIS RESPONSE SERVICES COVERED.Subd. 4a.Alternative provider standards. 
If a county demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services according to the standards in subdivision 4, paragraph (b), clause (9), the commissioner may approve a crisis response provider based on an alternative plan proposed by a county or group of counties. The alternative plan must: 

(1) result in increased access and a reduction in disparities in the availability of crisis services; 

(2) provide mobile services outside of the usual nine-to-five office hours and on weekends and holidays; and 

(3) comply with standards for emergency mental health services in section 245.469. 

Subd. 5.Mobile crisis intervention staff qualifications. 
For provision of adult mental health mobile crisis intervention services, a mobile crisis intervention team is comprised of at least two mental health professionals as defined in section 245.462, subdivision 18, clauses (1) to (6), or a combination of at least one mental health professional and one mental health practitioner as defined in section 245.462, subdivision 17, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, treatment engagement strategies, working with families, and clinical decision-making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources such as the county social services agency, mental health services, and local law enforcement when necessary. 

Subd. 6.Crisis assessment and mobile intervention treatment planning. 
(a) Prior to initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.462, subdivision 6, and 245.469, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify parties involved, and determine an appropriate response. 

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment evaluates any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, current functioning, and the recipient's preferences as communicated directly by the recipient, or as communicated in a health care directive as described in chapters 145C and 253B, the treatment plan described under paragraph (d), a crisis prevention plan, or a wellness recovery action plan. 

(c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As opportunity presents during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required in subdivision 9. 

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The treatment plan must be updated as needed to reflect current goals and services. 

(e) The team must document which short-term goals have been met and when no further crisis intervention services are required. 

(f) If the recipient's crisis is stabilized, but the recipient needs a referral to other services, the team must provide referrals to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. If the recipient is unable to follow up on the referral, the team must link the recipient to the service and follow up to ensure the recipient is receiving the service. 

(g) If the recipient's crisis is stabilized and the recipient does not have an advance directive, the case manager or crisis team shall offer to work with the recipient to develop one. 

Subd. 7.Crisis stabilization services. 
(a) Crisis stabilization services must be provided by qualified staff of a crisis stabilization services provider entity and must meet the following standards: 

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 11; 

(2) staff must be qualified as defined in subdivision 8; and 

(3) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating of the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community. 

(b) If crisis stabilization services are provided in a supervised, licensed residential setting, the recipient must be contacted face-to-face daily by a qualified mental health practitioner or mental health professional. The program must have 24-hour-a-day residential staffing which may include staff who do not meet the qualifications in subdivision 8. The residential staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental health professional or practitioner. 

(c) If crisis stabilization services are provided in a supervised, licensed residential setting that serves no more than four adult residents, and one or more individuals are present at the setting to receive residential crisis stabilization services, the residential staff must include, for at least eight hours per day, at least one individual who meets the qualifications in subdivision 8, paragraph (a), clause (1) or (2). 

(d) If crisis stabilization services are provided in a supervised, licensed residential setting that serves more than four adult residents, and one or more are recipients of crisis stabilization services, the residential staff must include, for 24 hours a day, at least one individual who meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the residential program, the residential program must have at least two staff working 24 hours a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as specified in the crisis stabilization treatment plan. 

Subd. 8.Adult crisis stabilization staff qualifications. 
(a) Adult mental health crisis stabilization services must be provided by qualified individual staff of a qualified provider entity. Individual provider staff must have the following qualifications: 

(1) be a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6); 

(2) be a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional; 

(3) be a certified peer specialist under section 256B.0615. The certified peer specialist must work under the clinical supervision of a mental health professional; or 

(4) be a mental health rehabilitation worker who meets the criteria in section 256B.0623, subdivision 5, clause (4); works under the direction of a mental health practitioner as defined in section 245.462, subdivision 17, or under direction of a mental health professional; and works under the clinical supervision of a mental health professional. 

(b) Mental health practitioners and mental health rehabilitation workers must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years. 

Subd. 9.Supervision. 
Mental health practitioners may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met: 

(1) the mental health provider entity must accept full responsibility for the services provided; 

(2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by phone or in person for clinical supervision; 

(3) the mental health professional is consulted, in person or by phone, during the first three hours when a mental health practitioner provides on-site service; 

(4) the mental health professional must: 

(i) review and approve of the tentative crisis assessment and crisis treatment plan; 

(ii) document the consultation; and 

(iii) sign the crisis assessment and treatment plan within the next business day; 

(5) if the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the recipient face-to-face on the second day to provide services and update the crisis treatment plan; and 

(6) the on-site observation must be documented in the recipient's record and signed by the mental health professional. 

Subd. 10.Recipient file. 
Providers of mobile crisis intervention or crisis stabilization services must maintain a file for each recipient containing the following information: 

(1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient as to why the recipient would not sign the plan; 

(2) signed release forms; 

(3) recipient health information and current medications; 

(4) emergency contacts for the recipient; 

(5) case records which document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented; 

(6) required clinical supervision by mental health professionals; 

(7) summary of the recipient's case reviews by staff; 

(8) any written information by the recipient that the recipient wants in the file; and 

(9) an advance directive, if there is one available. 

Documentation in the file must comply with all requirements of the commissioner. 

Subd. 11.Treatment plan. 
The individual crisis stabilization treatment plan must include, at a minimum: 

(1) a list of problems identified in the assessment; 

(2) a list of the recipient's strengths and resources; 

(3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement; 

(4) specific objectives directed toward the achievement of each one of the goals; 

(5) documentation of the participants involved in the service planning. The recipient, if possible, must be a participant. The recipient or the recipient's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the recipient and the recipient's legal guardian. The plan should include services arranged, including specific providers where applicable; 

(6) planned frequency and type of services initiated; 

(7) a crisis response action plan if a crisis should occur; 

(8) clear progress notes on outcome of goals; 

(9) a written plan must be completed within 24 hours of beginning services with the recipient; and 

(10) a treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. The mental health professional must approve and sign all treatment plans. 

256B.0625 COVERED SERVICES.Subd. 35a.Children's mental health crisis response services. 
Medical assistance covers children's mental health crisis response services according to section 256B.0944. 

256B.0944 CHILDREN'S MENTAL HEALTH CRISIS RESPONSE SERVICES.Subdivision 1.Definitions. 
For purposes of this section, the following terms have the meanings given them. 

(a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation that, but for the provision of crisis response services to the child, would likely result in significantly reduced levels of functioning in primary activities of daily living, an emergency situation, or the child's placement in a more restrictive setting, including, but not limited to, inpatient hospitalization. 

(b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric situation that causes an immediate need for mental health services and is consistent with section 62Q.55. A physician, mental health professional, or crisis mental health practitioner determines a mental health crisis or emergency for medical assistance reimbursement with input from the client and the client's family, if possible. 

(c) "Mental health crisis assessment" means an immediate face-to-face assessment by a physician, mental health professional, or mental health practitioner under the clinical supervision of a mental health professional, following a screening that suggests the child may be experiencing a mental health crisis or mental health emergency situation. 

(d) "Mental health mobile crisis intervention services" means face-to-face, short-term intensive mental health services initiated during a mental health crisis or mental health emergency. Mental health mobile crisis services must help the recipient cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the recipient's baseline level of functioning. Mental health mobile services must be provided on site by a mobile crisis intervention team outside of an emergency room, urgent care, or an inpatient hospital setting. 

(e) "Mental health crisis stabilization services" means individualized mental health services provided to a recipient following crisis intervention services that are designed to restore the recipient to the recipient's prior functional level. The individual treatment plan recommending mental health crisis stabilization must be completed by the intervention team or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services may be provided in the recipient's home, the home of a family member or friend of the recipient, schools, another community setting, or a short-term supervised, licensed residential program if the service is not included in the facility's cost pool or per diem. Mental health crisis stabilization is not reimbursable when provided as part of a partial hospitalization or day treatment program. 

Subd. 2.Medical assistance coverage. 
Medical assistance covers medically necessary children's mental health crisis response services, subject to federal approval, if provided to an eligible recipient under subdivision 3, by a qualified provider entity under subdivision 4 or a qualified individual provider working within the provider's scope of practice, and identified in the recipient's individual crisis treatment plan under subdivision 8. 

Subd. 3.Eligibility. 
An eligible recipient is an individual who: 

(1) is eligible for medical assistance; 

(2) is under age 18 or between the ages of 18 and 21; 

(3) is screened as possibly experiencing a mental health crisis or mental health emergency where a mental health crisis assessment is needed; 

(4) is assessed as experiencing a mental health crisis or mental health emergency, and mental health mobile crisis intervention or mental health crisis stabilization services are determined to be medically necessary; and 

(5) meets the criteria for emotional disturbance or mental illness. 

Subd. 4.Provider entity standards. 
(a) A crisis intervention and crisis stabilization provider entity must meet the administrative and clinical standards specified in section 256B.0943, subdivisions 5 and 6, meet the standards listed in paragraph (b), and be: 

(1) an Indian health service facility or facility owned and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638 facility; 

(2) a county board-operated entity; or 

(3) a provider entity that is under contract with the county board in the county where the potential crisis or emergency is occurring. 

(b) The children's mental health crisis response services provider entity must: 

(1) ensure that mental health crisis assessment and mobile crisis intervention services are available 24 hours a day, seven days a week; 

(2) directly provide the services or, if services are subcontracted, the provider entity must maintain clinical responsibility for services and billing; 

(3) ensure that crisis intervention services are provided in a manner consistent with sections 245.487 to 245.4889; and 

(4) develop and maintain written policies and procedures regarding service provision that include safety of staff and recipients in high-risk situations. 

Subd. 4a.Alternative provider standards. 
If a provider entity demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services 24 hours a day, seven days a week, according to the standards in subdivision 4, paragraph (b), clause (1), the commissioner may approve a crisis response provider based on an alternative plan proposed by a provider entity. The alternative plan must: 

(1) result in increased access and a reduction in disparities in the availability of crisis services; and 

(2) provide mobile services outside of the usual nine-to-five office hours and on weekends and holidays. 

Subd. 5.Mobile crisis intervention staff qualifications. 
(a) To provide children's mental health mobile crisis intervention services, a mobile crisis intervention team must include: 

(1) at least two mental health professionals as defined in section 256B.0943, subdivision 1, paragraph (o); or 

(2) a combination of at least one mental health professional and one mental health practitioner as defined in section 245.4871, subdivision 26, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. 

(b) The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, and clinical decision making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources, including the county social services agency, mental health service providers, and local law enforcement, if necessary. 

Subd. 6.Initial screening and crisis assessment planning. 
(a) Before initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.4871, subdivision 14, and 245.4879, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify the parties involved, and determine an appropriate response. 

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment must evaluate any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, and current functioning. 

(c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As the opportunity presents itself during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required under subdivision 9. 

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The crisis treatment plan must be updated as needed to reflect current goals and services. The team must involve the client and the client's family in developing and implementing the plan. 

(e) The team must document in progress notes which short-term goals have been met and when no further crisis intervention services are required. 

(f) If the client's crisis is stabilized, but the client needs a referral for mental health crisis stabilization services or to other services, the team must provide a referral to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. 

Subd. 7.Crisis stabilization services. 
Crisis stabilization services must be provided by a mental health professional or a mental health practitioner who works under the clinical supervision of a mental health professional and for a crisis stabilization services provider entity and must meet the following standards: 

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 8; 

(2) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community; and 

(3) mental health practitioners must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years. 

Subd. 8.Treatment plan. 
(a) The individual crisis stabilization treatment plan must include, at a minimum: 

(1) a list of problems identified in the assessment; 

(2) a list of the recipient's strengths and resources; 

(3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement of the goals; 

(4) specific objectives directed toward the achievement of each goal; 

(5) documentation of the participants involved in the service planning; 

(6) planned frequency and type of services initiated; 

(7) a crisis response action plan if a crisis should occur; and 

(8) clear progress notes on the outcome of goals. 

(b) The client, if clinically appropriate, must be a participant in the development of the crisis stabilization treatment plan. The client or the client's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the client and the client's legal guardian. The plan should include services arranged, including specific providers where applicable. 

(c) A treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. A written plan must be completed within 24 hours of beginning services with the client. 

Subd. 9.Supervision. 
(a) A mental health practitioner may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met: 

(1) the mental health provider entity must accept full responsibility for the services provided; 

(2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by telephone or in person for clinical supervision; 

(3) the mental health professional is consulted, in person or by telephone, during the first three hours when a mental health practitioner provides on-site service; and 

(4) the mental health professional must review and approve the tentative crisis assessment and crisis treatment plan, document the consultation, and sign the crisis assessment and treatment plan within the next business day. 

(b) If the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the client face-to-face on the second day to provide services and update the crisis treatment plan. The on-site observation must be documented in the client's record and signed by the mental health professional. 

Subd. 10.Client record. 
The provider must maintain a file for each client that complies with the requirements under section 256B.0943, subdivision 11, and contains the following information: 

(1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient for not signing the plan; 

(2) signed release of information forms; 

(3) recipient health information and current medications; 

(4) emergency contacts for the recipient; 

(5) case records that document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented; 

(6) required clinical supervision by mental health professionals; 

(7) summary of the recipient's case reviews by staff; and 

(8) any written information by the recipient that the recipient wants in the file. 

Subd. 11.Excluded services. 
The following services are excluded from reimbursement under this section: 

(1) room and board services; 

(2) services delivered to a recipient while admitted to an inpatient hospital; 

(3) transportation services under children's mental health crisis response service; 

(4) services provided and billed by a provider who is not enrolled under medical assistance to provide children's mental health crisis response services; 

(5) crisis response services provided by a residential treatment center to clients in their facility; 

(6) services performed by volunteers; 

(7) direct billing of time spent "on call" when not delivering services to a recipient; 

(8) provider service time included in case management reimbursement; 

(9) outreach services to potential recipients; and 

(10) a mental health service that is not medically necessary. 

9555.6255RESIDENT'S RIGHTS. Subpart 1.Information about rights.  
The operator shall ensure that a resident and a resident's legal representative are given, at admission: 

A.
 an explanation and copy of the resident's rights specified in subparts 2 to 7; 

B.
 a written summary of the Vulnerable Adults Act prepared by the department; and 

C.
 the name, address, and telephone number of the local agency to which a resident or a resident's legal representative may submit an oral or written complaint. 

Subp. 2.Right to use telephone.  
A resident has the right to daily, private access to and use of a non-coin operated telephone for local calls and long distance calls made collect or paid for by the resident. 

Subp. 3.Right to receive and send mail.  
A resident has the right to receive and send uncensored, unopened mail. 

Subp. 4. Right to privacy.  
A resident has the right to personal privacy and privacy for visits from others, and the respect of individuality and cultural identity. Privacy must be respected by operators, caregivers, household members, and volunteers by knocking on the door of a resident's bedroom and seeking consent before entering, except in an emergency, and during toileting, bathing, and other activities of personal hygiene, except as needed for resident safety or assistance as noted in the resident's individual record. 

Subp. 5.Right to use personal property.  
A resident has the right to keep and use personal clothing and possessions as space permits, unless to do so would infringe on the health, safety, or rights of other residents or household members. 

Subp. 6.Right to associate.  
A resident has the right to meet with or refuse to meet with visitors and participate in activities of commercial, religious, political, and community groups without interference if the activities do not infringe on the rights of other residents or household members. 

Subp. 7.Married residents.  
Married residents have the right to privacy for visits by their spouses, and, if both spouses are residents of the adult foster home, they have the right to share a bedroom and bed. 

9555.7100SCOPE. 
Parts 9555.7100 to 9555.7600 govern the investigation and reporting of maltreatment of vulnerable adults and some aspects of the emergency and continuing protective social services required to be furnished by local social services agencies under Minnesota Statutes, section 626.557. 

9555.7200DEFINITIONS. Subpart 1.Scope.  
As used in parts 9555.7100 to 9555.7600, the following terms have the meanings given them. 

Subp. 2.Abuse.  
"Abuse" means: 

A.
 any act which constitutes a violation of Minnesota Statutes, section 609.322related to prostitution; 

B.
 any act which constitutes a violation of Minnesota Statutes, sections 609.342to 609.345 related to criminal sexual conduct; or 

C.
 the intentional and nontherapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress. 

Subp. 3.Caretaker.  
"Caretaker" means an individual or facility which has responsibility for the care of a vulnerable adult as a result of family relationship, or which has assumed responsibility for all or a portion of the care of the vulnerable adult voluntarily, by contract, or by agreement. A person who has assumed only financial responsibility for an adult is not a caretaker. 

Subp. 4.County of financial responsibility.  
"County of financial responsibility" means the county designated as the county of financial responsibility. 

Subp. 5.Facility.  
"Facility" means a hospital or other entity required to be licensed pursuant to Minnesota Statutes, sections 144.50 to 144.58; a nursing home required to be licensed pursuant to Minnesota Statutes, section 144A.02; an agency, residential or nonresidential program required to be licensed pursuant to Minnesota Statutes, chapter 245A; a mental health program receiving funds pursuant to Minnesota Statutes, section 245.61; and any entity required to be certified for participation in titles XVIII or XIX of the Social Security Act, United States Code, title 42, section 1395 et seq. 

Subp. 6.False.  
"False" means disproved to the satisfaction of the investigating agency. 

Subp. 7.Host county.  
"Host county" means the county in which a facility is located. 

Subp. 8.Impairment of mental or physical function or emotional status.  
"Impairment of mental or physical function or emotional status" means a condition which includes being substantially unable to carry out one or more of the essential major activities of daily living, such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, or working; being unable to protect oneself from hazardous or abusive situations without assistance; a substantial disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality or ability to cope with the ordinary demands of life; substantial difficulty in engaging in the rational decision-making process, and inability to weigh the possible benefits and risks of seeking assistance; a condition in which an individual is so fearful, so ashamed, so confused, or so anxious about the consequences of reporting that that individual would be unable or unlikely to make a responsible decision regarding whether or not to report abuse or neglect. 

Subp. 9.Licensing agency.  
"Licensing agency" means: 

A.
 the commissioner of health, for a facility which is required to be licensed or certified by the Department of Health; 

B.
 the commissioner of human services for programs required by Minnesota Statutes, chapter 245A, to be licensed; 

C.
 any licensing board which regulates persons pursuant to Minnesota Statutes, section 214.01; and 

D.
 the Minnesota Department of Health if the human services occupation of the alleged perpetrator is credentialed pursuant to Minnesota Statutes, section 149A.20or 214.13. 

Subp. 10.Local social services agency.  
"Local social services agency" means the local agency under the authority of the human services board or board of county commissioners which is responsible for social services. 

Subp. 11.Neglect.  
"Neglect" means failure by a caretaker to supply or to ensure the supply of necessary food, clothing, shelter, health care, or supervision for a vulnerable adult. 

Subp. 12.Report.  
"Report" means any verbal or written report of abuse or neglect of a vulnerable adult received by the local social services agency, police department, county sheriff, or licensing agency. 

Subp. 13.State agency.  
"State agency" means the Minnesota Department of Human Services. 

Subp. 14.Substantiated.  
"Substantiated" means proved to the satisfaction of the investigating agency. 

Subp. 15.Vulnerable adult.  
"Vulnerable adult" means any person 18 years of age or older: 

A.
 who is a resident or patient of a facility; 

B.
 who receives services at or from a program required to be licensed pursuant to Minnesota Statutes, chapter 245A; or 

C.
 who, regardless of residence, is unable or unlikely to report abuse or neglect without assistance because of impairment of mental or physical function or emotional status. 

Subp. 16.Inconclusive.  
"Inconclusive" means a report which cannot be substantiated or disproved to the satisfaction of the investigating agency. 

9555.7300COMPLAINT INVESTIGATION BY LOCAL SOCIAL SERVICES AGENCIES. Subpart 1.Duty to accept and investigate complaints.  
The local social services agency shall accept and investigate all complaints alleging that a vulnerable adult has been abused or neglected in that agency's county. The local social services agency shall notify each relevant licensing agency and the local police departments or county sheriffs and shall cooperate in coordinating its investigation with the investigations of the licensing agencies, police departments, and sheriffs. The local social services agency shall immediately send a report of its findings to all other agencies notified concerning the complaint in question. 

Subp. 2.Time limits to initiate investigations.  
The local social services agency shall begin to investigate all complaints within the following time limits: 

A.
 The local social services agency shall conduct an immediate on-site investigation for complaints alleging or from which it can be inferred that a vulnerable adult is in need of immediate care or protection because the adult is life-threatened or likely to experience physical injury due to abuse or abandonment. 

B.
 The local social services agency shall begin its investigation within 24 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly abused. 

C.
 The local social services agency shall begin its investigation within 72 hours for complaints alleging, or when there is substantial evidence, that a vulnerable adult is not in need of immediate care or protection but is allegedly neglected. 

Subp. 3.Investigations related to a facility.  
When an investigation involves an alleged incident or situation related to a facility, the local social services agency shall make an on-site visit to the facility to assess the validity of the complaint. This investigation shall include the following activities when necessary to make an accurate assessment, but activities specified in items A, C, and E need not occur on the site of the facility: 

A.
 discussion with the reporter; 

B.
 discussion with the facility administrator or responsible designee; 

C.
 discussion with the physician or other professionals, or any corroborating contacts as necessary; 

D.
 contact with the alleged victim; 

E.
 discussion with the alleged perpetrator; 

F.
 examination of the physical conditions or the psychological climate of the facility; and 

G.
 inspection of the alleged victim's record. 

The local social services agency shall also determine whether the reported abuse or neglect places other vulnerable adults in jeopardy of being abused or neglected. 

The local social services agency shall immediately send a report of its findings to all other agencies notified concerning the complaint in question. 

Subp. 4.Investigations not related to a facility.  
When an investigation involves an alleged incident or situation which is not related to a facility, the local social services agency shall assess the validity of the complaint. This investigation shall include the following activities where necessary to make an accurate assessment: 

A.
 discussion with the alleged victim; 

B.
 discussion with the reporter or any corroborating contacts, as necessary; 

C.
 discussion with the alleged perpetrator; 

D.
 discussion with the physician or other professionals; and 

E.
 examination of the physical conditions or the psychological climate of the residence. 

The local social services agency shall also determine whether the reported abuse or neglect places other vulnerable adults in jeopardy of being abused or neglected. 

Subp. 5.Investigations by agencies which are not in the county of financial responsibility.  
When a complaint involves a vulnerable adult who is receiving services from a facility located in a county other than the adult's county of financial responsibility, the local social services agency of the host county shall: 

A.
 investigate the complaint in accordance with subpart 3 and determine whether the complaint is substantiated, inconclusive, or false; 

B.
 notify each relevant licensing agency, the police or sheriff, and the county of financial responsibility; 

C.
 consult with the county of financial responsibility, unless the host county must take immediate emergency measures and representatives of the county of financial responsibility are not available; 

D.
 take whatever measures are necessary to correct the situation or to remove the adult from the facility and notify the county of financial responsibility of the actions taken to correct the situation or of the removal of the adult from the facility; and 

E.
 complete and transmit all required written forms and findings to appropriate agencies. 

The local social services agency of the county of financial responsibility shall then resume responsibility for ensuring ongoing planning and services for the vulnerable adult. 

Subp. 6.Use of outside experts.  
When it is investigating alleged abuse or neglect of a vulnerable adult, the local social services agency shall consult persons with appropriate expertise if the local agency believes that it lacks the expertise necessary for making judgments pertaining to the allegations. This consultation may include matters of physical health, mental health, specialized treatment such as behavior modification, geriatrics, or other matters. 

Subp. 7.Investigations after initial complaint assessment.  
If upon the initial assessment required by subparts 1 to 6 there appears to be substance to a complaint, the local social services agency shall attempt to determine the following: 

A.
 the risk posed if the vulnerable adult remains in the present circumstances; 

B.
 the current physical and emotional condition of the vulnerable adult, including the history or pattern of abuse or neglect or related prior injuries; 

C.
 the name, address, age, sex, and relationship of the alleged perpetrator to the vulnerable adult; and 

D.
 in a complaint of neglect, the relationship of the caretaker to the vulnerable adult, including the agreed-upon roles and responsibilities of the caretaker and the vulnerable adult. 

9555.7600ACTIONS ON BEHALF OF A VULNERABLE ADULT WHO REFUSES SERVICES. 
If a vulnerable adult who is the victim of abuse or neglect by a caretaker refuses an offer of services from a local social services agency and in the judgment of that agency the vulnerable adult's safety or welfare is in jeopardy, the agency shall seek the authority to intervene on behalf of that adult. If the agency believes it to be in the adult's best interest, it shall seek or help the family or victim seek any of the following: 

A.
 a restraining order or a court order for removal of the perpetrator from the residence of the vulnerable adult pursuant to Minnesota Statutes, section 518B.01; 

B.
 guardianship or conservatorship pursuant to Minnesota Statutes, sections 525.539 to 525.6198, or guardianship or conservatorship pursuant to Minnesota Statutes, chapter 252A; 

C.
 a hold order or commitment pursuant to the Minnesota Hospitalization and Commitment Act, Minnesota Statutes, chapter 253A; or 

D.
 a referral to the prosecuting attorney for possible criminal prosecution of the perpetrator under Minnesota Statutes, chapter 609.